Objective To explore the application value of gastrointestinal reconstruction by continuous jejunum interposition after total gastrectomy.Methods A retrospective analysis in March 2006 to March 2012 was performed in 60 patients with gastric underwent continuous jejunal interposition after total gastrectomy.Results There were no operation death and anastomotic fistula.Follow-up for 12-24 months,some patients had mild reflux esophagitis,generation of gastric capacity of more than 300 ml,emptying time of 30-100 min.The quality of life was improved after operation.Conclusions Continuous jejunal interposition pouch is safe and reliable,with satisfactory effect of digestive tract reconstruction.

BACKGROUND:Intertrochanteric fractures are often treated with extramedulary fixation and intramedulary fixation. Which internal fixation can better repair intertrochanteric fractures remains controversial. OBJECTIVE: To compare the efficacy and safety of dynamic hip plate and proximal femoral intramedulary nail fixation in treatment of intertrochanteric fracture in adults. METHODS: Al randomized clinical trials relevant to comparing proximal femoral intramedulary nail fixation with dynamic hip plate for intertrochanteric fracture in adults from 1966 to 2013 were identified. The quality of the trials was assessed. The outcomes included length of surgery, operative blood loss, postoperative femoral shaft fracture, cut-out of the implant from the femoral head, non-union of the fracture, reoperation rate, wound infection, postoperative hip pain (hip joint pain and thigh pain), which were extracted and reviewed systematicaly. RESULTS AND CONCLUSION:4 757 trial participants with 4 748 fractures were included in the 31 published trials. There was no significant difference in the length of surgery, reoperation rate, cut-out of the implant from the femoral head, non-union of the fracture, wound infection and postoperative hip pain between the two groups (P > 0.05) between dynamic hip plate and proximal femoral intramedulary nail fixation. Compared with dynamic hip plate fixation, proximal femoral intramedulary nail fixation had less blood loss and significantly higher rate of femoral shaft fractures (P=0.003). Experimental findings show that, in treatment of intertrochanteric fracture, intramedulary nail fixation is associated with significantly lower blood loss. However, the risk of femoral shaft fracture is increased compared with dynamic plate fixation. There were no differences in length of surgery, cut-out of the implant from the femoral head, non-union of the fracture, reoperation rate, wound infection and postoperative hip pain. The results of this systematic review should be explained prudently because of some limitations of included trials. To obtain more reliable conclusions, large-scale randomized controled trials of strict design, uniform index and long-term folow-up are needed.

Objective To evaluate the therapeutic effectiveness of echo-guided percutaneous radiofrequency ablation(RFA) by using a LeVeen needle electrode combination in the treatment of large liver tumor,and to discuss the relationship between the amount as well as the distribution pattern of the electrodes and the therapeutic effectiveness.Methods During the period of Feb.2006-Dec.2008,echo-guided RFA was performed in 113 patients with large and unresectable liver tumor,with a total of 118 lesions.According to the size of the tumor,the patients were divided into four groups.The tumor’s diameter of Group A(n = 64) was 4.0-5.0 cm,Group B(n = 28) was 5.1-6.0 cm,Group C(n = 11) was 6.1-7.0 cm and Group D(n = 10) was 7.1-9.3 cm.Based on the tumor’s diameter,the amount of the electrodes to be used and the sites to be ablated were determined.After the procedure,the follow-up checks with MRI or CT scanning were carried out to observe the necrotic extent and the local recurrence.Results Two months after the treatment,the complete necrosis rate of the tumor in Group A,B,C and D was 88.4%,78.6%,63.6% and 40.0%,respectively,with an overall necrosis rate of 79.7% in total 118 lesions.During a follow-up period of 3-36 months,the local recurrence rate in Group A,B,C and D was 5.5%,10.0%,28.6% and 50.0%,respectively.Severe complications,including intrahepatic infection(n = 2),puncture passage bleeding(n = 1),symptomatic pleural effusion(n = 4) and biloma(n = 2),occurred in 9 cases.No death related to RFA treatment occurred.Conclusion Echo-guided percutaneous radiofrequency ablation by means of multi-sites superimposition method with a LeVeen needle electrode combination is an safe and effective therapy for the hepatic tumors with the diameter over 4 cm.

OBJECTIVE:To compare the effects of total knee arthroplasty performed with and without patellar resurfacing. METHODS:All randomized clinical trials relevant to comparison of total knee arthroplasty performed with and without patellar resurfacing between 1966 and 2008 were collected. The quality of the trials was assessed. The outcomes data including the prevalence of reoperations,postoperative anterior knee pain,patient satisfaction,and the improvement in various knee scores were extracted and reviewed systematically. RESULTS:1 731 knees were included in the 15 published trials,including 842 knees in the resurfaced group and 889 in the nonresurfaced group. During the four years following surgery,there was no significant difference between the resurfaced and the nonresurfaced groups in re-operation rate (relative risk=0.56,95% CI 0.17-1.85); whereas the re-operation rate of the nonresurfaced group was significantly greater than resurfaced group 4 years after surgery (relative risk=0.46,95% CI 0.25-0.84). On the prevalence of postoperative anterior knee pain,there was no significant difference between two groups (relative risk=0.65,95% CI 0.35-1.21). No significant difference was found in patient satisfaction (relative risk=1.00,95% CI 0.95-1.05). There was no significant difference between the resurfaced and the nonresurfaced groups in the KSS scores (weighing mean difference:-0.41; 95% CI:-3.08 to 2.26). CONCLUSION:The long-term rate of reoperations in total knee arthroplasty performed with patellar resurfacing was lower than that without patellar resurfacing. There were no significant differences in the terms of prevalence of postoperative anterior knee pain,patient satisfaction,and the improvement in various knee scores between the resurfaced and the nonresurfaced groups. The results of this systematic review should be explained prudently because of some limitations of included trials. For more reliable conclusions,more trials with high quality on methodology are needed.

Object The process of seed germination and haustorium formation in Cistanche deserticola Y C Ma was observed Methods Seeds were inoculated on culture medium, the process of seed germination and haustorium formation were observed using light and electron microscopy Results The seedling sprouted after two weeks, then a tube like organ formed, finally the apex expanded to attachment organ The outer papillar surface of the extended apex bears wall protuberances that are encircled with a thick cuticular belt and covered with a thin cuticle Conclusion The seed germination of C deserticola is single pole of racidle The attachment organ adheres host first

CT data regarding PUMCⅡ d2 adolescent idiopathic scoliosis obtained from one female patient were input into modeling software minics 11.11 to obtain medical simulation model.Then finite element analysis models of AIS patients (T1-S) were created by introducing simulation models into software abaqus 6.7.Finite element models of T6 11 segments were corrected by 5 different correction methods:simple concave bracing,simple convex pressurization,concave distraction and convex compression simultaneously,concave distraction prior to convex compression and concave distraction after convex pressurization.Abaqus software was used to simulate correction of scoliosis with vertebral arch pedicle screw by loading 50 N,100 N,and 200 N distraction forces on the concave side pedicles of the end vertebrae T6 and T11.The displacement of vertebrae T6 in Y-axis (sagittal plane) and Z-axis (coronal plane),which respectively represented the correction effects of kyphosis and scoliosis,was compared between prior to and after correction.Simple concave distraction provided better outcomes in terms of displacement of T6 in Z-axis than the remaining four methods (P ＜ 0.01).Concave distraction and convex compression simultaneously,concave distraction prior to convex pressurization and concave distraction after convex compression produced identical displacements of T6 in Y-axis,which were all better than simple concave distraction (P＜ 0.01).The present findings imply that for curative effects of five methods on correction of scoliosis in the coronal plane:simple concave distraction＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compressio= concave distraction after convex compression ＞ simple convex pressurization;for curative effects of five methods on correction of kyphosis in the sagittal plane:simple convex compression ＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compression= concave distraction after convex compression＞ simple concave bracing.Simple concave distraction could not produce obvious corrective effects on kyphosis rather than lead to worsened kyphosis to some extent.Simple convex compression could not produce obvious corrective effects on scoliosis rather than result in aggravated scoliosis to some extent.

Objective To investigate the MRI features of hepatic IgG4?related inflammatory pseudotumor (IPT). Methods Nine patients with 11 histopathologically proven IgG4?related hepatic IPTs were retrospectively analyzed. The clinical, morphological and MRI signal features on T1WI, T2WI, dynamic?enhanced, and diffusion?weighted imaging were assessed in detail and correlated with pathological findings. The paired t test was used to compare the ADC values of the tumors and the hepatic tissue. Results Hepatic IgG4?related IPT displayed certain MRI features. The dominant lesions were subcapsularly distributed (n=7) with a clear boundary (n=8), which typically showed hypointensity on T1WI (n=11), mild hyperintensity on T2WI (n=8), progressive (n=5) or persistent (n=4) enhancement pattern. Accompanied signs included delayed capsule?like enhancement (n=6) and central nonenhanced areas (n=7). Two lesions showed atypical wash?out pattern with iso or hypointensity on portal and delayed phases. In diffusion weighted imaging, all lesions were hyperintense, and the mean ADC value of the lesions [(1.42 ± 0.36) × 10?3mm2/s] was mildly lower than that of surrounding liver [(1.55±0.31)×10?3mm2/s], although no statistical differences were found(t=0.78, P=0.46). Conclusions Hepatic IgG4?related IPTs display various MRI manifestations. The lesions normally show progressive enhancement pattern with diffuse homogeneous or heterogeneous hyperintensity, accompanied by delayed capsule?like enhancement and central nonenhanced areas.

Objective To explore the roles of vascular endothelial growth factor (VEGF) and P38MAPK in the pathogenesis of Alzheimer's disease(AD) rats,and the effects of butyIphthalide on the influence of VEGF and P38MAPK in hippocampus of AD rats.Methods SD rats were randomly divided into blank group,AD model group,butylphthalide low-dose group and high dose group (n =8 rats per group).Aggregated Aβ1-42 was injected into the bilateral hippocampus of rats by stereotaxic coordinates method to induce AD.Morris water maze test was used to determine the abilities of learning and memory.Western blotting combined with Gel Doc imagine systems were used to investigate the expression of VEGF and P-P38MAPK in hippocampus of AD rats.Results The result of Morris water maze experiment showed that one week after modeling,escape latency was different(F =66.658,P ＜ 0.05),and either dose the frequency of crossing platform (F =6.884,P ＜0.05).Compared with the blank group,the other three groups'latent period of escape was extended significantly(P ＜ 0.05),and frequency of crossing platform was significantly less (P ＜ 0.05).After drug intervention for 4 weeks,the expression of VEGF was difference(F =171.064,P ＜0.05),it was decreased obviously in the model group than blank group(P ＜=0.05),but it was increased in the drug intervention groups than model group (P ＜ 0.05),and increased more significantly in the high dose group than low dose group (P ＜ 0.05).The expression of P38MAPK had no obvious change among four groups (P ＞ 0.05),however,the expression of P-P38MAPK showed difference(F =104.395,P ＜ 0.05),it was increased in drug intervention and model group than blank group (P ＜ 0.05),it was increased in drug intervention and model group than blank group (P ＜ 0.05),reduced significantly in drug intervention groups than model group (P ＜ 0.05),and decreased more significantly in high dose groups than low dose group (P ＜ 0.05).Conclusions Butylphthalide could obviously enhance the expression of VEGF,reduce the expression of P-P38MAPK in hippocampus of AD rats.

Background Lasein situ keratomileusi(LASIK) imainstream surgery forefractive correction,and femtosecond laseimuch often used to create thin corneal flap.The measuremenof OPTOVUE RTVue-100 OCto flap and stromal bed thicknesseofferuseful basifoLASIK.Ican be used in measuring the thicknesand shape of the corneal flap.Buthe study on the comparison of flap thicknesbetween WavelighFS200 femtosecond laseand MoriM2 microkeratome 90 μm-knife (Mori90 microkeratome) LASIK by OCilack.Objective The aim of thitrial wato compare the featureof corneal flapcreated by the WavelighFS200 femtosecond laseand Mori90 microkeratome.Methodpiloand prospective study wadesigned.Written informed consenwaobtained from each patienprioto LASIK.Sixty righeyeof 60 patientwith myopiomyopiastigmatism were enrolled in thiclinical trial.The patientwere randomized into the FS200 femtosecond lasegroup and Mori90 microkeratome group with matching demography.RTVue OCwaused to measure flap thicknesusing 10 settingon the 60 eye1 month afteoperation.The featureof the LASIK flapwere analyzed based on the measuring outcomes.ResultThe central flap thickneswa(112±3) μm and the mean flap thickneswa(112 ±3) μm in the FS200 femtosecond lasegroup,which wasignificanlowethan the central flap thicknesa(121±7) μm and the mean flap thicknesa(128±11) μm in the Mori90 microkeratome group respectively (P=0.031,0.030).Corneal flapin the FS200 femtosecond lasegroup showed flashape and thain the Mori90 microkeratome group wameniscushape.The central flap thickneswanoevidently differenfrom thaof peripheral thicknesin the FS200 femtosecond lasegroup (P =0.320).However,in the Mori90 microkeratome group,the central flap thickneswaobviously thinnethan thain the peripheral thicknes(P=0.038).The mean deviation between the actual and predicted flap thicknes(110 μm) wa(3±4)μm in the FS200 femtosecond lasegroup and (17±10) μm in the Mori90 microkeratome group,showing significandifference between them (P =0.009).ConclusionRTVue OCdeterminethathe shape of flapcreated by the FS200 femtosecond laseimore uniform and closeto the expected thicknesof 110 μm than the onecreated by the Mori90 microkeratome.OPTOVUE RTVue-100 OCiuseful tool to evaluate the flap shape and thicknesafteLASIK.

AIM:To investigate the effect of hirsutine on hypoxia-induced migration and invasion abilities of human breast cancer MCF-7 cells and its possible mechanism. METHODS:CCK-8 assay was employed to detect the cyto-toxic effect of hirsutine on the MCF-7 cells. Cell migration was observed by wound healing assay,and cell invasion ability was measured by Transwell invasion assay. Western blot was used to analyze the protein levels of hypoxia-inducible factor-1α(HIF-1α),Snail,E-cadherin and matrix metalloproteinase-9 (MMP-9). The mRNA levels of HIF-1α was detected by RT-PCR. RESULTS:Hirsutine remarkably reduced the cell viability from 32 μmol/L(P<0.05),and the IC50value was 62.82 μmol/L. In hypoxia state,MCF-7 cells showed more powerful capabilities of migration and invasion (P<0.05), higher protein levels of HIF-1α,Snail and MMP-9 (P<0.05),lower protein level of E-cadherin(P<0.05),and higher mRNA level of HIF-1α (P<0.05). These hypoxia-induced effects were all inhibited by hirsutine at 16 μmol/L (P<0.05),apart from the mRNA level of HIF-1α. CONCLUSION:Hirsutine inhibits hypoxia-induced migration and inva-sion in human breast cancer MCF-7 cells most likely via down-regulation of the protein levels of HIF-1α,Snail and MMP-9,and up-regulation of the protein level of E-cadherin.