Glycerol enema, mainly composed of glycerol, sorbitol, and magnesium sulfate, was a kind of OCT caccagogue. The application of convenience, low prices made it used widely in patients with constipation. However, if the drug should not follow the indications and application of Methods , a series of improper consequences will be caused. The authors reviewed the application of Glycerol Enema, rectal injury and rectal ulcer in patients with constipation.

One hundred and twenty stroke patients were randomly divided into rehabilitation group (n =60) and control group (n =60).Patients were assessed with National Institute of Health Stroke Scale (NIHSS) ,Fugl-Meyer Assessment (FMA),Bathel Index (BI) and World Health Organization Quality of Life Assessment Instrument Brief Version(WHOQOL-BREF) before and 6 weeks after treatment by the same doctor.The scores of NIHSS,FMA,BI and WHOQOL-BREF were improved significantly in rehabilitation group after treatment; while those of control group were no improved.The scores after treatment of rehabilitation group were significantly higher than those of control group ( P ＜ 0.05 ).

Objective To analyze the fusion genes derived from 29 types of chromosome structural aberrations in leukemia patients,and the significances on the MICM typing,risk grouping,and minimal residual disease(MRD)monitoring of leukemia.Methods The bone ulan-ow or blood samples from 141 leukemia patients were analyzed with a novel multiplex nested RT-PCR.In addition.chromosomal karyotypes were investigated in some patients.Results Of the 141 leukemic samples,66(46.8%)carried 13 types of MLL/AF6,MLL/AF9,dupMLL MLI/ENL,CBFβ/MYH11 and TLS,ERG.Fusion genes were positive in 27 of 57 ALL patients(47.4 q%),and 33 of 78 AML patients(42.3%),respectively.In these ALL or AML patients,7 or 6 chromosome structural aberrations were found. Conclusion This multiplex nested RT-PCR reaction could screen 29 types of chromosome structural aberrations at the same time. It may be helpful for the diagnosis, risk grouping,prognosis evaluation and the detection of minimal residual diseases after chemotherapy and bone marrow transplantation in these leukemia patients.

Objective To discuss the clinical value of new- utility anal vacuum tube in preventing anastomotic fistula after colorectal cancer anterior resection. Methods Ninety-six patients having underwent the colorectal cancer anterior resection were divided into new-utility anal vacuum tube group and normal anal vacuum tube group by random digits table method with 48 cases each. The complication, anus exhaust time and postoperative drainage volume were compared between 2 groups. Results The incidences of tube defluxion, proctalgia, anus skin damage, bed sheet pollution and anastomotic fistula in new-utility anal vacuum tube group were significantly lower than those in normal anal vacuum tube group: 6.25% (3/48) vs. 31.25% (15/48), 10.42% (5/48) vs. 41.67% (20/48), 0 vs. 25.00%(12/48), 6.25%(3/48) vs. 60.42%(29/48), 2.08%(1/48) vs. 12.50%(6/48), the anus exhaust time was significantly shorter than that in normal anal vacuum tube group:(44.1 ± 8.9) h vs. (48.9 ± 9.6) h, the postoperative drainage volumes form the first day to fifth day were significantly more than those in normal anal vacuum tube group: (31.2 ± 15.1) ml vs. (15.6 ± 8.2) ml, (25.3 ± 13.2) ml vs. (15.8 ± 6.5) ml, (15.6 ± 9.1) ml vs. (10.3 ± 4.5) ml, (104.3 ± 38.2) ml vs. (90.6 ± 12.3) ml and (93.7 ± 32.5) ml vs. (80.7 ± 18.9) ml, and there were statistical differences (P<0.01 or <0.05). The patients in new-utility anal vacuum tube group had different symptoms, but patients could tolerate. Conclusions The new-utility anal vacuum tube can reduce the incidence of anastomotic fistula, and be safe and reliable, which is worthy of wide application.

Objective:To study the feasibility and efficacy of the modified posterolateral laparoscopic approach for resection of massive splenomegaly.Methods:The data of 48 patients who underwent laparoscopic splenectomy for massive splenomegaly at the Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital) from January 2016 to July 2019 were retrospectively analyzed. There were 29 males and 19 females, with an average age of 55.8 years. These 48 patients were divided into two groups according to the operative approach, the study group ( n=26) using the modified posterolateral approach which treated the splenic pedicle as the last step; and the control group ( n=22) which used the posterior tunnel of splenic pedicle established by anterior approach to treat the splenic pedicle first. The operation time, gastrointestinal function, recovery time, intraoperative blood loss, rates of conversion to laparotomy and postoperative complications were compared between two groups. The follow-up data were also analyzed. Results:There were no significant differences in operation gastrointestinal function recovery and hospitalization time between the two groups (all P>0.05). The intraoperative blood loss, numbers of patients with convention to open surgery and intraoperative blood transfusion, were (50.2±15.1) ml vs (160.1±40.3) ml, 2 patients (7.7%) vs 7 patients (31.8%), and 1 patients (3.8%) vs 5 patients (22.7%), in study group and control group respectively. The differences between groups were significant (all P<0.05). The complications of the study group and control group were 9 patients (34.6%) vs 13 patients (59.1%), which were significantly in the two groups ( P<0.05). On follow-up which ranged from 1 to 15 months, the numbers of patients with thrombocytosis and portal vein thrombosis in the study group and the control group were 20 patients (76.9%) vs 17 patients (77.3%), and 7 patients (26.9%) vs 6 patients (27.3%), respectively. Conclusion:The modified posterolateral laparoscopic approach for resection of massive splenomegaly was safe and feasible. It should be promoted to treat massive splenomegaly.

Five hundred elderly patients with ischemic stroke admitted from January 2008 to December 2010 were enrolled in the study,including 352 recurrent cases and 148 primary cases.There was a positive correlation of stroke recurrence with age,blood pressure,blood glucose and lipid levels,smoking and alcohol consumption of patients(P ＜0.05 ); while the stroke recurrence was negatively correlated with physical exercise(P ＜ 0.05).Stepwise multiple regression analysis indicated that the blood pressure,blood glucose and lipid levels were risk factors for the recurrence of ischemic stroke in elderly patients.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism ( PHPT) initially with urinary calculus .Methods The clinical data of 26 patients who diagnosed as PHPT ini-tially with urinary calculus were retrospectively reviewed .Results There were 22 cases with bilateral urinary calculus and 4 cases with unilateral relapsed urinary calculus .Ultrasonography , CT and radionuclide were helpful to determine the location of the neoplasia .24 cases underwent percutaneous nephroscope or ureteroscopy pneu-matic ballistic lithotripsy , 2 cases discharged ureteral calculi by themselves .All patients were performed surgical treatment of PHPT , which was confirmed by intraoperative frozen pathology and postoperative pathological exami -nation.There was great improvement of clinical symptoms after surgical procedures .The preoperative serum calci-um, urine calcium and parathyroid hormone elevated , while serum phosphate decreased .The postoperative indi-cators were just the opposite .The difference had statistical significance ( P<0.05 ) .Conclusions Laboratory investigations and imaging studies are very important to diagnose PHPT initially with urinary calculus .The para-thyroid surgery can remarkably reduce the calculus recurrence and improve renal function .

Objective To discover,diagnose and treat colorectal cancer in the early period and further improve the survival rate,reduce morbidity and mortality of the colorectal cancer by early screening for colorectal cancer in Jinjiang.Methods According to “The Guide of Cancer Screening and Early Diagnosis and Treatment in China by the Experts Group of Ministry of Health”,the case history was collected while the stool occult blood and FOBT were detected to discover high risk crowd who then inspected by electron enterscope.Results The screening was practiced in Xibin,Zimao and Neikeng town respectively.The crowd of 40-74 years old was 10 116 and 2631 of them accepted screening(acclimation rate,26％).Two hundred and fifty-seven high-risk people were discovered(9.8％ of 2631)and 86 of them(acclimation rate,33％,86/257)were inspected by electron enterscope.Twenty-two cases were detected with colorectal affection(detection rate,8.6％,22/257),20 cases were diagnosed as colorectal adenoma and 2 cases were diagnosed as adenocarcinoma by pathological section.All of them accepted therapy.Conclusion Carrying out early screening for colorectal cancer is important.It can reduce morbidity and mortality of the colorectal cancer and then improve the cure rate and prolong survival in patients with colorectal cancer.

Objective To describe the clinical presentations,radiographic findings and histological pathology of bones,diagnosis,treatment options and prognosis for patients with Gorham-Stout syndrome (GSS).Methods Clinical data of 5 GSS patients seen from January 1980 to January 2008 were reviewed.Results(1)There were 2 males and 3 females,aged 15 years to 37 years(mean age was 30.2 years).(2)All of thern had osteolysis,but the site and extent of involved bones were not the same.Three cases had large amount of bloody pieural effusion and two of them had also chylous effusion.All of the 5 cases had no evidence of malignancies.Four cases accepted bone biopsy.Among them,2 cases having local puncture and open biopsy showed typical bone pathologic manifestations.(3)Various forms of treatment including bisphosphonates,calcium supplementation,active vitD3 treatment,local radiation therapy and surgical ligation of thoracic duct were tried.(4)Follow up and clinical outcomes:the two cases,who had only bone osteolysis remained stable.Of the other three cases who had bone osteolysis associated with pleural effusion,one patient needed interrupted effusion drainage with stable bone impairment and the other two cases were out of contact.Conclusions GSS is a rare disorder charactcrized by progressive osteoIysis.The clinical presentations of this disease are variable and depend on the sites of involvement.There were no standard therapy available.Prognosis depends on the site of involvement,extent of the disease and presence of complications.Those who have plueral effusion had poor prognosis.

Objective To evaluate the feasibility of methylene blue as a method in lymphatic mapping and the effect factors of SLNB identification rate. Methods The results of SLNB in 276 patients with clinical stage T-T2N0M0 breast eaneer were analyzed to evaluate the effect factors of identification rate and false-neg-ative rate of SLNB. Results The identification of SLN was carried out using methylene blne . When the mapping time of SLN and lymphatic were controlled in 20～30 minutes, the SLN could be visualized easily. SLN was successfully identified in 246 of 276 patients (89.1%) ,423 SLNs were retrieved(1～4). The SLN accurately predicted the status of the axilla in 226 of 246 patients (77.3%) yielding a FNR(false negative rate)of 8.1% (20/246) ,false positive rate of0, and an accuracy of 91.9% (226/241). For the identified rate of SLN, the clinical stage of T2N0M0 disease was higher than the clinical stage of T1N0M0 disease (P=0.046,P<0.05), Upper outer quadrant and lower outer quadrant were higher than other evidently (P<0.0010). SLNs were easily retrieved in those cases aged above 50 years than below 50 years (P<0.001).In the view of false-negative rate of SLNB, the FNR rate in patients of 50 years old was less than older ones (P=0.037, P<0.05). No significant correlation was found between the stage of TMN, the expression of ER and PR, histologic status and FNR. Conclusion When SLNB was performed using methylene blue, we found age, clinical stage of TMN, the location of tumor had relationship with the identified rate of SLN. Ag-ing and location of tumor may adversely affect FNR of SLNB.