Molecular Engineering of Metal-Organic Frameworks for Boosting Photocatalytic Hydrogen Peroxide Production.

The development of novel metal-organic frameworks (MOFs) as efficient photocatalysts for hydrogen peroxide production from water and oxygen is particularly interesting, yet remains a challenge. Herein, we have prepared four cyclic trinuclear units (CTUs) based MOFs, exhibiting good light absorption ability and suitable band gaps for photosynthesis of H2O2. However, Cu-CTU-based MOFs are not able to photocatalyzed the formation of H2O2, while the alteration of metal nodes from Cu-CTU to Ag-CTU dramatically enhances the photocatalytic performance for H2O2 production and the production rates can reach as high as 17476 µmol g-1 h-1 with an apparent quantum yield of 4.72 %, at 420 nm, which is much higher than most reported MOFs. The photocatalytic mechanism is comprehensively studied by combining the isotope labeling experiments and DFT calculation. This study provides new insights into the preparation of MOF photocatalysts with high activity for H2O2 production through molecular engineering.

Functionalized reduced graphene oxide with aptamer macroarray for cancer cell capture and fluorescence detection.

An integrated aptamer macroarray functionalized with reduced graphene oxide (rGO) to specifically capture and sensitively detect cancer cells is reported. The capture for cancer cells is based on effective recognition of the modified rGO surface through the aptamer against epithelial cell adhesion molecule (EpCAM). The rough structure of rGO enhances morphologic interactions between rGO film interface and the cancer cells, while super-hydrophilicity of modified rGO hinders nonspecific cell capture. The synergistic interactions offer the aptamer macroarray high efficiency of cancer cell capture. By means of a turn-on fluorescence strategy based on the conformation change of the aptamer induced by the target recognition, the enriched cancer cells can be directly read out at excitation/emission wavelengths of 550/680 nm without washing, separation, and dying steps. The working range is 1 × 102 to 2 × 104 cells per mL with a detection limit of 22 cells per mL. The results indicate that the aptamer macroarray has a considerable foreground for early diagnosis, therapy, and monitoring of cancer. Graphical abstract.

Fluorometric visualization of mucin 1 glycans on cell surfaces based on rolling-mediated cascade amplification and CdTe quantum dots.

A rolling-mediated cascade (RMC) amplification strategy is described for improved visualization of profiling glycans of mucin 1 (MUC 1) on cell surfaces. CdTe quantum dots (QDs) are used as fluorescent labels. The RMC based amplification allows even distinct glycoforms of MUC1 to be visualized on the surface of MCF-7 cell via an amplified Förster resonance energy transfer (FRET) imaging strategy that works at excitation/emission wavelengths of 345/610 nm. This is achieved by utilizing antibody against MUC1 modified with the fluorescent label 7-amino-4-methylcoumarin-3-acetic acid (AMCA) as the energy donor in FRET. The QDs (used to label surface glycans) act as acceptors. N-Azidoacetylgalactosamine-Acetylated (Ac4GalNAz) as a non-natural azido sugar, can be incorporated into the glycans of the cell surface, which can promote further labeling. The method has the advantage of only requiring a small amount of non-natural sugar to be introduced in metabolic glycan labeling since too much of an artificial sugar will interfere with the physiological functions of cells. Graphical abstract Schematic for the DNA rolling-mediated cascade (RMC)-assisted metabolic labeling of cell surface glycans by using CdTe quantum dots as labels and an intramolecular amplified FRET strategy for imaging glycans on a specific glycosylated protein, MUC1.

[Expressions of Spinal Macrophage Colony Stimulating Factor and Its Receptor CSF-1R in the Development ofComplicated Regional Pain Symptom I].

OBJECTIVES: To study the changes of mechanical allodynia and temperature hyperalgesia, as well as the expression of the spinal macrophage colony stimulating factor (M-CSF) and its receptor CSF-1R during the development of complicated regional pain symptom I(CRPS I). METHODS: The animal model of CRPS I was established using prolonged ischemia-reperfusion injury of rodent left hindpaw. The mechanical allodynia and temperature hyperalgesia of ipsilateral hindpaw were continuously measured for 14 d after reperfusion, and the expressions of spinal M-CSF and CSF-1R in ipsilateral spinal cord horn were measured with immunofluorescence technique on day 3, day 7 and day 14 after reperfusion. RESULTS: The thresholds of mechanical allodynia and temperature hyperalgesia of ipsilateral hindpaw were significantly decreased (P<0.05). M-CSF was secreted by the astrocytes. CSF-1R was primarily distributed on the microglia. The immunofluorescence intensities of M-CSF and CSF-1R in ipsilateral spinal cord horn were significantly increased on day 7 and day 14 after reperfusion (P<0.05). CONCLUSIONS: The ischemia-reperfusion injury simulated pain syndrome in CRPS I and increased the expressions of spinal M-CSF and CSF-1R.

[Effect of Epidural Volume Extension on Combined Spinal-anesthesia of Parturients in Women Undergoing Cesarean Delivery].

OBJECTIVE: To evaluate the blocking characteristics of epidural volume extension on combined spinal-anesthesia of parturients undergoing cesarean delivery. METHODS: Eighty parturients were randomly allocated to one of four groups, receiving 0, 5, 10 or 15 mL normal saline, respectively, through epidural catheter at a rate of 0.5 mL/s (n = 20 in each group) after combined spinal-anesthesia with 11 mg intrathecally isobaric bupivacaine. Peak sensory block height, time for sensory block to sixth thoracicdermatome level, time for highest modified Bromage motor score, time for sensory regression to tenth thoracicdermatome level, and motor block recovery to Modified Bromage 0 were recorded. RESULTS: The groups with 10 mL and 15 mL epidural extension had a higher level of peak sensory and shorter time for the sensory block to sixth thoracicdermatome level compared with the control group (P< 0.05). There were no significant group differences in the time for sensory regression to tenth thoracicdermatome level (P > 0.05). The saline epidural extension groups had significant shorter time for highest modified Bromage motor score and motor block recovery to Modified Bromage 0 compared with the control group (P < 0.05). The use of phenylephrine was significantly higher in the 15 mL treatment group (P < 0.05). CONCLUSION: 10 mL of epidural saline volume extension is optimal for combined spinal-epidural anaesthesia of parturients undergoing caesarean delivery.

[Effects of Different Concentrations of Glucose on the Osteogenic Differentiation of Orofacial Bone Mesenchymal Stem Cells].

OBJECTIVES: To determine the effects of different concentrations of glucose on the proliferation and osteogenic differentiation of orofacial bonemesenchymal stem cells (OFMSCs). METHODS: OFMSCs were primarily cultured and identified in vitro to undergo osteogenic/adipogenic/chondrogenic differentiation. The cells were exposed to osteogenic medium containing different levels of glucose: 5.5,11,16.5,25,44 mmol/L. The cell activity and proliferation index were measured using a cell counting kit (CCK)-8 and flow cytometry. The alkaline phosphatase (ALP) activity of the cells was measured at the 4th and 7th day. Alizarin red staining was carried out at the 21st day. RT-PCR detecting osteogenesis-related gene Runx2 and Osterix mRNA expression was performed at the 4th, 7th, 14th and 21st day. RESULTS: Osteogenesis induced calcium nodes was observed with Alizarin red staining at the 21st day. Adipogenic induced red lipid droplets was observed with Oil Red O staining at the 14th day. Chondrogenic induced blue cytoplasm was observed with Alcian blue staining at the 14th day. With 5.5 to 25 mmol/L glucose,OFMSCs proliferation was promoted.But when the concentration of glucose continued to increase (from 25 to 44 mmol/L),OFMSCs proliferation significantly reduced.The ALP activity decreased with glucose in a concentration-dependent manner ( P<0.05). Osteogenesis induced Alizarin red staining and mineralization showed at the 21st day. The calcium nodes and mineralization quantity decreased with glucose in a concentration-dependent manner ( P<0.05).The cells exposed to 5.5 mmol/L glucose had a higher level of expression of Runx2 and Osterix mRNA than the others (P<0.05).The experssion of Runx2 and Osterix mRNA in all groups showed a trend of rising first, followed by an obvious down regulation. CONCLUSIONS: With certain limits,OFMSC proliferation is promoted by glucose. Osteogenic differentiation is inhibited by glucose in a concentration-dependent manner.

[Study on the Characteristics of Bone in Type-2 Diabetic Rats by Micro-CT].

OBJECTIVES: To study the characteristics of bone in type 2 diabetic rats using micro-CT. METHODS: Sixteen male Sprague Dawley(SD) rats, aged 8 week-old, were randomly divided into normal group and experimental group (n =10). Afer being fed with high-fat chow, the rats in experimental group were given low-dose streptozotocin (STZ,30 mg/kg) to induce type 2 diabetic disease. Serum glucose, insulin and tissue sections of pancreas is used to evaluate the effect of type 2 diabetic rat model. The characteristics of bone in the two groups were measured and compared by micro-CT. RESULTS: Compared with normal group (n =10), the experimental group (n =9) had the body mass and serum glucose increased significantly (P<0.05). The level of serum insulin was equivalent in two groups(P>0.05). Pancreatic tissue section staining showed in experimental group islet morphology was irregular, edge boundary was blur and islet cells were saperated with increasing fiber tissue. The bone volume of normal and experimental groups were (0.194 2±2.332)%, and (0.080 7±1.952)%, respectively. Trabecular thickness (unit:mm) were 0.052 9±0.004 5 and 0.043 6±0.002 4, respectively. Trabecular number (unit:mm⁻¹) were 3.668 8±0.134 5, and 1.851 7±0.288 8, respectively ( P<0.05), while trabecular space (unit:mm) were 0.219 6±0.072 1 and 0.496 5±0.076 4, respectively( P<0.05). Bone tissue morphology metrology test results was consistent with the results of micro-CT. CONCLUSIONS: The diabetic rat model showed declined bone volume and trabecular density, trabecular number. Micro-CT may be more intuitive in bone quality inspection to reflect the characteristics of bone microstructure morphology.

A cyclic trinuclear silver complex for photosynthesis of hydrogen peroxide.

The development of metal complexes for photosynthesis of hydrogen peroxide (H2O2) from pure water and oxygen using solar energy, especially in the absence of any additives (e.g., acid, co-catalysts, and sacrificial agents), is a worthwhile pursuit, yet still remains highly challenging. More importantly, the O2 evolution from the water oxidation reaction has been impeded by the classic bottleneck, the photon-flux-density problem of sunlight that could be attributed to rarefied solar radiation for a long time. Herein, we reported synthesis of boron dipyrromethene (BODIPY)-based cyclic trinuclear silver complexes (Ag-CTC), and they exhibited strong visible-light absorption ability, a suitable energy bandgap, excellent photochemical properties and efficient charge separation ability. The integration of BODIPY motifs as oxygen reduction reaction sites and silver ions as water oxidation reaction sites allows Ag-CTC to photosynthesize H2O2 either from pure water or from sea water in the absence of any additives with a high H2O2 production rate of 183.7 and 192.3 µM h-1, which is higher than that of other reported metal-based photocatalysts. The photocatalytic mechanism was systematically and ambiguously investigated by various experimental analyses and density functional theory (DFT) calculations. Our work represents an important breakthrough in developing a new Ag photocatalyst for the transformation of O2 into H2O2 and H2O into H2O2.

[Minimal dosages of fentanyl and sufentanil with bupivacaine for epidural analgesia in labor].

OBJECTIVE: To estimate the minimal dosages of fentanyl and sufentanil in combination with 0.0625% W/V bupivacaine for epidural analgesia in labor. METHODS: Forty-six pregnant women with full term gestation who requested epidural analgesia in labor were enrolled in this up-down sequential allocation study. Ten mL of fentanyl or sufentanil in combination of 0.0625% W/V bupivacaine was injected into the L2-3 epidural space of the women when their cervical dilated at about 2-4 cm. The effectiveness and side effects of the analgesia were observed in the following 30 minutes. The initial dose for the first study participant was set at 100 microg for fentanyl and 20 microg for sufentanil, respectively. The subsequent doses for the next study participants were determined by the response of the previous participants (testing interval, 5 microg for fentanyl and 1 microg for sufentanil). The minimum analgesic dose (MAD) of fentanyl or sufentanil was calculated using Dixon-Massey method. RESULTS: The MAD was 65.9 microg for fentanyl and 15.3 microg for sufentanil with 0.0625% W/V bupivacaine for epidural analgesia in labor. There were no significant differences in analgesia equality and side effects between fentanyl and sufentanil. CONCLUSION: When combined with 0.0625% W/V bupivacaine for epidural analgesia in labor, the minimum analgesic dose is 65.9 microg for fentanyl and 15.3 microg for sufentanil.

Effective colorectal cancer education for Asian Americans: a Michigan program.

Asian Americans are among the fastest growing population groups in the USA. Despite the fact that colorectal cancer (CRC) is the second most common cancer for this group, Asian Americans have low CRC screening rates. An established health promotion program, Healthy Asian Americans Project (HAAP), expanded to include community-based CRC education during 2005-2006. Using Asian-language media, HAAP promoted awareness throughout local Asian Indian, Chinese, Filipino, Hmong, Japanese, Korean, and Vietnamese American communities and recruited men and women over 50 years to attend health fairs at local community/cultural centers. Evaluation data from 304 participants in an evidence-based educational intervention showed significantly increased knowledge and attitudes about the importance of screening. Follow-up conducted between 6 and 12 months showed that 78% of those receiving the educational intervention had been screened in the last 12 months, compared with the 37% who had ever been screened with any of the tests prior to the study. This community-based health promotion program reached underserved populations and the educational intervention improved CRC screening rates. This and similar programs may help lower CRC mortality among Asian Americans.

[Effect of focal irrigation with mild hypothermic artificial cerebral spinal fluid on the spinal ischemia/reperfusion injury].

OBJECTIVE: To investigate the effect of focal irrigation with mild hypothermic artificial cerebral spinal fluid on the spinal ischemia/reperfusion injury. METHODS: Eighteen health male New Zealand white rabbits were randomly divided into three groups: normal control group (Group NC), spinal ischemia-reperfusion group (Group SIR) and focal irrigation with mild hypothermic artificial cerebral spinal fluid group (Group FI). The rabbits in Group SIR and Group FI were subjected to spinal ischemia/reperfusion injury by clamping the infrarenal abdominal aorta. The rabbits in Group FI received focal irrigation with 25 degrees C artificial cerebral spinal fluid during the spinal ischemia period. The mean arterial pressure (MAP) and cerebral spinal fluid pressure (CSFP) were continuously measured during the ischemic/reperfusion processes. The neurological conditions of the rabbits were assessed at 24 h, 48 h and 72 h after reperfusions. The spinal cords were harvested 72 h after reperfusions for histological analysis. RESULTS: The MAP and CSFP in Group NC remained stable. The MAP in Group SIR and Group FI decreased continuously in the first 30 min of spinal ischemia period and 30 min after reperfusion. The CSFP in Group SIR increased continuously in the first 10 min of spinal ischemia and was higher than the baseline and those in Group NC. The CSFP in Group FI decreased to 3.8 mmHg (1 mmHg = 0.1333 kPa) at the beginning of spinal ischemia, and remained at 3-5 mmHg until 20 min after reperfusions. Group FI had better neurological outcomes and less severe pathological changes than Group SIR measured at 72 h after ischemia/reperfusion. CONCLUSION: Focal irrigation with mild hypothermic artificial cerebral spinal fluid can decrease CSFP during spinal ischemia/reperfusion and protect spinal cords against ischemia/reperfusion injuries.

Tumor-Penetrating Hierarchically Structured Nanomarker for Imaging-Guided Urinary Monitoring of Cancer.

The capacity to diagnose cancer with the existing endogenous biomarkers remains limited because biomarkers usually act at the tumor site and are thus challenging to be detected directly from body fluids with high sensitivity and specificity, especially in the early stage of tumorigenesis. Here, we demonstrate an exogenous tumor-penetrating nanomarker composed of fluorescent nanoparticles conjugated with specific fluorescein-labeled peptides. The injectable nanomarkers perform four functions: they penetrate the tumor, target sites of cancer, cleave specific peptides by on-target protease, and drop off the labeled peptide into host urine for fluorescent detection. Sensitive in vivo tracking and monitoring of the cyclic process of the nanomarker was also accomplished. The nanomarker can noninvasively diagnose and monitor tumors with a volume of about 17 mm3 without invasive core biopsies. Enhanced capacity of early point-of-care detection for cancer is accomplished by receptor-dependent specificity of the signal generation in the urine compared with clinically used blood biomarkers.

Novel composite drug delivery system as a novel radio sensitizer for the local treatment of cervical carcinoma.

In this study, we investigated in vivo radiosensitizing effects of a gel-based dual drug delivery system (DDS) (PECE/DDP + mPEG-PCL/PTX, or PDMP) in a cervical cancer model, and determined its possible mechanisms of action. A xenograft cervical cancer model was used to investigate the radio sensitization effect of PDMP. Mice underwent paclitaxel (PTX) + cisplatin (DDP), PECE, or PDMP treatment followed by single radiation doses ranging from 0 Gy to 20 Gy. Radio sensitization was analyzed by tumor regrowth delay (TGD). The sensitization enhancement ratio (SER) was calculated by the doses needed to yield TGD when using radiation treatment alone and when using radiation plus drug treatment. The impact of irradiation and drugs on TGD was determined, and an optimum radiation dose was chosen for further evaluation of radio sensitizing effects. The data showed that PDMP yielded the highest radio sensitization (SER was 1.3) and a radiation dose of 12 Gy was chosen for further investigation. PDMP + radiotherapy treatment was most effective in inhibiting tumor growth, prolonging survival time, decreasing expression of CD31, CD133, and aldehyde dehydrogenase 1 (ALDH1), inducing G2/M phase arrest, apoptosis, and expression of Ataxia telangiectasia mutated (ATM) and histone H2AX phosphorylation (γ-H2AX). Thus, our data indicated that PDMP is a promising anti-tumor and radio sensitization reagent for the treatment of cervical carcinoma.

Molecular Characterization, Gene Evolution, and Expression Analysis of the Fructose-1, 6-bisphosphate Aldolase (FBA) Gene Family in Wheat (Triticum aestivum L.).

Fructose-1, 6-bisphosphate aldolase (FBA) is a key plant enzyme that is involved in glycolysis, gluconeogenesis, and the Calvin cycle. It plays significant roles in biotic and abiotic stress responses, as well as in regulating growth and development processes. In the present paper, 21 genes encoding TaFBA isoenzymes were identified, characterized, and categorized into three groups: class I chloroplast/plastid FBA (CpFBA), class I cytosol FBA (cFBA), and class II chloroplast/plastid FBA. By using a prediction online database and genomic PCR analysis of Chinese Spring nulli-tetrasomic lines, we have confirmed the chromosomal location of these genes in 12 chromosomes of four homologous groups. Sequence and genomic structure analysis revealed the high identity of the allelic TaFBA genes and the origin of different TaFBA genes. Numerous putative environment stimulus-responsive cis-elements have been identified in 1,500-bp regions of TaFBA gene promoters, of which the most abundant are the light-regulated elements (LREs). Phylogenetic reconstruction using the deduced protein sequence of 245 FBA genes indicated an independent evolutionary pathway for the class I and class II groups. Although, earlier studies have indicated that class II FBA only occurs in prokaryote and fungi, our results have demonstrated that a few class II CpFBAs exist in wheat and other closely related species. Class I TaFBA was predicted to be tetramers and class II to be dimers. Gene expression analysis based on microarray and transcriptome databases suggested the distinct role of TaFBAs in different tissues and developmental stages. The TaFBA 4-9 genes were highly expressed in leaves and might play important roles in wheat development. The differential expression patterns of the TaFBA genes in light/dark and a few abiotic stress conditions were also analyzed. The results suggested that LRE cis-elements of TaFBA gene promoters were not directly related to light responses. Most TaFBA genes had higher expression levels in the roots than in the shoots when under various stresses. Class I cytosol TaFBA genes, particularly TaFBA10/12/18 and TaFBA13/16, and three class II TaFBA genes are involved in responses to various abiotic stresses. Class I CpFBA genes in wheat are apparently sensitive to different stress conditions.

The efficacy of hyperbaric oxygen therapy in improving the quality of life in patients with problem wounds.

The unpredictable course followed by severe, chronic, non-healing wounds not only restricts the daily activities of affected patients, but also impairs their quality of life (QOL). Hyperbaric oxygen therapy (HBOT) treatment for such wounds elevates tissue oxygen content, increases cellular repair functions and the probability of wound healing, and improves the patient's QOL. This was a longitudinal, prospective study, and used a purposive sampling method. A total of 15 patients receiving HBOT at a medical center were enrolled. Data were collected by questionnaire before and after HBOT. The questionnaire included basic patient characteristics, self-perceived wound severity, wound physiological indices, and a QOL scale. The overall QOL score of the subjects after HBOT was higher than before HBOT. After HBOT, there was a positive correlation between the QOL of patients with problem wounds and the scoring of the Strauss wound classification system. After HBOT, there was a negative correlation between the QOL of patients with problem wounds and their self-perceived severity of the wound. The results were then used to provide suggestions for nursing care and additional research directions in order to effectively assist patients with problem wounds receiving HBOT, with the goal of achieving an optimal QOL.

[Coping: a concept analysis].

Hundreds of studies have been conducted by nuring researchers on stressors requiring coping. Unfortunately, the concept of coping is poorly defined. This paper presents a conceptual analysis of the phenomenon of coping. Within the classic framework developed by Walker and Avant (1995), coping is analyzed and critical attributes are distilled. A model case, a related case and a contrary case are constructed as conceptual clarity is established. Empirical referents that exemplify the concept of coping are identified. The concept analysis provides a forum for dialectics, offering one defensible interpretation of a complex human occurrence. The implications for nursing are discussed in the conclusion.

[An experience nursing a patient with amyotrophic lateral sclerosis using the theory of self-care].

Amyotrophic lateral sclerosis (ALS) is a progressive and lethal motor neurodegenerative disease. The cause of the disease is unknown, and there is no cure current clinical treatment methods include Riluzole and supportive therapy. However, Riluzole only decelerates the patient's muscle strength loss and prolongs survival by about 3-5 months (Aventis Pharmaceutical, 2004). The patient will die eventually because of aspiration pneumonia or respiratory failure. This paper documents the use of Orem's self-care theory and holistic nursing assessment in a patient with amyotrophic lateral sclerosis. There are four areas of nursing concern: impaired self-care ability (dressing, feeding, toileting, and bathing), risk of falls, impaired verbal communication, and powerlessness. In terms of these problems suitable nursing activities are provided to develop the patient's ability to care for himself, prevent accidents, promote skills of non-verbal communication, and alleviate powerlessness in order to strengthen control.

[An experience of taking care of an adolescent spinal surgery patient suffering from scoliosis].

This case report describes the experience of taking care of an adolescent (nineteen year-old) girl, who needed spinal surgical treatment because of scoliosis. The author assessed the patient's condition by observation, interview, and the Gordon 11-item functional health pattern assessment guide. Because she had had no previous surgical experience, and faced changes in her bodily appearance, the adolescent had physical and psychological problems, such as acute pain, self-care deficit, anxiety, and body image disturbance. Besides applying professional knowledge and technical ability, to alleviate the discomfort caused by the young lady's surgery, the author used caring, listening and empathy to encourage and support her in learning self-care, to accept her change in body image, and to overcome the impact of the disease. Through this nursing process, the author came to understand that nurses must concern themselves with both physical problems and mental needs in order to provide holistic health care.

Tumor micrometastases in mesorectal lymph nodes and their clinical significance in patients with rectal caner.

AIM: To investigate the number, size, and status of lymph nodes within the mesorectum and to explore the prognostic significance of lymph node micrometastases in patients with rectal cancer. METHODS: Thirty-one patients with rectal cancer undergone total mesorectal excision between October 2001 and October 2002 were included. Mesorectal nodes retrieved from the resected specimens were detected with a combination of haematoxylin and eosin (HE) staining and immunohistochemistry (IHC). The relations between lymph node metastases, micrometastases and postoperative recurrence were analyzed. RESULTS: A total of 548 lymph nodes were harvested, with 17.7+/-8.2 nodes per case. The average number of metastatic nodes in HE-positive patients and micrometastatic nodes in IHC-positive patients was 5.2+/-5.1 per case and 2.2+/-1.3 per case, respectively. The mean size of all nodes and metastatic nodes was 4.1+/-1.8 mm and 5.2+/-1.7 mm in diameter, respectively. The mean size of micrometastatic nodes was 3.9+/-1.4 mm in diameter. The size of the majority of mesorectal nodes (66.8%), metastatic nodes (52.6%), and micrometastatic nodes (79.5%) was less than 5 mm in diameter. During a median follow-up period of 24.6+/-4.7 mo, 5 patients (16.7%) had recurrence, of them 2 died and 3 survived. Another case died of tumor unrelated cause and was excluded. All 5 recurrent cases had 3 or more nodes involved, and one of them developed only lymph node micrometastases. The mean number of both metastatic and micrometastatic nodes per case differed significantly between the recurrent and non-recurrent groups (P<0.01 and P = 0.01, respectively). CONCLUSION: The majority of lymph nodes, metastatic, and micrometastatic lymph nodes within the mesorectum are smaller than 5 mm in diameter. The nodal status and the number of lymph nodes involved with tumor metastases and micrometastases are related to the rapid postoperative recurrence.