Objective:To summarize the stapled hemorrhoid on the mucousmembrane circumcision(PPH)is the treatment of hemorrhoids of their experiences and explore issues related to the surgical in order to improve efficacy.Methods:A retrospective summary of 75 cases in August 2006 ～2009 years,in April between the application of PPH treatment of hemorrhoids in patients with clinical data.Results:The operative time was 20～45 minutes(average 29 minutes),hospital stay 3～7 days(average 4.9 days)post-operative urinary retention in 32 cases(43%),severe postoperative pain compared with 18 cases(24%),75 patients without bleeding and anal stenosis,postoperative symptom improvement were satisfied with 70 cases(93%),the remaining effective,follow-up in June-2 years without recurrence.Conclusion:(1)PPH is simple,pain,light,short hospital stay and effective(.1)attention to all aspects of PPH should be effective factors in order to improve surgical treatment of PPH.(3)with severe PPH Hemorrhoid surgery may be the main line with other conventional surgery,for improving the results of operations of great help.

Multiple organ failure (MOF) is a severe complication induced by intra-abdominal sepsis (IAS) in surgical patients. The study was planned to evaluate the role of metabolic support with different formulas of nutrient substants in 42 rabbits of MOF model which was establishei before. The results showed that metabolic support in the early stage of MOF induced by IAS coul increase body weight in varying degree, promote protein synthesis and decrease protein degration in rabbits. Lower non-protein calorie supplied with glucose might decrease stress response, increase nitrogen retention and improve lung function. Overloads of amino acid nitrogen could increase stress response, increase urinary nitrogen excretion and deteriorate the respiratory function.

Objective: To construct IκBα vector carrying SAA3 promoter and to observe its effect on NF-κB activity and LPS-induced inflammation, so as to lay a foundation for treatment of sepsis. Methods: Mouse liver cells and kupffer cells were co-cultured and were divided into three groups: control group, LPS group and LPS+ gene transfer group. Twenty-four hours after LPS injection, the levels of AST, ALT, LDH, IL-6 and TNF-α were measured in the supernatants of the each group. For animal experiments: (1) Mice were divided into three groups: control group, LPS group and LPS+gene transfer group(n=10). The levels of TNF-α and IL-6 were measured in the serum and liver tissues 24 hours after intraperitoneal injection of 250ug LPS or saline. (2) Mice were also divided into two groups: LPS group and LPS+gene transfer group(n=21). Mice were injected with 150 μg LPS twice at 0 and 48 h, then the activities of NF-κB and IκBα in the liver were measured at 0,2,24,48,50,72, and 96 h after the first injection. The values at 0 h were taken as control group. (3) Mice were also divided into another two groups: LPS group and LPS+gene transfer group(n=20). The survival rates of animals were observed at 0,2,24,48,50,72, and 96 h after injection of 350 μg LPS. Results: Compared with LPS group, the levels of AST, LDH, TNF-α and IL-6 in the culture supernatants of LPS+gene transfer group were decreased, but were still higher than those in the control group(P<0.05). Compared with LPS group, the levels of TNF-α and IL-6 in the liver tissues and sera of LPS + gene transfer group were significantly decreased(P<0.05). Compared with LPS group, the activity of NF-κB in the liver tissues of LPS + gene transfer group were decreased, but was still significantly higher than that of the control group(P<0.05). Compared with LPS group, LPS+gene transfer group had higher survival rate at 72 and 96 h(P<0.05). Conclusion: IκBα gene can be expressed in the liver with SAA3 promoter, and transfection of IκBα can effectively inhibit endotoxin-induced liver and general inflammation.

Objective: To investigate the protective effects of isoflurane on liver flow and oxygen consumption after anoxia and reoxygenation in isolated rat liver. Methods: The perfusion model of isolated rat liver was established. Rat livers were harvested and were perfused with modified Krebs' buffer, which was saturated with 95% O2, 5% CO2 and contained 10 mmol/L glucose (for nutrition) and 1% albumin (for osmatic pressure). The perfusion pressure was kept at 1.2 kPa for oxygenation and 0.2 kPa for anoxia. Meanwhile, pH value and temperature were properly maintained and oxygen pressure and liver flow were measured. Different concentrations of isoflurane were fed into artificial lung with mixed air. Results: Is oflurane had no obvious influence on liver flow under basal condition,but improved liver flow after liver was exposed to anoxia and reoxygenation. It also decreased liver oxygen consumption under basal condition and improved liver oxygen consumption after liver was exposed to anoxia and reoxygenation. Conclusion: Isoflurane can improve oxygen supply-consumption balance after anoxia and reoxygenation in isolated rat liver.

A 300 cm-long ileus tube was inserted from nasal cavity to the jejunum under the radiophotography guidance in 16 patients with recurrent adhesive small-bowel obstruction. Along with entire intestinal decompression, the ileus tube was moved forward to the terminal ileum and remained for 13 to 25 days for internal intubation plication. All the participants improved during the follow-up (range, 8 months to 2 years), and no intestinal adhesion or obstruction occurred. Non-surgical intestinal intubation plication might be a simple, safe and effective treatment for adhesive intestinal obstruction.

Objective: To detect the correlation of lymphatic vessel density (LVD) with a high mobility group box-1 Protein (HMGB1) and tumor-associated macrophages (TAMs) in cervical carcinoma and the effect on prognosis. Methods:Immunohistochem-istry was applied to detect HMGB1, CD68, and D2-40 expressions in cervical squamous cell carcinoma in 93 cases. t test,χ2 test, Spear-man rank correlation analysis, Kaplan-Meier method, and Cox regression were performed to analyze the expression levels, correlation, and prognosis. Results: HMGB1 protein, CD68, and D2-40 were highly expressed in CSCC. As HMGB1 and TAM expressions in-creased, lymphatic vessel density increased. As HMGB1 and TAM expressions decreased, lymphatic vessel density decreased. Positive correlations were also found between the HMGB1 protein, TAM content, and LVD. In the group with low HMGB1 and TAM expres-sions, the survival time of the group with a high LVD expression was significantly lower than that of the group with a low LVD expres-sion. A multivariate Cox regression model showed that HMGB1 and lymph node metastasis were independent prognostic factors. TAMs and LVD were not independent prognostic factors. Conclusion:HMGB1 proteins and TAMs were highly expressed in CSCC. Patients who exhibit increased HMGB1 expression or increased TAM count consequently show enhanced LVD expressions, increased lymph node metastasis, and poor prognosis.

Objective To evaluate the safety and efficacy of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer.Methods The clinical data were retrospectively analyzed in 108 patients undergoing radical LAG for advanced gastric cancer from March 2008 to November 2011.Results 98 out of 108 patients were followed-up,the follow-up rate was 90.7％,with medium follow-up period of 30 months (range 6-70 months).26 patients died and 3 patients developed recurrence during the follow-up period.The overall recurrence rate was 26.9％ (29/108),in which the recurrence rate was 0 for Ⅰ B cases,18.8％ (6/32) for ⅡA,30％ (6/20) for ⅡB,30.8％ (8/26) for ⅢA,and37.5％ (9/24) for ⅢB,respectively.The overall 1,2,3-year survival rates were 95.4％,88.9％,73.8％,and 1,2,3-year progression free survival rates were 93.5％,83.3％,73.8％,respectively.Conclusions Compared with open gastrectomy LAG is a safe and feasible surgical procedure with satisfactory 3-year survival in patients of advanced gastric carcinoma.

ObjectiveIn order to improve the survival of graft liver after liver transplantation, this study was designed to investigate whether intraportal injection of 150mg/kg N-acetylcysteine (NAC) in rats could reduce hepatic ischemia-reperfusion injury after 48 h of cold storage and 2 h of reperfusion. Methods Healthy male Wistar rats weighing 250-350g were used. The study consisted of three groups: control group (group Ⅰ) ;NAC-treated group(group Ⅱ). 1 ml of 5% dextrose (D5%) or 1 ml D5% containing 150mg/ kg NAC was injected into the superior mesenteric vein. 15 min after the injection of D5 % or NAC the liver was flushed with cold (4℃) Ringer' s solution through the portal vein . After perfusion, the liver was removed and kept in 100 ml UW solution at 4℃ for 48 h. In group Ⅲ animals were pretreated with buthionine sulfoximine (BSO) 2 h before intraportal injection of D5 % or NAC and liver harvesting. After cold storage, the livers were then perfused for 2 h by a closed circulating system. Aspartate transaminase (AST), alanine transaminase (ALT), and lactate dehydrogenase (LDH) activities in the perfusate were determined by reflectometry. Lactate and acid phosphatase activities were determined by enzymatic methods. ResultsAfter 48 h of cold storage and 2 h of reperfusion, livers from NAC-treated group produced larger amounts of bile than those in the control group, and released less LDH, AST, ALT and acid phosphatase, a marker of Kupffer cell injury in the perfusate. The protective effects of NAC against cold ischemia-reperfusion liver injury were maintained when animals were pretreated with BSO, a specific inhibitor of glutathione synthesis. ConclusionsThis study shows that intraportal administration of NAC in vivo significantly improves the initial function of the isolated rat liver. Our results also indicate that NAC inhibits the activation of Kupffer cells, which are the first source of reactive oxygen intermediates during reperfusion.

Objective To evaluate the long-term effects of postnatal dexamethasone administration in prevention or treatment of chronic lung disease (CLD) in preterm infants.Methods All randomized controlled clinical trials (RCT) on long-term effect of postnatal dexamethasone in prevention or treatment of chronic lung disease in preterm infants were searched in Medline,Embase database,Cochrane Library and Chinese Medical Citation Index database,China National Knowledge infrastructure,VIP Chinese Periodical Database and Chinese Digital Hospital Library and Wanfang Chinese periodical database.As a supplementation,the works of domestic and international pediatric conferences were collected by manual search.The follow-up time was defined as longer than two years.Revman 5.0 was used for Meta-analysis for the effects of dexamethasone on nervous system,respiratory system and mortality.Results Eight RCTs fulfilled the including criteria.Statistical analysis revealed that the incidence of recurrent respiratory disease decreased from 49.7％ to 38.9％ in the dexamethasone group compared to the control group with RR =0.57 (95％ CI:0.37-0.88,P ＜ 0.05).But the incidence of cerebral palsy in dexamethasone group increased significantly (RR =1.95,95％ CI:1.41-2.71,P ＜ 0.01).Stratified analysis revealed that the incidence of cerebral palsy in early-use group (within 1 week after birth) was higher than that in control group (RR =2.59,95％ CI:1.59-4.21,P ＜0.01) ; while the incidence in later-use group (1 week after birth) was not statistically different from that in control group (RR =1.5,95％ CI:0.95-2.36,P =0.08).There were no significant differences in the incidence of mental retardation (RR =0.77,95％ CI:0.28-0.14,P ＞ 0.05),deafness (RR =0.52,95％ CI:0.17-1.56,P =0.24) and severe visual impairment (RR =1.56,95％ CI:0.77-3.18,P =0.22) between dexamethasone group and control group,as well as in mortality rate (RR =0.91,95％ CI:0.71-1.16,P ＞ 0.05).Conclusions Intravenous administration of dexamethasone after birth for prevention or treatment of CLD in preterm infants can reduce the incidence of recurrent respiratory diseases in childhood; meanwhile the incidence of cerebral palsy may increase,it almost occurs in the early dexamethason administration group,not in the late group.Dexamethasone may not reduce the mortality of CLD.

Objective In order to improve the survival of graft liver after liver transplantation, this study was designed to investigate whether intraportal injection of 150mg/kg N-acetylcysteine (NAC) in rats could reduce hepatic ischemia-reperfusion injury after 48 h of cold storage and 2 h of reperfusion.Methods Healthy male Wistar rats weighing 250-350g were used.The study consisted of three groups: control group (group Ⅰ);NAC-treated group(group Ⅱ).1 ml of 5% dextrose (D5%) or 1 ml D5% containing 150mg/kg NAC was injected into the superior mesenteric vein.15 min after the injection of D5% or NAC the liver was flushed with cold (4℃) Ringer's solution through the portal vein .After perfusion, the liver was removed and kept in 100 ml UW solution at 4℃ for 48 h.In group Ⅲ animals were pretreated with buthionine sulfoximine (BSO) 2 h before intraportal injection of D5% or NAC and liver harvesting.After cold storage, the livers were then perfused for 2 h by a closed circulating system.Aspartate transaminase (AST), alanine transaminase (ALT), and lactate dehydrogenase (LDH) activities in the perfusate were determined by reflectometry.Lactate and acid phosphatase activities were determined by enzymatic methods.Results After 48 h of cold storage and 2 h of reperfusion, livers from NAC-treated group produced larger amounts of bile than those in the control group, and released less LDH, AST, ALT and acid phosphatase, a marker of Kupffer cell injury in the perfusate.The protective effects of NAC against cold ischemia-reperfusion liver injury were maintained when animals were pretreated with BSO, a specific inhibitor of glutathione synthesis.Conclusions This study shows that intraportal administration of NAC in vivo significantly improves the initial function of the isolated rat liver.Our results also indicate that NAC inhibits the activation of Kupffer cells, which are the first source of reactive oxygen intermediates during reperfusion.