Multidisciplinary treatment of rectal cancer and precise surgical strategy and total mesorectal excision(TME) are the basis for effective treatment of rectal cancer.At present,the best scheme of neoadjuvant therapy for rectal cancer has not been established.The neoadjuvant chemotherapy,neoadjuvant short and long range radiotherapy,radiotherapy adverse reaction,the timing of surgery for rectal cancer are summarized as follows.

Many long non -coding RNA ( lncRNA ) has been found in recent years .The abnormal ln-cRNA expression is closely related to the occurrence and development of tumor .LncRNA can be divided into the tumor promoting and tumor inhibiting according to the function .lncRNA generally overexpresses in solid tumor tis-sue,acts as an important factor involved in tumor invasion ,proliferation and metastasis ,and has been associated with prognosis of neoplasm .This paper describes the current situation of lncRNA research .We mainly introduce several functions of lncRNA which thoroughly researched at present (such as HOTAIR,H19,MALAT-1,Lin-cRNA-p21,GAS5,etc) and their expression in colorectal tumor tissue ,indicating that regulating the expression level of lncRNA may provide a new basis for the diagnosis and treatment of colorectal cancer .

OBJECTIVE To investigate hand hygiene of healthcare workers in burn ward in our hospital and provide scientific basis for the effective prevention and control of hospital infection in burn ward.METHODS Selected randomly 30 healthcare workers in burn ward and sampled from hands for bacterial culture.RESULTS The average colony of hand pathogens of the 30 healthcare workers was 105.42 CFU/cm2,the maximam was 1093 CFU/cm2.Among the hand pathogens,40.91% were Bacillus subtilis,36.36% were micrococcus and 13.64% were Staphylococcus aureus.CONCLUSIONS Hand hygiene of healthcare workers are not optimistic in burn ward.Strengthening the education of hand hygiene and raising the executable rate of hand hygiene are important measures to prevent and control the hospital infection in burn ward.

Impaired clearance of apoptotic cells is important in the pathogenesis of autoimmune disease.C-reactive protein (CRP) is an acute phase protein that plays a major role in the regulation of the autoimmune and inflammatory response .CRP has a role in the clearance of bacteria and dying and altered cells through binding to phosphocholine and might also have more complex immunomodulatory functions . CRP function as opsonins for pathogens and dying and apoptotic cells through activation of the complement pathway and through binding to Fcγreceptors , and is associated with the clearance of apoptotic cells and nuclear antigen , thus becoming a protective molecule against pathogenic autoimmune responses in general . Measurement of serum CRP level is in widespread clinical use as a sensitive marker of inflammation and autoimmune disease , particularly in relation to the use of the CRP-based disease activity score in the evaluation of rheumatoid disease.

Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.

Objective To explore the associations between polymorphisms in CYP24A1 gene and the risk and prognosis of colorectal cancer ( CRC) .Methods A case-control study consisting of 528 CRC patients and 605 cancer free controls and a follow up study with 317 cases were conducted to explore the associations be-tween two polymorphisms in CYP24A1 and the risk and prognosis of CRC,as well as the combinations and inter-actions of polymorphisms with dietary factors on CRC risk.Results Although there was no association between polymorphisms in CYP24A1 and the risk of CRC,significant combinative effects between polymorphisms and diet-ary factors on CRC risk were observed.For Rs4809957 polymorphism,the prognosis of AA genotype carriers was worse than GG/GA carriers in CRC,colon cancer and rectal cancer(Log-rank test P=0.01,P=0.01,P=0.02,respectively).Compared with GG genotype,AA genotype carriers of Rs4809957 polymorphism had worse prognosis in CRC(HR =2.35,95%CI =1.28~4.30),colon caner(HR =2.37,95% CI =1.09~5.14) and rectal cancer(HR =2.11,95% CI =1.11~4.01).Conclusion The combinations of the polymorphisms in CYP24A1 gene with dietary factors are associated with the susceptibility of CRC,and Rs4809957 polymorphism may lead to a worse prognosis of CRC.

Objetcvi e Inhibitor of growth TNG3 is a candidate tumor suppressor gene ,which belongs to the human ING gene family .It has been interested by scientist because of its putative roles as tumor suppressors . There is a low expression level of ING3 in a variety of tumors.However,the relationship of ING3 and the develop-ment of colorectal cancer is unclear yet .The aim of this studyis to examine the expression of ING 3 in colorectal cancer by qRT-PCR.Methods Statistical analysis was performed with the expression of ING 3 mRNA which has been evaluated in 82 matched samples comprising primary colorectal cancer and paired non -cancerous mu-cosa samples.Results In 51%colorectal cancer patients ,the expression level of ING3 was significantly lower in cancer tissue than that in normal tissue .The expression level of ING3 was closely related to pT、pM stage , and TNM stage(P<0.05).The Univariate analysis showed that the pT、pN、pM stage,TNMstage and ING3 expression levels were associated with disease -free survival(P<0.05).CRC patients with low -expression level of ING3 showed shorter disease -free survivals(P<0.05).Conclusion The expression of ING3 might contribute to the CRC development or progression .

Objective Inhibitor of growth 1 ( ING1 ) gene has been identified as a novel candidate of tumor suppressor gene .Over-expression of ING1 plays well-established roles in numerous cell processes ,inclu-ding DNA repair and cell apoptosis .Our study is to investigate the clinical significances of expression of ING 1 in colorectal cancer ( CRC) .Methods The mRNA level of ING1 in 82 matched samples comprising primary CRC and paired non-cancerous mucosa were detected and compared by quantitative RT -PCR.Then the correlations of mRNA level of ING1 with the clinicopathological characteristics and prognosis of patients with CRC were ana -lyzed.Results (1)In the same matched tissues,the expression level of ING1 was significantly higher in normal tissues than that in cancer tissues.(2)mRNA expression of ING1 was associated with certain clinical -pathologic variables such as tumor infiltrating level ,lymphatic metastasis,distant metastasis and advancing TNM stage .(3) We obtained the expression levels ratio of cancer tissue and normal tissue and found the lower ratio has a lower Disease-Free Survival(DFS)(P<0.0001).(4)ING1,as a candidate of tumor suppressor gene ,remained a sta-tistically-significant prognostic marker in the Cox regression analysis .Conclusion Down-regulation of ING1 may be correlated tightly with the occurrence and progression of sporadic colorectal cancer .Its expression level can be used to predict prognosis of CRC .

Objective To investigate the effects of erythropoietin (EPO) on complement 3a (C3a)-induced renal tubular epithelial to mesenchymal transition. Methods The HK-2 cells were divided into 6 groups namely control group,EPO group,TGF-β group,TGF-β+EPO group,C3a group and EPO+C3a group.The mRNA and protein expressions of α-SMA,E-cadherin and C3 were investigated by RT-PCR,Western blot and immunofluorescence respectively. Results Compared with control group and EPO group,the mRNA and protein expressions of α-SMA in HK-2 cells were up-regulated after the intervention of C3a or TGF-β (all P＜0.05).On the contrast,the mRNA and protein expressions of E-cadherin were down-regulated(P＜0.05),the mRNA and protein expressions of C3 were enhanced (all P＜0.05).However,all those above effects of C3a or TGF-β were inhibited after the intervention of EPO (all P＜0.05). Conclusion EPO is capable of suppressing the epithelial to mesenchymal transition induced by C3a.

Objective To investigatethe status of physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals in Suzhou, and to analyze the influence factors and to provide the basis for promoting cooperation consciousnes and quality of work. Methods One hundred and seventy-seven physicians and 506 nurses were investigated by the Nurse-Physician Collaboration Scale(NPCS) in 15 secondary hospitals and 15 tertiary hospitals in Suzhou. Results The cooperative status of physicians in tertiary hospitals was better than that of nurses (t=2.597, P=0.010). The cooperative status of nurses in tertiary hospitals was better than that in secondary hospitals (t=2.080, P=0.009). There was no significant difference in the cooperation between physicians and nurses in secondary hospitals (t=1.845, P=0.066). Multiple regression analysis showed that sex, profession, professional title, age, education degree and work seniority were the influence factors of physician-nurse collaboration intertiary hospitals (t=2.771, 2.597,F=3.745-12.513,P<0.01 or 0.05). Conclusions The physician-nurse collaboration in nutritional support among neurosurgical patients in secondary and tertiary hospitals is in good shape.Administrators should pay attention to influence factors of physician-nurse collaboration, and take measures to promote quality of medical care and nursing care.