Objective To investigate the efficacy of preoperative concurrent radiotherapy and chemotherapy in middle and low rectal cancer.Methods From October 2012 to September 2016,64 patients with middle and low rectal cancer underwent surgical treatment,were randomly divided into two groups,the treatment group 32 cases,the application of simultaneous preoperative radiotherapy and chemotherapy and surgery,control group of 46 patients,only the application of surgical treatment.After treatment,the efficacy,tumor decline,adverse reactions,serum CEA levels,the lower edge of the tumor to the anal distance,the longest diameter of the tumor and quality of life improvement were compared between two groups,and compared the local recurrence and survival of 2 groups in 3 and 5 years.Results The total effective rate of the treatment group was 78.13％,the rate of tumor decline was 87.5％,the improvement rate of quality of life 84.38％,the survival rate of 3 years and 5 years were 90.63％and 75％(19.14±8.52)ng/mL,the distance from the lower edge of the tumor to the anal margin was(7.88±2.07)cm,and the longest diameter of the tumor was(2.24±1.15)cm(P<0.05).The local recurrence rates were 6.25％and 15.63％in 3 years and 5 years,which were all lower than those in the control group(P<0.05).The side effects after radiotherapy and chemotherapy in the treatment group were(31.8％),nausea and vomiting(46.88％),radioactive pancreatitis(71.88％),neurotoxicity(3.13％),liver function abnormality(31.25％),leukopenia(25.00％),hemoglobin reduction),Diarrhea(87.5％),the vast majority of Ⅰ～Ⅱ degrees,the corresponding treatment were relieved.Conclusion The clinical curative effect of preoperative concurrent chemoradiation and radiotherapy of middle and low rectal cancer is significant,which has clinical value.

Objective To investigate the relationship of pancreatic exocrine function with the pancreatic cancer staging and the size of tumor. Methods N-benzoyl-tryrosyl para-aminobenzoic acid (NBT- PABA) test was used to measure the pancreatic exocrine function of 39 pancreatic cancer patients, 46 chronic pancreatitis patients and 20 normal subjects. In pancreatic cancer group, the relationship of pancreatic exocrine function with the size of tumor (TS) and JPS classification (T factor) was analysed. Results The rate of NBT-PABA excretion in normal subjects, chronic pancreatitis patients were (78.9±15.9)%, (58.6± 19.3)%, respectively; in mild, moderate, severe chronic pancreatitis patients, the values of NBT-PABA were (75.5±23.6)%, (57.9±21.5)%, (45.5±16.7)% ; respectively. The rate of NBT-PABA excretion in pancreatic cancer patients was (47.6±18.3)%, and the rate of NBT-PABA excretion in patients with T3+T4 stage was (42.2±21.70%, and was obviously less than (64.8±11.2)% of T1+T2 stage (P<0.05). Tthe rate of NBT-PABA excretion in patients with TS3+TS4 was (34.8±17.2)%, and was significantly lower than (55.6±23.5)% of TS1+TS2(P<0.05). The rate of NBT-PABA excretion in patients with pancreatic head cancer was (42.5±16.4)%, which was significantly lower than (71.8±9.6)% of the pancreatic body and tail (P<0.05). In the 33 patients with pancreatic head cancer, the rate of NBT-PABA excretion in patients with main pancreatic duct stricture was (54.2±14.1) %, which was significantly higher than (37.6± 14.1)% of patients with main pancreatic duct interruption (P<0.05). There was no significant difference in pancreatic exocrine function between pancreatic cancer and moderate or severe chronic pancreatitis.Conclusions The pancreatic exocrine function was related to the pancreatic cancer staging and the size of tumor to some degree,but it was affected by mass location,and it was also affected by degrees of the pancreatic duct obstruction. The pancreatic exocrine function can not be used to differentiate pancreatic cancer from moderate or severe chronic pancreatitis.

CpG oligodeoxynucleotides (ODN) have potent immunostimulatory effects and can enhance the anti-cancer activity of cancer treatments. CpG ODN directly induced the activation and maturation of plasmacytoid dendritic cells, stimulated the secretion of Th1-type cytokines, and enhanced the differentiation of B cells into antibody-secreting plasma cells. CpG oligodeoxynucleotides as vaccine adjuvants can enhance both the humoral and cellular responses to antigens in some clinical trails. CpG ODN was applied in several clinical trials as an adjuvant of tumor vaccine. CpG ODN alone had anti-tumor activity and had synergistic effects with other anti-tumor therapies including monoclonal antibodies, chemotherapy, radiotherapy, cytokines, etc. Compared with standard regimen, in the phase Ⅲ clinical trial CpG ODN did not prolong the median survival time and induced severe adverse reaction in the treatment of ⅢB-Ⅳ stage non-small cell lung cancer. But CpG ODN had definite anti-cancer activity in other clinical trials. The safety and efficacy of CpG ODN in anti-tumor therapy needs to be further verified in clinic.

Objective To explore the influence of CYP1A2 and CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug duloxetine on depression patients in southern region of Fujian.Methods 82 patients with depression were selected from southern region of FuJian, China,and all participates received duloxetine for two weeks.Blood concentrations of duloxetine were detected by HPLC-MS,and CYP1A2 and CYP2D6 genotypes were determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of duloxetine were evaluated by Hamilton depression scale (HAMD) and treatment emergent symptom scale (TESS) respectively.Results Subjects were divided into GG,GA and AA three groups based on CYP1A2 * 1C genotyping.There was no significant difference in blood concentrations of duloxetine, dose-corrected blood concentrations, the reduction rate of HAMD and the reduction rate of TESS among the three groups.Results were the same with CYP1A2 * 1F,which were divided into CC, CA and AA three groups.Subjects was divided into CC, CT,TT three groups based on CYP2D6 * 10 locus genotyping.Blood concentrations of duloxetine were (13.89±3.22) ng · ml-1 , (16.08±4.24) ng · ml-1 , (17.25±4.62) ng · ml-1 respectively and there was significant difference(F=3.21, P＜0.05).CC group was significantly lower than TT group(P＜0.05) , and CT group was lower than TT group but without significant difference (P＞0.05).Dose-corrected blood concentrations were (304.84± 103.76), (368.13± 143.49), (444.50± 195.58) respectively and there was significant difference(F=4.19, P＜0.05), and CC group was significantly lower than TT group (P＜0.05).The reduction rate of HAMD were 0.42±0.11,0.46±0.11,0.52±0.09 respectively and there was significant difference (F =6.29, P＜0.05), and CC and CT group was significantly lower than TT group(P＜0.05).The reduction rate of TESS were 1.14±0.66,1.48±0.69, 1.69±0.69 respectively and there was significant difference(F=3.38, P＜0.05).CC group was significantly lower than TT group(P＜0.05).Conclusion Among the 3 loci studied,only CYP2D6 * 10 locus within CYP2D6 gene can affect blood concentration,efficacy and adverse effects of duloxetine,which indicate that CYP2D6 gene polymorphism may contribute to therapeutic efficacy of duloxetine on depression in southern region of Fujian.

Objective: To observe the clinical effect of foot bath with Tao Hong Si Wu Tang plus massage on acupoints at the sole for grade 0 diabetic foot. ＜br> Methods: One hundred and sixty eligible cases were randomly divided into an observation group and a control group, 80 cases in each group. The two groups were treated with routine basic medications to control blood sugar. The patients in the observation group were given foot bath withTao Hong Si Wu Tangplus massage on acupoints at the sole, once every day. At the same time, the patients were instructed to understand the knowledge of diabetes, accept the education on foot care and to know the self-management for diabetes. The patients in the control group only accepted the education on foot care and studied the self-management for diabetes. The patients in the two groups were followed up once every week by phone. The local examination was intensified for the patients in their clinical visit every month. The therapeutic effects were assessed after three months of continuous treatment. ＜br> Results: The total effective rate was 92.5% in the observation group, remarkably higher than 65.0% in the control group. The difference in comparison of the general therapeutic effect was statistically significant (P＜0.01). ＜br> Conclusion: Foot bath withTao Hong Si Wu Tang plus massage on acupoints at the sole was beneficial to the improvement of clinical symptoms of grade 0 diabetic foot.

Objective Based on the analysis of time domain of heart sound with envelop to extract the envelope character of heart sounds.Methods The envelope extraction of heart sounds based on Hilbert-Huang Transform was given.Firstly,the original heart sounds signal was preprocessed by Huang Transform.Secondly,the envelope of heart sounds was got with Hilbert Transform.Results The first heart sound and the second heart sound were extracted,and all kinds of characters in time domain of heart sound were acquired more accurately.Conclusion The envelope of heart sound is extracted correctly.The foundation for further analysis of heart sounds is established.

Objective To investigate the incidence of insomnia in patients with nasopharyngeal carcinoma during radiotherapy and analyze the influencing factors.Method A sleep quality questionnaire for patients with nasopharyngeal carcinoma during radiotherapy was designed and used for the investigation of the incidence of insomnia as well as the influencing factors related to insomnia.Results The incidence of insomnia was 42.2%.Univariate analysis revealed that radioactive xerostomia,nausea,hospital environmental noise,radioactive oral mucositis,worry about job,worry about prognosis,burp,vomiting,worry about family influence were related to insomnia in nasopharyngeal carcinoma patients during radiotherapy;multivariate analysis showed that radioactive oral mucositis,environmental noise and job stress were the independent factors leading to insomnia(All P<0.05).Conclusions There is a high incidence of insomnia in patients with nasopharyngeal carcinoma during radiotherapy.Radioactive oral mucositis,environmental noise and job stress might be the independent factors relative with insomnia during radiotherapy.

Objective To analyze the treatment and pathogenetic condition of chronic heart failure of coro -nary heart disease(CHD) and ventricular arrhythmia (VA).Methods 100 patients with chronic heart failure were collected to observe the treatment of chronic heart failure and pathogenetic condition of VA .Results 44 cases occured VA and 56 cases without VA in 100 patients.NT-proBNP(3 110.00 ±522.00)pg/mL of VA group was sig-nificantly higher than that (2 200.00 ±486.00)pg/mL of non-VA group(t=8.996,P<0.05).LVEF(0.25 ± 0.08) of VA group was lower than that of non -VA group(0.41 ±0.98) (t=11.625,P<0.05).The occurrence (100.00%) of premature ventricular contraction ( PVC) of ≥70mm group in left ventricular internal diameter (LVID) was higher than that of 60 -69mm group (60.87%),50 -59mm group (37.04%),40 -49mm group
(15.38%) with statistically significant(χ2 =5.853,12.532,27.375,all P<0.05).The amount(44.20 ±12.90)mg of use βreceptor blockers of amiodarone group was significantly lower than that of non -amiodarone group(44.20 ± 12.90)mg (t=5.284,P<0.05).Conclusion NT-proBNP of CHEF of CHD and VA patients will improve and amiodarone can reduce the amount of use anti -heart failure drug .

From June 2008 to December 2012,video-assisted thoracoscopic surgery (VATS group) was performed for 24 cases of thymoma.Their operative procedures,postoperative complications,remission of myasthenia gravis (MG),perioperative mortality and oncological outcomes were compared with 19 cases of trans-sternal open thymectomy (OT group).Compared with OT group,VATS group had significantly shorter operation duration,less blood loss,shorter postoperative hospital stay,shorter chest tube duration and less chest drainage amount (P ＜ 0.05).The total rate of postoperative complications of VATS group was 4％ (1/24) and it was less than OT group (4/19) without significant difference (P ＞0.05).The effective remission rate of thymomatous MG was 7/9 in VATS group and it was similar to that in OT group (6/8,P ＞ 0.05).VATS group had a recurrent or metastatic rate of 0％ (0/23) and it was better than OT group with 1/17.And there was no significant inter-group difference (P ＞ 0.05).The total survival rate of VATS group was 100％ and it was similar to that of OT group (16/17,P ＞ 0.05).Thoracoscopic thymectomy is safe,feasible,efficacious and mini-invasive for thymoma.With fewer complications and a quicker recovery,it has similar short-term outcomes to conventional open thymectomy.

Objective To explore the effect of CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug venlafaxine.Methods 69 cases of patients with depression were selected randomly from southern region of FuJian,China.The blood concentration of venlafaxine was detected by HPLC,and the CYP2D6 genotype was determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of venlafaxine were evaluated by Hamilton depression scale(HAMD) and treatment emergent symptom scale(TESS) respectively.Results Subjects was divided into CC,CT,TT three groups based on rs16947 locus genotyping.The blood concentrations of venlafaxine were (157.35±15.63) ng/ml,(70.17±5.11) ng/ml,(115.72± 10.2) ng/ml respectively and there was no significant difference (F=1.257,P=0.301).The dose-corrected concentrations and normalized concentrations were not significantly different (F=1.683,1.547,P＞ 0.05).Similarly,the reduction rate of HAMD (CC:(40.6 ± 7.23) ％,CT:(51.7±7.09)％,TT:(42.8±14.1)％) and TESS scores (CC:1.3±0.21,CT:1.3±0.36,TT:1.2±0.28) were not significantly different either (P＞0.05).In 69 samples in this study,genotyping of rs3892097 locus only found GG type,and no further examination was performed.Genotyping divided rs1065852 locus into CC,CT,TT three groups.The blood concentrations of venlafaxine were (42.87±9.9) ng/ml,(64.25 ± 13.59) ng/ml,(181.56± 14.15) ng/ml respectively,and there was significant difference among the three groups (F=4.893,P=0.016).The dose-corrected concentrations and normalized concentrations were also significantly different (F=3.985,3.648,P＜0.05).The reduction rate of HAMD (CC:(42.6±8.23) ％,CT:(48.8± 10.8) ％,TT:(63.4±9.15) ％) was not significantly different (F=2.961,P=0.07).The difference of TESS scores was similar to that of HAMD reduction rate.Conclusion Among the 3 loci studied,only rs1065852 locus within CYP2D6 gene can affect its enzyme activity and then influence the therapeutic efficacy and adverse effects of venlafaxine.