Objective; To evaluate the role of total mesorectal excision in radical resection of rectal carcinoma. Methods:The data of 538 consecutive patients with middle and lower rectal cancer were analyzed retrospectively. These patients were treated with total mesorectal excision between January 1997 and March 2004. Results;All 538 patients had middle or lower rectal cancer, 322 male, and 216 female. No patients died perioperatively and presented presacral hemorrhea. A total of 420 patients were treated by anterior rectal resection; 118 patients had to undergo abdomino - perineal resection. 403 patients were followed - up (12-60 months). The rate of local recurrence was 4.5%. 1 year and 5 - year survival rates after curative resection were 90. 3% and 65. 8% respectively. Conclusion; In our experience, with TME technique, the postoperative mortality and complication would not be increased. The anus - saving rate is increased and the patients'living quality is improved. These findings recommend TME as gold standard procedure for middle and lower rectal cancer.

Three kinds of enzymes,pepsin,trypsin and catalase,were selected to research the effects and mechanisms of ultrasound on protein,taking advantage of the change of their biological activity under sonication as the index.The results indicate that the three kinds of enzymes display different modes and degrees of activity change under sonication.In addition,the effects of ultrasound on the enzymes vary with their concentration,which means that the destruction of ultrasound to enzyme could be reduced by adjusting their concentration.Mannitol,a strong free radical scavenger,and Tween-80,a kind of non-ionic surfactant,could protect the activity of the enzymes during sonication.That implies that free radicals,which are produced through the thermal dissociation of water induced by ultrasound cavitation,and the cavitation bubbles,which could disturb the hydrophobic environment around the enzyme molecules,play important roles during the destruction of sonication to enzymes.However,for different enzyme,different factor play the main role.

Objective To study the effect of edaravone on serum IL-6、TNF-α and neurologic functional in acute cerebral hemorrhage,discuss the protective mechanism of Edaravone on cerebral hemorrhage.Methods 80 casesof cerebral hemorrhage in 72h were randomly divided into treatment group(40 cases)and control group(40 cases),and the control group was given routine treatment,and the treatment group was administered with edaravone,30mg/d,for 14 days on the based treatment of the control group.The serum IL-6 and TNF-αwere detcted by ELISA before therapy and after treatment for 14 days.Neurological function deficit scores were utilized for assessment before given treatment.On the 21 th day after treatment,the patients were assessed again,and the efficacy was recorded.Results After 14 days treatment.the mean scale of NIHSS,the serum levels of IL-6 and TNF-α in treatment group were more obviously decreased than that in control group(all P＜0.05).Conclusion Edaravone could obviously alleviate inflammatory reaction on acute cerebral hemorrhage,which could effectively remove the generous free radicals and reduce the brain edema after intracerebral hemorrhage.So it could protect the tissue of brain.

Ultra-wide-field fluorescein angiography (UWFA) is a novel breakthrough in ocular fundus imaging technology, which can capture a single, high-resolution, 200° wide image of the ocular fundus that traditional fluorescein angiography cannot reach. This technology has important impacts on the screening, diagnosis, staging, treatment and follow-up of vascular diseases involving peripheral retina (such as diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, uveitis and so on).

Objective Explore the species of pathogenic microorganism and analysis the antibiotic resistance in Emergency department patients in West China Hospital, finding out the evidence for clinical therapy. Methods Select the patients from May 2013 to April 2015 in Emergency department, analyses the species of pathogenic microorganism and the result of drug sensitivity test.Results In the 1 622 cases, there are 1 237 cases of gram-negative bacilli, 324 cases of gram positive coccus, 60 cases of fungus and 1cases of gram-negative coccus, accounted for 76.3%, 19.9%, 3.7%and 0.1%respectively.The top five is E.coli, acinetobacter baumannⅡ, klebsiella pneumoniae, pseudomonas aeruginosa and staphylococcus aureus, accounted for 21.4%, 16.7%, 12.4%, 11.5% and 6.5%; according to the sample species, the detection rate of sputum is highest, accounted for 46.6%, next is blood, urine, secretion; in regard to multiple resistant bacteria, detection rate of ESBL-E.coil, ESBL-KPN , CRAB and MRSA is 62.0% , 26.0%, 80.5% and 26.5%; the detection rate of VREF is 9.4% and does not find Vancomycin resistant enterococcus bacteria. Conclusions The species of pathogenic microorganism in emergency department is rich, especially gram-negative bacilli as E.coli, acinetobacter baumannⅡ, and the drug resistance situation is not optimistic. Emergency department shall communicate with microbiology laboratory timely, pay attention to the situation of the species and the drug resistance result, take rational use of antibiotic according to the results of the analysis of drug resistance.

Objective To investigate the efficacy of bundle care under the supervision of professionals in preven-ting ventilator-associated pneumonia(VAP). Methods Patients who received mechanical ventilation between July 2013 and June 2014 in the intensive care unit(ICU)of a hospital were selected,July-December 2013 was as control group (n= 150),patients received bundle care,but without special supervision;January-June 2014 was as special supervision group (n= 177),patients received bundle care under the supervision of professionals,incidence of VAP,duration of mechanical ventilation,and length of ICU stay were compared between two groups. Results In special supervision group,141 patients received invasive mechanical ventilation,mechanical ventilation day were 1937 days,9 patients developed VAP,incidence of VAP was 4.65‰ ;in control group,127 patients received inva-sive mechanical ventilation,mechanical ventilation day were 1965 days,21 patients developed VAP,incidence of VAP was 10.69‰ ,difference was statistically significant between two groups(χ2= 5.68,P= 0.042). In special su-pervision group,overall compliance rate of bundle management strategies,duration of average invasive mechanical ventilation,and length of ICU stay were 94.92% ,(11.11±2.57)days,and(15.11±2.88)days respectively,in con-trol group were 48.67% ,(14.67±4.35)days,and(19.33±5.81)days respectively,difference was statistically sig-nificant between two groups (all P<0.05). Conclusion Bundle care strategies supervised by professionals can ef-fectively prevent the occurrence of VAP,the implementation of bundle care strategies should be set up according to the clinical practice.

Histone deacetylases inhibitors(HDACIs)are a group of compound regulating gene expression at transcriptional level.HDACIs can induce protein hyperacetylation and subsequently lead to chromatin remodeling,cell-cycle arrest,cell differentiation and apoptosis,and transcriptional activation and repression.HDACIs demonstrate promising antitumor activity and are presently tested in clinical studies for solid and hematologic malignancies.Cumulating evidence in animal models of immune disorders also suggests immunosuppressive properties of HDACIs,which provides us with new ideas for treating immune disorders and rejection after transplantation.This paper reviews the recent progress of immunosuppressive function induced by HDACIs from the following aspects:immune diseases,T lymphocytes,inflammatory cytokines and dendritic cells.

MTH1 enzyme belongs to the family of Nudix hydro-lases, which can prevent the oxidative damage of nucleic acid by cleaning up oxidized purine nucleotides .Close relationships were found between the activity of MTH 1 and neurodegenerative dis-eases, anti-aging et al.In recent years, MTH1 has been regar-ded as a new promising target for cancer treatment , because it plays an essential role in tumor growth , survival , invasion and metastasis.The transcription and translation , structure, catalyt-ic mechanism, detection and application of MTH1 were de-scribed, as well as various MTH1 inhibitors.

Objective To discuss the mechanism of growth hormone (GH) in infection and its safety. Methods Advances in the application of GH in infection of recent years were reviewed. Results In infectious patients, GH may promote protein synthesis, strengthen the immunity of body, and protect the integrity of intestinal barrier function. But some patients present GH resistance. The safety of GH for infectious patients needs further evaluation. Conclusion GH may play a supplementary role in infection therapy, but further research is needed.

Objective To investigate the clinical characteristics and related factors of metabolic disorder in acute cerebrevascular disease (ACVD) and to provide clinical basis for intervention of ACVD.Methods The clinical data of 202 healthy individuals (control group) and 621 cases of ACVD (341patients with cerebral infarction and 280 patients with cerebral hemorrhage) was analysed retrospectively.Based on the level of blood pressure,blood glucose and blood fat, 621 cases of ACVD were divided into me tabolism syndrome( MS ) group (hypertension + hyperglycemia + hyperlipidemia),two kinds of risk fatorsgroup (hypertension + hyperglycemia or hypertension + hyperlipidemia or hyperglycemia + hyperlipidemia),one kind of risk factor group (hypertension or hyperglycemia or hyperlipidemia) and no risk fastor group.Results Of the patients with cerebral infarction and cerebral hemorrhage 320 eases(93.8%) and 259 cases (92.5%) had hypertention,163 cases (47.8%) and 101 cases (36.1%) had hyperglycemia, 115 cases (33.7%) and 141 cases (50.4%) had hyperlipidemia, respectively. The blood pressure in one kind of risk factor group, two kinds of risk factors group and MS group was significantly higher than those in control group and no risk factor group,the body mass index (BMI), fasting plasma glucose (FPG),total cholesterol(TG)and low density lipoprotein cholesterol (LDL-C) in two kinds of risk factors group were higher than those in control group and no risk factor group (P <0.05). The age,BMI,blood pressure,FPG,TC,TG,high density lipoprotein cholesterol(HDL-C) and LDL-C had obvious correlation with ACVD. Conclusion ACVD is often combined with various kinds of metabolic disorders risk factors, suggesting that an effective control of metabolic disorders is benefit to intervention of ACVD.