After receiving radical resection of primary rectal cancer,about 4％ to 30％ patients would occur local recurrence.Diagnosis of local recurrence relies on postoperative follow-up,physical examination,tumor markers and imageological examination.For the local recurrent patients,conservative therapeutic regimen had been popular in the past days with poor prognosis and quality of life.Nowadays multimodality treatment with radical resurgery combined with chemoradiotherapy and IORT has been taking the main part in the management of local recurrence.The choice of surgery depends on the site of recurrence and invasion situation inside the pelvic cavity.The aim of the radical reoperation is R0 resection because it leads to an optimistic prognosis.Previously irradiated patients are relatively safe after receiving median-dose reirradiation.For the cases whose recurrence are unavailable for radical resection,palliative operation and chemoradiotherapy may be the wise choice to relieve their symptoms and improve the quality of life.

There is persuasive clinical and experimental evidence that macrophages promote cancer initiation and malignant progression. The aggregation of macrophages indicates poor prognosis of tumor associated diseases. During tumor initiation, macrophages create an inflammatory environment that is mutagenic to cells and promotes cell growth; as tumors progressing, macrophages create premetastatic niche for the arriving tumor cells at premetastatic sites ; then macrophages provide critical nutrients for these initial metastatic tumor cells.Along with these great achievements in research of macrophage, it is believed that several novel directions of tumor therapy surely occur in the future.

Ovarian cancer is one of the highest mortality rate of gynecologic malignant tumors. Chemotherapy can improve the survival rate of the traditional ovary. In recent years, PARP [poly(ADP-ribose)polymerase]inhibitors in breast cancer susceptibility gene (breast cancer susceptibility gene, BRCA) mutations in patients with ovarian cancer can significantly improve the disease-free survival, may change the prognosis of patients with ovarian cancer. This part of PARP [poly(ADP-ribose)polymerase] inhibitors, inhibiting the repairment of DNA damage in tumor cell, causing DNA damage accumulation, eventually killing tumor cells.In breast cancer susceptibility gene 1 (breast cancer susceptibility gene1, BRCA1)/BRCA2 mutation patients with ovarian cancer, PARP inhibitors and BRCA mutation of the synthetic lethal effect provides a new direction for the development of anti-cancer drugs. Now, many highly selective and sensitive PARP inhibitors have been developed and applied in clinical trials.Although PARP inhibitor monotherapy can produce a therapeutic effect in BRCA mutation in patients with ovarian cancer, but the clinical application is still used in combination with other chemotherapy or radiotherapy. This review is focused on the recent progress in clinical trials of PARP inhibitors in combination with common chemotherapeutic agents.

Objective To construct an eukaryotic expression vector carrying human glutathione-S-transferase(GST)A1gene and to provide study materials for toxicology and pharmacogenetic.Methods The GST A1cDNA was amplified and separated from human liver total RNAs by RT-PCR approach and recombined with eukaryotic expression vector pcDNA3.The recombined plasmid pcDNA3-hGSTA1was verified using PCR,restriction analysis and sequencing determination.Results Human GST A1gene was recombined correctly with pcDNA3,compared with Genbank,in code152T→C,amino acid Met→Thr.Conclusion The eukaryotic expression vector pcDNA3-hGSTA1was constructed for research on toxicology and pharmacogenetics.

Objective To determine the feasibility of ex vivo liposome-mediated gene transfer ( Lac-Z gene ) to lung isografts and to get expression. Methods An orthotopic rat left lung transplant model was developed with the use of a modification of the “cuff” technique. 18 SD rats were divided into three groups randomly. Gene transfer group ( group 1 ): PSV-?-gal/ liposome ( Lipofectin R○ ) complex was transfered into the donor left lung via the left pulmonary vein route at the time of lung harvesting. Liposome group ( group 2 ) and Control group ( group 3 ) : Grafts underwent the same procedure but received liposome and 0 9% saline solution respectively. Donor lungs were harvested one day after transplantation. The transgene expression of Lac-Z gene was detected by histochemical staining. Results Transgene expression of ?-gal in group 1 was detected in bronchial epithelial cells and alveolar epithelial cells. But no expression of ?-gal was found in groups 2 and 3. Conclusion Ex vivo plasmid vector/liposome complex-mediated gene transfer to lung isografts via the left pulmonary vein route is feasible. This study provides the scientific proof to the feasibility of functional gene therapy of complications such as ischemia-reperfusion injury, rejection and infection after rat lung transplantation.

Objective: To evaluate the therapeutic effects of early enteral nutrition in the treatment of severe acute pancreatitis by nasojejunal tube.Methods: Forty-one cases of SAP were retrospectively analyzed and divided into 2 groups.There were 20 cases in conventional therapy group and 21 cases in enteral nutrition group.Major causes,treatments and clinical results were analyzed and APACHEⅡ score,CT score,serum albumin and prealbumin were compared between two groups.Results: Fortyone cases were cured and no one needed surgical intervention except six pateints with pseudocysts.EN cases were fed via a nasojejunal tube placed at the seventh day after admission.EN was well tolerated throughout the course of disease.The improvement of APACHEⅡ score of the EN group was significantly higher than that of conventional therapy group(P

OBJECTIVE: To explore the diagnostic value of brain natriuretic peptide (BNP) level in patients with sepsis of blood-stasis syndrome. METHODS: The prospective method of clinical diagnostic test and evaluation principles of diagnostic test were applied. One hundred and seventy-four patients with sepsis were divided into two groups: blood-stasis syndrome group and non blood-stasis syndrome group. The levels of serum BNP in two groups were detected. RESULTS: The level of BNP in sepsis patients was related to blood-stasis syndrome (P<0.01). BNP cut-off level was 150 ng/L, sensitivity was 85.3%, specificity was 81%, the maximum value of Youden index was 0.663, and the area under the receiver operating characteristic curve (ROC) value was (0.886+/-0.025). CONCLUSION: BNP can be used as an objective index of blood-stasis syndrome diagnosis for sepsis, and BNP with boundary value of 150 ng/L is an optimal biological index.

Objective To study the quality control of previous process of apheresis platelets detection .Methods Single and double apheresis platelets each of 100 samples were collected and were diluted 1∶1 ,1∶3 and 1∶7 .Aautomatic Blood Cell Count-er was employed to detect the platelet count .Another 100 samples of apheresis platelets were collected and stand at room tempera-ture for 0 ,30 ,60 ,90 ,120 min ,After 1∶3 dilution ,the platelet counts were detected .Results Differences of platelet counts be-tween 1∶1 and 1∶3 dilution ,1∶3 and 1∶7 dilution of single or double apheresis platelets showed statistically significant differ-ences(P<0 .05) .Differences of platelet counts between standing for 0 ,30 min and standing for 60 ,90 ,120 min were found statis-tically significant(P<0 .05) .Conclusion Quality control of previous process of apheresis platelets detection is very important for platelet count after collection .

ObjectivesTo discuss the safety of surgical treatment and the feasibility of laparoscopic surgery for the elderly patients with gastric cancer. MethodsThe clinical and pathological materials of 104 elderly patients(65 years old or above) undergone surgical treatments retrospectively were analyzed,in order to analysis the postoperative complication incidence and the short-term outcomes in different age groups and different surgical pattern groups.ResultsThere were more preoperative comorbidities in ≥75 years old group than in ＜75 years old group(especially hypertension and diabetes),however,the incidence of postoperative complications was not significantly different.There was no difference of preoperative comorbidities, postoperative complications, surgical time or the amouts of blood loss during surgery between the laparoscopic and the traditional surgical groups,while the laparoscopic groups had short period of postoperative hospitalizing and earlier orally intake of fluid diet. There was also no difference of pathological results.ConclusionThe elderly patients with gastric cancer should have surgical treatments if the conditions are permitted, and the areas of dissection should be standard as far as possible. The old patient undergone laparoscopic surgery may have a shorter hospitalized period after operation, because their recovery of bowel function is more quickly.

Objective To evaluate the clinical features and guanosine triphosphate cyclohydrolase 1 (GCH-1) gene mutation in a family with dopa-responsive dystonia (DRD).Methods The clinical features of this family were collected and their peripheral blood samples were screened for mutation in GCH-1 gene using PCR and DNA direct sequencing.Results The clinical features among each patient in this family were different.But all affected family members had quite a good response to levodopa treatment without significant adverse reactions.DNA test showed an AT deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene in 5 affected members and 1 asymptomatic immediate family member.Conclusions Clinical heterogeneity is an important characteristic of DRD and clinical symptoms vary intra-families.Same gene type may cause different phenotype and not all carriers are patients.The deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene should be considered as a pathogenic mutation for DRD.