Rectal carcinoma is a common malignant tumor in China. Although it decreased greatly after the introduction of total mesorectal excision and preoperative radiotherapy, the local recurrence rate of rectal carcinoma after curative surgery is still up to 11.3%. Surgery is the most effective treatment for local recurrence of rectal carcinoma. If excised radically, the five-year survival of patients with rectal carcinoma could be more than 35%. Only a few patients will benefit from ex-tended radical surgery because of its extremely high postoperative morbidity and mortality. Strict selection of patients by mul-tiple preoperative examinations makes extended radical surgery more reasonable. For the unresectable advanced recurrent rectal carcinoma, multimodality palliative therapy could lead to symptom relief, elevated quality of life and prolonged surviv-al. We discuss the diagnosis and treatment of recurrent rectal carcinoma in this review.

Three cellulose derivatives were synthesized and used as chiral stationary phases based on silica gel.The effects of adsorbances on the column numbers and stabilities have been investigated.These stationary phases exhibited high chiral recognition for various racemates.At the same time,the on-line curves of polarimeter were obtained by high performance liquid chromatography with polarimeter as on-line detector.

Hospital information management has penetrated into each aspect of hospital management.We discussed briefly the role of the hospital information system in medical records management in Chinese medicine hospital on information sharing,data statistics and convenience of case consulting and management,which improved greatly the efficiency of medical records management.

There are 10％-25％ inherited breast cancer patients among all breast cancer patients.Hereditary factors play an important role in the occurrence and development of inherited breast cancer.There are three kinds of susceptibility genes of inherited breast cancer including high penetrance susceptibility genes,middle penetrance susceptibility genes and low penetrance susceptibility genes.Various susceptibility genes are closely related to inherited breast cancer.

Objective:To simultaneous determine six flavonoids in Shuxuening injection by quantitative analysis of multi-compo-nents by single marker ( QAMS) and examine the durability and system suitability of the analysis. Methods:Shuxuening injection was the study object and rutin was used as the internal material, the relative correction factor ( f) between rutin and narcissus glycosides, quercetin-3-O-β-D-glucosyl (1-2)-α-L- rhamnoside, kaempferol-3-O-β-D-glucose group (1-2)-α-L-rhamnopyranoside, quercetin-3-O-[2-O-(1-O)-p-coumaric acid-β-D-glucose-yl]-α-L-rhamnoside, kaempferol-3-O-[2-O-(6-O)-on coumaroyl-β-D-glucose-based]-α-L-rhamnosides was respectively established. The result differences between the internal standard method and external standard method were compared, and the internal standard method was re-validated. Results: The contents of the six flavonoids in Shuxuening injection were calculated by the correction factors. Compared with those of the external standard method, the differences in the contents of the method were small( RSD<5%) . Conclusion:QAMS can be used as a simple and accurate quantitative quality evaluation meth-od for the determination of a variety of ingredients in Shuxuening injection, which provides reference for the subsequent study on quality standard.

OBJECTIVE To investigate the hearing level of deafmute children in three deafmute schools in Nanning,Liuzhou and Guilin cities and reveal the importance of early diagnosis and intervention.METHODS The pure tone hearing thresholds of 0.5,1,2,4 kHz of 357 deafmute children in three deafmute schools were recorded. The disability grade was evaluated according to the average threshold of 4 frequencies.RESULTS A total of 410 students were in the three deafmute schools.There were 248 male and 162 female with an age ranged from 2 to 27 years(14.5 years). The number of hearing disability grade fromⅠtoⅣwere 232(65 %),64(18.0 %),48(13.5 %)and 10(2.6 %)respectively,and 3 children(0.9 %)could not graded the hearing disability.Sixty one children (17.0 %)with light or moderate hearing loss missed their optimal opportunity of hearing and speech rehabilitation.CONCLUSION The results reveal the importance of early diagnosis and intervention of hearing loss.

Objective: To investigate the protective effect of adenosine on hearing in acute acoustic trauma and its modulatory action in the cochlea. Methods:Guinea pigs were exposed to 118 dB SPL white noise for 30 min. During the process of exposure, artificial perilymph or artificial perilymph containing 1 mmol/L adenosine was infused into the cochlea through perilymphatic perfusion. Thresholds of compound action potentials (CAP) evoked by click and tone burst were measured before and after noise exposure. Results: Immediately after exposure, the mean threshold shifts evoked by click of the control group and adenosine treated group were (40?6.68) dB and (20?5.70) dB respectively. The threshold shifts evoked by tone burst at 2 8 kHz in the control animals were 32 50 dB, while in the adenosine treated animals, 20 35 dB. There were significant differences between the 2 groups except that at 6 kHz. Two hours after exposure, there was an increase of 4 8 dB at all frequencies in the control group; no changes in the adenosine treated group were found. There were significant differences in threshold shifts between the 2 groups at all test frequencies. Conclusion: Adenosine has protective effect on temporary threshold shift in acute acoustic trauma in guinea pigs. [

Objective To understand the epidemiological characteristics of bacillary dysentery and etiological characteristics of Shigella in Tianjin, and to provide evidence for the prevention and control measures. Methods The data of disease surveillance information reporting system from 2008 to 2014 were analyzed retrospectively. A total of 3955 stool samples came from the clinically diagnosed cases of bacillary dysentery were collected, according to the extraction method of stratified sampling in Tianjin city, suburban area, Binhai New Area and suburban area sentinel hospitals, and according to the sampling interval for the May to October from 2008 to 2014. Samples were detected and cultured for Shigella flora. Results (1) Epidemiological characteristics:from 2008 to 2014, a total of 65179 cases of bacillary dysentery were reported in Tianjin city, with an average annual incidence of 72.00/100 thousand. The annual incidence rate showed a downward trend year by year. The incidence was a downward trend, including urban (120.28/100 thousand), suburban areas (70.36/100 thousand), Binhai New Area (64.22/100 thousand) and the outer suburbs (19.39/100 thousand). The onset time was mainly concentrated in June-September, and the peak incidence occurred in August. The incidence rate was higher in people below 5 years old and above the age of 85. The annual incidence rate was higher in male patients of 0 to 24 years old and above 75 years old than that of female. The annual incidence rate was higher in female patients of 50 to 74 years old age group than that of male (P<0.05). The distribution of occupation was scattered among children and retirees. (2) Distribution of bacteria:the 229 Shigella strains were positive (5.79%), including 136 strains of Shigella sonnei (59.39%), 93 strains of Shigella flexneri (40.61%). The 89 strains of Shigella flexneri (4 strains were not detected) were detected in 8 subtypes, F2a (49.44%), F2b (22.47%) and FX (13.48%). The subtypes of Shigella flexneri were detected decreased year by year from 2008 to 2014, showing a single subtype. The highest detection rate of Shigella was found in 10-19 years old (9.55%). The S.sonnei positive rate was the highest in urban (5.09%), and the Shigella flexneri positive rate was the highest in suburban areas (3.09%). Conclusion The key population for the prevention and control of bacillary dysentery in Tianjin is scattered children and old people. It is necessary to strengthen the propaganda and health education to improve the health consciousness of the key population and their daily nursing staff. With the continuous changes of Shigella flora, it is necessary to carry out long-term monitoring to find out the regularity of shigella.

Objective:To control the maintenance cost of medical equipment and improve the efficiency and service level for maintenance, and to research the management about classification maintenance for medical equipment based on analytic hierarchy process (AHP).Methods: 69 clinical department and 14 engineers were involved in the questionnaire survey and the evaluated factors were obtained from their questionnaires. The (AHP) was used to determine what is the factor weight of maintenance for the medical equipment, and then calculate the maintenance scores of the equipment. Finally, the weight scores were applied to ABC classification method and the equipments will be divided into three types (A\B\C) as this method, and they will be managed by different mode.Results: Depended on the sixth order analysis data from 6 factors of evaluation (price, frequency, stability, running time, standby factor and difficulty of maintenance) that were compared between any two factors by using AHP, through comprehensive scores ratio to got A\B\C classification and work out relative implement countermeasure of maintenance. The new classification management mode has achieved planning and preventive maintenance for key equipment, regular maintenance for major equipment, and maintenance after event for general equipment. After the method was applied, the fault rate of second half of 2016 year was decrease 30% compared with same time of 2015 year. The total cost of maintenance of 2016 year decreased 10% compared with that of 2015 year. And the satisfaction of clinical department for department of equipment was enhanced.Conclusion: The AHP is applied to classified manage medical equipment and maintain them as weight of factor. This method has resolved many problems on maintenance of equipment, such as confused primary and secondary, and formalism and so on. According to the factor weight of maintenance to manage medical equipment at classification mode, hospital can catch key point of maintenance of equipment, and the maintenance cost can be efficiently controlled, and the work efficiency and clinical service level of equipment department can be improved and enhanced.

Clinical practice is an important step in medical education. However,its effect is now becoming worse and worse because of the influence of employment difficulties,post-grad-uate entrance exam and medical environment. It is hard to resolve these problems by simply education method. These problems are very common in management and can be found in prejob training,employee loyalty and quality management,respectively. It is a new approach to improve clinical practice education by enhancing teachers'management ability.