Objective To study the effect of laparoscopic surgery on the quality of life in patients with middle and low rectal cancer.Methods 108 cases with middle and low rectal cancer in accordance with the number table,were randomly divided into two groups.54 patients in the observation group were operated through laparoscopic surgery and 54 patients in the control group received traditional open surgery.The patients were followed up for 6 months,the patients' quality of life were assesed.Results The operative time,blood loss and length of hospital stay in the observation group were less than the control group (P ＜ 0.01).The lymph node dissection between the two groups had no significant difference(P ＞0.05).47 patients in the observation group were rectal sphincter preservation,the rate was 87.0％,37 patients in the control group with rectal sphincter preservation,the rate was 68.5 ％,the difference between the two groups was significant (x2 =4.92,P ＜ 0.05).The patients'quality of life after surgery in two groups was increased than before surgery,and the observation group increased more significantly than the control group(P ＜ 0.05).Conclusion Laparoscopic surgery can significantly improve the quality of life in patients with middle and low rectal cancer.

Rapid development of personalized medicine in cancer treatments needs urgent support of proper tumor biomarkers.Comparing to tissue tests,serum/plasma tumor biomarkers show advantages in easy sample collection and flexibility of detecting methods.Nowadays,large scales of investigations have discovered sufficient blood tumor biomarkers for preclinical diagnosis and evaluation of clinical treatment or prognosis,with the development of screening techniques and strategies.Moreover,tremendous promotion would appear in cancer diagnosis and treatment with future profound investigation and rigorous verification from clinical practice.

As a new identified help T cell lineage different from Th1 and Th2 cells, Th17 cell has been found played important roles in the pathogenesis of autoimmunity and inflammatory disease. To further identify their roles, the differentiation and regulation of Th17 cells has been widely explored recently. Now it has been confirmed that TGF-beta, combined with IL-6 or IL-21, play critical roles in the differentiation of Th17 cells. While IL-23 mainly contribute in promoting the secretion of IL-17 and maintaining the function of Th17 cells. Corresponding with the Th1,Th2, and Treg cells, which has special transcription factors T-bet、GATA3、Foxp3 respectively, now it has been confirmed that ROR-?t(retinoid-related orphan receptors-?t) is the special transcription factor which specially regulate the differentiation of Th17 cells. Th17 cells function through their secreted pro-inflammatory cytokines, including IL-17A, IL-17F, IL-21, IL-22, IL-6, TNF-?. Among them IL-21,which act as a autocrine cytokine of Th17 cells, play critical roles in promoting the differentiation of Th17 cells while inhibiting the differentiation and function of Th1 and Treg cells. On the other hand, IL-2, which is obligatory for the growth of Th1,Th2,Treg and CD8+T cells, now has been found negatively regulate the differentiation of Th17 cells. In all, differentiation of Th17 and Treg,Th1 cells are exactly regulated in vivo, in which TGF-beta played critical roles. As both Th1 and Th17 cells participate in the pathogenesis of autoimmunity and inflammatory diseases, are they play synergistic roles or function at different time point or location? How TGF-? regulate Th17 and Treg cells?Can Th17 cells be used as a target for immune tolerance induction? All above questions will certainly be of continuing interest.

Accidents, Occupational ; prevention & control ; statistics & numerical data ; Adult ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Poisoning ; epidemiology ; prevention & control

Ischemia reperfusion injury (IRI) is a multistep pathophysiological process involving a complex of multi-factors.To alleviate the IRI is of great importance in clinical liver transplantation,especially for marginal donor livers.This article overviewed the protective strategies and the latest progress for alleviation of IRI in three stages of liver transplantation,which includes liver procurement,preservation and reperfusion.

Based on the pathogenic mechanisms of age-related macular degeneration (AMD),tremendous preclinical and clinical trials have demonstrated that cell transplantation which aim to replace impaired retinal pigment epithelium (RPE) with healthy RPE cells is a promising approach to treat AMD.So far,choices of cell sources mainly are autologous RPE,iris pigment epithelium,fetal RPE,human embryonic stem cell-derived RPE and human induced pluripotent stem cell-derived RPE,and some of them are undergoing clinical researches.Grafting manners in cell-based therapies are various including RPE sheet or RPE-choroid complex transplantation,RPE cell suspension injection,and RPE sheet transplantation with scaffolds.This review is limited to cell-based therapies for RPE that damaged first in the progress of AMD and focus on recent advances in cell sources,transplantation methods,preclinical and clinical trials,and the obstacles that must be overcome.

BACKGROUND: Most of the displaced fractures of calcaneus reed operation treatment. Because early postoperative dirigation is sometimes ignored,most patients receive only good anatomic reduction but less pleased functional reduction.OBJECTIVE: To compare the effect of different starting time of the postoperative dirigation on the functional recovery of the joint of the foot after the operation of the fracture of calcaneus with joint surface displacement.DESIGN: Non-randomized and concurrently controlled retrospective analysis with blind evaluation.SETTING: Orthopedic Department of Renji Hospital of Shanghai Second Medical University.PARTICIPANTS: Cases with the fracture of the calcaneus with joint surface displacement, in the Orthopedic Department of Renji Hospital of Shanghai Second Medical University were chosen from October 2000 to June 2003. There were totally 64 cases(72 sides), male 40 sides and female 32sides, whose ages varied from 22 to 68 years old. According to the starting time of the postoperative dirigation, the cases were divided into two groups,the 1-week dirigation group with 34 cases(38 sides), male 20 sides and female 18 sides, and the 6-week dirigation group with 30 cases(34 sides), male 20 sides and female 14 sides.METHODS: Totally 64 cases were involved in the result analysis. In the two groups, the same operative therapeutic methods and postoperative dirigation were taken except the starting time of the dirigation. The dirigation was started respectively 1 or 6 weeks after the operation and lasted for 6weeks. Six months later, follow-ups were done according to the Maryland Grade(excellent 90-100, good 75 -89, moderate 50 -74, poor ＜ 50) to evaluate the activity of the talocrural joint and the stability of the anterior half of the foot and the gait as well.MAIN OUTCOME MEASURES: Primary results: the postoperative function of the injured foot of the two groups. Secondary results: the adverse events and side effect.Maryland Grade: In the 34 cases(38 sides) of the 1-week dirigation group,the average mark was 87. 8, and in the 30 cases(34 sides) of the 6-week dirigation group, the average mark was 73.2, and the difference had signifigroup, 3 cases had poor healing of the incision, and achieved the healing after 2-week medication. And 2 cases had injury of the lateral dorsal cutaneous nerve of the foot. In the 6-week dirigation group 2 cases had poor healing of the incision and achieved the healing after 2-week medication, and 1 case had injury of the lateral dorsal cutaneous nerve of the foot. There was no significant difference between the two groups.CONCLUSION: After the operation of the fracture of calcaneus with joint surface displacement, early application of dirigation is beneficial to the functional recovery of the foot and talocrural joint without unsafety.

Objective To review the clinical manifestation,pathological characteristics,treatment and prognosis of borderline phyllodes tumor of the prostate. Methods A case of borderline phyllodes tumor of the Prostate was reported and relative literature was reviewed. Results A 32-year-old man was admided to hospital with a history of aggravated dysuria 2 weeks and urinary retchtion one day. The enlarged prostate was palpated softly and smoothly by DRE.The serum PSA was 20.62 ng/ml.Transrectal ultrasonography and MRI revealed a well-demarcated poly-cystiform tumor which compressed the right lobe of the prostate to flattening.The diagnosis of benign stroma tumor which was not differentiated maturity obtained after transrectal sextant needle biopsy,and the transvesical enucleation was performed under epidural anesthesia.The tumor was histologically diagnosed as borderline phyllodes tumor of the prostate. Microscopic examination showed the tumor was composed of epithelial and stroma cells.The stroma cells proliferated obviously with atypia and mitosis,and the epithelial cells propagated without atypia.Immunohistochemical staining was performed.Vimentin was typically positive,PSA and PAP was positive,and SMA was negative.Forty days after the enucleation,the tumor recurrenced then radical prostatectomy was performed.The diagnosis of low potential malignant phyllodes tumor of the prostate was made.The tumor was limited in tegument and the cross-section of urethra was infiltrated.The patient received external radiation to the whole pelvis(66 Gy)1 month postoperatively.At 6 months'follow up,the patient was asymptomatae. Conelusions The right diagnosis can not be obtained by needle biopsy because hyperptastic epithelial cells can not get and the recurrences of phyllodes tumor increase malignant potential.Radical prostatectomy is the most reliable method of treatment at present.

Objective:To improve the CT and MRI diagnostic accuracy of intracranial atypical cavernous angiomas(ACA).Methods:We retrospectively analyzed CT and MRI appearances,operative and pathological findings of 12 cases with ACA.Of them,11 cases were seanned by CT,10 cases by MRI and 9 by both CT and MRI.Results:Of 12 cases:One case as located at the sella ,1 case was at the fourth ventricle,5 cases were located at the cerebral hemisphere,4 cases were located at the middle cranial fossa and 1 case was at the posterior cranial fossa.There was edema in 3 cases,1 case had cystic component and 4 cases had cerebral hemorrhage.The localized rate of ACA by CT and MRI was 100%,but 11 cases were misdiagnosis and 1 case did not made the qualitative diagnosis. Conclusion:The qualitative diagnosis of ACA have some difficulty,so that the emphasis should be on the analysis of the combination imagiology and clinic.

Objective To study the clinical applied value of computed tomography perfusion imaging(CTPI) in early stage of ischemic stroke.Methods Routine CT scan and CTPI were performed in 45 patients with early stage of ischemic stroke(onset within 24 hours).CTPI yields a set of perfusion related parameters of relatine cerebral blood flow(rCBF), cerebral blood volume(rCBV),mean transmit time(rMTT),time to peak(rTTP) and positive enhancement integral (rPE).Results In all 45 patients,21 cases showed concerning lesions in the 29 cases with cerebral ischemia results of routine CT scan.16 cases presented normal results. 24 cases were not showed concerning lesions.The sensitivity of diagnose for early stage of ischemic stroke by CT was 46.67% (21/45).The specificity was 72.41% (21/29).44 cases of CTPI with abnormal perfusion changes were all showed concerning lesions. Only one case of CTPI presented negative result,which was acute brainstem infarction confirmed by follow-up magnetic resonance imaging (MRI).The sensitivity of diagnose for early stage of ischemic stroke by CTPI was 97.78% (44/45).The specificity was 100% (44/44).There was significant difference between CTPI and routine CT scan(P