Objective:To explore the value of flow-mediated vasodilation(FMD)of brachial artery,which was assessed by high-frequency ultrasound assessment,combined with serum phosphatidylserine 1 phosphate(S1P)levels in predicting vascular endothelial function of patients with sepsis.Methods:A total of 140 patients with sepsis who admitted to the People's Hospital of Nanchuan Chongqing from February 2021 to February 2023 were selected as the case group,and 140 volunteers who underwent health physical examinations in the hospital during the same period were selected as the healthy control group.High-frequency ultrasound was used to measure the brachial artery FMD of the two groups,and the serum S1P levels of the two groups were also detected.The correlation between FMD,S1P and vascular endothelial function in patients with sepsis was analyzed,as well as the diagnostic performances of FMD and S1P in assessing vascular endothelial function of patients with sepsis.And then,the correlation between FMD,S1P levels and the vascular endothelial function score(VEFS)in patients with sepsis was further analyzed.Results:The FMD(4.21±1.63),S1P(0.82±0.24)and VEFS(0.42±0.15)levels in the case group were significantly lower than those(7.35±2.15,1.28±0.32,0.78±0.18)in the healthy control group(t=-14.23,-13.56,-17.32,P<0.05),respectively.The FMD and S1P levels were significantly positive correlation with VEFS in the case group(r=0.62,0.58,P<0.01),and they were significantly negative correlation with C-reactive protein(CRP)(r=-0.55,-0.51,P<0.01),respectively.As single-factor indicators of predicting vascular endothelial function of patients with sepsis,area under curve(AUC)values of receiver operating characteristic(ROC)curves of FMD and S1P levels were respectively 0.83 and 0.82,and the sensitivities of them were respectively 74.0%and 77.0%,specificities of them were respectively 78.0%and 75.0%.As the multi-factor indicator of predicting vascular endothelial function of patients with sepsis,the AUC,sensitivity and specificity of the combination of FMD and S1P levels were respectively 0.90,88.0%and 77.0%.Conclusion:Brachial artery FMD,which is assessed by high-frequency ultrasound,combined with serum S1P levels can effectively predict vascular endothelial function of patients with sepsis,which has important clinical significance in diagnosing and treating patients with sepsis.

Colorectal surgery originated in early civilizations, since then, its evolution follows a certain pattern. Most surgical techniques have their historical basis and have never been separated from social, technological, and conceptual progress. Given that the development of colorectal surgery and the development of surgical platforms and surgical concepts have mutually reinforced each other, this article collects historical information related to colorectal surgery and provides its historical review from the ancient Egyptian culture to modern civilization, taking into account the development of surgical platforms and concepts. The evolution of colorectal surgery is described as "for an understanding of the future, look to the past". For colorectal surgeons, in particular, a proper understanding of the evolution of colorectal surgery is the best way to understand its direction.

Objective To assess the clinical features and treatment of children with long QT syndrome (LQTS)and syncope.Methods Eleven cases of children with LQTS and syncope between January 2009 and July 2014 in Hunan Children′s Hospital were retrospectively analyzed for clinical features,treatment and long term follow -up.Results There were 11 cases of children with LQTS aged 4.0 -14.5(9.16 ±2.71)years,8 male and 3 female, with syncope more than once.The range of QTc was 460 -521(483.72 ±22.90)ms.For 3 cases of acquired LQTS,1 case was parathyroid hypothyroidism causing hypocalcemia,1 case was myocarditis complicated with third degree atrio-ventricular block,and 1 case showed atrial flutter receiving amiodarone post congenital cardiac surgery.All patients re-covered after the inducement removed and primary illness cured.For 8 cases of congenital LQTS,3 cases of LQTS un-derwent genetic test (1 case of KCNQ1 gene mutation,2 cases of KCNH2 gene mutation).One case died after frequent torsade de pointes (Tdp)and ventricular fibrillation during hospitalization,the remaining 7 patients were given oral pro-pranolol,potassium chloride sustained -release tablets after discharge.Follow -up time was 8 to 75 months,an average of (45.73 ±24.42)months.One case died suddenly at home after 25 months of follow -up.The remaining 6 cases of children with congenital LQTS could withstand general activities without syncope,in which 4 cases had normal QTc by electrocardiography(ECG),and the findings in 2 cases did not change compared with those previously.The QTc re-turned to normal in children with acquired LQTS in the follow -up review.Conclusions Children with congenital LQTS should receive early genetic screening and genotyping for rational use of drugs.For children with higher risk of sudden death,drug therapy combined with implantable cardioverter defibrillator should be considered.For acquired LQTS,it should be better to remove the inducement and treat primary disease actively.

Objective To evaluate the performance of virtual touch tissue quantification (VTQ)technique in noninvasive assessment of esophageal varices (EV) in patients with hepatitis B cirrhosis.Methods One hundred and thirty-five patients were enrolled in this study.Liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) were obtained by VTQ technique,and the detection of EV was performed by upper endoscopy per patient.The severity of EV was staged on a G1-G3 scale.Liver function was also tested.ResultsThe mean value of LSWV in patients with cirrhosis was (2.48±0.50)m/s,LSWV was not correlated with the stage of EV.The mean value of SSWV was (3.25 ± 0.44) m/s,a significant,direct,linear correlation ( r =0.66,P＜0.001 ) was found between SSWV and the stage of EV.The cut-off value of SSWV for predicting the presence of EV was 3.16 m/s and the area under ROC curve was 0.83,with the sensitivity and specificity of 0.83 and 0.80,respectively.The cut-off value of SSWV for predicting severe EV was 3.39m/s and the area under ROC curve was 0.84,with the sensitivity and specificity of 0.83 and 0.77,respectively.ConclusionsIn cirrhotic patients infected with hepatitis B virus,SSWV measured by VTQ technique can be used as a noninvasive method for determining the presence and the severity of EV,however evidence to support a similar role for LSWV is lacking.

Objective To study the etiological factors,clinical characteristics and diagnosis of acute pancreatitis (AP).Methods The clinical data of 217 patients with AP treated from January 2005to December 2010 in our hospital were studied retrospectively.Results The majority of patients were male (60.4％).The average age was 52.5 years.Cholelithiasiss,hyperlipidemia and trauma were the most frequent etiologic causes of AP.There were 164 patients with mild (75.6％) and 53 patients with severe (24.4％) AP.151 patients underwent surgical or endoscopical treatment (69.6 ％) while 66 patients underwent non-operative treatment (30.4 ％).14 of 53 patients with severe AP died.Conclusions AP should be treated according to the cause and the type.The key to reduce complications and increase cure rate is to find the cause of AP and then treat the underlying disease.

Objective To explore and analyse the causes of reoperation after biliary duct operation, so as to decrease the reoperation rate of biliary tract. Methods Clinical data of 71 patients who underwent reoperation of biliary duct diseases in our hospital between January 2005 to September 2010 were analysed,and the causes of biliary duct reoperation were summarized and analysed. Results The main cause of reoperation was recurrent or retained bile stone (76.1%,54/71), noncalculous stenosis of biliary tract ( 15.5 %, 11/71 ),biliary tract obstruction due to tumor (4.2%,3/71), and other factors (4.2%,3/71).Conclusion Recurrent or retained bile duct stone were the main cause for biliary reoperation, but noncalculous stenosis of biliary tract and biliary tract obstruction due to tumor could not be ignored. The initial rational operative method, approporiate operation time and the thoroughness of operation are the key factors to decrease bile duct reoperations.

Objective To prepare lipid-coated ultrasound microbubbles containing 10-HCPT(HLM) and explore the antitumor effects on mice xenografed H22 solid tumor using the technique of ultrasound-mediated HLM destruction. Methods Sixty-four tumor-bearing mice were radomly divided into A and B groups. Each group was divided into four groups again and administered respectively by tail vein with HI.M, non-drug-loaded microbubbles,10-HCPT and saline once a day. Ultrasound irradiation was applied on the tumor sites immediately after injection. After 7 days of consecutive treatment, all mice in group A were sacrificed and the tumors were harvested to measure weights. The tumor inhibition rate was calculated by weights. The tumor microvessel density (MVD) was detected by immunohistochemical staining. The tumor growth curve was depicted according to volumes. The survival time of mice in group B was recorded. Results The tumor inhibition rate was the highest in HLM group while this group's MVD was the lowest. Survival time in HLM group and 10-HCPT group were obviously longer compared with the control group,while no statistic difference was observed between the two groups. There was no statistic difference between the group of non-drug-loaded microbubbles and the control group. Conclusions Ultrasound irradiation mediates HLM destruction so that the drug is released from the vihicles at the same time, which can significantly enhance the tumor inhibition effect of 10-HCPT on the H22 tumor. This technique is expected to be adopted as a novel tool for liver cancer chemotherapy.