Objective To investigate the influence of early rehabilitation on the recovery of patients who have undergone the low rectal cancer resection. Methods 130 patients with low rectal cancer resection were divided into the rehabilitation group and the control group randomly, there were 65 cases in each group. The control group were accepted the routine nursing care, and the rehabilitation group were accepted the early recovery intervention. Compared the time of anus exhaust, the time of stomach extubation, the incidence rate of postoperative complication, the time of bed rest and the quality of postoperative life in these two groups. Results All the indexes which have compared between these two groups were significant better in the rehabilitation group than those of in the control group, P

OBJECTIVE:To study the stability of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride in-jection in 0.9% Sodium chloride injection. METHODS:At room temperature [(25±1)℃],three injections were poured into infu-sion bag of disposable analgesia pump,and diluted with 0.9% Sodium chloride injection. The changes in precipitation,turbidity, color and pH value of the mixture were observed. The relative percentage of three injections within 72 h were determined by HPLC method. RESULTS:There was no significant change in the pH value and appearance of the mixture. Relative percentage of tramad-ol hydrochloride,fentanyl citrate and ondansetron hydrochloride were all higher than 97% within 72 h. CONCLUSIONS:The mix-ture of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride injection in 0.9% Sodium chloride injection keep stable within 72 h under room temperature.

Objective To study the impact of local fractionated irradiation on lung metastasis in H22-bearing mice, and to explore its mechanism involved. Methods Subcutaneous transplantation tumor model bearing with H22 was established. Mice were divided into three groups as healthy control, tumor control and irradiation groups. The size of subcutaneous tumors was measured and lung metastasis was observed. The expressions of PCNA, VEGF and MVD were detected immunohistochemically. The plasma levels of CD4 and CD8 were determined by using flow cytometry. Results The tumor size in irradiated group was smaller than that in tumor control group. The tumor inhibition rate in irradiated group was 30%.Lung metastasis in irradiated group was more severe than that in tumor control group (x2 = 8.31,4.48,9. 60, P＜ 0.05 ). The expressions of PCNA, VEGF and MVD in two groups were statistically different( t =23.78,-2.47, -6.43, P ＜ 0. 05). The levels of CD4 and CD8 in irradiated group were statistically different compared to healthy control group ( t = 4. 72 and 3.31, P＜ 0.05 ). Conclusions For the H22 model, radiation might inhibit the local transplantation tumor, but increase the risk of lung metastasis.

Objective To analysis the clinical features of elderly diffuse large B-cell lymphoma (DLBCL) patients with Epstein-Barr virus (EBV) infection and their prognostic factors.Methods 250 cases of DLBCL were retrospectively studied by in situ hybridization (ISH) to detect the EBV and by immunohistochemical to evaluate the histological type and Ki-67 protein.Results 36 cases with EBVpositive included 28 elderly (aged ≥ 60 years), of which 21 cases were Han, 15 cases were Uygur, male/ female ratio was 2 : 1.There were 23 cases with nodal presentation only, 13 cases with extra-nodal presentation.Twenty-nine patients presented with advanced disease (Ann Arbor stage Ⅲ/Ⅳ), 30 patients were found with high lactate dehydrogenase (LDH), 22 patients with high IPI score (3-5).Histological observation showed a diffuse and polymorphic proliferation of large lymphoid cells with varying degrees of reactive components.These tumor cells were frequently characterized by a broad range of B-cell maturation, containingcentroblasts, immunoblasts, and Hodgkin-and Reed-Stemberg (HRS)-like giant cells.Immunohistochemical studies showed that tumor cells were positive for CD20 and (or) CD79a in almost cases, most of the cases had a high proliferative index.CD10, bcl-6, Mum-1 performed histological type, 31 cases were non-germinal center.Except the age and location (P ＜ 0.05), no other significant differences were observed in Han and Uygur elderly EBV+ DLBCL (P ＞ 0.05).Conclusion The incidence of elderly EBV+ DLBCL is low, it has some unique clinical and pathological features with poor prognosis.

Objectives To investigate the significance of electronic bronchoscopy and bronchoalveolar lavage in diagno-sis and treatment in children with pulmonary mass lesion. Methods A total of 74 hospitalized children from January 2011 to June 2012 whose imaging examinations showed massive patchy shadow were examined and treated by electronic bronchoscopy and bronchoalveolar lavage. Their clinical data were retrospectively analyzed. Results The major cause for the massive shadow was infection according to electronic bronchoscopy examination (68/74, 91.89%), 65 cases of them were lobar pneumonia, 3 cas-es were pulmonary tuberculosis followed by 5 cases of foreign body (6.76%) and one case of pneumorrhagia (1.35%).The lower left lung was the most frequently seen site of infection, followed by lower right lung. The agreement between infection sites and imaging examination was 97.30%. Bronchoalveolar lavage fluid showed that the primary pathogen of lobar pneumonia infection is Mycoplasma pneumoniae (MP) (42/65, 64.62%). The highest detection rate of MP was found in preschool group and the detec-tion rate between different age groups indicated statistically significant difference (P<0.01). The imaging examination showed pulmonary lesions in 61.54%children with lobar pneumonia improved significantly in one week. The improvement rate of pul-monary lesions was higher in infected children with short duration (1-2 weeks, 90.91%) between disease onset and electronic bronchoscopy inspection than those with longer duration (2-3 weeks, 51.72% and >3 weeks, 35.71%) (P<0.05). Conclusions Electronic bronchoscopy and bronchoalveolar lavage play dual roles in etiological diagnosis and therapy in children with pulmo-nary mass lesion.

Objective To explore the risk factors in elderly type 2 diabetes mellitus with cerebral infarction. Methods Retrospective investigarion was performed on 148 elderly hospitalized patients with type 2 diabetes.The patients were classified based on the presence or absence of cerebral infarction and compared with 60 controls.Logis- tic regression analysis was used to reveal the risk factors for cerebral infarction.Results The levels of systolic blood pressure(SBP),body mass index (BMI),fasting blood glucose (FBG),total cholesterol (TC),triglyceride (TG) and plasma fibrinogen(Fg) were higher in the patients with cerebral infarction[141.15?17.46)mmHg,(23.81?3.53)kg/m~2,(8.82?2.81)mmol/L,(5.69?1.15)mmol/L,(2.08?0.75)mmol/L and (4.08?0.65)g/L] than those without cerebral infarction[(129.78?14.65) mmHg,(22.18?3.22)kg/m~2,(7.06?1.72 )mmol/L,(5.09?1.12)mmol/L,(1.62?0.43)mmol/L and (3.48?0.58)g/L].The logistic analysis showed COUR,SBP,FBG, TC,TG and Fg were the independent risk factors for cerebral infarction.Conclusion Early intervention of the inde- pendent risk factors including SBP,FBG,TC,TG and Fg in elderly patients with type 2 diabetes was important for reduction and postponement of cerebral infarction.

Objective Analyzing the construction process and application of health appropriate technology database in Zhejiang province and proposing related considerations and recommendations for the database construction.Methods To design and construct the technology database system,and using excel software to calculate statistic data.Results Established a health appropriate technology database,which contains 826 technologies that can be selected and promoted by the demonstration bases in the whole province.Conclusions The establishment of the technology database increased the efficiency of health appropriate technology transformation at the provincial level,and also provided a reference for the national-wide generalizing of health appropriate technology.

Objective To detect the sera anti-enteric neuronal antibodies ( AENA ) in irritable bowel syndrome with diarrhea ( IBS-D) patients and analyzed its correlation with IBS-D symptoms to explore the potential roles of AENA in the pathogenesis of IBS.Methods IBS-D patients diagnosed with RomeⅢdiagnostic criteria were en-rolled in this study.The sera of healthy subjects were used as controls.Indirect immunofluorescence ( IIF) was used to detect the sera AENA with the substrate of ileal submucosal plexus of guinea pig .The immune reactivity ( IR) stains were read in blinded method .The bowel symptoms of patients with positive AENA were compared to thatwithnegativeandweeklypositiveantibodies.Results 1)Atotalof127IBS-Dpatientswereenrolledinthis study.The positive rate of sera AENA was 85.8%in IBS-D patients, and 7.0%in healthy controls.Among 109 IBS-D patients with positive IIF reactivity , 23.6%present with strong positive , 43.3% with positive and 18.9%with weakly positive stain .The IR patterns included cytoplasm staining , nucleus staining , cytoplasms and nuclei staining , nuclear membrane staining , cytoplasm and nuclear membrane staining .Six positive sera of healthy control showed cytoplasm staining to substrate neurons .2 ) More patients of IBS-D with positive IR had higher intestinal symptoms scores (>10 scores, 58.8%vs 38.1%), frequent abdominal pain in non-defecation period (91.7%vs 60.0%) , and severe abdominal pain/discomfort before defecation ( 24.7% vs 9.5%) comparing to those with negative and weekly positive IR of AENA;IBS-D patients with positive IR of AENA are more commonly associated with urgency comparing to those with negative IR in IIF (57.1%vs 87.3 ) .Conclusions AENA may play a role in the pathogenesis of IBS , and is a potential biomarker of IBS-D.

Objective Irregular antibody screening and identification are very important to reduce hemolytic reaction.The dis-tribution of irregular antibodies of blood group was analyzed in patients, to provide evidence for using Micro column gel test to detect and identify irregular antibodies transfusion safety. Methods Micro column gel anti-globulin technique was used to screen the irregular an-tibodies and cross-matching in 29770 patients.If the serum had irregular antibodies, the spectrum cells were used to identify the specific-ity of irregular antibodies. Results Among 29 770 patients, 120 cases had irregular antibodies of blood group.The positive rate was 0.4%.The irregular antibodies include Rh system(n=67),MNS system (n=7), Lewis system(n=5),cases of Kidd system(n=3) and undefined specified antibodies(n=38).Among the 120 antibody-positive patients, 70 were female patients and 50 were male patients. Further study showed that the pregnancy history was to the main factor causing irregular antibodies in women (46 positive cases among 70 female patients) . Conclusion The study showed that some patients had irregular antibodies of blood group, especially female patients with pregnancy history.These results suggested that irregular antibody screening and cross-matching by micro column gel method in pa-tients before transfusion had great significance for ensuring the blood transfusion safety.

Pancreatic cancer is malignant with a poor prognosis,and its incidence is rising worldwide in recent years.Multiple slices spiral computed tomography and computed angiography are the first choice for the diagnosis of pancreatic cancer,while misdiagnosis of pancreatic cancer still exists.From August 2009 to October 2011,80 patients with pancreatic or periampullary cancer were diagnosed using the medical image three dimensional visualization system (MI-3DVS).The threedimensional models of the liver,pancreas,vascular system and tumors were reconstructed successfully based on the 64-slice spiral computed tomography data.According to the analysis of the three dimensional models,4 patients underwent standard pancreaticoduodenectomy,1 received palliative surgery.MI3DVS plays an important role in the diagnosis and assessement of resectability of pancreatic and periampullary cancer.