In the latest 50 years,the radical dissection rate of colonic cancer and the 5-year survival rate have been improved as colonic surgery techniques improve.In 1991,Jacob performed the first laparoscopic hemicolorectomy in the world,and data from multiple prospective studies have shown no significant difference between laparoscopic and open radical resection of colonic cancer in aspects of postoperative survival and incidence of tumor recurrence.In the year of 2009,Hohenberger suggested the concept of complete mesocolic excision (CME).Clinical data Showed that CME could further improve the postoperative survival and reduce the incidence of tumor recurrence,and it could become the standard surgical procedure following total mesorectal excision.

ObjectiveStudy on the effect of nasal decontamination hefor aerosol inhalation in elderly patients with general anesthesia postoperation.Methods130 elderly patients with general anesthesia postoperation were randomly divided into routine treatment group and nasal decontamination group.The time of first sputum,the time of postoperative sputum changing characters,respiratoty-related indicators,sputum cuhure positive rate of bacterial,the incidence of postoperative pulmonary complications was examined.ResultsCompared with routine group,nasal decontamination group obviously shorten sputum character changing time ( P ＜ 0.05 ).Postoperative nasal decontamination group and conventional group sputum Staphylococcus aureus positive rate were 7.7％ (5 cases) and 20.0％ ( 13 cases) respectively,the difference was significant(x2 =4.13,P ＜0.05).ConclusionGiven nasal decontamination before aerosol inhalation could improve character of sputum and reduce sputum bacterial culture positive rate,and had good efficacy and safety.

Objective To study the the current situation of sexual for college students in luzhou area and to provide basis for their sexual health education .Methods 2 226 college students from four colleges in luzhou area were investigated by stratified clus-ter sampling method ,SPSS11 .5 software was used to analysis the results .Results 59 .62% of the students′knowledge was mainly from the media ,the test for sexual knowledge of college students′was satisfactory ;58 .94% of college students would like to com-municate and communication about sex and love ,84 .61% of the students thought that college students should have correct love and chastity view ,82 .95% of the students thought that should make efforts to prevent venereal disease and AIDS ,55 .27% of the students were firmly opposed to marriy during school study ;75 .15% of the students were firmly opposed to premarital sexual be-havior ,44 .44% of the students minded that lover once had sex ,36 .56% of the students broken up immediately when found that loveer had sex before .Conclusion The college students′sexual maturity in advance but knowledge of sex education relative lag , making them for many sexual problems and phenomena ,so scientific and systematic sexual health education should be strengthen in students .

Objective To assess the value of ultrasonic elastography in the diagnosis of special type breast cancers. Methods Routine ultrasonograms, color Doppler flow images and elasticity images of 13 patients with special type breast cancer confirmed surgical pathologically were retrospectively analyzed. Results The score of mucinous carcinoma, inflammatory breast cancer (1 patient), lactation breast cancer, invasive micropapillary carcinoma, tubular carcinoma and invasive lobular carcinoma (2 patients) were 4-5. The score of 1 patient of invasive lobular carcinoma was 1 and 1 patient of lactation breast cancer was 3. The characteristics of color Doppler flow imaging of majority patients were varies, while no obvious lesion was observed in Paget's disease. Conclusion Ultrasonic elastography is helpful to the diagnosis of inflammatory breast cancer, lactation breast cancer, invasive micropapillary carcinoma of the breast, papillary carcinoma and tubular carcinoma of the breast. Early diagnosis of Paget's disease still depends on pathology.

Objective To study the effect of nasal decontamination on clinical index of elderly patients with long -term indwelling nasogastric tube.Methods 89 elderly patients with long -term indwelling nasogastric tube were randomly divided into nasal decontamination group and routine treatment group.The sputum culture positive rate of bacterial and the incidence of pulmonary complications,pharyngitis,sinusitis of the two groups were observed. Results Sputum Staphylococcus aureus positive rates in the nasal decontamination group and conventional group were 13.043% (6 cases)and 39.535% (17 cases)respectively,the difference was significant(χ2 =8.139,P =0.004).The incidence rates of pulmonary infection in the nasal decontamination group and conventional group were 4.348% (2 cases)and 18.605% (8 cases)respectively,the difference was significant(χ2 =4.529,P =0.033). The incidence rates of pharyngitis in the nasal decontamination group and conventional group were 10.870%(5 cases)and 37.209% (16 cases) respectively,the difference was significant (χ2 =8.553,P =0.003 ). Conclusion Nasal decontamination can decrease the positive rate of sputum bacterial culture,the incidence of pulmonary infection and pharyngitis in elderly patients with long -term indwelling nasogastric tube.For its efficacy and safety,it deserves clinical application.

Objective To explore the effective treatment in children of abdominal allergicpurpura.Methods To retrospectively analyze the clinical data of 54 children with abdominal allergicpurpura.54 cases were divided into three groups.Each 18 cases in group Ⅰ,groupⅡ,and group Ⅲ.It was used large doses of methylprednisolone in the group Ⅰ,ranitidine in the groupⅡ,and cimetidine in the groupⅢ,based on conventional treatment.To analyze the effect and adverse effect after the treatment.Results The effect of groupⅠ,and groupⅡ,was significantly higher than group Ⅲ(t=11.775,8.901,7.613,5.786,10.105,12.347,all P＜0.05).There was no significant difference between groupⅠ,and group Ⅱ(P＞0.05).The adverse effect of groupⅠ,was significantly higher than the other groups(x2=4.500,5.017,all P＜0.05).Conclusion The treatment of hormone had obvious effect in children with abdominal allergicpurpura,but it had some risks in the gastrointestinal,so we should close observe the gastrointestinal tract in children.Ranitidine and cimetidine are the drugs of inhibiting gastric acid secretion,but the ranitidine much better than cimetidine.

The discovery of limbal stem cells is the key advancement in ophthalmology in the 20th century.Many clinical researches have proved that limbal stem cells transplantation is an effective method to treat severe ocular surface diseases.However, some important issues associated with the identification,isolation,standardized culture in vitro and differentiation after transplantation are still not clear and need to be paid more attention.Strengthening the underlaying research in this field will play important role in treating corneal blindness.

Objective To evaluate the blood-saving effect of tranexamic acid in elderly patients undergoing total hip replacement.Methods One hundred and sixty ASA Ⅱ or Ⅲ patientss of both sexes,aged 65-70 yr,with a body mass index of 16-22kg/m2,undergoing total hip replacement,were randomly divided into 2 groups(n =80,each):control group(group C)and tranexamic acid group(group T).Anesthesia was induced with midazolam,fentanyl,etomidate and atracurium.The patients were tracheal intubated and mechanically ventilated.PEr CO2 was maintained at 35-45 mm Hg.Aneslhesia was maintained with propofol,remifentanil and atracurium.Before the skin incision,tranexamic acid 15 mg/kg was infused over 15 m in in group T,while the equal volume of normal saline was given instead in group C.Hemoglobin(Hb),platelet count(PLT),prothrombin time(PT),and activated partial thromboplastin time(APTT)were monitored during operation to guide blood transfusion.Intraoperative and postoperative blood loss and allogeneic blood transfusion were recorded.Postoperative complications were also recorded.Results There was no significant difference in the amount of intraoperative blood loss between the two groups(P ＞ 0.05).The amount of postoperative blood loss was significantly smaller and less allogeneic red blood cell was transfused in group T than in group C(P ＜ 0.05).No complications occurred after operation in either group.Conchusion Tranexamic acid has blood-saving effect in elderly patients undergoing total hip replacement,but the clinical value is limited.

Objective To investigate the status of second trimester maternal serum screening for Down's syndrome from 2006 to 2009 to evaluate the screening quality in Beijing.Methods Birth defect data (birth defect register) from 2006 to 2009 and screening data reported by certificated screening hospitals from 2008 to 2009 in Beijing were retrospectively analyzed by descriptive statistic method.Results Three hundred and thirty Down' syndrome babies were delivered from 2006 to 2009 in Beijing,among which 166 mothers accepted Down' syndrome serum screening and 85(51.2％) were diagnosed finally according to the screening results;among the 85 mothers,35 were≥35 years old with the detection rate of 62.5％ (35/56),and 50 cases were ＜35 with the detection rate of 45.5％ (50/110).The prenatal diagnostic rate of Down's syndrome babies increased from 26.8％(11/41) in 2006 to 47.4％(46/97) in 2009.The detection rate of Down's syndrome with serum screening increased from 23.1％(3/13) in 2006 to 62.9％(22/35) in 2009.One hundred and fifty-eight 21-trisomy cases accepted mid-term ultrasound screening,among which 62 cases (39.2％) were found abnormal.Conclusions Quality control for second trimester maternal serum screening for Down's syndrome should be improved in Beijing.Second trimester maternal serum screening for Down's syndrome in elderly primipara is not suggested.More attention should be paid on prenatal ultrasound screening.

Objective To observe the impact of different pacing sites in hemodynamic and cardiovascular events after restoration of spontaneous circulation.Methods A total of 76 patients with-in hospital cardiac arrest occurred from November 2010 to January 2014 were confirmed by electrionic device monitoring or electrocardiogram and they received cardiopulmonary resuscitation,and their ages were over 18 years.Patients with end-stage of various disease,malignancy and cardiac arrest due to incurable diseases or debility of physical conditions were excluded.The 76 patients were divided into two groups according to pacing site checked by X-ray fluoroscopy in emergency rescue unit:right ventriclular outflow trace pacing group [n =36,male 26 cases,female 10 cases,age (57.31 ± 16.65) years] and right ventricular apex pacing group [n =40,22 male cases and 18 female cases,age (60.43 ± 15.48) years].All patients' QRS duration were measured by ECG after pacemaker implantition and left ventricular ejection fraction (LVEF),left ventricular short axis reduced rate (FS),heart rate (HR),cardiac index (CI) were tested by bedside echocardiography and non-invasive hemodynamic monitoring was used during the early to middle stage.All the hemodynamic variables and the cardiac events were observed after spontaneous circulation recovery.All the data were analyzed by SPSS version 13.0 statistical software.Results There were no significant differences in age,gender,the primary disease,the time from cardiac arrest to spontaneous circulation restoration and dosage of epinephrine (P ＞ 0.05).In comparison with right ventricular apex pacing group,LVEF,FS,HR,CI were higher in right ventriclular outflow trace pacing group [(0.46 ± 0.04)％ vs.(0.44 ±0.05)％,(0.34±0.05) vs.(0.32±0.04),(0.04±0.46) L/minvs.(3.47±0.46) L/min,(0.46±0.29) L/ (min · m2) vs.(2.46 ±0.26) L/ (min · m2),P ＜ 0.05] and right ventriclular outflow trace pacing group had shorter QRS duration than right ventriclular apex pacing group [(128.25 ± 6.06) ms vs.(151.93 ± 8.99) ms,P ＜ 0.05]; fewer atrial fibrilation event was detected in right ventriclular outflow trace pacing group after restoration of spontaneous circulation than that in right ventricular apex pacing group.But incidences of cardiac failure and thrombus were not different between two groups (P ＞ 0.05).Conclusions The right ventriclular outflow trace pacing resulted in better hemodynamic and fewer atrial fibrilation after restoration of spontaneous circulation.