Objective To explore the risk factors and prevention measures for anastomotic leakage after rectal radical resection.Methods The clinical data of 404 patients with rectal radical resection were analyzed retrospectively and the risk factors for anastomotic leakage were analyzed.Results Thirty-one patients (7.67％,31/404) were subjected to anastomotic leakage.The mean leakage time was 6.5 (3-14) d postoperatively.The muhivariate Logistic regression analysis showed that preoperative hemoglobin (OR =3.023,95％ CI:1.101-8.303,P=0.031 8),tumor size (OR =2.543,95％ CI:1.075-6.018,P=0.033 7) and tumor distance from anal verge (OR =3.160,95％ CI:1.387-7.199,P=0.006 2) were the risk factors for anastomotic leakage.Conclusions Preoperative hemoglobin,tumor size and tumor distance from anal verge are significant factors for anastomotic leakage.Therefore correction of anemia,improvement of surgical technique and suitable use of preventive diversion stoma ane all benefit for prevention of anastomotic leakage after rectal radical resection.

Purpose:To study the expression of CD 44 V 5 and Nm23 H 1 gene products and their significance in esophageal cancer patients.Methods:The expression of CD 44 V 5 and Nm23 H 1 in 85 cases of formalin fixed, paraffin embedded specimens of esophageal cancer were measured by immunohistochemistry S P method. Fifty cases were followed up for 3 years after operation.Results:①The positive expression rate of CD 44 V 5 and Nm23 H 1 was 61.2% 、57 6%, respectively in esophageal cancer.②Overexpression of CD 44 V 5 gene products were closely related with the invasive extent , histopathologic classification , TNM stage ,lymph node metastasis(LNM) and prognosis of Ec( P

Objective To investigate the clinical value of continuously detecting serum and pelvic drainage fluid C-reactive protein (CRP) and drainage fluid matrix metalloproteinase-9 (MMP-9) in the early diagnosis of anastomotic leakage after anterior resection of low rectal cancer.Methods The levels of CRP and MMP-9 in serum and pelvic drainage fluid were measured on postoperative 1,3,5,7 d in 158 patients with low rectal cancer anterior resection.The patients were divided into the anastomotic group (n=9) and non-anastomotic leakage group (n=149).The differences in the detection values between the two groups were compared and analyzed statistically.Results Among 158 cases,anastomotic leakage occurred in 9 cases.The correlation analysis of serum and drainage fluid CRP detection value and postoperative days (POD) in the two groups showed the POD 3,POD 5 and POD 7 difference was statistically significant (P＜0.05).The ROC curve analysis showed that the accuracy of the serum and drainage fluid CRP continuous detection for diagnosing the anastomotic leakage on postoperative 3 d was middle,which on postoperative 5,7 d was higher.The patients with CRP detection value ＞ 128.23 mg/L and drainage fluid CRP ＞89.93 mg/L on postoperative 5 d and those with CRP detection value＞113.71 mg/L and drainage fluid CRP＞81.75 mg/L on postoperative 7 d developed the anastomotic leakage.The drainage fluid MMP-9 detection value had no statistical difference between the anastomotic leakage group and the non-anastomotic leakage group (P＞0.05).Conclusion Continuous detection of serum and drainage fluid CRP level can be used for early diagnosing postoperative anastomotic leakage in low rectal cancer anterior resection.The drainage fluid MMP-9 continuous detection has no relation with early diagnosis of anastomotic leakage after low rectal cancer anterior resection.

The Ebola virus belongs to the Filovirus family, which causes Ebola hemorrhagic fever (mortality, 25%-90%). An outbreak of infection by the Ebola virus is sweeping across West Africa, leading to high mortality and worldwide panic. The Ebola virus has caused a serious threat to public health, so intensive scientific studies have been carried out. Several vaccines (e.g., rVSV-ZEBOV, ChAd3-ZEBOV) have been put into clinical trials and antiviral drugs (e.g., TKM-Ebola, ZMAPP) have been administered in the emergency setting to patients infected by the Ebola virus. Here, recent advances in vaccines and drugs against the Ebola virus are reviewed.
Animals ; Antiviral Agents ; administration & dosage ; Ebola Vaccines ; administration & dosage ; genetics ; immunology ; Ebolavirus ; drug effects ; genetics ; immunology ; physiology ; Hemorrhagic Fever, Ebola ; drug therapy ; prevention & control ; virology ; Humans

The relationship between acupuncture and stress is discussed from three aspects, including is it possible for acupuncture stimulation to be a stressor, whether acupuncture will start stress reaction, and whether acupuncture effects contain some stress factors. It is believed that correct acupuncture manipulation will not cause stress response, however, under some circumstances, such as inaccurate manipulation, improper treatment or patients who are very nervous but do not receive effective intervention, acupuncture is likely to cause stress response. Acupuncture-induced stress response is totally different from acupuncture anti-stress. The possible stress factors in acupuncture effect are explored, which can provide a new angle for the research on action mechanism of acupuncture. From the view of stress to review acupuncture treatment, there are three enlightenments: emphasizing on communication between doctors and patients, avoiding over-pursuit of deqi and focusing on analysis of the body constitution.
Acupuncture Points ; Acupuncture Therapy ; adverse effects ; psychology ; Humans ; Qi ; Sensation ; Stress, Physiological

Objective To analyze features of the lateral leg peroneal artery perforator free flap,and study the clinical application of free peroneal artery perforator flap transplantation for repairing forefoot defects.Methods Retrospectively analyzed 9 patients with forefoot defects which had been repaired with free lateral leg peroneal artery perforator flap transplantation.In this group,the skin and soft tissue defects size were 4.5 cm ×4.0 cm-13.5 cm × 6.5 cm,Focused on analyzing the features of forefoot skin and soft tissue defects,the design and harvesting of lateral leg peroneal artery perforator flap,and vascular anastomosis and vessel matching,meanwhile,follow-up the survival condition and appearance of the flap,the function of foot and ankle after operation.Results In the 9 cases,the larger myocutaneous perforator arising from peroneal artery,accompanying 2 vena comitans,were found slightly above the midpoint of the line between fibula head and lateral malleolus in lateral leg.The flaps transfered to repair forefoot defects,artery end-end anastomosis:in 5 cases cutaneous branch of peroneal artery to dorsal artery of foot,in 4 cases by cutaneous branch of peroneal artery to dorsal metatarsal artery;vein end-end anastomosis:in 1 case 2 accompanying veins of peroneal artery cutaneous branch to 2 accompanying veins of dorsal artery of foot,in 5 cases 1 accompanying vein of peroneal artery cutaneous branch to 1 accompanying vein of dorsal artery of foot or metatarsal,in 3 cases 1 accompanying vein of peroneal artery cutaneous branch to 1 accompanying vein of dorsal artery of foot or metatarsal,simultaneously,the another accompanying vein of peroneal artery cutaneous branch to 1 dorsal superficial vein of the foot.All the 9 flaps survived,and no vessel articulo happened.The venous return of flaps had no significant difference between repairing 1 vein and 2 veins in gross appearance.All wounds healed in one-period.Followed-up 2-6 months postoperative,1 patient was performed flap reshaping due to flap fat and clumsy at 5 months postoperative,others,the skin texture and appearance of the flaps were good and satisfactive.Conclusion Free transplantation of the lateral leg peroneal artery perforator flap broke away from the bondage of pedicled flap,had more freedom in flap design,and effectively controlled the trauma of donor and recipient site.The flap have the merits,blood vessel anatomy is relatively stable,blood supply is reliable,harvesting is simple,skin texture is similar to the forefoot and the effect is better,operation of the donor and recipient sites can accomplish under a identical anaesthesia and tourniquet.Thus,the lateral leg peroneal artery perforator free flap is an effective metheod in reparation of the forefoot defects.

BACKGROUND:Neural stem cells transplanted into the infarct region can promote the recovery of damaged nerve cells after cerebral infarction.
OBJECTIVE:To analyze the relevant influential factors of neural stem celltransplantation in the treatment of cerebral infarction.
METHODS:In this paper, we analyzed the experimental studies concerning neural stem celltransplantation for cerebral infarction published in recent years based on database search. There were main two aspects for discussing the progress in neural stem cells and cerebral infarction, the Chinese clinical trial registration and basic experimental studies.
RESULTS AND CONCLUSION:After cerebral infarction, neural stem cellproliferation and differentiation is closely related to the brain microenvironment. Large amount of nerve cellloss can be found in the infarct region. Cytokines can play a role in the neural stem celltransplantation to repair neurological injury after cerebral infarction, and also can induce neural stem cellproliferation, differentiation and migration, including epidermal growth factor, brain-derived neurotrophic factor, insulin-like growth factor 1, nerve growth factor, and basic fibroblast growth factor. Acupuncture and traditional Chinese medicine can promote the proliferation, migration and differentiation neural stem cells in the subependymal zone after cerebral infarction. Neural stem celltransplantation in the treatment of cerebral infarction has yielded progress, but there are stil many issues that need to be resolved in the future.

Objective To investigate effect of paclitaxel on expression of programmed death ligand-1 ( PD-L1 ) in the surface of cervical cancer TC-1 cells and its mechanism. Methods ①The cells were divided into two groups: paclitaxel group, paclitaxel combined with PKD blocker (G? 6976) group. There were 4 concentration gradient and 5 holes for each group, and each hole has its corresponding concentration of drugs. Influence of paclitaxel on TC-1 cell viability and effect of PKD blocker G? 6976 on IC50 value of paclitaxel were evaluated by MTT method.②The cells were divided into 0. 9% sodium chloride solution ( NS) group and paclitaxel group, There were 5 holes of each group. Effect of paclitaxel on PD-L1 expression on the surface of TC-1 cells were measured by immunohistochemistry.③The cells were divided into 4 groups:NS+DMSO group, G? 6976 group, paclitaxel group and paclitaxel+G? 6976 group. There were 5 holes for each group. Effect of paclitaxel and G? 6976 on PD-L1 expression on the surface of TC-1 cells were measured by immunohistochemistry. The expressions of PD-L1 on the surface of cells were measured by immunofluorescence treated with different drugs. Results The IC50 value of paclitaxel was 40 μg·mL-1 in paclitaxel group, and 38. 9 μg·mL-1 in paclitaxel combined with PKD blocker G? 6976 group, without significant difference between the two groups (P>0. 05). The expression of PD-L1 in the surface of TC-1 cells were significantly higher in paclitaxel group than in negative control group [(88. 48±13. 44)% vs. (39. 59±5. 99)%, P<0. 05]. The expression of PD-L1 in the surface of TC-1 cells was (79. 7%±4. 7)% after treatment with paclitaxel combined with PKD blocker G? 6976 for 24 h, and it was significantly lower than that in paclitaxel group [(96. 8±2. 5)%, P<0. 05]. Conclusion Paclitaxel promotes the expression of PD-L1 in the surface of TC-1 cells, which could be significantly inhibited by blocking PKD pathway. Paclitaxel may exert its effect through PKD pathway.

Objective To investigate the expressions of metastasis suppressor 1 (MTSS1 )and calcium activated protein 43 (Cap43)in esophageal squamous cell carcinoma (ESCC)tissue,and to clarify the relationship between the expressions of MTSS1,Cap43 and the clinicopathological features of ESCC.Methods 80 cases of ESCC tissue and 30 cases of normal adjacent-cancer tissue were collected,and the protein and mRNA expressions of MTSS1 and Cap43 in ESCC tissue and normal tissue were detected by streptavidin-perosidase (SP)immunohistochemistry and RT-PCR;their relationships with the clinicopathological features of ESCC were analyzed.Results The positive expression rate of MTSS1 in normal esophagus tissue was significantly higher than that in ESCC tissue detected by SP (83.3%vs 21.3%,P<0.01)and RT-PCR (0.703±0.085 vs 0.295±0.065,P<0.01),However,the positive expression rate of Cap43 in normal esophagus tissue was significantly lower than that in ESCC tissue by SP method (16.7%vs 76.3%,P<0.01)and by RT-PCR (0.236±0.052 vs 0.693±0.078,P<0.01).The mRNA expression levels of MTSS1 and Cap43 in ESCC tissue were significantly related with the invasive extent, histological differentiation,TNM stage,and lymphatic metastases (P<0.05)of ESCC,but not related with the age,sex,tumor size and pathological type (P>0.05). The mRNA expression of MTSS1 was negatively correlated with the expression of Cap43 (r=-0.457,P<0.05).Conclusion The low-expression of MTSS1 and over-expression of Cap43 in ESCC tissue may contribute to tumor invasion and metastasis;the imbalance of MTSS1 and Cap43 may be one of the mechanisms of tumor invasion and metastases.

Objective To analyze the bibliometry of the literature of acupoint thread-embedding in treating simple obesity, and to provide references for clinic.Method By both computer and manual retrieval, the relevant literatures over the past 30 years were collected from the Chinese Journal Full-text Database (CJFD), Vip database, WanFang database. By using the SPSS 17.0 software for statistical analysis, the distribution (province or city), publication year, and journal of the literatures, supporting fund, sample size, research method, material of the thread, use frequency of the involved acupoints, and the meridians of the selected acupoints were summarized.Result The included eligible 175 articles were distributed over many provinces and cities; the publication amount had been increasing year by year; there was a variety of thread materials; the literature with supporting funds only occupied a small percentage, while the research with a small sample size occupied a comparatively large percentage, and the randomized controlled trials (RCTs) also had a small percentage.Conclusion As a common Chinese external therapy in treating simple obesity, acupoint thread-embedding has been paid more and more attention for its practical value and bright future. However, the relevant governmental department hasn’t paid enough attention to this therapy, and the low clinical research quality also makes it difficult to scientifically evaluate its clinical efficacy and safety. Therefore, more attention is required, RCTs of multicenter and large sample size are expected, and clinical research quality also needs improvement, to provide references for clinic.