0.05).Conclusion Trans anal local excision for rectal cancer might only be successfully performed in se lected patients(T_1～T_2N_0M_0,well moderately-differentiated carcinoma). Postoperation adjuant radiation therapy is the main points for T_2 patients to controll local recurrence.

Objective To observe the efifcacy and safety of XELOX plus bevacizumab as a ifrst-ine treatment for Chinese patients with metastatic colorectal cancer. Methods In this study, we retrospectively reviewed cases in which XELOX plus bevacizumab were administered in order to evaluate its efifcacy and safety in clinical practice.In total, 40 patients with mCRC who presented at Fuchu Hospital received XELOX plus bevacizumab as a ifrst?line treatment from September, 2009 to April, 2012. Eligible patients had histologically conifrmed mCRC. XELOX consisted of a 2-h intravenous infusion of oxaliplatin 130 mg/m 2 on day 1 plus oral capecitabine 1,000 mg/m 2 twice daily for two weeks of athree?week cycle. Overall survival (OS) and survival benefit were analyzed when patients continued with XELOX plus bevacizumab beyond disease progression. Results The median progression?free survival (PFS) was 290 days [95%conif-dence interval (CI):222?409 days] and the median OS was 816 days (95%CI:490?842 days). The response rate (RR:complete plus partial response) was 67.5%, and the disease control rate (RR plus stable disease) was 90%. Conclusion XELOX plus bevacizumab may be considered a routine ifrst?line treatment option for patients with mCRC.

Objective To investigate the effect of oxaliplatin combined with capecitabine on the rate of local control and anal sphincter preservation of rectal cancer.Methods Eighty patients with stage Ⅱ/Ⅲ colorectal adenocarcinoma were randomly divided into control group and observation group,each group in 40cases.The patients in the observation group were treated with oxaliplatin and capecitabine.The control group was treated with oxaliplatin combined with leucovorin and 5-fluorouracil.The patients were followed up for 2~4 weeks.The local curative effect, perioperative biochemical index,R0 (excision margin without cancer cell) resection rate and sphincter preserving rate were compared between the two groups.Results In the control group, the short-term curative effect was 47.50%, which in the observation group was 60.00%, the difference was statistically significant (x2=4.22,P<0.05).There were no statistically significant differences in the biochemical indicators between the two groups (all P>0.05).The R0 resection rates of the control group and the observation group were 62.50%,57.50% (x2=0.67,P>0.05).The anal sphincter preservation rates of the control group and observation group were 32.50%,37.50% respectively (x2=0.67,P>0.05).The local control rates of the control group and observation group were 90.00%,92.50%,which of the observation group was higher than the control group, but the difference was not statistically significant(x2 =0.32,P>0.05).Conclusion The combination of oxaliplatin and capecitabine can improve the local curative effect in patients with rectal cancer without affecting the biochemical indicators of perioperative patients, but the effect of R0 resection rate and preserving anus rate in patients with rectal cancer compared with the chemotherapy regimen of FOLFOX4 has no significant difference, it is worthy of clinical promotion.

Background Researches have reported that arsenic trioxide (As_2O_3) is an effective method of treating solid tumor,and its mechanism is to inhibit the cellular proliferation and induce cellular apoptosis.However,the research on DNA damage caused by As_2O_3 is not clear.Objective This study is to investigate the roles of arsenic trioxide (As_2O_3) on DNA damage of retinal pigment epithelial cell in rabbit.Methods Retinal pigment epithelial cells were isolated from pigmented rabbits and cultured in vitro according to the method of Singh NP[2].Cultured cells were identified by cytokeratin.The third or fourth generation of cells were used to this study.50.00,5.00,2.00,1.00,0.50 and 0.25 μmol/L of As_2O_3 were added into medium respectively for 1 hour,and the same volume of PBS was added as negative control group.Cultured cells were exposed to ultraviolet (UV) rays with wave length of 254 nm for 10 minutes as positive control group.The cell vitality was detected by trypan-blue staining.The comet assay was applied to evaluate the DNA damage.SPSS 13.0 software was used for statistical analysis.Results The black granule were seen in cultured RPE cells.Cultured cells showed the positive brown-yellow particles in cytoplasm for cytokeratin with the positive rate over 90%.The morphology of the cells was similar among experimental group,UV irradiation group and PBS group under the inverted microscope.The normal cell activity was exhibited by trypan-blue staining in these three groups.Compared with PBS group,As_2O_3 caused obvious abnormality of DNA of RPE cell in a dose-dependent manner.Both the percentage of tail DNA and tail moment were gradually increased with the enhance of As_2O_3 concentration (F=88.548,P=0.000; F= 129.704,P=0.000).Significant differences also were found between different concentrations of As_2O_3 groups and UV irradiation group compared with PBS group (P＜0.05).As_2O_3 caused the obvious breaking up of DNA strands of RPE cells at the concentration of 50.00 μmol/L,but there was no statistical difference in spontaneous DNA damage of RPE cells between 0.50 and 0.25 μmol/L of As_2O_3 (P＞0.05).Conclusion As_2O_3 has a potential genotoxicity for rabbit retinal pigment epithelial cells in vitro.

Objective To observe the real-time effect of retaining needle at Lingtai (GV 10) and Shendao (GV 11) on ST-T segment on cardiogram in patients with angina pectoris of coronary heart disease (CHD).Method Thirty patients with angina pectoris of CHD who received acupuncture at Lingtai (GV 10) and Shendao (GV 11) were divided into group A with needles retained after insertion of the needles and group B without needles retained. The two groups were observed by using 12-lead electrocardiogram (ECG) before and after treatment, to compare the ST segment and T wave atⅡ,Ⅲ, avF lead and V4, V5, V6lead before and after treatment.Result After treatment, ST segment atⅡ,Ⅲ, avF lead and V4, V5, V6lead was changed significantly in group A (P<0.05). T wave was significantly changed atⅡ,Ⅲ, avF lead after treatment in group A (P<0.05). T wave at V4, V5, V6 lead was significantly changed after treatment in both groups (P<0.01,P<0.05).Conclusion Acupuncture at Lingtai (GV 10) and Shendao (GV 11) can improve myocardial ischemia in angina pectoris of CHD; compared to acupuncture without needles retained, retaining needles after acupuncture can produce a more significant effect in improving the inferior and anterior myocardial walls and a better real-time effect on ST-T on ECG of angina pectoris of CHD.

Based on the statistics of the tide and key words of three magazines in 2015,a total of 30 documents and after expert consultation and analysis,the literature was divided into 10 research fields,and four aspects including correlation with teaching,talent cultivation,development of student and assessment were elaborated on to explore the current hot issues of medical education in China.In the ending part,the author summarized and put forward four shortages that covered deficiency of theoretical research,illegibility of talent orientation,teaching reform combining without actual condition and not paying attention to the development of teachers in study of medical education research,and provide suggestions and references for further research on medical education.

OBJECTIVE:To observe therapeutic efficacy and safety of Duhuo jisheng decoction combined with glucosamine gulfate for genual osteoarthritis. METHODS:Totally 86 patients with genual osteoarthritis selected from our hospital during Dec. 2015-Apr. 2016 were divided into trial group and control group according to random number table,with 43 cases in each group. Control group was given Glucosamine sulfate tablets 1-2 tablet,po (at mealtime),tid. Trial group was additionally given Duhuo jisheng decoction,one dose a day,decocting 200 mL with water,morning and evening at twice,on the basis of control group. Both groups received treatment for 28 d. Clinical efficacies of 2 groups were observed as well as the levels of hs-CRP,TNF-α, IL-6,MMP-3,MMP-9 and MMP-13. The occurrence of ADR was recorded during treatment. RESULTS:Before treatment,there was no statistical significance in hs-CRP,TNF-α,IL-6,MMP-3,MMP-9 and MMP-13 between 2 groups(P>0.05). After treat-ment,total response rate of trial group(95.3%)was significantly higher than that of control group(76.7%),with statistical signif-icance (P<0.05). The level of hs-CRP in trial group was significantly lowered,and the levels of TNF-α and IL-6,MMP-3,MMP-9,MMP-13 in 2 groups were decreased significantly;above indexes of trial group were significantly lower than those of con-trol group,with statistcal significance(P<0.05). The incidence of ADR in trial group(7.0%)was significantly lower than control group (46.5%),with statistical significance (P<0.05). CONCLUSIONS:Duhuo jisheng decoction combined with glucosamine gulfate shows good therapeutic efficacy for genual osteoarthritis with good safety.

OBJECTIVE:To investigate the application of antibacterials in patients with chronic obstructive pulmonary disease(COPD)in our hospital.METHODS:A retrospective analysis was performed on 77 COPD inpatients with respect to the varieties of antibiotics,DDDs,drug costs,routes of administration,medication duration,combined use of antibiotics,therapeutic outcome,bacterial culture and susceptibility test,adverse drug reactions(ADR)and irrational drug use etc.RESULTS:100% of the patients received antibacterials.Topping the first five places on the DDDs list were levofloxacin,cefuroxime,amoxicillin/clavulanate potassium,ceftazidime and azithromycin.The combined use of two kinds of antibiotics accounted for 77.65% versus 2.35% of three kinds concomitantly.CONCLUSION:The use of antibacterials in COPD patients in our hospital is basically rational;however,the indications of antibacterials for COPD patients should be followed strictly toachieve rational and standard drug use.

With the development of the population aging and the shifting of medical paradigm,as well as the deeply expansion of community health services,the importance of general medicine has become more and more evident.This paper describes the development history of general medicine and general medical education at home and abroad,analyzes the main problems of general medical education in China.By studying the characteristics of different models,we provided the basis of literature for the related policies.

In this review, the analytical methods of polyethylene glycol-modified proteins are introduced, including spectroscopy, liquid chromatography, electrophoresis, mass spectrometry, etc. These methods are compared in respect to their individual characteristics.