The incidence of low rectal cancer, which severely threatens human health, has been increasing annually in China. Sur-gical operation is the most effective treatment for low rectal cancer. In-depth analyses on the physiology and anatomy of the rectum and the biological characteristics of low rectal cancer have led to the wide application of anus preservation operation as a treatment for this disease. Anus preservation operation is widely used, especially because the application of the laparoscopic technique has recently be-come a popular topic in colorectal surgery. Alternative laparoscopic sphincter-preserving procedures for this disease include the follow-ing: laparoscopic anterior resection; and laparoscopic anterior resection with inter-sphincter resection or with prolapse technique. Colorectal anastomosis with double-stapler technique, hand-sewn coloanal anastomosis, and colonic J-pouch-anal anastomosis are com-mon reconstruction procedures. Each procedure has its own adaptive range, advantages, and disadvantages. Radical surgery must be pri-oritized, but we should also consider the patients' life quality when selecting a mode of surgery.

BACKGROUND:Although the therapeutic effect of total knee arthroplasty for severe gonarthritis is reliable, deep vein thrombosis also occurred in many patients. Therefore, deep vein thrombosis has been a major reason for unexpected death after total knee arthroplasty. OBJECTIVE:To study the incidence of deep vein thrombosis after total knee arthroplasty with general and epidural anesthesia. METHODS:We searched“PubMed”,“Medline”,“Elsevier”,“Embase”, Cochrane library,“Wanfang”,“China National Knowledge Infrastructure”for papers published from January 2000 to March 2015. The mesh words were“total knee arthroplasty”,“TKA”,“thrombosis”,“DVT”,“randomized control ed trial”,“RCT”for studies concerning deep vein thrombosis after total knee arthroplasty with different anesthetic methods. The double blind method was used for data extraction and assessment of literature quality. Revman5.3 software was utilized to analyze the extracted data using meta-analysis. RESULTS AND CONCLUSION:There were 8 studies including 885 patients. The heterogeneity of the included studies was very low (I2=0, P=0.72). The combined OR was 0.25 (95%confidence interval:0.18, 1.35), indicating that continuous epidural anesthesia in total knee arthroplasty could apparently reduce the possible formation of postoperative deep vein thrombosis. Because of lack of the changes in coagulation factors under general anesthesia and epidural anesthesia, the mechanism underlying epidural anesthesia to reduce the incidence of deep vein thrombosis deserves further investigations. Among patients with deep vein thrombosis, continuous epidural anesthesia could diminish the possible formation of deep vein thrombosis. Thus, epidural anesthesia should be used firstly for knee replacement in patients with high risk of deep vein thrombosis.

SUMMARY Behcet’sdisease(BD)isachronicvascularinflammatorydiseaseofunknowncauses.Itis called intestinal BD,when digestive tract is involved.To investigate small bowel feature of intestinal BD, we now report 5 intestinal BD cases undergone capsule endoscopy from December,2010 to April,2014 in Peking University People’s Hospital.General information,clinical feature and endoscopic feature were presented,and literatures were reviewed.There were 3 male and 2 female patients.Age range was from 23 to 55 years old (median age 40 years old).Disease course was from 3 days to 28 years (median course 9 years).4 patients were diagnosed as systemic BD,and the rest independent intestinal BD.4 systemic BD patients all presented as recurrent oral aphthous as initial symptom and had history of vulvar ulcer and skin lesion.They all had gastrointestinal symptoms,including retrosternal pain (2 cases),he-matochezia (3 cases),diarrhea (3 cases)and abdominal pain (2 cases).1 patient had a history of fis-tula of ileocecal junction and underwent caecectomy.5 patients all underwent whole digestive tract exami-nation by endoscopy,including gastroscopy,colonoscopy and capsule endoscopy.Except of 1 normal re-sult of colonoscopy,all endoscopy results revealed lesions.Capsule endoscopy results of all patients were abnormal.Types of small intestinal lesion were various,including ulceration,erosion,protrusion and vasculopathy.All digestive tract can be involved in BD patients.Capsule endoscopy can evaluate lesions throughout whole digestive tract,especially in small intestine.As a consequence,it is helpful to explain gastrointestinal symptom,increase early diagnostic rate.Intestinal BD (IBD)mainly involves small bow-el,and ileum is the major involved segment,not only limited in ileocecum.The updated perspective of IBD lesion distribution will contribute to differential diagnosis between IBD and Crohn’s disease.This is the first time to report capsule endoscopic feature of BD patients in China.

Objective To investigate changes in the expression of apurinic/apyrimidinic endonuclease (APE) and the oxidative DNA damage marker 8 OHdG in distant hippocampus regions of the rat brain after focal cerebral ischemia of the middle cerebral artery.Methods SD rats were divided into the sham surgery group and the pMCAO group (induced by middle cerebral artery occlusion).Pathological changes in brain tissues were examined at 2 h,6 h,12 h,24 h,48 h and 72 h.The expression of APE and 8-OHdG was measured by immunohistochemical staining methods.TUNEL staining was performed to detect apoptosis.Results Reduction of APE expression in the CA1 region of the hippocampus on the ischemia side appeared at 2 h in the pMCAO group and continued as ischemia persisted (F=11.91,P＜0.05).The expression of 8OHdG and TUNEL immunoreactivity in the CA1 region of the hippocampus on the ischemia side were first observed at 6h in the pMCAO group and intensified during the remainder of induced ischemia (F=9.23 and 10.46 respectively,P＜0.05 for both).Compared with the sham group,8-OHdG expression and TUNEL immunoreactivity in the pMCAO group were at nearly the same levels from 24 h to 72h.Conclusions Oxidative DNA damage occurs in hippocampus regions of the rat brain after experimentally induced focal cerebral ischemia of the middle cerebral artery.APE expression declines in regions distant from focal cerebral ischemia.Development and accumulation of oxidative DNA damage can induce apoptosis in certain brain regions.

Objective To investigate the effects of simethicone on the quality of video capsule endoscopy (VCE) examination.Methods A prospective study was performed in 90 patients received VCE examination from February 2010 to October 2014.The randomized table was set according to different dosage of simethicone the patients received,by which patients were divided into three groups.Group 1 (35 cases) received 15 mL simethicone,group 2 (30 cases) received 30 mL simethicone and control group (25 cases) received no simethicone.The small intestinal visualization quality of VCE was scored by segments.Segment A was proximal small intestine (one hour after VCE passing pylorus).Segment B was distal small intestine (one hour before VCE passing ileocecal valve).Segment A and B were scored according to the air bubbles and degree of cleanliness.Gastric transit time,small bowel transit time and VCE completion rate were recorded.Student's t test,Mann Whitney rank sum test and chi square test were performed for statistical analysis.Results The average scores of segment A of group 1,group 2 and control group were 0.58,0.33 and 1.67,respectively,and the average socres of segment B were 0.25,0.00 and 1.17,respectively.The lesion detection rates of group 1,group 2 and control group were 68.6％ (24/35),80.0％ (24/30) and 52.0％ (13/25),respectively,and the differences was statistically significant (x2 =8.238,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =7.354 and 9.349,P=0.034 and 0.005).The detection rates of small intestinal erosion of group 1,group 2 and control group were 22.9％ (8/35),70.0％ (21/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2=8.714,P=0.013).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =10.600 and 7.380,P=0.005 and 0.025).There was no statistically significant difference in the detection rates of ulcer,vascular malformation and protrusion among the three groups (all P＞0.05).The detection rates of lesions＜0.5 cm of group 1,group 2 and control group were 37.1％ (13/35),66.7％ (20/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2 =8.242,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =9.250 and 7.842,P =0.011 and 0.017).Conclusion Oral adminstration of 30 mL simethicone could obviously decrease air bubbles in small intestine,and increase lesion detection rate of VCE.

Objective To observe the effect of antisense hypoxia inducible factor-1?(HIF-1?) on (chemosensitivity) of human pancreatic cancer cell line BxPC-3 under hypoxia. Methods BxPC-3 cells were divided into 3 groups:(1)BxPC-3 cells were non-transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(hypoxia control);(2)normoxic BxPC-3 cells were non-transfected with antisense(HIF-1?) plasmid(normoxia control);(3)BxPC-3 cells were transfected with antisense HIF-1? plasmid and exposed to 0.5% O_2 for 4hr(experimental group).Expression of HIF-1? and survivin was detected by RT-PCR and Western Blot.Growth inhibition rates and apoptosis rates of BxPC-3 cells under different(dosages) of chemotherapeutic agents(5-fluorouracil,doxorubicin and gemcitabine) were measured by MTT(colorimetric) assay and flow cytometry (FCM).Results Expression of HIF-1? was obviously down-regulated and at the same time susvivin expression was markedly down-regulated in experimental group(P

Objective To investigate changes of serum levels of interleukin(IL)-4,-6,-8 and tumor necrosis factor-?(TNF-?),and probe their clinical significance in children with Henoch-Schonlein purpura(HSP)/ HenochSchonlein purpura nephritis(HSPN).Methods Serum levels of IL-4,-6,-8 and TNF-? of 45 children with HSP/HSPN and 43 healthy children were examined by enzyme linked immunosorbent assay(ELISA),changes and correlation between the aforementioned cytokines in children with HSP /HSPN were analyzed.Results 1.Serum levels of IL-4,-6,-8 and TNF-? of children with HSP were higher than those of control group(P0.05);The serum level of TNF-? was positively correlated to the serum levels of IL-6,-8 of patients with HSP(r=0.670 P

Objective To analyze various state of anxiety of infertility women's access to an in vitro fertilization and embryo transfer (IVF-ET) after the treatment cycle, and the relattionship between personality trait and anxiety. Methods A total of 96 patients who received the IVF-ET treatment were surveyed by questionnaire for the day state-trait anxiety at the start of treatment cycle. The patients were investigated with the questionnaire at the day, before an hour ova harvest, waiting for ? human chorionic gonadotropin (β-HCG) at 13 days after post transplant respectively. Results (1) the mean of trait anxiety was 37.66±9.11. Three points in the survey had gradually increased (36.44±9.20, 39.37±11.27 and 40.98±12.73 respectively), the difference showed significant. (2) According to research group: a highly significant difference among the level of patients' anxiety was showed between those with high-trait anxiety value and low-trait anxiety value (P<0.05). Conclusions Nurses should pay close attention to psychological state of infertility women' s received IVF-ET and carry out measures to alleviate their psychological pressure so as to improve their treatment compliance and pregnancy success rate.

OBJECTIVE Inflammatory myofibroblastic tumor(IMT) is a rare lesion of unknown etiology which was first described in the lung. The clinical and pathologic characteristics,treatment, prognosis of IMT in head and neck were discussed. METHODS The clinical data of 4 cases of IMT were analyzed retrospectively. The specimens of the 4 cases were prepared for immunohistochemical staining and light microscopy. RESULTS The patients included 3 males and 1 female. Their age ranged from 32 to 58 years. The tumors located at the true vocal cord in 2 cases, at the nasal cavity and maxillary sinus in 1 case, at the maxillary sinus in 1 case. Histological examination was found that the tumors consisted of spindle cells,chronic inflammatory cells and myxoid background with delicate vasculature. Immunohistochemical staining demonstrated that the SMActin and Vimentin were expressed positively in the tumor. The patients were followed up for 9 to 21 months after operation. Three patients were alive with no evidence of diseases, one patients recurred at 4 months after operation and were alive with IMT. CONCLUSION IMT is a true neoplasm with a potential of local recurrence. The main treatment of IMT is to resect the lesions thoroughly.