Objective To compare the clinical efficacy between laparoscopic resection and open resection for rectal cancer and explore the safety and feasibility of laparoscopic resection.Methods The clinical data of 68 patients suffering rectal cancer resection were analyzed retrospectively.The patients were divided into laparoscopic group(31 cases)and open group(37 cases)according to the operation method.Results There was no significant difference in the number of lymph nodes dissection and postoperative complication rate between two groups(P ＞ 0.05).The operation time in laparoscopic group was significantly longer than that in open group [(162.03 ±39.78)min vs.(142.70 ±30.29)min].The bleeding in laparoscopic group was less than that in open group [(153.23 ± 58.94)ml vs.(247.46 ± 92.51)ml].The recovery of intestinal function time and hospital stay in laparoscopic group was shorter than that in open group [(51.39 ±7.28)h vs.(77.81 ±11.68)h,(12.65 ±2.24)d vs.(15.29 ±3.11)d].And there were significant differences between two groups(P ＜ 0.05 or ＜ 0.01).Conclusion Laparoscopic resection for rectal cancer can achieve short-term clinical efficacy similar to the traditional open surgery,and advantages in terms of safety and postoperative recovery worthy of further promotion.

This study firstly reviews the history and current situation of course construction, then combines closely with the objectives and the summary of current situation of the standardized residency training, and finally puts forward concrete countermeasures from the several angles, such as teaching objectives, teaching team development, teaching content and forms, as well as evaluation mechanism, advocating the promotion of problem-based learning (PBL), medical simulation teaching (MST), literature discussion and other teaching methods, encouraging the integration of humanities education and clinical guidelines into teaching, and adopting objective structured clinical examination + standardized patient (OSCE+SP) assessment method and conducting two-way assessment, so as to assist in the education development of the standardized residency training.

Objective To evaluate the safety,efficiency of retroperitoneal laparoscopic partial nephrectomy combined with four points location in 3D model or 3Dimensional CT for completely endophytic tumors,and summarize the surgical experience.Methods From Jan 2015 to Jan 2016,5 patients with completely endophytic tumors,who underwent retroperitoneal laparoscopic partial nephrectomy were recruited.one patient underwent 3D printing kidney model,and another 4 patients underwent 3Dimensional CT and locating four projection positions of the tumor on the surface,in order to guide the tumor resection in laparoscopic partial nephrectomy.Perioperative,operative,and postoperative,as well as oncological outcomes were analyzed.Results In all 5patients,preoperative four points location in 3D model or 3Dimensional CT for completely endophytic tumors is feasible and accurate in term of locating the tumor.The mean operative time was(129.0 ± 19.5) min,mean warm ischaemia time was (19.6 ± 5.4) min and mean estimated blood loss was(100 ± 83) ml.Pathological examination showed cell renal cell carcinoma.All the patients had a negative surgical margin,and no tumor recurrence or metastasis during 6-18months of follow up.Conclusions In experienced institutes,retroperitoneal laparoscopic partial nephrectomy combined with four points location in 3D model or 3Dimensional CT for completely endophytic tumors is a feasible and safe procedure in terms of accurate locations,low complication rates,reasonable functional and oncologic outcomes after an intermediate-term follow-up

Objective To compare the changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes in CHD patients with impaired glucose tolerance (IGT) before and after statin therapy. Methods A total of 196 CHD with IGT and 160 controls were included. The changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes were analyzed before and after Rosovastatin therapy. Sequenom Mass ARRAY platform was used to detect the CETP TaqI B SNPs. Results The genotype frequency of the B1B1, B1B2 and B2B2 in CHD with IGT group was 35.7%, 48.0% and 16.3% respectively, while in control group was 31.3%, 53.1% and 15.6% respectively. HDL-C, PA and MLA levels increased after Rosuvastatin therapy, while LDL-C, TG, TCH, Lpa, PA, EEMA and PB levels decreased. Conclusions CETP gene polymorphisms TaqI B would have association with the effects of Rosuvastatin therapy in the CHD with IGT.

Objective:The characteristics of bacteriology and the change of drug resistance in PICU of our hospital during recent 5 years were analyzed to guide clinical rational drug use.Methods:All positive results of bacterial culture in PICU from January 2016 to December 2020 were retrospectively analyzed, and were classified according to the sample source, strain type and drug sensitivity results.The bacterial etiology spectrum and drug resistance in PICU were summarized.Results:A total of 800 pathogenic bacteria were isolated from the specimens collected from the PICU from January 2016 to December 2020, including 476 Gram-negative bacteria, 292 Gram-positive bacteria, and 32 fungi, accounting for 59.50%, 36.50%, and 4.00%, respectively.The top 9 bacteria were: Staphylococcus aureus 134(16.75%), Haemophilusinfluenzae 79(9.88%), Klebsiellapneumoniae 78(9.75%), Streptococcus pneumoniae 74(9.25%), Escherichia coli 56(7.00%), Acinetobacterbaumannii 51(6.38%), Moraxella catarrhalis 48(6.00%), Enterobacter cloacae 26(3.25%), Pseudomonas aeruginosa 25(3.13%). Drug sensitivity results showed that 27(48.21%, 27/56)strains of EScherichia coli and 42(53.85%, 42/78) strains of Klebsiella pneumoniae were positive for ultrawide spectrum β-lactamase, and a total of 24(17.91%, 24/134)strains of methicillin-resistant Staphylococcus aureus were detected.Staphylococcus aureus was almost 100% resistant to penicillin G and ampicillin, and had high resistance rates to clindamycin and erythromycin(72.70% and 72.30%, respectively). It was 100% sensitive to minocycline, teicoranin, vancomycin, linezolid, and dattomycin.The drug resistance rates of Streptococcus pneumoniae to erythromycin and clindamycin were 98.60% and 98.50%, respectively.The drug resistance rates to azithromycin were 96.80%, the drug resistance rates to penicillin G, cefotaxime and ceftriaxone were 12.30%, 5.40% and 1.50%, respectively, and the drug resistance rates to moxifloxacin, linezolid and vancomycin were 100% sensitive.Conclusion:During the past five years, the etiology of the PICU in our hospital is mainly Gram-negative bacteria, and the most common pathogenic bacteria is Staphylococcus aureus.Klebsiella pneumoniae and Escherichia coli infections remain a great challenge.Bacterial resistance moitoring should be strengthened to provide evidence for the rational use of antibiotics.

Objective To observe the cardiac function in acute brain injury patients(ABI)and the relationship between ABI and plasma neuropeptideY(NPY),and to inspect the mechanism and find the evidences for preventing cardiac impairment caused by ABI. Methods 89 patients with acute brain injury within 24 hours after the injury were divided into severe group(n =47)and mild group(n = 42)according to Glasgow Coma Scale(GCS),and 35 normal healthy adults were selected as control group.In 24 hours and 72 hours after the brain injury,all patients were examined with echocardiography to observe cardiac structure,Doppler blood flow velocity and cardiac function,and in the same time the plasma NPY were determined by radioimmunoassay.Then the results were compared with controls. Results The parameters of cardiac function such as EF、 SV.AV、CO、CI had statistical change in 24 hours and 72hours after the brain injury between severe ABI group and mild ABI group,and it also had statistical change between severe ABI group and control group(all P <0.05),but no statistical change between mild ABI group and control group(all P ＜0.05).The level of plasma NPY in ABI patients was significantly higher than that before injury,there was statistically different change between severe ABI group and mild ABI group,and it also had statistical change between severe ABI group and control group(all P＜0.05).The parameters of cardiac function was negatively correlated with the rise of plasma NPY by pearson correlation analysis(EF:r =- 0.79,P <0.01; SV:r =- 0.71,P <0.01;AV:r=-0.67,P ＜0.01 ;E/A:r =-0.63,all P ＜0.01)and(CO:r =- 0.32,P ＜0.05;CI:r =-0.35,all P ＜0.05). Conclusion The parameters of cardiac function were significantly decreased in the patients with acute brain injury,and it was closely related with the level of plasma NPY.

Objective To evaluate the feasibility of a new reduction technique by comparing 2 reduction strategies in the treatment of distal femoral fractures with less invasive stabilization system (LISS).Methods A retrospective study was performed on the clinical data of 31 patients with distal femoral fracture who had been treated with LISS at Department of Orthopedics,Huadong Hospital Affiliated to Fudan University from January 2014 to December 2016.They were 11 males and 21 females.In 21 of them reduction of the fracture ends was conducted before fixation of the distal femur (strategy one),involving 9 males and 12 females with an age of 73.2 ± 16.2 years;in the other 10 of them reduction of the fracture ends was conducted after fixation of the distal femur (strategy two),involving 2 males and 8 females with an age of 70.8 ± 20.4 years.The 2 groups were compared in terms of perioperative blood loss,operation time,postoperative complications and the modified Hospital for Special Surgery (HSS) score of the affected knee joint.The enumeration data were compared with Fisher exact test and the measurement data with t-test.Results The 2 groups were compatible due to the insignificant differences in their preoperative general data (P ＞ 0.05).There were no significant differences between the 2 groups in terms of perioperative blood loss (593.3 ± 99.1 mL versus 494.7 ± 94.4 mL),operation time (121.7 ± 8.1 min versus 106.4 ± 8.5 min),rate of postoperative complications (0 versus 10％) and modified HSS score of the affected knee joint (83.8 ± 1.4 versus 84.2 ± 3.1) (P ＞ 0.05).Conclusions The 2 reduction strategies can lead to similar surgical effects in the treatment of distal femoral fractures with LISS.Strategy two can be a feasible alternative for surgeons with its theoretical advantage of simplicity.

Objective:To investigate the attention deployment emotion regulation disorder and its neural mechanisms in major depressive disorder(MDD).Methods:Twenty-six MDD patients(MDD group) and twenty-nine healthy control individuals(control group) were enrolled in this study.The accuracy and reaction time were recorded in the attention deployment behavioral paradigm.Neuroscan 64 Brain Evoked Potentiometer was used to detect the N1 and P3 components of the above two groups of subjects.SPSS 16.0 software were used to analyze the data.Results:(1)In the accuracy of attention deployment paradigm, the group main effect was significant ( F=11.626, P=0.001), indicating that the MDD group (0.82±0.01) was significantly lower than the control group(0.89±0.01)( P=0.001). In the reaction time of attention deployment paradigm, the group main effect was significant( F=16.55, P<0.01), indicating that the MDD group (1 460.82±41.86)ms)was significantly higher than the control group(1 226.31±39.63)ms)( P<0.01). (2)In the event-related potential of attention deployment paradigm, the group main effect of N1 was not significant ( F=2.949, P=0.092), and the interaction between task and group was significant ( F=4.756, P=0.034), indicating that the N1 amplitude induced by the MDD group in the calculation task(-3.699±0.441)μV) was significantly smaller than that of the control group (-5.055±0.418)μV)( P=0.030). The group main effect of P3 was not significant ( F=1.165, P=0.285), and the interaction between task and image attributes was significant ( F=11.602, P=0.001), indicating that the P3 amplitude induced by negative images(2.757±0.438)μV) was significantly higher than that of neutral images (1.963±0.460)μV)( P=0.002). Conclusion:Patients with MDD have difficulty transferring attention in emotional strategies, and it occurs in the early stages.

Objective To investigate the anti-oxidative effects of alprostadil on contrast-induced nephropathy(CIN)after percuteous coronary intervention (PCI)in patients with chronic kidney disease(CKD).Methods A total of 200 patients with CKD were enrolled in our hospital.According to the random number table was divided into alprostadil 100 cases,100 cases of conventional treatment group.The levels of serum creatinine (Scr),creatinine clearance (eGFR),serum cystatin C (ScysC)and 8-hydroxy-deoxyguanine (8-OHdG)were observed before and after operation at 72 h and 7 d after operation.Results The incidence of CIN in the alprostadil group was significantly lower than that in the conventional treatment group (6% vs 12%,P<0.05).There was no significant difference in the level of Scr,eGFR,ScysC and 8-OHdG between the alprostadil group and the conventional treatment group (P>0.05).The level of Scr in the alprostadil group was significantly lower than that in the conventional treatment group at 72 h and 7 d after operation.The level of eGFR was significantly higher than that of the conventional treatment group (P<0.05).The levels of ScysC and 8-OHdG in the two groups were significantly higher than those before operation at 72 h and 7 d(P>0.05).The levels of ScysC and 8-OHdG in the alprostadil group were significantly lower than those in the conventional treatment group at 72 h and 7 d after PCI(P<0.05).Conclusion Alprostadil may improve the oxidative stress in patients with CKD and provide a preventive effect on CIN.

【Objective】 To share the technical key points and experience of transvesical robot-assisted radical prostatectomy (TvRARP). 【Methods】 The clinical data of 13 patients with prostate cancer (PCa) receiving TvRARP during Nov.2021 and May 2022 were collected. The operation time, estimated blood loss, blood transfusion rate, catheter removal time, postoperative length of hospital stay, immediate urinary continence rate, postoperative IIEF-5 score and perioperative complications were evaluated. 【Results】 The operation time was (142±39) min, estimated intraoperative blood loss was (76±40) mL, and no transfusion was needed. The median postoperative IIEF-5 score was 16 (12-22), hospital stay 3 (2-5)days, and catheter removal time 7(5-14)days. Of all 13 patients, 12(92.3%) achieved immediate urinary continence at the removal of catheter. There were no postoperative complications of Clavien Ⅲ and above. Clavien Ⅰ-Ⅱ complications were observed in 4 patients (30.8%). 【Conclusion】 TvRARP is feasible and safe for selected patients with clinically localized PCa, which can ensure promising postoperative urinary continence and preserve erectile functional.