Colorectal cancer is one of the malignant tumors that endangers human health. Nowadays the surgery is the primary therapy for colorectal cancer. Laparescopic surgery has developped for more than ten years. It consolidates its position in the field of colorectal surgery gradually. We now make a comparison of laparoscopic surgery and open surgery about the safety, the pathophysiological influence and the effective-ness, etc, in order to discuss the value of the laparoscopic surgery in the therapy of colorectal cancer.

Objective:To study the application and clinical significance of autotransfusion hemodilution inlaryngectomy. Method:Autotransfusion hemodilution was adopted in 30 patients with Ⅲ or Ⅳ stage laryngealcarcinoma during operation as the experimental group, and the blood transfusion only was adopted in the patientswith excessively blood loss. The other 30 patients with the same stages of disease and the same kinds ofoperation were performed as the control group, without autotransfusion hemodilution and the blood transfusionwas adopted if necessary. Result: Blood transfusion was necessary to be performed only in 8 patients of theexperimental group, on the contrary,it was necessary in 19 of 30 patients of the control group (P＜0.01).There were no complications during the operations , and the postoperative complications were no significance (P＞0. 05) between two groups. Conclusion:The application of autotransfusion hemodilution may be of help to aplenty of patients with laryngeal carcinoma in advanced stage to keep off the blood transfusion duringlaryngectomy.

Objective To explore clinical effect of choledocholithotomy by laparoscopy-assisted choledochoelectroscopy and endoscopic retrograde cholangiopancreatography.Methods The clinical data of 126 gallstone and choledocholithiasis patients treated by laparoscopy-assisted choledochoelectroscopy(L group)and endoscopic retrograde cholangiopancreatography(E group)were analyzed retrospectively.In L group,the patients were performed LC and choledocholithotomy by laparoscopy-assisted choledochoelectroscopy directly,but in E group,the treatment procedures were finished by two steps.Firstly,the bile duct stones were carried out by ERCP,days later LC operations were performed.Between the two groups,the hospital days,costs,the rate of residual stone,the rate of bihary infection or panereatitis and the rate of stone recur were compared.Results In the two groups,hospital days were(6.5±0.3)d and(12.5±0.5)d,costs were(1.22±0.17)and(1.98±0.24)ten thousand yuan,the rate of residual stone was 0 and 5.3%,the rate of biliary infection or pancreatitis was 1.4%and 15.8%,and the rate of stone recur was 1.4%and 10.5%respectively.When compared each other the difference was statistically significant(t=2.48,1.96,χ2=4.32,4.90,8.79,all P＜0.05).Conclusion In patients with gallstone and bile duct stones,laparoscopy-assisted choledochoelectroseopy presented more predominances when compared with two steps methods.

Objective To explore the treatment of chronic infective wounds .Methods A retrospective analysis of clinical data in 225 patients were admitted from 2000 to 2010 .Results (1) They were mainly traumatic ulcers ,pressure ulcers ,postoperative ul-cers ,diabetes ulcers ,vascular ulcers in the group ,accounted for 80 .4% (181/225) .(2) Bacterial culture positive rate was 87 .1%(196/225) ,a total of 46 kinds with 342 pathogens were cultured ,gram-positive bacteria 40 .6% (139/342);gram-negative bacteria 57 .6% (197/342);Fungi 1 .8% (6/342) .The main pathogens were S .aureus(52) ,E .coli(43) ,P .aeruginosa(44) ,Klebsiella .SPP (27) ,which were highly resistant to penicillin ,erythromycin ,ampicillin ,gentamicin ,cotrimoxazole and the multidrug resistance rate was 37 .1% (127/342) .Chronic wounds and multidrug resistant bacteria showed rapidly increasing trend from 2007 .(3) 201 pa-tients with topical antibiotic treatment ,208 patients(49 patiens underwent re-operation)underwent operations to close wounds ;213 patiens were recovery ,12 patiens had to leave hospital because economic burden .Conclusion Chronic infective wounds were affect-ed by many factors .emphasizing on debriding ,reasonablechoice ,circulative ,alternate use of antibiotics and wound bed preparation , appling surgery to close wounds in early stage could effectively control wound infection and promote wound healing .

Objective To investigate the effect of carbon dioxide (CO2) pneumoperitoneum with different duration periods on renal function.Methods Eighty-nine patients undergoing laparoscopic operations from October 2009 to December 2011 were divided into 3 groups according to operative time.The patients whose operative time was less than 1 hour belonged to group T1,between 1 hour and 2 hours belonged to group T2,and more than 2 hours belonged to group T3.The levels of serum creatinine,urinary creatinine,urinary microalbumin were detected at preoperation as well as 10 minutes,1 hour,24 hours after operation.Results There was no significant difference regarding of the endogenous creatinine clearance rate(Ccr) postoperatively between group T1 and T2 (P ＞ 0.05).The Ccr levels at 10 minutes after operation in group T3 was significant lower than at preoperation(P ＜0.05),and increased gradually at 1 h and 24 h after operation.The ratio of urinary microalbumin to urinary creatinine (A/C) increased at post-operation compared with at pre-operation in all 3 groups (P ＜ 0.05),but there was no significant difference between the 3 groups after operation (P ＞ 0.05).The renal function post-operation of patients over 60 years old was as same as that of patients less 60 years old in group T1 (P ＞ 0.05).However,the Ccr level in patients over 60 years old at post-operation was lower than that of patients less 60 years old in group T2 and T3 (P ＜ 0.05).Conclusion Long CO2 pneumoperitoneum could lead to the acute and obvious injury on renal function,especially in the patients over 60 years old.Fortunately,the renal function recovered to be normal gradually in a short time.

Objective To develop a simple microfluidic chip technology for analyzing the electrotaxis of cancer cells . Methods The basic structure of the proposed microfluidic electrotaxis chip included a straight microchannel and liquid storage pools located on both sides of the microchannel .Two platinum electrodes were inserted into the liquid pools to create a controllable direct current ( DC ) field in the microchannel .The distribution and strength of the DC field in the microchannel was analyzed by the finite element analysis software COMSOL multiphysics and experiment tests .Finally, the electrotactic behavior of the rhabdomyosarcoma RD cells in the DC field of different strength was characterized using the accumulated distance, average velocity, x forward migration index ( xFMI) and y forward migration index ( yFMI) as quantitative parameters.Results The results of element analysis and experiments showed that the structure of the designed microfluidic electrotaxis chip was able to guarantee a uniform and strength-controllable DC field in the microchannel .The experiment of cell electrotaxis showed that the RD cells migrated toward the anode of the DC field .Meanwhile , the values of xFMI and accumulated distance for RD cells increased with the enlargement of the DC field , with the strength ranging from 188 to 1320 V/m.Conclusion The microfluidic chip technology developed in this paper for assaying the electrotaxis of cancer cells is simple and easily implementable , and it can be used for studies of the electrotactic behavior and underlying mechanisms of various cancer cells and normal cells in the future .

Objective:To study the expression of SKP2 and MRP-1/CD9 protein in glottic cancer and adjacent tissues,and to analyze its significance for a safe surgical margin.Method:Thirty-eight cases of glottic squamous cell carcinoma were studied for its cancer tissue, tissue 2 mm, 5 mm , and 10 mm away from cancer ,and 10 cases of vocal cord polyp were served as control. SKP2 and MRP-1/CD9 protein were examined by immunoh istochemical method.Result:The positive expression of SKP2 proteins decreased in sequence of polyp mucosa, those adjacent to carcinoma (10 mm, 5 mm, 2 mm ) and cancer tissue, and there was significant difference between them(P<0.05);On the contrary, the positive expression of the MRP-1/CD9 proteins increased in sequence of polypusmucosa, those adjacent to carcinoma (10 mm,5 mm, 2 mm) and cancer tissue,and there was significant difference between them (P<0.05).Conclusion:SKP2 and MRP-1/CD may act as the reference index for judging the biological speciality of LSCC. It is appropriate to regard 5 mm or above 5 mm away from tumors as a safe margin for surgical treatment of glottic carcinoma.

BACKGROUND: The Chinese medicine, Sheng-Ji Ointment, is utilized to cure bone defect due to infectious open fractures in the clinical field. So it was imagined that it was a new inductive factor of osteogenesis and its ingredients could acceleate the proliferation of bone marrow-derived mesenchymal stem cells (BMSCs) and induce them into osteoblasts. In our primary experiment, the Sheng-Ji liquor, which was extracted from the same Chinese herbs with Sheng-Ji Ointment, had been identified that it affected the proliferation of BMSCs with its different concentration.OBJECTTVE: To investigate the effect of Sheng-Ji liquor on the osteogenesis of in vitro cultured BMSCs from rabbit tibia.DESTGN: An observation in single kind of sample.SETTING: Orthopaedic Research Institute of Tianjin Hospital.MATERIALS: The experiment was carried out in the Tissue Engineering Laboratory of Tianjin Orthopadic Institute of Integrated Chinese and Western Medicine from October 2004 to December 2005. BMSCs were obtainedfrom male healthy Japanese long-eared rabbits of 3 months old, (3.5±0.5) kg. Sheng-Ji liquor (5×102 g/L) was extracted from the Chinese herbs with Sheng-Ji Ointment (Tianjin Factory of Chinese Crude-drug and Cut Crude-drug), including the crude drugs of angelica, rehmannia dride rhizome, carapax testudinis, corium elephatis and crinis carbonisatus.METHODS: The Sheng-Ji liquor was put to BMSCs in different concentrations of 25, 8.3, 5 g/L. Basic medium without Sheng-Ji liquor was taken as blank control, while the standard-controlled medium contained the ingredients of the following blank-controlled medium, dexamethasone 10-8 mol/L, vitamin C 0.05 g/L and β-sodium glycerophosphate 10 mmol/L. The BMSCs passaged in different conditions were seeded in plate and cultured for 2-3 weeks, then the mineralized nodes were observed under inverted fluorescence microscope, and the cell expressions were observed with acheomycin labeling and collegan Ⅰ immunohistochemical staining. The culture medium was collected to determine the contents of extracellular and intracellular alkaline phosphatase (ALP), osteocalcin (OCN) and lactate dehydrogenase (LDH), then the ratios of ALP/LDH and OCN/LDH were calculated.MAIN OUTCOME MEASURES: After 2 and 3-week culture, the mineralized nodes, results of acheomycin labeling and collegan Ⅰ immunohistochemical staining, and the ratios of ALP/LDH and OCN/LDH were observed.were prolonged, proliferated assembly and overlapped. The inter-cell limits disappeared gradually and sporadic cellular Results of acheomycin labeling and collegan Ⅰ immunohistochemical staining: There were positive cells and mineralized nodes in all of groups with Sheng-Ji liquor and standard-controlled group. BMSCs of the blank-controlled group were negative. The positive cells and mineralized nodes were green with yellowish color under irrigation of fluorescence; The results of immunocytochemistry for collagen Ⅰ were positive in all of groups with Sheng-Ji liquor and standard-controlled group. The result of blank-controlled group was negative. The positive induced BMSCs had the cytoplasm with granula of highest as compared with the other groups (P ＜ 0.05). The ratios of ALP/LDH and OCN/LDH in the other groups were close (P ＞ 0.05).

Objective To investigate the curative effect of photodynamic therapy on acnes and summarize the nursing measures.Methods Twenty-four acne patients were treated with photodynamic therapy from our hospital.The nursing experience was summarized.Result Nineteen had complete recovery,3 significant improvement,and 2 mild improvement,with a total effective rate of 91.7%.Conclusion Health education on acnes,keeping the patients away from strong sunlight and instructing them to clean skin in a right way and timely treatment of complications are critical for the improvement of curative effect.

Gastrointestinal stromal tumors (GISTs) are relatively common mesenchymal tumors of the digestive tract characterized by c-kit mutations and the stomach is the commonly involved site.Clinical and pathological diagnosis of GISTs can be achieved by B sonography,computed tomography and immunohistochemical detection of marker CD117.Surgical resection of GISTs has been the most effective therapy.Target therapy with tyrosine kinase inhibitors may reduce the development of recurrence or progression of GISTs.The optimized method of diagnosis and treatment of huge GISTs is still controversial.In this paper,the diagnosis and treatment for huge GIST combined with large right inguinal hernia were discussed.