Objective To study the surgical treatment strategy for elderly(aged at 80 years or over)colorectal cancer patients.Methods There were 65 cases of colorectal cancer undergoing Surgical treatment in Beijing Cancer Hospital from 1999 to 2006,and results were analyzed retrospectively.Results In this group of patients.the postoperative morbidity was 53.8%,but anastomotic leakage rate was only 3.9%,operative mortality was 1.5%.Postoperative 1-,3-and 5-year survival rate was 78.92%,27.79%,and 16.32%respectively.Kaplan-meier analysis and Cox regression analysis showed that:the TNM stage of the tumor and preoperative hemoglobin and WBC level were independent prognostic factors,but patients' age,gender,preoperative serum level of CEA and albumin,tumor differentiation,tumor size were not independent prognosis factors.Conclusion Elderly CRC patients have a higher risk of surgical treatment.But with the improvement of perioperative management,the anastomotic fistula and mortality rate were not increased significantly and the result is satisfactory.

Objective To investigate the expression of ?-catenin protein in colorectal cancer. Methods Thirty-six CRC cases underwent radical operation from February 2001 to September 2001, ?-catenin protein expression was studied with immunnohistochemistry. ?-catenin mRNA expression was examined by reverse transcription-polymerase chain reaction (RT-PCR). The correlation between ?-catenin protein expression and CRC clinical pathological factors was studied. Results ?-catenin protein expression was positive in 30 CRC cases ( 83. 3% ) , and 2 cases ( 5. 6% ) in normal colorectal epithelium cells ( P

Objective To evaluate if mucinous subtype has a relevant impact on disease-free survival (DFS) of patients with rectal carcinoma.Methods The clinicopathological data of patients with rectal adenocarcinomas (ring cell carcinoma were excluded)undergoing radical surgery at Beijing Cancer Hospital from Jan 2010 to Jan 2012 were retrospectively studied,survival analysis was done to detect potential prognostic predictors.Results 353 patients with stage Ⅰ-Ⅲ rectal cancer were included in this study,of whom 28 (7.9％) had mucinous histology.The 3-year DFS for patients with a mucinous adenocarcinoma was 50.0％ and 83.4％ for patients with nonmucinous adenocarcinoma (P ＜ 0.001).Mucinous adenocarcinoma was associated with advanced pathologic T (T3/4,100％ vs 52.3％,P ＜0.001) and N stage (N1/2,64.3％ vs.32.6％,P =0.001).More patients were diagnosed under 40 years in mucinous adenocarcinoma group (21.4％ vs.5.5％,P =0.005).Conclusions Patients with mucinous adenocarcinoma more often present at a younger age,mucinous adenocarcinomas are associated with more advanced tumor stages,and should be regarded as a dismal prognostic factor for the survival of patients with rectal cancer.

Objective:To fabricate and to study the surface morphology and biological safety of a novel coating on microarc-oxidized titanium.Methods:The novel functional coating was fabricated by cross-linking the double-layer nanoparticles loading rhBMP-2 and SDF-1 with gelatin on microarc-oxidation coating on titanium implant surface.The surface topography was observed and optimized,and the biological safety of the novel coating was primarily evaluated by cell toxicity test,oral mucosa stimulation test and hemolysis test in vitro.Results:The novel functional coating possesses excellent morphology.The coating showed the cytotoxicity of score 1 and no mucous membrane irritation,the hemolytic rate of the coating was 4.6％.Conclusion:The coating possesses good morphology and biological safety.

Objective To identify if intraoperative injecting carbon nanoparticles (CNP) is a feasible,precise and safe method of sentinel lymph node mapping (SLNM).Methods In this study,63 colon cancer patients from July 2009 to March 2011 were included.1 ml (50 mg) CNP was locally injected into subserosa around the neoplasm intraoperatively.In comparison 90 colon cancer patients underwent radical resection without CNP injection (control group).After operation both SLN and non-SLN were collected and analyzed compared with the lymphnodes collected in control group.Clinical feasibility,detection rate,and sensitivity of the method were analyzed.The categorical variables were analyzed with the Pearson Chi-square or Fisher's exact test,whereas the continuous variables were analyzed with t test,significance was determined as P ＜ 0.05.Results 1640 lymph nodes were detected in 63 patients(with an average 26.0 per case),SLNs were identified in all cases(100％),481 SLNs were collected (with an average 7.6).Totally 198 metastatic lymph nodes were detected in 31 patients (average 3.1),including 34 metastatic SLNs.Total number of lymph nodes and number of metastatic lymph nodes detected in CNP group were higher than those of control group (P =0.000,P =0.001).The sensitivity,accuracy,specificity and false negative rate were 52％,76％,100％ and 48％ respectively.The sensitivity,accuracy,specificity and false negative rate were adjusted to 79％,90％,100％ and 21％ respectively if all T4 stage patients were excluded.Conclusions SLN detection can increase the number of lymph nodes harvested and improve the detection rate of lymph node metastasis.

BACKGROUND:The brachial plexus injury anastomosis suture technique is necessary to understand the mechanics characteristic of brachial plexus nerve stress relaxation.Previous studies mainly focused on single tension mechanics of brechial plexus nerve,but few studies concerning stress relaxation and creeping elasticity.OBJECTIVE:To observe and analyze experimental animal brachial plexus nerve stress relaxation mechanics characteristic in the description manner of function,to provide experimental parameters for clinic.DESIGN,TIME AND SETTING:The experimental observations to use function as a way to describe from 1~(st) to 10~(th_ March,2007 at the Experimental Center of Jilin University.MATERIALS:The experimental male Sprague Dawley rats aged 6 months were provided by Changchun Gaoxin Medicine Animal Experimentation Center.METHODS:The stress relaxation experiment was performed in Experimental animal Brachial plexus Nerve on the the electronic universal testing machine (Shimadzu,Japan).The stress relaxation experiment strain increased speed was 1%/s,setting time of 7 200 seconds.100 empirical data were collected and disposed by one-way linear regression analysis.MAIN OUTCOME MEASURES:The stress relaxation data and curve,the Stress and time change rule were measured.RESULTS:The stress relaxation quantity of animal brachial plexus nerve test specimen at 7 200 s was 0.316 MPa.Stress relaxation curve changed with logarithm.Stress relaxation changed rapidly at 600 seconds,decreased gradually,and reached a balance level at 7 200 seconds.CONCLUSION:The stress relaxation curve changed with the logarithm relations.Brachial plexus has visco-elastic mechanical properties.

Objective To compare the effects of BOSU ball exercise and treadmill walking on lower limbs function in patients after stroke. Methods 40 patients more than 6 months after stroke were randomly divided into BOSU ball group (n=20) and treadmill group (n=20), who accepted BOSU ball or treadmill exercise on the basis of routine rehabilitation. They were assessed with Berg Balance Scale (BBS), 30-s chair stand (CS-30), sit and reach (SR), 6 minutes walk test (6MWT) and modified Barthel Index (MBI) before and 12 weeks after treatment. Results The scores of all the assessment improved in both groups after treatment (P<0.05), and the socres of BBS and MBI improved more in the BOSU ball group than in the treadmill group (P<0.05). Conclusion BOSU ball exercise can improve more of the balance and activities of daily living in post-stroke patient than treadmill walking.

Objective To investigate the efficacy of jet endotracheal tube (JET) designed by Wei (WEI JET) for tracheal intubation.Methods One hundred and two ASA Ⅰ-Ⅲ and Cormack & Lehane grade Ⅰ-Ⅳ patients of both sexes,aged 15-50 yr,weighing 40-99 kg,requiring tracheal intubation under general anesthesia,were randomly allocated into 2 groups (n =51 each):conventional tracheal tube group (group C) and WEI JET group (group WJ).Groups C and WJ were further divided into 2 subgroups according to Cormack & Lehane grade:difficult airway subgroup (n =16) and non-difficult airway subgroup (n =35).The patients were tracheal intubated with the common Kendall endotracheal tube in group C.Jet ventilation (driving pressure 100 kPa,frequency of ventilation 15 bpm,I∶ E =1∶2) was performed and the patients were simultaneously tracheal intubated with WEI JET of the same internal diameter in group WJ.PETCO2 was recorded immediately after mechanical ventilation.The success rate of tracheal intubation at first attempt and time spent were recorded.The complications were also recorded within 24 h after extubation.Results Compared with group C,the intubation time was significantly prolonged,and the success rate of tracheal intubation at first attempt was increased in patients with a difficult airway than that in the patients without difficult airways in group WJ (P ＜ 0.01).There was no significant difference in PETCO2 recorded immediately after mechanical ventilation,intubation time and the success rate of tracheal intubation at first attempt between the patients with a difficult airway and the ones without difficult airways in group WJ (P ＞ 0.05).PET CO2 recorded immediately after mechanical ventilation was significantly higher and the success rate of tracheal intubation at first attempt was lower in the patients with a difficult airway than in the patients without difficult airways in group C (P ＜ 0.01).No severe barotrauma such as pneumothorax,mediastinal emphysema and subcutaneous emphysema occurred in group WJ.There was no significant difference in the incidences of laryngospasm,sore throat,and flatulence between the two groups (P ＞ 0.05).Conclusion WEI JET can not only provide adequate ventilation safely and effectively in patients requiring tracheal intubation under general anesthesia,but also increase the probability of successful tracheal intubation in patients with a difficult airway.

Choledochojejunostomy is a common surgical method for the treatment of organ diseases such as hepatobiliary, gastrointestinal and pancreatic diseases, but there are many complications related to the operation. Benign biliary-enteric anastomosis stricture (BBES) is the most common long-term complication after operation, which seriously affects the quality of life of patients. At present, bile duct reconstruction and endoscopic treatment are the main methods to deal with BBES, but there are some limitations. The new interventional therapy has the advantages of small trauma, good repeatability, high success rate and few complications. It has been applied in many medical centers. The main treatment methods include percutaneous transhepatic biliary balloon dilatation, percutaneous temporary stent placement, percutaneous transhepatic choledochoscopy, magnetic compression anastomosis and intrabiliary ablation. Up to now, there is no uniform standard for the choice of interventional therapy for BBES at home and abroad, so it is of great clinical significance to establish a standardized interventional therapy strategy.

Objective:To explore the clinical efficacy of radical resection for lung metastasis from colorectal cancer and the prognostic factors.Methods:The retrospective cohort study was conducted. The clinicopathological data of 63 colorectal cancer patients with lung metastasis who were admitted to Peking University Cancer Hospital from January 2004 to December 2015 were collected. There were 35 males and 28 females, aged (57±12)years. Patients underwent radical resection for primary lesion and lung metastasis from colorectal cancer. Observation indicators: (1) diagnosis and treatment; (2) follow-up and survival; (3) prognostic factors analysis. Follow-up was conducte by outpatient examination and telephone interview to detect the survival of patients after operation up to December 2018. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages. The Kaplan-Meier method was used to calculate survival rates and draw survival curves. Log-rank test was used for univariate analysis and COX proportional hazard model was used for multivariate analysis. Results:(1) Diagnosis and treatment: of 63 patients with lung metastasis from colorectal cancer, 6 had synchronous lung metastasis and 57 had metachronous lung metastasis. Eighteen cases of suspected lung metastasis were initially detected by chest X-ray, and further confirmed by computed tomography (CT). Forty-five cases of suspected lung metastasis were initially detected by chest CT. All the 63 patients underwent radical resection for primary and metastatic lesions. Two of 22 cases undergoing mediastinal lymph nodes dissection were detected one positive lymph node, respectively. All patients recovered well after operation, without severe complications. There were 57 of 63 patients receiving more than 6 months of postoperative adjuvant chemotherapy and targeted therapy based on fluorouracils. (2) Follow-up and survival: 63 patients were followed up for 8-143 months, with a median follow-up time of 58 months. During the follow-up, 19 of 63 patients died, 24 patients had secondary recurrence with a 5-year recurrence rate of 38.1%(24/63) and a recurrence interval of 18 months(range, 3-58 months). Of 24 patients with secondary recurrence, 19 had lung metastasis, 3 had brain metastasis, 2 had bone metastasis, 2 had liver metastasis; some patients had multiple metastases. Of 24 patients with secondary recurrence, 5 underwent reoperation and 19 underwent chemotherapy and radiochemotherapy. The 5-year overall survival rate of 63 patients was 62.7%. (3) Prognostic factors analysis: results of univariate analysis showed that location of primary lesion, the number of lung metastases and carcinoembryonic antigen (CEA) level before resection of lung metastasis were related factors for prognosis of patients with lung metastasis from colorectal cancer ( χ2=4.162, 7.175, 6.725, P<0.05). Results of multivariate analysis showed that the number of lung metastases and CEA level before resection of lung metastasis were independent influencing factors for prognosis of patients with lung metastasis from colorectal cancer ( hazard ratio=2.725, 2.778, 95% confidence interval as 1.051-7.064, 1.072-7.021, P<0.05). Conclusions:Radical resection for lung metastasis from colorectal cancer is safe and feasible. The number of lung metastases and CEA level before resection for lung metastasis are independent influencing factors for prognosis of patients with lung metastasis from colorectal cancer.