Objective:To discuss the effect of bifid triple viable capsules on plasma D-lactic acid and stool S-IgA in the patients with colorectal cancer after the operation. Methods:Totally 68 cases of patients with colorectal cancer after the operation were selected and divided into the observation group and the control group at random. The patients in the two groups were given enteral nutrition and postoperative routine medical treatment with the treatment course of one week from the third day after the operation. The patients in the observation group were additionally given 620 mg bifid triple viable capsules, twice a day. The occurrence rates of diarrhea and flora imbalance, D-lactic acid in plasma, S-IgA in stool and adverse drug reaction ( ADR) in the two groups were observed and compared after the medical treatment. Results:After the one-week medical treatment, the occurrence rates of diarrhea and flora imbalance in the observation group were much lower than those in the control group (P<0. 05). After the treatment, D-lactic acid in plasma in the two groups was declined, while S-IgA in stool was decreased than that before the treatment, and the changes in the observation group were more notable than those in the control group (P<0. 05 or P<0. 01). No obvious ADR appeared in the two groups during the medical treatment. Conclusion:The application of bifid triple viable capsules in the patients with colorectal cancer after the operation can re-duce D-lactic acid in plasma and ralse S-IgA in stool, which can effectively recover intestinal mucosal barrier function and local immu-nity, and reduce alteration of intestinal flora and occurrence of diarrhea with high security.

Objective To evaluate the clinical efficacy of absolute ethanol combined with histoacryl sclerotherapy in treating high-reflux venous malformation in children.Methods The clinical data of a total of 339 sick children with venous malformation,who were admitted to authors' hospital during the period from April 2009 to April 2014 to receive interventional sclerotherapy under general anesthesia,were retrospectively analyzed.Sclerotherapy with absolute ethanol combined with N-butyl cyanoacrylate (NBCA) was carried out in 137 sick children with high-reflux type venous malformation.The patients were followed up for 6-24 months (mean of 15 months).Results Successful sclerotherapy with absolute ethanol combined with NBCA was achieved in all 137 sick children with high-reflux type venous malformation.Complete cure was obtained in 23 sick children,basic cure in 31 sick children,and effective response (improvement) in 42 sick children;the total effective rate was 70％ (96/137).Ectopic embolization due to reflux of NBCA occurred in one sick child,skin ulceration was seen in 8 sick children and intraoperative transient pulmonary hypertension was observed in 3 sick children.The adverse reaction rate was 8％(12/137).Conclusion For the treatment of high reflux venous malformation in children,sclerotherapy with absolute ethanol plus NBCA is safe and effective,this technique carries low incidence of adverse reactions.(J Intervent Radiol,2017,26:217-220)

The paper describes the major steps taken by Hongze County of Jiangsu Province in reforming the health personnel system. These include: (1)adopting the personnel agent system; (2)implementing the all-personnel appointment system; (3)exploring ways of reforming the executive personnel management system; (4)setting up a flexible mobility system of health technicians; and (5)putting into effect the system of yearly salaries for Party and government principals. By reforming the personnel system, the awareness of crisis on the part of the entire staff was evidently enhanced, the quality of medical services was significantly improved, and the advancement mechanism of the health cause was rendered more flexible. As a result, the development of the health cause in rural areas was pushed to a new stage.

Objective To explore the feasibility and safety of right ventricular septal pacing with active fixation electrodes.Methods This was a randomized and control clinical trial.Patients implanted with pacemaker were randomly divided into two groups.One group underwent the right ventrieular high septal pacing with the active fixation electrodes(RVS group),and the other group underwent the right ventricular apical pacing with the passive fixation electrodes(control group).The parameter was recorded in two groups in and after operation and compared accordingly.Results (1)There were no significant differences in the procedure time between two groups[averaged(59.6±3.2)and(60.2±3.7)minutes respectively].But the time of exposing X-ray was significant longer in RVS group.(2)There was no significant difference in acute implanting measurement,except perioperative and postoperative threshold 1 month in RVS group was higher than that in control group(P＜0.05 or＜0.01).After 3 months,there was no significant difference.(3)Impedance decreased significantly in 1 month and 3 months in RVS group[P＜0.01 or＜0.05).(4)There was no difference in R-wave sensing between two groups.(5)After 100%pacing,the mean QRS duration Was shorter in RVS group,but the difference was not significant.(6)Operations in two groups came off smoothly and there were no complications.Conclusion It is feasible and secure to pace from RVS with active fixation electrodes.

Objective To investigate the morphological change of intratumoral microvessels after administration of thalidomide in the murine hepatic metastases. Methods Among 20 mice with hepatic metastases created by injection of colon-26 tumor cells into the spleen, 10 were treated with thalidomide (200 mg/kg) by intraperitoneal injection daily, the other 10 were treated with saline only by intraperitoneal injection daily. Fifteen days after inoculation of tumor cell, the intratumoral mierovessel of hepatic metastases with similar size in both groups were studied with in vivo microscopy (26 and 27 neoplasms in experimental group and control group respectively ) and immunohistochemistry for CD34 (52 and 55 neoplasms in experimental group and control group respectively). Two-tailed student t test was used to determine differences in intratumoral microvessel density (MVD), intratumoral branch density (BD) and CD34 positive intratumoral microvessel density (MVD-CD34) between the small ( < 400 μm in diameter) and large metastases in both groups, and that between thalidomide treated group and control group. Results For the control group, although the MVD and MVD-CD34 of larger metastases was more than that of small metastases respectively [(18.1±3.5)% vs (13.0±3.2) %, t =2.840,P<0.01;(22.9±2.8)vs ( 12. 8±2. 5) vessels per field, t = 9. 860, P < 0. 01 ], the BD was similar to that of small metastases [(110.0±20.5)vs(99.7±17.3) branches/rnm2, t = 1.040,P >0.05]. For the thalidomide treated group, despite the MVD-CD34 of larger metastases was more than that of small metastases [ ( 17.4±2. 3)vs (11.5±2. 5 ) vessels per field, t = 8. 770, P < 0. 01], the MVD and BD was similar to that of small metastases respectively [(14.7±3.5)% vs(13.2±3.3) %, t =0.826,P >0.05; (95.3±18.3)vs (97. 1±21. 0)branches/mm2,t=0. 347,P>0. 05]. The MVD, BD and MVD-CD34 of small metastases were similar to each other between two groups ( t = 0. 098, 0. 392,1. 190; P > 0. 05 ), however, that of large metastases were significantly lower in thalidomide treated group than in control group ( t = 3. 140,2. 870, 9. 850;P < 0. 01 ). Conclusions Thalidomide exerts antiangiogenic effect on the hepatic metastases with angiogenesis only, and the different vascular components in the tumor vasculature demonstrate variousresponses to antiangiogenic therapy.

[Objective]To investigate the characteristics and treatment strategy for fresh high energy fracture dislocation of tarsometatarsal joints in a retrospective study.[Method]From September 2002 to April 2008,43 patients with fresh high energy fracture dislocation of tarsometatarsal joints were treated with cannulated screw combined with Kirschner wire fixation or Kirschner wire fixation alone.There were 35 males and 8 females,with a mean age of 37.5 years(range,18 to 55 years).The injury was caused by a road accident in 15 patients,by a heavy crash in 21 patients,and by a fall from a height in 7 patients.According to the Myerson damage typing,there were 9 cases of type A,2 cases of type of B1,25 cases of type B2,4 cases of type CI and 3 cases of type C2.Eight were open injuries(6 of Gustilo-Anderson type I and 2 of type Ⅱ)and 35 closed injuries.Internal fixation were undertaken at an average of 4.6 days after injury(range,2.5 hours to 21 days).At 4-6 weeks all the patients began functional exercises after removal of the plaster casts.At 16-18 weeks all the patients began to walk with partial weigh loading after removal of the internal fixators.[Result]All the 43 patients were followed up for 26 months on average(range,13 to 38 months).No infection,breakage,loosening of internal fixator,nonunion or longitudinal arch collapse was found.According to ZHOU'S assay standard.excellent result was achieved in 26 cases,good in 14 cases,and fair in 3 cases,with excellent to good results of 95.3%.Six patients had post-traumatic arthritis,which was complicated with injured articular surface.[Conclusion]Fresh high-energy fracture dislocation of tarsometatarsal joints can be diagnozed correctly.Early diagnosis and correct classification,proper operation timing,anatomical reduction,rational internal and external fixation and timely functional training are essential for patients to achieve good clinical result.

Objective To explore the features of verbal working memory in elderly patients with anmestic mild cognitive impairment (aMCI).Methods Thirty patients with aMCI and 30 normal controls (NC), whose age were over 65 years old, were examined with verbal working memory software and the other neuropsychological tests, such as verbal fluency test (VFT) and digit span test.Results The correct rate of visual semantic verbal working memory test was significantly lower in aMCI patients (79.83% ± 3.22% )than in NC ( 87.00% ±: 1.93 % , t = - 1.03, P = 0.002).There was no significant difference of correct rate of the visual phonological verbal working memory test between the aMCI (78.92% ± 8.60% ) and NC (86.80% ±2.14%, t = - 2.34, P = 0.060).Also, aMCI cases achieved significantly lower scores than NC on VFT (22.96 ±2.31 vs 31.53 ±3.72, t = - 1.08, P =0.004) and BDS ( 1.53 ±0.86 vs 3.63 ±0.56, t = - 1.23, P = 0.027).Conclusion The visual semantic verbal working memory is impaired and visual phonetic working memory is saved in aMCI patients.Both scores of verbal fluency test and digit span test are significantly decreased in aMCI patients, too.

Objective To evaluate the clinical value and safety of hysteroscopy in diagnosis of abnormal uterine bleeding.Methods The clinical characters and histopathological data of 272 cases of abnormal uterine bleeding were retrospectively analyzed.They received hysteroscopy in our hospital from Jan.2010 to Jan.2015.Results Histopathological diagnosis showed 75 cases were with endometrial polyps,including 5 cases misdiagnosed as submucosal fibroids,and the correct diagnostic rate was 93.3％ (70/75).50 cases were with submucosal fibroids,and the diagnostic rate was 90.9％ (50/55).97 cases were endometrial hyperplasia,including 7 cases misdiagnosed as atypical hyperplasia or cancer by hysteroscopy,and the correct diagnostic rate was 92.8％ (90/97).19 cases were atypical hyperplasia or endometrial carcinoma,and the diagnostic rate was 73.1％(19/26).Atrophic endometrium were 23 cases.8 cases had intrauterine device remained.Conclusions Premenopausal women are more likely to present with endometrial hyperplasia,submucosal fibroids,endometrial polyps,while endometrial cancer and precancerous lesions are rare.But in postmenopausal women endometrial polyps,atrophic endometrium,cancer and precancerous lesions are mainly included.Hysteroscopic has a good diagnostic value in endometrial diseases which should be combined with histopathological examination.

Objective To investigate the therapeutic effect of laparoscopic radical resection of rectal carcinoma via natural orificespecimen extraction(NOSE). Methods Laparoscopic resection of rec-tal carcinoma was performed using NOSE technique in 35 cases of rectal cancer from October 2013 to 2015 July. Analysis of clinical data,postoperative exhaust time,the number of resected lymph node,and anastomotic leakage rate was conducted. Results All 35 cases underwent laparoscopic radical resection of rectal cancer with successful anus preservation. There were no preventive transverse colostomy. Among them,the success rate of laparoscopic radical resection via NOSE for rectal cancer was 85. 71%(30 /35). The operation duration ranged from 105 to 186 min(mean 129. 50 min). Anal exhaust time was 22 to 80 h(average 38. 13 h). Postoperative hospital stay lasted for 9 ~ 21 days(mean 10. 27 d). Anas-tomotic leakage occurred in 1 case and puncture infection in 2 cases. Conclusion Laparoscopic radical resec-tion of rectal carcinoma in middle and low rectal cancer is safe and reliable,which is worthy of being spread.

Objective To investigate the effect of continuous positive airway pressure therapy (CPAP) on heart rhythm and blood pressure variability in primary hypertensive patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods Ninety seven patients with OSAHS and primary hypertension were randomly divided into treatment group (n =49) and control group (n =48).Patients in control group receive antihypertensive medication only,while patients in treatment group received antihypertensive medication in combination with CPAP therapy for 4 weeks.The dynamic electrocardiogram (ESG) and ambulatory blood pressure for 24 h were measured before and after treatment in both groups.Results After CPAP treatment,the night index of standard deviation of the average NN intervals (SDANNniGHt) in treatment group was (89.0 ± 21.4) ms,while the day and night index of square root of the mean squared differences of successive NN intervals (rMSSDday and rMSSDnight) was (35.9 ± 17.2) ms and (45.7 ± 18.3) ms respectively.Compared with those before treatment,the index of SDANNnight was decreased and the indexes of rMSSDday and rMSSDnight were increased (P ＜ 0.01).Compared with control group,the SDANNnight was decreased,and the rMSSDday and rMSSDnight were increased (P ＜ 0.01,P ＜ 0.05).After CPAP treatment,the night index of low-frequency power (LFnight) in treatment group was (15.3 ± 5.7) ms,which was lower than that before treatment,and the night index of high-frequency power (HFnigh) was (16.3-± 8.1)ms,which was higher than that before treatment (P ＜ 0.01);the LFnight in treatment group was decreased and the HFnight was increased (P ＜ 0.01).After CPAP treatment,the day and night indexes of systolic blood pressure (SBPday and SBPnight) and the night indexes of diastolic blood pressure (DBPnigh) t in treatment group were (136.1 ± 13.4) mmHg,(128.7 ± 9.8) mmHg (1 mmHg =0.133 kPa),and(83.7 ±7.2)mmHg respectivley,which were all lower than those in control group (P ＜ 0.05 or P ＜ 0.01).The incidences of morning peak blood pressure and non-dipper hypertension in control group were significantly higher than those in treatment group (P ＜ 0.01).Conclusion CPAP therapy can effectively adjust the heart rate and blood pressure levels in patients with OSAHS and primary hypertension,especially in the night.