Neoadjuvant chemoradiotherapy has been used as a standard treatment for patients with locally advanced (T2 and T3 ) rectal carcinoma. Some patients who receive neoadjuvant chemoradiotherapy obtain pathological complete remission, namely, the absence of any tumor cells in the surgical specimens. The patients who obtain pathological complete remission get a better survival rate after canceling operation. Researches are still needed to investigate whether it is safe for patients in order to avoid risk and adverse reaction.

Objectives:To analyze the influencing factors and status of hospital seeking behavior among floating population by focusing on the function of health insurance , and provide evidence to comprehensively promote tiered health care system in China .Methods:Using data from 2014 National Floating Population Dynamic Monitoring Survey , multivariate logistic regressions were applied to analyze the influencing factors of hospital seeking behavior for inpatient care .Chi-square tests were used to analyze the different proportion of having basic medical insurance reimbursement and reasons for not having it for different hierarchical inpatient care , and T test were used to analyze the ratio of basic medical insurance reimbursement for hospital costs .Results:The proportion of hospitalization at the county level and below was 56.4%among floating population , the proportion of inflow patients being 51.5%and the rest of the hospital population being counted at a proportion of 37.9%, lower than the corresponding proportion of 72.6%among local res-idents derived from the Fifth National Health Services Survey , but this ratio was 78.9%among registered population . The multivariate logistic regression results indicated that demographic , socio-economic and flow characteristics , hospital location and reasons for hospitalization have significantly affected the migrant inpatients facilities , but health insurance did not significantly influence the hospital seeking behaviors among floating population .Conclusions:The proportion of hospitalization at the county level and below was low among migrants and this proportion presented great regional differ -ences;and medical insurance didn't play a guiding role in the diversion of the internal floating population .

Objective To explore the effect of token on the pain and compliance of wound care of postoperative children with hypospadias, and provide evidence for the pain management and psycho-behavior intervention of children. Methods Selected 80 cases of hypospadias and they were assigned to the experience group and the control group. The control group was guided by conventional nursing intervention method while the experience group was guided by token intervention. Compare the pain score and compliance of two groups. Results The pain score of the experience group were (2.65±1.89), (2.40± 1.73), (2.10±1.43) points, the control group were (4.10±2.52), (3.35±2.09), (2.90±1.75) points. There were significant differences between the two groups (t=2.912, 2.399,- 2.239, all P<0.05). There were significant differences between the two groups for the compliance (χ2=5.415, 7.587, 9.372, all P<0.05). Conclusion Token can relief the pain of wound care of postoperative children with hypospadias, increase the compliance of wound care of the children.

Objective To investigate the mechanism and clinical value of sacral plexus perfusion method in the treatment of rachi lumbocrural pain.Methods 80 cases of patients with rachi lumbocrural pain in our hospital from May 2014 to May 2016 were selected, they were randomly divided into sacral plexus perfusion method treatment group ( study group) and infrared short medium long frequency therapeutic instrument combined with acupuncture and massage therapy group (control group) two groups, 40 cases in each group.The main clinical symptoms scores, main clinical signs scores, thoracolumbar spine flexion, VAS scores, clinical efficacy of the two groups were statistically analyzed.Results The low back pain, cold limbs, numbness, leg redicular pain scores of the study group were significantly lower, the difference was statistically significant (P<0.05), the both sides L3 transverse tip tenderness scores, VAS score were significantly lower, the difference was statistically significant (P<0.05), the thoracolumbar flexion was significantly higher, the difference was statistically significant (P<0.05), the total treatment efficiency 92.5%(37/40) was significantly higher than the control group 67.5%(27/40), the difference was statistically significant (P<0.05).Conclusion The clinical value of sacral plexus perfusion method in the treatment of rachi lumbocrural pain is higher than infrared short medium long frequency therapeutic instrument combined with acupuncture and massage therapy, it can more effectively improve the clinical symptoms and signs, relieve the pain, enhance the thoracolumbar flexion and total treatment efficiency of patients.

0.05),Glibenclamide(0.1?mol/L,1?mol/L,10?mol/L) increased cell′s apoptosis by2.35,2.71,2.94 folders(P

Objective To summarize the clinical efficacy of Endu combined with intrapleural injection of cisplatin in the treatment of malignant pleural effusion of non-small cell lung cancer.Methods80 patients with malignant pleural effusion were selected from January 2014 to December 2015.The patients were randomly divided into observation group and control group (n=40).The control group was given Endu(40mg/time, 1 time/week) combined with cisplatin (40mg/time, 1 time/week) intraperitoneal injection treatment, the treatment group was given Endu intraperitoneal injection therapy, After 4 weeks of treatment, the clinical efficacy and adverse reactions were observed.ResultsThe clinical efficacy of the observation group was significantly higher than that of the control group (50.00%).The difference was statistically significant (P<0.05).The incidence of adverse reactions in the observation group was 15.00% higher than that in the control group, but the difference was not significant.The improvement rate of life quality in the observation group was significantly higher than that in the control group (52.50%).The difference between the two groups was statistically significant (P<0.05).ConclusionThe clinical efficacy of Endu combined with intrapleural injection of cisplatin in the treatment of malignant pleural effusion of non-small cell lung cancer is superior to that of simple analgesia, which can significantly improve the clinical symptoms and quality of life.It is worthy to be popularized in clinical practice.

Objective To compare the clinical effect of Doxofylline and aminophylline in the treatment of bronchial asthma.Methods The clinical data of 112 patients with bronchial asthma treated in Jiaxing Second Hospital from February 2015 to December 2016 were retrospectively analyzed.The patients were divided into two groups: the treatment group(56 cases), the use of doxofylline treatment, and the control group(56 cases), the use of aminophylline treatment.After 1 w treatment, the curative effect and adverse reactions were compared between the two groups to observe the changes of lung function before and after treatment.Results The total effective rate of the treatment group and the control group were 91.07% and 76.79% respectively(P<0.05).After treatment, the FVC of the treatment group was(2.24±0.63)L, FEV1 was(1.59±0.47)L, VC was(2.94±0.77)L, the incidence of adverse reactions was 10.71%, which was superior to the control group, the difference was statistically significant(P<0.05).Conclusion Doxofylline treatment of bronchial asthma clinical efficacy is remarkable, worthy of clinical promotion.

Objective To compare three methods for the extraction of mycobacterial DNA.Methods Two commercial DNA extraction kits and an ordinary freeze-thawing method were used to extract DNA from the pure suspensions of three species of Mycobacteria (M.tuberculosis,M.leprae and M.smegmatis) at different densities (1 × 10 to 1 × 105 cells/ml),simulated clinical specimens containing different concentrations of mycobacterial cells (1 × 10 to 1 × 104 cells/ml).The purity and concentration of the extracted DNA were evaluated.Then,PCR was performed to amplify the 16S rRNA region of Mycobacteria.The performance of the three methods was compared by the purity and concentration of extracted DNA as well as the results of PCR.Further more,76 clinical skin specimens suspected to be infected with Mycobacteria were used to further validate the performance of these methods.Results All the extracted DNA samples could be detected by PCR.The highest purity of DNA was obtained by the kit A,followed sequentially by the freeze-thawing method and the kit B.When pure suspensions were used,the detection limit was consistently 1 × 102 cells/ml for all the three methods.With simulated specimens,the detection rate was consistently 100％ for all the three methods at the concentration of 1 × 103 cells/ml,60％ (12/20),55％ (11/20) and 55％ (11/20) for the kit A,kit B and freeze-thawing method respectively at the concentration of 1 × 102 cells/ml.The analysis of clinical specimens showed that the kit B could be used to extract DNA from paraffin-embedded specimens,with the detection rate similar to that of kit A and freeze-thawing method.Conclusions The kit A could rapidly yield high-quality genomic DNA of Mycobacteria by repeated cleaning of columns,and may serve as the optimal method for scientific and clinical studies,and the kit B is suitable for extracting mycobacterial DNA from fresh tissue specimens besides paraffin-embedded specimens.

Objective To assess the diagnostic value of glycosylated hemoglobin A1c (HbA1c) ≥6.5％ for diabetes in Chinese adults with oral glucose tolerance test(OGTT) as the reference standard.Methods Major databases were searched to get all diagnostic tests with HbA1c ≥ 6.5％ for diabetes in Chinese adults.QUADAS items were used to evaluate the quality of the eligible studies.Meta-disc software was used to perform comprehensive quantitative assessment for all included studies and summary ROC (SROC) curve were drawn.Results A total of 11 studies were included.The outcomes of the diagnostic value with HbA1c ≥6.5％ were as the following:pooled sensitivity 0.62 (95％ CI:0.60-0.64),pooled specificity 0.96 (95％ CI:0.95-0.96),diagnostic odds ratio (DOR) 40.25 (95％ CI:20.79-77.95) and AUCSROC 0.7702 (sx =0.0636).Conclusions The diagnostic specificity is pretty high for the diagnostic test with HbA1c ≥6.5％,while sensitivity is low.Combination of HbA1c and glucose tests is needed to reduce the missed diagnosis rate.

Objective To observe the effect of extracorporeal shock wave (ESW) combined with intervertebral foramen injection on the lumbar facet joint syndrome.Methods Ninety-three patients presenting the syndrome were randomly divided into acombined group,ashock wave group and acontrol group,each of 31,according to a random number tab.All three groups were given a nonsteroidal anti-inflammatory drug,the shock wave group was additionally treated with a course of ESW,while the combined group received the shock wave treatment and lumbar intervertebral foramen injection.The three groups were assessed using theOswestry disability index (ODI),theRoland Morris Disability Questionnaire (RMDQ)and a life quality scale (QOL-SF36) beforetreatment and after 1,4 and 8 weeks of treatment.Pain was reported using a visual analogue scale (VAS).Results Theaverage VAS,ODI,RMDQ and QOL-SF36 scores of the three groups had all improved after the treatment.After one week the average scores of VAS (2.6±1.4),ODI (15.9±8.3),RMDQ (9.9±5.4) and QOL-SF36 (74.6±17.1) of the combined group had improved significantly more than those of the control group [VAS (4.3± 1.3),ODI(22.8± 6.9),RMDQ (14.9±7.7) and QOL-SF36 (61.6±17.7)].Fourweeks after the treatment,the averageVAS,ODl,RMDQ andQOL-SF36 scores [(2.5±1.3),(15.1±7.3),(9.8±5.1) and (76.8±16.8)] of the shock wave group had improved significantly more than those of the control group [(3.9 ± 1.4),(20.3 ± 8.2),(13.9 ± 8.1) and (67.2±20.6)].Such significant improvements lasted until 8 weeks after the treatment.ConclusionsESW combined with intervertebral foramen injection can relieve the pain oflumbar facet joint syndrome,improve lumbar vertebral function and patients' quality of life.It is worthy of clinical application.