Laparoscopic surgery has gained wide acceptance for its use in benign gastrointestinal cancer in the past 20 years, while its use in malignant gastrointestinal cancer has been highly controversial until the recent 3-5 years. Several prospective randomized clinical trials have suggested that the long-term outcome of laparoscopic surgery for colon cancer is the same as or better than that of open surgery. As for rectal cancer, whether the principles of total mesorectal excision can be well followed in laparoscopic surgery remains. Most recently, the trial of large number of patients doesn't show any differences upon local recurrence and 3-year survival rate between rectal cancer patients in laparoscopic group and open group. Laparoscopic surgery has been widely accepted as a standard treatment regimen for early gastric cancer in many specialized centers. Meanwhile, the feasibility and effectiveness of laparoscopic D2 lymphadenectomy for gastric cancer has been proved by several scholars. The use of laparoscopic surgery for advanced gastric cancer especially for T3 gastric cancer still remains controversial. The early concern that laparoscopic surgery for malignant cancer might increase tumor dissemination is not confirmed. The system of technical training and occupational qualification, proper selection of patients and adherence to all the principles of cancer clearance will ensure a good result of laparoscopic surgery for malignant gastrointestinal cancer.

The incidence of rectal cancer has been increasing over past decades in China, making it the third most common malignant tumor. Multidisciplinary treatment plays a fundamental role in the successful treatment of rectal cancer.Total mesorectal excision has been wildly accepted as the standard technique, however, this procedure has not been standardized in China. Neoadjuvant radiation has been accepted as a standard regimen for patients with an advanced rectal cancer at a higher risk of local recurrence, even though controversies remain, such as the selection of patients for preoperative radiation and the optimum regimen for radiation. Combination of chemotherapeutic agents and targeted therapies is recommended according to updated results of randomized controlled trials (RCTs). In the future, multidisciplinary treatment should be adjusted according to the socioeconomic status of China and RCTs results in Chinese population. Standardization of surgery and surgery quality control also continue to play a core role in improving treatment results of rectal cancer in China.

Software for quantitative analysis of endothelial cell (EC) area, form fac-tor, intercell-plasma-membrane distance and percentage of intercellular gap area in the cellmonolayer was established in a computer image analysing system with great capacity, highspeed and high resolution. The effects of platelet activating factor (PAF) on EC morpho-logical parameters were studied. The results showed that the untreated EC monolayer hadclose contact and narrow gap among cells. After 60 min treatment with 10~(-8)mol/L PAF,the cells showed obvious retraction, with procession of different size from the plasma mem-brane and increased intercellular gap. Computerized quantitative analysis revealed thatthe treatment with PAF for 10 min increased intercellular distance and percentage of inter-cellular gap area in cell monolayer. Thirty minutes treatment decreased cell area butincreased form factor ascertaining to the retraction of EC. This is probably an importantmechanism of increased vascular permeability induced by PAF It is also suggested thatcomputerized image analysis is helpful in rapid, precise and quantitative measurement ofEC morphological changes. It provides a new method for studying the effects of endothe-lial cells in increased vascular permeability.

BACKGROUND: Orthopedic academics are committed to the modification of calcium phosphate cement (CPC) by adding different additives, including the promotion of curing agents, plasticizers, anti-water blood solvent, porogen, enhancer, or biological activity substance or drug compound to the CPC in order to enhance its physical and chemical and biological properties which is a research hotspot in the field. OBJECTIVE: To investigate the physical and chemical characteristics of a biodegradable injectable CPC. DESIGN, TIME AND SETTING: Duplicated testing study was performed at the National Key Laboratory, College of Materials, South China University of Technology from December 2008 to May 2009. MATERIALS: Calcium phosphate with partial crystallization and strontium phosphate and calcium hydrogen phosphate dehydrate with partial crystallization were added with modified starch and type I collagen to prepare a new type of self-injectable CPC. METHODS: CPC phase was analyzed using X'Pert Pro X-ray diffractometer; CPC morphology was observed using HITA2 -CHIH-800 transmission/scanning electron microscope; setting-up time was tested using Vicat apparatus according to A S TM C190203 standard; compressive strength was measured using Instron 5567 omnipotent electron apparatus; syringeability was detected using syringe apparatus with 1.6 mm of inside diameter; collapsibility was tested using soaking-shaking quantitative materials. MAIN OUTCOME MEASURES: Phase component and microstructure of CPC products, setting-up time, syringeability, compressive strength, and collapsibility. RESULTS: The material coul be injected with an excellent performance, and the modified starch significantly improved the resistance of bone cement collapsibility. As the bone cement liquid-solid ratio increased, the compressive strength of cement decreased. When the bone cement liquid-solid ratio was 0.3, the compressive strength for cement was (48.0±2.3) MPa when the bone cement liquid-solid ratio was 0.6, the compressive strength of bone cement reduced to (21,0±2.5) MPa. Hydration productof cement-like bone hydroxyapatite crystallization also could be seen from the X-ray diffraction, due to the hydration of-cement was not complete, a baseline level of volatile explained fully hydrated conditions, suggesting that the bone cement could farther improve the compression strength. CONCLUSION: Developed an injectable strontium-contained collagen CPC is coincidence with the biomechanical strength of the human body and meets the requirements of the operation conditions.

OBJECTIVE Deep sternal wound infection (DSWI) is one of the most serious complications after the open heart cardiac surgery. To explore the risk factors and appropriate treatment methods,we performed this study retrospectively. METHODS Between Jan 2001 and Jan 2006,1123 patients underwent various cardiac surgical procedures via a median sternotomy in the Cardiovascular Center of Beijing Tongren Hospital. These patients were divided into two groups by whether suffered from DSWI. Univariate analyses were performed for possible risk factors,and Logistic regression was used in multivariate analysis. RESULTS Eight among 1123 (0.71%) patients suffered from DSWI. No one died from wound infection. Results from both single variate analysis and multivariate analysis showed that only age significantly associated with DSWI. No other independent risk factors significantly associated with DSWI. Blood culture in acute DSWI group tended to be positive,while in chronic group it tended to be negative. All patients with DSWI were effectively cured. CONCLUSIONS Age is an independent risk factor for DSWI. Early debridement with closed chest catheter irrigation and antibiotics using are strongly recommended as an easy and effective way to treat DWSI. Large-scale multicenter studies are still needed to determine reliable risk factors for DSWI.

Objective To evaluate the effectiveness of locking compression plate (LCP) in treatment of comminuted fractures of distal end of radius. Methods A retrospective analysis of the clinical data was done for the 24 patients with comminuted fracture of distal end of radius who had been treated by locking compression plate fixation from August 2002 to August 2003. Results The follow up duration averaged 7.8 months. The satisfactory rate of functional outcome with LCP fixation was 91.6 percent. Conclusion Although LCP can provide the outstanding stability theoretically, it has not resulted in more exciting outcomes in treatment of comminuted fractures of distal end of radius than traditional methods.

BACKGROUND: Overexpression of cancer suppressor gene ING1 may cause apoptosis of many kinds of cancer cells and results in cell cycle arrest in G1 stage. ING1 is involved in p53 signaling pathway and regulates the activity of p53 as a transcription-activating factor.OBJECTIVE: To explore the association of ING1 gene expression and mutation with the clinicpathological features of colorectal cancer.DESIGN: A controlled observation of the pathological samples.SETTING: Department of General Surgery, Southwest Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 52 fresh colorectal cancer samples were obtained from patients hospitalized in the Southwest Hospital, Third Military Medical University of Chinese PLA from October 1998 to October 1999. Normal mucosal tissues were also collected 10 cm from the margin of the tumor during the operation. The patients included 29 male and 23 female patients with an average age of 50.28 years.METHODS: ING1mRNA and protein expressions were detected in the 52 colorectal cancer tissue samples. The ING1 gene mutation was detected by analyzing single-stranded DNA polymorphism. The expression of p53 protein in the colorectal cancer tissue was detected immunohistochemically.tion-single-strand conformation polymorphism.was obviously decreased in comparison with that in the normal mucosa(0. 626 ±0. 382 vs 1. 166 ±0. 245, P ＜ 0. 001) . The expression of ING1 in the tumor tissue of patients with lymphatic metastasis was significantly lower than that in the tumor tissues from patients without lymphatic metastasis (0. 393 ±0. 243 vs 0. 960 ±0. 299, P ＜0.01). The expression of p53 protein was positively correlated with ING1 mRNA expression( P ＜ 0.01). Only one of the 52 samples was positive for ING1 gene mutation.CONCLUSION: ING1 gene may participate in the occurrence and progression of colorectal cancer and its decreased expression inhibits the action of tumor suppressor genes. The decrement in ING1 mRNA and protein expression without gene mutation indicates that ING1 participates in the pathogenesis of colorectal cancer in a manner quite different from that of the classic tumor suppressor genes.

Objective To evaluate biomechanical properties of self-designed polyaxial self-locking anatomical plate so as to offer scientific evidence for clinical application.Methods According to anatomic characteristics of distal tibiae of domestic people,a polyaxial self-locking anatomical plate for distal tibia was designed.Six paired ( left,right) fresh cadaver tibial specimens were used to make fracture fixation models and were divided into groups A and B,six specimens per group.Common anatomical locking plates were assembled in group A and polyaxial self-locking anatomical plates were assembled in group B.The biomechanical tests were performed by using 858 Mini Bionix testing machine.Non-destructive tests were performed in both groups,including axial loading,4-point bending and torsional loading and the stiffness of the two fixation instruments was compared.SPSS 13.0 software was used for statistical analysis.Results Polyaxial self-locking anatomical plate was fit for the morphology of distal tibiae.The self-designed pelyaxial plate could increase angular regulation amplitude for the locking screw up to 30°.Compression stiffness was (557.53 ± 20.72) N/mm in group A and (562.80 ± 28.26 ) N/mm in group B.Four-point bending stiffness was ( 268.02 ± 36.77) N/mm in group A and ( 265.76 ± 27.21 ) N/mm in group B.Torsional stiffness was (0.28 ±0.01) Nm/deg in group A and (0.29 ±0.02) Nm/deg in group B.The three tests in two groups showed no statistical significance ( P ＞ 0.05 ).Conclusions The self-designed polyaxial self-locking anatomical plate of distal tibia is fit for the tibial morphology of domestic people.Its biomechanical properties are equivalent to those of common anatomical locking plate,which can meet the needs for clinical application.

We established a method to study vascular permeability in vitro on perfused endothelial cell monolayer cultured on micropore filter membrane. It can be used to determine filtration coefficient (Kf) and osmotic reflection coefficient (?) to proteins. Hanks balanced salt solution (HBSS) or 5 g/L albumin in HBSS was used to perfuse confluent endothelial monolayer. Control Kf values were 10.1 ?0.75 and 3.6?0.75?l . min-1 . cm-2 . kPa-1 (n = 3, x?sx) respectively for HBSS and albumin HBSS perfusion, suggesting that albumin may decrease endothelial monolayer permeability to water and small molecules. After exposure of endothelial monolayer to 10-8 mol/L platelet-activating factor (PAF) for 30 min, Kf values increased to 193.1% and 133.3% respectively for HBSS and albumin HBSS perfusion. Protein clearance rate (?l. min-1 . cm-2:) and osmotic reflection coefficient of control endothelial monolayer were 8.0?3.22 and 0. 37?0.09 respectively. In PAF treated endothelial monolayer,they were 12.2 ? 2.95ul min-1 cm 2 and 0.18?0.06, revealing increased permeability to albumin. Computer-assisted image processing demonstrated that PAF treatment decreased cell area while increased cell form factor and intercellular space. The results sug-gest that endothelial cells retracted, rounded and it may be an important mechanism in PAF-induced increased vascular permeability.

Objective On basis of physical dose optimization, LQ model was used to investigate the difference between the curves of biological effective dose and physical isodose. The influence of applying the biological dose concept on three dimensional conformal radiotherapy of prostate carcinoma was discussed. Methods Four treatment plannings were designed for physical dose optimization: three fields, four-box fields, five fields and six fields. Target dose uniformity and protection of the critical tissue -rectum were used as the principal standard for designing the treatment planning. Biological effective dose (BED) was calculated by LQ model. The difference between the BED curve drawn in the central layer and the physical isodose curve was studied. The difference between the adjusted physical dose (APD) and the physical dose was also studied. Results Five field planning was the best in target dose uniformity and protection of the critical tissue -rectum. The physical dose was uniform in the target, but the biological effective doses revealed great discrepancy in the biological model. Adjusted physical dose distribution also displayed larger discrepancy than the physical dose unadjusted. Conclusions Intensified Modulated Radiotherapy (IMRT) technique with inversion planning using biological dose concept may be much more advantageous to reach a high tumor control probability and low normal tissue complication probability.