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.

ObjectiveTo investigate the effects of hyperbaric oxygen therapy on T-lymphocytes 1 and cytokines including IL-6, IL-10 and TNF-α asindicators well representing immune function and inflammation in normal rats and rats with systemic inflammatory response syndrome. Methods Forty Sprague-Dawley male Rats were randomly ( random number) divided into five groups.Rats of group A were treated by saline solution (0.9 ％ NaCl,5 mL/kg),and served as control group; rats of group B were treated with saline solution and hyperbaric oxygen therapy three times; rats of group C were treated with zymosan (500 mg/kg) ; rats of group D were treated with zymosan and hyperbaric oxygen therapy once; and rats of group E were treated with zymosan and hyperbaric oxygen therapy three times.At 24 hours after saline or zymosan administration,rats were sacrificed and blood samples were collected from the portal vein.CD3 +,CD4+,CD8+ cells were counted by flow cytometer,and plasma levels of IL-6,IL-10 and TNF-αwere measured by ELISA.The results were analyzed by one - way ANOVA and LSD post-hoc test.Results CD4 T cell of normal rats was decreased by hyperbaric oxygen (P＜0.01 ),CD4/CD8 T cell ratio was also decreased ( P ＜ 0.05 ).Of rats with zymosan administration,CD4 T cells and CD8 T cells were both decreased on a parallel (P＜0.01 ).A single one HBO and HBO for three times both raised the percentage of CD4 T cells which was significantly decreased by zymosan administration ( P ＜ 0.01 and P ＜ 0.05 ).In rats without hyper- inflammation,hyperbaric oxygen therapy showed a pro-inflammatory effect by elevating TNF-α (P＜0.01),IL-6 (P＜0.05) and reducing 1L-10 (P＜0.05).ConclusionsHBO reduces CD4 T cells in normal rats.HBO reduces the production of TNF-α,IL-6 and IL-10 during hyper- inflammation.HBO is pro - inflammatory in normal rats and minor SIRS rats withourt appreciable hyper-inflammation in circulation.

Objective To evaluate the relationship between pressure derived fractional collateral flow (Q C/Q N) and left ventricular remodeling after acute myocardial infarction(AMI) Methods The Q C/Q N was measured in 21 patients with first AMI treated with percutaneous transluminal coronary angioplasty (PTCA), being determined by simultaneous measurement of mean aorta pressure (P a), distal coronary pressure (P w) during the balloon occlusion 21 patients were divided into two groups according to the value of Q C/Q N (group A, Q C/Q N≥0 25, group B, Q C/Q N0 05) At one month follow up, the difference in EF ( P 0 05) Both ESVI and EDVI were considerably increased in two groups Conclusion Angiographic Rentrop′s classification has its limitation in assessing the collateral circulation Q C/Q N is a major determinant of left ventricular remodeling and prognosis in patients with AMI

Objective To assess the diagnostic and curative efficacy of laparoscopy combined with hysteroscopy for tubal infertility. Methods A combined use of laparoscopy and hysteroscopy was performed in 62 cases of tubal obstructive infertility (124 oviducts), which had been tentatively diagnosed by lipiodol hysterosalpingography (HSG). Results Out of the 62 cases, 11 cases (22 oviducts) were found bilaterally unobstructed (17.7%, 22/124), 8 cases (8 oviducts) were found unilaterally unobstructed (6.5%, 8/124). Tubal interstitial or isthmus obstruction was observed in 40 oviducts (32.3%, 40/124) and hydrosalpinx in 54 oviducts (43.5%, 54/124). The consistency ratio between lipiodol HSG and endoscopy in the diagnosis of tubal obstruction was 75.8% (94/124). Tubal catheterization under hysteroscope and laparoscope was adopted in the 40 ducts of interstitial or isthmus obstruction, and 30 were cured, 5 perforated and 5 failed. Laparoscopic salpingostomy and salpingolysis was employed successfully in 54 tubes. Conclusions Combined use of hysteroscopy and laparoscopy is useful in the diagnosis and treatment of tubal obstruction and infertility tentatively diagnosed by HSG.

Through investigating the hospital admission and hospital discharge of vagrant mental patients in Xi-aoshan Hospital from January 2011 to December 2015 , the present study found that there existed some ethical di-lemmas including the risk ofdiagnosing mental disorder but actually not, lack of the guarantee of patients' rights and interests and supervision mechanism without guardian, long-term retention in the wards, and so on. It is sug-gested to establish right protection and supervision committee for vagrant mental patients, reduce the misdiagnosis ofdiagnosing mental disorder but actually not through the error correction mechanism, ensure proper treatment and care, create retention way, protect the basic rights of the vagrant mental patients, reduce mental disability, avoid to stray again, so as to perfect the social management system.

Advanced studying doctors play important roles in the clinical services, and how to train them to improve training quality is worth investigating. We classified them into three types such as the clinical skills-improved, the special skills-trained and clinical knowledge eextensively-spread, then employed the individual teaching methods and emphasized the medical ethics during the training, which is not only beneficial to us, but also of great importance and necessity to advanced studying doctors themselves.

Objective To investigate the distribution and effect of endothelial nitric oxide synthase (eNOS) on the zero-stress state of carotid arteries in rats at different ages.Methods Morphometry and microstructure of carotid artery in 3-month-old,6-month-old and 12-month-old Sprague-Dawley rats were studied quantitatively by histological method and computer image analysis.Immunohistochemistry and the NADPH-diaphorase reaction were used to localize the endothelial nitric oxide synthas (eNOS) in different age rats.The changes of opening angle in the zero-stress state was also observed.Results With increasing age,there was a significant reconstruction changes in morphometric parameters and microstructure parameters of the carotid arteries in rats.While the expression of eNOS protein of endothelium and vascular smooth muscle cells were decreased.Compared with 3-month-old rats,the zero-stress state.of opening angle in 6-month-old and 12-month-old group were increased.However,pre-incubation of vessel rings with L-arginine (30 mmol/L),a substrate of eNOS,attenuated the changes of the zero-stress state.Conclusions The results suggest that the carotid arterial wall in different age rats shows unequal growth and different zero-stress state eNOS may be involved in the age-related changes of zero-stress state of the carotid artery in aged rats.The results may provid an experimental base for vascular transplantation and vascular reconstruction.

Objective To explore the risk factors of hospital infection for hypertensive intracerebral hemorrhage ( HIGH). Methods 408 patients from Department of Neurology whose length of stay equaled or exceeded 72 hours and who fitted in with the criterion for the diagnosis of hospital infection were chosen as the HICH infection group while HICH patients without hospital served as the control group. The risk factors for HICH were studied by means of both single factor analysis and multifactor analysis. Results Of more than 30 possible risk factors that were studied by means of single factors analysis, more than 20 manifested marked difference (P < 0.05). Uncondition Logistic regression analysis of the more than 20 variables indicated that rise of inhalation of food resulting from indwelling, stomach tube,kinds of antibiotics used,spray inhalation and fasting blood-glucose,accidental were the risk factors of HICH infection. Conclusion HICH infection results from the synergetic action of various factors and hospital infection could be controlled and reduced by strengthening supervision.

Epilepsy is one of the most common chronic diseases of the central nervous system,many epilepsy patients need lifelong medication.Epidemiological studies have shown that 3‰-5‰ neonates born by women suffering from epilepsy.Treatment become more challenging because not only the patients themselves but also the breastfed in fants should be taken into consideration.This paper reviewed how to choose lactation antiepileptic drug.In short,choosing drugs which transport less to milk and have less side effects to infants,using the lowest effective dose and avoiding combination if possible can ensure the safety of breastfeeding.