Objective To explore the values of manual anastomosis with two operations out of anus in laparoscopic anal sphincter preserving resection of ultra low rectal cancer. Methods Radical excision of ultra low rectal cancer was performed with ultrasonic scalpel in 12 patients based on the concept of total mesorectal excision (TME) and ultra low coloreclal/anal anastomosis was performed applying manual anastomosis with two operations out of anus. Results All the operations were finished successfully, without conversions to open for surgery. One case had anastomotic leakage, and there were no bleeding and infection of abdominal cavity, anastomotic stenosis and other complications. The operating time was 185-310 (218 ±10) min, the blood loss was 160-450 (232 ±8) ml,the length of hospital stay was 9-14 (11 ±3) d. All patients were followed up 6-36(18 ± 2) months, local recurrence was not found but 1 case had liver metastasis.Conclusions The manual anastomosis with two operations out of anus in laparoscopic anal sphincter preserving resection of ultra low rectal cancer is safe,economical,effective,minimally invasive, and has the benefits of less bleeding during the operation and shorter hospital stay. It should be widely used.

Objective To establish the determination method synthetic borneol and menthol in Keyou nanoemulsion. Methods HP-5 quartz capillary column (30 m×320 μm×0.25 μm) was used with nitrogen as the carrier gas, and FID as the detector. The temperature of the entrance of the capillary vessel column was at 230 ℃. Results Synthetic borneol and menthol in Keyou nanoemulsion were separated well. The calibration curves of synthetic borneol was obtained with good linear relationship within the range of 0.337-1.685 μg (r 2=0.998 2), the average recovery was 97.5%. The calibration curves of menthol was also obtained with a good linear relationship within the range of 0.234-1.17 μg (r 2=0.997 4), the average recovery was 97.0%. Conclusion The methord is simple and accurate. It can be used to control the quality of Keyou nanoemulsion.

Objective: To explore the mediating effect of sensation seeking and the moderating effect of parenting style at cumulative ecological risk on psychosexual health in left behind adolescents. Methods: Using convenience cluster sampling, 509 left behind adolescents in 12 middle and primary schools were selected from May to July 2020. Cumulative ecological risk, psychosexual health, sensation seeking and parenting style were evaluated at baseline (T1) and 1 year follow up (T2). Results: T1 accumulative ecological risk predicted T2 psychosexual health after sensation seeking at T1 was controlled ( β=0.37, P <0.01). T1 sensation seeking predicted T2 psychosexual health after controlled for psychosexual health at T1 ( β=-0.26, P <0.01), sensation seeking played a mediating role, indirect effect accounted for 35.85% of the total effect; T1 cumulative ecological risk ×T2 parenting style had predictive effects on T2 sensation seeking and psychosexual health ( β=0.17, -0.24, P <0.01). Conclusion The cumulative ecological risk influences psychosexual health through sensation seeking, parenting style moderates the associations between cumulative ecological risk, sensation seeking and psychosexual health. Left behind teenagers with high cumulative ecological risk can cultivate good sexual psychological level by reducing high seeking traits and optimizing parental rearing styles.

Objective To explore the effect of calreticulin (CRT) on cell proliferation and invasion of human hepatocellular carcinoma cell line SMMC-7721 and HepG2.Methods SMMC-7721 and HepG2 cells were transfected with small interfering RNA (siRNA).The transfection rate was detected by immunoflurescence and western blot.The cell proliferation,invasion and apoptosis of SMMC-7721 and HepG2 cells were determined by using cell counting kit-8 (CCK-8) assays,transwell assays and flow cytometry,respectively.The p-Akt and Akt levels were detected by western blot.Results The growth inhibition rate in the siRNA experimental group of SMMC-7721 and HepG2 cells for 24,36 and 48 h were (41.0 ±2.2) ％,(46.5 ±1.6)％,(59.7 ±2.2)％ and (36.8 ±2.7)％,(47.3 ± 1.8)％,(61.5 ±3.2)％,respectively.The apoptosis rate after down-regulating the expression of CRT in SMMC-7721 and HepG2 cells for 36h were (45.2 ± 9.1) ％ and (48.9 ± 8.0) ％,respectively.Compared with the blank group and the negative control group,the growth inhibition rate in the siRNA experimental group was lower (P ＜0.05),but the apoptosis rate was significantly higher (P ＜ 0.05).Transwell experiments confirmed that the numbers of invaded SMMC-7721 and HepG2 cells in the blank group and the negative control group and siRNA experimental group were (96.8±7.3),(95.6±5.4),(34.0±4.2) and (124.0 ±9.9),(121.6 ±7.0),(70.4±9.5),respectively,indicating that cell invasion in the siRNA experimental group was significantly suppressed (P ＜ 0.05).The expression of p-Akt was decreased (P ＜ 0.05) after down-regulating the expression of CRT for 36h.Conclusion CRT gene silencing by siRNA can inhibit the SMMC-7721 and HepG2 cell proliferation and invasion,but increase the cell apoptosis by regulating PI3K/Akt signal pathway.

In this study,the intestinal microbial flora diversity of adult and young African lions in the same breeding environment was detected by PCR-DGGE technique.Total bacterial DNA was extracted and 16S rDNA V3 region was amplified,then conducting PCR-DGGE.Subsequently,the specific bands of DGGE were cloned and sequenced.The bacterial species were identified by comparing the sequence through BLAST.The results indicated that the intestinal microbial flora of adult African lions includes Clostridium,Lachnospiraceae bacterium,Anaerovorax,Lactococcus,Peptostreptococcus and Blautia.While the intestinal microbial flora of young African lions is lesser,most bacteria are common to adult and young lions,such as Bacteroidetes bacterium and rumen bacterium.The UPGMA clustering analysis of the DGGE fingerprint showed the similarities of the bacteria structures between adult and young African lions were only 34％.These results revealed that the intestinal microbial flora has significant difference in different stages of African lions.This study lays a foundation for the development of microecological agents in different growth stages of wild animals.

Objective:To evaluate the efficacy and safety of using platelet-rich plasma (PRP) eyedrops for the treatment of moderate to severe dry eye disease (DED).Methods:A total of 395 patients (790 eyes) with moderate to severe DED diagnosed and treated in the Armed Police Liaoning Corps Hospital and the PLA 967 Hospital from March 2018 to October 2019 were collected. Random number table method was used to divide into autologous PRP treatment group (196 cases, 392 eyes) treated with autologous PRP and control group (199 cases, 398 eyes) treated with artificial tears. The changes of subjective symptoms of DED, Schirmer test (ST), corneal fluorescein staining (CFS) and Ocular Surface Disease Index (OSDI) before and after treatment were observed in both groups.Results:After 1 course of treatment, the ST values of both groups increased, which was statistically significant compared with before treatment ( P<0.05). After treatment, the OSDI and CFS scores of the two groups were reduced. The difference in OSDI and CFS scores of the PRP treatment group before and after treatment was statistically significant ( P<0.05), and there was no statistically significant difference in the control group before and after treatment ( P>0.05). After treatment, the OSDI and CFS scores of the PRP treatment group were lower than those of the control group [(16.8 ± 18.7) scores vs. (43.2 ± 14.5) scores, (0.21 ± 0.53) scores vs. (1.62 ± 0.69) scores], the differences were statistically significant ( P<0.05). After one course of treatment, the total effective rate of the autologous PRP treatment group was higher than that of the control group [80.1% (157/196) vs. 51.76% (103/196)], the difference was statistically significant ( P<0.05). Conclusions:Autologous PRP can treat patients with moderate-to-severe autologous PRP treatment group, which can greatly improve patients' eye discomfort and other symptoms.

Poor experience of teacher-student interaction and low user loyalty exist in MOOC (massive open online courses).Therefore,the campus open online courses (COOC),a network teaching platform,was developed to integrate traditional classroom teaching and network teaching and to build an online-offline curriculum system according to professional training scheme of school.The online-offline teaching design and learning evaluation in COOC platform was also developed.The running data of COOC platform showed that the online-offline learning evaluation model has guiding impact on students' learning attitude because it can record the students' learning process and learning effect,which can enhance students' active participation in self-directed learning.The learning evaluation model in COOC is objective and scientific,which is helpful to improve the quality of teaching and learning.

Objective:To systematically evaluate the clinical effect and safety of bevacizumab combined with FOLFOX regimen in patients with advanced colorectal cancer.Methods:An electronic search of Pubmed, Embase, CNKI and other Chinese and English databases were retried from their inception to December 2018 to identify relevant literatures, by taking "Bevacizumab, FOLFOX, Advanced Colorectal Cancer, Randomized Controlled Trial" as the keywords for retrieval. Patients were divided into a combination group (bevacizumab combined with FOLFOX program) and a control group (using FOLFOX program alone) according to the treatment method, using Revman 5.3 software for meta-analysis.Results:A total of 11 articles, involving 3178 patients, were included with 1599 in the combination group and 1579 in the control group. The objective group response rate ( OR=3.15, 95% CI: 2.25 ~ 4.40, Z=6.71, P<0.000 01) and disease control rate ( OR=2.73, 95% CI: 1.91 ~ 3.90, Z=5.49, P<0.000 1) in combination group were higher than those in the control group. In terms of adverse reactions, the incidence of gastrointestinal reactions in the combination group was higher than that in the control group ( OR=1.29, 95% CI: 1.07~1.55, Z=2.64, P=0.008 ), There was no significant difference in the incidence of liver injury, leukopenia, hypertension, and neurotoxicity between the two groups. Conclusion:Bevacizumab combined with FOLFOX regimen is more effective than FOLFOX regimen for patients with advanced colorectal cancer, but it will increase the risk of gastrointestinal reactions.

Objective To analyze and investigate the risk factors for intraoperative and postoperative bleeding complications of stent implantation for ruptured intracranial aneurysms(from rupture to operation time ≤14 d). Methods A total of 249 consecutive patients with aneurysmal subarachnoid hemorrhage (aSAH)treated with stent intravascular interventional therapy at the Department of Neurosurgery,Tangdu Hospital,the Second Hospital Affiliated to Air Force Medical University(the Fourth Military Medical University)from August 2014 to July 2017 were enrolled retrospectively.According to whether having intraoperative and postoperative bleeding complications,they were divided into either a hemorrhage complication group(n=33)or a non-complication group(n=216).The baseline data,clinical data,and aneurysm characteristics,including age,sex,hypertension,Glasgow Coma Scale(GCS)score,aSAH to the patients were documented and analyzed,and multivariate logistic regression analysis was used to analyze the risk factors for bleeding complications. Results (1)The incidence of perioperative bleeding complications was 13. 3% (33 /249). (2)There was significant difference in GCS scores between the bleeding complication group and the non-complication group (P < 0. 05). There were no significant differences in age,male,hypertension,and aSAH to operation time between the two groups (all P >0. 05). (3)There were significant differences in Hunt-Hess grade (χ2 = 10. 392,P = 0. 001),Fisher score (χ2 = 7. 370,P =0. 007),number of aneurysms (χ2 = 4. 825,P = 0. 028),and aneurysm location (χ2 = 6. 818, P = 0. 033)between the bleeding complication group and the non-complication group. There were no significant differences in Raymond grade between the two groups (P > 0. 05). (4)Taking the occurrence of bleeding complications as a dependent variable,a further multivariate logistic regression analysis on Hunt- Hess grades Ⅲ-Ⅴ and multiple aneurysms was performed after variable screening,the results showed that Hunt-Hess grades Ⅲ-Ⅴ(OR,3. 658,95% CI 1. 660 -8. 061)and multiple aneurysms (OR,2. 667,95% CI 1.178-6.036)were the independent risk factors for stent placement in the treatment of bleeding complications of ruptured intracranial aneurysms(all P <0.05). Conclusions The single stent and stent-assisted coils can be used for endovascular treatment of rupture intracranial aneurysms,but preoperative Hunt-Hess grades Ⅲ-Ⅴ and multiple aneurysms are easy to cause perioperative bleeding complications in patients with aSAH.

OBJECTIVE： To study the dose-time-effect relationship of Tibetan medicine Rannasangpei in cerebral ischemic- reperfusion injury model rats with intragastric administration. METHODS： The rats were randomly divided into sham operation group （normal saline， 10 mL/kg）， model control group （normal saline， 10 mL/kg）， positive control group （nimodipine， 30      mg/kg）， Rannasangpei different dose groups （0.52， 1.04， 2.08， 4.17， 8.33， 16.67， 33.34， 66.68， 133.36， 266.72 and 533.44    mg/kg）， with 18 rats in each group. Each group was given relevant medicine intragastrically once； 25 min after intragastric administration， cerebral ischemic-reperfusion injury model was established with suture-occluded method in those groups except for sham operation group. 24， 48， 72 h after cerebral ischemia， neuroethology of rats were graded in each group. The rate of cerebral infraction was detected to evaluate the optimal effective time， the optimal dose （Dmax） and maximal effect （the rate of minimum cerebral infraction， Emax） of Ratnasampil at different periods of cerebral ischemia. Dose-time-effect relationship of Rannasangpei dose with the rate of cerebral infraction was fitted with Thermo Kinetica 5.1 software. The area under curve （AUClast） and retention dose （MRTlast） of dose-effect curve were calculated， and detect the levels of SOD and MDA. RESULTS： Compared with sham operation group， the neurobehavior of model group was significantly abnormal （P＜0.05 or P＜0.01）， and the rate of cerebral infarction was significantly increased （P＜0.01）； the level of SOD was decreased significantly （P＜0.01， 48 h）， and the level MDA was increased significantly （P＜0.05， 48 h）. Compared with model control group， there was no significant change in neurobehavioral abnormalities in the nimodipine group （P＞0.05）， and the rate of cerebral infraction was decreased significantly （P＜0.01， 24， 48 h）. The level of SOD in rats were increased significantly （P＜0.01， 48 h）， while the level MDA decreased significantly （P＜0.05， 48 h）. Rannasangpei 2.08-33.34 mg/kg could significantly improved neurobehavioral abnormalities （P＜0.05， 24 h）； 24 h after cerebral ischemia， the rate of cerebral infraction was decreased significantly in Rannasangpei 4.17-133.36 mg/kg group （the lowest is 33.34 mg/kg group， P＜0.05 or P＜0.01）. The level of SOD in rats were increased significantly in 33.34-533.44 mg/kg groups （P＜0.05）. the level MDA was decreased significantly in 0.52-2.08， 8.33， 33.34， 266.72 and 533.44 mg/kg groups （P＜0.05）. Dmax was 33.34 mg/kg， Emax was 3.02％， AUClast was 5 141.76 mg/kg and MRTlast was 329.161 mg/kg. 48 h after cerebral ischemia， the rate of cerebral infraction was decreased significantly in Rannasangpei 2.08-133.36 mg/kg groups （the lowest is 66.68 mg/kg group， P＜0.05 or P＜0.01）， while the level of SOD was increased significantly in 1.04-533.44（except for 4.17）mg/kg groups （P＜0.05）. The level of MDA was decreased significantly in 16.67-66.68， 533.44 mg/kg groups （P＜0.05）， Dmax was 66.68 mg/kg， Emax was 2.13％， AUClast was    5 219.36 mg/kg and MRTlast was 340.521 mg/kg. 72 h after cerebral ischemia， the rate of cerebral infraction and the level of MDA had no significant decreased in Rannasangpei groups （P＞0.05）， and the levels of SOD had no significant increase （except for 0.52 mg/kg group， P＞0.05）. CONCLUSIONS： The optimal effective time of Rannasangpei for the treatment of cerebral ischemia-reperfusion injury in rats is 48 h， and the Dmax is 66.68 mg/kg. The improvement mechanism may be related to increase the level of SOD and decrease the level of MDA.