Adjuvant and neoadjuvant therapy are the important therapeutic methods for rectal cancer.Neoadjuvant concurrent chemoradiotherapy and postoperative adjuvant chemotherapy play a crutial role in rectal cancer treatment.New chemotherapy drugs and targeted therapy drugs could further improve the therapeutic effect of rectal cancer.

Objective To examine the effect of tetraethylammonium (TEA, K~+ channel blocker) on pancreatic ?-cell apoptosis and explore the mechanism. Methods Mouse ? cells (NIT cells) were exposed to streptozotocin(STZ) to induce apoptosis, and TEA of different concentrations were applied along with STZ to prevent efflux of intracellular K~+. Cells were stained with annexin V, PI and rhodamine 123. Flow cytometer (FCM) was used to determine the percent of apoptotic or viable cells and the change of mitochondrial membrane potential. Culture media was collected to quantify the content of NO and ROS produced by NIT-cells. Cells were collected for detecting the activity of super oxide dismutase (SOD) in cells lysates. Results STZ induced apoptosis of NIT cells significantly (P

Objective To investigate the effect of astilbin on expression of CTLA-4 in activated T cells of mouse heart transplantation model with acute rejection.Methods Cardiomyocytes of BALB/ c mouse and spleen cells of C57BL/6 mouse were separated.The cardiomyocytes(2?10~5/ml)as irri- tation cells and spleen cells(1?10~6/ml)as responsers were mixed and cultured.The model of mouse heart transplantation with acute rejection in vitro was established.Three groups were set up:control group,Astilbin(15/?g/ml) group,Astilbin+anti-CTLA-4 mAb 9H10 (30?g/ml)group.Apoptosis of T cells was observed by TUNEL.The expression of CTLA-4 in activated T cells was detected by RT-PCR and Western blot.Results Apoptosis indexes of activated T cells in Astilbin group were sig- nificantly higher than those in the control group(73.4%?12.5% vs 35.1%?9.2%,P＜0.01). The expression of CTLA-4 in Astilbin group was significantly higher than control group(P＜0.01), but there was no apparently difference between control group and Astilbin+CTLA-4 mAb group(P＞0.05).Conclusion Astilbin induces apoptosis of activated T cells in heart transplantation,which may be partially related to its enhanced expression of CTLA-4.

Purpose To study the expression of HK2 in human prostate cancer (PCa) tissues and its effect on malignant phenotype of prostate cancer cells.Methods HK2 expression in PCa tissues was determined by microarray database and immunohistochemical staining.Subsequently,the change of cellular phenotype was detected by glycometabolism kit,CCK-8 kit,and flow cytometry after HK2 knockdown.Results HK2 expression was elevated followed by prostate cancer development.HK2 depletion inhibited cellular proliferation and aerobic glycolysis,and increased the ratio of early apoptosis.Conclusion HK2 expression increases in the process of PCa malignant progression.It plays a critical role in cellular proliferation,glycometabolism,and apoptosis,the mechanism of which needs further exploration.

Objective To develop a real-time electronic nursing records quality control system based on No.1 Military Medical Project to solve the existing problems in range,representativeness of detection results,information feedback,information storage and etc.Methods An integrated platform was implemented for information acquisition,integration and display on the bases of No.1 Military Medical Project as well as the interfaces with information management systems for electronic nursing records,clinical laboratory examination,medical examination,imaging and etc,which had the functions of auto monitoring of timeliness and logic of electronic nursing records,manual quality control of the connotation as well as the feedback,statistics and analysis on the problems.Results The system behaved well in stability,compatibility,and could be used for real-time and dynamic control of electronic nursing records,timely information feedback and statistical analysis.Conclusion The system contributes to the quality control of electronic nursing records,and is of great significance for its enhancement.

Objective To raise the awareness of acute kidney injury (AKI) and improve the level of diagnosis.Methods All the hospitalized adult patients in the Affiliated People's Hospital of Shanxi Medical University from January 2012 to July 2013 were screened.Those patients diagnosed as AKI were retrospectively analyzed in terms of incidence,the rate of missed diagnosis,etiology,distribution and prognosis of AKI.Results (1) The incidence of AKI in the patients was 0.67％ (381/56 835),the ratio of male to female was 1.91 ∶ 1,and the average age was (63.45±16.95) years.(2)There were 321 cases diagnosed as pre-renal AKI (84.25％),42 cases diagnosed as renal AKI (11.02％) and 18 cases diagnosed as post-renal AKI (4.72％).(3)There were 189 cases(49.61％) missed diagnosed among all the screened cases.The rates of missed diagnosis in neurosurgery,general surgery and cardiac surgery department was 62.96％,59.09％ and 50.00％,in cardiology,respiratory and neurology department was 50.00％,50.00％ and 45.45％ respectively.(4) Multivariate Logistic regression analysis showed that hypertension [odds ratio(OR)=1.631],renal replacement therapy(RRT)(OR=23.256) and oliguria history (OR=1.936) were independent risk factors of missed AKI diagnosis.Conclusion The missed diagnosis rate of AKI is high and has certain characteristics in different departments.Hypertension,RRT and oliguria history are independent impact factors of missed AKI diagnosis.

Objective To summarize the clinical result of patients undergoing endoscopic vein harvest (EVH) technology to collect greater saphenous vein (GSV) in coronary artery bypass graft (CABG) operation, and to assess the operation outcome of EVH. Methods A total of 862 patients underwent primary CABG, among whom saphenous vein of 482 patients were taken using EVH, and the others by open vein harvesting (OVH) based on patients' willingness. The operation risk factors and complication were compared between the two groups. The 64 multi-slice computed tomography (64-MSCTA) was used to evaluate the vein grafts patency after surgery for 1 year. The vein patency between the two groups was compared. Results There was no significant difference in risk factors of incision complication between two groups ( P>0.05). But the incidence of various incision complication was significantly lower in EVH group (10.2%,49/482) compared with that in OVH group (35.0%,133/380) ( P<0.05). The time of harvesting and the length of conduits was similar between two groups (P>0.05). After 1 year's follow-up, the vein graft patency were 86.0%(404/470) and 87.1%(324/372) in EVH group and OVH group, and there was no significant difference ( P>0.05). Conclusions The decrease in incision complication of EVH is unquestionably superior to those of OVH, especially for those patients with risk factors of incision complication. The EVH vein graft has good patency in short time.

Objective To explore the influence of resistive respiratory training for patients with chronic obstructive pulmonary disease(COPD) on rehabilitation effect.Methods According to the digital table,68 COPD patients were randomly divided into the observation group and control group,34 cases each group.The observation group were taken respiratory muscle training under the supervision of rehabilitation nurses for 8 weeks,and the respir-atory muscle training including shrinkage lip diaphragm breathing training and abdominal muscle resistance training. Before and after the abdominal muscle resistance training and training were given 1 h double nasal oxygen tube contin-uous low flow oxygen inhalation.The control group were taken pursed lips abdominal breathing training.In the two groups before treatment and 8 weeks after, the blood gas analysis ( PaO2 , PaCO2 ) , pulmonary function test ( FEV1 , FEV1/FVC%) and respiratory muscle function( MIP,MEP) were detected.Results After treatment,blood gas anal-ysis in the two groups comparison(tPaO2 =2.95,tPaCO2 =2.07),pulmonary function(tFEV1 =2.38,tFEV1/FVC%=2.04) and respiratory muscle physiology index(tMIP =6.40,tMEP =4.04),the differences were statistically (all P<0.05).In the observed group before and after treatment,blood gas analysis(tPaO2 =19.23,tPaCO2 =3.05),pulmonary function(tFEV1 =2.67,tFEV1/FVC%=4.19)and respiratory muscle physiology index(tMIP=9.09,tMEP=9.67) were compared,the differences were statistically(all P<0.01).Conclusion Respiratory mus-cle resistance training can improve COPD patients with respiratory muscle strength and endurance,and it has the cura-tive effect to improve pulmonary function.

OBJECTIVE To investigate the distribution and the resistance of pathogens from the children with VAP in PICU,and to analyze the reasons of antibiotics resistance of the pathogens.METHODS The sputum obtained from the children with final diagnosis of VAP in PICU was cultured and identified from Jan 2005 to Dec 2006.The resistance of the bacteria identified to antibiotics used frequently was determined by Kirby-Bauer method.RESULTS A total of 187 strains were isolated from sputum specimens,of which Gram-negative bacilli and Gram-positive cocci accounted for 76.5% and 23.5%,respectively.Acinetobacter baumannii(17.7%),Escherichia coli(16.0%),Pseudomonas aeruginosa(15.0%) and Klebsiella pneumoniae(13.9%) were the most frequently isolates of Gram-negative bacilli.Their resistant rates to ?-lactam antibiotics were high,especially the ESBLs-producing strains in E.coli and K.pneumoniae.The Staphylococcus epidermidis(5.9%),Staphylococcus aureus(4.8%) and Enterococcus faecalis(4.3%) were the most common strains of Gram-positive cocci.No vancomycin-resistanct strains were found,but resistance rates to ?-lactam antibiotics and other antibiotics were high in S.epidermidis and S.aureus.CONCLUSIONS The main strains cultured from the sputum specimens of children with VAP in PICU are Gram-negative bacilli with high resistance rates to antibiotics,especially the ESBLs producing bacilli to ?-lactam antibiotics.Staphylococcus are the main Gram-positive cocci.