Adenocarcinoma ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; epidemiology ; Rectal Neoplasms ; pathology ; surgery ; Treatment Outcome

Objective To point out the weak link of general medical education and explore the training mode and evaluation mechanism for communication. Methods Totally 100 general practi-tioners from four Shanghai hospitals took a questionnaire survey to know the present situation and the training needs of doctor-patient communication skills. Results Among all the subjects, there were 73%who thought strengthening the doctor communication ability was the key to improving the doctor-patient relationship, 71%who chose doctor-patient communication practice course as the training con-tent, 78%who tended to personalized analysis and guide, 57%who accepted experienced GP in class. Conclusion For GPS communication skills training requirements, curriculum integration, clinical practice teaching should be strengthened to set up the corresponding training evaluation system.

Objectives To analyze comparatively the adverse reactions of Nedaplatin(NDP)and Cisplatin(DDP)in concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma and summarize the nursing points as well.Methods From March 2012 to March 2013,112 patients with locally advanced nasopharyngeal carcinoma were randomly divided into NDP group and DDP group.Besides intensity modulated radiotherapy for both groups,NDP group were treated with intravenous drop infusion of NDP by 100 mg/m2 and the control group with intravenous drop infusion of DDP by 100 mg/m2 both for three courses of once every three weeks (e.g.day one,day 22 and day 43 during the course).The two groups were compared in terms of therapeutic effects and incidences of adverse reactions.Results The complete remission rates of the NDP group and DDP group were 87.5%and 85.7%,respectively (P>0.05).The incidences of adverse reactions like gastrointestinal reactions and radioactive mucositis in the NDP group were significantly lower than those in the DDP group(P<0.05)and the index of platelet decrease was significantly higher(P<0.05).There were no significant differences between the two groups in terms of liver and kidney dysfunction and white blood cells decrease(P>0.05). Conclusions Chemotherapy with NDP combined with radiotherapy for locally advanced nasopharyngeal carcinoma has fewer adverse effects and is easy to be accepted by patients so that their quality of life can be improved.In the application of the two kinds of chemotherapy,we should pay attention to the adverse reactions on patients in order to give pertinent care.

Objective To investigate the prevalence of pulmonary acariasis among the employees working on traditional Chinese medicinal materials and observe the effect of treatment. Methods History inquiry, detection of mites in sputum, blood examination for eosinophils and specific antibodies, x-ray chest film were carried out for 327 workers involving in traditional Chinese medicinal materials. Mites were found in sputum in 121 persons who were then treated with metronidazole, twice a day with a daily dosage of 0.8g for seven days as a course of treatment. Two courses were conducted with an interval of 7-10 day. Prevalence and morbidity in different groups of occupation, age, and sex were analyzed. Results The overall infection rate of mites in sputum was 37.0% (121/327) with an average morbidity of 12.5% (41/327). Among the four types of worker investigated, the highest infection rate (51.8%), and morbidity (18.6%) were in those working in transfer warehouse; the second highest infection rate (40.7%) and morbidity (15.7%) were in employees in factory of Chinese traditional medicine. Both groups showed a significant difference with others(?2inf=11.36,P0.05). After treatment with metronidazole, 88.4% showed negative in sputum examination for mites and the efficacy of the treatment for pulmonary acariasis was 92.3%. Conclusions Employees engaged in traditional Chinese medicinal materials are one of the groups at the highest risk of pulmonary acariasis. Metronidazole is effective in treating the infection.

The QCC campaign at the emergency center was themed as minimizing incidence of risky transport of critically ill patients,which aimed at continued quality improvement by means of conditions review,problem analysis,measures making,and procedure improvement.The incidence of risky transports dropped from 26％ to 0.9％ in six months.Another promising outcome was a sharp betterment of clinical nurse management. It has proved that QCC can effectively downsize risky transports of critically ill patients,making it a functional means to improve nursing quality.

ObjectiveTo explore the clinical manifestations of infant cytomegalovirus infection in different age. MethodThe clinical data of 237 infants who suffered from cytomegalovirus infection was analyzed retrospectively and divided into three groups: 0-3 months old (77 cases,group A) ,4-6 months old ( 65 cases , group B ) , 7-12 months old ( 95 cases , group C ). ResultsThe incidence of respiratory infection was the highest among all infectious organs in three groups, the numbers of patients who had wheeze in group A was less than that in the other two groups[24.7％(19/77) vs. 61.5％ (40/65), 61.1％( 58/95 )](P ＜ 0.01 ).The incidence of jaundice decreased gradually as the babies grew up[23.4％( 18/77 )→7.7％(5/65 )→1.1％( 1/95 )](P ＜ 0.05). There was no significant difference in diarrhoea and bleeding among three groups (P＞0.05 ). The proportion of alanine aminotransferase], aspartate amino transferase increasing was similar among three groups, but gamma-glutamyl transferase (GGT) was different, the proportion of GGT increasing was 77.9％ (60/77) in group A which was higher than that in the other two groups[10.8％ ( 7/65 ), 2.1％ ( 2/95 )].Granulocytopenia in group B was obviously decreased compared with the other two groups (P ＜ 0.05 ), anemia was easily occurred in group C (P ＜ 0.05 ). ConclusionThe injury of cytomegalovirus infection may be related to month old.

Objective To investigate the frequency of micresatellite instability (MSI) and loss of heterozygosity (LOH) and select sensitive loci for studying microsatellite DNA imbalance in thymic squamous cell carcinoma. Methods 5 microsat-ellitc polymorphism markers and extrated DNA were selected from 9 specmiens of paired thymie squamous cell carcinoma/nor-real tissues. MSI and LOH in the specmiens of thymic carcinoma and relevant pericancerou tissues were detected by polymerase chain reaction (PCR) followed by 6% polyacrylamide gel electrophoresis(PAGE) with silver staining. Results MSI or LOH was detected in 9 thymic carcinoma tissues. The frequency of MSI or LOH was 66.7% (6/9) at loci of D6S1708, 33.3% (3/9) at TP53, 33.3% (3/9)at DM, 33.3% (3/9)at D11S988 and 0% (0/9)at D8S136, LOH at D6S1708 (5/6) was a common genetic alteration. DI1S988 had only LOH alteration. Conclusion D6S1708, TP53, DM, and D11S988 are sensi-tive loci for studying microsatellite DNA imbalance in thymic squamous cell carcinoma. Microsatellite DNA imbalance may play a certain role in occurrence and development of thymic squamous cell carcinoma, and the relationship between MSi or LOH.The linicopathological features of thymic squamous cell carcinoma needs further investigation.

AIM: To evaluate the efficacy and safety of orbital decompression in the treatment of Graves ophthalmopathy. ·METHODS: Totally 55 patients 77 eyes with Graves eye disease were selected in our hospital from February 2011 to February 2016. All eyes underwent orbital decompression, the visual acuity, exophthalmos and complications of the patients were followed up for 6mo. · RESULTS: Postoperatively 6mo, the best corrected visual acuity were 0. 23±0. 09, which were better than that of preoperative 0. 46±0. 07(P<0. 05). Postoperatively 6mo, the degree of exophthalmos of the patients were 16. 20 ± 1. 99mm, which was significantly lower than that preoperative 20. 13±1. 87mm (P<0. 05). Postoperative CAS score was ≤3 points in 56 eyes ( 73%) , significantly increased compared with preoperative 15 eyes (19%), the difference was statistically significant (P<0. 05). There were 50 eyes ( 65%) with color vision disorder before operation;after operation, 42 eyes (55%) had significant improvement in visual impairment, and there was no change in the eye in 8 eyes (10%). Postoperatively 6mo, the average decreased degree of exophthalmos were 3. 87±1. 03mm;5 cases were found postoperative diplopia, new diplopia rate was 10%;followed up for 3mo, diplopia disappeared. ·CONCLUSION:Orbital decompression is an effective method for the treatment of Graves ophthalmopathy, but attention should be paid to postoperative complications such as diplopia.

Objective To determine if pregnancy affects the toxicity of bupivacaine and to investigate the effect of Shenfu injectio,a preparation of Chinese herbal medicine,on central nervous system and cardiac toxicity of bupivacaine in pregnant rats.Methods Twenty-four SD rats weighing 320-360 g were assigned to 3 groups(n =8 each):Ⅰ non-pregnant control group,Ⅱ pregnant control group and Ⅲ Shenfu injectio pretreatment group. The animals were anesthetized with isoflorane(2%-4%)-O_2 inhalation which was stopped before bupivacaine infusion was started.Femoral artery was canunlated for MAP monitoring and blood sampling and femoral vein was cannulated for bupivacaine infusion.MAP,HR and ECG were continuously monitored.All animals in the 3 groups received continuous infusion of 5% bupivacaine at 2 mg?kg~(-1).min~(-1).In group Ⅲ Shenfu injectio 10 ml?kg~(-1) was injected intraperitoneally(IP)30 min before bupivacaine infusion whereas in the two control groups(group Ⅰ and Ⅱ)equal volume of normal saline was injected IP instead of Shenfu injectio.The duration between the beginning of bupivacaine infusion and onset of convulsion/arrhythmia(QRS≥90 ms)/asystol was recorded and the amount of bupivacaine infused was calculated.Results There was no significant difference in the amount of bupivacaine causing convulsion and asystol between group Ⅰ and Ⅱ but the amount of bupivacaine causing arrhythmia was significantly larger in group Ⅰ(non-pregnant) than in group Ⅱ(pregnant control group)(P＜0.05).The amount of bupivacaine causing convulsion,arrhythmia and asystole was significantly larger in Shenfu injectio pretreatment group(group Ⅲ)than in pregnant control group(group Ⅱ)(P＜0.05 or 0.01).Conclusion Bupivacaine- induced cardiotoxicity is increased in pregnant rats and Shenfu injectio pretreatment can reduce the systemic toxicity of bupivacaine in pregnant rats.

Objective To obtain highly expressing cell lines by inserting the glutamine synthetase (GS) screening system and replacing the promoter of the vector.Methods The mutation of the point BamHⅠwas induced to build a new vector pIRES2-EGFP.The marker gene GS was inserted by AseⅠ and NheⅠ, and the promoter hCMV was replaced by PacⅠand NheⅠ.The new vector pHGS1.0 and the vector pIRES2-enhanced screen fluorescein protein( EGFP)-B were inserted by the recombinant protein TEM8 ( 1-227 )-VEGFR1 domain2-IgG2 ( TV-IgG2 ) gene to analyze the advantages of the expression.Results The glutamine synsthetase is successfully inserted, the human cytomegalovirus replaced, and recombinant protein is increased 5-fold by human immunoglobulin quantification kit.Conclusion The GS system is a highly protein expressing system.