Objective To explore the significance of multiple microelectrode guided technique in determining the sensory?motor area of the sub?thalamic nucleus(STN)in deep brain stimulation(DBS)surgeries. Methods A total of 22 electrophysiological recording data of STNs recorded by multiple microelectrode was retrospectively analyzed ,while another 20 electrophysiological recording data of STNs recorded by a single micro?electrode was recruited as the control group. Results A total of 64 microelectrodes were used in 22 STNs guided by multiple electrophysiological recording electrodes. Sensory or motor activated potentials were recorded in 21 sides(95.5%),while regular discharge was recorded in one side. The average length of typical STN activity on the optimal channel of multiple electrophysiological recording electrodes was 5.58±0.53 mm,and the average length of sensory or motor activated potentials was 3.27±1.54 mm. In contrast,the average length of typical STN activity recorded by single microelectrode was 5.02±1.01 mm. However,sensory or motor activated potentials were recorded in 13 sides(65.0%)with the average length of 1.36±0.98 mm. Among the 22 STNs guided by multiple electrophysiological recording electrodes,the final implanted target was consistent with the initially selected anatomic target in 13 sides(coincidence rate,59.1%). In 9 sides,the electrophysiological target was inconsistent with the initially selected anatomic target. Conclusion STN DBS performed with multiple electrophysiological recording electrodes resulted in better outcomes of recording of the average length of typical STN activity or the average length of sensory or motor activated potentials of STN ,final confirmation of STN sensory motor area and determination of the optimal channel of implantation. Application of multiple electrophysiological recording electrodes provides a premise for the precise electrode placement in STN DBS surgeries.

Objective To study the relationship between intradialytic hypertension (IDH) and inflammatory factors in patients with maintenance hemodialysis.Methods Forty maintenance hemodialysis patients were involved,including 20 patients with IDH (IDH group) and 20 patients without IDH(non-IDH group) during hemodialysis.All of them had no sign of acute infections or other progressive disease.The levels of C-reactive protein (CRP),interleukin (IL)-1 β,IL-6,tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assay (ELISA) before hemodialysis and 1,2,4 h after hemodialysis.The correlation of hypertension to CRP,IL-1 β,IL-6,TNF-α was analyzed.Results The levels of CRP,IL-1β,IL-6,TNF-α were increased in IDH group with the progress of hemodialysis,but were stable innon-IDH group.Logistic regression analysis indicated that there were positive correlations between CRP (r =0.3652),IL-1β (r =0.3261 ),IL-6(r =03156),TNF- α (r =0.3324) and blood pressure during hemodialysis (P ＜ 0.01 ).Conclusion The levels of CRP,IL-1β,TNF-α,IL-6 are positively related to the IDH in maintenance hemodialysis patients.

Objective To investigate the autophagy capacity in clear cell renal cell carcinoma tissue compared with adjacent normal tissue.Methods Sixty-nine pairs of samples from human clear cell renal cell carcinoma tissues and relatively healthy renal tissues adjacent to the tumor were collected during surgical resection.The expressions of proteins that were participating in the regulation and execution of autophagy were detected by immunohistochemisty.Electron-microscopy was also carried out for the morphometrical analysis.Results The protein expression of p-mTOR (P =0.004),P62 (P =0.000) and ULK1 (P =0.000) were up-regulated in the carcinoma tissue,while the expression of Beclin1 (P=0.000),LC3 (P =0.000) and ATG7 (P =0.000) were down-regulated,and the expression of ATG5 (P =0.349) had no signif-icant difference compared with adjacent normal tissue.Morphometrical analysis showed that the basal autophagic activity (measured by the presence of autophagy vacuole compartment) was remarkably down-regulated in carcinoma tissue,compared with adjacent normal tissue.The expression level of mTOR was correlated with P62,LC3 and ATG7,but results showed no correlation between mTOR and Beclin 1.Conclusion Our studies show a relatively reduced autophagy capacity in clear cell renal cell carcinoma,which is regulated by multiple autophagy-related proteins such as mTOR,Beclin 1 and LC3.

Objective According to the characteristics of skin defects in ankle and foot select the posterior lateral leg pedide skin flaps supplyed by different blood to repair,providing advice and reference.Methods Between January,2001 and December,2015,163 cases of soft tissue defects at the foot and ankle were treated in our department.①The sural neurovascular flap was used in 93 cases in ankle and foot defect.②The sural nerve nutritional vessel flap pediele with the perforating branch of the peroneal artery in 36 cases in ankle and foot defect.③The sural nerve nutritional vessel flap pediele with the perforating branch of the peroneal artery including sensory reconstruction in 16 cases in heel rejion defect.④Peroneal artery perforator flap in 10 cases in anterior ankle,lateral malleolus and posterior malleolus defect.⑤The use of the sural fasciocutaneous flap alonged with peroneal artery and perforators in 8 cases in dorsal foot defect.The donor site with skin graft.Results Of the 93 sural neurovascular flaps,8 had partial loss,which were cured after dressing.All the sural nerve nutritional vessel flaps pediele with the perforating branch of the peroneal artery survived.Sensory grading standard by UK Medical Research Council was used to evaluate the recovery of sensory function on the last follow-up.The sensory function recovery of heel region flaps with reconstruction of the sensory was between S0 and S1.All peroneal artery perforator flaps survived.One of the sural fasciocutaneous flap alonged with peroneal artery and perforators occurred distal epidermis,which were cured after dressing.All patients were followed up 6-50 months (mean 20 months).All patients had recoveryed walking function,and infection wound had no recurrence after surgery.Conclusion According to the location,size,severity and the injury of peripheral vascular,select the most simple,safe,minimal damage flap for the soft tissue defects at the foot and ankle.The right choice and the exact design can improve flap survival rate,and recieve good clinical results.

OBJECTIVE To study effective and convenient method for paraffin oil sterilization.METHODS By using carrier qualitative germicidal test,to compare pressure steam sterilization,dry heat sterilization and cobalt-60(gamma)-ray radiation sterilization to test the sterilizing effect and operating procedure.RESULTS Pressure steam sterilization was unable to achieve 100% sterilizing effect,whether we extended the time or use the intermittent(sterilization).After dry heat or radiation sterilization processes,no microorganism was found.CONCLUSIONS Effect of sterilization with dry heat or radiation sterilization is trustable,but its packing,operation and equipment are requested strictly,and pressure steam sterilization may be not good for paraffin oil.

Objective To explore the short and long-term efficacy of extralevator abdominoperineal excision (ELAPE)vs.conventional abdominoperineal excision (APE)on distal rectal cancer.Methods Relevant studies were identified by search of Medline,EMBASE,and Web of Science published between January 1,2008 and February 28,2015,and included in the systematic review and meta-analysis with Stata software (version 12.0). Results Our Meta-analysis included 14 studies involving 3278 patients,of whom 1843 (56.2%)underwent ELAPE and 1435 (43.8%)underwent APE.Compared with patients undergoing APE,those undergoing ELAPE had a significantly reduced risk of intraoperative bowel perforation (IBP)involvement (OR=0 .55 ,95% CI= 0 .37-0 .85 ),but no significant reduction in the occurrence of CRM positivity (OR=0 .81 ,95% CI=0 .52-1 .25 ), local recurrence (LR)(OR=0.49,95% CI=0.18-1.30),wound complications (WCs)(OR=0.93,95% CI=0.65-1.35)or in-hospital death (IHD)(OR=0.89,95% CI=0.47-1.71).Conclusion ELAPE can reduce the risk of IBP but not for CRM positivity or LR when compared with APE.Therefore,more higher-quality studies are needed to verify the short-and long-term effects of ELAPE procedure on distal rectal cancer.

Objective To analyze and discuss four methods of calculating likelihood ratio of DNA mixture. Methods In the case with CNAS-T0757 proficiency testing in 2013, the likelihood ratios were calculated and compared among four methods, including unrestricted combinatorial method, Clayton’s method, p2 principle method, and recommendations fromISFG . Results The likelihood ratios were maximumby Clayton’s method and recommendations fromISFG , followed by result of the unrestricted combinational method. The minimu mlikelihood ratio was obtained by p2 principle. Conclusion The unrestricted combi-national method could give furthest consideration to both information preservation and appraiser protection.

Objective To provide an experimental basis for long-term in vitro proliferation,tissue construction and function maintaining of human primary hepatocytes by preparing three-dimensional (3D) porous specific extracellular matrix (ECM) derived from porcine liver with different decellularizing methods.Methods The porcine liver tissue slices were treated using six different decellularization/oxidation ways,and the decellularization extent and ECM structure were evaluated through qualitative and quantitative analysis.Results The decellularized liver-ECM could maintain the original shape during the whole process of the decellularization.HE staining showed that the cellular components and nucleus disappeared in the decellularized ECM,indicating that all of these six decellularization methods can completely decellularize the porcine liver tissue slices.Determination of DNA content showed that 91％ ～ 97％ of cell components have been removed.Electron microscopy scanning observed that the pore sizes and ultrastructures of the liver ECMs under six decellularization treatments were significantly different.Conclsion The six decellularization/oxidation methods evaluated in this study could successfully create a 3D specific decellularized liver ECM with porous ultrastructure,which further lays basis for the development of a novel in vitro 3D culture model for human hepatocytes.

Objective To compare the effects of isoflurane or sevoflurane in combination with remifentanil anesthesia on blood amyloid beta protein (Aβ) in the elderly patients undergoing abdominal surgery.Methods Two hundred patients of both sexes,aged 65-75 yr,weighing 51-76 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective abdominal surgery under general anesthesia,were randomly divided into 2 groups (n =100 each) using a random number table:isoflurane combined with remifentanil anesthesia group (IR group) and sevoflurane combined with remifentanil anesthesia group (SR group).Fifty healthy elderly subjects served as control group (group C).After anesthesia was induced with iv penehyclidine,sufentanil,propofol and vecuronium,the patients were endotracheally intubated and mechanically ventilated.In group IR,anesthesia was maintained with inhalation of isoflurane (end-tidal concentration 1.68 ％,in IR group) or sevoflurane (end-tidal concentration 1.71％,in SR group),and target-controlled infusion of remifentanil (target plasma concentration 2-6 ng/ml).At l day before surgery and 3 days after surgery,the patients' cognitive function was assessed using Mini-Mental State Examination (MMSE),the development of postoperative cognitive dysfunction (POCD) was recorded,and blood samples were taken for determination of serum Aβ40 and Aβ42 concentrations.Results The incidence of POCD was 5％ (in C group),56％ (in IR group) or 22％ (in SR group),and there was no significant difference among the three groups.There were no significant differences in the serum Aβ42 and Aβ40 concentrations after surgery among the three groups.Conclusion The mechanism by which sevoflurane or isoflurane in combination with remifentanil anesthesia results in POCD is not related to the levels of blood Aβ40 or Aβ42 in the elderly patients undergoing abdominal surgery.