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??Under-ulcer sector-punctured ablation in the laser treatment of lower limb venous ulcers WANG Tao??ZHAO Jun??MEI Jia-cai??et al. Department of Vascular Surgery??the Sixth Affiliated Hospital, Shanghai Jiao Tong University School of Medicine?? Shanghai 200233??China
Corresponding author??ZHAO Jun??E-mail??junnzhao@126.com
Abstract Objective To evaluate the method of under-ulcer sector-punctured ablation in the laser treatment of lower limb venous ulcers. Methods A total of 104 patients with lower limb venous ulcers admitted between January 2010 and May 2015 in the Sixth Affiliated Hospital, Shanghai Jiao Tong University School of Medicine were divided into two groups. Patients underwent routine endovascular venous laser therapy (EVLT) plus under-ulcer sector-punctured ablations were set into the study group??while routine EVLT as the controlled group. All the patients received the dressing change after operations. The ulcer healing rate??healing time??numbness??burning sensation??ecchymosis??skin burns and the incidence of limb edema in the two groups were revealed. The ulcer healing time of the two groups were calculated by Kaplan-Meier analysis. Results The ulcers healing rate in study group was significantly higher than that in control group (85.5% vs. 52.4%??χ2=25.658??P=0.00)??while the ulcer survival time was much lower ??2.59±0.11??w vs. ??3.12±0.16??w??χ2=6.133??P=0.01). There was no significant difference in the numbness??burning sensation??ecchymosis??skin burns and the incidence of limb edema between the two groups (P>0.05); Neither adverse invents nor complication occurred. Conclusion The method of under-ulcer sector-punctured ablation blocked the reflux in perforator veins seems to be a satisfied??safe therapy in the laser treatment of lower limb venous ulcer.     

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??Minimally invasive interventional therapy of colorectal liver metastases ZHANG Hang-yu, ZHU Xu, GUO Jian-hai. Department of Interventional Therapy, Peking University School of Oncology, Beijing Cancer Hospital & Institute; Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing 100142, China
Corresponding author:ZHU Xu,E-mail:drzhuxu@163.com
Abstract Compared with systemic chemotherapy and surgery, minimally invasive interventional therapy has the advantages of repeatable, minimally invasive and high local control rate. With the development of technology and the update of clinical evidence, minimally invasive interventional therapy in the multidisciplinary team (MDT) has gain more acceptance.For the tumor feeding artery administration, interventional treatment via the vascular as a second-line treatment after systemic treatment failure has been recommended by the Guide. It can not only improve the tumor local control effect, but also reduce the toxicity of chemotherapy drugs. Non vascular minimally invasive treatment as a necessary complement to the comprehensive treatment of colorectal liver metastases, the reasonable choice of indications can obtain unparalleled curative effect compared with systemic chemotherapy and surgery. However , systemic treatment must be considered when making the choice of the local treatment methods.     

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??Surgical treatment of large abdominal wall defect with loss of domain NIE Xin??GU Yan. Hernia and Abdominal Wall Surgical Disease Center??Shanghai Jiao Tong University; Department of General Surgery??Shanghai Ninth Hospital??Shanghai Jiao Tong University School of Medicine??Shanghai 200011??China
Corresponding author??GU Yan??E-mail??yangu@sjtu.edu.cn
Abstract Repair and reconstruction of large abdominal wall defects with loss of domain (LOD) is still a challenge to most of the abdominal wall surgeons. Understanding of the pathogenesis??an initial assessment and comprehensive preoperative preparation are essential for the successful treatment of patients with LOD. Prosthetic mesh reinforcement should be regarded as the essential surgical technique and components separation or tissue grafts based on prosthetic mesh reinforcement will provide significant assistances for abdominal repair and reconstruction to patients of large abdominal wall defects with LOD.     

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??OBJECTIVE To explore the bacteriostasis and plasmid elimination activities of different extracted parts of traditional Chinese medicine Radix Scutellariae Baicalensis on NDM-1 Acinetobacter calcoaceticus.METHODS The in vitro antibacterial effect of the extracts from Radix Scutellariae Baicalensis was studied. Inhibition zone and minimum inhibitory concentration(MIC) of the alcohol extract and water decoction were examined by using MH agar plates and microdilution susceptibility testing. The growth curve of the NDM-1 Acinetobacter calcoaceticus was tested after being incubated with alcohol extract and water decoction at sub-MIC. At three time points after incubation with different extracts at sub-MIC, photocopy dish method was used to screen plasmid-cured strains of NDM-1 Acinetobacter calcoaceticus. The plasmid-elimination rates and phenotypic changes were compared.RESULTS Both the alcohol extract and water decoction of Radix Scutellariae Baicalensis inhibited the growth of NDM-1 Acinetobacter calcoaceticus. The MICs were 1.56 mg??mL^-1 for the alcohol extract and 6.25 mg??mL^-1 for the water decoction. The growth curve showed that the antibacterial effect of the alcohol extract was more obvious. Both the alcohol extract and water decoction of Radix Scutellariae Baicalensis had some degrees of plasmid elimination effect. The plasmid-elimination rates in the alcohol extract group were higher than those in the water decoction group. The plasmid-elimination rates were 61.27% for the alcohol extract and 49.78% for the water decoction, respectively.CONCLUSION Radix Scutellariae Baicalensis can inhibit the growth of NDM-1 Acinetobacter calcoaceticus and eliminate the drug-resistant plasmid effectively and has the potential to be used to control the spread of pan-drug resistant Acinetobacter strains or be an adjuvant treatment method for clinical infections. Its alcohol extract has better effect.     

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??OBJECTIVE To investigate the impacts of particle size and preferred orientation on relative peak intensity, number of peaks and order of peak intensity in powder X-ray diffraction (PXRD) analysis of organic and inorganic pharmaceutical crystalline materials and evaluate the phase identification methods in various pharmaceutical compendiums.METHODS The PXRD patterns of organic and inorganic materials with different particle sizes obtained by sieving or grinding were acquired and the number of diffraction peaks, peak position and intensity of diffraction peaks were compared across different samples. RESULTS Due to preferred orientation effects, the diffraction patterns of samples with different particle sizes were apparently different, including the number of peaks, relative peak intensity and the order of the peak intensity. CONCLUSION Scientists may get different CONCLUSION s from the RESULTS of same tests performed according to the related guiding principles of current Chinese Pharmacopeia and USP39, EP8.0, JP16 ???? pharmacopoeia for identifying the crystalline forms.The phase identification by PXRD method in current Chinese Pharmacopeia neglects the effects of preferred orientation on diffraction peaks and relative peak intensity. This guideline needs to be updated to better reflect the scientific observation in industry and align with other well accepted compendiums such as USP, EP and JP.     

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??Lateral lymph node dissection via lateral vascular approach with en-bloc dissection of laparoscopic total mesorectal excision for advanced middle and low rectal cancer LIANG Jian-wei, LIU Qian, ZHOU Si-cheng, et al. National Cancer Center & National Clinical Research Center for Cancer & Cancer Hospital??Chinese Academy of Medical Sciences and Peking Union Medical College??Beijing 100021??China
Corresponding authors: LIU Qian??E-mail: fcwpumch@163.com??WANG Xi-shan??E-mail: wxshan1208@126.com
Abstract Objective To investigate the feasibility and safety of the en-bloc resection via lateral vascular approach combined with lateral lymph node dissection (LLND). Methods The clinical and pathological data of 72 cases of laparoscopic total mesorectal excision resection of rectal cancer combined with LLND via lateral vascular approach were retrospectively analyzed. There were 38 cases of preoperative chemoradiotherapy??9 patients with neochemotherapy??25 cases without preoperative treatment. All patients were diagnosed with lateral lymph node metastasis by MRI or PET-CT before treatment. The first step of LLND was performed by the distal of external iliac artery??then high ligation the inferior mesenteric vascular and opened the left Toldt’ space??and the final step was the total mesorectal excision. All of the spacemen were en-bloc dissection of the later lymph node with the rectal cancer. Results There were 19 cases of bilateral LLND??28 cases with unilateral left LLND??25 cases on the right side. The harvested pelvic lymph node detection was 8.3??19.4% of lateral lymph node metastasis rate??14/72????12 cases of unilateral lateral lymph node metastasis??2 cases of bilateral metastasis??and 7 patients combined viscera resection??9.7%??. The operative time was 281.4??145~600??min and the intraoperative blood loss was 89.7??30~1200??mL. A total of 11 cases??15.3%??had surgical complications and no surgical death. The positive rate of lateral pelvic lymph node in preoperative chemoradiotherapy patients was 23.7% ??9/38????and 22.2%??2/9??in the neochemotherapy group. Conclusion Laparoscopic resection of rectal cancer combined with LLND via transvascular lateral approach is safe and feasible??and not increase in operative complications.