Objective To discuss the feasibility and safety of total mesorectal excision under laparoscopy by ultrasonic scalpel for rectal carcinoma. Methods The data of 83 patients with rectal carcinoma who received gastrointestinal surgery under laparoscopy in our hospital from March 2011 to September 2013 were analyzed. According to the method of total mesorectal excision,they were divided into ultrasound knife group of 44 cases and a high-frequency electric knife group of 39 cases. The differences of the intraoperative and postoperative related index between two groups were compared and the postoperative complications were analyzed. Results All gastrointestinal operations under laparoscopy were completed successfully. The operation time(221. 6 ± 48. 7) min and the peri-operative bleeding (64. 2 ± 39. 5) mL of ultra-sound knife group were significantly lower than the operation time(284. 3 ± 52. 4) min and the peri-operative bleeding (98. 7 ± 49. 3) mL of high frequency electric knife group (P<0. 05). Intraoperative dissected lymph node number (7. 8 ± 2. 7) of ultrasound knife group was sig-nificantly higher than that of the high frequency electric knife group (5. 2 ± 2. 2) (P<0. 05). The difference of anal exhaust time and post-operative hospital stay between two groups was not statistically significant (P>0. 05). The volume of harmful gas included CO and acryloni-trileis at the 15min,30min,45min during the operation of ultrasound knife group were significantly lower than that of high frequency electric knife group (P<0. 05). There was no statistically significant difference in complication rate between the two groups (P>0. 05). Conclu-sion Treatment of laparoscopic surgery for rectal cancer by ultrasonic scalpel in total mesorectal excision has the advantages of less operation time,intraoperative blood loss and less harmful gases,which is effective and safe.

Human resources are the principle factor for survival and sustainable development of hospital libraries, the paper analyzes the status of human resources of hospital libraries in Shandong province where it could reveal the factors that effect human resources construction in hospital libraries, and then puts forward that hospital libraries should be under the management of information department,the leader of library should establish people-oriented concept for human resources construction and the developing trends of human resources construction should be established.

A method based on ultra performance liquid chromatography-tandem mass spectrometry ( UPLC-MS/MS) has been proposed for the determination of coccidiostat residues in chicken skin and fat. The sample was extracted with the combination of methanol, acetonitrile, and acetic acid, and cleaned-up by Sep-Pak tC18 solid phase extraction cartridge. Data acquisition under positive electrospray mode was performed by applying multiple reaction monitoring for both identification and quantification. The limits of detection and quantification for halofuginone and robenidine were 7 μg/kg and 20 μg/kg, respectively. The limit of detection of salinomycin, monensin, narasin, maduramicin, and lasalocid was 5 μg/kg, and limit of quantification was 15 μg/kg. The recovery was 75% to 110% in the spiked concentration range from 15 μg/kg to 200 μg/kg, with intra-day precision lower than 12. 8%, and inter-day precision lower than 13 . 4%.

Objective To analyze the clinical characteristics of antiphospholipid syndrome (APS) in a cohort of Chinese patients. Methods From January 1996 to October 2009, 174 patients with defined APS were retrospectively studied,χ2 test was selected. Results The cohort consisted of 151(86.8%) female and 23 (13.2%) male. Mean age at study was (42±13) years (range: 14-75 years). Thirty-one (17.8%) patients had primary APS, 143 (82.2% ) patients had APS associated with other diseases, including 138 cases of systemic lupus erythematosus (SLE). One hundred and forty-one (81.0%) had thrombosis episodes, among which the most common presenting manifestations were stroke (27.6%), deep venous thrombosis (27.6%) and pulmonary embolism (6.3% ). Stroke was more prevalent in Chinese than European patients. Forty-five patients (31.9%) had thrombotic recurrences and 62 patients (44.0%) had more than two sites of thrombosis. Patients with primary APS had higher rates of rethrombosis than those with secondary APS (P<0.05). Fetal morbidity rate of 126 married women in our study was 50.0%. Seven of APS patients with APS nephropathy were characterized by thrombotic microangiopathy. The presence of anticardiolipin antibodies was detected in 112 patients (64.4% ), anti-beta-2 glycoprotein Ⅰ antibodies in 103 patients (59.1%) and lupus anticoagulant in 50 patients (28.7%). Conclusion APS is characterized by recurrent thrombosis, pregnancy morbidity and positive antiphospholipid antibodies tests. Stroke, deep venous thrombosis and pulmonary embolism are the most common manifestations both in Chinese and European patients. Rethrombosis is more prominent in primary APS. Thrombotic microangiopathy is one of the most common histological changes of APS nephropathy. Multiple tests for aPL are proposed.

Objective To explore the relationship of content of plasma endothelin(ET)-1 with the change of pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Method Thirty cases of the normal people were as group A ,34 cases of the patients with COPD with acute exacerbation before treatment were as group B and the patients with remission period after treatment were as group C,the plasma ET-1,arterial blood gas and pulmonary function parameters were determined from the patients before and after treatment.Results The plasma ET-1 in group B and group C were significantly higher than that in group A,the content of the plasma ET-1 had negatively correlated with PaO2,and that had positively correlated with PaCO2,P＜0.01.The pulmonary function parameters (VC,FEV1/FVC,MVV,V50 V25)in group B were significantly lower than those in group A and group C[(55.3±24.5)%,(54.8±19.3)%,(54.2±16.2)%,(54,8±9,9)%,(58.7±14.5)%;(114.8±24.1)%,(84.9±21.6)%,(86.4±17.2)%,(78.5±14.8)%,(90.3±15.4)% and (110.1±19.4)%,(85.8±15.5)%,(85.9±16.7)%,(74.5±13.4)%,(89.4±18.6)%,respectively],P＜0.01.Conclusion Pathophysiological effects of patients with COPD can be commonly adjusted by the plasma ET-1,oxygen and carbon dioxide retention,which affect pulmonary function.

Objective This study has explored the role of antibody against annexin A2 in patients with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE). Methods Using purified recombinant annexin A2, IgG anti-annexin A2 antibody was measured by ELISA in 101 APS patients, 41 SLE patients with thrombosis, 124 SLE patients without thrombosis and 120 healthy controls. Results The positive rate of IgG anti-annexin A2 antibody in APS patients and SLE patients with thrombosis was 21.8%, 26.8%, respectively, they were all significantly higher than in SLE patients without thrombosis (6.5%). IgG anti-annexin A2 antibody was associated with thrombosis and/or pregnancy morbidity (P<0.01). Conclusion Anti-annexin A2 antibody is associated with thrombosis and/or pregnancy mnrbidity. It suggests that anti-annexin A2 antibody may be helpful in identifying in some potential AIRS.

Objective : To investigate the prevalence of comorbid chronic obstructive pulmonary disease (COPD) and osteoporosis (OP) and its influencing factors among residents aged 40 years and older in Zhangjiagang City, Jiangsu Province, so as to provide insights into prevention of comorbid COPD and OP. Methods: Permanent residents aged 40 years and older were sampled using a multi-stage stratified cluster random sampling method in Zhangjiagang City in 2019, and their pulmonary functions and bone mineral density were measured. The prevalence of comorbid COPD with OP was estimated. The demographic features, smoking, diet, exercises and physical examinations were collected, and factors affecting the prevalence of comorbid COPD with OP were identified using a logistic regression model. Results: Totally 3 140 subjects were enrolled, including 1 315 men (41.88%) and 1 825 women (58.12%), and a mean age of (62.89±9.13) years. A total of 137 subjects were detected with comorbid COPD and OP, with prevalence of 4.36%. The patients with COPD alone included 19 cases with mild, 133 cases with moderate, 87 cases with severe and 26 cases with very severe COPD, and the patients with comorbid COPD and OP included 10 cases with mild, 56 cases with moderate, 56 cases with severe and 15 cases with very severe COPD. The grade of pulmonary functions was higher in patients with comorbid COPD and OP than in patients with COPD alone (Z=-12.304, P<0.001). Multivariable logistic regression analysis identified ages of 65 years and older (OR=2.703, 95%CI: 1.862-3.923), women (OR=2.897, 95%CI: 1.915-4.384) and physical labor (OR=1.540, 95%CI: 1.083-2.189) as factors affecting the development of comorbid COPD and OP. Conclusion The prevalence of comorbid COPD and OP was 4.36% among residents at ages of 40 years and older in Zhangjiagang City, and moderate and severe degree was the predominant grade of pulmonary functions. The elderly, women and physical labors are at a high risk of developing comorbid COPD and OP.

OBJECTIVE: To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit. METHOD: Medical records for 30 patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele, some of them were operated auxiliary incision. Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up. RESULT: All cases were successfully performed surgery without complications after the surgeries, or the majority of symptoms. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay treatment can seriously compromise the recovery of vision impairment. Moreover, the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed. CONCLUSION Endoscopic surgery has effect on nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention,a good understanding of the disease and prompt imaging studies are important.
Adult ; Aged ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucocele ; pathology ; surgery ; Orbit ; pathology ; surgery ; Paranasal Sinus Diseases ; pathology ; surgery ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Young Adult

ObjectiveTo establish pediatric serum CysC reference intervals based on the children's hospital laboratory data in Zhejiang Province and analyse the effects of CysClevels on age and gender. MethodsCysC was one of tests of a routine biochemical screening panel employed for most outpatients and inpatients in the children's hospital, and 8 127 subjects (4 264 boys and 3 863 girls) were selected from 13 567 subjects from laboratory information system according to the exclusion criterion with seriously systemic diseases, cardiovascular diseases, kidney diseases, elevated values of creatinine, urea or ALT for which 1.5-fold upper limit, serum samples with hemolysis, icterus or lipid turbidity, same patients with non-first-time CysC results and living addresses which were not in Zhejiang. The serum CysC was determined by transmission turbidimetry on Roche DPP modular automatic biochemical analyzer. SPSS 17.0 software and EXCEL 2003 were employed for statistical analysis in this study. Results The serum CysC concentration was a Gaussian distribution after log transformation. The mean Log-transformated CysC lg (CysC) concentration of boys in five age groups ( ＜ 1 month, 1 to 3 months, 4 to 11 months, 1 to 2 years and 2 to 16 years) were 0. 224,0. 170,0. 112,0. 061, -0. 011 (mg/L,lg) respectively, and the mean Log-transformated CysC lg(CysC) concentration of girls in five age groups were 0. 222, 0. 164, 0. 089, 0. 057,-0. 010 ( mmg/L, lg) respectively, and no statistically significant differences between Ig( CysC ) and gender in five age groups were found ( t values were 0. 174, 0. 362, 0. 445,- 1. 464 and - 0. 093, respectively,and corresponding P values all were greater than 0. 05 ). The mean lg ( CysC ) concentrations in five age groups were 0. 222,0. 166,0. 100,0. 059, - 0. 010 ( mmg/L, lg), and significant differences between Lg ( CysC ) and ages by Analysis of Variance were observed ( F = 309. 785 and P = 0 in between-groups totally,P = 0 in any two groups). Serum CysC levels were highest in the age of ＜ 1 month, then declined to the age of 2 years and kept stable in the age of 2 to 16 years. The serum CysC reference intervals for children were as follows:0. 95 -2. 92 mg/L in the age of ＜ 1 month, 0. 81 -2.67 mg/L in the age of 1 to 3 months, 0. 65 -2.45 mg/L in the age of 4 tol2 months, 0. 56 -2. 35 mg/L in the age of 1 year and 0. 45 -2. 13 mg/L in the age of 2 to 16 years. ConclusionsThere is no significant effect on pediatric CysC levels with gender but close correlated with age below 2 years old. It is necessary to establish appropriate age-related reference intervals of serum CysC for efficiently evaluating renal function in local children.

Objective To compare the effect of different positive end-expiratory pressures (PEEPs) on the efficacy of volume therapy guided by global end-diastolic volume index (GEDVI) and central venous pressure (CVP) in patients with septic shock.Methods Twenty-five patients with septic shock complicated with respiratory failure,of both sexes,aged 18-64 yr,were enrolled in the study.Their APACHE [[scores were 13-31.The patients were endotracheally intubated and underwent volume-controlled ventilation,PEEP was 5-15 cmH2O,and pulse oxygen saturation was maintained ＞ 90 ％.The patients were divided into low PEEP (5-10 cmH2 O) group and high PEEP (11-15 cmH2 O) group depending on the different PEEP levels.6 ％ hydroxyethyl starch (200/0.5)6 ml/kg was infused over 30 min for volume therapy.Right internal jugular vein or subclavian vein was cannulated for CVP monitoring,and GEDVI was continuously monitored by pulse indicator continuous output monitoring (PiCCO) technology.CVP and GEDVI were recorded before and after volume therapy and the changing rate was calculated.Results Compared with CVP and GEDVI before volume therapy,CVP and GEDVI were significantly increased after volume therapy in low PEEP group (P ＜ 0.05),and GEDVI was increased after volume therapy (P ＜ 0.05) and no significant change was found in CVP after volume therapy in high PEEP group (P ＞ 0.05).Compared with low PEEP group,the changing rate of CVP was significantly decreased (P ＜ 0.05),and no significant change was found in the changing rate of GEDVI in high PEEP group (P ＞ 0.05).Conclusion High PEEP can decrease the efficacy of volume therapy guided by CVP,while exerts no effect on the efficacy of volume therapy guided by GEDVI in patients with septic shock.