Objective To analyze the tumor characteristics associated with achieving pathological complete response(pCR) and tumor prognosis in the patients undergoing laparoscopic rectal cancer surgery after neoadjuvant chemoradiotherapy(nCRT). Methods A retrospective review was conducted on clinical and pathological data of locally advanced rectal cancer(LARC) patients who underwent nCRT at Renji Hospital from January 2017 to January 2024. Factors influencing the achievement of pCR were analyzed, and the patients prognosis of pCR group and non-pCR group was compared. Results Univariate analysis, multivariate Logistic regression analysis, and receiver operating characteristic (ROC) curve analysis showed that tumor length less than 5 cm(cutoff value 5.24 cm) and baseline carcinoembryonic antigen(CEA) less than 5 μg/L(cutoff value 5.33 μg/L) were independent predictors of achieving pCR after nCRT in LARC patients. Prognostic survival analysis showed that the 3-year overall survival(OS) rate for pCR group and non-pCR group were 92.86% and 82.46%, respectively (P=0.193), and the 3-year disease-free survival (DFS) rate were 85.71% and 70.18%, respectively (P=0.141), with no statistically significant differences between the two groups. Conclusions Tumor length and baseline CEA level are independent predictors for achieving pCR after nCRT in LARC patients. Additionally, there were no statistically significant differences in 3-year OS and DFS between pCR group and non-pCR group.

Objective:To evaluate the pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap for the treatment of soft tissue defects at the contrallateral leg.Methods:Between January of 2012 and January of 2016, 8 patients with soft tissue defects at the leg were treated at Department of Orthopedic Surgery, Hand and Foot Surgery Hospital of Lanzhou. They were 5 men and 3 women, aged from 19 to 50 years (mean, 35 years). All of them were treated by bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap pedicled with posterior tibial artery. The size of the defects ranged from 10 cm×9 cm to 13 cm×8 cm. The immediate coverage of the muscle flaps and vessel pedicle was repaired by a meshed split-thickness skin graft. The donor site was closed directly. The therapeutic efficacy was assessed at the final follow-up according to the criteria by Iowa for tibial fractures.Results:All the skin flaps and muscle flaps survived without any vascular crisis. One case developed necrosis of small skin graft at the distal muscle flap which spontaneously healed after dressing change for 2 weeks. Their follow-up ranged from 2.5 to 4.5 years (mean, 3.8 years). A good contour was confirmed at the recipient area. By the Iowa criteria at the final follow-up, 3 cases were excellent, 4 good and one fair.Conclusion:Pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap is a good treatment for soft tissue defects at the contrallateral leg which has only one major blood vessel, reducing damage to the donor site.

Objective To investigate the effects of etomidate and propofol on circulatory system and the depth of anesthesia in laparoscopic surgery of ectopic pregnancy.Methods From January 2014 to January 2015, 40 patients with ectopic pregnancy in our hospital were selected and divided into the etomidate group and propofol group according to the principle of complete random grouping.Patients in the etomidate group received etomidate induced anesthesia, and the patients in the propofol group received propofol induced anesthesia.Hemodynamic parameters and bispectral index(BIS) of two groups were evaluated at 4 time points.The incidence of postoperative nausea and vomiting, chills and bronchospasm were recored.Results There was no significant difference in heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure(DBP) between the two groups at T0,T2and T3.But at the time of induction(T1), the heart rate of patients in propofol group was significantly lower than that in etomidate group(P<0.05).While T1, compared with etomidate group, the HR and SBP significantly decreased and DBP increased in the propofol group (P<0.05), The HR and SBP at T1of patients in the propofol group and etomidate group decreased significantly and DBP increased when compared with T0(P<0.05).and etomidate group decreased significantly compared with T0 ( P <0.05 ).There were no significant differences in BIS indexes at four time points.However, BIS indexes at T1 ,T2 and T3 were significantly lower than T0 ( P <0.05 ).There was no significant difference in three kinds of complications rates in two groups.Conclusion Etomidate, compared with propofol, can better control the cardiovascular response during induction of anesthesia.Both drugs have a consistent depth of anesthesia.There is no difference in the incidence of complications.Etomidate is more suitable for patients with ectopic pregnancy laparoscopic surgery.

Objective To evaluate the feasibility and curative effect of extracorporeal liver perfusion (ECLP) in treatment of acute liver failure (ALF) in pigs. Methods The experiments were carried out in healthy pigs (weight 20-30 kg) under general anesthesia. All of the pigs were randomly divided into 3 groups. ALF model was established by liver blood supply obstructing and portal-systemic shunting. ALF group (n=5): ALF pigs were killed 8 h after establishing. ALF+ECLP group (n=5): ALF pigs were perfused with ECLP for 4 h and killed 8 h after establishing. Normal liver+ECLP group (n=4): normal pigs were dealt with just as ALF+ECLP group. The data of PT, AST, TNF, blood ammonia were collected in all groups. Pathologic changes in liver and brain were detected. Results The levels of PT, AST, TNF, blood ammonia, RBC and HCT in the ALF+ECLP group were lower than those in the ALF group (P