The efficacy of laparoscopic Dixon operation for the treatment of rectal cancer has been proven,while at the same time there are opportunities to make the procedure less invasive.From January 2010 to March 2011,9 cases of single access laparoscopic Dixon operation have been performed at the Shengjing Hospital.An incision with the length of 3 cm was created in umbilicus and 3 trocars were inserted through the fascia on the abdominal wall.The dissection and anastomosis were performed through the incision.The resected tumors were removed through the umbilical incision or anus.The operation was successfully performed on 9 patients,and one more incision with the length of 12 mm was created on the lower abdominal wall in 1 patient in order to install the stapling device.The average operation time was 202 minutes.No postoperative bleeding,intestinal obstruction or anastomosis leakage was found.

Objective To study the feasibility and curative effect of transumbilical single-incision (TSIL) vs multiple-incision (MIL) laparoscopic splenectomy.Methods Ten cases (2 cases of idiopathic thrombocytopenia purpura,1 case of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of cirrhotic splenomegaly) underwent TSIL from Jan 2010 to Ju12011,and 12 cases (3 cases of ITP,2 cases of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of splenomegaly) underwent MIL.Clinical data were compared with each other.Results No severe complications occurred in either group.The mean operation time of single-incision group and multiple-incision group was ( 182 ± 23 ) min and ( 169 ± 19) min,and blood loss was( 160 ± 13 ) ml and ( 155 ± 16) ml ( P ＞ 0.05 ).The post-operative pain score in TSIL and in MIL group was respectively [ ( 1.60 ± 0.20) vs (3.60 ± 0.90) on day 1,P ＜ 0.05 ; (0.50 ±0.10) vs (2.00 ±0.45) on day 2,P ＜0.05].There was no significant difference between the two groups in the recovery of the gastrointestinal function,the length of hospital stay and the cost of hospitalization, all P ＞ 0.05.The umbilical incision in TSIL cases is more cosmetic.Conclusions Transumbilical single-incision laparoscopic splenectomy is feasible and safe in experienced hands.

Objective To investigate the effect of signal transducers and activators of transcription 3(STAT-3)on sen-sitizing oral squamous cell carcinoma to cis-dichlorodiamineplatinum via downregulating miRNA-21. Methods Tscca and Tca8113P160 human tongue squamous cell carcinoma cell lines were employed in this study. WP1066 was used to suppress STAT-3 signaling pathway. Cells were divided into three groups:dimethyl sulphoxide (DMSO) group, cis-dichlorodiamine-platinum (DDP) group and WP1066+DDP group. Transcription level of miR-21 was assessed by real-time PCR, while the expression levels of STAT-3, p-STAT-3, tissue inhibitor of metalloproteinase-3 (TIMP-3) and matrix metalloproteinase-2/9 (MMP-2/9 ) were evaluated by Western blot assay. Matrigel matrix and transwell assay were used to determine cancer cell colony formation and invasive ability respectively. Expression level of miR-21 was examined by luciferase reporter gene as-say. Results Expression levels of STAT-3, pSTAT-3 and miR-21 were significantly suppressed by WP1066 treatment. The diameters of culture colony in cells treated with WP1066 and DDP were smaller than those in control group. The number of tongue cancer cells that migrated through the transwell membrane in WP1066 and DDP treated group was less than that in control group. Additionally, MMP-2/9 expression decreased while TIMP-3 increased dramatically in both cell lines in WP1066+DPP group compared to the other two groups. Conclusion Reduction of STAT-3 can sensitize oral squamous cell carcinoma to cis-dichlorodiamineplatinum via downregulating miR-21. Our study shows that DDP, in combination with WP1066, might be used as a potential target in the treatment of human oral squamous cell cancer.

Spontaneous intracranial hypotension (SIH) is caused by single or multiple cerebrospinal fluid (CSF) leaks in the spine with the prototypical symptom of postural headache. One of the characteristic MRI features in SIH is intracranial venous engorgement. This report presents a case of SIH with engorgement of the bilateral superior ophthalmic veins (SOVs) which resume their normal diameters by the third day of successful epidural blood patches (EBPs). We define this phenomenon as the "reversal of the SOV" sign.
Aged ; *Blood Patch, Epidural ; Cerebrospinal Fluid Rhinorrhea/*complications ; Diagnosis, Differential ; Humans ; Intracranial Hypotension/*diagnosis/etiology/*therapy ; *Magnetic Resonance Imaging ; Male ; Orbit/*blood supply

Objective To investigate the clinical manifestation of hMPV in infants and young chil-dren presented with acute respiratory tract infection and to identify the molecular character. Methods Na-sopharyngeal aspirates were taken from 310 hospitalized pediatric patients from February to May in 2006, March to April in 2008, and September 2008 to February 2009, and the N gene fragments of hMPV were de-tected by nested PCR amplification. Phylogenetic analysis of 17 strains hMPV N genes was performed. The clinical materials of patients were collected and analyzed. All hMPV-positive samples were examined by multi-PCR for other respiratory viruses. Results Of 310 pediatric patients, 20 (6.5%) were positive for hMPV. The median age of hMPV infected children was 15.0 months(from 16 days to 9 years old), 90% (18/20)of the cases were under 2 years, and 60% were male. Phylogenetic analysis of 17 N gene fragments showed that 11 hMPV strains were A2b subtype. 20 hMPV-positive children were subjected to pneumonia, accounting for 7.1% (20/282) among all pneumonia subjects in this study. The common clinical manifesta-tions of hMPV infected patients were cough, wheezing, shortness of breath and fever. 35% (7/20) needed intensive care, 15% (3/20) were given oxygen therapy. The median length of hospital stay was (11.9 ±4.8) d. No significant seasonal distribution of hMPV was displayed. Two patients were coinfected with ade-novirus and rhinovirus respectively. Conclusion hMPV was an important respiratory pathogen in young children subjected to pneumonia in Tianjin. Three subtypes(A2a/A2b, B1, B2) were prevalent in Tianjin, and A2b was the predominant subtype. No significant difference of clinical characters was observed between A and B type hMPV infected patients.

The seeds of Rabdosia rubescens were as the materials to research the impacts of different lead (Pb2+) concentrations(0, 135, 270, 540, 1 080 mg x L(-1)) on seed germination and seedling growth. The results show that: Low concentration of lead had no obvious effect on early germination of the seed, the germination vigor and germination speed were lightly higher but not significantly differed at the level of Pb concentration 135 mg x L(-1) with control group; Mid-high concentration of Pb solution (270-1 080 mg x L(-1)) significantly inhibited the seed germination and seedling growth, which reduced the seed germination rate, germination vigor, germination index, embryo root length and shoot length, growth index with increasing of Pb concentrations. There was a inhibitory effect on embryo shoot length and root length at mid-high lead concentrations stress, and stronger inhibitory effect on root , which was more sensitive than shoot to Pb stress(P < 0.05). Pb bioaccumulation coefficient (BC) was 0.76-2.59, increased with concentration of Pb; Pb enrichment in seedling mainly caused the growth inhibition. The fitting model predictive analyses show, the critical concentration of Pb, which causes the germination rate and biomass fresh weight reducing 10%, is 195.18, 101.65 mg x L(-1).
Germination ; drug effects ; Isodon ; drug effects ; growth & development ; Lead ; toxicity ; Seedlings ; growth & development ; Seeds ; growth & development ; Stress, Physiological

This study reports the outcomes of a collaborative program between dialysis clinics and a referral hospital, which consisted of clinical monitoring and supplementary routine surveillance, for improving the quality of vascular access care. Methods: This retrospective observational study was performed at five dialysis clinics as part of a 2-year collaborative program (2019–2020) in conjunction with a hospital-based dialysis access management center. A total of 392 hemodialysis patients (arteriovenous fistula [AVF], n = 339 and arteriovenous graft [AVG], n = 53) were included. Outcome measures included the prognosis of vascular access, clinic satisfaction, and referral rate to the hospital. Results: Increased vascular access flow was observed and critical flow events decreased from the first to the second year (AVF: 18.3% vs. 12.7%, p < 0.001; AVG: 26.2% vs. 20.1%, p = 0.30). There were fewer percutaneous transluminal angioplasty events in the AVG group (0.77 per person-year vs. 0.51 per person-year, p = 0.005). New AVF or AVG creation events also remained low. All dialysis clinics were satisfied with the program. The overall referral rate from the participating clinics increased (65.7% vs. 72.0%) during the study period independently of the physical distance between the dialysis clinic and the hospital. Conclusion: The collaboration between dialysis clinics and a referral hospital for improving the quality of vascular access care was successful in this study, and the model can be used by other clinics and hospitals looking to improve care coordination in dialysis patients.

OBJECTIVETo investigate the relationship between inhibitory effect of triamcinolone acetonide(TA) on hypertrophic scar and oxygen free radicals in rabbits.

METHODS18 New Zealand rabbits were used. 14 rabbits were selected randomly to construct animal models of hypertrophic scar on the ears. Another 4 rabbits (8 ears) were used as controls. 6 weeks after operation, the hypertrophic scar on the ears were randomly divided to receive intra-lesion injection of TA (n=10), or normal saline (n=10), or nothing (n=8, sham group). 9 weeks after operation, scar specimens were taken for scar thickness measurement, fibroblast counting under microscopy and MDA content detection by spectrophotometric method.

RESULTS(1) 3 weeks after TA treatment, the scar became very thin and soft with a similar color to normal skin and a smooth surface; (2) Histologic study showed the collagen fibers in TA group were reduced markedly and arranged parallelly; (3) Compared with normal skin, the fibroblast density in sham and saline groups increased significantly (P < 0.05), while it was not markedly different in TA group (P > 0.05). There was also no significant difference in scar hypertrophic index between sham and saline groups (P > 0.05), but the scar hypertrophic index was decreased dramatically in TA group (P < 0.05); (4) The MDA content was highest in TA group (P < 0.05), followed by that in sham and saline groups (P < 0.05), while there was no difference between these two groups (P > 0.05). It was lowest in normal control group (P < 0.05).

CONCLUSIONSThe oxygen free radicals in the hypertrophic scar can be further increased by local injection of TA.

Animals ; Cicatrix, Hypertrophic ; drug therapy ; metabolism ; pathology ; Disease Models, Animal ; Malondialdehyde ; metabolism ; Rabbits ; Random Allocation ; Reactive Oxygen Species ; metabolism ; Triamcinolone Acetonide ; administration & dosage ; therapeutic use

INTRODUCTIONWe report a case of neurogenic pulmonary oedema (NPO) following massive left cerebral infarct, which was initially misdiagnosed as acute myocardial infarction (AMI).

CLINICAL PICTUREThis 52-year-old man presented with acute loss of consciousness with normal brain computed tomography (CT). He was treated as non-ST-elevation AMI complicated with pulmonary oedema based on findings of chest radiograph (bilateral pulmonary oedema), electrocardiogram (marked ST-T changes in leads V3 to V6), and cardiac enzymes [elevated creatinine kinase (CK) and CK-MB]. However, coronary angiogram and serial cardiac enzymes were inconclusive. Anisocoria developed after admission and a repeat brain CT was evident for large left cerebral infarct.

TREATMENTDecompressive craniectomy was carried out.

OUTCOMEMortality.

CONCLUSIONSThe diagnosis of NPO can be challenging when it occurs without abnormal findings on preliminary brain CT. It can be mistaken for cardiogenic pulmonary oedema secondary to AMI.

Cerebral Infarction ; physiopathology ; Coma ; Diagnosis, Differential ; Diagnostic Errors ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; Pulmonary Edema ; diagnosis ; physiopathology ; Radiography, Thoracic ; Taiwan

OBJECTIVE: To explore the etiology of paranasal sinus fungus ball and evaluate the curative effect of endoscopic sinus surgery on paranasal sinus fungus ball. METHOD: The clinical and follow-up data of 55 patients with paranasal sinus fungus ball were retrospectively analyzed. RESULT: All patients were cured by endoscopic sinus surgery, no complications were observed. Following up for 6-48 months, two cases were recurred. CONCLUSION Anatomic abnormalities of the paranasal sinuses and wound in the mucosa are the main pathogenesis of paranasal sinus fungus ball. Endoscopic sinus surgery is an effective treatment of paranasal sinus fungus ball. Relapse rate is related with regular irrigation after operation.
Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Endoscopy ; Female ; Fungi ; pathogenicity ; Humans ; Male ; Middle Aged ; Mycoses ; surgery ; Retrospective Studies ; Sinusitis ; microbiology ; surgery