At present,the main treatment methods of the patients with advanced colorectal cancer include surgery,chemotherapy,radiotherapy,targeted therapy,physical ablation and immunotherapy,but the chemotherapy is still the main treatment.The emergence of new chemotherapy drugs and the combination of radiotherapy,chemotherapy and targeted therapy in clinical have improved curative effect for the patients with advanced colorectal cancer.In order to better improve the quality of life,reduce side effects and obtain the best effect,now the individual multidisciplinary treatment has become an inevitable trend in the treatment of advanced colorectal cancer in clinical.

Objective To observe the effect of swallowing training exercise for promoting rehabilitation of swallowing dysfunction after skull base tumor surgery. Methods We averagedly divided 86 patients with swallowing dysfunction into experimental group and control randomly, and the patinets of control group received routine treatment and care, the patients of experimental group not only on the basis of routine treatment and but also received a self-designed swallowing training exercise. Results The effective rate of swallowing function rehabilitation was 100. 0% in the experimental group while it was 65. 1% in the control group (U=360. 5,P<0. 01). The length of hospitalization in the experimental group was lower than that of the control group. Conclusions Swallowing training exercise can promote functional recovery, shorten hospital stay and improve the quality of life of patients.

Objective:To explore the expression and clinical significance of ASB6 in colorectal cancer tissue.Methods:The cancer tissues and para-carcinoma tissues were selected from 106 patients with colorectal cancer admitted to the Department of Gastrointestinal Surgery, Third Affiliated Hospital of Shandong First Medical University from January 2015 to January 2018. Immunohistochemical method was used to detect the expression level of ASB6 protein in tissues, and the correlation between its expression and clinical pathological characteristics of patients was analyzed. At the same time, the expression of ASB6 mRNA in colorectal cancer tissues and para-carcinoma tissues was detected by quantitative real-time PCR (qRT-PCR). The Kaplan-Meier survival analysis method was used to explore the relationship between the expression of ASB6 and prognosis in colorectal cancer patients. The Cox regression model was used to analyze the independent prognostic factors of colorectal cancer patients.Results:The high expression rate of ASB6 in colorectal cancer tissues (67.9%, 72/106) was significantly higher than that in para-carcinoma tissues (10.4%, 11/106, χ2=73.67, P<0.001). Further analysis showed that the expression of ASB6 protein was significantly correlated with lymph node metastasis ( χ2=7.34, P=0.007) and TNM stage ( χ2=16.85, P<0.001). There was no significant correlation between the expression of ASB6 protein and age ( χ2=0.42, P=0.516), sex ( χ2=0.76, P=0.385), tumor size ( χ2=0.91, P=0.341), tumor location ( χ2=2.29, P=0.130), histological classification ( χ2<0.01, P>0.999), differentiation degree ( χ2=2.54, P=0.111) and distant metastasis ( χ2=3.38, P=0.066). qRT-PCR results showed that the expression level of ASB6 mRNA in colorectal cancer tissues was significantly higher than that in para-carcinoma tissues (5.37±0.13 vs. 3.39±0.09, t=-12.48, P<0.001). Kaplan-Meier survival analysis showed that the overall 5-year survival rates of patients in the ASB6 high expression group (72 cases) and the ASB6 low expression group (34 cases) were 45.8% and 73.5%, respectively ( χ2=6.82, P=0.009). Univariate survival analysis found that ASB6 protein expression ( HR=3.09, 95% CI: 1.25-7.65, P=0.015), lymph node metastasis ( HR=0.41, 95% CI: 0.21-0.82, P=0.011), distant metastasis ( HR=0.20, 95% CI: 0.10-0.42, P<0.001), and TNM stage ( HR=0.10, 95% CI: 0.03-0.32, P<0.001) were prognostic factors, while multivariate Cox survival analysis found that distant metastasis ( HR=0.22, 95% CI: 0.09-0.50, P<0.001) and TNM stage ( HR=0.25, 95% CI: 0.11-0.58, P<0.001) were independent prognostic factors. Conclusion:The expression of ASB6 in colorectal cancer tissues is significantly higher than that in para-carcinoma tissues, and the prognosis of patients with high expression of ASB6 is significantly worse than that of patients with low expression of ASB6. ASB6 can be used as an important indicator for early monitoring and postoperative survival assessment of colorectal cancer patients in the future.

Objective: To evaluate the differences of serum total light chain(sTLC), urine total light chain(uTLC) and serum free light chain(sFLC) in different stages of chronic kidney disease(CKD) and their correlation with renal function indexes. To investigate the predictive value of light chain indexes in CKD staging. Methods: 292 patients with CKD were analyzed retrospectively, and plasma cell diseases, acute kidney injury and tumor diseases were excluded. According to the estimated glomerular filtration rate(eGFR), CKD patients were divided into five groups from CKD 1 stage to CKD 5 stage. The levels of sTLC, uTLC, sFLC and corresponding biochemical indexes of CKD patients were detected, and the differences and correlations among the indexes of each group were compared. The receiver operating curve(ROC curve) was used to analyze the predictive value of each light chain index in CKD stage, with CKD1-2 stage combined as control group and CKD3-5 stage combined as case group. Results: There was no significant difference in sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ among CKD1-5 stage(P>0.05). There were significant differences between sFLC κ, sFLC λ and uTLC κ, uTLC λ among CKD1-5 stage(P<0.05), which increased with the increase of CKD staging. The correlation between sFLC κ, sFLC λ and serum creatinine(Scr), blood urea nitrogen(BUN), eGFR were better than uTLC κ, uTLC λ(P<0.001). The sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ had no correlation with renal function indexes(P>0.05). The best critical points of sFLC κ and sFLC λ for predicting CKD3-5 stage were 35.4 mg/L and 52.8 mg/L, and AUC was 0.916(0.883-0.949) and 0.915(0.881-0.949), which were higher than uTLC κ and uTLC λ,AUC was 0.811(0.754-0.869) and 0.787(0.728-0.846), respectively. Conclusion With the increase of CKD staging, the levels of sFLC and uTLC gradually increase. The sFLC and uTLC can effectively predict patients with CKD3 and above, which has an important reference value in stratified management of patients with CKD.