Objective To investigate the treatment of local recurrence after sphincter preserving surgery for low rectal cancer. Methods Fifty-six patients with local recurrence after sphincter preserving surgery for low rectal cancer were divided into three groups, 20 cases underwent radical resection (group A), 21 cases underwent palliative resection combined with 3 dimensional conformal radiation therapy (group B), and 15 cases only received 3 dimensional conformal radiation therapy (group C). Results All the patients were followed up from 6 months to 3 years. The 1-year,2-year and 3-year survival rates were 100.0%(20/20),80.0% (16/20),65.0% (13/20) in group A,90.5% (19/21),52.4% (11/21),33.3% (7/21) in group B and 80.0%(12/15),40.0%(6/15),20.0%(3/15) in group C respectively. Both 2-year and 3-year survival rates in group A were significantly higher than those in group B and group C (P <0.05). Conclusions The first choice of patients with local recurrence after sphincter preserving surgery for low rectal cancer is radical resection. Palliative resection combined with 3 dimensional conformal radiation therapy is the second choice.

OBJECTIVE:To discuss the importance and prospects of the reforming of the Chinese medicinal decoction pieces. METHODS: The advantages and disadvantages of all kinds of decoction pieces(categorized by particle diameter) in preparation, application and management were analyzed comprehensively. RESULTS & CONCLUSION: Comminuting and extracting are two basic approaches for the current reform of the Chinese medicinal decoction pieces, and the reform of the decoction pieces is mainly aimed at nano-Chinese medicinal decoction pieces.

MicroRNAs(miRNAs) are small non-coding RNAs that regulate gene expression at posttranscription. Its abnormality expression could be one of the main mechanisms on development of pancreatic neoplasm. It also offers new candidate targsts for diagnostic and therapeutic strategies of pancreatic neoplasm.

Objective To investigate the relationship between postoperative survival quality with social support and coping style of the main caregivers in the elderly patients with laryngeal carcinoma surgery.Methods A total of 60 inpatients with laryngeal carcinoma surgery and their main caregivers were investigated by the Medical University of Washington Quality of Life Scale (UW-QOL),Coping Styles Questionnaire(CSQ) and Social Support Rating Scale(SSRS).And the obtained data were statistically analyzed by adopting the statistical methods such as Pearsons correlation analysis.Results The postoperative survival quality of the elderly patients with laryngeal carcinoma surgery was generally lower.The social support was in the medium level.The main caregivers adopted more coping style of solving problem and seeking help.The patients' survival quality showed significantly positive correlation with the social support(P＜0.05),significantly positive correlation with the main caregivers' solving problems and seeking help coping style(P＜0.05),and significantly negative correlation with the main caregivers' self-accusation and withdraw and keep off coping style(P＜0.05).Conclusion Increasing the social support level and the main caregivers taking a positive the coping style to face the disease have an important significance for improving the quality of life in elderly patients with laryngeal carcinoma.

This paper categorizes implantable medical device of collagen on Chinese market according to manufacturing technique and performance.Combining with supervision requirements from China Food and Drug Administration (CFDA), this paper discusses safety evaluation in following aspects, such as immunogenicity risk,virus and infectious pathogen risk, and product technical requirements.Finally, the paper looks into the future of collagen implants considering technology progress in biomedical engineering, tissue engineering, and genetic engineering fields.

Objective: To investigate the effects of different anaesthesia on serum catechlomine and IL-6 in surgical breast cancer patients,and evaluate the influence of anaesthesia on surgical stress.Methods: Forty breast cancer patients submitted to elective masteetomy were randomly divided into 2 groups:GEA group (general plus epidural anaesthesia,n=20),GA group (genernal anaesthesia,n=20). Blood samples were taken before operation, 30min, 120min following the incision and at the 1st and 3nd postoperative days. The concentrations of serum catechlomine and IL-6 were detected.Results: The concentrations of serum norepinephrine(NE),epinephrine(E),dopamine(DA) and catechlomine(CA) were similar in 2 groups before operation,and remarkably increased at 30min after incision and reached the peak values at 120min after incision. They were at the high level at the 1st day after operation(P

OBJECTIVE:To observe the therapeutic effect of Yindanxinnaotong Soft Capsules combined with three chemicals for coronary disease angina pectoris. METHODS:91 cases which were up to the diagnosis standard were randomly divided into control group(n=44) and treatment group(n=47) . Control groups were treated with the routine isosorbide 5-mononitrate sustained release tablets(10～20 mg,bid) ,bisoprolol fumarate tablets(5～10 mg,qd) ;amlodipine besylate tablets(5 mg,qd) . Treatment group were additionally treated with 2 to 4 Yindanxinnaotong Soft Capsules,tid,p.o,with treating course of 30 days. RESULTS:The total efficacy rate of angina pectoris and the electrocardiogram were 80.85% and 74.47% for treatment group while 61.36% and 56.82% for control group. There was significant difference between two groups(P

BACKGROUND: Attention deficit and hyperkinetic disorder (ADHD) isfrequently treated with psychostimulant medications, which had beenshown to improve both cognitive and behavioral outcomes for most chil dren. OBJECTIVE: To compare the efficacy and adverse effects of olanzapinevs methylphenidate treatment in childhood hyperkinetic syndrome.DESIGN: Clinical comparative study. SETTING: Department of Psychiatry, Beijing Huilongguan Hospital; De partment of Mental Psychiatry, Shangdong Mouping People's Hospital. PARTICIPANT S: Sixty children with hyperkinetic syndrome from theclinics of the Department of Psychiatry,Beijing Huilongguan Hospital andthe Department of Mental Psychiatry of Shandong Mouping People's Hos pital between March 2002 and April 2004 were enrolled into this prospec tive study after obtaining the consents from their guardians.The patientswere randomly divided into 2 group: the olanzapine group (n=30) and themethylphenidate group (n=30). METHODS: In the olanzapine group olanzapine 2.5-7.5 mg per day wasgiven as a single dose in every evening.In the methylphenidate groupmethylphenidate 5-15 mg per day was given in divided dose in everymorning and evening.The dosage ofolanzapine and methylphenidatewere adjusted according to age, body mass and patient's clinical condi tions. And the period of treatment for either drug was 12 weeks. Conners teachers scale was used before and at the end of the 12 weektreatment(①hyperkinetic index consisted of 10 items②hyperkinetic behavior factorconsisted of 7 items. Each item was rated “none=0, a little=1, quite alot=2, and very much=3 ). Side effect scale was used to evaluate the hy perkinetic symptom and adverse reactions which consisted of behavior toxicity, abnormal laboratory tests , symptoms of the nervous system, au tonomic nervous system, cardiovascular system and skin etc with. 0=none; 1 =suspicious or very mild, 2=mild, 3 =moderate, 4=severe. The highestscore was 22,and the lowest was 0 with a score over 2 being positivefinding). MAIN OUTCOME MEASURES:Hyperkinetic syndrom score and ad verse reaction score at the end of the 12 weeks treatment. RESULTS:All 60 children completed the study and their results wereentered into the data analysis① At the end of the 12th week treat ment, the total hyperkinetic index score and total behavior score in boththe olanzapine group and the methylphenidategroup were significantly lower than those before the treatment as shown in Table 1 (t=8.16-15.26, P ＜ 0.05-0.01 )]; The total hyperkinetic behavior score in the olanzap inegroup was significantly lower than that in the methylphenidategroup (t=2.69, P ＜ 0.05 ). ② The adverse reaction score of patients inthe olanzapine group and the methylphenidategroup was 10.3±4.5and 10.9±3.8 respectively ,with no significant difference(P ＞ 0.05)between the two groups. CONCLUSION: Olanzapine produced similar effect as methylphenidatein the treatment of the hyperkinetic symptoms and attention deficits with a better efficacy in treating the behavior disorder than methylphenidate.

Objective: To explore the effects of pulmonary rehabilitation on exercise tolerance ability. Methods:Fifteen (10 males,5 females)stable COPD patients, entered into 48 weeks of rehabilitation program. The lung function, 6 minutes walk distance(6MWD) were measured at pre, post and first post-maximal exercise training. Results: There was no significiant change in FEV1, FEV1/predict and FEV1/FVC at pre, post and first post-maximal exercise training in COPD patients. 6MWD significantly increased in COPD patients after 48 weeks exercise training program. There was no significant change in baseline and first post-maximal exercise training in COPD patients. Conclusion:There were no significant changes in parameters of lung function before and after training. The exercise tolerance in COPD patients was significantly improved by 48 weeks exercise training.

Thoracic radiotherapy is an important means of local treatment for non -small cell lung cancer (NSCLC).Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs)have the effect of systemic therapy.Studies have shown that NSCLC patients with EGFR exons 19,21 mutation have a synergistic effect in the combination therapy .Radiotherapy activates EGFR signaling pathway ,inducing cell proliferation and DNA damage repair,leading to radiation resistance .Therefore,EGFR-TKIs have the effect in increasing radiosensitivity .Lung injury is one of the most common side effects when the two therapies combined .Studies suggest that radiotherapy combined with EGFR-TKIs may have conflicting functions in the development of pulmonary fibrosis ,the discrep-ancy between these studies may depend on the differences in the experimental systems ,the differences in pulmo-nary fibrosis models,as well as the differences between different species and individuals .Therefore,a more com-plete understanding of the etiology for pulmonary fibrosis is necessary to the development of improved treatments .