Objective To investigate the reasons and prevention measures of anastomotic leak after total mesorectal excision (TME) in middle and lower rectal cancer.Methods Clinical data of 216 cases of middle and lower rectal cancer patients from March 2005 to March 2013 were retrospectively analyzed.Results All the 216 cases,anastomotic leak occurred in 19 cases,which from March 2005 to February 2009 surgery in 96 cases,13 cases of anastomotic leak,from March 2009 to March 2013 surgery in 120 cases,6 cases of anastomotic leak.Time of the anastomotic leak occurrence was postoperative 4-10 d with an average of 7.3 d.There was no correlation between the occurrence of postoperative anastomotic leak and gender,Dukes stage,histological type and incomplete intestinal obstruction (P ＞ 0.05).However,there was correlation with the age,tumor distance from the anal margin lower end,anemia,hypoproteinemia,diabetes and the stapler hand-sewn anastomosis strengthen (P ＜ 0.05 or ＜ 0.0 1).Sixteen cases were healed by conservative treatment,3 patients with severe anastomotic fistula underwent transverse colostomy surgery to cure.Conclusions Anastomotic leak after TME in middle and lower rectal cancer is caused by a variety of factors,fine operation technique,good agreement,full-effective drainage and anal is the key factor to reduce the occurrence of anastomotic leak.Anemia,hypoproteinemia,diabetes and low anastomotic are the risk factors for the anastomotic leak,most cases of anastomotic leak are able to cured by conservative treatment,and if the conservative treatment fails,then choose the right time to colostomy.

Objective To explore the correlation between carotid atherosclerosis and coronary artery atherosclerosis, and their relationship with macrophage colony stimulatory factor (M-SCF), C-reactive protein(CRP) and plaque stability.Methods A total of 400 patients having underwent a selective coronary angiography were divided into no coronary heart disease (NCHD) group (93 cases), acute coronary artery syndrome(ACS) group (202 cases) and stable angina pectoris(SAP) group ( 105 cases).Based on coronary angiography plaque morphology, the patch was typed as Ⅰ, Ⅱ and Ⅲ and based on ultrasound for the carotid artery, plaque was typed as stable and unstable plaques.The plaque type, the levels of peripheral blood M-SCF, CRP was compared among ACS group,SAP group and NCHD group.Results Coronary artery atherosclerosis was mainly type Ⅱ in ACS group[78.7%(159/202)], and carotid atherosclerosis was mainly unstable[69.3%(140/202)].Coronary artery atherosclerosis of type Ⅰ , Ⅱ , Ⅲ was 40.0%(42/105), 30.5% (32/105) and 29.5%(31/105) in SAP group,and carotid atherosclerosis was mainly stable.The levels of peripheral blood M-SCF, CRP in ACS group were higher than those in SAP group and NCHD group (P＜ 0.05 ) ,and there was no significant difference between SAP group and NCHD group (P＞ 0.05 ).The levels of peripheral blood M-SCF, CRP in coronary artery atherosclerosis with type Ⅱ were higher than those with type Ⅰ , Ⅲ (p＜ 0.05).The levels of peripheral blood M-SCF, CRP in carotid atherosclerosis with unstable plaque were higher than those with stable (P ＜ 0.05 ).Conclusion Coronary arteriosclerosis is closely related with carotid arteriosclerosis.The levels of M-SCF and CRP are related to plaque structural characteristics and plaque stability.

Objective To fully understand the medicinal plants of Fritillaria L.,the physicochemical properties of starch in two species of Fritillaria L.,F.thunbergii and F.ussurensis.were investigated by means of various analytical methods.Methods The properties of starch in the two different species of Fritillaria L.were compared by X-ray diffraction,scanning electron microscope(SEM) and themogravimetric analysis(TGA).Results The crystal type of starch in the two species of Fritillaria L.was the characteristic B-type which was in consistent with that of potato starch.The degrees of crystallinity of F.thunbergii starch and F.ussurensis starch were about 29.9% and 20.1%,respectively.However,the degree of crystallinity of the potato starch was 44.9%.From the crystallinity degree of the starch in two species of Fritillaria L.,it could be concluded that the content of amylose in F.ussurensis starch was higher than that in F.thunbergii starch.The granule size of the starch in two species of Fritillaria L.ranged from 5 to 40 ?m,which were all smaller than that of the potato.The starch granule in two species of Fritillaria L.was in cycloidal or elliptic-shape.It could be concluded that the thermal stability of the starch in two species of Fritillaria L.was different due to the different structures of different starch in various plants by TGA.Conclusion The physicochemical properties of starch in two different species of Fritillaria L.differ a lot due to their geographical origin.

OBJECTIVE:To provide a reference for promoting and strengthening pharmaceutical services by retail pharmacies in rural area in Yongzhou of Hunan. METHODS:Investigation was conducted on 13 aspects including the service concept,service mode,service process,service contents,hardwares and softwares and professional quality of practitioners of 357 retail pharmacies in rural area in Yongzhou of Hunan to know about current pharmaceutical services. RESULTS & CONCLUSIONS:In this area, 78.9% of pharmacies operated in the name of a licensed pharmacist or pharmacist who did not work in that pharmacy;only 53.3%of practitioners were pharmacy graduates;the proportion of the practitioners who takes part in training every year was less than 30.0%,average training time was not more than 8 hours;65.3% of practitioners in the pharmacies were not aware of the concept of pharmaceutical services;the pharmacies which were not equipped with basic hardwares and softwares for pharmaceutical servic-es accounted for 47.0%,those which had not established a pharmaceutical service management process accounted for 87.4%;and less than 10.0% of retail pharmacies provided door-to-door pharmaceutical services. Safe,effective and rational drug use should be achieved by intensifying the management and training for retail pharmacy practitioners,standardizing the contents of pharmaceutical services,establishing standard pharmaceutical service process,defining basic hardwares and softwares for pharmaceutical services, strengthening performance appraisal and evaluation for pharmaceutical services and urging the pharmacy to serve society.

Objective To investigate the effect of different target plasma concentrations (Cp) of remifentanil on sedative effect of propofol. Methods Eighty adult ASA Ⅰ or Ⅱ patients aged 18-60 yr undergoing elective laparoscopic cholecystectomy were randomly assigned into 4 groups (n = 20 each). Anesthesia was induced with TCI of remifentanil (Cp = 2, 4 and 8 ng/ml in group Ⅱ-Ⅳ respectively) and propofol TCI (the initial Cp of propofol was 2 μg/ml in the 4 groups). Then the Cp of propofol increased by 0.5 μg/ml every 1 min until BIS value decreased to 50. BIS value and the Cp of propofol were recorded as the patient lost consciousness.The Cp and consumption of propofol were recorded when BIS value decreased to 50. Results BIS value was significantly increased, while the Cp of propofol was significantly decreased as the patient lost consciousness, and the Cp and consumption of propofol were significantly decreased when BIS value decreased to 50 in group Ⅲ - Ⅳ compared with group Ⅰ (P ＜ 0.05). Conclusion Remifentanil 4 ng/ml is the suitable Cp for anesthesia when combined with propofol.

ObjectiveTo evaluate the effects of ketamine on the minimum alveolar concentration of scvoflurane for blunting adrenergic responses to skin incision (MAC_(BAR)) in patients undergoing abdominal surgery. Methods Forty-four ASA Ⅰ or Ⅱ patients aged 30-60 yr undergoing elective abdominal surgery were randomly divided into 2 groups (n=22 each) : control group (group K_0) and ketamine group (group K_1). Anesthesia was induced with propofol 2 mg/kg and fentanyl 3 μg/kg. Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg. The patients were mechanically ventilated. Anesthesia was maintained with sevoflurane inhalation (the initial end-tidal concentration 3% ). Ketamine at 14 μg·kg~(-1)·min~(-1) was infused at the same time in group K,. The patients' response to skin incision was described as positive if MAP or HR increased by≥15%. If the response was positive, the end-tidal concentration of sevoflurane for the next patient was increased by 0.5%, while if negative, decreased by 0.5% . ResultsThe MAC_(BAR) of scvoflurane was 3.25 % (95 % confidence interval 3.05%-3.45%) in group K_0, and 2.20% (95% confidence interval 1.96%-2.44%) in group K~1. The MAC_(BAR) of sevoflurane was significantly lower in group K~1 than in group K_0 (P<0.05). Conclusion Ketamine infusion at 14 μg·kg~(-1)·min~(-1) can reduce MAC_(BAR) of sevoflurane and enhance the inhibitory effect of sevoflurane on the stress response.

Objective To compare the efficacy of dexmedetomidine and pethidine for prevention of postoperative shivering in patients requiring general anesthesia.Methods Sixty ASA Ⅰ-Ⅲ patients of both sexes,aged 18-75 yr,weighing 40-85 kg,were randomly divided into 2 groups (n =30 each) ∶ pethidine group (group P) and dexmedetomidine group (group D).At the end of pneumoperitoneum,pethidine 0.5 mg/kg and dexmedetomidine 1 μg/kg were infused intravenously over 10 min in groups P and D,respectively.The shivering,respiratory depression,somnolence,nausea and vomiting,bradycardia and hypotension were recorded within 1 h after operation.Results There were no significant differences in the incidence and degree of shivering between group D and group P (P ＞ 0.05).The incidences of respiratory depression and nausea and vomiting were significantly lower,and the incidence of bradycardia was significantly higher in group D than in group P(P ＜ 0.05).Conclusion The efficacy of dexmedetomidine for prevention of postoperative shivering is better than pethidine in patients requiring general anesthesia.

Objective To express the recombinant antigen coded by Pagumogonimus skrjabini adult cysteine protease gene fragment and to investigate the immunoreactivity of the fusion protein for further usage on serodiagnosis of the fluke disease. Methods The target gene fragment was amplified by PCR. After purification with gel purification recoverykit, the target gene fragment was ligated with PinPointTM Xa 1 T vector and transduced into E.coli JM109 strain. The expressed fusion protein sample was prepared with alkaline lysis solution, and then analyzed by SDS PAGE. The expression level was determined by Coomassie blue staining and the streptavidin alkaline phosphatase staining. The immunoreactivity of fusion protein was examined by Western blotting. Results A total of 8 positive clones were harvested, and only one had the proper orientation verified by sequencing. The recombinant antigen was obtained after being induced with IPTG (Isopropltio ? D galactoside), and a positive band of 32?10 3 was found by streptavidin alkaline phosphatase staining. In the same position, the fusion protein was also detected by Western blotting. Conclusion The expression vector of adult cysteine protease gene PinPointTM Xa 1 T vector was successfully constructed. The recombinant antigen obtained after being induced with IPTG possesses good immunoreactivity.

Cancer gene expression data have the characteristics of high dimensionalities and small samples so it is necessary to perform dimensionality reduction of the data. Traditional linear dimensionality reduction approaches can not find the nonlinear relationship between the data points. In addition, they have bad dimensionality reduction results. Therefore a multiple weights locally linear embedding (LLE) algorithm with improved distance is introduced to perform dimensionality reduction in this study. We adopted an improved distance to calculate the neighbor of each data point in this algorithm, and then we introduced multiple sets of linearly independent local weight vectors for each neighbor, and obtained the embedding results in the low-dimensional space of the high-dimensional data by minimizing the reconstruction error. Experimental result showed that the multiple weights LLE algorithm with improved distance had good dimensionality reduction functions of the cancer gene expression data.
Algorithms ; Gene Expression Regulation, Neoplastic ; Genes, Neoplasm ; Humans ; Neoplasms ; genetics

Due to the minimum free energy model, it is very important to predict the RNA secondary structure accurately and efficiently from the suboptimal foldings. Using clustering techniques in analyzing the suboptimal structures could effectively improve the prediction accuracy. An improved k-medoids cluster method is proposed to make this a better accuracy with the RBP score and the incremental candidate set of medoids matrix in this paper. The algorithm optimizes initial medoids through an expanding medoids candidate sets gradually. The predicted results indicated this algorithm could get a higher value of CH and significantly shorten the time for calculating clustering RNA folding structures.
Algorithms ; Cluster Analysis ; Nucleic Acid Conformation ; RNA ; chemistry