Objective To assess the efficacy of surgical treatment and the prognostic factors predicting survival for patients with local recurrence of rectal cancer. Methods The clinical data of 43 rectal cancer patients who received reoperation at Beijing Cancer Hospital from November 1998 to April 2005 were retrospectively analyzed. The postoperative 5-year survival, incidence of complications, perioperative mortality were calculated. Postoperative survival was analyzed by Kaplan-Meier method and prognostic factors by univariate analysis and Cox proportional hazard regression model. Results Of all patients, 35 underwent radical resection, 8 underwent palliative resection or colostomy. The incidence of complications, perioperative mortality and postoperative 5-year survival were 26% (11/43), 2% (1/43) and 9% (4/43), respectively. Patients who received radical resec-tion, with primary tumor of TNM Ⅱ stage, with normal level of carcinoembryonic antigen, and with the time of recurrence within postoperative 24 months had better prognosis (χ~2 = 21.30, 14.17, 5.93, 5.53, P < 0.05). Modality of reoperation and TNM staging of primary tumor were the independent factors influcing the prognosis (χ~2 = 8.89, 6.96, P < 0.05). Conclusion Radical resection for patients with postoperative local recurrence of rectal cancer results in a favorable prognosis.

Objective To explore the timing of surgical intervention for severe acute pancreatitis (SAP). Meth-ods One hundred and fifty-seven cases with SAP treated in our hospital from March, 1998 to December, 2007 were analyzed retrospectively. Influence of surgical intervention and conservative treatment on curative rate were e-valuated in pancreatic necrotic area and with or without infected pancreatic necrosis. Results The overall curative rate of surgical treatment and conservative treatment was 80.4%, 87.1% respectively; the two methods had no sta-tistical difference. Conservative treatment was better than surgical treatment in patients with lesa than 30% necrotic area and surgical treatment was better than conservative treatment in patients with more than 50% necrotic area. But the two methods had no statistical difference in 30% ～ 50% necrotic area. Conservative management was better than surgical management in sterile pancreatic necrosis, but surgical management was better than conservative manage-ment in pancreatic necrosis with infection or suspection of infection. Conclusion Surgical intervention treatment plays an important role in SAP patients, we should combine pancreatic necrotic area and with or without infection to choose the timing of surgical intervention for severe acute pancreatitis.

0.05).Tn-C、CD44v6 were negative expression in group C.Conclusion Tn-C、CD44v6 protein are useful in early diagnosis of follicular thyroid carcinoma.

Objective To investigate the relationship between standard CD44(CD44s)expression and tumor stage and prognosis in colorectal cancer.Methods CD44s expression was detected by immunohistochemistry in tumor tissues and normal mucosa specimens from 74 cases of primary colorectal cancer.Results Of 74 cases,the expression of CD44s in colorectal cancer tissue and normal mucosa specimens was documented in 42% and 16%,respectively.The expression of CD44s in primary tumors significantly increased in stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ(39% vs.6%,x~2=8.46,P＜0.01).A statistically significant correlation was observed between the overall survival and CD44s expression(x~2=17.82,P＜0.01).Furthermore,a poor prognosis of CD44s-positive tumors was observed in patients with stage Ⅲ and Ⅳ colorectal cancer(x~2=16.23,P＜0.01),but not in patients with stage Ⅰ and Ⅱ colorectal cancer(x~2=1.34,P＞0.05).Multivariate analysis indicated that TNM stage and CD44s expression were independent predictors of overall survival in colorectal cancer.Conclusion CD44s overexpression is involved in the progress of colorectal cancer and predicting the prognosis.

Objective To compare enteral nutrition (EN) and total parenteral nutrition (TPN) in the treatment of severe acute pancreatitis(SAP) elucidate the advantage of EN. Methods Fifty-nine patients were assigned to TPN and EN groups. The nutritional index was detected, and the therapeutic efficacy was reviewed comparetively. Results After giving the nutritional support, the serum contents of albumin, pre-albumin, transferrin and beamoglobin were increased obviously (P < 0.05);and prealbumin, transferrin had statistical difference between the TPN and EN groups(P <0.05). APACHE Ⅱ score was lowered significant-ly in the EN group, comparing with the TPN group (P <0.05). In the EN group, complications, infection rate, food intake time, and hospitalization costs were significantly lower compared with the TPN group(P< 0.05), although mortality rate, hospital stay days had no statistical significance (P > 0.05). Conclusion EN is on ideal modality of nutrition support in SAP patients, which has many advantages in improving nu-tritional status, preserving gut mucosa barrier, decreasing bacterium and toxin shifting, regulating inflamma-tory and infective response, decreasing costs in the hospital.

OBJECTIVE:To explore the role of clinical pharmacists participating in drug therapy for patients with severe infec-tions. METHODS:Clinical pharmacists participated in drug treatment for a patient with tropical candidemia and assisted physicians to adjust anti-infective treatment plan. According to the results of blood culture,clinical pharmacists suggested Piperacillin sodium and tazobactam sodium for injection 3.75 g,ivgtt,q8 h+Caspofungin acetate for injection 50 mg (initial dose of 70 mg),ivgtt, qd,for symptomatic treatment;increased the daily dose of Caspofungin acetate for injection to 50 mg,ivgtt,bid due to plasma ex-change;Caspofungin acetate for injection 50 mg,ivgtt,qd+Amphotericin B for injection 0.1 mg/kg,ivgtt,qd for anti-infective plan due to the possible“contradiction”of echinocandins;closely monitored ADR,such as allergy,erythra,renal function injury. RE-SULTS:Physicians adopted the suggestions of clinical pharmacists,vital sign of patient kept stable,and tropical candidemia was not detected in the blood culture;the patient was transferred to general ward for further treatment. CONCLUSIONS:Based on the results of blood calture,clinical symptoms and the characteristics of drug effects,clinical pharmacists participated in the treatment for the patient with severe infection,retrieved related treatment guideline,assisted physicians to adjust anti-infective plan and close-ly monitored possible ADR so as to guarantee the effectiveness and safety of anti-infective treatment.

Objective To study the changes of heart rate variability (HRV) and the effects of treatment with nasal continuous positive airway pressure (nCPAP) in elderly patients with sleep apnea/ hypopnea syndrome (SAHS). Methods SAHS patients and controls were examined by polysomnography(PSG) and dynamic cardiograph(DCG). Mean RR interval(Mean RRi), standard deviation of RR interval (SDRRi), low frequency(LF), high frequency(HF) and their ratio(LF/HF) were calculated. Results When compared with controls(847.9?113.8)ms vs (45.7?16.2) ms, there was significantly decrease in the Mean RRi and SDRRi in moderate, severe elderly patients and non-elderly SAHS patients(764.3?131.0)ms, (709.4?101.8)ms, (759.5?80.0)ms and (37.5?12.2)ms, (31.5?9.6)ms, (41.4?10.6)ms. There was statistical differences in LF, HF, and LF/HF between elderly and non-elderly severe SAHS (P

0.05).Univariate analysis showed SOFA,APACHEII,CTSI,age and pancreatic infection were related to prognosis of SAP.Multivariate analysis revealed that only SOFA,APACHEII,CTSI were independent prognosis-related factors of SAP.Conclusions SOFA,APACHEII,CTSI all have good predictive ability for prognosis of SAP during dynamic in-hospital observation,and combination of the three factors has greater ability for prognosis of outcome of SAP.

Objective To study the effects of exercise on hemodynamic parameters and cardiovascular humoral factors in the elderly patients with hypertension. Methods The modified Bruce assessment (MBA) was employed in an essential hypertension (EH) group (group 1, n =34) composed by elderly EH patients and a control group (group 2, n =31) composed of normal subjects. Heart rate (HR),systolic and diastolic blood pressure (SBP、DBP), and the quantum and duration of exercise (QE, DE) were explored, while the serum concentrations of nitric oxide (NO), endothelin 1(ET1), atrial natriuretic factor (ANF) and AngiotensinⅡ(AngⅡ) were measured at 3 min before and after treatment. Results There were no significant differences between groups 1 and 2 with regard to HR, SBP, DBP, total DE and peak QE before and after treatment, in addition, at the peak of exercise ( P 0.05). Pretreatment SBP and DBP were significantly and positively correlated with those at the peak of and after treatment ( r =0.648,0.630, P

Aim To investigate the vasodilatory effect and the mechanisms of urocortin(Ucn) on the thoracic aorta of spontaneously hypertensive rats(SHR).Methods Rings cut from SHR thoracic aorta were used in vitro.The endothelium dependent and independent vasorelaxing effects of Ucn were measured.Furthermore,it was also explored whether the relaxing effects of Ucn were affected by N~((?)) nitro-L-arginine methyl ester(L-NAME), methylene blue(MB) and glybenclamide.Results Ucn(1 nmol?L~(-1)～1 ?mol?L~(-1)) caused concentration dependent relaxation in SHR thoracic aorta with endothelium and without endothelium(P