Precision medicine is a medical model that proposes the individual therapy,with a joint medical method of genomics,proteomics,metabolomics and clinical big data tailored to the individual patient.The diagnosis and treatment of colorectal cancer have entered the model of precision medicine with the entering the era of precision medicine.In this article,authors summarized the recent progress of diagnosis and therapy under the guidance of precision medicine,with an aim to provide some new clues for surgeons and supports for precision prevention,diagnosis and therapy.

The development of laparoscopic techniques has made surgical treatment enter into the era of minimally invasive surgery,and the application of three-dimensional (3D) high-definition laparoscopic system has brought the important innovation for laparoscopic techniques,meanwhile,it also provides stereoscopic visions and more accurate spatial orientation for surgeons.During the process of laparoscopic radical resection of lower rectal cancer,3D vision can help to identify blood vessels,nerve and tissues around the rectum,ensure accurate lymph node dissection,reduce difficulty of operation,and the learning curve of laparoscopic radical resection of lower rectal cancer for inferior surgeons might be shorten by using 3D imaging system.With the development of technology,the value on clinical application of 3D high-definition laparoscope will become more evident.

Digestive tract reconstruction after proctocolectomy is a critical step of colorectal surgery, proper reconstruction can promote the recovery of digestive tract function and improve the quality of life.At present, there are some candidate reconstruction methods after proctocolectomy, but standardized and proper one is not still established.Since there are differences of the reconstruction methods after proctocolectomy at the different parts of colorectum, the best reconstruction methords should be selected according to the condition and intraoperative situation of patients.

Objective To research the effect of alimentary tract reconstruction after gastrectomy on the treatment of type 2 diabetes mellitus(non-insulin-dependent diabetes mellitus, NIDDM). Methods From January 2005 to January 2008, perioperative blood glucose level and insulin therapy in 24 gastric cancer or periampullary carcinoma patients with non-obesity type 2 diabetes were retrospectively analyzed. These patients underwent different alimentary tract reconstruction, including 8 patients for Billroth I, 10 for standard Whipples operation, 6 for esophageal Roux-en-Y jejunostomy after total gastrectomy. Glucose level and insulin dosage of thease patients were compared. Results In the patients underwent Billroth I operation, change of blood glucose level before and after operation was not significant(P＞0.05). The level of blood glucose in patients underwent Whipples operation and total gastrectomy were significant changed 1 and 2 months after the operation (P<0.001). In Billroth I group, 5 patients used insulin to control hyperglycemia preoperatively. After the operation, 2 patents maintained preoperative insulin dosage, 2 had to increase the use of insulin and 1 decreased the insulin dosage. In Whipples group, 6 patients used insulin preoperatively. Interestingly, 4 patents needed less insulin to control hyperglycemia and 2 were free of insulin dependance. In total gastrectomy group, there were 4 patients using insulin to control hyperglycemia. After the operation, 2 patents needed less insulin dosage and 2 stopped using insulin. Conclusions Both Whipples operation and total gastrectomy lead to decreased blood glucose level in NIDDM patients and less need of insulin.The effect of some types of alimentary tract reconstruction after gastrectomy on treatment of type 2 diabetes mellitus is assertive.

Objective To investigate the correlation between clinical features of breast cancer and microsatellite instability(MSI).Methods 60 samples of breast cancer were eollected and 5 microsatellite polymorphism loci were selected.MSI analysis Was made after DNA isolation,PCR amplification,electrophoresis and EB staining.Results The rate of MSI was 33.3%in breast cancer and 0%in normal breast tissues.MSI in breast cancer was associated with carcinoma differentiation degree.Conclusion MSI is an early event during breast carcinogenesis and it plays an important role in estimation of malignant degree.

Objective To research the effects of bosentan in on unilateral ureteral obstruction (UUO) rats. Methods Wistar rats were randomly divided into three groups. UUO group was subjected to complete ligation of left ureter, sham operation group with sham operation was used as control. Bosenten group was subjected to complete ligation of left ureter and to stomach with bosentan suspension. Three groups were killed at 5,10,15,20 d. We examined renal pathological changes and the expressions of transforming growth factor-?1 (TGF-?1) in kidney of all rats using immunohistochemistry analisis method. The plasma and ureteral obstructive kidney urinary concentration of endothelin - 1 (ET - 1) was determined by radioimmunoassay. Results In Bos and UUO groups, the urinary concentration of ET - 1 increased substantially and the expression of TGF - ?1 were much higher than those in the S group. At the same time.tubulointerstitial fibrosis was present in the kidney of rats in Bos and UUO group. But the expression of TGF- ?1 and tubu-lointerstitial fibrosis in Bos group were lower than those of UUO group. Conclusion Bosentan can effectively amelirate tubulointerstitial fibrosis in rats with UUO by ET and TGF - ?1 machanism.

Objective To determine the expression of endothelin in kidneys of rats with unilateral ureteral obstruction (UUO). Methods Rats were evenly divided into two groups. Some were subjected to complete ligation of left ureter and the others with sham operation were used as control group.Four weeks later, we examined the mRNA expressions of ET-1 in kidneys of all these rats using reverse transcription-polymerase chain reaction (RT-PCR) method.The immunohistochemistry analysis was carried out to investigate the protein level of ET-1. The urinary concentration of ET-1 was determined by radioimmunoassay.Results In UUO group, the urinary concentration of ET-1 increased substantially;both gene expression and protein level of ET-1 were much higher than those in control group. At the same time, tubulointerstitial fibrosis was present in the kidneys of rats with UUO. Conclusion ET-1 is involved in the pathogenesis of the injury of UUO.

AIM:To study the purified factors of Guanxinning for Injection(Radix et Rhizoma salviae miltiorrhizae,Rhizoma Chuanxiong,etc). METHODS: The total of salvianolic acid B、protocatchuci aldehyde and ferulic acid were used to evaluate for the study of type of macroporous adsorption resin,sample volume,the ratio of diameter to height,pH value and sample consistency etc. RESULTS: pH value Guanxinning extract was adjusted to 3.0,through D101 resin finally reached the ratio of diameter to height 1∶2,4 times of water was applied to elution and then 3 times of 70% ethanol for re-elution and collected. CONCLUSION: These factors are approprite for purifying Guanxinning for Injection.

Objective:To study the effect of B7-1 costimulatory molecule in inducing tumor immunity.Methods:The lymphocytes were examined in vitro,for both proliferation induces(PI) and specific cytotoxic activity,H22 mice were challenged subcutaneously either by the mock following which the latency,survival time and tumor mass growth were noted.Results:The H22-B7-1 cells more effectively induced the proliferation of effecter lymphocytes and the generation of specific lytic activity against H22 cells.The H22-B7-1 cells demonstrated slower rate(P

Objective To evaluate pericardial devascularization with splenectomy (PCDV) for the treatment of cirrhotic portal hypertension. Methods From January 1994 to December 2004, 177 patients were treated by PCDS, among them posthepatitic cirrhosis was identified in 170 cases, and alcoholic cirrhosis in 7. One hundred and thirty two patients were operated on electively, 25 prophylactically, and 20 emergently. Results The bleeding control rate was 95% , the overall operative mortality rate was 4. 5%. The main causes of death were upper gastrointestinal bleeding, hepatic failure and intra-abdomimal hemorrhage. The mean follow-up time was 3. 6 years. The 5-year survival rate was 90%. The 5-year recurrent bleeding rate was 5. 1% , The rate of postoperative hepatic encephalopathy was 5. 1%. Conclusions This procedure has the advantage of high successful rate of bleeding control, low complication rate, and long term survival.