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 This study is to evaluate the advantages between percutaneous and peratrial device closure of secundum atrial septal defects(ASD) under single transesophageal echocardiographic (TEE) guidance.Methods From December 2010 to December 2012,53 patients with the ASD of≤25 mm in diameter underwent percutaneous device closure under simple TEE guidance(the percutaneous group).The device was implanted through the femoral vascular access.Fifty patients with similar age and similar-sized ASD to the percutaneous group,were selected from 350 consecutive patients who underwent peratrial device closure of ASD and assigned to the peratrial group.The ASDs were occluded through a right minithoracotomy approach.The success rate,intracardiac manipulation time,procedural time,postoperative stay and the follow-up results were recorded.Results When the maximum diameter of ASD was ＜ 20 mm,the success rate of both groups was 100％.When the ASD diameter was 20 mm but 25 mm,the success rate was 84％ in the percutaneous group and 100％ in the peratrial group.Three patients failed in the percutaneous group with the ASD diameter of 20 mm and the aortic rim of 3 mm.They were successfully converted to peratrial device closure.The average intrcardiac manipulation time was(20±7) minutes in the percutaneous group and (5 ± 6) minutes in the peratrial group(P ＜ 0.05).The average procedure time was(24 ± 7) minutes in the percutaneous group and (39 ± 6) minutes in the peratrial group(P ＜ 0.05).The postoperative hospital stay was (3.0 ± 0.8) days in the percutaneous group and(4.7 ± 1.5) days in the peratrial group(P ＜ 0.05).Conclusion The percutaneous device closure of ASD under simple TEE guidance is feasible,safe,and efficacious in patients with the ASD diameter of ≤25 mm.It has the advantages of less trauma,less procedural time,shorter hospital stay and better cosmetic results.However,when the ASD diameter was 20 mm and the aortic rim was 3 mm,the peratrial approach may be a better choice.

Objective: To analyze the association between the concentration of metalloestrogens ( MEs ) in seminal plasma and sperm quality in infertile patients, so as to provide the basis for the study of MEs on human sperm quality. Methods: The spermatozoa concentration, progressive rate ( PR ), normal morphology rate ( NMR ) and DNA fragmentation index ( DFI ) were determined in the infertile male patients from Zhejiang Provincial People's Hospital from March to April, 2020. The contents of As, Cd, Co, Cr, Cu, Hg and Ni in seminal plasma were determined by inductively coupled plasma mass spectrometry ( ICP-MS ). The distribution of MEs in seminal plasma and the sperm quality in different concentration of MEs ( grouped by quartiles ) were analyzed. Results: Among 105 cases recruited, 28 cases were normal in sperm parameters and 77 cases were abnormal, including 22 cases of oligospermia, 47 cases of asthenospermia, 54 cases of dysspermia and 30 cases of abnormal DFI. As, Cr, Cu, Hg and Ni were detected in all samples, the detection rates of Cd and Co were 78.57%-90.91%. Compared with the normal group, the concentration of As in oligospermia group was higher [( 18.96±12.56 ) µg/L vs. (13.67±4.19) µg/L, P<0.05],the concentration of Cr was higher in asthenospermia, dysspermia and abnormal DFI in Q3 and Q4 groups groups [( 386.62±81.92 ), ( 378.02±81.46 ), ( 393.88±77.03 ) µg/L vs. ( 343.12±55.08 ) µg/L,P<0.05]. The PRs in Q3 and Q4 groups of Cr were lower than that in Q2 group [( 32.95±18.22 )%, ( 27.74±22.77 )% vs. ( 54.18±24.64 )%, P<0.05], the DFI in Q3 and Q4 groups was higher than that in Q2 group [( 26.91±14.77 )%, ( 29.91±16.93 )% vs. ( 9.87±10.93 )%, P<0.05], and the NMR in Q4 group was lower than that in Q2 group [( 1.62±1.72 )% vs. ( 3.36±1.97 )%, P<0.05]. The concentration of sperm in Q3 group of Cu was higher than that in Q2 group [( 115.87±88.22 )×106/mL vs. (61.91±66.16)×106/mL, P<0.05]. Conclusion As and Cu in seminal plasma are associated with abnormal sperm concentration, and Cr is associated with NMR, PR and DFI.

Twenty-four compounds in the fruits of Forsythia suspensa were isolated and purified by column chromatography and preparative TLC. On the basis of comprehensive spectroscopic methods including IR, ESI-MS/MS, 1D and 2D NMR, these compounds were identified as ten ceremides (1-10), six triterpenes (11-16), one steroids (17), three flavonoids (18-20), two C6-C2 alcohols (21-22) and two lignans (23-24). Compounds 1-10 were reported from F. suspense for the first time, among which 1, 2, 4 and 5 were new ones.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Forsythia ; chemistry ; Fruit ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure

OBJECTIVETo study on the differences of metabolites in the blood of rats after injection or oral administration of volatile oil in Houttuyniae Herba and of 2-undecanone in order to validate hypothesis of network compatability and to establish the theoretical foundation of elucidating metabolic mechanism for multiple constituents in Chinese Material.

METHODA gas chromatography-mass spectrometry method was employed for qualitative determination of the metabolites in blood of rats by injection or oral administration of volatile oil in Houttuyniae Herba and of 2-undecanone, which were compared with the differences between binary two drugs as well as two administration.

RESULTThere were 45 kinds of ingredients in volatile oil for original materials for Houttuyniae Herba, and 53, 69 kinds of metabolites were detected in blood of rats for oral administration of volatile oil in Houttuyniae Herba, and 2-undecanone, respectively, whereas 52, 42 kinds of metabolites were detected for injection administration. Although there were various constitutes, i. e. single versus multiple ingredients, administrated by various ways, i. e. oral versus injection, the metabolites were so similar with each manners, in which alpha-pinene and beta-myrcene occurred in two constitute forms and two administrations, while there were 18, 13 kinds of ingredients for oral or injection administration of volatile oil in Houttuyniae Herba, i. e. 34%, 25% of total ingredients, respectively, and 17, 15 kinds of ingredients, i. e. 24.6%, 35.7% for that of, 2-undecanone, respectively, on average of 29.8% that suggested one of third as co-metabolites.

CONCLUSIONThere are network compatibility existed in metabolism of the houttuynia volatile oil in rats, and similar metabolic pathways in accordance with original plant, among their ingredients no matter alone or multiple constitute forms and oral or injection administration.

Administration, Oral ; Animals ; Gas Chromatography-Mass Spectrometry ; Herb-Drug Interactions ; Houttuynia ; chemistry ; Injections, Intravenous ; Ketones ; administration & dosage ; pharmacokinetics ; Oils, Volatile ; administration & dosage ; pharmacokinetics ; Plants, Medicinal ; chemistry ; Rats

Objective: To investigate the regulatory mechanism of long non-coding RNA (lncRNA) 53106 in the apoptosis model of MIN6 cells stimulated by cytokines. Methods: The stimulation model of cytokines 10 ng/ml interleukin-1β, 50 ng/ml tumor necrosis factor-α, 50 ng/ml interferon-γ in MIN6 islet cell lines were established. The apoptosis rate was measured by flow cytometry and the expression levels of lncRNA53106 and (C-X-C motif) ligand (CXCL)10 were detected by realtime quantitative PCR (qPCR). LncRNA53106 smart silencer and CXCL10 siRNA were constructed, and lncRNA53106 and CXCL10 were knocked down respectively. Then inflammatory cytokines were combined to stimulate, and their roles in the apoptosis of min6 cells were detected by flow cytometry, qPCR, and Western blotting. Results: In the apoptosis model of MIN6 cells stimulated by cytokines, the apoptosis rate of cytokines group was significantly increased and reached statistical significance. The apoptosis rate of the knocked down lncRNA53106 group was significantly lower than that of the control group (P<0.05). The expression of CXCL10 was also decreased in the knockdown group by qPCR and Western blotting, the expressions of the apoptosis-related factors Bax and Caspase3 mRNA were decreased. The apoptosis rate in the knocked down CXCL10 group was significantly lower than that in the control group (P<0.05), and the expression of lncRNA53106 was slightly increased, but the difference was not significant (P=0.61). Conclusion LncRNA53106 may promote the expression of apoptosis factor by upregulation of CXCL10, and promote the apoptosis of β cells of the pancreas, which may lead to the occurrence of type 1 diabetes.