Colorectal cancer is one of the most common malignancies in human.Early diagnosis is the key points in improving the prognosis of patients with colorectal cancer.The implementation of standardized operation and comprehensive treatment for advanced and late stage cancer can improve the outcome.Based on the pattern of lymph node metastasis and the concept of complete mesocolic excision,the operation of colonic cancer has entered the era of normalization and standardization.The surgical procedure of rectal cancer (especially low rectal cancer) should be individualized based on the gold standard of total mesorectal excision (TME).For hepatic metastasis of colorectal cancer,hepatectomy is currently the standard and the only potentially curative treatment method.Therefore,how to evaluate the resectability of hepatic metastasis of colorectal cancer is particularly important.Surgeons are the most important participants in the diagnosis and treatment of colorectal cancer,and standardized diagnosis and treatment is the key to improve the prognosis of patients.

Compared with patients with high-middle rectal cancer,local recurrent rate of low rectal cancer in patients is worse.The poor outcome of low rectal cancer is due to the unique anatomical features of the low rectum and the lack of clearly defined anatomical excision planes.Therefore,how to use the appropriate imaging methods,evaluate accurately preoperative cancer staging,plan feasible surgical plane and select the appropriate surgical approach,these will be very important for radical resection of rectal cancer.Therefore,the quality of life and long-term survival of the patients will be improved.

Setting up a society in harmony is one of important abilities of our Party being in power.Right health care system in rural areas is one of important contents of setting up socialist society in harmony.This article argues from three aspects that setting up a society in harmony is mankind's moral ideal,building up health care system in rural areas is to appeal to morality which sets up a society in harmony,and building up health care system must be strengthened.But the writer thinks that there are many lacks now.So we should take some steps to build and complete the health care system in rural areas,it is significant for setting up a society in harmony.

The principle of R0 resection for colorectal cancer(CRC)has been widely accepted based on the preoperative imaging evaluation.The surgeons should scientifically and strictly assess resectability of tumors and furthest reduce tumor residuals.Patients with initial unresectable CRC will give priority to conversion therapy and then undergo R0 resection if converting into resectable tumors.Palliative operation for the patients who cannot receive R0 resection according to the clinical assessment should strictly follow surgical indications and achieve wellplanned and clear surgical purposes.There is no evidence that the palliative operation or cytoreductive surgery benefits to survival of patients,and decreasing complications and improving quality of life through minimum wound are the basic principles.

In October 2010,the Department of Medical Administration of the Ministry of Healthy of China published Diagnosis and Treatment Standard of Colorectal Cancer.Since then,the diagnosis and treatment of rectal cancer are under regulation.Standardization of preoperative diagnosis and proper selection of imaging or histopathological examinations are key points in improving the efficacy of individual treatment of patients with rectal cancer.In this article,suggestions from the National Comprehensive Cancer Network (2011 version ),American College of Radiology and College of American Pathologists are analyzed,and the recommendations of imaging and histopathological examinations are highlighted.

ObjectiveTo observe the short-term and long-term efficacies of acupuncture at phenomaxillary ganglia in treating allergic rhinitis.MethodThe recruited subjects were intervened by acupuncture at phenomaxillary ganglia, once a week and 6 times asa treatment course. Visual Analogue Scale (VAS) was adopted to evaluate the general condition and nasal symptoms, and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to estimate the quality of life (QOL). The evaluations were performed before and after intervention, as well as 2 years after the intervention.ResultThe subjects all had significant improvements in the clinical symptoms after 6 sessions, and the VAS scores of the general conditional nasal symptoms and RQLQ score were significantly decreased (P<0.01); in the follow-up study conducted 2 years later, except for the scores of the non-nasal/eye symptoms, all symptoms scores were significantly lower compared to that before intervention (P<0.05,P<0.01), and the results were insignificantly different from that after intervention (P>0.05).ConclusionAcupuncture at phenomaxillary ganglia is effective in treating allergic rhinitis, and the efficacy lasts stably within 2 years.

Objective To investigate the correlation and clinical diagnosis significance between ultrasound elastography and the distribution of myofibroblast in breast tumor.To assess the value of ultrasonic elastography and myofibroblast in the diagnosis of breast cancers.MethodsThree-hundred and fifteen patients recruited from May 2009 to November 2010 were divided into benign group and malignant group according to postoperative pathological diagnosis results considered as gold standard.The clinical value of the score of ultrasonic elastography was evaluated.The expression levels of CD34 and α-SMA protein in breast tissues were examined by immunohistochemistry.ResultsThe difference was statistically significant for the expression level of CD34 and α-SMA between malignant breast tumor patients compared with benign ( P ＜0.05).The expression level of CD34 was lower,but α-SMA was higher in the patients of breast cancer compared with benign tumor.However,the expression level of CD34 and α-SMA was just the opposite in the patients of benign tumor.The expression level of CD34 was the negative correlation with the elastography score ( P ＜0.05) in the breast tumor,but α SMA just the opposite situation.Conclusions The score of ultrasound elastography can represent MFS distribution characteristics in breast tumors in the result that α-SMA +/CD34- can determine the existence of myofibroblast.

Objective To study the effect of selective COX-2 inhibitor NS398 on IL-10 and IFN-γexpression in human keratinocytes induced by UVA,and further to explore the effect on anti human skin photoaging.Methods HaCaT cells were divided into three groups:simple UV exposure group,NS398-intervene group and blank group.For UV radiation,simple UV exposure group and NS398-intervene group were irradiated with UVA at a dose of 30 J/cm2.In order to assess the effect of NS398,HaCat cells were treated with NS398 at the dose of 0,20,40,80μmol/L respectively and then incubated without irradiation for 2h,substrate changed and cultured for 24h,and then the expression of IL-10 and IFN-γ mRNA was detected via RT-PCR.Results Simple UV exposure group had obviously higher expression of IL-10 mRNA and lower expression of IFN-γ mRNA than that of control group,while NS398-intervened group had significantly lower expression of IL-10 mRNA and higher expression of IFN-γ mRNA than that of simple UV exposure group,and dose-dependency existed.Conclusions NS398 may delay photo-damage of human skin via inhibiting the expression of IL-10 mRNA and up-regulating the expression of IFN-γ mRNA in human keractinocytes.

Objective To study the meaning of breast cancer staging system by AJCC eighth edition to invasive lobular carcinoma and analysis the clinical pathological characteristics.Methods According to the eighth edition of the AJCC staging to evaluate the TNM stage and prognosis evaluation of invasive lobular carcinoma cancer patient in Peking University Shenzhen Hospital from 2011 to 2016,and compared with others in clinical pathological data.Results There were 21 cases of invasive lobular carcinoma,accounting for 2.7％ of all invasive breast cancer.We found that invasive lobular carcinoma shows no significant difference (P ＞ 0.05) in ages,menstrual status,molecular features and anatomic staging and prognosis staging with others;histological grade were significantly different (P ＜ 0.05).There were significant differences in the prognosis and staging of invasive lobular carcinoma.Conclusions Eighth AJCC staging systemn provides a new reference for the clinical treatment of breast cancer,should be evaluated with anatomic stage.Histological grade is relatively good in invasive lobular carcinoma and the prognosis is good,needs more research to the individualized treatment of invasive lobular carcinoma.

Objective: Retro-laparoscopic partial nephrectomy is a challenge for ventro-renal tumors, especially hilar tumors.The tumors are partial or entirely out of operative field and there is blind space for operation.To solve this problem, a set of techniques including renal pedicle rotation is developed.Methods: A set of techniques including renal pedicle rotation, double-layer suture, early artery unclamping for retro-laparoscopic nephrectomy for ventro-renal tumors, especially hilar tumors were developed.Hilar tumors were located anteriorly to the angle of the renal and renal arteries and in contact with the anterior surface of the renal artery.The evaluation of the outcomes included the operation time, warm ischemia time, estimated haemorrhage, surgical margin, renal function after operation, and complications.This study reviewed the data of 28 patients with ventro-renal tumor, including 15 patients with complex hilar tumors.Results: The average tumor size was (3.8±0.5) cm.The average R.E.N.A.L score was 8 (ranging from 7 to 9).The average warm ischemia time was (23.8±4.7) min, and suture time was (26.2±6.5) min, and operation time was (124.1±12.1) min.The median hospital stay was 4 days and the average estimated haemorrhage was (139.1±54.0) mL.All the surgeries were operated under laparoscope and no surgery switched to open surgery.Seven patients developed Clavien Dindo Ⅰ-Ⅱ complications after operation.Three patients (10.7%) developed collective system damage and received repair of collective system in time and three patients (10.7%) developed slightly gross hematuria (Clavien-DindoⅠ).Two patients developed wound infection (Clavien-DindⅡ).Three patients (10.7%) got renal vein clamped because of capillary hemorrhage from basilar part of tumors.There were 14 patients received early unclamping of renal artery, and no obvious renal vessel damage was found.There were statistically significant differences between the serum creatinine levels (P<0.05) and the estimated glomerular filtration rates (P=0.02) before and after surgery.All the patients'' serum creatinine levels were in normal range and no patient needed regular dialysis.There was no positive surgical margin and the median follow-up was 7 months without local recurrence or distant metastasis.Conclusion: It is safe and effective to apply renal pedicle rotation technique in retro-laparoscopic partial nephrectomy for ventro-renal tumors.The short-term follow-up results are optimistic, but long follow-up is required.