Objective To compare the differences between laparoscopic-assisted and open resection of rectal carcinoma in respect of peri-operative levels of C-reactive protein (CRP), rest energy expenditure (REE), and visceral proteins. Methods According to patients' choice of operation, either laparoscopic-assisted (n=20, Laparoscopic Group) or open (n=25, Open Group) resection of rectal carcinoma was performed. The levels of CRP and visceral proteins-including albumin (ALB), prealbumin (PRE), transferrin (TRF), and retinal-binding protein (RbP)-were assayed preoperatively and on the 1st, 2nd, and 3rd day postoperatively. The levels of REE were also measured by indirect calorimetry in the morning. Results Compared with the preoperative period, the CRP levels in both groups were significantly increased on the 1st, 2nd, and 3rd day (P0.05). The levels of PRE in the Laparoscopic Group were significantly higher than those in the Open Group on the 2nd postoperative day (P

Objective To explore the influence of Al2O3 nanoparticle (20nm in average) on RP4-mediated conjugation and its mechanism was explored further. Methods Mating was conducted between E.coli HB101(RP4) and Salmonella aberdeen Kauffmann 50312(strR) in saline at 25 ℃ without stirring for 8 h,the concentrations of Al2O3 nanoparticle were 0.005,0.05,0.5,5,50 mmol/L respectively. The initial concentration of donor and recipient were both about 109 cfu/ml(donor per recipient ratio was 1∶3).Later transmission electron microscope(TEM) and laser scan confocal microscope (LSCM) were exploited to investigate cell morphology and structure. Results 5 mmol/L and 50 mmol/L Al2O3 nanoparticle could increase the conjugal transfer frequency by 150-fold and 40-fold respectively. TEM observation on thin section indicated several bacterial were prone to form conjugational junction together in 5 mmol/L and 50 mmol/L Al2O3 nanoparticle treated group,which was rarely seen in control group. Meanwhile the cell envelope of bacterial was significantly damaged upon the treatment by 50 mmol/L Al2O3,which might be the reason why transfer frequency of 50 mmol/L Al2O3 group was less than 5 mmol/L Al2O3 group. LSCM result indicated that Al2O3 nanoparticle might damage cell envelope and the damage was positively related to the accumulation of Al2O3 in bacterial. Conclusion Al2O3 nanoparticle can stimulate RP4 conjugal transfer. Conjugative gene is highly regulated. Al2O3 nanoparticle might modulate conjugative gene expression directly or influence cell membrane permeability and thus modulate the process of conjugation indirectly .

[Objective]To discuss the common complications and the methods of prevention and treatment in the operation of displaced acetabular fracture.[Method]Sixty-six cases with displaced aceuabular fracture were treated operatively from August 2005 to June 2009.Approach included anterior ilioinguinal approach,posterior Kocher-Langenbeck approach,or combined ilioinguinal and Kocher-Langenbeck approach.The functional results and complications were analyzed.[Result]All cases were followed up for an average of 29 months(12-46 months).According to the Matta evaluation,the anatomical reduction of acetabular fracture were in 34 cases,perfect in 25,and unsatisfactory in 7.According to the modified Merle d' Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as being excellent in 23 cases,good in 29,fair in 8,poor in 6.Sciatic nerve injury after operation were noted in 2 hips,osteoarthritis in 14,heterotopic ossification in 10,and avascular necrosis of femoral head in 2.No infection and death were founded in this group.[Conclusion]The important factors to decrease the operative complications of acetabular fracture include correct fracture classification,suitable operative time,good operative approach,proficient technique of reduction and fixation and reasonable perioperative measures.

Objective To discuss the method and surgical technique in treatment of the displaced acetabular fracture.Methods The study involved 66 patients with displaced acetabular fracture treated operatively with reconstruction plates from August 2005 to June 2009.Based on the fracture typing,the surgical techniques including anterior ilioinguinal,posterior Kocher-Langenbeck,combined ilioinguinal and Kocher-Langenbeck and Y shaped approach were performed in 12,30,22 and 2 patients,respectively.Results The operation time was mean 3.4 hours(1.5-6.5 hours),with mean blood loss of 550 ml(range,350-1 200 ml).All patients were followed up for average 29 months(range,12-46 months).According to Matta evaluation standard,the reduction of acetabular fracture was anatomical in 34 patients,imperfect in 25 and unsatisfactory in seven.According to the modified Merled' Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as excellent in 23 patients,good in 29,fair in eight and poor in six.Conclusion The factors key to successful operation include correct fracture classification,good approach anatomy,proficient technique of reduction and fixation,and reasonable perioperation measures.

Objective To investigate the effects of ghrelin on colonic motility in mice.Methods The eflfects of ghrelin on colonic propulsive movement were detected by charcoal suspension pushing test after injection of normal saline and different doses of ghrelin(20,50,100,200 ng/g).The effects of atropine,NG-nitro-L-arginine methylester hydrochloride(L-NAME)or D-Lys3-GHRP-6 on the changes of colonic propulsive movement caused by ghrelin(100 ng/g)were also investigated.In vitro,the effects of different doses of ghrelin(0.01,0.1,1,10μmol/L)on the spontaneous contraction amplitude of proximal colonic circular muscle strips were studied.Results Ghrelin significantly accelerated the colonic propulsive movement in dose-dependent manner,but the efiect was significantly inhibited in the presence of atropine,L-NAME or D-Lys3-GHRP-6(t=10.230,12.560,11.590,P＜0.05).Administration of ghrelin significantly increased the contraction amplitude of colonic circular muscle strips.but this effect was inhibited when the colonic circular muscle strips were pretreated by tetrodotoxin.ConclusionsGhrelin can accelerate colonic propulsive movement by activating growth hormone secretagogue receptor of cholinergic excitatory pathways and nitrergic nervous pathways in the enteric nervous system of colon.

Objective To investigate the clinical efficacy of atlantoaxial pedicle screw fixation plus bony fusion in treatment of traumatic upper cervical instability.Methods From October 2009 to August 2013,29 patients with traumatic upper cervical spine instability were treated with posterior atlantoaxial pedicle screws.The patients underwent autografting (n =19) and allografting (n =10) for spinal fusion.Surrcal outcomes were recorded including intraopcrativc blood loss,operation time,with or without nerve,blood vessel and spinal cord injury,wound healing and bone fusion rate.Results All operations were completed smoothly with operation time of 110 minutes (range,85-135 minutes) and blood loss of 150 ml (range,80-500 ml).At the follow-up of 10 months to 5 years (mean 18 months),bony fusion was detected for all the patients.Postoperative radiographs verified all patients were bony fusion with satisfactory cervical spine stability.No complications of reduction loss,fixation failure,and spinal cord or vertebral artery injury were observed except for 1 patient with low viruleut infection and 2 with delayed wound healing.Conclusion Single posterior atlantoaxial pedicle screw fixation provides security and reliable stability in treatment of upper cervical instability,however wound healing problems should be taken seriously.

Objective To investigate the clinical efficacy and toxicity in the use of simultaneous integrated boost intensity modulated radiation therapy (SIB-IMRT) for inoperable locally advanced nonsmall cell lung cancer (LA-NSCLC).Methods Between February 2012 and July 2015,58 pathologically diagnosed inoperable LA-NSCLC patients treated with SIB-IMRT were analyzed.A radiation dose of 50-64 Gy was administered in 1.8-2.2 Gy/fraction (26-30 fractions) to the planning target volume (PTV).Simultaneously,60-70 Gy was administered in 2.0-2.35 Gy/fraction (26-30 fractions) to the planning gross tumor volume (PGTV).Results The median follow-up time was 28.0 months (ranging from 6.0 to 40.0 months).The median overall survival (OS) and progress-free survival (PFS) were 25.0 (95％ CI:23.8-26.2) and 15.0 (95％ CI:11.3-18.7) months,respectively.The 1-,2-year OS were 91.4％ and 51.7％,respectively.The 1-,2-year PFS were 56.9％ and 22.7％,respectively.None of the patients developed grade 4 or 5 pneumonitis and esophagitis.In addition,in the subgroup analysis,the patients with N3 have a higher incident of ≥ grade 2 esophagitis compared with N0-N2,the incident are 29.2％ and 20.6％,respectively (P ＜ 0.05).Conclusions SIB-IMRT is feasible and well-tolerated for inoperable LA-NSCLC patients.It remains to be further evaluated in a large sample size prospective clinical trial.

Objective To investigate the potential differences in efficacy of anterior and posterior cruciate ligaments(ACL &PCL)reconstruction by using arthroscopy between autologous tendon and tendon allograft.Methods A total of 144 patients with ACL or PCL fracture were assigned into two groups,namely anterior tibial muscle tendons allograft(n =82)and tendons autograft(n =63).The graft was fixed by using the Endobutton and Intrafix systems. The general information,drawer test,Lachman test,IKDC score,Lysholm score and Tegner score were compared between groups before and after surgery.The mean follow -up period was 16 months,ranged from 6 to 24 months. Results Both two groups received significant improvement after surgery and met the requirements of ligament reconstruction.However,those patients received autologous tendon had less complications,better knee stability.There were significant differences in Lachman score,ADT/PDT score,IKDC score[(83.43 ±4.37)points vs.(81.05 ± 4.41)points],Lysholm score [(90.59 ±3.43)points vs.(89.03 ±3.25 )points],and Tegner score [(7.79 ± 0.94)points vs.(7.37 ±0.90)points]between the two groups in 12 -month(χ2 =9.509,9.080,t =3.237,2.770, 2.729,all P <0.05).Conclusion The efficacy of autologous tendon is better than tendon allograft in anterior and posterior cruciate ligaments reconstruction,which should be considered has highest priority in treating patients with anterior or posterior cruciate ligaments fracture.

Objective To investigate the efficacy and mechanism of subcutaneously given recombinant Der p 2 entrapped PLGA nanoparticles(DEPN) on mouse model with allergic airway inflammation.Methods 40 BALB/c mice were randomly divided into 5 groups,group A(normal control) were treated with saline(100 ?l) all the time,groups B,C,D and E were sensitized intraperitoneally with crude dust mite extracts(10 ?g) and then subcutaneously treated respectively with PBS(100 ?l),2 mg empty PLGA(EP),100 ?g rDer p 2,and 2 mg DEPN(loaded with 100 ?g rDer p 2) for 3 times,once per day,followed by intranasal challenge of 50 ?g rDer p 2.One day post challenge,mice were sacrificed and bronchoalveolar lavage fluid(BALF) was collected.Number of the total cells and eosinophils was determined,and airway inflammation and mucus secretion were analyzed by haematoxylin and eosin(H&E) staining and periodic acid-Schiff(PAS) staining.Level of cytokines in the supernatant of splenocyte culture was assayed by ELISA.Level of rDer p 2 specific IgG2a and IgE in the sera was determined by ELISA.Results The lung histology showed development of eosinophil infiltration in the airway of mice in groups B and C.The lung inflammation and mucus secretion in groups D and E were significantly alleviated than that of groups B and C.Number of total cells(63.50?5.12) andeosinophils(15.32?3.04) in BALF decreased in group B.Compared with group B,the number of total cells in groups D(55.3?5.20) ? 104 /ml and E(41.00?4.91) ?104 /ml greatly decreased(P

Objective To discuss the method and efficiency of less invasive stabilization system (LISS) in treatment of comminuted tibia[ fractures. Methods A total of 14 patients with comminuted tibial fractures were treated with LISS between January 2005 and July 2006. There were 10 males and four females, at age range of 19-61 years (mean 34 years). Of all, 11 patients were with proximal fractures of tibia and three with distal ones, including six with open fractures and eight with closed ones. The period from injury to operation was 2-13 days. An observation was done on postoperative soft tissue recovery and fracture healing. Results The average period of follow-up was 9.4 months (4-16 mouths). All frac-tures were healed up after average 7.8 months (4-12 months). All incisions were healed up at one stage, with no complications on nerves, blood vessels or soft tissues. The axes of tibia were good, with sound function of knee and ankle joints. Conclusion LISS is characterized by easy operation, minor trauma, high healing rate and low complications in treatment of comminuted tibial fractures.