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.

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.

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 analyze the mutations of GATA4 gene in Han Chinese patients with atrioventricular septal defect(AVSD)and investigate the association between GATA4 gene and pathogenesis. Methods Ninety-four Han Chinese patients with AVSD were recruited,including 23 patients with Down syndrome and 71 patients without. One hundred healthy age-matched Han children were used as the control. Blood samples were drawn. Encoding region and flanking introns of GATA4 gene were amplified using polymerase chain reaction. The mutations were detected by DNA fragment sequences analysis. Results Three novel missense mutations(c.106C ＞ G,p.P36A;c.259C ＞ T, p.P87S;c.504C ＞ A,p.D168E)of the GATA4 gene were identified in three patients with complete AVSD without Down syndrome,and a fourth novel missense mutation(c.1079A ＞ G,p.E360G)was noted in a patient with complete AVSD and Down syndrome. A polymorphism of the GATA4 gene(c.G99T,p.A33A)from six patients was detected. Conclusions The GATA4 gene might be involved in the etiology of AVSD by functional changes resulting from gene mutation. The low incidence of GATA4 gene mutations in patients with AVSD with or without Down syndrome might suggest that AVSD is a polygenetic disorder.

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 evaluate the effectiveness of volume therapy guided by the response of CVP and global end-diastolic volume index (GEDVI) in septic shock patients.Methods Twenty-three patients of both sexes aged 18-64 yr who had been in septic shock for ＜ 6 h were randomly divided into 2 groups:control group (group Ⅰ,n =12) and study group (group Ⅱ,n =11 ).Tracheal intubation was performed and the patients were mechanically ventilated in both groups.Right internal jugular vein or subclavian vein was cannulated for CVP monitoring and fluid administration.PiCCO catheter was inserted into femoral artery.Normal saline,6％ hydroxyethyl starch 200/0.5,albumin and plasma were infused via CVP line.CVP was maintained ≥8 mm Hg in both groups while in Ⅱ group GEDVI was maintained at 600-750 ml/m2 during resuscitation.Blood samples were taken from artery and CVP line before (baseline) and at 6 h of volume therapy (T2) for determination of blood lactate concentration and central venous oxygen saturation ( ScVO2 ).The changing rate of lactate ( (baseline lactate concentration-lactate concentration at 6 h of volume therapy) ÷ baseline value × 100％ ) and ScvO2 ( ( ScvO2 at 6 h of volume therapy - baseline ScvO2 ) ÷ baseline value × 100％ ) ) was calculated.Results The changing rate of lactate was significantly higher in Ⅱ group than in Ⅰ group.There was no significant difference in the changing rate of ScvO2 between the 2 groups.Conclusion Volume therapy guided by CVP and GEDVI can provide better tissue perfusion than by CVP alone in septic shock patients.

Objective To investigate the changes of serum apolipoprotein A-I and its clinical significance to acute respiratory infection.Method Totally 44 patients with acute respiratory infection were divided into three groups according to various concentration of Serum apolipoprotein A-I.They were procaleitonin(PCT)＜0.5 ng/ml group,0.5 ng/ml≤PCT＜2 ng/ml group and PCT≥2 ng/ml group.We measured apolipoprotein A-I,C-reactive protein,procalcitonin and albumin within 24 hours after admission.Results With the increase of serumPCT,the production of ApoA-I and albumin were down-regulated,while CRP up-regulated.Conclusions Apolipoprotein A-I has a sound relationship with the acute respiratory infection.It can be used as one of the diagnostic criteria in severe infection patients who have disorders of lipometabolism.