Objective To explore the detection rate of colorectal cancer by endoscopic,and study the value of digital rectal examination,fecal occult blood test,tumor markers examination,painless colonoscopy in colorectal cancer screening.Methods The data of 2 167 colonoscopy patients were retrospectively analyzed from January 2010 to December 2013.All the patients accomplished the digital rectal examination,fecal occult blood test,tumor markers examination before colonoscopy,the results were compared with pathology and surgical results.Results There was no statistical difference in the ratio of male and female in the year 2010-2013 (x2 =3.640 5,P ＞ 0.05).The detection rates of rectal adenoma in the year 2010-2013 were 4.762％ (25/525),8.180％ (40/489),8.276％ (48/580) and 8.028％ (46/573),there were no statistical differences (x2 =6.785 7,P ＞ 0.05).The detection rates of colorectal cancer in the year 2010-2013 were 12.571％ (66/525),11.656％ (57/489),13.448％ (78/580) and 10.820％ (62/573),there were statistical differences (x2 =2.065 7,P ＞ 0.05).The colorectal cancer accounts for the percentage of positive results of colonoscopy in the year 2010-2013 were 72.527％ (66/91),58.763％ (57/97),61.905％(78/126) and 57.407 ％ (62/108),there were statistical differences (x2 =5.679 8,P ＞ 0.05).Conclusions The detection rates of colorectal cancer are stable in the year 2010-2013.Combined with digital rectal examination,fecal occult blood test and tumor markers examination is the value of screening colonoscopy population,enhancing the pertinence,thus improving the colorectal cancer early diagnosis and early treatment levels.

Objective To explore the function of intensive care unit (ICU) in earthquake disaster. Mothod ICU in tent set by doctors from Second Military Medical University and Sichuan Jiangyou People's Hospital in 5·12 Wenchuan earthquake disaster. The value of ICU in tent was estimated by retrospective analysis of the experi-ence of emergency treatment for the critical injuries. Results Inside ICU in tent,there were many critical patients successfully rescued, including a soldier with septic shock, a casualty with traumatic shock during aftershock, a middle school student with crush injury and cornpartment syndrone, a peasant trapped under mined buildings for 168 hours with capillary leak syndrome, and a traffic victim and an aged patient with cardiac arrest. Patients after replatation of severed limb and patients after thoracic operation were monitored. Teaching rounds in the wards and logistics health drilling were made as well. Conclusions ICU in tent as a place where the critical casualties and patients after major operations could be rescued,cared for and monitored successfully,as well as the venue of teach-ing activity and logistics health drilling.

Objective To explore the ultrasound imaging characteristics of thyroid papillary carcinoma complicated cervical lymph node tuberculosis, and to elucidate the key points of ultrasound diagnosis and to distinguish with cervical lymph node metastasis of papillary thyroid carcinoma.Methods In total, 1 5 well-documented cases of papillary thyroid carcinoma diagnosed definitely were selected, and there were 6 cases of concomitant lymph node metastasis. The ultrasonography of lymph node enlargement was analyzed, and the differences of the ultrasonographic characteristics between lymph node tuberculosis and metastatic lymph node including the location, swelling, calcification, blood flow and regional nodal liquefaction. Results Thyroid papillary carcinoma complicated with cervical lymph node tuberculosis was often found in the areas of Ⅲ,Ⅳ and Ⅴ, especially in the area of Ⅴ. Variety of echo was mixed in tuberculous of lymph node, and the echo was inhomogenous. The tuberculosis of lymph node calcification was patchy inhomogeneous distribution.The echo in part of liquefaction of lymph node tuberculosis was cottony weak. The flow signal of tuberculous lymph appeared the surrounding or internal punctate distribution,and the soft tissue was echogenic and disorder around the lymph node tuberculosis. Conclusion When ultrasonography examination is performed in the patients with the thyroid papillary carcinoma complicated with cervical lymph node enlargement, the history should be considered to analyze the ultrasound characteristics to dignose by observing the lesions of the surrounding soft tissues.

Objective To compare the myocardial damage in patients with severe valvular heart disease undergoing open heart surgery under propofol and sevoflurane combined anesthesia.Methods Thirty-two patients with severe heart valvular disease undergoing open heart surgery were randomized into 3 groups:midazolam group (group M,n =8),propofol group (group P,n =12) and sevoflurane group (group S,n =12).Midazolam 1-5 mg,vecuronium 0.15 mg/kg and fentanyl 10-20 μg/kg were injected intravenously in group M.Propofol 1-2 mg/kg,vecuronium 0.15 mg/kg and fentanyl 10 μg/kg were injected intravenously in group P.In group S,the patients inhaled sevoflurane until the eyelash reflex disappeared,the end-tidal concentration of sevoflurane was 0.5 ％-2.0％,and vecuronium 0.15 mg/kg and fentanyl 10μg/kg were injected intravenously.The patients were mechanically ventilated after tracheal intubation.Anesthesia was maintained with iv infusion of midazolam 0.1 mg· kg-1 · h-1,fentanyl 0.2 μg· kg-1 · min-1,and vecuronium 0.12 mg· kg-1 · h-1 in group M,with iv infusion of propofol 150 μg· kg-1 · min-1 and fentanyl μg· kg-1 · min-1 in group P,or with inhalation of 0.5％-2.0％sevoflurane in group S.CPB was established routinely.The concentration of sevoflurane was 0.5 ％-1.0％ during CPB.Venous blood samples were collected before anesthesia (T1),at 20 min and 2 h after aortic unclamping (T2,3),and at 24 h after operation (T4) for determination of the levels of plasma lactic dehydrogenase (LDH),creatine kinase (CK),creatine kinase MB (CK-MB),cardiac troponin Ⅰ (cTnⅠ),superoxide dismutase (SOD)and tumor necrosis factor (TNF)-α.Myocardial tissues were taken at T2 for determination of heme oxygenase-1 (HO-1) expression and for examination of the myocardial ultrastructure.Results Compared with group M,the levels of plasma LDH,CK-MB,and CK were significantly decreased at T2-4,the levels of plasma SOD and cTnⅠ were significantly increased at T2,3,and the expression of HO-1 was up-regulated at T2 in groups P and S,and the levels of plasma TNF-α were significantly decreased at T2-4 in group P and at T2,3 in group S (P ＜ 0.05).The pathologic changes induced by I/R were less severe in groups P and S than in group M.Conclusion Both propofol and sevoflurane can attenuate the myocardial damage in patients with severe valvular heart disease undergoing open heart surgery and the effects are comparable.

OBJECTIVE:To provide reference for the improvement of pharmacy management in primary hospital.METHODS:Some problems about pharmacy management and its operation process in primary hospital were introduced briefly.Reasons of above problems were investigated and analyzed,and relevant countermeasures were put forward.RESULTS & CONCLUSION:Pharmacy management of primary hospital should be strengthened,standardized and improved.More efforts should be put into the pharmacy work of primary hospital in order to make primary hospital become a great contributor for primary medical care.

Objective To compare several methods for the rapid detection of methicillin resistant StaphylOCOCCUS aureus(MRSA).Methods Forty-four Staphylococcus aureus isolates from Tianjin Medical University Cancer Institute and Hospital(TMUCIH)were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method,Oxacillin micro-broth dilution method,E tests and PBP2a Latex agglutinaltion assay.These above results were compared with PCR analysis.Results PCR analysis showed that 36 MRSA strains containing mecA was identified.Thirty-two MRSA strains were detected by Oxacillin Kirby-Bauer disk diffusion method,Cefoxitin Kirby-Bauer disk diffusion method and Oxacillin micro-broth dilution method.Compared with PCR analysis,the sensitivity and specificity is 88.9%and 100%respectively.Thirty-three MRSA strains were identified by E test,with the sensitivity of 88.9%and specificity of 87.5%.Twenty-nine MRSA strains were identified by PBP2a latex agglutination assay with the sensitivity of 80.5%and specificity of 100%.Conclusions The turnaround time of PBP2a Latex agglutination assay could be reduced 24 h compared with other methods for detection of MRSA.This rapid,convenient and specific method could be applied in clinical laboratories for MRSA detection.

Objective To compare the difference of training field of nurse specialist between America and China, and offer proposals to the development of Chinese nurse specialist. Methods Network information resources and citespace were used to conclude and compare training field of nurse specialist. Results The nurse specialist training in America has a mature system meanwhile it is not yet mature in China. Conclusions Reference to the mature development experience of America, combining the actual situation of China, suitable strategy should be developed for the Chinese nurse specialist training.

Objective To observe the curative effect of auricular point sticking on menstrual distending pains of breasts. Methods Sixty-two patients with hyperplasia of mammary glands were randomized evenly into experiment group and control group:the former were managed with auricular point sticking and the latter with oral administration of Xiaoyao Pills for three treatment courses, each menstrual cycle as a course.The two groups were compared in terms of menstrual distending pains of breasts.Results The experiment group was significantly better than the control group in terms relieves of pains as well as the curative effect after the trial (P<0.01 for both).Conclusions Auricular point sticking is effective in relieving the menstrual distending pains of breasts.It is simple for manipulation and thus worth clinical spreading.

This study was aimed to examine the correlation of the cytotoxic effects induced by two types of TNF-α to cell cycle. Hoechst 33342 and PI were used to detect the morphological changes in the cell death induced by the two types of TNF-α. TdT and PI co-staining was performed to determine the phase of cell cycle of apoptotic cells. L929 cells in different phases of cell cycle were further synchronized and their sensitivity to the two types of TNF-α was observed. Our results showed that the apoptosis of HepG2 cells triggered by tm-TNF-α mainly occurred in G(1) phase while in HL-60, Raji and K562 cell lines it mainly took place in S phase. The apoptosis of L929 cells induced by tm-TNF-α mainly occurred in S phase while the apoptosis induced by s-TNF-α mainly appeared in G(1) phase. L929 cells were sensitive to s-TNF-α when synchronized in G(1) phase (cytotoxicity 49.8%) while their sensitivity to tm-TNF-α was highest in S phase (45.7%) and G(1)/S phase (cytotoxicity 40.6%). It was concluded that tm-TNF-α-induced apoptosis of different target cells took place in different phases of cell cycle. The apoptosis of the specific cell line induced by the two types of TNF-α occurred in different phases of cell cycle. The sensitivity of the specific cell line to the two types of TNF-α was correlated with the phase of cell cycle.

Objective To evaluate Mandarin disyllables recognition scores in noise for normal hearing people , and to establish a model for teaohing .The second goal is to get the spatial separated advantage while the noise chan‐ging its direction .Methods Percentage of correct word recognition was measured for each list by testing 50 Manda‐rin-speaking people aged from 18 to 30 with normal aural/oral communicational abilities And .6 of them joined the pilot study aimed to identify a presentation level that would be used in the formal test .The other 44 subjects partici‐pated in the formal speech test .Results When the noise was at 0 and 90 ,the speech recognition changed along with the change of signal-to-noise ratio levels .Despite of the speech recognition effect ,there was a strong relation be‐tween the signal-to-noise ratio of 0° and 90° .Conclusion The direction of speech and noise may strongly influence the speech recognition scores .When the noise and signal is separated ,the score will be better .