It is important for patients with colorectal cancer to receive standard and reasonable treatment. There are many clinical practice guidelines for diagnosis and treatment of colorectal cancer. However, the most influential guidelines are NCCN, ESMO and NICE guidelines. NCCN guidelines are the most world-renowned guidelines from National Comprehensive Cancer Network of the United States; ESMO guidelines are promulgated by the European Society for Medical Oncology; NICE guidelines are guidance of diagnosis and management for colorectal cancer issued by the National Institute for Health and Care Excellence of the United Kingdom. They are very similar in case management and treatment principles. However, there are still some differences in indications for drugs, treatment of hereditary colorectal cancer, laparoscopy indication and management of ileus. Here we discuss some of these differences and provide a reference for standardization of colorectal cancer treatment in China.

Objective To summarize the current status and development of therapy for anal canal cancer. Methods Application of Medline database and CHKD database, with "anal canal cancer", "chemotherapy", "radiotherapy", "abdominoperineal resection" as key words search literature about anal canal cancer published from January 1996 to June 2009. Retrieval criteria: the epidemiology of anal canal cancer; the etiology of anal canal cancer; the clinical manifestation and classification of anal canal cancer; strategies and development of therapy for anal canal cancer. Sixty-seven of them met the retrieval criteria, while finally 22 related papers were analyzed. Results Over the last 30 years, treatment of anal canal cancer has undergone a profound evolution. Combined-modality treatment combined with chemoradiotherapy (CRT), including three-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT), novel anti-tumor agent and salvage surgery, had resulted in a 5-year survival rate of approximately 80 %. Conclusion Anal canal cancer is a rare tumor. CRT has replaced surgery as the first choice of anal canal cancer. The development of molecular biology will likely lead to further proposals for trials of anal canal cancer.

300 ?m ) damage when the islets are rewarmed to 37 ℃ . These novel findings may help to understand the pathophysiology of early loss of islet tissue after transplantation,and may provide a new strategy to improve graft function in the clinical setting of islet transplantation.

ObjectiveTo investigate the clinical difference of ondansetron,metoclopramide and haloperidol in the prevention of postoperative nausea and vomiting after neurosurgery.MethodsNinety patients with neurosurgery were divided by random digits table method into four groups:control group ( 18 cases ) treated with 10 ml 0.9％ sodium chloride ;ondansetron group(24cases ) received ondansetron 4 mg;metoclopramide group (24 cases) with metoclopramide 10 mg and haioperidol group (24 cases) with haloperidol 2.5 mg.The efficacy and adverse reaction were compared among four groups.Results Compared with control group,ondansetron,metoclopramide and haloperidol could obviously inhibit the occurrence of postoperative nausea and vomiting after neurosurgery,the difference had statistical significance (P＜ 0.05).Total effective rate of ondansetron group [79.2％( 19/24)] was significantly higher than that of metoclopramide group [ 58.3％ ( 14/24 ) ] and haloperidol group [ 54.2％ ( 13/24 ) ] (P ＜ 0.05 ).And total effective rate of metoclopramide group and haloperidol group had no significant difference (P ＞ 0.05 ).The occurrence rate of adverse reaction of metoclopramide group [ 16.7％(4/24)] had no statistical significance compared with that of ondansetron group[8.3％(2/24)] and haloperidol group[ 12.5％(3/24)] (P ＞ 0.05).ConclusionsOndansetron,metoclopramide and haloperidol can obviously inhibit the occurrence of postoperative nausea and vomiting after neurosurgery,and the effect of ondansetron is significantly better than that of metoclopramide and haloperidol.Therefore,it is necessary to use drugs for preventing postoperative nausea and vomiting for patients during neurosurgery.

ObjectiveTo study the expression of growth factor receptor binding protein 2(GRB2) in bladder transitional cell carcinoma (BTCC),and clarify the role of GRB2 in the development and progression of BTCC.MethodsThe GRB2 expression of BTCC tissue from 60 patients who first got BTCC (BTCC group) and adjacent normal bladder from 30 patients(control group) were detected by SP immunohistochemical method.ResultsThe GRB2 positive expression rate of BTCC group [81.7％(49/60)] was significantly higher than that of control group [30.0％(9/30)] ( X2 =12.122,P ＜0.05).According to tumor histological grade,the GRB2 positive expression rate was grade Ⅰ[66.7％( 16/24)] ＜gradeⅡ [89.3％(17/19)] ＜grade Ⅲ [94.1％(16/17)],grade Ⅰ and grade Ⅱ,Ⅲ had significant difference (P ＜0.05),but grade Ⅱ and grade Ⅲ had no significant difference(P ＞0.05).The GRB2 positive expression rate in the clinical stage was stage T1 [63.0％ (17/27)]＜ stage T2 [95.7％ (22/23)] ＜ stage T3[ 100.0％(10/10) ],stage T1 and stage T2,T3 had significant difference (P ＜ 0.05 ),but stage T2 and stage T3 had no significant difference (P ＞0.05).The GRB2 expression among different gender and age had no significant difference (P ＞0.05).ConclusionsGRB2 has high expression in BTCC tissues.GRB2 expression is related to tumor histological grade andclinical stage.GRB2 plays an important role in the process of BTCC cell proliferation and differentiation.

Objective To analyse the lab diagnosis guideline in the patients with PM and DM,and guide the clinical diagnosis. Methods Stage the controlling condition and examine the serologic zymogram,electromyography and pathology.Results In the and Hospital of Hebei medical Vnirersity,from Jan.2003 to Jan.2005 CK,CK-MB,AST,LDH and HBDH was higher in 82.9%patients of aetive stage than the stable stage,especially changed obviously in CK.The occurance ritio(75.9%,48.3%)of the inside electricity and multiphase wave were much higher than the stable stage(46.7%,20.0%).Lots of organic fibre shrank in PM,so did the inflammation of lymohocyte soakage.In DM,the fascicle began to shrink in different degrees.Conclusion CK could become the guideline to watch the activity of illness.The number of the electromyography inside electricity and multiphase wave are related to the illness stage of patients with PM and DM.In PM pathology,muscle fibre had some infected cell soakage,with the differential recessive change.The pathology character in DM was the atrophy around the facicle and the change of tiny blood vessel.

Objective To study the influence of diabetes on the CK activity in different tissues of streptozotocin induced diabetic rats.Methods Serum samples,heart and skeletal muscles,brain and bladder tissues were collected from both streptozocin induced diabetic rats and control group.CK was measured by enzymatic method.Results The body weight,heart weight,and brain weight reduced significantly compared with control group(P

Objective:To investigate the expressions of peroxisome proliferator-activated receptor gamma (PPARγ), estrogen re-ceptor alpha (ERα), and estrogen receptor beta (ERβ) in endometrial carcinoma and to analyze their correlations and clinical signifi-cance. Methods:Immunohistochemical assay and Western blot were used to detect the expressions of PPARγ, ERα, and ERβin normal endometrial tissues and well-differentiated, moderately differentiated, and poorly differentiated endometrial carcinomas. Results:PPARγexpression was significantly lower in endometrial carcinoma than in the normal endometrium and was intimately associated with cli-ni-copathologic variables. ERαexpression gradually decreased in moderately and poorly differenti-ated endometrial carcinomas. How-ever, no significant differences were found between the normal endometrium and well-differentiated endometrial carcinoma. ERβex-pression only decreased in the poorly differentiated endometrial carcinoma. No significant association was observed between ERβand clinicopathologic variables. Pearson correlation analysis showed a significant positive cor-relation between the expressions of PPARγand ERα. No correlations were observed between the expressions of ERαand ERβand between that of ERβand PPARγ. Conclusion:The expression lev-els of PPARγand ERαwere significantly associated with the clinicopathologic stage of endometrial carcinoma, and have essential functions in endometrial tumorigenesis and tumor progression.

OBJECTIVE:To study the protective effect of shuanghuanglian sterilized powder for injection on hepatic in?jury of model mouse induced by human cytomegalovirus(HCMV)infection.METHODS:The mice were randomized into nor?mal control group,infection model group,ganciclovir group and shuanghuanglian sterilized powder for injection group(high,middle and low dosage),all of which except the normal control were vaccinated with HCMV5d to establish the hepatic injury model,each group was administered with different drugs;10days later,the enzyme activity of ALT and AST in the eye sockets blood of each group was determined;The mice were put to death by cervical vertebra dislocation and the necrosis degree of livers from the dead mice was evaluated and the pathological observation was conducted.RESULTS:The activity of ALT and AST were normal in the normal control,and no significant changes were found in the livers of this group;Compared with the normal control,the plasma ALT and AST levels have been increased significantly and there was a significant pathological hepatic injury in the infection model group;Compared with the infection model group,significant decreases were found in the activity of ALT and AST in the high and middle dosage groups of shuanghuanglian sterilized powder for injection,and there were obvious alleviated pathologic hepatic injury while no significant differences were found in the plasma ALT and AST ac?tivity in the low dosage group;Compared with the infection model group,the ALT and AST activity of the ganciclovir group were lowed significantly;Compared with the ganciclovir group,no significant differences were found in the ALT and AST ac?tivity in the high and middle dosage groups of shuanghuanglian sterilized powder for injection.CONCLUSION:Shuanghuan?glian sterilized powder for injection does have protective effect on hepatic injury of model mouse induced by HCMV.

Objective: To study the effect of casein hydrolysate (CH) on hypertensive rats. Method: Hydrolysate of casein was desalinated by macroporous adsorption resins DA201C. Angiotensin converting enzyme (ACE) inhibitory activity and antihypertensive activity of casein hydrolysate at the dose of 500, 1 000 mg/kg were measured. Results: CH had significant inhibitory activity against ACE (the inhibitory rate 80.1%), and low concentration (500 mg/kg bw?d) had remarkable antihypertensive activity on spontaneously hypertensive rats (SHR), and extremely remarkable at high concentration (1 000 mg/kg bw?d). Conclusion: Casein hydrolysate showed antihypertensive activity in SHR.