Total mesorectal excision (TME) is an effective surgical method to reduce the local recurrence of rectal cancer and improve patient prognosis. However, there is debate about which surgical platform to use to achieve the best surgical outcome for TME. The emergence and technological progress of transanal total mesorectal excision (taTME) can solve the problem of difficulty in lower rectal resection and achieve better surgical resection results. Based on relevant literatures and combined with team clinical practice, the authors explore the technical advantages and oncological efficacy of taTME in rectal cancer.

Objective:To explore the postoperative electrocardiogram characteristics and its clinical significance in patients who had undergone orthotopic heart transplantation with double vena cava anastomosis .Methods :The electrocardiogram results of 70 patients during postoperative follow‐up ,who underwent orthotopic heart transplantation with double vena cava anastomosis in Zhongshan Hospital ,Fudan University from 2009 to 2012 ,were retrospectively analyzed .Results:The patients’ average ventricular rate was a bit faster than normal after operation ,and the common phenomena of electrocardiogram were non‐ischemic ST‐T changes ,increasing P terminal force in lead V1(Ptfv1) and incomplete right bundle branch block(IRBBB) .The rare phenomena such as slow ventricular rate ,ischemic ST‐T changes and arrhythmia ,however ,indicated poor prognosis . Conclusions : The postoperative electrocardiogram characteristics in patients who have undergone orthotopic heart transplantation with double vena cava anastomosis are conducive to predicting the patients ’ prognosis .

Objective To compare the clinicopathological features of signet ring cell gastric carcinoma ( SRCC) with those of non-signet ring cell cancers and explore the prognostic factors of signet ring cell gastric carcinoma.Methods We retrospectively reviewed the medical records of 1447 gastric cancer patients, including gastric signet ring cell and non-signet ring cell cancers.Their clinicopathological characteristics and overall survival data were analyzed.Results The differences in the age, sex, tumor location, depth of invasion, lymph node metastasis, distant metastasis, TNM classification and surgical type were significant between gastric signet ring cell and non-signet ring cell gastric carcinomas.The 5-year survival rate of the patients with gastric signet ring cell carcinoma was 29.6%, while that of the non-signet ring cell cancers was 42.9%(P<0.05).The 5-year survival rate for each stage of gastric signet ring cell carcinoma and non-signet ring cell cancers was 71.0%and 79.3%for stageⅠ, 45.6%and 58.3%for stageⅡ, 16.9%and 29.2%for stageⅢ,and 6.0%and 11.9%for stageⅣcases, respectively, with a significant difference only between stages Ⅲ and Ⅳ cancers ( P<0.05 ) .Multivariate analysis showed that tumor diameter, T stage and N stage were independent prognostic factors for signet ring cell gastric carcinoma. Conclusions The signet ring cell gastric carcinoma has unique clinicopathological features compared with non-signet ring cell carcinoma.Early detection and treatment can improve the prognosis for patients with gastric signet ring cell carcinoma.

Objective To compare the clinicopathological features of signet ring cell gastric carcinoma ( SRCC) with those of non-signet ring cell cancers and explore the prognostic factors of signet ring cell gastric carcinoma.Methods We retrospectively reviewed the medical records of 1447 gastric cancer patients, including gastric signet ring cell and non-signet ring cell cancers.Their clinicopathological characteristics and overall survival data were analyzed.Results The differences in the age, sex, tumor location, depth of invasion, lymph node metastasis, distant metastasis, TNM classification and surgical type were significant between gastric signet ring cell and non-signet ring cell gastric carcinomas.The 5-year survival rate of the patients with gastric signet ring cell carcinoma was 29.6%, while that of the non-signet ring cell cancers was 42.9%(P<0.05).The 5-year survival rate for each stage of gastric signet ring cell carcinoma and non-signet ring cell cancers was 71.0%and 79.3%for stageⅠ, 45.6%and 58.3%for stageⅡ, 16.9%and 29.2%for stageⅢ,and 6.0%and 11.9%for stageⅣcases, respectively, with a significant difference only between stages Ⅲ and Ⅳ cancers ( P<0.05 ) .Multivariate analysis showed that tumor diameter, T stage and N stage were independent prognostic factors for signet ring cell gastric carcinoma. Conclusions The signet ring cell gastric carcinoma has unique clinicopathological features compared with non-signet ring cell carcinoma.Early detection and treatment can improve the prognosis for patients with gastric signet ring cell carcinoma.