Anus fine of low rectal cancer surgery, can make the quality of Life of patients significantly im-proved,but postoperative anastomotic leakage is still the main complication, its occurrence can lead to in-creased perioperative mortality, prolonged hospitalization, increased cost, causing a great deal to patients suffering. In this paper, we review the causes and prevention of low rectal cancer after anterior resection of anastomotic leakage.

Along with the quickly popularization of Internet, the literature resource sharing mode in library has been changed. The paper introduces the current development of it, including interlibrary loan, document delivery, IC card service, proposes shortcomings and ideas for the further development of literature resource sharing.

The functions of the top 15 medical APP were compared.Their major functions of medical advice, information service and medical service were analyzed.The key functions of mobile medical APP used in China were described with suggestions for their development.

Objective To investigate the expression of blood CD +4 CD +25 Treg GITR,CD +4 T cell GITRL in children with asthma,and the role of them in asthmatic inflammation.Methods 50 cases of severe asthma were selected,and were controlled with thirty two healthy children.The venous blood was collected both in the period of acute episode and clinic remission.The mean fluorescence intensity of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL was detected by flow cytometry.Results The expression of CD +4 CD +25 Treg GITR in the asthma acute period group was (24.2 ±8.2)MFI,which was significantly lower than (28.5 ±6.0)MFI in the control group(t =2.5,P <0.05).While there was no significant difference of CD +4 T cell GITRL expression between the asthma acute period group[(5.2 ±3.6)MFI]and the control group[(4.6 ±1.0)MFI](t =1.1,P >0.05).Moreover,the expression of CD +4 CD +25 Treg GITR in the asthma in remission group after treatment was (29.5 ±8.3)MFI,which was significantly higher than that in acute period group before treatment(t =-9.9,P <0.01 ).Whereas,there was no significant difference of CD +4 T cell GITRL expression in asthma group between in remission after treatment[(5.7 ±3.6)MFI] and in acute period before treatment(t =-1.6,P >0.05).Furthermore,there was no significant correlation between levels of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL.Conclusion The level of CD +4 CD +25 Treg GITR in acute period asthmatic patients was decreased,but it was increased in remission,but no changes of CD +4 T cell GITRL expression were observed.GITR/GITRL signal system might be involved in the asthmatic inflammation procession.

Objective To explore the relationship between the Interleukin 6 , matrix metalloproteinases 2 and early embryo arrest. Methods Real time-PCR was used to measure the mRNA expression of IL-6 and MMP-2 and immunohistochemistry (IHC, SP method)was used to measure the location and expression of the two different kinds of protein in villus. ELISA was used to measure the level of IL-6 in serum. Results Real-time PCR and IHC showed that the expression levels of IL-6 was significantly lower in experimental group than in control group, and MMP-2 was significantly higher than the control group (P < 0.05). Differenc of IL-6 level in serum between the two groups was not statistically significant (P > 0.05). Conclusion Proper expressions of IL-6 and MMP-2 in the villus tissue play a key role in the maintenance of early pregnancy.

UL48 plays essential role in replication of MDV genome and interacts with UL36 as well as other MDV tegument proteins.To investigate the interaction between UL48 and UL36 during MDV oncogenisis,antibody against UL48 was prepared and characterized in current study.UL48 gene was amplified from MDV-Ⅰ genome and then subcloned into pTYB1 and pGEX-4T3 vectors for UL48 expression with induction of IPTG in BL21(DE3) E..coli cells.Chitin-sepharose and Glutathion-sepharose were,respectively,used to purify fusion protein intein-UL48 and GST-UL48.Four subcutaneous injections of intein-UL48 fusion protein were done on the lower back and the thigh of rabbit and then other three injections with an interval 10 days.The titer of antibody was measured by the sandwich ELISA with UL48 protein isolated from GST-UL48 after cleavage of thrombin.Western blot was carried out for specificity analysis of antibody against UL48 protein.The results suggested that UL48 antibody was succesfully prepared,and its titer was 1 ∶ 512 000.

Objective To research the effects of hyperbaric oxygen (HBO) on the ultrastructure of heart,brain and lung in rats with plateau deacclimatization.Methods Forty-mine SD rats were selected.Fortyfour SD rats were routinely fed in a hypobaric hypoxia chamber at the simulated altitude of 5 000 m for 3 months.Nine rats died in the hypobaric hypoxia chamber.After coming out from the chamber,35 survival rats were randomly divided into the high altitude control group (instantly after out of the hypobaric hypoxia chamber),HBO group Ⅰ,Ⅱ and Ⅲ (7 days,1 months and 2 months after HBO treatment) and control groups Ⅰ,Ⅱ and Ⅲ according to the body mass,5 cases in each group;the HBO groups were treated by HBO for 7 d.The control group Ⅰ,Ⅱ and Ⅲ were synchronously fed in normal pressure and oxygen environment after HBO treatment.The rats in all groups were synchnonously sacrificed,the other 5 SD rats as the plain control group were fed in hormal pressure oxygen environment.The frontal cortex,heart and lung tissues were taken out for observing the ultrastructure changes by optical microscopy and electron microscopy.Results Hypoxia induced mitochondria swelling and ridge breakage in cranial nerves cells,swelling of mitochondria and peripheral structures,myocardial cells cloudy swelling,vacuolar degeneration,muscle fibers irregular arrangement,inflammatory cell infiltration and vasodilatation.The alveolar septm was broadened,blood capillaries were dilated and congestive,alveolar space was filled with pink transudation,inflammatory cells were infiltrated,and alveolar wall was incrassated.After HBO treatment,the tissue ultrastructure injurys were significantly improved compared with the control group,the recovery in the HBO group Ⅱ was significantly better than that in the HBO group Ⅰ,and the HBO group Ⅲ was significantly better than the HBO group Ⅱ,which recovered to plain level after 2 months.Conclusion HBO treatment has the effects for improving cranial nerves injury in hypoxia rat,promotes cellular function recovery,decreases hypoxia induced pulmonary hypertension,and has the protective effect on ischemic myocardium.

Purpose/Significance To expound the content features of online medical reviews and its impact on the utilization of pa-tients'online consultation services,and to provide references for the information management of online medical platforms.Method/Process The LDA topic model based on TF-IDF is constructed,the semantic analysis method based on sentiment dictionary is adopted to mine the content features of online medical reviews,and the principal component analysis(PC A)is applied to classify and explore them,and the regression analysis is carried out by binary logistic.Result/Conclusion The content features of online medical reviews are divided into 3 categories,including 9 indicators.Among them,the attributes of reviewers,timeliness,consultation process,service atti-tude and platform feedback have a significant impact on the utilization of efficient online consultation services by patients.It is suggested to improve the utilization level of online consultation services by optimizing related services of online medical platform review section.

Objective To evaluate the effect of bundles of care on the prevention of postoperative delirium among elderly patients with hip fractures.Methods A prospective randomized case control study was conducted on 80 patients (≥65 years old) with hip fractures from March 2017 to June 2017.The patients were divided into experimental group (n =43) and control group (n =37) according to the random number table method.The experimental group received bundles of care,while the control group received routine nursing.The patients in both groups were all surgically treated,and the confusion assessment method (CAM) was applied to diagnose delirium after surgery.Gender,age,fracture type,duration from injury to operation,internal fixation type,operation time,total amount of bleeding,visual analogue scale (VAS),incidence of delirium,complications,and adverse events were compared between the two groups.Results Among the 80 patients,there were 11 males and 69 females,aged averagely 79.3 years (range,65-95 years).No significant differences were found between experiment group and control group in terms of gender (male:6 cases vs.5 cases,females:37 cases vs.32 cases),age [(79.8 ± 7.8) years vs.(78.7 ± 8.9) years],cause of injury (traffic injuries:7 cases vs.4 cases;falling injuries:36 cases vs.33 cases),duration from injury to operation [(66.1 ±14.3)hours vs.(63.4 ±14.9) hours],fracture type (femoral neck:13 cases vs.10 cases;intertrochanteric:26 cases vs.24 cases;subtrochanteric:4 cases vs.3 cases),internal fixation type (artificial total hip:5 cases vs.5 cases;artificial femoral head:8 cases vs.5 cases;PFNA:29 cases vs.27 cases),operation time [(55.5 ± 16.8) minutes vs.(51.6 ± 17.0) minutes],total blood loss [(114.4 ± 73.9) ml vs.(108.1 ±72.0) ml] (P ＞ 0.05).After bundles of care intervention,the postoperative VAS [(2.2 ± 0.8) points vs.(4.3 ± 1.2) points],postoperative delirium incidence (9％ vs.32％),incidence of complications and adverse events (2％ vs.19％) in experimental group were significantly lower than those in control group (P ＜ 0.05).Conclusion Bundles of care can relieve the pain and effectively reduce the incidences of postoperative delirium,complications,and adverse events in elderly patients with hip fracture.

OBJECTIVE： To systematically review the efficacy and safety of colesevelam hydrochloride combined with other hypoglycemic drugs in the treatment of T2DM， and to provide evidence-based reference for clinical treatment of T2DM. METHODS： Retrieved from PubMed， Embase， Medline， Cochrane Library， CJFD， VIP and Wanfang database during database establishement-Jul. 2019， randomized controlled trials （RCT） about the efficacy and safety of colesevelam hydrochloride combined with other hypoglycemic drugs （trial group） vs. placebo or other hypoglycemic drugs （control group） in the treatment of T2DM were collected. After extracting data from clinical studies that met the inclusion criteria， the quality of the studies was evaluated by Cochrane System Evaluator Manual 5.1.0. Meta-analysis was conducted by using Rev Man 5.3 statistical software in respects of the levels HbA1c， FPG， LDL-C， the incidence of total ADR， incidence of hypoglycemia and incidence of gastrointestinal ADR. RESULTS： A total of 11 RCTs were included， involving 2 625 patients. Results of Meta-analysis showed that HbA1c levels [MD＝－0.37， 95％CI（－0.51， －0.22），P＜0.001]， FPG level [MD＝－0.47， 95％CI（－0.88， －0.07）， P＝0.02] and LDL-C level [MD＝－0.38， 95％CI（－0.49， －0.28）， P＜0.001] in trial group were significantly lower than control group， with statistical significance. In terms of safety， the incidence of total ADR [OR＝1.24， 95％CI（1.06， 1.45）， P＝0.007] and gastrointestinal ADR [OR＝1.78，95％CI（1.05， 3.02），P＝0.03] in trial group were significantly higher than control group， with statistical significance. There was no significant difference in the incidence of hypoglycemia [OR＝1.03， 95％CI（0.62，1.72），P＝0.90]. CONCLUSIONS： Colesevelam hydrochloride combined with other hypoglycemic drugs can effectively reduce the levels of HbA1c， FPG and LDL-C in T2DM patients， but attention should be paid to the occurrence of gastrointestinal ADR.