Objective To explore the values of manual anastomosis with two operations out of anus in laparoscopic anal sphincter preserving resection of ultra low rectal cancer. Methods Radical excision of ultra low rectal cancer was performed with ultrasonic scalpel in 12 patients based on the concept of total mesorectal excision (TME) and ultra low coloreclal/anal anastomosis was performed applying manual anastomosis with two operations out of anus. Results All the operations were finished successfully, without conversions to open for surgery. One case had anastomotic leakage, and there were no bleeding and infection of abdominal cavity, anastomotic stenosis and other complications. The operating time was 185-310 (218 ±10) min, the blood loss was 160-450 (232 ±8) ml,the length of hospital stay was 9-14 (11 ±3) d. All patients were followed up 6-36(18 ± 2) months, local recurrence was not found but 1 case had liver metastasis.Conclusions The manual anastomosis with two operations out of anus in laparoscopic anal sphincter preserving resection of ultra low rectal cancer is safe,economical,effective,minimally invasive, and has the benefits of less bleeding during the operation and shorter hospital stay. It should be widely used.

Objective:To study the protective effect of Huangqi Injection on cardiotoxicity induced by doxorubicin (DOX) and its mechanism. Methods: The molders of Dox-induced myocardial mitochondria damage of rat in vitro and Dox-induced cardiotoxicity in mice were used. The protective effect of Huangqi Injection on cardiotoxicity induced by doxorubicin was determined by biochemical method.Results: Doxorubicin can increse malondialdehyde level, induce mitochondrin swelling and decrease glutathione (GSH) content of myocardial mitochondria of rat in vitro, while all these damages caused by doxorubicin were reduced significantly by Huangqi Injection. Cardiotoxicity of doxorubicin in mice as measured by increases of myocardial malondialdehyde level and serum creatine phosphokinase activity, decreases of superoxide dimutase was significantly alleviated by Huangqi Injection. Conclusions: Huangqi Injection can protect heart against Dox-induced cardiotoxicity, which provides experimental evidence for Huangqi Injection as an anti-tumor adjuvant drug in clinical application.

Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS),and analysis the correspondence to conventional images.Methods It was a retrospective case series study.Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled.There were 12 females and 1 male,aged from 22 to 57 years,mean age was 34.5 years.All the eyes underwent fundus color photography,optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF).Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes.The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA.All the eyes were followed up every 1 to 2 weeks,with an average of 16.7 weeks.The characteristic images of SW-FAF and corresponding OCT were studied during follow up.Results MEWDS presented with numerous multiple hyper-autofluorescent spots,sized from 50-500 μm,with a vague boundary in ultra-wide field SW-FAF.These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern.The lesions extended to the mid-peripheral retina as well and became more scattered.The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA.It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well.But the number of the spot showed in FAF is much more than that in FFA,and slightly less than that in ICGA.The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.After the recovery,the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely.Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF.The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph,FFA and ICGA in late-phase.The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.

Objective To discuss the relationship between the substype of peripheral blood CD8 lymphocyte in patients with chronic hepatitis virus B and clinic condition and the replication of HBV. Methods CD45RO, CD45RA and CD28 of peripheral blood CD8 lymphocyte were detected by flow cytometry with multicolor fluorescence technology in 107 patients with chronic hepatitis virus B and 20 healthy volunteers. Results The total quantity of CD8 lymphocyte in patientswith chronic hepatitis virus B was not different from that in controls. The percent of CD3+ CD8+/CD45R0+ cells in patients with chronic active hepatitis was significantly higher than that of the control (15.7?3. 35)% vs( 8. 56?1. 12)% , P

Objective To assess the value of the dynamic enhanced MR (DE-MRI)morphological features in diagnosis of non lac-tation mastitis.Methods We retrospectively studied the breast DE-MRI image data of 1 5 patients with non lactation mastitis con-firmed by pathology were retrospectively studies and the lesion morphological features and distribution were analyzed.Results Amonge 1 5 patients with non lactation mastitis,6 cases were the plasma cell mastitis,5 cases were granulomatous mastitis,2 cases were abscess,and 2 cases were cyst associated with inflammation.The typical features of non lactation mastitis on DE-MRI were fast wash-in,centrifugal enhancement sign,blur boundaries between lesions and normal breast tissue,increasing unilateral vessel sign in diseased breast.Conclusion Breast DE-MRI can show typical morphological features of non lactation mastitis.When dynam-ic information is obtained inconveniently,these are helpful in diagnosing and differential diagnosing non lactation mastitis.

ObjectiveTo study the application of three-dimensional simulated surgical technique in precise hepatectomy. MethodsFrom July 2009 to February 2010, 16 patients with primary liver cancer underwent preoperative simulated imaging and three-dimensional simulation of liver resection.The 3D extent of simulated hepatectomy and actual hepatectomy was compared and analyzed. ResultsThe shape and the extent of the liver resected were very similar in the simulated and the actual hepatectomies. The mean differences in the length, breadth and depth of the remnant livers were 0. 6118 cm,0. 4490 cm and 0. 3199 cm, respectively. ConclusionsSimulation hepatectomy could predict the extent of the actual liver resection, and provided accurate guidance and preoperative planning for precise hepatectomy.

Objective Re stenosis is the common complication of stenting. This study was designed to investigate the functional changes of fibroblast in local re stenosis esophageal tissue after stenting and its relation to re stenosis. Methods Sixteen healthy adult dogs were divided into four groups. Esophageal stent was placed by means of “autogenous broad fascia transplantation and fixation”. At the end of 1,2,4 and 8 weeks,the dogs were killed, and the esophageal tissue with stent were taken out and analyzed by gross observation, light microscopy and electron microscopy. The expression of proliferation cell nuclear antigen (PCNA) and alpha smooth muscle actin (? SMA) in esophageal tissue at 1,2,4 and 8 weeks after stenting were studied by immunohistochemistry. The contents of hydroxyproline and gross amino acid(AA) in re stenosis tissue were measured by amino acid analysis. Results At week 1 and 2 the inflammatory reaction occurred evidently in stented esophagus, with granulation and fibrosis; in some places esophageal tissues began to proliferate towards the lumen. At week 1 some fibroblasts began to express PCNA and ? SMA, and at week 2 the expression augmented significantly. The content of hydroxyproline and AA was significantly higher in the esophageal tissues at 1 and 2 weeks after stenting than that in normal esophagus. At week 4 and 8 esophageal lumen became narrow conspicuously, with a lot of fibrotic tissue and few inflammatory cells. Only a few fibroblasts displayed the expression of PCNA instead of the expression of ? SMA at week 4. There was no expression of PCNA and ? SMA at week 8. The content of AA at week 4 increased significantly compared with that at week 2, and the level was similar between 4 and 8. Electron microscopy revealed that the fibroblasts were in the state of vigorous proliferation and secretion in esophageal tissue at week 2, and a lot of fibrotic tissue formed at week 8. Conclusions Re stenosis mainly expressed as granulation and fibrosis. At week 4 and 8 the fibrosis becomes stable gradually with the lessening of inflammatory reaction. Within 4 weeks of stenting fibroblast retains active proliferation and secretion, but after week 4 the function of fibroblasts gradually lessen or even lose.

Objective To investigate the clinical value of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the treatment and therapeutic effect evaluation of patients with an exacerbation of chronic obstructive pulmonary disease.Methods The levels of serum sTREM-1,procalcitonin (PCT) and C-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay (ELISA) in 49 exacerbation of chronic obstructive pulmonary disease (COPD) subjects [acute exacerbation of chronic obstructive pulmonary disease (AECOPD) group],49 stable COPD subjects(sCOPD group) after treatment and 49 healthy volunteers as healthy control group.The levels of sTREM-1,PCT and CRP in different groups were compared and the relationship between the level of sTREM-1 in AECOPD and sCOPD groups,and PCT,and CRP was analyzed,respectively.Results The content of sTREM-1,PCT and CRP between different groups had significant difference(P ＜0.05).The level of sTREM-1 in both AECOPD and sCOPD groups was significantly positive correlated with PCT (P ＜ 0.05) and negative correlated with CRP (P ＞ 0.05).Conclusions For guiding the treatment and curative effect evaluation of patients with AECOPD,sTREM-1 has important clinical reference value.

Objective To evaluate the efficacy and safety of laparoscopic technique in the treatment of refractory adhesive intestinal obstruction. Methods In a retrospective matched?pair analysis, 68 patients of re?fractory adhesive intestinal obstruction whose relapsed more than 3 times were included in the research. All patients were treated with laparoscopic operation or continued follow?up observation after conservative treatment from Janu?ary 2011 to January 2016. The patients were divided into 2 groups, laparoscopic surgery (32 cases) and observation group (36 cases), to contrast the recurrence rate and safety of the two types of treatment. Results The recurrence rate of laparoscopic surgery group was significantly lower in the observation group (18.8%vs. 77.8%, P<0.05). Re?fractory adhesive intestinal obstruction is further divided into Mixed type, Patchy adhesion type and Cable Belt Com?pression type, in the laparoscopic surgery subgroup analysis, hybrid recurrence rate (66.7%, 4/6 cases) was signifi?cantly higher than that of patchy adhesion type (10.0%, 1/10 cases) and cord compression type (6.3%, 1/16 cases). Conclusion Laparoscopic operation is safe and feasible in the treatment of refractory adhesive intestinal obstruc?tion, and then it can effectively reduce the recurrence rate of refractory adhesive intestinal obstruction;the curative effect is closely related to the type of adhesion.