ObjectiveTo investigate the risk factors for early postoperative cognitive dysfunction (POCD) in elderly patients after colorectal cancer surgery.Methods One hunderd and twenty ASA Ⅱ or Ⅲ patients aged ≥ 65 yr undergoing colorectal cancer surgery were divided into POCD group and non-POCD group according to the results of the Mini-Mental State examination (MMSE) at 7th day after operation.Age,weight,sex,the educational level,anatomical location of the tumor,TNM stages,complications,preoperative TCM syndrome type,duration of anesthesia,emergence time,the blood loss during opertion and the number of intraoperative hypotension were recorded.The cognitive function was assessed at 1 d before operation and at 1,3,7 d after operation using MMSE.The risk factors for POCD were analyzed by multivariate logistic regression analysis.ResultsThe incidence of POCD was 29.2 ％.Logistic regression analysis results indicated that age,the educational level,anatomical location of the tumor and the number of intraoperative hypotension were the risk factors for POCD( P ＜ 0.05).Conclusion Age,the educational level,anatomical location of the tumor and the number of intraoperative hypotension are risk factors for POCD in elderly patients after colorectal cancer surgery.

OBJECTIVETo investigate whether paclitaxel (Taxel) can efficiently induce apoptosis of ACC-2 or not, and to study the relation of apoptosis and arrest of cell mitosis.

METHODSPaclitaxel-induced arrest of cell mitosis and apoptosis of ACC-2 cells in various concentration and different treat time were determined using transmission electron microscope (TEM), fluorescence microscope, flow-cytometry and DNA agarose gel electrophoresis technique.

RESULTSUnder fluorescence microscope, apoptotic cells were green with irregular clumping of nucleus chromatin, or even nuclear chromatin segregation. The typical ultra-structural changes of apoptosis observed by TEM were cell compaction, margination of nuclear chromatin, condensation of cytoplasm, protuberances and apoptotic body. "DNA Ladder" was absent in agarose gel electrophoresis of DNA extracted from culture of ACC-2 cells and paclitaxel-induced ACC-2 cells. "Sub-G(1)" phase peak of ACC-2 cells induced by 50 nmol/L paclitaxel in 48 h and 72 h was 17.13% and 16.26%, respectively. The percentage of G(2)/M phase increased in accordance with raise of the paclitaxel concentration and prolongation of treatment. The typical ultra-structural changes of apoptosis were observed in case that G(2)/M phase was arrested.

CONCLUSIONSPaclitaxel could induce apoptosis of ACC-2 cells. Arrest of G(2)/M phase might induce apoptosis of ACC-2 cells.

Apoptosis ; drug effects ; Carcinoma, Adenoid Cystic ; pathology ; ultrastructure ; Dose-Response Relationship, Drug ; G2 Phase ; drug effects ; Humans ; Mitosis ; drug effects ; Paclitaxel ; pharmacology ; Tumor Cells, Cultured

OBJECTIVETo investigate the clinical and pathological features, optimal treatment and prognostic factors in primary intestinal non-Hodgkin's lymphoma.

METHODSThe clinical presentations, pathological features and therapeutic results of 32 primary intestinal non-Hodgkin's lymphoma were retrospectively analyzed. Statistical analyses were performed with SSPS 10.0 software.

RESULTSThe most frequently site of the lesions in the 32 patients was the large intestine (n = 16, 50.0%), followed by small intestine (n = 8, 25.0%), ileocaecal region (n = 6, 18.8%) and multiple intestinal sites (n = 2, 6.2%). Clinical presentations were as follows: abdominal pain and/or distention (n = 26, 81.2%); abdominal mass (n = 14, 43.8%); diarrhea (n = 12, 37.5%); melena (n = 10, 31.3%); weight loss (n = 10, 31.3%) and fever (n = 8, 25.0%). Twenty-one patients (65.6%) were diagnosed as B-cell lymphoma, 15 (46.9%) were diffuse large B-cell lymphoma. Ten patients (31.2%) were diagnosed as T-cell lymphoma and one (3.1%) as histiocytic lymphoma. Twenty-nine patients were treated initially by surgery with or without chemotherapy, 19 of them (59.4%) achieved complete response. Based on Cox multivariate analysis, stage III - IV, B symptoms and T cell phenotype of the disease were the independent adverse prognostic factors (P < 0.05).

CONCLUSIONThe clinical presentation of primary intestinal non-Hodgkin's lymphoma are not specific clinically. Most of the histological types are diffuse large B-cell type lymphoma. Complete resection combined with chemotherapy may be the best effective approach for treatment of this disease. The prognosis of this disease are correlated with the stage, B symptoms and T cell phenotype.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Intestinal Neoplasms ; drug therapy ; pathology ; surgery ; Lymphoma, B-Cell ; drug therapy ; pathology ; surgery ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; surgery ; Lymphoma, Non-Hodgkin ; drug therapy ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Prednisone ; administration & dosage ; Proportional Hazards Models ; Remission Induction ; Retrospective Studies ; Survival Rate ; Vincristine ; administration & dosage

OBJECTIVETo explore a good way of the reconstruction of severe tibial shaft fractures by using different flaps and external fixators.

METHODSEighty-five patients of Type IIIC tibial shaft fractures with average age of 42.5 years were treated in our hospital from 1990 to 2005. Injuries were caused by motorcycle accidents in 66 patients, by machine accidents in 16 patients, and by stone bruise in 3 patients. The management procedures consisted of administration of antibiotics, serial debridment, bone grafting if needed, application of different flaps, such as free thoracoumbilical flaps, fasciocutaneous flaps, saphenous neurocutaneous vascular flaps, sural neurocutaneous vascular flaps and gastrocnemius muscular flaps, and different external fixations, for instance, half-ring fixators, unilateral axial dynamic fixators, AO fixators, Weifang fixators, and Hybrid fixators. The average follow up was 6.3 years.

RESULTSAll flaps survived. Eighty-three cases had bone healed. The average bone healing time of different external fixations was 5.5 months in 47 cases with half-ring fixators, 9.2 months in 4 cases treated with unilateral axial dynamic fixators, 8.5 months in 6 cases with AO fixators, 10.7 months in 16 cases with Weifang fixators, and 7.8 months in 10 cases with assembly fixators. Except half-ring fixation, other fixations all needed necessary bone graft. Two cases treated with unilateral axial dynamic fixators had nonunion of bone and developed osteomyelitis. The wounds healed after the removal of the fixators and immobilization by plaster. The last follow up examination showed ankle and knee motion was normal and no pain was noted.

CONCLUSIONSThe combination of half-ring external fixators with various flaps provides good results for Type IIIC tibial shaft fractures.

Adolescent ; Adult ; Aged ; Bone Transplantation ; Child ; Child, Preschool ; Debridement ; Female ; Fracture Fixation ; methods ; Fracture Healing ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgical Flaps ; Tibial Fractures ; surgery ; Treatment Outcome