Objective To evaluate transanal endoscopic microsurgery (TEM) for the resection of rectal neoplasms. Methods In order to analyze the therapeutic effect of TEM in the management of rectal tumors, clinical data of 110 patients with rectal neoplasms treated by TEM between April 2006 and August 2009 were summarized and analyzed retrospectively. Result The mean diameter of rectal lesions was 1.7±0.8 (range, 0.5 ～5.5)cm. The average distance of lesions from the anal verge was 7.4 ±2.6(range, 4 ～20) cm. 40 lesions were located at the anterior wall of the rectum, 29 on the posterior wall,22 on the left wall and 19 on the right. Surgical procedures included the transmural excision (98 cases) and the submucosal excision with partial muscular layer excision (12 cases). The average operating time was 73.5 ±31.1 (range, 25 ～180) min. The mean operative blood loss was 10.8 ±7.8 (range, 3 ～60) ml.The postoperative pathological examination identified 41 rectal adenomas、 35 rectal adenocarcinomas or carcinomatous changes of adenomas (21 Tis, 6 T1, and 8 T2 cases), 14 rectal carcinoids, 1 stromal tumor、1 leiomyoma and 18 cases of inflammatory polyps or others. Surgical margins of all specimens were negative.Postoperative complications included 2 cases of anal hemorrhage, one case of pulmonary infection and one urinary infection with a postoperative morbidity of 3.6%. The average postoperative stay was 3.4 ± 1.3( range, 2 ～ 8 ) d. With a mean follow-up period of 12. 5 (3 ～ 40) months, no tumor recurrence or metastasis was found. Conclusions TEM shows advantages of decreased blood loss, good therapeutic effect, and fast recovery of the patients, which can be adopted as the choice of therapy for small and well confined rectal neoplasms.

0.05).Conclusions Serum DAO can be used as a sensitive marker to early diagnose gastrointestinal dysfunction in critical neonates.Serum D-lactate will be of high specific clinical significance in diagnosis,the change of D-lactate may have relations to the features of intestinal microflora in early neonates.

In this paper, a novel electrochemiluminescent (ECL) detection approach was developed for highly sensitive detection of ECL inhibitors based on the ECL inhibition of Ru(bpy)32+/2-(Dibutylamino)ethanol (DBAE) system. A microfluidic ECL detection cell was fabricated to couple with the capillary electrophoresis system, the electrochemical system and the postcolumn injection system. Both Ru(bpy)32+ and DBAE solutions were injected directly to the working electrode surface by a micro-infusion system to obtain a high and stable ECL signal. The performance of this setup was demonstrated by the analysis of two typical ECL inhibitors, dopamine and epinephrine. Under the optimal conditions, the limit of detection (LOD) for dopamine and epinephrine was 50nM and 5nM respectively. The proposed method was also successfully used for the trace analysis of dopamine and epinephrine in human serum samples.

Objective To investigate the causes and outcome of different treatment methods of iatrogenic rectovaginal fistula. Methods Clinical data of 52 patients with iatrogenic rectovaginal fistula were analyzed retrospectively. Results Twenty-two fistulae occurred after gynecological operation (42.3%), fourteen after obstetric injury (26.9%), thirteen after colorectal operation (25.0%) and three due to miscellaneous causes (5.8%). The fistulae were located in the lower rectum in 27 cases(51.9%), mid rectum in 10 cases(19.2%) and upper rectum in 15 cases(28.9%). They were treated by non-surgical treatment in 9 cases(17.3%), permanent diverting stoma(loop transverse colostomy) in 8 cases(15.4%), and surgical repair by various approaches in 35 cases(67.3%). The fistulae of all nine patients who received non-surgical treatment failed to heal. Eight patients who received permanent diverting stoma had symptomatic improvement without fistula healing. The overall cure rate of surgical repairs in 35 cases was 77.1%(27/35). The cure rates of trans-sphincteric (Mason′s operation), transanal, transabdominal, transperineal and transvaginal approaches were 100%(8/8), 100%(2/2), 83.3%(5/6), 0%(0/1) and 66.7%(12/18), respectively. The cure rate of Mason′s operation for the mid and lower rectovaginal fistulae was higher than that of transvaginal approach (100% vs 66.7%). Conclusions Iatrogenic rectovaginal fistula is caused by obstetric injury or injury of rectovaginal septum due to surgical mismanagement. Surgical repair is the only method that can cure rectovaginal fistulae. Mason′s operation is a favorable treatment method for the mid and lower (especially mid) rectovaginal fistulae.

Objective To observe the parameters and effect of endocardial pacing by steel wire electrode cardiac puncture on heart with normal beat in living animal, and evaluate its safety.Methods After anaesthesia and thoracotomy in 6 living dogs with normal heart beat, the pericardia were excised. Steel wire electrodes with annular or hook tips were used respectively at right ventricular 4 corresponding spots to perform cardiac puncture endocardiac pacing (each dog experienced 8 times of puncture); the time from puncture to effective pacing, pacing parameter and puncture complication (time and quantity of bleeding) of each electrode at each spot were recorded. Finally, the two types of electrode completed 24 times of manipulation respectively; the data collected of the two types were compared. Results The cardiac pacing successful rates in the two groups were 100%; the time taken from the beginning of heart puncture to effective pacing in annular tip group was less than that in hook tip group, but the time difference between the two groups showed no statistical significance (s: 18.4±2.3 vs. 19.6±4.1,P > 0.05). The parameters of pacing in the annular tip group, such as operation time (s: 18.4±2.3 vs. 19.6±4.1), the threshold value of pacing (V: 2.1±0.2 vs. 2.2±0.8), the amplitude of R wave sensed (mV: 11.3±3.2 vs. 12.6±4.1) and the impedance of electrode (Ω: 674.2±89.7 vs. 668.5±101.3) were not significantly different compared with those in the hook tip group (allP > 0.05). Either after puncture or after the electrodes were taken out, the time of bleeding [after puncture (minutes): 4.4±2.3 vs. 4.5±3.1, after the electrodes taken out (minutes): 4.1±2.2 vs. 4.8±2.5] and the volume of bleeding [after puncture (mL): 2.8±2.4 vs. 3.2±3.5, after the electrodes taken out (mL): 3.3±1.7 vs. 3.5±2.6] were not significantly different between the two groups (allP > 0.05).Conclusions In living dogs with normal heart beat, the manipulation and function of endocardiac pacing by cardiac puncture with either steel wire annular or hook tip electrode are well and effective, and the performance is simple and safe without any serious myocardial injury and complication. Thus, it is helpful to quickly establish efficient endocardiac pacing in emergency cases.

Objective To explore the best time point for the ipsilateral hepatocellular apoptosis and the contralateraI hepatic hypertrophy after selective portal vein embolization(SPVE)in rabbit.Methods In a randomized study design,forty rabbits were divided into 5 groups with 8 rabbits per-group,including one as the control and the other 4 were treated with SPVE during open surgery.The rabbits were killed postoperatively,in 3,7,14,21 days respectively after the embolization.The hepatic lobes volume,the ipsilateral hepatocellular necrosis rates and apoptosis index,and liver functions were determined as well. Results In the treatment groups,the average amount of the right liver volumes decreased from 46.4 cm~3 preoperatively to 46.0,44.4,42.0,39.7 cm~3 in groups of 3,7,14,21 days postoperatively;meanwhile,the left liver volumes increased from 54.0 cm~3 preoperatively to 54.5,56.3,61.7,63.9 cm~3 respectively during 3, 7,14,21 days after the procedures.The rates of future remaining live volumes(FRLV)increased from 53.8% preoperatively to 54.2%,55.9%,59.0%,61.0% at 3,7,14,21 days postoperatively.The apoptosis indexes of hepatocells from group A to E were 8.1%,12.2%,19.4%,20.1%,14.2% respectively.Conclusions SPVE leads to atrophy of the ipsilateral hepatic lobe and hypertrophy of contralateral lobe,indicating that hepatocytes undergone apoptosis,rather than necrosis.The time point is 7 to 14 days.

OBJECTIVETo explore the clinical effect of using dorsal two wing-shaped flap to reconstruct finger web for treatment of congenital syndactyly.

METHODSThis technique has been used in 19 children with congenital syndactyly. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle were designed and was just sewed up with an anchor-shaped incision at the palm. The web was primarily reconstructed without skin graft at base of fingers. Distal end of fingers were separated by using serrated flap and were closed after removal of fatty tissue. At some cases with tight skin connection. The defect area at lateral and distal end of fingers was closed by small pieces of skin graft.

RESULTSAll the webs were reconstructed primarily without skin graft at the base of fingers. 7 cases with tight skin connection had small pieces of skin graft at lateral and distal end of fingers. Primary healing was achieved in all cases. After 1 to 6 months of follow-up, both the appearance and function were satisfactory without conspicuous scar. The reconstructed finger webs were in normal depth and width.

CONCLUSIONSPrimary web space can be achieved by dorsal two wing-shaped flap without skin graft at base of fingers. It is one of the best choices for treatment of congenital syndactyly.

Adipose Tissue ; surgery ; Child ; Cicatrix ; Dermatologic Surgical Procedures ; methods ; Fingers ; surgery ; Humans ; Skin Transplantation ; Surgical Flaps ; transplantation ; Syndactyly ; surgery ; Wound Healing

Connexin43 has been shown to play a pivotal role in wound healing process. Wound repair is enhanced by acute downregulation of connexin43, by increasing proliferation and migration of keratinocyte and fibroblast. Angiogenesis is also a central feature of wound repair, but little is known about the effects of connexin43 modulation on functions of endothelial cells. We used connexin43 specific small interference RNA (siRNA) to reduce the expression of connexin43 in human umbilical vein endothelial cell (HUVEC), and investigated the effects of connexin43 downregulation on intercellular communication, viability, proliferation, migration and angiogenic activity of HUVEC. Treatment of siRNA markedly reduced the expression of connexin43 by -80% in HUVEC (P < 0.05), and decreased the intercellular communication by -65% (P < 0.05). The viability, proliferation, migration and angiogenic activity of HUVEC decreased significantly (P < 0.05), compared with that of the normal cells. The results suggest that temporally downregulation of connexin43 expression at early stage of wound to inhibit the abnormal angiogenesis characterized with leaky and inflamed blood vessels, maybe a prerequisite for coordinated normal healing process.
Cell Movement ; Cell Proliferation ; Cell Survival ; Connexin 43 ; metabolism ; Down-Regulation ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; Neovascularization, Physiologic ; Umbilical Veins ; cytology ; Wound Healing

Cochlear Nerve ; chemistry ; pathology ; Cranial Nerve Neoplasms ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Heart Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Neurilemmoma ; metabolism ; pathology ; S100 Proteins ; metabolism ; Vestibulocochlear Nerve Diseases ; metabolism ; pathology ; Vimentin ; metabolism