Objective To explore the value and criteria for primary tumor resection in patients with stage Ⅳ rectal cancer. Methods The clinical data were retrospectively analyzed for 53 patients with stage Ⅳ rectal cancer undergoing primary tumor resection. Results All patients were graded according to Eastern Cooperative Oncology Group (ECOG) performance as status 1. Seventeen of 53 patients (32%) received palliative resection. Thirty-six patients received adjuvant radiotherapy and/or chemotherapy. The median follow-up was 14 months. Forty-seven patients had complete resolution of their symptoms related to the primary rectal cancer for a year. The median survival was 16 months and 2-year overall survival of 24.5%. On multivariate analysis, chemotherapy was a determinant of prolonged survival (P=0.046). Conclusions Resection of primary tumor in patients with stage Ⅳ rectal cancer can improve the quality of life. Patients who have a good performance status, minimal metastatic disease and normal preoperative liver function tests should undergo resective surgery and aggresive systemic chemotherapy.

OBJECTIVE To analyze and compare the value of c-reactive protein(CRP) and body temperature in the infection diagnosis and severity of infection among the patients with malignant hematological disease.METHODS According to the microorganism detection and application of antibiotics,we divided the 119 patients into infection group and noninfection group from May 2004 to May 2005 in our ward.CRP and temperature of the patients were measured and.RESULTS There were 88 cases in the infection group and 31 cases in the noninfection group.The CRP plasma concentration had significant difference between too groups(P

A gap is found between the existing quality of care,and social expectations and the PDCA model.Peking University People's Hospital applied the quality control circle in building a supervision platform for medical quality and sustained improvement of civilized services.This study demonstrated the efforts in this regard made by the hospital,and the major outcomes of the platform in its 6-year practice in identifying service defects,optimizing service processes and sustained improvement of medical services.In addition,it also shared insights on enhanced real-time supervision,standardized management,and long-term mechanisms of the hospital.

Objective To construct eukaryotic expression vector encoding rat IMD gene and deliver it into rat renal tissue via ultrasound-mircobubbles. Methods IMD gene was inserted into pCDNA3.1 ( + )between Hind Ⅲ and EcoRI enzyme sites. The recombinant plasmid designated as IMD-pCDNA 3.1 wasconfirmed by restrictive enzyme digestion and sequencing. Eighteen male Wistar rats were randomized into 3groups, which were treated with no transfection, empty vector transfection and IMD transfection, respectively, in renal tissue via ultrasound-microbubbles. RT-PCR and Western blotting were applied to detect the expression level of IMD. Results Enzyme- digestion and sequencing data showed that IMD-pCDNA 3.1 was correctly constructed. The differences in ALT, AST, BUN and SCr were not significant; No obvious damage in the glomerular, tubular and interstitial was observed in all the treated groups;Compared with non-transfection group and empty vector-transfection group, IMD mRNA and protein expression in IMD transgenic renal tissue were significantly increased. Conclusion IMD-pCDNA 3.1 expression vector was successfully constructed and well expressed in rat kidney.

Objective To know the establishment of the flap pedicle blood supply and the right moment of the cutting off of pedicle by means of laser Doppler blood perfusion imaging instrument on the random flap blood flow changes.Methods 20 adult healthy rabbits were divided in to four groups and each 5 have unilateral flaps.1,3,5,7,9,12,14,18 days after operation,the pedicle blood perfusion values (PU) measurement of the distal pedicle on the flap and midpoint of both ends of the pedicle were performed,and PU values were analyzed.Results Pedicle of the PU values at the different time points changed little (P＞0.05).The PU value in the distal flap reached the minimum 1 day after operation and then increased gradually [3 d (1.24±0.07),5 d (1.57±0.15),7 d (1.79±0.08),9 d(1.89±0.13),12 d(2.01±0.16),14 d(2.18±0.09) and 18 d(2.40±0.18),P＜0.05].When distal PU values/pedicle PU value≥1.2,the flap survival rate reached 99%.Conclusions The establishment of random skin flap blood circulation,as well as the ratio of PU values of distal to the pedicle flap pedicle can be used as the timing of an important indicators.

Objective To investigate the expressions of intermedin /adrenomeduliin 2 (IMD/AM2) and its receptor calcitonin receptor-like receptor (CRLR) in the kidney of rats after renal ischemia reperfusion injury(IRI). Methods Male Wistar rats were divided randomly into two groups: sham group and operation group. Renal IRI model was induced by clamping both renal arteries. Blood and kidney were harversted at 0 h, 6 h, 12 h, 24 h, 48 h, 72 h after reperfusion, respectively. Renal histological changes were semi-quantitated. Expressions of IMD and CRLR in the kidney were detected by Western blot, and the content of IMD in serum was measured by radioimmunity at 12 h, 48 h, 72 h after repeffusion. Results Kidneys of renal IRI model rats displayed significant pathologic changes, and the changes were much severer at 48 h after reperfusion. The expressions of IMD and CRLR in kidney were significantly up-regnlated at 12 h, 48 h, 72 h after renal IRI (P<0.01). The level of IMD in serum increased at 12 h, 48 h, 72 h after renal IRI (P<0.05). Conclusion The expressions of IMD and its receptor are up-regulated in the kidney after renal IRI, which may participate in the pathophysiological changes induced by renal IRI.

BACKGROUND: Random flap as a primary means of wound healing, is widely used at present, its blood circulation to establish the situation is also researched a lot, but not yet the system of random skin flap perfusion were observed and measured. In addition, the timing of pedicle division of a pedicle flap random is also a hot topic, but not yet a mature clinical testing method has been discovered to determine the best timing.OBJECTIVE: By means of laser Doppler blood perfusion imaging, this study was designed to dynamically observe random flap microcirculation, to understand the changes on random flap blood flow, and to determine the best timing of pedicle division. METHODS: A total of 18 cases were divided into traditional pedicle division group and early pedicle division group. Pedicle flap blood perfusion values were statistically measured immediately after surgery, at 3, 7,11,15, and 19 days after surgery, before division, immediately after division, and at 24 hours after pedicle division, 8-9 phases in total.RESULTS AND CONCLUSION: Distal blood perfusion value was increased with the time prolongation in both groups; while, the blood perfusion in various time phases was significantly different from that after surgery (P < 0.05); but, the blood perfusion was decreased immediately after surgery, which was still significantly compared with traditional pedicle division group (P< 0.05). There was no significant different in blood perfusion between early pedicle division and immediate after surgery of pedicle division (P > 0.05), but there was significant difference between 24 hours after pedicle division and immediate after surgery of pedicle division (P< 0.05). Blood perfusion values were less changed in both groups (P> 0.05). The ratio of both groups peaked before pedicle division and then gradually decreased after pedicle division. The best timing of pedicle division was the ratio of 1.2.

BACKGROUND: Pentoxifylline (PTX), as an effective drug to improve blood rheology, has been used as a vasodilator for the treatment of vascular diseases and peripheral vascular disease science 1960s. But the role of PTX on skin blood flow to improve flap survival remains still unclear. OBJECTIVE: Through the clinical application of PTX therapy, the dynamic observation of random flap to understand that the PTX can promote flap survival and improve blood circulation of flap. METHODS: A total of 39 patients (27 males and 12 females aging 7-54 years) with skin tissue defect undergoing random flap repairing were selected from Department of Burn and Plastic Surgery, First Hospital of Hebei Medical University. The 39 cases were randomly divided into control group and drug group. Patients in the drug group were given intravenous injection of 250 mL PTX at day 2 after random flap operation, once a day, until 14 days after flap repairing surgery. On the first day after flap pedicle surgery, 250 mL PTX sodium chloride injection was intravenously given, once a day, until 7 days after flap pedicle surgery. The control group was not given PTX treatment. The value of blood perfusion (PU) was measured using laser-Doppler blood reperfusion image after flap transplantation, before and after pedicle division. RESULTS AND CONCLUSION: All 39 patients were completely cured and discharged, with no interruption experiments. Before pedicle division, PU value at distal flap in both drug and control groups were increased obviously, and the PU value in the drug group was significantly higher than control group (P < 0.05); after pedicle division, the PU value in the two groups were decreased, and there was no significant difference between the two groups (P > 0.05). Prior to pedicle division, the PU value of pedicle was gradually decreased and then increased in the drug group, and that in the control group was gradually increased. On the seventh day, the PU value of pedicle was stable in the drug group, and there was no significant difference between the two groups (P> 0.05); after pedicle division immediately, the PU values of pedicle were decreased in the two groups, and then the increase in the drug group was remarkable compared to control group (P < 0.05). Two sets of random flaps all survived, and skin defects were successfully repaired after pedicle division. PTX can markedly increase blood perfusion after random flap transplantation, promote flap survival and pedicle division in an early stage, and effectively shorten the healing time.

Objective To analysis the effect of Longdanxiegan capsule on serum sVCAM-1, immune globulin and SOD level in patients with sudden deafness and tinnitus.Methods 48 patients who were diagnosed with sudden deafness and tinnitus were collected.All patients were randomly divided into experimental group and control group,24 cases in each group.Patients in the control group received conventional western medicine treatment, patients in the experimental group were given Erlongzuoci pill on the basis of control group treatment , after the treatment, the serum levels of sVCAM-1, IgG, IgA, IgM and SOD were detected in all patients.Results After treatment, compared with control group, the serum levels of sVCAM-1 was lower in the experimental group,and the difference was statistically significant(P<0.05);the serum IgG, IgA and IgM levels were lower in the experimental group (P<0.05); the serum SOD level was higher in the experimental group (P<0.05).Conclusion The Longdanxiegan capsule can reduce significantly the serum sVCAM-1, IgG, IgA and IgM levels, improve serum SOD level in patients with sudden deafness and tinnitus, improve immune function and the ability to remove free radicals , and have a guiding significance for clinica .