ObjectiveTo explore the value of CT virtual endoscopy in the treatment strategies in low rectal cancer surgery.MethodsFifty- seven cases of rectal cancer in Jining First Hospital were collected,preoperative rectum CT virtual endoscopy,detailed records of patients with rectal invasion and the circumstances surrounding lymph nodes were investigated.Differences were compared in patients after routine pathological examination.And the distance of the tumor from the anal margin was compared with the preoperative rectum on rectal examination and rectal CT virtual endoscopy.ResultsPreoperative rectum CT virtual endoscopy had no significant difference in evaluation of metastases of the surrounding lymph nodes.Compared with postoperative pathological examination( x2 =2.5,P ＞ 0.05 ),while had significant difference in evaluation in perirectal infiltration( x2 =4.44,P ＜ 0.05 ).Rectal examination and rectum CT virtual endoscopy had no significant difference judgement of the tumor from the anal margin ( P ＞ 0.05 ).ConclusionsCT virtual endoscopy has a great significance in the preoperative evaluation of rectal cancer surgical treatment strategies,which should be further studied.

Objective To investigate the risk factors of postoperative delirium in elderly patients with intertrochanteric facture.Methods This retrospective analysis was conducted on 256 patients aged over 65 years treated with internal fixation of intertrochanteric facture between January 2012 and December 2013.Incidence and risk factors of postoperative delirium were documented.Results Incidence of postoperative delirium was 14.8％ (38/256).Risk factors of postoperative delirium included body mass index (BMI) less than 20 kg/m2 (P ＜ 0.05),preoperative hemoglobin (Hb) less than 100 g/L (P ＜ 0.05),atrial fibrillation (P ＜ 0.05),low sodium (P ＜ 0.05),preoperative total protein less than 60 g/L (P ＜ 0.05),preoperative waiting time more than 4 days (P ＜ 0.05),preoperative cognitive impairment (P ＜ 0.05),operation time more than 2.5 hours (P ＜ 0.05),perioperation blood loss more than 1,000 ml (P ＜ 0.05),and more than two kinds of medical conditions (P ＜ 0.05).Logistic regression identified three independent factors for postoperative delirium:preoperative waiting time more than 4 days (P ＜ 0.05,OR =2.74),BMI less than 20 kg/m2 (P ＜ 0.05,OR =13.27),preoperative cognitive impairment (P ＜ 0.05,OR =4.47),and operation time more than 2.5 hours (P ＜ 0.05,OR =4.56).Conclusions Risk factors of postoperative delirium in elder patients with femoral intertrochanteric fracture are complicated.Therefore,overall situation should be taken into consideration and comprehensive and effective treatment should be formulated to prevent the occurrence of postoperative delirium.

Objective To explore the nursing after free great toe fibular flap transplant to repair finger pulp defects. Methods 12 cases with finger pulp defect accepted the free great toe fibular flap were reviewed. Results All flaps survived and no vascular crisis occurred. The flap shaped well, and the skin sweated and the two point discrimination was 4-6 mm. Conclusion Close monitoring and appropriate is important after free great toe fibular flap transplant to repair finger pulp defects.

BACKGROUND: Demineralized bone matrix (DBM) has natural mesh pores, good plasticity and biocompatibility. However, the decalcification time in preparation of DBM remains controversial.OBJECTIVE: To compare effects of varying degrees of decalcification with DBM on the proliferation of bone marrow stromal stem cells (BMSCs) so as to provide the best DBM scaffold for cartilage tissue engineeringMETHODS: Rabbit iliac bones were prepared into strips, defatted, followed by 6,12 and 24 hours of decalcification and 2 days of soaking in alcohol to prepare DBM. DBMs were placed in 24-well plates. The third passage of BMSCs at a density of 5×10~9/L were incubated on 24-well plate with DBMs. The DBM porosity and pore size were observed by scanning electron microscopy;BMSCs proliferation on the DBM was determined by MTT, and cell attachment on DBM was observed by scanning electron microscopy.RESULTS AND CONCLUSION: DBM displayed natural high-density porous grid structure, in the presence of bone trabecula,trabecular space and bone luminal system. The porosity and pore size of DBM decalcified for 6,12 and 24 hours were similar (P > 0.05). Compared with decalcified for 12 and 24 hours, BMSCs attached to DBM decalcified for 6 hours more closely and the DBM showed better compatibility. SEM observation showed the BMSCs on DBMs decalcified for 6 hours proliferated stably after 8 days and applicable for transplantation. Moreover, the number of cells were significantly more than DBMs decalcified for 12 and24 hours (P< 0.01).

BACKGROUND: Demineralized bone matrix (DBM) having a great biocompatibility is a common material to repair bone defect in clinic Bone marrow stromal cells (BMSCs) which can differentiate into bone and cartilage cells are ideal for repairing cartilage defect. OBJECTIVE: To observe the effects of allograft DBM combined with autograft BMSCs on repairing the articular cartilage of rabbits. METHODS: Bone and cartilage defect was induced in 27 rabbits and the models were randomly divided into combined group (DBM combined with 8-day-curtured autograft BMSCs), DBM group (DBM implantation alone), and control group. The reparative tissue samples were evaluated grossly, histologically, and immunohistochemically. The repairing effect was evaluated by Wakitani's score system.RESULTS AND CONCLUSION: The repaired tissues were hyaline cartilage-shaped, smooth and glossy, and well combined with peripheral cartilage and subchondral tissues at 12 weeks after implantation in the combined group; some tissues were cartilage-likely repaired in the DBM group; a few of tissues were fiber-like repaired in the control group. Immunohistochemical staining showed that type Ⅱ collagen was positive in both combined and DBM groups. Repaired cells which could express type Ⅱ collagen were cartilage cells. However, the expression of type Ⅱ collagen was negative in the control group. At 4,8, and 12 weeks after implantation, the scores in the combined group were significantly higher than in the DBM and control groups (P < 0.01), suggesting that DBM/BMSCs complex could be an efficient graft to repair the articular cartilage defects.

Objective:To analyze the diagnostic value of sex hormone combined with carcinoembryonic antigen on lymph node metastasis in breast cancer patients.Methods:52 cases of breast cancer patients who underwent surgical resection were collected and divided into non-metastasis group and metastases group after axillary lymph node ultrasonography. The blood samples was collected from patients and the levels of serum estradiol, testosterone, progesterone and carcinoembryonic antigen were detected; The diagnostic value of the above indexes in patients with lymph node metastasis was analyzed; Logistic risk regression model was used to analyze the independent risk factors for lymph node metastasis after surgical resection.Results:There were significant differences between the non-metastatic group and the metastatic group in the largest tumor diameter and menopause (all P<0.05), but there were no significant differences among other general data (all P>0.05). The serum estradiol level in the non-metastatic group was (153.97±35.55) pg/ml, the progesterone level was (0.33±0.05) ng/ml, and the carcinoembryonic antigen level was (11.44±3.77) ng/ml, while the estradiol level in the metastatic group was (207.19±52.11) pg/ml ( t=4.13, P<0.001), progesterone level (0.38±0.04) ng/ml ( t=4.01, P<0.001), carcinoembryonic antigen level (15.41±3.46) ng/ml ( t=3.94, P<0.001). The above three indicators were significantly increased in patients in the transfer group. The area under the curve of estradiol was 0.83, the area under the curve of progesterone was 0.80, the area under the curve of carcinoembryonic antigen was 0.77, the area under the curve of the combination of the three was 0.85, and the area under the curve of the combination of the three was the largest. Logistic risk regression model showed that estradiol, progesterone, and carcinoembryonic antigen levels were independent risk factors affecting lymph node metastasis in breast cancer patients (all P<0.05) . Conclusion:The sex hormone estradiol, progesterone combined with carcinoembryonic antigen has a high diagnostic value for lymph node metastasis in patients with breast cancer, and can independently predict the occurrence of lymph node metastasis in breast cancer patients.

Renal glomus tumor is rare, and this report describes two cases of it. Two patients, aged 37 and 60 years old, were admitted to the hospital due to renal masses discovered during physical examinations. Both cases underwent preoperative ultrasound and CT examinations, which revealed a left kidney tumor and a fully endogenous renal tumor in the left kidney, respectively. Subsequently, they received appropriate surgical interventions, with one case undergoing radical nephrectomy and the other undergoing laparoscopic partial nephrectomy. Postoperative pathology revealed a glomus tumor and a glomus tumor of undetermined malignant potential, respectively. No recurrence or metastasis was observed in either case. At the 121-month and 14-month follow-up, respectively, there was no evidence of recurrence or metastasis.

Plain combined with three-phase contrast-enhanced CT is the most commonly used imaging technique for the diagnosis of renal masses, and it also plays an important role in predicting the malignancy and aggressiveness of renal tumors. The pathological findings of renal tumors are important in determining treatment options as well as prognosis. This article reviews current research and summarizes common CT variables for renal tumors, including tumor diameter, growth rate, enhancement characteristics, tumor margins, the proportion of cystic components, and variables related to the R. E.N.A.L. score. This paper aims to analyze the role of these variables in predicting the pathological malignancy and aggressiveness of the renal tumor.

OBJECTIVETo investigate the expression of TMEM16A in gastric carcinoma and its clinical implications.

METHODSA total of 72 surgical specimens of gastric carcinoma were collected for examination of TMEM16A expression with immunohistochemical staining.

RESULTSTMEM16A expression was detected in the cytoplasm and cell membrane of the tumor cells. Of the 72 specimens of the tumor tissues, the total positivity rate of TMEM16A expression was 80.56% (58/72), significantly higher than the rate in the adjacent tissues (4.17%, 3/72, P<0.005).

CONCLUSIONAberrant expression of TMEM16A occurs in the majority of gastric carcinoma cases. TMEM16A can be used as a new candidate target for diagnosis and treatment of gastric carcinoma.

Adult ; Aged ; Anoctamin-1 ; Carcinoma ; metabolism ; pathology ; Chloride Channels ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

Objective:To analyze clinical and imaging features of Sturge-Weber syndrome in children.Methods:Clinical data were collected from 27 children with Sturge-Weber syndrome in Xuzhou Children′s Hospital, Xuzhou Medical University from July 2013 to December 2019, and analyzed retrospectively.Results:Among the 27 children, 17 were males and 10 were females. Their age at the clinic visit ranged from 2 days to 10 years and 7 months, and averaged 2.54 years. All the 27 patients presented with facial port-wine stains of varied color from light red to purple red, which were all distributed across the facial midline, including 21 with predominantly unilateral port-wine stains and 6 with bilateral symmetrical port-wine stains. There were 17 patients with ocular choroidal vascular malformations, including 14 with congenital glaucoma, 5 with high intraocular pressure, and 1 with optic nerve atrophy accompanied by transient blindness. Neurological impairment occurred in 12 patients, and all manifested as epilepsy. All the 27 children underwent imaging examination, and abnormalities were found in 20. Among the 10 patients with abnormal computed tomography images, local calcification was observed in 8, and local thickening of the skull on the side affected by skin lesions in 8; 13 of 14 patients with abnormal magnetic resonance imaging scan results had signs of brain atrophy, 9 showed enhanced gyrus-like blood vessel formation by enhanced magnetic resonance imaging, and 5 showed decreased branches of the anterior and middle cerebral artery on the affected facial side by magnetic resonance angiography.Conclusions:Children with Sturge-Weber syndrome are clinically characterized by predominantly unilateral port wine stains on the face, some of whom are accompanied by epilepsy, glaucoma or mental retardation, and imaging examinations mainly show local calcification, brain atrophy, local thickening of the skull plate, enhanced gyrus-like blood vessel formation, etc. Early definite diagnosis and comprehensive systemic treatment are needed to reduce disability and mortality rates in patients with Sturge-Weber syndrome, and long-term follow-up should be considered.