Aim To study the effect of tubeimosides on human rectal cancer cell line SW480 in vitro and the mechanisms of its antitumor effect.Method The morphological changes were determined by means of light microscopy and electron microscopy respectively.Cell apoptosis was detected by flow cytometry through Annexin V assay and PI fluorescent staining methods.The protein levels of Bc1-2,p53 and Fas were determined using immunohistochemical technique.Results Apparent morphological characteristic of apoptosis was detected under the optical and electric microscope.The percentage of apoptotic cell increased when comparing the drug groups with control after treatment with tubeimoside Ⅰand Ⅲ.Immunohistochemical analysis revealed apoptosis was and induced by tubeimosides through inhibiting Bcl-2 and p53,and upregulating Fas.Conclusion Tubeimosides can induce apoptosis of SW480 cells,which may be one reasons of its antitumor effects.

Objective To explore the effect of comprehensive intervention on postoperative pain of patients with rectal disease. Methods A total of 200 patients with postoperative pain after the treatment of anorectal perianal disease from May 2015 to May 2016 were randomly divided into two groups with 100 cases each. The control group was treated with drugs and usual nursing, the observation group were adopted drugs and comprehensive nursing intervention. The improvement of pain, psychological states and the quality of sleep were compared between two groups. Results The VAS pain scores at 4, 6, 12, 24, 48 h after treatment was (2.1 ± 0.6), (3.3 ± 0.4), (3.5 ± 0.3), (2.3 ± 0.5), (1.9 ± 0.5) points in the observation group, and (3.0 ± 0.5), (5.1 ± 0.6), (6.2 ± 0.6), (5.7 ± 0.8), (5.8 ± 0.5) points in the control group, and the difference was statistically significant (t=8.539-38.806, P < 0.05). The Self-rating Anxiety Scale was (20.32 ± 6.16) points in the observation group, and (35.58 ± 7.43) points in the control group, and the difference was statistically significant (t=41.188, P<0.05). The sleep quality, the amount of sleep , sleep time, sleep efficiency of Pittsburgh Sleep Quality Index Questionnaire scores was (0.91±0.28), (0.86±0.2), (0.83±0.27), (0.59±0.31), (0.62±0.27), (0.58±0.41), (4.39±1.79) points in the observation group, and (1.61± 0.88), (1.32 ± 0.75), (1.59 ± 0.89), (1.34 ± 0.58), (1.36 ± 0.45), (1.29 ± 0.86), (8.51 ± 3.55) points in the control group, and the difference was statistically significant (t=4.557-17.740, all P<0.05). Conclusions The comprehensive intervention on postoperative pain relief in patients with anal disease is significant, it is beneficial to relieve the pain response, improve sleep quality, and achieve physical and psychological comfort, and has a positive effect to clinical.

Objective To explore the clinical effects of integrative nursing for rectal cancer patients with colostomy.Methods A total of 80 cases of rectal cancer patients after colostomy were selected from our hospital from December 4,2009 to May 15,2013.They were assigned to the control group and the observation group according to the admission sequence with 40 patients in each group.The control group had been treated with conventional care,the observation group had been treated with integrative care intervened by ostomy technician.Postoperative anxiety,quality of life and complication rates were analyzed between the two groups.Results Anxiety score from the Self-Rating Anxiety Scale was lower in the treatment group respectively on the day of the operation,one month after operation and one year after operation (58.22 ± 8.23 vs.64.46 ± 9.82,50.55 ± 7.53 vs.59.76 ± 9.83,42.26 ± 2.88 vs.58.46 ± 9.82),P ＜ 0.05.the incidences of complications were significantly rarer than the control group such as the postoperative infection [7.50％ (3/40) vs.25.00％ (10/40)],colostomy hemorrhage [5.00％ (2/40) vs.25.00％ (10/40)],colostomy necrosis [2.50％ (1/40) vs.30.00％ (12/40)],other complications [5.00％ (2/40) vs.15.00％ (6/40)],P ＜0.01 or ＜0.05.Moreover,the defecation function,psychological function,social function and material life (92.55 ± 20.56 vs.84.03 ± 24.60,83.05 ± 23.66 vs.61.86 ± 18.20,79.95 ± 36.02 vs.71.09 ± 27.56,59.08 ± 28.56 vs.50.55 ± 25.96) were improved obviously in the observation group,while the incidences of nausea and vomiting and pain (10.15 ± 3.67 vs.18.99± 7.29,12.05 ± 7.90 vs.22.10 ± 9.56) were lower than the control group,based on QLQ-C30 core questionnaire for the European Quality of Life Evaluation,P ＜ 0.05.Conclusions Integrative nursing may effectively improve rectal cancer patients' quality of life after colostomy,reduce the postoperative complications and relieve anxiety,which may be useful in the clinical application.

Objective To analyze the distribution of image noise in low-dose chest CT scan and optimize the relative scanning parameters.Methods The CT images of the Chinese anthropomorphic chest phantom( CDP-1 C) were simulated into six groups of low-dose images with different noise indexs by using an image noise addition tool.The difference between the preset noise index and analog noise value was compared.The CT images of 20 volunteers were also simulated into nine groups of low dose scans with the tube currents of 10,30,50,80,100,120,150,180 and 240 mA.The noise values of images were recorded and analyzed.Results There was no statistical difference between the analog noise value and the noise index.The image noise of low-dose chest scan was increased with the decrease of tube current.The noise was increased quickly when the current was decreased from 50 to 30 mA ( F =24.09 - 40.79,P ＜ 0.05),but the noise increased slowly when the current decreased from 240 to 80 mA.There was no statistical difference between the noise of 80 mA group and that of 120 mA(P ＞ 0.05).Conclusions The noise addition tool can be used to evaluate the image noise of low-dose chest CT scan.Adoption of 80 mA in chest CT scan would result in low radiation dose without adding image noise.

Objective To study the impact of enteral nutrition (EN) or parenteral nutrition (PN) in postoperative colorectal cancer patients on viscera organ function and "passing wind" time.Methods Totally 30 patients with colorectal cancer joined this study with informed consent.Patients were randomly divided into EN group and PN group.Both two groups were given nutritional support from the first post-operative day to the 7th post-operative day.The pre-operative and post-operative viscera organ functions and the recovery time of gastrointestinal functions are observed.Results Total bilirubin was significantly lower in EN group than in PN group (P ＜ 0.05).The length of post-operative hospital stay was significantly shorter in EN group than in PN group (P ＜0.01).The post-operative complications were not significantly different between two groups (P ＞ 0.05).Conclusion Postoperative EN support is beneficial for colorectal cancer patient in terms of lower bilirubin levels,shorter post-operative hospital stay,and lower cost.

Objective: To explore the application value on combined examination of blood levels of growth differentiation factor-15 (GDF-15) and NT-pro B-type natriuretic peptide (NT-proBNP) in patients after successful cardiopulmonary resuscitation (CPR) for their recent prognosis.
Methods: A total of 102 patients with sudden cardiac arrest and successful CPR in our hospital were enrolled. Blood levels of GDF-15 were examined at immediately, 12 h and 24-48 h after CPR respectively. According to GDF-15 levels, the patients were divided into 3 groups: Group A, the patients with GDF-15<1200 ng/L at all-time points,n=31; Group B, GDF-15 level consistently increasing and GDF-15>1200 ng/L at all-time points,n=35; Group C, GDF-15 level consistently increasing at 12 h and 24-48 h after CPR, while it was lower at 24-48 h than 12 h after CPR,n=36. Blood levels of NT-proBNP and left ventricular ejection fraction (LVEF) were also examined. The patients were followed-up for 6 months for post-CPR death.
Results: Blood levels of GDF-15 and NT-proBNP were related, NT-proBNP level was changing with GDF-15 varying. GDF-15 and NT-proBNP level was negatively related to LVEF (r=-0.530,P<0.001), the patients with GDF-15>1800 ng/L and NT-proBNP>400 pg/ml had the higher mortality than those had the lower levels of GDF-15 and NT-proBNP,P<0.05. Survival analysis presented that 6 months survival rate in Group B was lower than Group A and Group C,P<0.05; survival rate was similar between Group A and Group C,P>0.05.
Conclusion: Combined examination for blood levels of GDF-15 and NT-proBNP may better predict the recent prognosis in patients who received CPR.

Objective To explore the diagnostic value of artificial intelligence (AI) cytology combined with DNA-image cytometry (DNA-ICM) auxiliary diagnostic system for the identification of benign and malignant pleural effusion and ascites. Methods Liquid-based cytology technology (LCT), DNA-ICM, AI, and AI combined with DNA-ICM were used to identify benign and malignant pleural effusion and ascites specimens in 360 cases, and their sensitivity, specificity, accuracy, Kappa value, Youden index and AUC were statistically analyzed. Results The sensitivity, specificity, and accuracy of AI combined with DNA-ICM in detecting benign and malignant pleural effusion and ascites were 95.23%, 94.12%, and 94.44%, respectively, which were higher than those of the three other separate detection methods (all P < 0.05). The kappa values of LCT, DNA-ICM, and AI were 0.646, 0.642, and 0.586; their Youden index values were 0.693, 0.687, and 0.676, and their AUC values were 0.846, 0.843, and 0.838, respectively. The Kappa value of AI combined with DNA-ICM was 0.869, the Youden index was 0.893, and AUC was 0.947, which were all higher than those of the three detection methods alone. Conclusion Among the three separate detection methods, LCT has the highest reliability, authenticity, and diagnostic value, and it can be used as a common method for the clinical identification of benign and malignant pleural effusion and ascites. The diagnostic performance of AI combined with DNA-ICM auxiliary diagnosis system in identifying benign and malignant pleural effusion and ascites is better than those of the three separate detection methods and can be used as a reliable method for the clinical identification of benign and malignant pleural effusion and ascites.

Lung transplantation is the ultimate treatment for many kinds of end-stage lung diseases. However, the perioperative management of lung transplantation is complicated with high fatality of patients. Extracorporeal membrane oxygenation (ECMO) is an effective method of extracorporeal respiration and circulation support. ECMO plays an important role in the perioperative support treatment of lung transplantation, which breaks the limitation of contraindications and promotes the development of lung transplantation. In this article, the indications, catheter placement strategies and application of ECMO in the perioperative period of lung transplantation were reviewed.

Lung transplantation is the only effective approach to treat end-stage lung diseases. Nevertheless, early prognosis of lung transplant recipients is significantly worse than that of other solid organ transplant recipients. Primary graft dysfunction (PGD) is one of the main causes affecting clinical prognosis of the recipients. PGD is an early acute lung injury after lung transplantation, which is the main cause of early death of lung transplant recipients. Risk factors of PGD after lung transplantation consist of donor, recipient and operation, etc. In this article, the risk factors of PGD after lung transplantation were reviewed, aiming to provide reference for clinical practice.

Objective To evaluate the effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis (IPF) after lung transplantation. Methods Clinical data of 235 IPF donors and recipients of lung transplantation were retrospectively analyzed. Univariate and multivariate Cox proportional hazard regression models were employed to analyze the correlation between donor age and short-term mortality rate of IPF patients after lung transplantation. Kaplan-Meier was used to draw the survival curve. Results Univariate Cox regression analysis showed that donor age was correlated with the 1-year fatality of IPF patients after lung transplantation. The 1-year fatality of recipients after lung transplantation was increased by 0.020 times if donor age was increased by 1 year (P=0.009). Oxygenation index of the donors, preoperative oxygenation index, preoperative lung allocation score, preoperative N-terminal pro brain natriuretic peptide, pattern of transplantation, pattern of intraoperative extracorporeal membrane oxygenation and intraoperative blood transfusion volume of the recipients were correlated with 1-year fatality after lung transplantation (all P < 0.1). Multivariate Cox regression analysis demonstrated that there was no correlation between donor age and 30-, 90-, 180-d and 1-year fatality of IPF patients after lung transplantation (all P > 0.05). Sensitivity analysis showed that there was no significant difference in 30-, 90-, 180-d and 1-year fatality after lung transplantation among donors aged < 18, 18-33, 34-49 and ≥50 years (all P > 0.05). Conclusions Donor age exerts no effect upon short-term survival of IPF patients after lung transplantation. Considering the mechanical ventilation time, oxygenation index, infection and other factors of donors, the age range of lung transplant donors may be expanded.