Objective To investigate the association between the positive rate of circulating tumor cells (CTC) and clinicopathological parameters, recurrence and metastasis in patients with colorectal cancer. Methods 7.5 ml peripheral blood of 138 cases of newly diagnosed colorectal cancer who met inclusion criteria, 82 post-operative cases of colorectal cancer and 34 healthy controls were collected. The CTC was enriched by beads which packaged the anti epithelial cell adhesion molecule and counting the CTC (CK+ DAPI+ CD45-). To investigate the association between the preoperative positive rate of CTC and clinicopathological parameters, and the relationship between the positive rate of CTC and recurrence and metastasis in post-operative colorectal cancer patients who have not accepted any therapy more than one month. Results The positive rate of CTC in patients with colorectal cancer and healthy controls were 47.1%(65/138), and 0 (0/34) respectively, and the difference was statistically significant (χ2= 25.743, P< 0.001). No association between CTC positive rate and age, gender, primary tumor site, T staging, platelets, cancer embolus, NK cells, regulatory T cell was observed (all P> 0.05); The significant association between the positive rate of CTC and N or M staging was found. CTC positive rates in N0, N1, N2 stage were 38.3 %(23/60), 37.9 % (11/29), and 63.9 % (23/36) respectively (χ2= 6.819, P= 0.033); CTCs positive rates of M0, M1 stage were 38 . 0 % ( 38/100 ) and 71 . 1 % ( 27/38 ) respectively , and there was a statistical difference (χ2= 12.074, P= 0.001). In 82 post-operative cases of colorectal cancer, the positive rates of CTC were 51.6 % (32/62) and 90.0 % (18/20) in non-recurrence and recurrence, respectively, and the difference was statistically significant (χ2=9.365, P=0.002). Conclusion CTC detection may assess the occurrence of metastasis and recurrence in colorectal cancer patients.

Objective To evaluate the effect of age on pharmacodynamics of eisatracurium target-controlled infusion(TCI). Methods Forty patients under N_2O-O_2-propofol-fentanyl anesthesia were divided into groups of Ⅰ and Ⅱ with 20 cases each. Under TOF stimulation monitoring, eisatracurium 0. 15 mg/kg was injected and tracheal intubation was performed when TOFr being zero. and the intubation conditions were evaluated. When T1 restored to 50% cisatracurium TCI started to keep TOFr less than 10%. The recovery times of neuromuscular blockade were recorded after stopping infusion. The amount of cisatracurium consumption was calculated. Results Intubation conditions the onset time and recovery index were not significantly different between two groups. The nonresponse period, duration of action, and recovery time were longer in group Ⅰ than those in group B. Cisatracurium consumption was more in group Ⅰ than that in group Ⅱ (P<0.05). Conclusion By TCI,cisatracurium dosage needed for keeping TOFr less than 10% is less,but the recovery process is still longer in the elderly than those in the younger.

Bacterial cellulose,as a new material,due to its unique nano-fiber mesh structure with good purity,physical and chemical properties such as mechanical strength and water holding capacity,biocompatibility and adaptability,has been widely used in medicine,food,paper,textile,acoustical materials and other industries.In medical field,especially,it has been rapidly developed in recent years.This review discusses the current bacterial cellulose and its performance optimization products which relates to the medical applications.

Objective:To describe antipsychotic medication prescription patterns and estimate the associated costs for patients with schizophrenia in Tianjin,China. Methods:Data were 30%random sampling from the Tianjin Urban Employee Basic Medical Insurance (UEBMI)database. Adult patients with≥ 1 diagnosis of schizophrenia, antipsychotics prescribed at the first diagnosis of schizophrenia (index date),and 12-month continuous enrollment after the first antipsychotic prescription (follow-up period)between 2008 and 2010 were included. The classes and number of antipsychotics patients prescribed at index date and patterns of antipsychotics patients maintained/changed during the study period were described. The total direct medical costs were also estimated. Results:Among 2125 patients with schizophrenia,1739 (81. 8%)prescribed with antipsychotic medication prescriptions were in-cluded. At the index date,1461 (84. 0%)of the patients prescribed with one antipsychotic medication,278 (16. 0%)with more than two antipsychotics,and 747 (43. 0%)were prescribed with first-generation antipsychot-ics,813 (46. 8%)with second-generation antipsychotics and 179 (10. 2%)with both. During the following 12 months,1387 (79. 8%)patients remained on the index antipsychotic class. The total cost for 1739 patients was (12498. 9 ±14575. 2)CNY. The total direct medical cost was significantly lower for patients only prescribed with second-generation antipsychotics compared with ones only with first-generation antipsychotics [(9064. 1 ±13209. 8) CNY vs. (1 1928. 6 ±13767. 4)CNY,P<0. 001 ]. In addition,the cost for patients prescribed with first-generation and second-generation antipsychotics was 18821. 8 ±15702. 7 CNY. Conclusion:Majority of patients are prescribed with monotherapy,and tend to stay with one antipsychotic medication class. The total medical cost for patients with second-generation antipsychotic medications is lower than first-generation ones.

BACKGROUND:Chitosan is a kind of biomaterial with good hemostatic, antibacterial and absorption properties. The guanidine modified chitosan holding better antibacterial and absorption abilities is a commonly used chemical separation material. However, its coagulation property is still unclear. OBJECTIVE:To evaluate the in vitro hemostatic property and cytotoxicity of the guanidine modified chitosan, and to explore its availability as a hemostatic material.METHODS:The guanidine modified chitosan was synthesized with the raw materials of chitosan and arginine, and the coupling agents of EDC and NHS. The coagulation ability was evaluated preliminarily through the whole blood coagulation time, and three in vitro coagulation indexes (activated partial thromboplastin time, prothrombin time and thrombin time). The guanidine modified chitosan extracts were co-cultured with the mouse fibroblasts, and then the cell growth was observed by MTT assay and fluorescence microscope. RESULTS AND CONCLUSION:The guanidine modified chitosan shortened the whole blood coagulation time, suggesting its hemostatic property. In vitro coagulation results indicated that the guanidine modified chitosan exerted the effect not through the traditional endogenous and extrinsic coagulation pathways. Guanidino group has not been proved to be hemostatic, so the chitosan may be the effective component. MTT assay showed that the cell proliferation rate was 87.8%and the toxicity level was grade 1. Fluorescent staining observed abundant live cells, and few dead cells, indicating that the guanidine modified chitosan exhibits low cytotoxicity.

Objective To evaluate the interference of 13 kinds of β‐lactam antibiotics in fructosamine detection .Methods A se‐ries of solution of antimicrobial drugs were formulated with water for injection ,and added into the mixture fresh serum volume by 5% .Interfere with antimicrobial drugs on the test results of fructosamine were evaluated .Results When the blood concentrations of cefathiamidine and ticarcillin sodium/clavulanate potassium were up to 37 .5 mg/L and 247 .5 μg/mL respectively ,they began to produce positive interference on fructosamine detection .However ,the degree of interference was not correlated to the serum concen‐tration of fructosamine .Conclusion Cephathiamidine and ticarcillin sodium/clavulanate potassium have positive interference on fructosamine detection .

Objective To observe the distribution of aerobic bacteria in conjunctival sac of patients with proliferative diabetic retinopathy and the sensitive antimicrobial agents in order to master the distribution of bacteria in the conjunctival sac and select sensitive antibiotics to decrease the infection rate and improve the therapeutic effect. Methods From March 2013 to August 2016, 248 patients with proliferative diabetic retinopathy were treated with aerobic bacterial culture and antibiotic susceptibility test. The distribution characteristics of aerobic bacteria in conjunctival sac and the sensitivity of antibiotics were observed. Results There were 112 strains in this study, the positive rate was 45.16% (including 8 cases of mixed infection), including 104 strains of gram-positive bacteria, 92.86% of gram-negative bacteria and 7.14% of gram-negative bacteria, the difference was statistically significant differences (P<0.05). Among them, the positive rate of staphylococcus epidermidis higher than other types of strains, the difference were all significant differences (P all<0.05). The sensitivity of vancomycin to gram-positive bacteria 100% was higher than that of, ofloxacin 13.46%,ciprofloxacin 21.15%,gentamicin 69.23% and rifampicin 88.46%, (P all<0.05). The sensitivity of gentamicin to gram-negative bacteria 87.50% was higher than that of rifampicin 0 and vancomycin 12.50%, (P all<0.05). Positive rate of culture results and staphylococcal multidrug resistance rate were 72.94%,31.76%, the incidence of >65 years of age were higher than ≤ 65 years old 30.67%,12.27%, male 51.61%,23.12% than female 25.81%,6.45%, there are basic diseases 69.15%,31.91% were higher than those without underlying diseases30.54%,11.04%, (P<0.05). Staphylococcus number composition ratio, the difference was not statistically significant. Conclusion To strengthen the observation of aerobic bacteria and the sensitivity of commonly used antimicrobial agents in patients with proliferative diabetic retinopathy, especially the high risk population, it is helpful to master the distribution characteristics of bacterial conjunctival sac and sensitive antimicrobial agents, so as to achieve the preoperative conjunctival sac Bacteria and reduce the rate of infection and other purposes.

Ojective To evalute the efficacy of the procedure for prolapse and hemorrhoids (PPH) in the treatment of patients with severe hemorrhoids (grade Ⅲ～Ⅳ?) Methods 60 cases of hemorrhoids at the third or fourth degree were operated on by PPH. Results The mean operation time was 9 minutes and mean hospitalization time was 2.5 days. Postoperative bleeding was noted in 8 cases (13.3%) at the 1 st and 7 th day after operation, which was cured by conservative methods. 24 patients had no annal spasm following the procedure. Follow-up period lasting for 1-7 months showed no complications Conclusions PPH is a safe and effective treatment for hemorrhoids at the third or fourth degree with the advantages of shorter hsopitaliztion time and quicker recovery.

Normal lung tissues are inevitably exposed to X-ray in thoracic radiotherapy,causing radiation-induced lung injury (RILI).The main pathological manifestations include the accumulation of inflammatory cells,release of cytokines,accumulation and proliferation of fibroblasts,and excessive deposition of alveolar interstitial collagen in the irradiated region.RILI severely affects the treatment compliance and quality of life and even threatens the life in the patients receiving radiotherapy.In recent years,numerous studies have found that Th1/Th2 imbalance is closely associated with the development and progression of RILI,and the cytokine network plays an executive role in the progression of RILI.Therefore,restoring the Th1/Th2 balance in vivo may provide a new way to prevent and treat RILI.

Objective To identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on patients'long-term prognosis.Methods Chnical data were analyzed from 720 patients who underwent low anterior resection(LAR) for rectal cancer between 1996 and 2006.Results Anastomotic leakage after anterior resection occurred in 44 cases(6.1%).The median time of anastomotic leakage after operation was 5.6 days.Muhivariate analysis showed male patients.history of preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were independent risk factors predisposing anastomosis leakage (P<0.05).Tumor local recurrence rate was 13.6% in patients suffering from leakage and 5.9% for those without leakage (χ2= 4.116,P<0.05).The distant metastasis rates were 25.0 and 14.1 percent for the leakage and noaleakage groups,respectively(χ2=3.943,P<0.05).The survival rates were 56.8 and 72.5 percent in the leakage and nonleakage groups,respectively(χ2=4.979,P<0.05).Conclusion Sex,preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were found to be independent risk factors for anastomotic leakage after rectal cancer surgery.Anastomotic leakage was associated with poor prognosis.