Obstructing colorectal cancer is one of the acute abdominal diseases which are common in clinical practice.The initial symptoms of 8.0％-33.9％ patients with obstructing colorectal cancer are complete or incomplete acute colonic obstruction.Seventy percent of obstructing colorectal cancer located at the left colon.There are no standard treatment methods for obstructed left colonic carcinoma (OLCC).Previously,a staged procedure was recommended.With the improvement of the intestinal surgical techniques,one-stage resection and anastomosis including intraoperative colonic irrigation,subtotal colectomy,metal stents placement and transanal drainage tube placement were preferred by most of the surgeons.In addition,metal stents placement and transanal drainage tube placement can reduce bowel pressure,which creates the possibility for the treatment of malignant colorectal obstruction by laparoscopes.

Objective To evaluate the accuracy of bispectral index (BIS) for monitoring the depth of sevoflurane anesthesia in children of different ages.Methods One hundred and five children (0-14 yr) undergoing abdominal surgery were divided into 3 age groups (n=35 each): group Ⅰ 4-14 yr (older children); group Ⅱ 1-3 yr (young children) and group Ⅲ < 1 yr (infants). All of the patients were anesthetized with sevoflurane combined with epidural or caudal blockade. Anesthesia was induced with 5 % sevoflurane in O_2. After tracheal intubation, the patients were mechanically ventilated. P_(ET) CO_2 was maintained at 35-45 mm Hg. The end-tidal sevoflurane concentration (C_(ET)Sev) Was maintained at 3.2%, 2.6%, 1.9% and 1.4% in infants < 6 months andat 2.5%, 2.0%, 1.5% and 1.0% in children > 6 months. Each C_(ET)Sev was maintained for at least 15 min. MAP, HR, P_(ET)CO_2 and BIS were monitored and recorded before anesthesia (T_1, baseline), at loss of consciousness (T_2), immediately after tracheal intuhation (T_3), at the 4 C_(ET)Sev (T_(4-7)), recovery of pharyngeal reflex (T_8), extubation (T_9) and emergence of anesthesia (T_10). Results BIS values were significantly higher in children of 1-3 yr (group Ⅱ) than in children of 3-14 yr (group Ⅰ) at T_(4,6,7). BIS values were significantly lower in infants (group Ⅲ) than in children of 3-14 yr (group Ⅰ) at T_(5-9). BIS values were significantly lower in infants (group Ⅲ) than in children of 1-3 yr (groupⅡ) at T_(3-10). There was significant negative correlation between BIS and C_(ET)Sev in all 3groups(γ=-0.768,-0.709,-0.357).Conclusion BIS can accurately reflect the depth of sevoflurane anesthesia in children (> 1 yr). BIS should be interpreted cautiously in infants (< 1 yr).

Objective To know the remote quality of life of patients with tumor of larynx when ab-scised by different type, and then summarize proper countermeasures of nursing. Methods Selected 82 laryngocarcinoma patients with exacte]y diagnosis. There were 40 cases had received total laryngectumy, 42 cases had received partial laryngectomy. Evaluated the level of remote quality of life of 82 patients by QLQ-H&N65, and then analyzed the datum. Results The level of quality of life of patients with total laryn-gectomy were worse than those in patients with partial laryngectomy in the aspects such as general health, swallow, language, emotional function, social function, body fuction and so on. Conclusions The quality of life of patients with tumor of larynx is influenced by several factors, their remote quality of life should be emphasised by nurses.

The changes of serum apelin in patients with metabolic syndrome were investigated. The level of fasting serum apelin was determined by ELISA assay.The level of serum apelin was raised obviously in patients with metabolic syndrome(MS).Moreover,the level of serum apelin in patients with type 2 diabetes mellitus was higher than those in cases of MS with impaired glucose regulation and the group of subjects with overweight/obesity [ (475.8±37.3 vs 451.5±54.3 and 430.3±52.1 ) ng/L,P＜0.01 ].In a multiple step-wise regression analysis,In homeostasis model assessment of insulin resistance ( HOMA-IR),body mass index,and total cholesterol were independent factors of apelin.The increased serum apelin was closely related to metabolic abnormalities in metabolic syndrome.The increased insulin resistance might cause the raised level of serum apelin in patients with MS.

The level of serum fibroblast growth factor-21 (FGF-21) in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease (NAFLD) was determined by ELISA.The results showed that serum FGF-21 level in these patients was higher than that in type 2 diabetic patients [(266.55 ± 21.24 vs 220.32 ± 22.68) ng/L,P＜ 0.01].Serum FGF-21 levels in both groups were significantly higher than that in normal control group [(173.52 ± 16.18) ng/L,P＜0.01].Serum FGF-21 level was positively correlated with waist circumference,blood glucose,and triglyceride.FGF-21 may contribute to the development of NAFLD in the patients with type 2 diabetes mellitus.

Two DNA fragments, designated as P190CRI (AA1-55) and P190CRV (AA1597-1667) respectively, which encoded amino acid residues of conserved region I and V on the P190 antigen, were amplified by polymerase chain reaction from genomic DNA in FCC1/HN strain of Plasmodium falcipamm isolated from Hainan Province, China. It was found that there were five bases substitution in the P190CRV, in comparison with the nucleotide sequences of MAD20 strain. These two sequenced fragments were inserted into pGEX-2T plasmid. E.coli JM109 (DE3) were transformed with the recombinant plasmids and the parental plasmid. The results show that the two fragments were expressed at high level as C-terminal fusions with glutathione s-transferase (GST). The fusion proteins were easily purified from bacterial lysates by affinity chromatography using glutathione sepharose 4B.

190-kilodalton glycoprotein (P190) of Plasmodium falciparum. precursor of the major surface protein of merozoites, is considered a promising candidate for blood stage malarial vaccine. We designed six primers according to the sequence of MAD20 strain, with a GC clamp and BamHI site at the 5'- end of each one, and a GC clamp and Xbal site at the 3'- end of each one. The primers were synthesized by phosphoramidite approach (User's Manual of ABI Company) and purified using HPLC. Three fragments in the second, third and fourth conserved regions of P190 gene of Plasmodium falciparum FCC1/HN strain isolated from the blood of patients in Hainan Province of China were amplified by the polymerase chain reaction (PCR) technique. The amplified fragments were subcloned into pUC18 vectors and sequenced using the dideoxy chain termination method. All three regions of P190 gene of FCCl/HN strain also were highly conservative as compared with P190 gene of MAD20 (Papua New Guinea isolate), K1 (Thailand isolate), Wellcome (West Africa isolate) and CAMP (Malaysia) strains of Plasmodium falciparum. The C at position 81 in the second conserved block of P190 gene of FCC1/HN isolate was substituted by T, which did not change the amino acid determined by the coden corresponding to the substitution.

Objective To measure mitral annual displacement (MAD) by M-mode echocardiography in normal second and third trimester fetuses,and assess relationships between MAD and gestational age and routine echocardiographic parameters for evaluation of left ventricular function.Methods One hundred fifty-five normal fetuses from 19 to 38 weeks of gestation were recruited in the study.MVD and tricuspid annual displacement (TAD) were measured.Early diastolic inflow velocities (E) of the atrioventricular valves were assessed by pulsed-wave Doppler(PW),and early diastolic velocities (Em) of the mitral annular were estimated by pulsed-wave tissue Doppler imaging (TDI).The ratio of E/Em was calculated.Results In normal fetuses,the MAD was (7.05 ± 1.17) mm.There was significant positive correlation between the fetal MAD and advancing gestational age ( r =0.82,P ＜0.01 ),and between MAD and E,A,Em,Am or Sm ( r =0.25,0.24,0.32,0.29 and 0.40 respectively,P ＜0.01).There was no correlation between fetal MAD and E/A,E/Em,LVEF or LVFS.The left MAD was significantly lower than the right TAD ( P ＜0.01 ).Conclusions MAD of fetuses from 19 to 38 weeks of gestation can be quantitatively measured by Mmode echocardiogram.The measurement of MAD provides a reliable quantitative standard to estimate long axis ventricular function of fetuses,which may be clinically useful in prenatal detecting early cardiac failure.

Objective To explore the clinical manifestations,imaging findings,pathological classification and treatment of congenital cystic adenomatoid malformation (CCAM)of the lung.Methods The clinical features,imaging findings,pathology information,diagnosis,treatment method and its prognosis of children with CCAMconfirmed by ope-ration and pathology were retrospectively analyzed in Yuying Children′s Hospital Affiliated to Wenzhou Medical Univer-sity from August 2006 to August 201 4.Results Eleven patients were boys and 4 patients were girls.One case had a-symptomatic clinical features,1 2 cases had pulmonary infection,1 case had recurrent chest pain,and 1 case had de-pressed deformity in sternum inferior segment.Chest CT scanning indicated that 9 cases had multiple gas cysts at unila-teral side of lung,among which 1 case was of funnel chest and pulmonary sequestration,1 case of huge cyst containing air and fluid at inferior lobe of left lung,and 4 cases of high density lung shadow;CT examination indicated that 1 case had recurrent chest pain and eventration of diaphragm of the right side combined with pulmonary sequestration.All ca-ses were treated by surgical resection,of whom 1 case was given cystectomy and sequestrectomy,diaphragmatic plication respectively,1 case complicated with funnel chest disease underwent lesion pulmonary lobectomy,sequestrectomy and minimally invasive corrective surgery in pectus excavatum (Nuss surgery),and the remaining 1 2 cases received lesion pulmonary lobectomy.All of 1 5 cases recovered well without complications.Pathological classification type of CCAMin-cluded 1 1 cases of type Ⅰ,3 cases of type Ⅱ and 1 case of type Ⅲ,among which 2 cases had pulmonary sequestration. Conclusions CCAMis a rare disease which can be discovered along with pulmonary infection.Multiple gas cysts are the most common imaging findings and the preoperative diagnosis of CCAM is mostly based on chest CT examination. Type Ⅰ and type Ⅱ are the most common pathological classification.The surgical resection should be given early surgi-cal resection and the prognosis is usually good.

Senna contains anthraquinones, flavonoids, polysaccharide and volatile oil and other chemical substances, which show the effect of diarrhea, antibacterial, hemostatic, regulating immune function and antioxidation. This article reviewed the Senna chemical composition, pharmacological effects, clinical application and new formulations of drug development, in order to provide reference for the research and clinical application of Senna.