Objective To study the effect of the MafA therapy for blood slucose control in diabetic rats.Methods Rats were divided into 3 groups:treatment group,DM group and control group.In DM group,Wistar rats were rendered diabetic by intrvenous injection of streptozotocin(STZ).In treatment group,mixture of MafA and liposomes at the volume ratio of 1:1 was injected to the portal vein of the diabetic rats.Blood glucose change in the diabetic rats Was measured.Results ① For treatment group,blood slucose decreased from 20.6 mmol/L-22.8 mmol／L to 13.6 mmol／L-14.8 mmol／L and plasma insulin level was significantly elevated for a duration about 2 weeks.②After treatment,blood slucose level significantly decreased compared to DM group (P<0.05).③ Plasma insulin level Was significantly higher than that in DM group(P<0.05).④ Expression of MafA mRNA can be detected in the liver oftreatment group while it Was not found in DM group.Immunohistochemical analysis revealed that insulin expression Was found in the liver of treatment group while it Was not found in the liver of DM group.Conclusion Injection of MafA and liposomes at the volume ratio of 1:1 via the portal vein can effectively decrease blood glucose in diabetic rats.

ObjectiveTo analyze the reasons of complications after laparoscopic gastrectomy with D2.MethodsThe clinical courses of 150 cases who suffered from gastric cancer treated by laparoscopy in the First Affiliated Hospital of Yangzhou University from March 2007 to December 2010 were retrospectively analyzed.ResultsFourteen cases showed complications after operation,the rate being 9.33％ (14/150).The remaining patients with postoperative complications were discharged after treatment,no death occurred during the perioperation.ConclusionEnhancing the refinement of surgical operations,the postoperative observation and the management of drainage tube are the key to the prevention and treatment of complications after laparoscopic gastrectomy.

ObjectiveTo evaluate the feasibility,safety and therapeutic efficiency of laparoscopic total mesorectal excision (TME) with anal sphincter preservation in the treatment of the middle-lower rectal cancer.MethodsFrom February 2008 to June 2010,37 patients with middle-lower rectal cancer received laparoscopic TME with anal sphincter preservation,while 45 patients underwent conventional open TME with anal sphincter preservation according to their wills.The operative procedures,postoperative recovery,postoperative complication and short-term outcome were collected and compared between the two groups.ResultsBlood loss was (60.6 ± 20.9) mL in laparoscope group which was significantly less than that in laparotomy group (P＜0.01),time for bowel movement retrieval and hospital stay were (3.3 ±0.6) and (9.2 ±2.8) days respectively,which were significantly shorter than those in laparotomy group (P ＜ 0.01 ).The incidence of postoperative complications was 8.1％ in laparoscope group,which was significantly lower than those in laparotomy group (P ＜ 0.05 ).The mean distance between resected margin and the tumor,the mean number of disected lymph nodes were not different between the two groups.The rate of sphincter preservation was 91.9％ in laparoscope group,which was higher than those in laparotomy group (73.3％) ( P ＜ 0.05 ).All patients were followed-up from 6 to 36 months,the recurrent rate and overall survival rate were 10.8％ and 94.6％ in laparoscope group,with no significant difference compared to those in laparotomy group (11.1％ and 91.1％,P ＞ 0.05).ConclusionsLaparoscopic TME with anal sphincter preservation which achieved the same effect of oncological clearance is a safe and feasible procedure for middle-lower rectal cancer,with less postoperative complications and better recovery after treatment,and enhances the rate of sphincter preservation,which is worthy of clinical application.

Objective To evaluate the safety and efficacy of sorafenib for patients with advanced stage renal cell carcinoma.Methods The clinical data of 85 patients with advanced renal cell carcinoma were reviewed.These patients were treated by sorafenib 400 mg Bid,dose escalation of sorafenib(400 mg Bid 1-4 weeks;600 mg Bid 5-8 weeks;800 mg Bid since then) or sorafenib 400 mg Bid+NF-α,respectively,until intolerance or disease progression occurred.The primary end points were objective response,disease control rate and adverse effects rate.Results The data of 80 patients can be evaluated.The median follow-up duration was 72 weeks (4-108 weeks).One patient (1.2%) reached complete remission(CR),17 cases(21.2%) reached partial remission(PR),50 cases (62.5%) maintained stable disease (SD),and 12 cases (15%) progressed.The objective response (CR+PR) was 22.5%,disease control rate (CR+PR-SD)was 85.0%.By May 2009,only 18 patients died,progression free survival and overall survival were not available.The common side effects included hand-foot skin reaction (55.0%),mucosa hemorrhage (52.5%),diarrhea(40.0%),lassitude (35.0%),anorexia(22.5%),mucosa ulcer(20.0%),hypertension(15.0%) and baldness(15.0%)etc.Most of these side effects could be released by symptomatic treatment.Conclusion Sorafenib has good short term effect for patients with advanced renal cell carcinoma and is well tolerated.

Objective To study the changes of plasma gastrin (Gas), substance P (SP) and vascoactive intestinal peptide (VIP) among children with recurrent abdominal pain and their family members,and to explore if there is the rule of the changes.Methods The fasting plasma Gas, SP and VIP were determined by radioimmunoassay method among 30 children with recurrent abdominal pain, and 45 family members including first-degree relatives and second-degree relatives as well as 35 normal healthy children and 20 normal healthy adults. Individuals were divided into five groups:children with recurrent abdominal pain (study group 1), family members with recurrent abdominal pain (study group 2), normal healthy children (control group1), family adults without recurrent abdominal pain (control group2) and normal healthy adults (control group3) . The whole family members of 7 children with recurrent abdominal pain were focused on and analysed.Results 55 of 130 volunteers were with recurrent abdominal pain including 30 children and 25 adults. There were 22 adults with and 20 adults without recurrent abdominal pain in the whole family members of 7 children with recurrent abdominal pain. The fasting plasma Gas content had no difference between study group 1 and control group1 ( <0.05), but the levels of fasting plasma SP and VIP were both in decrease and had difference between study group 1 and control group1 (<0.05) .The fasting plasma Gas,SP and VIP had no difference between study group 2 and control group 2 ( >0.05) .The levels of fasting plasma Gas content had no difference between study group 2 and control group 3 (>0.05),but the levels of fasting plasma SP and VIP were both in increase and had difference between study group 2 and control group3. The fasting plasma Gas content had no difference between country group 1 and control group3 ( <0.05),but the levels of fasting plasma SP and VIP had difference between country group 1 and control group3 ( <0.01) .The levels of fasting plasma SP and VIP had no difference between study group 1 and study group 2 ( <0.05) .The levels of fasting plasma Gas, SP and VIP content had no difference among the whole family members of 7 children with recurrent abdominal pain including 22 adult members with and 20 adult members without recurrent abdominal pain (>0.05) .Conclusions There are the same plasma Gas contents in normal children and adults.However, the plasma SP and VIP contents are higher in normal children than ones in normal adults. The plasma SP and VIP contents are lower in children with recurrent abdominal pain than ones in normal children. The plasma SP and VIP contents are higher in adults with recurrent abdominal pain than ones in normal adults. These suggested that the increases of plasma SP and VIP may have a close relationship with the pathogenesis of children and adults with recurrent abdominal pain. The contents of plasma Gas, SP and VIP were consistent in the whole family members of 7 children with recurrent abdominal pain. It suggested that the secretion of gastrointestinal hormone is disorder in the families with recurrent abdominal pain.

Objective:To study the changes of Th17,regulatory T(Treg) cells and IL-17,IL-23 levels at acute phase and recovery phase in children with Henoch-Schonlein purpura(HSP) in order to further understand the immunological pathogenesis and provide help for treating HSP. Methods:The vein blood samples were collected from 65 children with HSP and 30 normal children. The proportion of Th17 cells and regulatory T cells were tested by FCM and concentration of IL-17 and IL-23 in plasma were tested by ELISA. Results:Compared with normal children,the levels of Th17,Th17/Treg and IL-17,IL-23 were in increase at acute phase in children with HSP(P<0. 05). At recovery phase,that were in decrease compared with the acute phase(P<0. 05),but still higher than the normal children(P<0. 05). Compared with normal children,the level of Treg was in decrease at acute phase in children with HSP (P<0. 01). At recovery phase,that was in increase compared with the acute phase(P<0. 01),but still lower than the normal children (P<0. 01). Among the simplex,abdominal and other type of children with HSP,the levels of Th17,Treg,Th17/Treg and IL-17,IL-23 were same( P>0. 05 ) . At acute phase in children with HSP, Th17 cells percentage had positively correlated with IL-17 levels ( r=0. 880,P<0. 01),IL-23 levels had positively correlated with Th17 cells percentage and IL-17 levels (r=0. 838 or 0. 877,P<0. 01). Conclusion:Th17,Treg,Th17/Treg,IL-17 and IL-23 are involved in the course of the immunological pathogenesis in children with HSP,but the levels of that have no significant difference among simplex,abdominal and other types,further researches need to be done.

Objective To study the change of levels of IL-6,IL-17,IL-23,IL-8,TNF-α and IFN-γ and their clinical significance on children with different types of Henoch-Schonlein purpura (HSP) Methods The blood specimens of 180 children with HSP as disease group and 30 health children as normal group were collected respectively.Disease group included 30 children at acute stage and 30 at convalescence stage of primary abdominal type,30 at acute stage and 30 at convalescence stage of primary non-abdominal type,30 at acute stage of secondary abdominal type,and 30 at acute stage of secondary non-abdominal type.The plasma levels of IL-6,IL-8,IL-17,IL-23,TNF-α and IFN-γ in the two groups were measured by ELISA method for comparison and analysis.Results The plasma levels of IL-6,IL-8,IL-17,IL-23 and TNF-α in disease group were higher than those in the normal group (P＜0.05).Those levels in the children at acute stage and of primary group were also found to be higher than those at convalescence stage (P＜0.05) and of secondary group (P＜0.05) respectively.Comparison of IL-6,IL-8,IL-17,IL-23 and TNF-α between abdominal type and the non-abdominal type had no significant difference (P＞0.05).The plasma level of IFN-γ in disease group was lower than those in normal group (P＜0.05).The levels of IFN-γ in the children at acute stage and of primary group were lower than those at convalescence stage (P ＜0.05) and of the secondary group (P ＜0.05) Comparison of IFN-γ between abdominal type and non-abdominal type had no significant difference (P＞0.05) Conclusions The plasma levels of IL-6,IL-8,IL-17,IL-23,TNF-o,IFN-γ show obvious changes in children with HSP,which suggests that the changes of cytokines are associated with the pathogenesis and prognosis of Henoch-Schonlein purpura.

Objective:To establish the model of rats with UC by 2,4,6 trinitrobenzene sulfonic acid ( TNBS)/ethanol to understand the changes of IL-17,IL-23,TGF-β1,IFN-γin pathogenesis of ulcerative colitis (UC) and the impacts of mesalazine,mont-morillonite powder and clostridium on that.Methods:85 rats were divided randomly into 6 groups including the model ,mesalazine, montmorillonite,clostridium,mesalazine combined with montmorillonite powder group (15 rats per group ) and an additional control group of 10 normal rats.TNBS/ethanol was used to establish the model of rats with UC.The dosage of model, mesalazine, montmorillonite powder ,clostridium and mesalazine combined with montmorillonite powder were converted by surface area of rat and given to the rats by gastric-tube daily.All rats were executed at the 12th day of the molding and treatment ,and the blood and colon samples were collected.The content of IL-17,IL-23,TGF-β1,IFN-γwas measured in the blood by the ELISA method.The different changes of the four cytokines were compared separately.Results: ( 1 ) TNBS/ethanol was used to establish the model of rats with UC.The obvious inflammation can be observed on distal colon of rats by pathologic sections of HE stained .(2) The levels of plasma IL-17,IL-23 and IFN-γin the model,mesalazine,montmorillonite,clostridium and mesalazine combined with montmorillonite powder group were higher than ones in the control gruop (P<0.05),meanwhile,the levels of plasma TGF-β1 are lower (P<0.05).3.Comparing with the model group,the levels of plasma IL-17,IL-23 and IFN-γin the mesalazine,montmorillonite,clostridium and mesalazine combined with montmorillonite powder group were lower , and the levels of TGF-β1 were higer.The differences have statistic significative ( P<0.05).(4)Comparing the efficacy of treatment among mesalazine ,montmorillonite powder,clostridium and mesalazine combined with montmorillonite powder ,mesalazine and mesalazine combined with montmorillonite powder gets the best results ( P<0.05 ).The efficacy between montmorillonite powder and clostridium is similar.Conclusion:(1) TNBS/ethanol can be used to establish the model of rats with UC and can be successfully approved by the measurement of symptoms and pathologic investigation .(2)The IL-17,IL-23 and IFN-γare very active higher in the blood of rats with experimental ulcerative colitis induced by TNBS /ethanol, and have a positive correlation with inflammation.The TGF-β1 is in decrease in the blood of rats with colitis , and has a Negative Correlation with inflammation.(3)Mesalazine,montmorillonite powder,clostridium and mesalazine combined with montmorillonite powder may renovate the damage of inflammatory tissues of rats with experimental ulcerative colitis , and relieve the symptom of inflammation by reducing exudation of proinflammatory cytokines IL-17, IL-23 and immune regulatory cytokines IFN-γby producing the exudation of proinflammatory cytokines TGF-β1 to be good for recovery of UC.

With the further development of endoscopic technology and the application of minimally invasive concept in the diagnosis and treatment of colorectal surgery diseases, the diagnosis and treatment of colorectal related diseases have undergone tremendous changes. Surgical diagnosis and treatment of colorectal diseases have achieved great results in the minimally invasive field, ranging from traditional transabdominal surgery to laparoscopic surgery, transvaginal surgery, and transvaginal specimen removal. One of the most cutting-edge surgical methods in the field of minimally invasive colorectal surgery at present, this method avoids the incision in the abdominal wall by taking specimens through the rectum and vagina, thus further minimally invasive colorectal surgery. The NOSES technology combines the advantages of traditional laparoscopic surgery with the concept of modern minimally invasive surgery. It embodies the characteristics of minimally invasive, fast track rehabilitation in surgery, functional surgery and other concepts on the basis of ensuring the operation effect. This paper mainly summarizes the relevant experience, experience and experience in the development of colorectal surgery diagnosis and treatment by carrying out the nose technology at home and abroad.