BACKGROUND: The occurrence of sexual and urinary dysfunction is higher in patients who have received rectal cancer surgeries. This could most likely be correlated with the age of the patients and the approach applied in the operation. Therefore, how to preserve the sexual and urinary functions has become a hot point in this field.OBJECTIVE: This study was designed to investigate the influence of differences in age and therapeutical approach on the sexual and urinary function in patients with rectal cancer.DESIGN: Investigation study on patients.SETTING: General Surgery Department, the 309 Clinical Division, General Hospital of Chinese PLA.PARTICIPANTS: Some male patients with rectal cancer hospitalized in the General Surgery Department, the 309 Clinical Division, General Hospital of Chinese PLA were involved from January 1999 to October 2000. All of the 79eligible patients had received a radical surgery for rectal cancer by the time of study. Their sexual and urinary function before surgery were normal and an over-2-year follow-up after surgery was conducted on each of them. The two groups, which were classified into two groups according to surgical ap-proaches they received, contained comparable quantity of sampling and age distributions, which prompts the validity of the comparison.METHODS: By distributing follow-up letters, outpatient inquiries and phone call investigations; the follow-up was conducted to evaluate the sexual functions in these patients, including their penile erection and ejaculation. The erectile function was assessed according to the International Index of Erectile Function Questionnaire-5 (IIEF-5). The assessment on ejaculation was based on whether the patients had a sexual climax and whether they can ejaculate. The definition of urinary function consisted of both short-term and long-term urinary functions.MAIN OUTCOME MEASURES: The sexual desire, erectile function, ejaculation and the urinary function in patients within different age brackets.RESULTS: After Miles operation, 81% patients developed sexual dysfunction, 46% got short-term urinary dysfunction(19/41) and 5 % (2/41) had long-term urinary dysfunction. While after Dixon operation, 55% patients had sexual dysfunction, 29% (11/38) had short-term urinary dysfunction, and none of the patients had long-term urinary dysfunction. The difference between the outcomes of the two operations was significant( P ＜ 0. 05) .Sexual dysfunction occurred at a rate of 38% in the less-than-40 age bracket, 60% in the 40-to-59 age bracket, and 96% in the over-60 age bracket. The overall differences between different pairs of age brackets were significantly ( P ＜ 0. 05 ).CONCLUSION: There is a high rate of postoperative sexual and urinary dysfunction in male population. The age of patients and the approach adopted in the surgery are directly correlated with the rate of dysfunction. An autonomic nerve-preserving radical operation for rectal cancer can reduce the occurrence of sexual and urinary dysfunction effectively.

Objective To evaluate the legitimate of regional artery infusion chemotherapy in the treatment of gastric carcinoma. Methods　The pharmacokinetics of 5-Fu after different route of administration was studied. Results High concentration of 5-Fu found in portal vein via left-gastric intra-artetial administration were 4-40 folds higher than the group via intravenous administration.The time of high concentrations of 5-Fu via left-gastric intra-arterial administration maintained significantly longer than by intravenous administraion. The concentration of 5-Fu in tumor tissues and paratumorous lymph tissues by intra-arterial administration were 19 times and 23 times of the group by intravenous administration. Conclusion Regional arterial infusion chemotherapy can significantly increase the concentration of chemotherapeutic drugs in the tumorous region.

Objective:To explore the relation of negative emotions to erroneous gambling cognition and gambling addiction in college students.Methods:Totally 357 college students in Macau were selected and assessed with the Depression Anxiety Stress Scales (DASS),Gambling Related Cognition Scale (GRCS) and South Oaks Gambling Screen (SOGS).Bootstrap was used to test the mediating effect.Results:The students with higher erroneous gambling cognition got higher scores on negative emotions and addiction gambling than low-score group with erroneous gambling cognition (Ps ＜0.01).Mediating effect test showed that the direct effect of negative emotions on gambling addiction was 0.14,and the indirect effect was 0.05 (Ps ＜0.05).The indirect effect accounted for the total effect 26.3％.Conclusion:It suggests that negative emotions not only have direct effect on gambling addiction,but also have indirect effect on gambling addiction through erroneous gambling related cognition.

Objective To evaluate the effect of intraoperative placement of super-selective intraarterial pump and postoperative regional infusion chemotherapeutics for the treatment of laparotomy proved inoperable advanced gastrointestinal cancer. Methods Intraoperatively the major artery supplying the tumor was identified and cannulated with the placement of a pump. Postoperative regional chemotherapy was carried out in 79 cases of gastrointestinal cancer. Among them there were 42 cases of gastric cancer, 37 of colorectal cancer. Results Complete tumor remission was achieved in 1 case, partial remission in 69 cases. This therapy also enabled second stage tumor resection in 11 cases. The total effective rate reached 88.6%. The 1-, 2-, and 3- years' survival rates were 84%,28% and 9%, respectively, averaging the survival period at 20.6 months. Conclusion Super-selective intraarterial pump-insertion and postoperative regional chemotherapy is effective in the treatment of advanced inoperable gastrointestinal cancer.

Objective　To study the effect of regional arterial chemotherapy (RACT) on unresectable gastric carcinoma (URGC). Methods　The clinical data of 100 patients with URGC treated by RACT were retrospectively analysed. Results　In addition to different degree of symptoms improvement, the size of gastric cancer became smaller in 81.2% of the cases, and the survival time of patients had been prolonged (mean 29.5 months). Conclusions　RACT is more effective for treating URGC and worthly of further clinical study.

ObjectiveTo explore the etiology of incisional hernia of abdomianal wall.Methods98 cases with incisional hernia were analyzed retrospectively in terms of incision type, technique of suture, suture materials,infection of incision, and the time of occurrence.ResultsLongitudinal incision, improper technique of suture,infection, increase of intraabdominal pressure, and diabetes mellitus were risk factors of incisional hernia. ConclusionsTransverse incision, prevention of infection of the incision, strict aseptic manipulation and hemostasis were effective in the prevention of incisional hernia. Most hernia developed within 6 months postoperatively.

Objective To evaluate the surgical treatment for patients with malignant colorectal mesenchymoma, and to analyze the clinical data, pathological features and the common presenting symptoms and its immunohistochemical staining property. Methods The clinical data and the pathological findings, including immunohistochemical staining, of 17 patients with malignant colorectal mesenchymoma admitted from Jan 1990 to Mar 2005 were retrospectively analyeed. All the patients were followed up carefully. Results All the patients underwent operation, and all the tumors were proved malignant pathologically. In 6 cases left hemicolectomy was done, in 3 cases right hemicolectomy was done, in 2 cases the treatment was local resection from the rectum, and 6 patients received Mile's resection. The 1, 3 and 5-year overall survival rates for 17 patients with the total resection of tumor were 100%, 70.6% and 47.1%, respectively. The median survival time for 17 patients was 52 months. The final diagnosis of malignant GIST depended on the pathological examination, but the most worthwhile diagnostic criterion was the presence of CD117 and CD34 cells. Conclusion Since the prognosis is very poor, radical hemicolectomy is the principal treatment, and comprehensive treatment is necessary to improve clinical result.

Objective To evaluate the technique of treating severe tuberculous peritonitis complicated with intestinal obstruction. Method Clinical data covering 44 cases from Jan. 1994 to Dec. 2004 were analyzed retrospectively. All the 44 cases were suffering from severe tuberculous peritonitis complicated with intestinal obstruction for a long time. Among them 36 cases were diagnosed pre-operatively and 8 cases were confirmed post-operatively. All the patients underwent laparotomy, and all intestinal adhesions were divided, then the intestine loops were regularly aligned. Result 43 cases were cured, 2 patients developed postoperative intestinal fistula, and one patient died. Conclusion No curative effect could be obtained if medical treatment only was given for tuberculous peritonitis complicated with complete intestinal obstruction. The present surgical technique offers a better chance to relieve intestinal obstruction as a reult of tuberculous peritonitis.

Objective To investigate the effect of preoperative regional intra-arterial chemotherapy on apoptosis and apoptosis-regulating genes in advanced breast cancer.Methods 56 patients were divided into 2 groups:Preoperative regional intra-arterial chemotherapy group(treatment group,28 cases)and non-preoperative chemotherapy group(control group,28 cases).Apoptotic cells were examined by TUNEL and bcl-2 expression,and bax was detected by immunohistochemical techniques.Results Apoptotic index(AI)of breast cancer in the treatment group was 8.74%,while that of the control group was 4.65%.The bcl-2 expression in treatment group was 0.68?0.06,while in control group was 2.24?0.36.Expression of bax in treatment group was 0.72?0.06,while in control group was 0.38?0.04(P

Through the qualitative study of peritoneal cavity free cancer cells of patients with gastric cancer, to evaluate the rational of exercising intraoperative no touch isolation technique, routine peritoneal and warm perfusion chemotherapy after the operation. 102 patients in PLA 309 Hospital with gastric cancer were included into the study. 100 ml peritoneal fluid were collected respectively before the investigation and before close peritoneal cavity,and rapidly sent for free cancer cells examination. Results: Before the investigation, the positive rate of free cancer cells is 36.3%, and the positive rate before close peritoneal cavity is 52.9%. The free cancer cells positive rate is concerned with tumor infiltration depth, serous membrane infection area and the type of the histopathology。Conclusions: Inside the peritoneal cavity of patients with gastric cancer, free cancer cells are able to survive and have a high degree of activity. Although all kinds of intraoperative no touch isolation technique are used, it still cannot be avoided that some cancer cells will exfoliate and slip into the peritoneal cavity. The wound stimulation during the operation will certainly increase the exfoliation. So, it is quite necessary in the course of operation to adopt no touch isolation technique and to use a great deal of normal saline to give peritoneal cavity lavage. And what's more important is, to give these patients who show positive in the free cancer cell examination perfusion chemotherapy after the operation.