Objective:To introduce the method of cylindrical abdominoperineal resection(APR)for low rectal cancer.Methods:Cylindrical APR was performed for 6 patients with advanced ultralow rectal cancer according to standard protocol in Stockholm from February to May in 2009.The procedure involved careful mobilization of the mesorectum as low as the origins of the levator muscle.After stoma formation,the abdomen was closed,the patient was rotated into the prone position,and an extended perineal dissection was performed.This included the sphinctercomplex and followed the inferior surface of the levators to a point laterally where they originated on the pelvic sidewall.This point should be just inferior to the level where the abdominal procedure was terminated.Results:The cylindrical technique removed more tissue in the distal rectum.There was no bowel perforation,perineal wounds were uneventfully.One patient developed perineal seroma.One patient developed peritoneocele hernia of pelvic floor.Conclusion:Cylin-drical APR performed in the prone position for low rectal cancer removes more tissue around the tumor that leads to a reduction in CRM involvement and intraoperative perforations,which should reduce local disease recurrence.

OBJECTIVE To validate the anticancer effect of Angong Niuhuang pill (AGNH) and pinpoint associated molecular mechanisms using human cancer cells.METHODS Human MGC-803 gastric carcinoma and human BEL-7402 hepatocarcinoma cells were incubated with AGNH 9,30,90,300 and 900 mg·L-1 for 24,48and 72 h,respectively.Cell viability was detected with 3-(4,5-dimethylthiazol-2-yl) -5-( 3-carboxymethoxyphe-nyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay and colony formation assay.Apoptosis was measured with flow cytometry and Hoechst 33258/PI staining.Change in mitochondrial membrane potential (△qψ) was detected by spectrofluorophotometer.RESULTS AGNH inhibited MGC-803 cell proliferation ( for 48 h,r =0.996,P =0.002; for72 h,r=0.756,P=0.024 ) and BEL-7402 cells (for 48 h,r =0.732,P=0.030; for72 h,r=0.702,P =0.037) in a concentration-dependent manner,as showed by MTS assay.AGNH inhibited colony formation on MGC-803 cells (r =0.914,P =0.011 ) and BEL-7402 cells (r =0.871,P =0.024) in a concentration-dependent manner for 24 h.Hoechst 33258/PI staining and flow cytometry assay showed that AGNH 900 mg·L-1 for 24 h induced apoptosis of MGC-803 and BEL-7402 cells,and the apoptosis rate was 27.2％ and 19.7％,respectively.Compared with normal control group,AGNH 900 mg·L-1 for 3 min decreased the mitochondrial membrane potential of MGC-803 and BEL-7402 cells to 15.9％ and 15.0％ of control group.CONCLUSION AGNH inhibits proliferation of human cancer cells.Apoptosis and depolarization of mitochondrial transmembrane potential are probablly its mechanism.

Objective To decrease tumor local recurrence after abdominoperineal resection (APR)for low rectal cancer using cylindrical abdominoperineal resection. Methods From February 2009 to February 2010 cylindrical APR was performed in 15 patients of advanced ultralow rectal cancer at the Department of General Surgery, Qilu Hospital of Shandong University, according to the standard protocol as described by Holm. The procedure involves careful mobilization of the mesorectum as far down as the origins of the levator muscle. Ater stoma formation, the abdomen is closed, the patient is rotated into the prone position, and an extended perineal dissection is performed. This includes the sphincter complex and the inferior surface of the levators to a point laterally where they originate on the pelvic sidewall. This point should be just inferior to the level where the abdominal procedure was terminated. The coccyx is often removed in continuity with the main specimen to improve direct visualization of the dissection.Results The cylindrical technique removed more tissue in the distal rectum. There was no bowel perforation, perineal wounds were primary healing. One patient developed perineal seroma. One patient developed peritoneocele hernia of pelvic floor. Conclusions Cylindrical APR performed in the prone position for low rectal cancer removes more tissue around the tumor that leads to a reduction in intraoperative perforations, which should reduce local disease recurrence.

Objective To explore the influence of inhaled glucocorticosteroid on ?-glutamylcysteine synthetase(?-GCS) in inflammatory cell of sputum in children with asthma.Methods Twenty-two asthmatic children were divided into 2 groups according to treatment.The children who were treated by inhaled budesonide combined with salbutamol were due to group A and the others inhaling salbutamol only were due to group B,the healthy children were acted as healthy control group(group C).The glutation(GSH),total GSH and the activity of ?-GCS in sputum were measured respectively;Expression of ?-GCS in inflammatory cell of sputum were detected by immunohistochemistry;the expression of ?-GCS heavy chain(?-GCS-h) mRNA were detected by reverse transcriptase-polymerase chain reaction(RT-PCR).Results 1.The total GSH[(1.08?0.14) ?mol/L] and oxidized glutathione(GSSG)[(0.37?0.09) ?mol/L] were decreased in sputum of group A of post-treatment compared with pre-treatment(Pa

Objective To study the stability of micro-implant orthodontic anchorage(MA)with different pitch in the case of immediate loading.Method Employing 3D finite element analysis method,the stress and dis-placement distribution on the bone interface of MIA with different pitch(0.3 mm、0.5 mm、0.7 mm and 1.0 mm,respectively),which was 1.47 N loaded vertically in the major axis direction,were analyzed.Result The pitch affected the stress distribution significantly,because the maximum stress increased with the pitch decreasing and the impact of pitch on stress distribution on neck and central locations of MIA were different;to decrease the pitch could reduce the max displacement of the jaw,but the impact of pitch on displacement distribution of MIA was not significant.Condusions In the case of immediate loading.MIA with pitch 0.5 mm-0.7 mm is suggested to be selected as orthodontic anchorage in the clinic.

Objective To study the stability of micro-implant orthodontic anchorage(MA)with different pitch in the case of immediate loading.Method Employing 3D finite element analysis method,the stress and dis-placement distribution on the bone interface of MIA with different pitch(0.3 mm、0.5 mm、0.7 mm and 1.0 mm,respectively),which was 1.47 N loaded vertically in the major axis direction,were analyzed.Result The pitch affected the stress distribution significantly,because the maximum stress increased with the pitch decreasing and the impact of pitch on stress distribution on neck and central locations of MIA were different;to decrease the pitch could reduce the max displacement of the jaw,but the impact of pitch on displacement distribution of MIA was not significant.Condusions In the case of immediate loading.MIA with pitch 0.5 mm-0.7 mm is suggested to be selected as orthodontic anchorage in the clinic.

At present, there is no cure for acquired immune deficiency syndrome (AIDS) due to HIV-1 latent reservoirs. Therefore, it urgently requires novel HIV-1 latency-regulating agents with high potency, low toxicity and favorable drug-like properties to achieve a functional cure for AIDS. Herein, we reviewed the advances in HIV-1 latency-regulating agents since 2019, including the drug discovery strategies, bioactivities, and mechanisms of these compounds. It is of great guiding significance in the development of latency-regulating agents with clinical value.

Objective : The patients with inguinal hernia were treated with plug mesh hernia repair. Methods:The hernia sacs were isolated and dissected back to the internal ring. The unoperated sacs were allowed to drop back through the internal ring into the abdominal cavity. A cone-shaped mesh hernia plug is inserted tapered end through ring and placed into position just beneath the crura. All our repairs were reinforced a second piece of flat was placed from the pubic tubercle, overlying the direct space. Results : Com-paired with conventional suture surgical techniques, a plug repair uses less disscection and ensures tenssion free hernioplusty. Conclusion : We believe that the two factors are the most important reseasons for greater patients confort, rapit rehabilitation, decreased recurrence and lessened overall complication rates with the mesh hernia plug techniques.

OBJECTIVETo explore the effect of transforming growth factor alpha (TGFalpha) on the expression of cyclin E and D1 in gastric carcinoma cells.

METHODSHuman gastric adenocarcinoma SGC7901 cells were cultured routinely and synchronized at G(0)/G(1) phase in serum-free RPMI-1640. The percentage of the cells at G(0)/G(1) phase was detected by propidium iodide staining and flow cytometry (FCM), and the synchronized cells were cultured in RPMI-1640 supplemented with 2.5% calf serum and treated with 10, 30, and 50 microg/L TGFalpha for 5 h. The expression of cyclin E and D1 in SGC7901 cells was detected by immunofluorescent staining and FCM.

RESULTSThe percentage of the cells at G(0)/G(1) phase increased from 54% in routine culture to 72% in the serum-free RPMI-1640 culture. TGFalpha treatment of the cells synchronized at G(0)/G(1) phase induced significant increment of cyclin E and D1 expressions (P<0.001), and at the dose of TGFalpha of 50 microg/L, their expressions increased by 25.18% and 27.52%, respectively (P<0.001).

CONCLUSIONTGFalpha can increase the expression of cyclin E and D1 in gastric carcinoma cells to promote their cell cycle progress.

Adenocarcinoma ; metabolism ; pathology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cyclin D1 ; biosynthesis ; Cyclin E ; biosynthesis ; Flow Cytometry ; Fluorescent Antibody Technique ; Humans ; Stomach Neoplasms ; metabolism ; pathology ; Transforming Growth Factor alpha ; pharmacology

BACKGROUNDThe technique of intersphincteric resection of tumors combined with coloanal anastomosis has been used to avoid permanent colostomy for patients with a rectal cancer located < 5 cm from the anal verge. This study aimed at assessing the preservation of continence function of the residual rectum and the clinical prognosis of patients with lower rectal cancer after intersphincteric resection using a prolapsing technique.

METHODSThis study included patients with the following inclusion criteria: (1) pathological evidence of rectal cancer and the tumors within distal margins located 5 cm or less from the anus by preoperative endoscopic examination; (2) no evidence by MRI of infiltration of either the external sphincter, puborectalis or the levator muscle; (3) the patients are eligible for intersphincteric resection and lower coloanal anastomosis with a preoperative biopsy showing the tumors with well-to-moderate differentiation. From January 2000 to June 2004, 23 patients with low rectal cancer were included in this study. We used the standard abdominoperineal approach to perform radical resection of tumors with excision of the mesorectum and total or part of the internal sphincters. The patients were followed for assessment of the function of the residual rectum and of cancer recurrence after the operations.

RESULTSThe median tumor distance from the anal margin was 4.5 (range 3.5 - 5.0) cm and the mean distal surgical margin 1.6 (range 1.0 - 2.0) cm. Cancer was classified into Stage I (30.4%), Stage II (47.8%), and Stage III (21.7%) according to the TNM classification. Two patients developed anastomotic fistula after the surgical resection and 2 patients (8.7%) developed later stages of anastomotic stricture at the site of coloanal anastomosis. The median follow-up period was 31.5 months (range 12 - 54) and 2 patients (8.7%) developed local recurrence. Three deaths were associated with distal organ metastasis. Twenty patients (87.0%) have maintained competence to control solid or liquid stool and the capacity of flatus continence after the surgery. Among these patients, 2 patients were able to control solid stool and occasionally lose continence of liquid stool. And only 1 patient (4.4%) has retained partial rectum function with good continence of solid stool but not liquid after the operations. Average times of defecation per day of 3, 6, 12, 24 and 36 months after the surgery were 13.1, 4.7, 3.1, 2.9, and 3.2 times/day. Anal manometer measurements showed a decrease of pressure during the resting time after intersphincteric resection and this change remained during the period of follow-up. The maximum squeeze pressure was improved after an initial decrease after the surgery.

CONCLUSIONSMore residual rectum function after the surgery may be preserved by intersphincteric resection of low rectum cancer. At the same time this technique is safe with few postoperative complication and low tumor recurrence after the surgery.

Digestive System Surgical Procedures ; methods ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Prognosis ; Rectal Neoplasms ; mortality ; pathology ; physiopathology ; surgery ; Rectum ; pathology