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 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 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 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 investigate the relationship between abnormal metabolism of aggrecan and joint destruction in patients with rheumatoid arthritis (RA).Methods 140 RA patients with duration less than 24 months were enrolled into this study.The study also included 100 normal controls and 95 patients with other rheumatic diseases.Three monoclonal antibodies (5D4,7D4 and BC-3) of aggrecan were used to detected aggrecan catabolic fragments in serum of RA patients and the other two groups of controls by enzyme linked immunosorbent assay (ELISA),and the correlation of aggrecan catabolic fragments with joint damage were analyzed.Sharp evaluation of hand joints in RA patients were performed at baseline and after one year follow-up.Calculating the area under the receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity of aggrecan catabolic fragments detected in serum of RA patients.Results Both levels of 5D4 fragment and BC-3 fragment of RA group were higher than those of normal control [5D4 of RA:(5.8±2.1) ng/μl,normal control:(2.2±1.3) ng/μl;BC-3 of RA:(11.1±3.4) ng/μl,normal control:(5.0±2.1) ng/μl,F=38.65,24.07,P＜0.001).There was no difference in 7D4 fragment among three groups (F=0.589,P=0.478).Both two fragment levels of RA patients with anti-CCP positive were greater than those patients with anti-CCP negative [5D4:(5.6±1.3) ng/μl vs (4.4±1.1) ng/μl,F=21.23,P＜0.01;BC-3:(12.2±3.9) ng/μl vs (9.3±2.8) ng/μ1,F=27.14,P＜0.01].Linear Regression showed that serum fragments detected by 5D4 and BC-3,and anti-CCP positive were risk factors for Sharp deterioration after one year follow-up.The sensitivity and specificity of combined detection of two aggrecan fragments in serum of RA patients for the prediction of joint Sharp were 56.5％ and 84.2％ respectively.Positive predictive value and negative predictive value are 74.3％ and 70.6％.respectively.Application of areas of ROC to identify the best evaluation of Sharp was 0.798.Conclusion There is positive correlation between aggrecan catabolic fragments in serum and joint Sharp evaluation of RA patients.Detection of aggrecan catabolic fragments in RA patients may predict early joint destruction.

The purpose of this study is to develop glipizide push-pull osmotic pump (PPOP) tablets by using a formulation design expert system and an artificial neural network (ANN). Firstly, the expert system for the formulation design of osmotic pump of poor water-soluble drug was employed to design the formulation of glipizide PPOP, taking the dissolution test results of Glucotrol XL as the goal. Then glipizide PPOP was prepared according to the designed formulations and the in vitro dissolution was carried out. And in vivo evaluation was carried out between the samples which were similar to Glucotrol XL and the Glucotrol XL in Beagle dogs. The range of the factors of formulation and procedure, which could influence the drug release, was optimized using artificial neural network. Finally, the design space was found. It was found that the target formulation which was similar to Glucotrol XL in dissolution test could be obtained in a short period by using the expert system. The samples which were similar to Glucotrol XL were bio-equivalent to the Glucotrol XL in Beagle dogs. The design space of the key parameter coating weight gain was 9.5%-12.0%. It could be concluded that a well controlled product of glipizide PPOP was developed since the dissolution test standard of our product was more strict than that of Glucotrol XL.

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 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.