New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Objective To investigate the pathogen and inspection methods of the middle-aged women with constipation and evaluate the accuracy and clinical application of imaging to constipation.Methods First colonic transit test were used to 98 cases of middle-aged women who were diagnosed constipation by doctors,then air-barium double contrast examination were applied.Defecation radiography or simulation rectum defecography were used to those who were diagnosed as outlet obstruction.According to the measure target and diagnostic criteria of professor LU,the results were studied.Results 6 cases were abnormal within 8 cases who were inspected by barium enema.14cases were abnormal within 16 cases who were inspected by defecation radiography.Colonic transit test were used to 74 cases and only 6 cases were normal.16 cases were true slow transmission and 20 cases were false slow transmission.52 cases were outlet obstruction.20 volunteers were inspected by suspension barium sulfate and simulation rectum defecography.Conclusions Air-bariun double contrast examination could discover the organic disease and abnormal of rectum.colonic transit test,defecation radiography and simulation rectum defecography were simply and perfect methods to discover the pathogen of constipation.

The most common clinical manifestations of Hashimoto’s thyroiditis (HT) are goiter and hypothyroidism. The biochemical thyroid function varies quite widely among patients. Anti-TPO antibodies (TPOAbs) are the most sensitive index to screen HT. The thyroid function deteriorates gradually, and the hypothyroidism is the permanent sequeala of HT. The natural history of HT in children and adolescents is not fully known, and monitoring of thyroid function for all patients should be long-term. Children with hypothyroidism should be treated with levothyroxine replacement therapy.

Objective To investigate incidence and severity of retinopathy of prematurity (ROP)screened by RetcamⅢ and the related factors.Comparative case series were designed.Methods A study was performed among infants who required screening by RetcamⅢ in the second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University,and carried out between May 2012 and April 2013.A total of 1097 infants met the study criteria,and were divided into group Ⅰ (n =333 from outpatient screening) and group Ⅱ (n =764 from inpatient screening).Variables were recorded,including birth weight (BW),gestational age (GA),number of births (NOB,singleton/twins/triplets),gender,neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus (PDA),neonatal asphyxia,neonatal hyperbilirubinemia,intracranial hemorrhage,congenital heart disease,neonatal anemia,neonatal sepsis,necrotizing enterocolitis (NEC),and bronchopulmonary dysplasia (BPD).The results of ophthalmological examinations by RetcamⅢ were also recorded.Spearman correlation analysis was used to identify the variables most significantly associated with ROP.Results There were 98 infants of ROP in group Ⅱ (total 764,12.8％).There was a significant association of ROP with variables (P ＜0.05),including BW,GA,and NOB.There was a significant association of ROP with diseases (P ＜ 0.05),including NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD.However,there was no association of ROP with diseases (P ＞ 0.05),including PDA,neonatal hyperbilirubinemia,and congenital heart disease.Conclusions RetcamⅢ can be used to screen retina of infants.ROP is still the most common eye disease in preterm infants.The incidence of ROP was 12.83％ in Wenzhou.Variables,including BW,GA,NOB,NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD,were the most significant factors associated with ROP.

BACKGROUND:In vitro experiments have confirmed that human umbilical cord mesenchymal stem cells can be induced to differentiate into hepatocyte-like cells, thus which can be considered to function as liver repair.
OBJECTIVE:To observe the therapeutic effect of human umbilical cord mesenchymal stem celltransplantation on acute liver injuries in rats through in vivo animal experiments.
METHODS:Healthy Sprague-Dawley rats were randomly divided into three groups:normal control group without modeling, celltransplantation group, and PBS group. Rat models of acute liver injury were prepared by 10%CCl4-olive oil solution in the celltransplantation and PBS groups which were fol owed by intraperitoneal injection of 0.5 mL human umbilical cord mesenchymal stem cellsuspension and 0.5 mL PBS, respectively.
RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that pathological changes related to acute liver injury appeared at 24 hours after intraperitoneal injection of CCl 4 . Then, the liver structure recovered at 7 days after celltransplantation, but it did not recover til the 14th day after PBS injection. Compared with the normal control group, serum alanine aminotransferase and aspartate aminotransferase levels were significantly increased in the other two groups (P<0.05-0.01). In the celltransplantation group, the serum alanine aminotransferase and aspartate aminotransferase levels were significantly lower than those in the PBS group at 3 days after treatment (P<0.05-0.01), and recovered normal y after 7 days. cells positive for anti-human nucleoprotein antibody were found in the portal area of liver tissues in the celltransplantation group after 3 days of transplantation, and then cells positive for anti-human albumin antibody appeared after 7 days. These findings indicate that intraperitoneal transplantation of human umbilical cord mesenchymal stem cells can improve liver function and repair injured liver tissues after acute liver injury in rats to some extent.

Objective To investigate whether HBx alone is sufficient to directly transform the nontransformed immortalized human liver cell line QSG7701 and induce hepatocellular carcinoma in vivo,and to explore preliminarily the pathogenic mechanism of transplantation tumor in nude mice.Methods The pCMVX/QSG7701 cells were vaccinated into subcutaneous tissue of nude mice.The pRcCMV2/QSG7701 and QSG7701 Cells were used as control.At the fifth weeks after vaccination,the nude mice were killed to observe whether a tumor was formed.The activity state and food intake of the nude mice was recorded.The texture,volume,and metastasis of transplantation tumor were observed grossly.The transplantation tumor was observed microscopically on the hematoxylin and eosin (HE) staining section.Immunohistochemical surfactant protein (SP) method was used to analyze the protein expression of mutant p53 and C-Myc genes.Results The transplantation tumor was occurred in all of the six nude mice vaccinated with pCMVX/QSG7701 cells at the second week after vaccination.No metastatic tumor was found in other organs.Transplanted tumor was not formed in all of the negative control groups.HE staining analysis confirmed that the character of transplanted tumor was hepatocellular carcinoma.p53 and C-Myc proteins were expressed in pCMVX/QSG7701,pRcCMV2/QSG7701,and QSG7701 cells,and their expression levels in the pCMVX/QSG7701 cells were significantly higher than those in the pRcCMV2/QSG7701 and QSG7701 cells,respectively(P ＜0.01).Conclusions HBx alone is sufficient to directly transform the non-transformed immortalized human liver cell line QSG7701 and induce hepatocellular carcinoma in vivo through up-regulating the expression of mutant p53 and C-Myc genes.

Objective To investigate the correlation of the the positive rate and necrosis rate of retropharyngeal lymph nodes with the clinical effects of intensity modulated radiotherapy (IMRT) in treatment of nasopharyngeal carcinoma (PNC).Methods Seventy-two patients with PNC,50 males and 22 females,with the median age of 50,underwent IMRT delivered into 33 times.The retropharyngeal lymph nodes involved and positive lymph nodes of neck were delineated on the CT image.The median dose and median fractionated dose for gross tumor volume (GTV) were 70.0 and 2.12 Gy respectively,and the median dose and median fractionated dose for clinical target volume (CTV) were 70.0 and 2.12 Gy respectively.The patients were followed up for 36 (5-54) months.Results The metastasis rate of the neck lymph nodes was 90.3％,the metastasis rates in the regions Ⅰ-Ⅴ were 2.8％,86.0％,51.4％,20.8％,and 37.5％,respectively.The metastasis rate of the retropharyngeal lymph nodes was 79.2％,and specifically the metastasis rates of the left,right,and bilateral retropharyngeal lymph nodes were 51.4％,45.9％,and 18.1％,respectively.The cross metastasis rate was 6.9％.Necrosis of the retropharyngeal lymph nodes was found in 15 cases.The necrosis rates of the left,right,and bilateral retropharyngeal lymph nodes were 21.6％,27.2％,15.4％,respectively.Retropharyngeal lymph nodes metastasis was significantly correlated with N stage and clinical stage(Fuzhou 92:r =-0.383,-0.314,P ＜ 0.05 ; UICC:r =-0.434,-0.306,P ＜ 0.05).Local recurrence was observed in 4 patients,6 patients had distant metastasis,and 7 patients died.The positiveness of retropharyngeal lymph nodes was significantly correlated with the recurrence rate,distant metastasis rate,survival rate,and disease free survival rate (r =0.085,0.138,-0.140,-0.124,P ＜ 0.05),and the necrosis of the retropharyngeal lymph nodes was significantly correlated with the recurrence rate and distant metastasis rate (r =0.256,-0.057,P ＜ 0.05),and not significantly correlated with the survival rate and disease free survival rate.Conclusions Retropharyngeal lymph nodes metastasis in NPC is correlated with the N stage and clinical stage.The positiveness of retropharyngeal lymph nodes is significantly correlated with local recurrence,distant metastasis,and survival.Necrosis of retropharyngeal lymph nodes in NPC is significantly correlated with local recurrence and distant metastasis after IMRT.

Objective To analyze the clinical effectiveness,safety and significance of treatment with external circular fixator,through the relationship of inducible nitric oxide synthase (iNOS) and bone regeneration to further explore the mechanism of the molecular biology of bone lengthening at the same time.Methods Collected bone defect after tibial shaft fractures secondary infection who were treated with external circular fixator as study group (28 cases),all the cases fixed by external circular fixator,20 healthy volunteers as control group.Study group in different time point measured the levels of serum iNOS content,were compared with the control group.Results All patients were scheduled to reach the extremity lengthening and the bone defect were repaired and healed in study group.The bacterial culture results showed that 18 cases (64.29％,18/28) of resistant Staphylococcus aureus,5 cases (17.86％,5/28) of Hemolytic streptocaccus,2 cases (7.14％,2/28) ofP.aeruginosa,one case (3.57％,1/28) of drug-resistant Enterobacter cloacae,one case(3.57％,1/28) of Staphylococcus epidermidis,one case(3.57％,1/28) of Onion-like aeromonas,the proportion of the former two was significantly higher than other bacteria (P ＜ 0.05).The levels of serum iNOS content 1 d after surgery in study group were increased,compared with control group,difference was no significant (P ＞ 0.05).The levels of serum iNOS content 14 d after surgery,stoped extend,1 d stoped extend,3 d stoped extend in study group were significantly higher than those in control group [(118.8 ± 6.6) U/L vs.(86.4 ± 5.4) U/L,(136.2 ± 8.4) U/L vs.(88.2 ± 3.6) U/L,(132.6 ± 9.0) U/L vs.(87.6 ± 4.8) U/L,(103.8 ± 5.4) U/L vs.(86.4 ± 4.2) U/L] (P ＜ 0.05),there was no significant difference between two groups in other times (P ＞ 0.05).Conclusions External circular fixator for the repair and reconstruction effects in patients with bone defect can achieve the desired therapeutic goal,the higher expression of iNOS may be one of the molecular biological mechanisms of bone lengthening.

BACKGROUND:With elevated medical levels, limb salvage surgery for limb malignant tumor is valuable day by day. At present, the limb salvage surgery has substituted amputation and becomes mainstream and development direction of present surgical treatment of limb tumors. However, so far, there are no unified surgical indications for proximal femur tumor, which are controversial. OBJECTIVE:To investigate the efficacy of artificial total hip arthroplasty combined with extended resection of tumor sections for proximal femoral bone tumors. METHODS:Patients with proximal femoral bone tumors in the Second Xiangya Hospital of Central South University were selected and divided into control group and observation group, with 30 patients in each group. According to the disease, lesion curettage, aneurysm wal inactivation, autologous and (or) al ogeneic bone, mixed bone graft and bone graft fixation were selected to treat the control group. The observation group patients received extended resection of tumor sections and total hip arthroplasty. The operative time, intraoperative blood loss, hospital stay and joint function of two groups were compared. 2 years later, patients were revisited. Metastasis and recurrence rate, death rate and quality of life of two groups were compared. RESULTS AND CONCLUSION:There was no significant difference in intraoperative blood loss and surgery time between the two groups (P>0.05). However, hospital stay of patients in the observation group was shorter than the control group. The excellent and good rate of recovery of joint function (83%) was higher in the observation group than in the control group (53%). The metastasis and recurrence rate within 2 years after surgery (7%) and death rate (3%) were lower in the observation group than in the control group (30%, 23%). Various indicators of quality of life of patients in the observation group were significantly better than the control group (P<0.05). These results confirmed that artificial total hip arthroplasty in the treatment of proximal femur tumors is safe and effective.

Objective To explore the effects of vecuronium bromide within 24 hours in severe bronchial asthma with acute attack with breathing machine in conventional sedatio.Methods Prospective study,double-blind randomized standard control,where 46 cases of patients of severe bronchial asthma with acute attack transferred to ICU using breathing machine in this year were randomly divided into the vecuronium bromide group (muscle relaxant group) and conventional sedation group (normal group) according to medical record number; Two groups of sample compositions were compared by x test,using two independent samples of t test to compare the effects the treatment and prognosis.Results After mechanical ventilation for 15min and 1-3h in muscle relaxant group,patients' vital signs were statistically analyzed,including respiration; Blood gas analysis parameters were as follows:pH,PaO2,PaCO2,SpO2 of these were improved compared with those in the conventional group (P ＜ 0.05) with statistically significant differences;Compared with the conventional group,in the muscle relaxant group,the retention time in ICU (146.20 ± 17.92) hours,(214.15 ± 22.21) hours,the using time of breathing machine (125.93 ± 16.23) hours,(192.89 ± 22.60) hours,and the dosage of glucocorticoid (2.61 ± 0.17) mg · kg-1 · d-1,(3.55 ± 0.26) mg · kg-1 · d-1,anticholinergic agent(6.25 ±0.51) μg · kg-1 · d-1,(10.64 ±0.75) μg · kg-1 · d-1 and β2 adrenergic receptor agonist (0.06 ±0.01)mg · kg-1 · d-1,(0.15 ±0.04)mg · kg-1 · d-1 were all reduced (all P ＜0.05) with statistically significant differences;The patients were smoothly transferred out of ICU,without the adverse events of mechanical ventilation and cardiovascular diseases.Conclusion The use of vecuronium bromide made the patients with severe bronchial asthma in routine sedation use of breathing machine rapidly correct the clinical symptoms and improve the off-period prognosis.