Objective To study the characteristics of tongue pictures of the terminal stage patients of colorectal cancer.Method The changes of tongue pictures of 7 patients of the terminal stage and 62 patients of non-terminal stage were observed by The System of Tongue Inspection of TCM,then the tongue proper and coating RGB(redness,greenness,blueness) values were measured.Results In the group of the terminal stage patients,light red and red tongue proper were more,yellow thick tongue coating and without tongue coating were more.Red tongue proper and yellow thick tongue coating were more in the other group.In the group of the terminal stage patients' tongue proper,G values were lower,B values were lower(P0.05).Conclusion The tongue proper and coating of the terminal stage patients of colorectal cancer have certain characteristics.

Objective To explore the application of HC video laryngoscope combined with fiberoptic bronchoscopy in tracheal intubation in patients with cervical spine immobilization.Methods 80 cases of cervical spine immobilization to surgery patients under general anesthesia were randomly divided into bronchoscopy group (F group), HC video laryngoscope composite fiber bronchoscope nasotracheal intubation group (H group), 40 cases in each group. Full of local anesthesia and intravenous anesthesia, spontaneous breathing, tracheal intubation. Recorded before induction (T0), immediately before intubation (T1), immediately after intubation (T2), 1 minutes after tracheal intubation (T3) mean arterial pressure (MAP), heart rate (HR) changes, record for the first time intubation success rate, intubation time of patients. The incidence of complications related to intubation operation.Results there were no significant differences between the two groups before and after tracheal intubation (T1) MAP and HR (t = 0.75,-0.51,P = 0.453, 0.611); After the two groups were intubated immediately (T2), MAP and HR than immediately before intubation (T1), the differences were statistically significant MAP (t = 5.08, 4.36,P = 0.021, 0.013) and HR (t = 7.22, 6.54,P = 0.026, 0.031), hemodynamics were maintained in the normal range, after intubation immediately (T2) between the two groups compared differences in MAP and HR had no statistical significance (t = -0.51, -0.31, P = 0.411, 0.518); There was no significant difference in HR and MAP between the two groups (t = 0.38, 0.26, P = 0.681, 0.372) in 1 min after intubation (T3). Patients with tracheal intubation success rate for the first time H group was obviously higher than that of group F, the difference was statistically significant (χ2 = 7.31,P = 0.007). The two group intubation time in H group was significantly less than that in F group, the difference was statistically significant (t = 5.75,P = 0.000). The incidence of sore throat in group F was significantly higher than H group, the difference was statistically significant (χ2 = 5.00,P = 0.025).Conclusions The patients with cervical spine immobilization of nasotracheal intubation, HC video laryngoscope combined with fiberoptic bronchoscopy, compared with the traditional fiberoptic intubation, intubation for the first time a higher success rate, shorter intubation time, no aggravation of hemodynamic lfuctuations, lower incidence of sore throats.

Objective To compare the lateral decubitus and supine position in the treatment of femoral intertrochanteric fractures with femoral proximal nail antirotation (PFNA).Methods A retrospective analysis was performed of the 85 patients with intertrochanteric fracture who had been treated at our hospital between September 2013 and September 2014.They were 24 men and 61 women,28 to 99 years of age (average,78.5 years).By Evans-Jensen classification,one case was type Ⅰ,15 cases were type Ⅱ,40 type Ⅲ,23 type Ⅳ,and 6 type Ⅴ.All the patients were treated with internal fixation with PFNA.Lateral decubitus position was adopted in 45 cases and supine position in 40.The 2 groups were compared in terms of operation time,intraoperative bleeding volume,difference between preoperative and postoperative hemoglobin values,tip-apex distance (TAD),calcar tip-apex distance (Cal-TAD),fracture healing time,and Harris score of the hip joint.Results The 85 patients were followed up for 9 to 21 months (average,13.6 months).Both 2 groups obtained fracture healing,with no screw cut-out.The lateral decubitus group had significantly less operation time (60.3 ± 17.5 min) and intraoperative bleeding volume (70.8 ± 37.8 mL) than the supine position group (72.7 ± 19.7 min and 90.3 ± 20.9 mL,respectively) (P ＜ 0.05).The former also had a significantly smaller difference between preoperative and postoperative hemoglobin values (24.1 ± 5.7 g/L) than the latter (28.2 ± 8.5 g/L) (P ＜ 0.05).There were no significant differences between the 2 groups in TAD,Cal-TAD,fracture healing time (3.7 ± 0.9 months versus 3.7 ± 1.0 months),or Harris hip score (73.4 ± 10.7 versus 75.5 ± 9.5) (P ＞ 0.05).Conclusion In the treatment of femoral intertrochanteric fractures with PFNA,lateral decubitus position may be associated with shorter operation time and less intraoperative blood loss compared with supine position.

Objective To study the clinical importance of TCM used in solidified therapy of colorectal cancer after radical resection. Method Prospective cohort study was applied to the trial, 84 cases in Xiyuan Hospital were selected to compare with 78 cases in western medicine hospital in the same time. The rates of relapse-metastasis and disease free survival of two groups were observed. Nine possible factors influencing disease-free survival were selected to analyze with COX regression model. Results 1-year, 2-year and 3-year relapse-metastasis rate of the teatment group were 0, 4.08% and 20% respectively, those were 5.12%, 22.91% and 36.11% in the control group. 1-year, 2-year and 3-year disease-free survival rate of teatment group were 100%, 95.91% and 80%, those were 94.87%, 77.08% and 63.88% in the control group. The main prognostic factors were lymph nodes metastasis and therapy. Conclusion TCM used in postoperative colorectal cancer could prevent relapse and metastasis.

Objective:Toprepare poly-DL-lactide-poly (PELA) microspheres encapsulating recombinant tissue inhibitors of metalloproteinase-1 (TIMP-1) adenovirus, and to investigate their effects on the proliferation of hepatocellular carcinoma HepG2 cells. Methods: The microsphere was constructed by encapsulating recombinant adenovirus containing TIMP-1 in biodegradable PELA. The diameter of the microsphere, quantity of virus encapsulated, loading rate, and releasing kinetics were measured. HepG2 cells were infected with the microspheres; the infection efficiency was examined by fluorescent microscope; and the ultrastructure was observed by TEM. The expression of TIMP-1 mRNA in HepG2 cells was examined by semi-quantitative RT-PCR, and the proliferation of HepG2 cells was detected by MTT assay. Results: The microsphere encapsulating recombinant TIMP-1 adenovirus was successfully constructed, with its diameter, entrapment efficiency, and virus loading rate being 1.965, 60.0%, and 10.5×10~8/mg, respectively. About 60% of the viruses were released within 120 h, and the total releasing time was longer than 240 h. Infection with rAdTIMP-1 PELA microsphere efficiently induced TIMP-1 expression in HepG2 cells, and significantly inhibited the proliferation of HepG2 cells, with the inhibitory rate being 47%. Conclusion: PELA microsphere encapsulating recombinant TIMP-1 adenovirus can markedly inhibit the proliferation of HepG2 cells, which provides an experimental basis for the combining macromolecular chemistry and gene therapy for treatment of hepatocellular carcinoma.

Objective To explore the effect of rhynchophylline and isorhynchophylline on headshakes behavior and levels of monoamine neurotransmitter in model rats with Tourette syndrome.Methods 40 Wistar rats were randomly divided into DOI-induced head-shakes rats (HSR group),haloperidol group,rhynchophylline group and isorhynchophylline group with 10 in each group.The inhibitory effects of rhynchophylline and isorhynchophylline were estimated by observing the HSR behavior.Dopamine (DA) and 5-hydroxytryptamine(5-HT) in the rat striatum were detected by the enzyme-linked immunosorbent assay (ELISA) method.The 5-HT2A receptor mRNA expression in prefrontal lobe cortex of the rats was measured by real-time PCR.Results Compared with HSR group,the head shakes of the rats in haloperidol group and isorhynchophylline group were significantly decreased(P＜0.01),and no change of head-shakes number was observed in rhynchophylline group (P＞0.05).There was no significant difference of head-shakes number between the haloperidol group and isorhynchophylline group(P＞0.05).Compared with HSR group,DA levels in the rat striatum were significantly decreased in isorhynchophylline group and haloperidol group((152.35± 5.80) μ~L vs (111.19±4.30) μg/L,(152.35±5.80) μg/L vs (126.42±3.17) μg/L,P＜0.01),while DA levels in the rat striatum in rhynchophylline group were not changed ((152.35±5.80) μg/L vs (142.71±5.51) μg/L,P＞0.05).There was no significant change of 5-HT2A receptor mRNA expression in rat prefrontal lobe cortex in every group(P＞0.05).Conclusion Isorhynchophylline may have an inhibitory effect on rats with DOI-induced HSR.Isorhynchophylline may decrease the DA levels in the rat stratum with DOI-induced HSR.Rhynchophylline has no significant inhibitory effect on head-shakes behavior and DA levels in the rat stratum with DOI-induced HSR.

BackgroundResearches demonstrated that the levels of soluble CD44 (sCD44)molecule in aqueous is significantly higher in primary open-angle glaucomous(POAG) eye than normal eye,but how the sCD44 would affect the expression of apoptosis protein in trabecular meshwork cells is below understanding.Objective The present study was to investigate the effect of sCD44 on the expression of regulatory proteins bcl-2 associated death factor bad in trabecular meshwork cells in the patients with POAG.MethodsHuman scleral tissue with trabecular meshwork were obtained from POAG patients during the surgery.The trabecular meshwork cells were primarily cultured by explant culture method and identified by immunochemistry.The third generation of cells were incubated with free-serum DMEM/F12 medium added differnt dosages of sCD44 (0,1,5,10,25,50 mg/L) for 48 hours.The expression of bad protein in cultured cells was detected using cell counting kit-8 (CCK-8) as the absorbance values at 490 nm(A,90 value),and the bad protein level in cultured cells was assayed by ELISA.ResultsThe cultured cells showed the positive response for laminin ( LM ),neuron specific enolase ( NSE ),fibronectin ( FN ) monoclonal antibodies.The CCK-8 assay showed that the A490 values of the trabecular meshwork cells in 0,1,5,10,25,50 μg/L of sCD44 groups were 0.2460±0.0019,0.1874±0.0015,0.1570±0.0016,0.1302±0.0019,0.1084±0.0018,0.0940±0.0020 respectively with a statistically significant difference among the 6 groups( F =14.922,P =0.000 ),and the A490 values in various dosages of sCD44 groups were significantly lower than the 0 μg/L sCD44 group (P=0.013,0.008,0.011,0.005,0.004).The ELISA assay showed that bad protein levels in 0,1,5,10,25,50 μg/L of sCD44 groups were ( 114.8461 ± 2.9560 ),( 137.8270 ± 2.4259 ),( 161.4194 ± 3.7381 ),( 170.9453 ± 3.2006 ),( 221.2252 ±4.3738 ),( 324.6167±4.4220) ng/L,showing a total difference among them ( F =16.610,P =0.000 ),and the bad protein levels in various dosages of sCD44 groups were significantly lower than the 0 μg/L sCD44 group( P =0.017,0.013,0.008,0.007,0.006).ConclusionssCD44 can contribute to the apoptosis of the trabecular meshwork cells in patients with POAG in certain dose range by regulating the apoptosis regulatory proteins bcl-2 associated death factor bad.

Objective To analyze the application of modified abdomen pathway for excising the adrenal huge pheoehromocytoma.Methods One patient(male,42-year-old)had adrenal huge pheochromocytoma.The pheochromocytoma was about 15.0 cm×8.0 cm×7.0 cm.After 3 weeks' preparations,the patient was operated.The operation was made through the modified abdomen pathway for excision,without excising the transverse on peritoneal,and the interference to organs of peritoneal was reduced.The tumor on adrenal gland adhered kidney very tightly.Expanded radical excision including tumor,kidney,adrenal gland was applied.Results The operative time was 300 rain and the volume of bleeding was about 1000 ml.In the operation process,blood pressure of the patient was stable,the visual field of operation was satisfactory.Blood pressure of the patient returned normal 6 months postoperatively.And there was no indication of tumour relapse or matastasis.Conclusion The modified abdomen pathway can expose the satisfactory visual field,and is safe and effective for adrenal gland tumor operation.

Objective:To explore the clinical effect ofpaishitang combined with tamsulosin hydrochloride on the patient with up per urinary calculi after extracorporeal shock wave lithotripsy (ESWL).Methods:120 cases with upper urinary calculi in our hospital from January 2015 to September 2016 were selected and divided into two groups according to the random number table,60 cases in each group.ESWL was given to both groups of patients and provided with tamsulosin hydrochloride postoperation,then paishitang were additionally given to the patients in the observation group.The clinical effect and changes of serum creatinine (Scr),neutrophil gelatinase as sociated lipocalin (NGAL),cystatin C (Cys-C) and glomerular filtration rate (GFR) levels before and after treatment were compared between two groups.Results:The total effective rate of observation group was 96.67％,which was 86.67％ in the control group,no signifi cant difference was found in the total effective rate between the two groups(P＜0.05).The stone discharge rate was 95.00％ in the observation group,which was significantly higher than that of the control group (P＜0.05);the incidence rate of renal colic was 6.67％,which was significantly lower than that of the control group(P＜0.05),the stone discharge time and the duration of hematuria were significantly shorter than those in the control group (P＜0.01).There was no significant difference in the recurrence rate between the two groups within one year (P＞0.05).The serum NGAL and Cys-C levels of both groups were gradually increased while the GFR levels were gradually decreased on the 1st,2nd day postoperation,but all the index mentioned above gradually recovered on the 3rd day postoperation.The levels of NGAL and Cys-C in the observation group were significantly lower than those in the control group on the 1st,3rd day postoperation while the GFR was significantly higher in the observation group than those of control group on the 1st,3rd day postoperation(P＜0.01).No significant difference was found in the Scr at different time points postoperation between two groups(P＞0.05).Conclusion:Paishitang combined with tamsulosin hydrochloride had significant clinical effect on thpatient with upper urinary calculus after ESWL and could effectively improve the renal injury induced by ESWL.

Objective In clinical practice,ultrasound-guided fine-needle aspiration biopsy (US-G FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules before operation.Re---sults of FNAB may vary substantially among operators with different skills.The aim of this study is to evaluate whether operator experience in US-G FNAB influences the rate of diagnostic procedures.Methods A total of 600 consecutive US-guided FNAB done by a single radiologist with 22-or 27-gauge needles from Feb.2008 to Apr.2012 were retrospectively analyzed.All specimens were prepared and fixed without the cytologist on site and were subsequently analyzed by 2 expert cytologists.The procedures were chronologically divided into 6 groups and further stratified according to the overall (A),solid nodules (B),mixed nodules (C),pure cystic nodules (D),acellular sample(E),heavily blood-stained sample(F),exclusively colloid material(G),incorrect slide fixation(H) and they were classified as diagnostic or no-diagnostic.Results The rate of no-diagnostic procedures for each group in learning curves were reported as:① Among A,34％ in group 1,15％ in group 2,18％in group 3,10％ in group 4,7％ in group 5,and 8％ in group 6.② Among B,4％ in group 1,1％ in group 2,0％ in group 3,0％ in group 4,0％ in group 5,and 0％ in group 6.② Among C,10％ in group 1,1％ in group 2,4％ in group 3,0％ in group 4,1％ in group 5,and 0％ in group 6.④ Among D,20％ in group 1,13％ in group 2,14％ in group 3,10％ in group 4,6％ in group 5,and 8％ in group 6.⑤ Among E,25％ in group 1,15％ in group 2,15％ in group 3,10％ in group 4,6％ in group 5,and 8％ in group 6.⑥ Among F,4％ in group 1,0％ in group 2,1％ in group 3,0％ in group 4,0％ in group 5,and 0％ in group 6.⑦ Among G,1％ in group 1,0％ in group 2,1％ in group 3,0％ in group 4,1％ in group 5,and 0％ in group 6.⑧ Among H,4％ in group 1,0％ in group 2,1％ in group 3,0％ in group 4,0％ in group 5,and 0％ in group 6.Among the 600 procedures,there were 2 cases of vertigo and 4 cases of moderate bleeding at the biopsy site,all of which resolved spontaneously.No major complications were recorded.Conclusions The rate of no-diagnostic US-guided FNAB is heavily dependent on the operator's experience.We estimate that at least 200 procedures are needed in order to achieve the levels of diagnostic accuracy reported in the literature.We therefore suggest operators to get specific training before routinely perform this procedure in clinical practice.