Objective To investigate the indicative value of Neutrophils /lymphocyte ratio in the progress of colorectal cancer .Methods Fifty one patients with colorectal cancer ,63 cases with adenomatous polyps ,75 cases with inflammatory and hyperplastic polyps ,48 case of another digestive system tumors and 21case of inflam-matory bowel diseases were enrolled in this study in the Affiliated Hefei Hospital of Anhui Medical University .We also chose sixty people as control group whom were conduct enteroscope as physical examination but didn 't find any abnormal lesions and compared the date of NLR CEA and CA 199 between six groups and different stages of colorectal cancer .The ROC curve was carried out to establish the cut off of NLR and the area under curve (AUC).Furthermore,we compared the diagnostic efficiency of the three tumor markers .Results The level of NLR in patients with colorectal cancer was obviously higher than that of adenoma group ,the polyp group ,another digestive system tumor group,inflammatory bowel disease group and normal control group (P<0.05),despite the NLR value in another digestive system tumor and inflammatory bowel disease patients was elevated slightly ,while there was no obvious differences between the another groups (P>0.05).The levels of NLR in patient with Dukes A and B stages were lower than Dukes C and D stages (P<0.05).The cut off of NLR was 2.73,AUC=0.727, suggesting an accurate diagnostic value .The diagnostic sensitivities of the three markers in order of NLR >CEA>CA199,and the specificities in order of CA199>CEA>NLR.Moreover,the diagnostic sensitivity and specificity of the combined detections of three markers were higher than either of screening respectively or two indicators of arbitrary joint .Conclusion The elevated value of NLR is corresponding to the high state of inflammation in colo-rectal cancer ,when used NLR as a potential marker for diagnosis of colorectal cancer ,the sensitivity is superior to the conventional tumor markers ,but the specificity is not high ,therefore,we should combined with the other tumor markers to improve the diagnostic accuracy .

ObjectiveTo investigate the effects of dexmedetomidine on postoperative cognitive dysfunction (POCD) in the elderly patients undergoing laparoscopic radical trachelectomy.MethodsSixty ASA Ⅰ or Ⅱ patients (aged 65-80 yr and weighing 55-74 kg) undergoing elective laparoscopic radical trachelectomy were randomly divided into two groups:30 patients received intravenous injection of dexmedetomidine 0.2 μg · kg - 1 ·h- 1 ( group D EX) and 30 received same volume of normal saline (control group,group NS) after induction of anesthesia.Cognitive function was assessed at 1 day before operation and on the 7th day after operation using a battery of nine cognitive dysfunction tests.ResultsCompared with group NS,on the 7th postoperative day,the incidence of POCD was decreased in group DEX ( P ＜ 0.05 ).ConclusionDexmedetomidine can improve POCD in the elderly patients undergoing laparoscopic radicaltrachelectomy.

Objective To investigate the effect of 6 % hydroxyethyl starch (HES) 200/0.5 infusion before operation on postoperative immne function in patients. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 21-58 yr weighing 47-79 kg were randomly divided into 2 groups ( n = 20 each): 6% HES 200/0.5 group (group H) and compound sodium acetate group (group A). 6% HES 200/0.5 10 ml/kg or compound sodium acetate solution was infused intravenously over 15 min before anesthesia induction. Anesthesia was induced with iv injection of propofol, fentanyl and vecuronium and maintained with target-controlled infusion of propofol and infusion of remifentanil. Venous blood samples were collected before operation and at 1 h, 1 day and 3 days after operation to detect the serum concentrations of IL-6, IL-8, TNF-α, IL-2, IL-10, IgG, IgA andIgM. Results Serum concentrations of IL-6, IL-8, TNF-α, II-2 and IL-10 were significantly higher after operation in the two groups, and serum concentrations of IgA and IgG were significantly lower after operation in group A than those before operation ( P ＜ 0.05 or 0.01 ). Serum concentrations of IL-6, IL-8 and TNF-α were significantly lower, while serum concentrations of IL-2, IL-10, IgA and IgG were significantly higher after operation in group H than in group A ( P ＜0.05). Conclusion Preoperative infusion with 6% HES 200/0.5 can improve the immune function after operation in patients.

Objective To evaluate the clinical effect of interactive intramedullary intertlocking nail on the elongation of lower extremity long bone. Methods The clinical data of 39 patients underwent the elongatin of femur and tibia using interactive intramedullary interlocking nail were retrospectively analyzed. Results The follow-up time was 8～34 months (average 14 months) after operation. The bone lengthening was 5～8cm(average 7 2cm), the consolidation index was 35d/cm, and lengthening rate was 33%. 2 cases had 5? deformity. There were not the complications of osteomyelitis and neurologic deficit, and secondary fracture did not occur in all patients. Conclusion The interactive intramedullary intertlocking nail is an effective device of bone lengthening, which is more suitable for femur and tibia elongation because of asking simpler skill and less operation time.

Objective To observe the effect of three immunosuppressive agents on the function of human adult islets of langerhans in vitro, and explore the suitable immunosuppressive protocols for human islet transplantation.Methods In vitro, the isolated and purified islets were incubated with the immunosuppressive agents (mycophenolic acid, sirolimus, and FTY720) at different concentrations for 24 h, then stimulated by glucose at low ((2.8) mmol/L) and high ((16.7) mmol/L) levels. The (insulin) release after stimulations was detected using ELISA kit, and stimulation index was calculated.(Results) In control group (no agents exposure), the insulin release were ((7.37)?(1.74)) ng/ml at low (level) and ((15.15)?(5.39)) ng/ml at high level respectively, with stimulation index achieved to (2.06)?(0.46). Compared to control group, treatment with mycophenolic acid led to dramatic reduction of (insulin) release (P

Objective To investigate the effect of hypoxia on vascular endothelial growth factor (VEGF) expression and secretion in human renal fibroblasts. Methods Human renal fibroblasts were primary cultured from donor kidney, and cells in passage 3 were used in this experiment. Hypoxia was induced by incubation in a gas-tight box gassed with 10% CO2/10% H2/80% N2 for 24 hours. VEGF mRNA levels were measured by semi-quantitative RT-PCR method. VEGF proteins expressed on cell surface were measured by flow cytometry. VEGF proteins secreted into supernatants were measured by ELISA method. Results Hypoxia caused a 2. 5-fold increase of VEGF mRNA level in human renal fibroblasts. Hypoxia also induced significant increases of VEGF proteins on cell surfaces (mean fluorescence intensities: 1. 053?0. 055 vs 0.763?0.057, n=4,P

Objective To investigate the vicissitude of infection pathogens and their change in resistance to antibiotics in our hospital in the past 10 years, and to offer scientific information for clinical anti-infection treatment. Methods The data of pathogens identified and susceptibility test with VITEK system as well as K-B methods from 1995 to 2002 were analyzed. Results Gram negative bacteria was the predominance bacteria in recent 5 years, accounting for 60.7%-70.2% of all pathogens, with Pseudomonas aeruginosa ranked first, followed by Escherichia coli, Klebsiella pneumoniae, Serratia sp, Enterobacter sp and Acinetobacter sp. The ratio of Acinetobacter sp seemed to be increased in 1998, and it kept a high level in recent years. The isolation rate of Staphylococcus aureus from clinical specimens was the highest among pathogens since 1999, and 42.9%-74.5% of them were Methicillin-resistance S. aureus (MRSA). MRSA was found to be highly resistant to many antibiotics, and there was a tendency of increasing resistance to all kinds of antibiotics in Ps. aeruginosa and Acinetobacter species. Conclusion The significant changes in infectious pathogens in our hospital were an increase in S. aureus and decrease in E.coli in constituent ratios, as well as an elevation of drug resistance level of predominate bacteria. The results suggest that corresponding adjustment should be made in the strategy of infection treatment.

Objective To study the mechanism of resistance to antibiotics and disinfectants of Pseudomonas aeruginosa isolated from clinical specimens in a hospital, and to provide a reference for the use of aminoglycoside antibiotics for the treatment of P. aeruginosa infection as well as disinfection and sterilization. Methods 35 strains of multi-resistant P. aeruginosa were screened from clinical specimens by susceptibility test of agar dilution. Five kinds of aminoglycoside modifying enzyme gene and qzcE?1 gene were detected by polymerase chain reaction (PCR) method. Results The positive rates of aminoglycoside modifying enzyme genes, including aac(3)-Ⅱ, aac(6′)-Ⅰ, aac(6′)-Ⅱ, ant(3″)-Ⅰ and ant(2″)-Ⅰ, were 48.6%, 40%, 54.3%, 45.7% and 60%, respectively, and nearly all strains were positive for 2 or more than 2 kinds of above aminoglycoside modifying enzyme gene. The positive rate of qzcE?1 gene was 94.3%. Conclusions There was a close relationship between aminoglycoside modifying enzyme producing P. aeruginosa and its multi-resistance to antibiotics, The results suugested that aminoglycosides should be used cautiously, and it should be based on the result of susceptibility test in the treatment of P. aeruginosa infection, and it was inadvisable to use quaternary ammonium and biguanides disinfectant in disinfection and sterilization.

Objective To evaluate the clinical effect of the treatment for calcaneal fractures by locking compression plate.Methods From January 2008 to December 2011,30 patients with 40 calcaneal fractures were operated with locking compression plate.There were 25 males (33 feet) and 5 females (7 feet) with an average age of 44.8 years (range,22-60 years).Fifteen feet were on the left side,and 25 feet were on the right side.All patients had closed fractures,with complicated spinal injury in 2 patients.According to Sanders classification,20 feet were type Ⅱ[fractures,15 feet were type Ⅲ,and 5 feet were type Ⅳ.The lateral approach was adopted for all the patients in the treatment in which locking compression plate fixation was used but no external fixation.Early and suitable rehabilitation was carried out postoperatively.The patients could bear part of the loading six weeks after the operation and all the loading twelve weeks after the operation.The results were validated using the Anerican Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.Results The patients were followed up for 8-20 months (average,12 months).Bone union occurred in all cases with roentgenographic evidence during 8-12 weeks postoperation (average,10 weeks).None of the patients had such complications as nerve injury or osteomyelitis.Incision dehiscence occurred in one case in which a little part of titanium plate and screw was exposed,but the incision was healed by dressing 1 month later.Two patients had subtalar arthritis and suffered from the pain while walking.Of the two patients,the pain was relieved for one after the operation of subtalar joint fusion,and the other was lost to the follow-up after he or she refused further treatment for economic reasons.According to AOFAS foot score standard,the effects of 20 cases were excellent,17 were good,and 3 were fair.The excellent and good rate was 92.5％.Conclusion The application of locking compression plate is an effective and satisfied treatment of calcaneal fractures which is beneficial for healing and functional exercise.Moreover,the rate of soft tissue complication after operation is low.

Objective To evaluate the efficacy and safety of continuous infiltration of Lidocaine in joint replacement surgery.Methods From May 2013 to October 2013,patients scheduled to undergo total hip or total knee arthroplasty were randomized into two groups:the local infiltration analgesia group received continuous infiltration of Lidocaine while the other group received PCIA filled with fentanyl after surgery.The equipments were removed 48 hours after the surgery.The visual analogue scale score at five points (immediate postoperative,24 hours after the surgery while resting,24 hours after the surgery while exercising,48 hours after the surgery while resting,48 hours after the surgery while exercising) were recorded and if the score was higher than 4,analgesics wound be given to the patients.The vital sign,blood test,ECG,the circumference of lower limbs,the range of motion of the joint,the rehabilitation and complications were also recorded.Results 42 patients were included,11 male and 31 female.There were 25 patients and 36 total knee arthroplasties.17 patients underwent a total of 19 hip arthroplasties.The demographic data,the diagnosis and the surgery type were comparable between two groups.The VAS scores at immediate postoperative,24 hours and 48 hours after the surgery while resting,the average dose of analgesics and the complication rate were statistically different be tween two groups.However,the VAS scores at 24 hours after the surgery and 48 hours after the surgery while exercising,the change of the circumferences of the lower limb,the range of motion of the joint,the rehabilitation satisfactory rate and length of stay were comparable between two groups,while no significant difference was observed.One patient in the PCIA group suffered from incision fat liquefaction and healed after three weeks.There were no infection and subcutaneous hydrocele in both groups.Conclusion Continuous infiltration of Lidocaine is more effective than the PCIA while resting after joint replacement surgery and no inferior to it while exercising.It can decrease the amount of Opioid.