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Objective: To investigate the expression of Macrophage migration-inhibitory factors (MIF) in hepatocellular carcinoma (HCC) tissues and its interaction with ERK1/2 signaling pathway, so as to establish a theoretical basis for further studying the molecular mechanism of MIF promoting HCC. Methods: From February 2020 to August 2021, 52 cases of hepatocellular carcinoma (HCC) tissues based on hepatitis B cirrhosis (HBV-LC) and 52 cases of adjacent tissues in Tianjin Medical University Cancer Hospital and 940th Hospital of Joint Logistic Support Force of PLA were collected as the experimental group, including 39 males and 13 females, aged 35-65 years. And 20 cases of normal liver tissue were selected as the control group. Immunohistochemistry was used to detect the expression of MIF, ERK1/2 and p-ERK1/2 proteins in liver tissues of the two groups, and in situ hybridization was used to detect the expression of ERK1/2 nucleic acid in liver tissues of the two groups.HepG2 HCC cells and L-02 normal hepatocytes were co-cultured with different concentrations of rMIF, the expression and phosphorylation levels of ERK1/2 and JNK1 proteins in the two kinds of liver cells were detected by Western-blot, and the expression levels of ERK1/2 nucleic acids in the two kinds of liver cells were detected by RT-PCR. One-way ANOVA was used for measurement data and χ 2 test was used for counting data. Results: The expressions of MIF, ERK1/2, p-ERK1/2 and ERK1/2 mRNA were significantly increased in HCC and para-cancer tissues (the expression of MIF in HCC group was 78.8%, and that in adjacent group was 75.0%; ERK1/2 80.8% in HCC group and ERK1/2 71.8% in paracancerous group. The expression of p-ERK1/2 75.0 % in HCC group and 46.2% in paracancerous group were respectively detected. ERK1/2 mRNA was expressed in HCC group 76.9%, ERK1/2 mRNA expression in paracancerous group 78.8%), and the differences were statistically significant compared with normal liver tissues ( P< 0.05), but there was no significant difference between HCC and para-cancer tissues ( P >0.05). The expressions of ERK1/2, p-ERK1/2 and ERK1/2 mRNA in HepG2 HCC cells were significantly increased with the increase of rMIF concentration, and the increase was most obvious when rMIF concentration was 200 ng/ml, and the difference was statistically significant compared with L-02 normal hepatocytes ( P <0.05). Conclusion: MIF, ERK1/2 and p-ERK1/2 are highly expressed in HCC tissues and HepG2 HCC cells, suggesting that MIF promotes the occurrence and development of hepatocellular carcinoma through ERK1/2 signaling pathway.

Objective: To investigate the effect of esculin on the proliferation of triple negative breast cancer cells and its molecular mechanism. Methods: MDA-MB-231 cells were treated with 28, 56, 112, 225, 450 and 900 μmol/L of esculin for 24, 48 and 72 h, respectively, and the cell viability was detected by cell counting kit 8 (CCK-8) assay. In addition, MDA-MB-231 cells were treated with 0, 225, 450 and 900 μmol/L of esculin for 48 h. And then the changes in cell morphology were observed by inverted microscope. The clone-forming ability was detected by colony formation assay. The mRNA expression levels of FBI-1, p53 and p21 were detected using real-time fluorescence quantitative polymerase chain reaction. The protein expression levels of FBI-1, p53, p21 and Ki67 were detected by western blot. Results: Compared with the blank control group, the cell viability of MDA-MB-231 cells that treated with esculin significantly decreased in a dose-dependent and time-dependent manners. After treatment with esculin, MDA-MB-231 cells shrunk, flattened, adhered poorly to the culture dish and the cell spacing became larger. Meanwhile, shedding and incomplete cells appeared, of which 900 μmol/L of esculin treatment group showed the most dramatic changes. In addition, the colony formation ratios were decreased to (77.18±5.13)%, (65.94±4.98)% and (45.92±3.70)% in the 225, 450 and 900 μmol/L of esculin treatment groups compared with blank control, respectively ( P <0.01). Furthermore, the mRNA and protein expressions of FBI-1 increased, while the levels of p53 and p21 mRNA and protein, as well as the protein expression of Ki67 decreased in a concentration-dependent manner ( P <0.01). Conclusion: Esculin may regulate cell cycle-related p53-p21 pathway via FBI-1 mediated DNA replication, thus inhibit the proliferation of triple negative breast cancer cells.

Musk,with unique and intense perfume,was a kind of deep brown precious medicinal material in traditional Chinese medicine. However,the immature musk in musk pot was white and stench. Given the fact that bacterial diversity generated odorous metabolites in animal hosts,in this study,musk samples at three different mature stages,including MJ( the end of June),MA( the end of August) and MO( the end of October) were harvested from three male forest musk deer,and then next-generation sequencing was used to intensively survey the bacterial communities in musk harvested at different mature stages. RESULTS: indicated that the average OTUs per sample at the end of June,August and October were 47 116. 00 ± 1 567. 24( SE),52 009. 00 ± 8 958. 75( SE) and50 004. 67±4 135. 57( SE),respectively. Feature of the musk 16 S rRNA gene showed a total of 418 genera belonging to 52 phyla were observed in all samples. The main microbiota was bacteria,which accounted for 98. 82%,99. 95% and 99. 58% in MJ,MA and MO,respectively. At phylum level,Firmicutes was the most abundant bacterial of MA( 32. 75%) and MO( 39. 19%). While,the major bacterial in MJ was Proteobacteria( 49. 14%). PICRUSt analysis revealed the functions of bacterial in MJ were mainly involved in secretion,while bacterial functions of MA and MO were mainly involved in amino acid or other substance metabolism,which was in accord with the musk secretion physiological process of forest musk deer. This is the first study involved in the bacterial diversity in musk of forest musk deer across the maturation process,while may provide a new insight into the musk generation mechanism.

Objective: To explore the clinical characteristics and treatments of patients with idiopathic sudden sensorineural hearing loss（ISSHL） with or without vertigo. Method: One hundred and twenty ISSHL cases were divided into vertigo group ( n =36) , without vertigo group ( n =84) , and with benign paroxysmal positional vertigo group ( n =15). All patients were in regular treatment. Besides, according to the types of BPPV, patients do the Epley maneuver or Barbecue roll maneuver. We summarized the result and treatment of the patients. Result: The audiometric curve of ISSHL with vertigo were mainly at flat type. After treatment of the ISSHL patients were better than the patients with vertigo in the degrees of hearing loss . Furthermore, the rate of the patients of marked efficiency, efficiency and total efficiency of ISSHL was lower than the ones without.The patients with BPPV, including 12 cases of posterior semicircular canal and the 3 cases of lateral semicircular canal, were all ipsilateral. Conclusion: ISSHL with vertigo group lost hearing is severer than ISSHL without vertigo. Thus the hearing and the treatment effect were worse.The symptoms without vertigo in ISSHL were better than the patients with vertigo., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To assess the effect of long-term high-fat diet on the expressions of insulin receptor substrates in the hippocampus and spatial learning and memory ability of obese rats., Methods: A total of 100 4-week-old male SD rats were randomly divided into two groups and fed with common diet (CD group, n=40) or high-fat diet (HFD group, n=60) for 16 weeks. At 4, 8, 12, 16 and 20 weeks, 8 rats were randomly selected from each group for testing their spatial learning and memory function using Morris water maze. After the tests, the rats were sacrificed for measurement of the metabolic parameters and detection of the expressions of insulin receptor substrate-1 (IRS-1) and IRS-2 mRNAs in the CA1 region of the hippocampus., Results: Compared with those in CD group, the rats in HFD group showed a prolonged escape latency, longer swimming distance, faster average swimming speed, and shorter stay in the platformat 12 weeks. In HFD group, the serum levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol, and fasting insulin were all significantly increased (P<0.05) and the level of high-density lipoprotein cholesterol decreased (P<0.01) in comparison with those in CD group at each of the time points. No significant difference was found in fast glucose levels between the two groups (P>0.05), but the expressions of IRS-1 and IRS-2 mRNAs were significantly decreased in HFD group at 12 weeks (P<0.05)., Conclusion: In obese rats, long-term feeding with high-fat diet leads to insulin resistance, which interferes with hippocampal expression of insulin receptor substrates and insulin metabolism to cause impairment of the cognitive function and accelerate cognitive deterioration.

Objective: To investigate the diagnosis and management of laryngeal cleft. Method: The clinical data of 13 cases of laryngeal cleft treated between 2007 and 2015 was analyzed retrospectively. Results: The children with laryngeal cleft were classified according to the classification of Benjamin-Inglis, as type Ⅰ(11 cases), typeⅡ(1 case) and type Ⅲ(1 case). All patients were confirmed by microlaryngobronchoscopy under general anaesthetic. Eleven typeⅠ and 1 type Ⅱ clefts were managed conservatively, with which all type Ⅰ patients were successfully managed, while the type Ⅱ patient was resolved by surgical endoscopy. The type Ⅲ patient was treated by open repair but the results was poor. Conclusions: Patients who suffered with choking on feeding or recurrent aspiration pneumonia, especially coexisted with other congenital malformation, needed detailed evaluation for laryngeal cleft, although which was a rare congenital abnormality. Electronic laryngoscope could be the first step to screen the cleft, while microlaryngobronchoscopy is the gold standard for diagnosis of laryngeal cleft. The majority of children with lower type clefts can be managed conservatively. Surgical endoscopy has high success rate when strictly following the indication. Type Ⅲ and Ⅳ clefts have high mortality for usually combining with severe complications and abnormalities.

Avalanche photodiode is widely used in laser rangefinder due to high gain characteristics, but introduces highly additive noise during the time of current’s multiplication that makes laser rangefinder’s SNR meet bottleneck. This paper proposes a method of designing a high SNR’s graphene photodetector based on microcavity. The graphene’s unique optoelectronic properties make it an ideal platform for a variety of photonic applications, such as fast lasers, optical modulators, transparent electrodes, and ultrafast photodetectors. It has been recognized internationally to have dominant advantages in photodetectors due to its high carrier mobility, gapless spectrum, and frequency-independent absorption coefficient. With the wavelength of 1.06 μm, the mechanism of light waves’ transmission in the cavity and the graphehne’s absorption are studied by using optical transmission matrix method and scattering matrix method; the light absorption model of the graphene photodetector based on microcavity is established. Device’s final quantum efficiency reaches 91.2%, respectively reaches 0.778 A·W(-1), its full width at half maximum (FWHM) reaches 6 nm; the influence between graphene’s position in the microcavity and device’s absorption shows that device’s absorption’s peak value changes periodically with graphene’s position under resonant condition, and the variety of length of microcavity does not have any influence on the peak value, but changes the graphene’s position when absorption reaches peak value, on the condition that the length of microcavity is n times of half of wavelength, the number of device’s absorption peak value is 2n with the variety of graphene’s position, and all the peak values are symmetrical with respect to the center of microcavity, the final graphene’s position is 0.402 8 mm away from the top mirror of microcavity, and the absorption reaches 94%, Compared with single layer graphene, the absorption rate increases 16 dB; By solving SNR equation of the graphene photodetector based on microcavity and SNR equation of the avalanche photodiode, eventually finds that the SNR of the graphene photodetector based on microcavity is 90.3, which raises 10 dB compared with the avalanche photodiode’s. Theoretical analysis shows the graphene photodetector based on microcavity has high absorption rate, high quantum efficiency, and high SNR. In this paper, the research achievements provide a theoretical reference to update and design higher SNR photodetector used in laser rangefinder’s receiving system.

Objective: To explore the risk factors for lung cancer-related cerebral infarction. Methods: The hospitalized active lung cancer patients on anti-cancer therapy with no traditional stroke risk factors, who experienced an acute cerebral infarct in the First Affiliated Hospital of Guangxi Medical University from January 2005 to December 2015, were consecutively collected as the LCRS (lung cancer-related stroke) group. The active lung cancer patients without cerebral infarction hospitalized at the same peroid matched with the LCRS group for age and gender were collected as the LC (lung cancer) group. Clinical data from the two groups were analyzed. Results: A total of 139 LCRS patients and 139 LC patients were enrolled in the study, with 110 male and 29 female in each group, and there were no significant difference for the mean age between the LCRS group (52.1±10.4 years old ) and the LC group (52.1±10.1 years old). Two or more acute ischemic lesions of the brain were showed by MRI in most patients in the LCRS group (117 cases, 84.2%). Compared with the LC group, more patients in the LCRS group were found with adenocarcinoma, metastasis, elevated plasma D-dimer, CA125 and CA199 levels [88 cases (63.3%) vs 47 cases (33.8%); 98 cases (70.5%) vs 56 cases (40.3%); (468.38±291.37) μg/L vs (277.59±191.22) μg/L; (221.42±146.34) U/ml vs (106.84±69.97) U/ml; (254.68±185.84) U/ml vs (97.15±63.64) U/ml; with all P <0.001]. By logistic regression analysis of multiple factors, the elevated plasma D-dimer, CA125 and CA199 levels were showed to be independent risk factors for the cerebral infarction ( OR =1.003, 95% CI 1.001-1.004; OR =1.006, 95% CI 1.003-1.010; OR =1.011, 95% CI 1.007-1.015). Conclusions: The elevated plasma D-dimer, CA125 and CA199 levels are the risk factors for the lung cancer related cerebral infarction, which may lead to hypercoagulation and induce cerebral infarction eventually.

Objective: To explore treatment and therapeutic effectiveness of patients with Meniere' s disease and benign paroxysmal positional vertigo. Method: A series of BPPV 60 cases was retrospective analyzed. The patients were divided into three groups: Meniere' s disease with multiple semicircular canal BPPV(n=6), with single semicircular canal BPPV (n=11) and BPPV without Meniere' s disease group(Control,n=43). All patients were diagnosed by the Dix-Hallpike test or roll test and treated with the canalith repositioning procedure. The outcomes were compared among the three groups. Result: Unilateral semicircular canal BPPV was more than bilateral BPPV, the posterior semicircular canal was the most common canal involved, and multiple semicircular canal BPPV with Meniere' s disease patients needed repeated canalith repositioning procedure and had a higher recurrence rate. Conclusion: A lower success rate of treatment and a higher recurrence rate was found in BPPV patients with Meniere' s disease compared with those without Meniere' s disease . The recurrence rate is highest in multiple semicircular canal BPPV with Meniere' s disease., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore anatomical material basis of the lung meridian and its three-dimensional position in vivo., Methods: Continuous thin-section CT image sets were collected from a normal adult female volunteer's left upper extremity after she was acupunctured at 8 acupoints in Lung Meridian of Hand-Taiyin (LU). The connective tissue around the needle-tip of LU acupoints in continuous thin-section CT image sets was observed. The LU acupoints and part of the meridian were three-dimensional reconstructed in vivo and displayed with digital medical technology based on the CT-scan data. Then, the images were compared with traditional meridian records., Results: The connective tissue structure around the needle-tip of the eight LU acupoints was observed as follows: 5 acupoints were closely related to periosteum and 3 of them were closely related to blood vessels and nerve sheath. Three-dimensional reconstruction of anatomical position of the Lung Meridian of Hand-Taiyin was successfully completed in vivo, and the traveling course of meridian was similar to classical meridian illustration in traditional Chinese medicine., Conclusion: There is no specific entity of anatomical structure of LU acupoints and the meridian. The fascia and connective tissue may be the anatomical basis of meridian.

Objective: To find out the optimum condition for the germination of seed of Dendranthema indicum by studying the effects of pretreatment,phytohormone and temperature on it, and offer the basis for its standardized culture., Methods: The seed purity, weight per 1000 seeds, seed moisture content and seed viability were determined. The germination of D. indicum seed was tested under following conditions: pretreatment (acid, base, warm water, boiling water), phytohormone (IBA, 6-BA, NAA) and treatments under different temperature (10, 20, 25, 30 degrees C)., Results: The seed purity was 99.4%; The weight per 1000 seeds was 0.2941 g; The seed moisture content was 4.39%; The seed viability was 85.3%; The tests of pretreatment couldnt increase the germination of D. indicum seed; Phytohormone had limited effect on the germination of the seed; Temperature condition showed significant effects on the germination., Conclusion: The optimum condition for the germination of the seed of D. indicum is 25 degrees C on filter paper.

Objective: To investigate the efficacy and safety of sphincter-preserving procedure with transabdominal intersphincteric resection for ultra-low rectal cancer., Methods: Clinical data of 61 cases with ultra-low rectal cancer (distance from anal verge ranged from 4-5 cm) were analyzed retrospectively. The patients underwent sphincter-preserving procedure with intersphincteric resection and telescopic anastomosis., Results: There were 34 males and 27 females. The mean age was 56.7 years. The inferior border of the tumor was 4 cm above the anal verge in 21 cases, and 5 cm in 40 cases. There 55 patients with rectal adenocarcinoma in this cohort. The tumor was well-differentiated in 24 cases, moderately-differentiated in 29 cases, and poorly-differentiated in 2 cases. There were 6 cases with malignant adenoma. The TNM staging was T1N0M0 in 36 cases, T2N0M0 in 23, and T3N1M0 in 2. The ability to control defecation significantly improved in 1-3 months postoperatively, and returned to normal in 6-12 months. Two patients developed anastomotic leak (3.3%), and 3 anastomotic stenosis (4.9%) postoperatively. Fifty-four patients(88.5%) had follow-up. The median follow-up time was 6.2 years. The local recurrence rate was 5.6%, and the 5-year-survival rate was 73.5%., Conclusion: Sphincter-preserving procedure with intersphincteric resection and telescopic anastomosis is a safe and effective procedure for ultra-low rectal cancer.

Objective: To evaluate the clinical efficacy, feasibility and safety of sphincter-preservation with telescopic anastomosis of colon and rectal mucosa in low-middle rectal cancer., Methods: A retrospective analysis was carried out in 371 patients with low-middle rectal cancer in whom telescopic anastomosis was used. There were 224 males and 147 females, with a mean age of 57.9 (21-99) years. The lower margins of the tumors located between 5-8 cm from the anal verge. On histopathology, there were 361 adenocarcinomas, including 138 well-differentiated, 201 moderately differentiated, 11 poorly differentiated, 11 mucinous adenocarcinoma, and 10 adenomas with neoplastic changes. According to the Duke's stage classification, 120 were TNM stage I, 222 stage II, 26 stage III, and 3 stage IV., Results: Three hundred and eighteen (318/371, 85.7%) cases were followed up, and the median follow up time was 5.8 years. Postoperative complications were observed, including 16(4.3%) cases with anastomotic leak, and 8 (2.1%) with anastomotic stenosis. All the patients resumed normal bowel function during 12-24 weeks after operation, with 1-3 times per day. The local recurrence rate was 6.3% (20/318). Hepatic and lung metastasis was 14.5% (46/318) and 2.5% (8/318), respectively. The 5-year survival rate was 69.7%., Conclusion: The sphincter-preservation with telescopic anastomosis procedure is safe and effective for low-middle rectal cancer, and the sphincter function can be well-preserved.

Objective: To evaluate the long-term therapeutic efficacy of extended parietal cell vagotomy (EPCV) in the treatment of duodenal ulcer complicated with acute perforation., Methods: Therapeutic efficacy of EPCV in 176 cases subjected to duodenal ulcer with acute perforation since 1979 was evaluated, including postoperative complication, ulcer recurrence rate, gastric empting function, endoscopic and radiographical examination, nutritional status and Visick classification., Results: Among 176 patients, 153 (86.9%) cases were successfully followed-up for 5 years after operation. No operative death was found. Postprandial superior belly fullness occurred in 13 cases (8.5%) and heartburn in 12 cases (7.8%), which could be relieved by Domperidone. Adhesive ileus was noted in 4 cases (2.6%) which was cured by adhesiolysis. The total ulcer recurrence rate was 2.6% (4 cases) within 2 to 3 years after operation. Superficial gastritis occurred in 21 cases (13.7%) and duodenal bulb in 31 cases (20.3%). Sinus ventriculi vermicular motion was good and gastric emptying was normal. No anemia was found. Body weight gained in 116 cases (75.8%). One hundred and forty-six cases(95.4%) were reforming Visick grade I and II , 3 cases(2.0%) grade III , and 4 cases (2.6%) IV ., Conclusions: EPCV is convenient for performance with low postoperative complication rate. Its long-term efficacies are quite good, which including normal nutritional status, high quality of life and low ulcer recurrence rate. EPCV is one of effective and safe treatments for duodenal ulcer complicated with acute perforation.

Objective: To investigate the clinical efficacy, feasibility and safety of sphincter-preserving procedure by casing anastomosis of colon and rectal mucosa in low rectal cancer., Methods: A retrospective analysis was carried out in 231 cases of low rectal cancer performed casing anastomosis., Results: One hundred and ninety-seven (197/231, 85.3%) cases were followed up, the median time of the follow up was 5.9 years (range, 2 months-14 years). Eight (3.4%) cases of stoma leak and 3 (1.2%) cases of stoma stenosis were found post operation. Defecating function recovered normally (1 - 3 times per day) in 12 - 24 weeks after operation in all patients. Local recurrence was found in 5.1% (10/197) of the cases. Hepatic and lung metastasis was found in 15.2% (30/197) and 2.5% (5/197) of the patients, respectively. The five-year survival rate was 71.6% totally., Conclusions: The casing anastomosis procedure with sphincter preservation is safe and efficacy for low rectal cancer. With the procedure, the anal function can be preserved well, stoma leak is decreased, and the five-year survival rate is the same as Miles operation.

Objective: To investigate and compare therapeutic effects of sphincter-preserving operation and Miles operation for rectal cancer., Methods: A retrospective analysis was carried out in 572 cases of rectal cancer operations performed from January 1980 to December 2006., Results: Sphincter-preserving operation was carried out in 403 cases and Miles procedure in 169 cases. The follow-up rate was 76.2% (436/572) with a period of 0.5 - 25.0 years (median, 9.5 years). Local recurrence occurred in 6.3% (20/317) of sphincter-preserving operation and 7.6% (9/119) of Miles operation, the differences was not significant (chi2 = 1.3942, P > 0.05). Distal metastasis was found in 50 cases (15.7%) of sphincter-preserving operation and 19 cases (16.2%) of the Miles operation with no significant difference (chi2 = 0.6672, P > 0.05). There was no significant difference in five-year survival rate between the two groups, with 67.8% in sphincter-preserving operation and 67.2% in Miles operation., Conclusions: Sphincter-preserving operations can improve the quality of life in rectal cancer although with the same five-year survival rate and recurrence rate as Miles operation. The operation for rectal cancer should be performed individually according to the location, the bionomics and the clinical stage.

Aim: To investigate whether NR2B-pERK1/2-pElk-1 signaling contributes to the Y-maze learning and memory of rat brain., Methods: 45 adult male SD rats were divided into 4 groups: (1) Ifenprodil peritoneal injection group (Ifenprodil ip, n = 14); (2) DMSO peritoneal injection group(DMSO ip, n = 15); (3) Ifenprodil cerebral ventricle injection group (Ifenprodil ic, n = 8); (4) DMSO cerebral ventricle injection group(DMSO ic, n = 8). Y-maze training and test were used as an learning and memory enhancing stimulus. Immunohistochemical and Western blotting methods were used for detecting pERK1/2 and pElk-1 expression intensity of different brain regions., Results: Compared with the DMSO ip group, the ifenprodil ip group showed no change on the Y-maze learning score (P > 0.05), but its Y-maze memory score tested 24 after learning decreased (P < 0.05). Ifenprodil peritoneal injection made brain pERK1/2 and pElk-1 expression decreased generally. In hippocampus, marginal division of striatum(MrD), amygdala,these changes were more significant (P < 0.05). Compared with the DMSO ic group, the reconsolidation of Y-maze memory tested 6 hours after ifenprodil injection was impaired in ifenprodil ic group (P < 0.05). The OD value of pERK1/2 and pElk-1 positive bands in ifenprodil ic group attenuated generally. The pElk-1 positive bands of caudate putamen and MrD almost disappeared in ifenprodil ic group., Conclusion: NR2B is essential for the formation of long-term memory, reconsolidation of Y-maze memory. The deactivation of NR2B by ifenprodil will impair these courses. Meanwhile, the deactivation of NR2B attenuates pERK1/2 and pElk-1 expression of learning and memory related regions after Y-maze learning and memory reconsolidation test. In MrD and caudate putamen, the pElk-1 expression are completely blocked by ifenprodil after memory reconsolidation test.

Objective: To investigate and analyse curative effects of Miles operation and anal sphincter preserving operation for rectal carcinoma in 20 years., Methods: From 1984 to 2004, 618 cases of rectal carcinoma that underwent radical resection including Miles operation and anal sphincter preserving procedures were analysed retrospectively each 10 years, earlier 10 years from 1984 to 1994, and later 10 years from 1994 to 2004., Results: Among the 618 cases, 492 (79.6%) were followed up. The median of the follow-up time was 5.4 years. In the earlier 10 years, local recurrence rate of post operation was 6.9% (14/201), for Miles operation and anal sphincter preserving procedures the local recurrence rate was 6.7% and 7.1% respectively. In the later 10 years, the local recurrence rate was 5.1% (15/291), 4.8% for Miles operation, 5.2% for anal sphincter preserving procedures. With the procedure of canular anastomosis of colon and rectal mucosa, the local recurrence rate was 4.9%. Overall five-year survival rate was 64.7% (130/201) in the earlier 10 years, 66.3% (59/89) for Miles operation, 63.4% (71/112) for anal sphincter preserving procedures. In the later 10 years, the five-year survival rate was 68.0% (198/291) in all, for Miles operation 66.3% (55/83), for anal sphincter preserving procedures 68.7% (143/208). With the procedure of canular anastomosis of colon and rectal mucosa, the five-year survival rate was 71.3% (62/87)., Conclusions: The operation for rectal cancer should be chosen individually according to locus, biological character, and clinical stages. Anal sphincter preserving procedures are performed increasingly, and they provide the same five-year survival rate as Miles operation does, and the patient's quality of life can be improved obviously.

Objective: To analyze the causes and the clinical characteristics of the neonatal inspiratory dyspnea; so to raise the diagnosis and cure rate of the disease., Methods: Eleven new born infants with severe inspiratory dyspnea were investigated from March, 2001 to June, 2004 in Shenzhen children's hospital. Six infants were male and 5 were female. The average age was 7.2 days ( range from 8 hours to 28 days). Four cases were hospitalized with trachea intubation. Three of them can not cry, and 2 cases were diagnosed as bilateral vocal cord paralysis, 1 case as multiple cranial nerve palsy with direct laryngoscopy. Two cases couldn't drink milk continuously and accompanied with deteriorated inspiratory dyspnea, and were diagnosed as congenital adenoid hypertrophy and neonatal rhinitis respectively with compute tomography and magnetic resonance imaging. Among the 6 cases with persistent inspiratory dyspnea, four of them were diagnosed as congenital laryngocele by direct laryngoscope, one case was diagnosed as subglottic stenosis by tracheoscopy and one case was confirmed to be thoracic tracheostenosis when tracheotomy performed., Results: Four congenital laryngoceles and one case congenital adenoid hypertrophy were cured with surgery. Two bilateral vocal cord paralysies and one case of subglottic stenosis received tracheotomy. One neonatal rhinitis case applied 0.25% ephedrine. One case of thoracal tracheostenosis died. The parents of the infant with multiple cranial nerve palsy refused to accept any treatment., Conclusions: The laryngoscope examination is recommended for patients with neonatal inspiratory dyspnea. It is necessary for patients with persistent dyspnea to be examined by tracheoscopy as early as possible.

Objective: To investigate the effect of cilazapril on endothelial cell function and fibrinolysis system in the canine atrial fibrillation (AF) models., Methods: All canines were divided into three groups: (1) Control group, without atrial pacing; (2) Atrial pacing group, in which atrial fibrillation was established by rapid atrial pacing at 400 bpm for 6 weeks; (3) Atrial pacing together with cilazapril group, in which cilazapril was given before and after atrial pacing. Nitric oxide (NO) of atrial endocardium was measured with NO-specific microelectrode. The expression of plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (tPA) protein in atrium was determined by Western Blot analysis and immunohistochemical staining. Plasma levels of von Willebrand Factor (vWF), PAI-1 and tPA were analyzed by enzyme-linked immunoadsorbent assay., Results: NO production from atrial endocardium was significantly increased in atrial pacing together with cilazapril group than atrial pacing group [(42.6 +/- 9.9) nmol/L vs (23.4 +/- 5.8) nmol/L, P < 0.05], whereas the plasma levels of vWF were decreased [(75.4 +/- 12.8)% vs (125.9 +/- 20.6)%, P < 0.05]. Compared to controls, the expression of atrium tPA protein in atrial pacing together with cilazapril group was significantly upregulated (4052 +/- 857 vs 1936 +/- 421, P < 0.05) and PAI-1 protein was downregulated (2487 +/- 542 vs 3164 +/- 827, P < 0.05). Cilazapril also significantly increased tPA antigen and decreased PAI-1 antigen in plasma., Conclusion: Cilazapril can favorably improve endothelial function and resume the balance of fibrinolysis system in AF, which might be of beneficial to hypercoagulated state in AF.

Objective: To study the role of transrectal ultrasound in detecting and deciding rectal cancer margin and surgical incisal edge., Methods: 33 surgical specimens of rectal carcinoma were examined with transrectal ultrasound. Cancerous margin and surgical incisal edge were determined. The results were compared with pathological examination. p53 and K-ras gene mutation as tumor molecular markers of residue cancer cells were detected in incisal edge tissue with PCR-SSCP method., Results: General accuracy for cancer infiltration depth with transrectal ultrasound was 86.6%. For mucosa and submucosa infiltration lesions, the accuracy was 72.7%. For lamina muscularis, the accuracy was 90.9%. And for adventitia and peripheral tissue infiltration of rectum, the accuracy was 88.5% and 100% respectively. No remains of cancer cells and tumor molecular markers were detected at distal incisal edges of 1.0 cm, 2.0 cm and 3.0 cm determined with transrectal ultrasound., Conclusions: Rectal cancer margine and surgical incisal edge determined with transrectal ultrasound are close to examined by pathology. Transrectal ultrasound is helpful and reliable to define incisal edge in rectal cancer surgery.

Objective: To study clinical effects of modified radical mastectomy with preservation of major and minor pectoral muscles., Methods: A retrospective analysis was carried out in 214 cases of breast cancer patients (including stage I 66 cases, stage II 141 cases and stage III 7 cases). Modified radical mastectomy with preservation of major and minor pectoral muscles was performed on all the patients., Results: Out of 214 cases, 12 (5.6%) had subcutaneous fluid, 16 (7.4%) had skin flap margin necrosis. Upper limb lymphatic edema was found in 8 (3.7%) patients, and pectoral muscle contracture with dyspraxia of upper arm occurred in 11 (5.1%) cases. Three year survival rate was 82.3% and five year survival rate was 63.4%. For stage I patients, the five year survival rate attained to 79.6%, and stage II 56.3%., Conclusions: Preservation of lateral branch of pectoral nerve can avoid complication of pectoral muscle contracture with dyspraxia of upper arm. Early chemotherapy of postoperation prevents breast cancer occurrence and metastasis. Comprehensive treat approaches for operative wound avert subcutaneous fluid, and complex therapy improves long-term effect of breast cancer patients.

Objective: To study cell membrane phospholipid variation and protein kinase C (PKC) isoenzyme expression and their effects on hepatic metastasis of large intestinal carcinoma., Methods: High function liquid chromatography was used to separate and detect cell membrane phospholipids of phosphatidylinosital (PI), phosphatidylserine (PS), phosphatidylethanolamine (PE) and phosphatidylcholine (PC) in primary foci, paratumor intestine mucosa and hepatic metastasis of large intestinal carcinomas. And mRNA expression levels of PKC-alpha, -beta II, -delta, -epsilon, -lambda, -zeta isoenzymes were detected using QRT-PCR technique., Results: Fifty-eight cases of colorectal cancer were examined., Contents: of PI, PC and PE in primary foci and hepatic metastasis were higher than those in paratumor mucosa. PE content in hepatic metastasis was much higher than that in primary foci (t = 98.88, P < 0.01). But PI and PC contents had no significant differences between primary and hepatic metastasis (t = 1.73, 1.36, P > 0.05). PKC-beta II, -delta, -epsilon, -lambda, -zeta expression were enhanced in primary foci and hepatic metastasis, but PKC-alpha level decreased in comparison with paratumor mucosa. And PKC-delta, -epsilon, -lambda, -zeta levels in hepatic metastasis were higher than those in primary foci (t = 4.31, P < 0.05). PI and PC had positive correlations with PKC-beta II expression. PE had positive correlations with PKC-delta, -epsilon, -lambda, -zeta, but a negative correlation with PKC-alpha., Conclusions: The increases of PI and PC and PKC-alpha/PKC-beta II ratio change are related with colorectal cancer genesis. High content of PE and enhanced expression of PKC-delta, -epsilon, -lambda, -zeta isoenzymes and decreased PKC-alpha level improved hepatic metastasis of large intestinal carcinoma.

Objective: To investigate the reliability and feasibility of abdominal-anus resection with preservation of anal sphincter by telescopic anastomisis of colon rectal mucosa for middle-lower segment of rectal cancer., Methods: A retrospective analysis was made for abdominal-anus resection with telescopic anastomosis of colon rectal mucosa in 102 cases of middle-lower segment of rectal cancer., Results: No anastomotic fistula and anastomotic stenosis occurred in the 102 cases. The increased defecation was found during early stage of postoperation, about 6-12 times per day. But this was easily controlled by antidiarrheal drugs. Twelve to 18 weeks later, defecation returned to normal. Follow-up was performed in 91 patients, and the follow-up rate was 89.2%. Mean follow-up period was 4.7 years. Local recurrence rate of the carcinoma was 5.4% (5/91), and hepatic metastasis rate was 13.1% (12/91). Three-year survival rate of postoperation was 86.9% (60/80), and five-year survival rate was 70.7% (29/41)., Conclusions: With telescopic anastomosis of colon rectal mucosa, colon stoma can be avoided, and anastomotic fistula can be prevented. The operation is safety and effective in preservation of anal sphincter for rectal cancer therapy.

Aim: To investigate the relationship of high hematocrit with changes of the blood viscosity during in the environment of altitude hypoxia., Methods: Index of hemorheology was determined from populations with different time of inhabit highland and normal controls., Results: (1) Hematocrit and RBC deformability were higher in all highland populations than that in normal controls, these increase were time-dependent. (2) The blood viscosity was increased significantly during the early stage of inhabit highland, and restored normal in late stage. (3) RBC aggregability was reduced significantly with time-dependent in highland populations. (4) The oxygen content of tissue was reduced significantly during the early stage of inhabit highland, and restored normal in late stage., Conclusions: In the environment of altitude hypoxia, RBC deformability increase and RBC aggregability decrease can suppress blood viscosity increase induced by erythrocytosis, these compensatory regulation is help to maintain the normal oxygen content of tissue.

Objective: To study the compression factor and clinical manifestation of the compression of the palmar cutaneous branch of the median nerve., Methods: Anatomic study was done on both sides of 2 cadavers and 6 cases of hand injury in the debridement, the origin, course, branch of the palmar cutaneous branch of the median nerve were observed. From 1995 to 1998, 12 patients of compression of the palmar cutaneous branch were treated by local blockade injection. Among them, there were 8 males and 4 females, aged from 23 to 65 years and the course of disease ranged 3 to 12 months., Results: The palmar cutaneous branch of the median nerve was (1.3 +/- 0.1) mm in diameter, it could be pulled when the wrist dorsi-extension. All cases showed good recovery of hand function and no recurrence after 4 to 12 months follow-up., Conclusion: The palmar cutaneous branch compression syndrome is closely related to the local anatomy. The diagnosis is definite according to the clinical symptoms and signs, and local blocking is effective on the most patients.

Experiments were performed on SD rats anaesthetized with urethane and chloralose. The left ventricular function and the parameters of hemorrheology during acute hypoxia were investigated. It was found that during acute hypoxia of 15 min, arterial blood gas value PaO2 decreased markedly. The parameters of the left ventricular function such as +/- dP/dtmax, Peak, HR, Vce40, Vmp, Vmax, L0 (CFU), decreased markedly either. At the same time, hyperviscosity was induced and red blood cell filtration (IF) increased. All these parameters recovered to normal control level after reoxygenation of 15 min. By intravenous injection of propranolol (0.5 mg/kg) and then hypoxia, the left ventricular function were suppressed markedly; and so were to the elevation of blood viscosity and IF. Preinjection of regitine (3 mg/kg) prior hypoxia has the same effect on the blood viscosity and IF. Acute hypoxia induced hyperviscosity and elevation of IF could be suppressed by destruction of carotid sinus region with phenol, but the left ventricular function decreased markedly. These results suggest that acute hypoxia induces hyperviscosity and decreases of red blood cell deformability and left ventricular function, which is probably mediated via the sympathetic nervous system and carotid sinus region.

Experiments were performed on 99 Wistar rats. It was found that hyperviscosity and elevation of blood pressure (BP) could be induced by hanging and restraining conscious rats with their four limbs tied on a frame. These effects were unaffected by bilateral vagotomy. By intravenous injection of propranolol or phentolamine, elevation of BP could be reduced, while stress-induced hyperviscosity could only be reduced by propranolol (i.v.). Stress-induced hyperviscosity and elevation of BP could be inhibited by electroacupuncture applied to the right hind leg or microinjection of morphine into 4th ventricle of the brain. On the other hand, if opiate receptor antagonist naloxone was given into the 4th-ventricle, the stress-induced hyperviscosity and elevation of BP could no longer be inhibited by electroacupuncture. It is suggested that the hyperviscosity and elevation of BP induced by hanging and restraining are mediated by excitatory cardiovascular sympathetic outflow with the result of activation of adrenoreceptors. Activation of the opiate receptors in the hindbrain may be responsible for decrease in stress-induced hyperviscosity and elevation of BP and for the inhibitory effect of electroacupuncture of the right hind leg on stress-induced hyperviscosity and elevation of BP.

The experiments showed that both tetramethylpyrazine and ferulic acid relaxed the norepinephrine-induced spasmodic contraction of rabbit and rat aorta strips, increased the coronary flow of isolated guinea pig hearts and reduced the whole blood viscosity in rats. Evaluated with Burgi's equation, the combined effect of these 2 drugs was obviously potentiated, but the combined acute toxicity in mice was greatly reduced.

Experiments were carried out on 62 wistar rats. The hyperviscosity and elevation of blood pressure were induced by hanging and restraining the rats with their four limbs tied on a frame. It was found that microinjection of 5-HT (25 micrograms/10 microliters) into the 4th ventricle of the brain or bilateral microinjection of 5-HT (4 micrograms/0.5 microliters/site) into rostral ventrolateral medulla (rVLM) reduced stress-induced hyperviscosity (p < 0.01) and elevation of blood pressure (p < 0.01). The effect of 5-HT injected into the 4th ventricle or rVLM was blocked by bilateral microinjection of cinanserine (4 micrograms/0.5 microliter/site) into rVLM. These results suggest that microinjection of 5-HT into 4th ventricle and rVLM could reduce stress-induced hyperviscosity and elevation of blood pressure and these effects were probably mediated via 5-HT receptors in the rVLM.