Purpose:To evaluate the efficacy and toxicity of the biweekly regimen of high dose leucovorin (CF), continuous central venous infusion(ccvi) of fluorouracil (5 FU) and oxaliplatin (OXA)for advanced and refractory colorectal cancer.Methods:28 patients (12 in rectum,16 in colon) received biweekly CF/5 FU/OXA (CF: 200 mg/m 2,ccvi 2 hour,days 1～2;5 FU:400mg/m 2,iv.,day 1; 5 FU: 1.6 g/m 2,ccvi.22 hours, days 1～2; OXA: 135 mg/m 2,ccvi.4 hour,day 1,every two weeks).Four treatment courses were carried out with an interval of one month.Results:The overall response rate was 39.28%.The response rates of rectal,colonic cancers were 33.33%% and 43.13%, respectively.Median duration of 11 partial responses were 5.0 months.Median survival of all patients was 7.0 months. Median survival of responsive patients,and non responsive was 11.0 and 7.0 months,respectively( P

In this paper, intelligent control of ultrasonic power during the process of thrombus ablation is realized through the combination of BP Neural Network and the expert system of ultrasonic thrombus ablation. One proper real-time power can be output correspondingly to different treatment circumstance according to expert ruler during the process of treatment.

Objective To investigate the effect of family supporting system on psychological emotion and quality life of leukemic children′s parents. Methods Fifty-eight parents of children with leukemia hosptalized from Juanary to December 2013 were set as control group, which received traditional education. Fifty-nine parents of children with leukemia hospitalized from Juanary to December 2014 were set as observation group which received family supporting system. The survey was done separately before intervention and 6 months after treatment by depression self rating scale (SDS), anxiety self-assessment scale (SAS) and SF-36 (the MOS 36 items short form health survey). Result There were statistical significances in the scores on SDS, SAS and SF-36 as compared those with the pre-intervention (P<0.05). Conclusion The leukemic children parents supporting system can effectively reduce the parents′depression and anxiety and improve their quality of life.

AIM: To explore the effects of glucocorticoids on fracture healing in a rat model of tibial fracture. METHODS: Sixty three months old female SD rats were divided into control and glucocorticoid-treated group. A glucocorticoid-induced osteoporosis model was established by intramuscular injection of prednisolone acetate (5 mg·kg~(-1)·d~(-1) for 3 weeks), in which the tibial was osteotomized by a wire saw as fracture healing model and internal fixed with a Kirschner pin. The rats were scarified at different time points after operation. The callus formation was monitored over a period of 6 weeks by histological method, bone mineral density (BMD) detection and biomechanical examination. Western blotting was used to measure the expression of type II collagen. RESULTS: A glucocorticoid-induced osteoporosis model was successfully established and conformed by BMD measurement. The formation of primary callus was observed in both groups 3 days after fracture. At 2 weeks after injury, the glucocorticoid-treated group had a lower BMD and less cartilage matrix as compared to control group. An increase in bone callus and chondrogenesis was observed at 4 to 6 weeks after fracture in glucocorticoid-treated group as compared to control group. The expression of type II collagen was delayed in glucocorticoid-treated group. Biomechanical measurement showed that the actual maximum load was increased by 35.8% in control group as compared to glucocorticoid-treated group at 6th week. CONCLUSION: These results indicate that chondrogenesis and transformation from cartilage callus to bony callus are delayed by glucocorticoids. The retardation of collagen Ⅱ production may be the reason for the inhibition of fracture healing.

Objective To explore the difference of the level of Th1/Th2 balance and change of CD4+ CD45R cell after treated by laparoseopy-assisted rectal cancer surgery and conventional open rectal cancer surgery, so to compare the effect of the two procedures on immunity function of the patients. Methods CD4+ IFN-γ+ T cell (Thl cell), CD4+ IL-4 + T cell( Th2 cell)and the ratio of Th1/Th2 were detected by flow cytometery ; The levels of IFN-γand IL-4 were measured by ELISA. The changes of CD4 + CD45RA+ T cell and CD4+ CD45RO+ T cell were detected in the different procedures so that the effect of the two procedures on eytoimmunity and immune balance were analyzed. Results Compared with baseline levels, the level of Th1 cells was decreased [ (4.51±1.52 ) %, (7.26 ±2.59) % vs. ( 12.06 ±1.82 ) % ] (P < 0.05 ) ; The level of Th2 cells was increased [ (6.70 ± 2.41 ) %, (6.70 ± 2.41 ) % vs. (4.47 ± 1.90) % ] ( P < 0.05 ) ; The level of IFN-γ was decreased [ (57.15± 23.64) ng/L, (72.70 ± 27. 31 ) ng/L vs. ( 123.47 ± 32. 52) ng/L ] ( P < 0. 01 ) ; The level of IL-4 was increased [(55.55±7.29)ng/L,(57.56 ±7.13)ng/L vs. [(41.87±5.83)ng/L] (P<0.05) on 2nd and 7th day after conventional open reeatal cancer surgery; The level of Thl, Th2, IFN-γ and IL-4 in the laparoscopy-assisted rectal cancer surgery was not different ( P > 0.05 ). At 7 day postoperatively, the level of the CD4+ CD45 RA+ T cells was in-creased (35.11 ±7.82) and the CD4+ CD45RO+T cells was decreased(61.21±9.13) compared with surgery be-fore(31.11±6.72) and (68.11 ±11.42) respectively (P< 0.05). Conclusions The laparoscopy-assisted rec-tal cancer surgery has less influence on immune balance, thus protect systemic cell immunity.

OBJECTIVE To investigate the ?lactamase genes in Escherichia coli and their resistance.METHODS Twenty strains of E.coli producing extended spectrum ?-lactamases(ESBLs) were isolated from hospitalized patients.?-Lactamase drug-resistant genes were detected by PCR.RESULTS There were higher positive rates of ?-lactamase genes of TEM,SHV,LEN,CTX-M-1,CTX-M-9,VEB,GES,PER(75.0%,20.0%,95.0%,15.0%,70.0%,5.0%,85.0% and 70.0%,respectively). This study showed that there were high positive rate of drug resistance.CONCLUSIONS There are very high positive percentages of TEM,LEN,CTX-M-9,GES,and PER genes in ESBLs producing E.coli isolated clinically,and showing highly drug-resistant E.coli of producing ESBLs can be transmitted in hospital and induce fulminant prevalence.

OBJECTIVE To investigate the plasmid AmpC genes,?-lactamases genes and intⅠgenes in Escherichia coli.METHODS M-H test was performed to detect the antimicrobial susceptibility of 40 strains of E.coli isolated from the clinic.?-Lactamases genes,plasmid AmpC genes and intⅠgenes were detected by PCR methods.RESULTS Forty strains of E.coli were multiple-drug-resistant.The positive rate of genes of TEM,SHV,LEN,CTX-M-1,CTX-M-9,VEB,GES and PER was 55.0%,7.5%,55.0%,12.5%,45.0%,5.0%,45.0% and 35.0%,respectively.The positive rate of plasmid AmpC genes of ACT-1 and DHA was 57.5% and 40.0%,respectively.The positive rate of intⅠgenes was 47.5%.CONCLUSIONS E.coli isolated from the clinic is multiple-drug-resistant and wityh high positive rate of the plasmid AmpC genes,?-lactamases genes and int Ⅰ genes.

Objective To investigate the injury mechanism, fracture characteristics, treatment strategy and prognosis of Pilon fracture without fibula fracture. Methods 28 cases of Pilon fracture without fibula fracture (29 fractures) treated in our hos?pital were adapted from January 2009 to December 2014. 22 cases were male, 6 were female, aged 46 years old (23-75). Cause of injury:tumble in 14 cases, fall from high place in 8 cases, traffic accident in 5 cases, bruise in 1 case. 10 cases had associated in?juries, and 2 cases were open injuries. The OA/ATO fracture type, Rüedi&Allgower fracture type, and characteristics of fractures were summarized. The appropriate treatments were selected, and the operative method, operative time, surgical approach, fixation, fracture healing time, ankle Mazur score, Burwell?Charnley reduction score and postoperative complications were recorded. Re?sults On the mechanism of injury, 28 cases mostly had a median?low energy injury mechanism with little open injuries. On the fracture characteristics, there was a 96.6%anterior distal tibia articular fracture involved with no other specific fracture character?istics occurred. The treatment of the fracture mostly received a single operative approach to complete open reduction and internal fixation operation. The average operation time was 119 minutes, the average fracture healing time was 7.1 months, the excellent and good rate of ankle Mazur score was 86.2%and the satisfactory rate of Burwell?Charnley fracture reduction score was 93.1%. Skin infections occurred in 3 patients after operation. After effective antibiotic and correct clinical treatment, the incisions got healed in these 3 patients. Conclusion Pilon fracture with intact fibula mostly is caused by median to low energy injury when an?kle at neutral or varus position, most with anterior distal tibia articular fracture by foot dorsal flexion. Generally use a single anteri?or approach can complete open reduction and internal fixation operation with satisfactory clinical treatment. This kind of fracture could achieve good reduction, good bone healing, good function and little complications after correct treatment.

Objective To investigate the value of external fixator in the treatment of posttraumatic elbow stiffness.Methods From January 2007 to December 2009,25 patients with posttraumatic elbow stiffness received surgical arthrolysis with assistance of external fixator.There were 10 patients with grade 1 stiffness,12 patients with grade 2 stiffness and three patients with grade 3 stiffness.The range of motion (ROM) was 0°-75° ( average 33.4°) preoperative,with ＜ 30° in 12 patients.For the patients with grade 1 stiffness,intraoperative distraction with an external fixator rather than open arthrolysis was performed ; for the patients with grade 2 stiffness,the heterotopic ossification was removed through a limited approach before the external fixator was applied; for the patients with grade 3 stiffness,additional osteotomy and internal fixation before arthrolysis were performed.After operation,there was a rehabilitation phase,followed by mobilization of the elbow joint under protection of the external fixator for a mean period of six weeks.Results The intraoperative mean ROM was 105.6°,which was significantly improved than that before operation (P ＜0.05).The maximal flexion degree was above 110°in all patients.No instability occurred.Two patients were excluded from the follow-up:one had ulna fracture two weeks after operation due to an incorrect placement of the pin,and additional internal fixation was then carried out;another patient had numbness in the ulna side when flexed the elbow after arthrolysis,and the ulna nerve transposition was performed through another operation.Other patients were followed up for a mean period of six months.At the latest follow-up,the mean ROM was 97.4°( range,70°-130°),significantly improved than that before operation (P ＜ 0.05 ),and lest 8.2°on average (0°-15 °) compared with the intraoperative ROM (P ＞ O.05).The maximal flexion in all patients was above 100° Conclusion With the advantages of minimal invasive or noninvasive,indirect capsular traction,stability maintenance during the movement,and prevention of the motion loss during the rehabilitation,arthrolysis of the elbow joint with the use of external fixation frame can be a good alternative in the treatment of posttraumatic elbow stiffness.

[Objective]To investigate the micro-structural alterations within whole brain white matter(WM) in cough syrup abuse addiction patients containing codeine,and to explore the correlation between aberrant WH and abuse time of cough medicine abuse patients.[Methods]Thirty cough syrup abuse addiction patients containing codeine and 30 controls participated in the study. Structural changes in FA and(mean diffusivity)MD were examined in cough syrup abuse addiction patients containing codeine which derived from DTI tractography. Pearson correlation analysis was performed to compare the mean FA value and duration of cough syrup abuse addiction in patients.[Results]Cough syrup abuse addiction patients containing codeine had lower FA value in bilateral anterior limb of internal capsule(ALIC)and higher MD in the bilateral hippocampus and insula,right anterior cingulate cortex(ACC)and superior temporal gyrus,compared to the controls. Cough syrup abuse addiction group also had positive correlation between mean FAvalues and duration of cough syrup abuse addiction in patients.[Conclusion]Micro-structural alterations within whole brain white matter(WM)are found in cough syrup abuse addiction patients containing codeine. This disturbance progresses as duration increases of cough syrup abuse addiction in patients.