Objective To evaluate the effects of intrarectal chemotherapy for advanced unresectable rectal carcinoma.Methods 86 cases of advanced unresectable rectal carcinoma were divided into two groups. The intrarectal chemotherapy group consisted of 43 cases to whom 5 fluorouracil or fluorouracil polyphase liposome oral liquid were administered by rectoclysis, and extract of Chinese herbs was administered as a adjuvant simultaneously. In the control group there were 43 cases who received oral administration of tegafuri(FT 207) or Fluorouracil polyphase liposome and adjuvant Chinese herbs.[WT5”HZ]Results [WT5”BZ] In the intrarectal chemotherapy group mean survial time was 18 2 months, 8 4 months longer than that in the control group ( SD =0 67, t =12 54, P

Objective To investigate the effect of diosmin on the pain and wound healing after modified anal fissure resection .Methods 98 patients from January 2015 to July 2016 in our hospital who were admitted to meet the inclusion criteria and improved anal fissure resection patients were selected and randomly divided into control group and study group, 49 cases in each group.And the control group was given routine postoperative treatment, the study group was treated with diosmin tablets on routine postoperative therapy , two groups were treated for seven days for a course of treatment, the wound pain, wound width and wound healing were observed and recorded before and after treatment, blood samples were taken to determine changes in serum inflammatory factors, the clinical efficacy and complications were compared.Results After treatment, the two groups of wound pain, the width of the wound and wound healing rate were decreased, the serum TNF-α, IFN-γ, IL-6 levels were decreased, the difference was statistically significant (P<0.05), compared with the control group, the degree of pain, the width of the wound and wound healing rate were lower, the serum TNF-α, IFN-γ, IL-6 content were lower, the average healing time and granulation growth time and remove decay time were shorter, the difference was statistically significant (P<0.05).The effective rate of the study group was 91.83%, higher than the control group 75.51%, the difference was statistically significant (P<0.05).All patients were followed up, no case falls off phenomenon, there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Diosmin tablets on the improvement of anal fissure after resection of wound healing has a role in promoting inflammation, reduce the severity of pain conditions.

Objective To research the effects of progressive time phase selective light (PTPSL)therapy on shift work disorder patients.Methods 24 shift work disorder patients were randomlv divided into PTPSL group and control group.Both groups received treatment for 12 days including 6 days during the night shift time and 6 days during the day shift time continuously.The clinical effects were evaluated by Karolinska Sleepiness Scale (KSS),Leeds sleep evaluation questionnaire (LSEQ) and core body temperature rhythm.Results (1) During the night shift time,PTPSL group patients were better in score LSEQ and KSS(discerned for 39.80 ± 2.89,6.59 ±0.48) than control group' s(discerned for 36.86 ± 3.88,6.98 ± 2.03) ; temperature curve peak phase in PTPSL group moved backward greater than that of control group((8.35 ± 0.82) h vs (7.45 ± 1.05) h) ; and the difference was statistical significance(P ＜ 0.05).During the day shift time,PTPSL group patients were better in score LSEQ and KSS(discerned for 45.57 ± 2.77,6.33 ± 0.48) than control group' s (discerned for 40.35 ± 4.19,6.82 ± 1.03),temperature curve peak phase in PTPSL group moved forward greater than that of control group((7.37 ± 0.94)h vs (6.31 ±1.37)h),and the difference was statistical significance(P＜0.05).Conclusion PTPSL can adjust shift sleep disorder patients' mussily sleep rhythm system in order,and make the inner rhythm svstem and external schedules tend to be consistent,and provides a new treatment choice for shift sleep disorders.

Objective To assess the effect of remote-interactive cognitive behavioral therapy in pa-tients with chronic insomnia.Methods A total of 62 patients with chronic insomnia were randomly divided into combined treatment group,cognitive behavioral therapy for insomnia ( CBTI) group and drug treatment group.The study lasted for 6-8 weeks.The curative effects were assessed using sleep diary and scales.Results The sleep onset latency (SOL) ((39.9±23.7)min) and wake time after sleep onset(WASO) ((79.1± 39.4) min) in the drug treatment group were higher than that in the combined treatment group ( ( 25.5 ± 11.2)min and (54.4±38.5)min,respectively) and CBTI group ((27.8±11.6)min and (51.8±29.0)min,re-spectively) at the end of treatment,the difference was statistical significance( P=0.018 and P=0.046 respec-tively).The sleep efficiency(SE) in drug treatment ((76.5±11.9)%) was lower than that in the other two groups((83.8±8.7)%and (82.8±7.0)%respectively),(P=0.042).And no similar difference were seen in TST after treatment(P>0.05).The Brief Version of Dysfunctional Beliefs and Attitudes about Sleep(DBAS-16) score in the drug treatment group (97.6±16.4) was higher than the other two groups((67.5±20.1) and ( 75.0±26.9) respectively) after treatment(P=0.000) .No significant difference was seen in scores of the oth-er scales among the three groups(P>0.05) .After treatment,a greater proportion of patients in the combined treatment group had withdrawn from hypnotics use completely (29%(6/20) vs 5%(1/18);odds ratio( OR ) was 7.286);and the combined treatment group produced significant reduction in frequency of hypnotics use ((3.35±3.05) nights/week) when compared with drug treatment group((5.56±2.33) nights/week, P=0.016) .Conclusions Remote-interactive cognitive behavioral therapy was effective and acceptable for treating pa-tients with chronic insomnia,combining drug treatment in the early period could quickly relieve the symptoms of in-somnia,and can avoid the adverse effect from the hypnotics.And the treatment method can reduce the dropout rate.

ObjectiveTo compare the results of laparoscopic and open radical operation for rectal cancer.MethodsThree hundred and twelve patients with laparoscopic operation and 226 cases with open operation during the period of June 2004 to August 2009 were included.The long-term survival,operative data,postoperative recovery and complications were compared between the two grougs.ResultsThere were no significant differences in age,sex,tumor stage and histologic types between the two groups.The 3 and 5- year-survival rate was 84.5％ and 66.7％ in laparoscopic group,83.3％ and 64.8％ in traditional operation group with no significant difference by Life-table method.The intraoperative blood loss in laparoscopic group was obviously less than that in open group (61 ± 13 nl vs 174 ±84 ml,t =23.24,P ＜0.05).The time of p assage of gas by anus and hospital stay in laparoscopic group were significantly shorter than those in openg roup (2.7 ±1.3 d vs 3.6 ±1.8 d,t =6.61,P ＜0.05;9.1 ±2.4 d vs 12.0 ±3.4 d,t =11.8,P ＜0.05).No significant difference was observed between the two groups in the lymph nodes clearance ( 11.0 ± 2.7 vs 12±3.6,t=1.72,P ＞0.05),specimen length (16.0 ±3.4 cm vs 16.0 ±4.3 cm,t =0,P＞0.05) and distal margin (3.2 ± 1.3 cm vs 3.2 ± 1.7 cm,t =0,P ＞0.05).Surgical site infection of incision developedin 28casesinopensurgerygroupandin8casesinlaparoscopicgroup(P＜ 0.05 ).ConclusionsLaparoscopic surgery for rectal cancer can achieve similar long-term survival as conventional laparotomy with minimal invasion,quicker recovery and less complications.

Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia.Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected,and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53).All the patients accepted relevant treatment for 8 consecutive weeks.Changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up.Results Compared with pre-treatment,SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P＜0.01),the decrease was more significant in CBT-I group than in regular treatment group (P＜0.01).The sleep latency,sleep efficiency,bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49 ± 22.75min vs.55.50 ± 34.96min;72.31％ ± 9.15％ vs.57.70％ ± 11.53％;302.65 ± 43.76min vs.262.70 ± 50.64min and 17.14 ± 6.45 vs.21.02 ± 6.64,respectively),the differences were of statistical significance (P＜0.05).In addition,no significant difference was found in the level of depression between CBT-I group and regular treatment group.Conclusion CBT-I can effectively shorten sleep latency,improve sleep efficiency,extend bed time and improve anxiety,meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality.

Objective To explore the correlation between oxygen reduction index(ODI) with blood lipid and renal function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) .Methods Selected 208 patients by polysomnography (PSG) and diagnosed as OSAHS ,divided into four groups according to ODI(ODI ≤ 7 ,7 < ODI ≤ 18 ,18 < ODI ≤ 38 and ODI > 38) .Four groups were compared in total cholesterol (TC) ,triglyceride (TG) ,high‐density lipoprotein cholesterol (HDL‐C) ,low density lipo‐protein cholesterol (LDL‐C) ,apolipoprotein A1 (ApoA1) ,apolipoprotein B (ApoB) ,urea ,creatinine ,uric acid and other differ‐ences ,analysis the correlation between ODI with blood lipid and renal function .Results There were significant different in TC ,TG , HDL‐C ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid in four groups with different degree of ODI (P< 0 .05) ;ODI were positively relat‐ed to TC ,TG ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid levels ,and negatively related to the level of HDL‐C .Conclusion Abnormity of blood lipid metabolic and changes in renal function are associated with the increase of ODI in patients with OSAHS .

OBJECTIVE To dectect the possible association between interleukin-4 receptor gene polymorphism and allergic rhinitis. METHODS The study was conducted in two different groups: patients with allergic rhinitis (the case group,n=50) and healthy people (the control group,n=40). The IL-4R Q576R polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The study compared frequencies distribution of genotype and allele between the two groups,and calculated odds ratio (OR) of genotype. RESULTS IL-4R allelic frequencies showed significant difference between the two groups (x2=9.12,P

Objective To evaluate the early and mid-term results of endovascular repair for acute and chronic type B aortic dissection, and to compare the clinical outcomes between the 2 groups. Methods From May 2002 to December 2006, 50 patients with type B aortic dissection were treated by endovascular stent-graft. There were 23 patients in the acute aortic dissection (AAD) group and 27 patients in the chronic aortic dissection (CAD) group. All patients were followed up from 1 to 54 months (average, 17±16 months).The immediate and follow-up clinical outcomes were documented and compared between the 2 groups. Results Placement of endovascular stent-grafts across the primary entry tears was technically successful in all 50 patients. Compared to the CAD group, the AAD group had a higher percentage of pleural effusion (17.4% vs. 0%,P=0.04) and visceral /leg ischemia (26.1% vs 3.7%, P=0.04). Procedure related complications, including endoleak and post-implantation syndrome, occurred more frequently in the AAD group than in the CAD group (21.7% vs 3.7% and 30.4% vs 11.1%, respectively; P=0.08 and P=0.04). Kaplan-Meier analysis showed no difference in the survival rate at 4 years between the 2 groups (86.4% vs 92.3%, P=0.42 by log-rank test). However, the event-free survival rate was higher in patients with chronic dissection than in patients with acute aortic dissection (96.2% vs 73.9%; P=0.02 by log-rank test). Conclusions Endovascular repair with stent-graft was safe and effective for the treatment of both acute and chronic type B aortic dissection. However, both immediate and long term major complications occurred more frequently in patients with acute dissection than in those with chronic dissection.

Objective To study the various aspects of the outstanding advantages that intersphinctefic resection, anal sphincter resection (ISR) was applied to the clinical ultra-low position rectal cancer anal surgery (SSO) treatment. Methods From 70 patients with rectal cancer in our hospital were divided into two groups at random in accordance with the operation mode and the average. Patients in one group were treated by laparoscopic ISR ultra-low a SSO (called a mirror abdominal group), and patients in another group were treated by opening the IRS ultra-low a SSO (control group), compared the clinical outcomes. Results From the point of the analysis of the clinical operation, all patients with abdominal lens group line TME (total mesorectum excision), no open treatment conditions, the average op-eration time and intraoperative blood loss were significantly and hospital stayed lower than control group in patients (P< 0.05), the main postoperative complications for colon membrane prolapse and crissum eczema (not severity complica-tion), and two groups of patients with postoperative bowel and anal pressure determination results had no significant dif-ference (P> 0.05). Conclusion Laparoscopic IRS ultra-low rectal cancer SSO wound was small, safe and feasible, for the short-term treatment of patients with rectal cancer curative effect was good and being worthy of application.