Rectal cancer does great harm to human health which is one of the common gastrointestinal malignancies.The most effective treatment to rectal cancer is surgical resection at present.With the increasing demand on the quality of life,we minimize the surgical resection to preserve the anal function of patients while removing the tumor completely depends on the distal excision margin.But how long of the distance is safe? Lots of domestic and foreign scholars have a great controversy without a certain definition.This article reviews the progress on the distal excision margin,aiming to give help to clinical sphincter-preserving surgery.

Objective To analyze the genetic characteristics of measles virus strains causing two outbreaks in Guizhou province from November 2014 to March 2015. Methods Throat swab samples collect-ed from measles cases in two outbreaks were inoculated into Vero/SLAM cells. Viral RNAs were extracted from positive cultures. Nucleoprotein genes were amplified by using reverse transcription-polymerase chain reaction ( RT-PCR) and the PCR products were sequenced and analyzed. Results Eleven strains of wild-type measles virus were isolated from the two measles outbreaks and all of them belonged to H1a sub-geno-type. Phylogenetic analysis showed that those strains were clustered into two distinct branches. Differences in nucleotide and amino acid genetic distances between the 11 strains of measles virus and the WHO reference strain of H1a sub-genotype (Chin9322) were 1. 1%-1. 6% and 0. 7%-3. 4%, respectively. Compared with the reference strain Chin9322 and Guizhou epidemic strains in recent years, six strains showed amino acid sequence mutations in 47 ( G to S) , 82 ( S to G) and 122 ( R to K) sites and two strains had a mutation in 98 ( P-L) site. Conclusion H1a sub-genotype measles virus was the predominant pathogen causing two measles outbreaks in Guizhou province during 2014 to 2015. Moreover, it was also a predominant sub-geno-type circulating in China and Guizhou province. Different measles virus strains of H1a sub-genotype contin-ued to be prevalent in Guizhou province. This study provided some scientific data for the control and elimina-tion of measles in Guizhou province.

OBJECTIVE: To investigate the infection in spotted fever group Rickettsiae (SFGR) in wild rodents from Heilongjiang, China. METHODS: Polymerase chain reaction (PCR) was used to detect the OmpA gene of SFGR in rodents collected in Heilongjiang. The PCR products amplified from rodent specimens were sequenced and compared with the corresponding part of the sequences deposited in the GenBank. Phylogenetic trees were constructed with Mega 5.0 software. RESULTS: A total of 514 rodents were collected from Heilongjiang during 2009-2011 and 11 species were included. The infection rate of SFGR in the rodents was 9.3% (95% CI: 7.1%-12.2%). Statistical analysis showed a significant difference in different areas of Heilongjiang (P=0.023). The highest prevalence was observed in Mudanjing area (12.42%). There were significant differences in different species of rodents (P=0.002). The infection rate of SFGR determined in Clethrionomys rufocanus was the highest (22.1%). Sequence analysis revealed SFGR belonged to R.heilongjiangensis and a new unknown rickettsia genotype. CONCLUSION R.heilongjiangensis has been presented in rodents in Heilongjiang, and a new SFGR genotype different from other rickettsiae genotypes may exist in this area.
Animals ; China ; DNA, Bacterial ; genetics ; isolation & purification ; Forests ; Phylogeny ; Polymerase Chain Reaction ; Rats ; Rickettsia ; classification ; genetics ; isolation & purification ; Rickettsia Infections ; microbiology ; veterinary ; Rodentia ; microbiology ; Sequence Analysis

Objective:To determine the risk factors of extubation failure and its effect on the prognosis of patients who had successfully passed a spontaneous breathing trial (SBT).Methods:The clinical data of patients with mechanical ventilation more than 24 hours who passed SBT admitted to department of intensive care unit (ICU) of First Hospital of Qinhuangdao from November 2018 to November 2019 were retrospectively analyzed. According to the outcome of weaning within 48 hours after weaning, patients were divided into weaning success group and weaning failure group. The baseline data, the presence of basic cardiopulmonary diseases, B-type natriuretic peptide (BNP), fluid balance, albumin and hemoglobin within 24 hours before weaning, the time of mechanical ventilation before weaning, rapid shallow breathing index (RSBI) during SBT, oxygenation index, cough peak flow at the end of SBT, and prognostic indicators were collected. The outcome of weaning was taken as the dependent variable, and the observation factors were taken as the independent variable for univariate analysis. The factors with statistical significance in univariate analysis were analyzed by binary Logistic regression to determine the influencing factors of weaning failure.Results:Of the 204 patients, 167 (81.9%) were successfully weaned, and 37 (18.1%) failed. Compared with the weaning success group, the total duration of mechanical ventilation and the length of ICU stay in the weaning failure group were significantly longer [days: 13.0 (7.5, 23.5) vs. 5.0 (3.0, 8.0), 17.0 (12.5, 31.0) vs. 10.0 (6.0, 15.0), both P < 0.01], and the tracheotomy rate and mortality were significantly higher (32.4% vs. 0%, 51.4% vs. 0%, both P < 0.01). Univariate analysis showed that there were significant differences in age, proportion of patients with cardiopulmonary diseases, BNP and cough peak flow between weaning failure group and weaning success group [age (years old): 70.65±15.78 vs. 62.69±15.82, cardiopulmonary diseases: 62.2% vs. 24.6%, BNP (ng/L): 416.87 (32.70, 1 225.80) vs. 45.36 (10.00, 273.60), cough peak flow (L/min): 59.89±9.06 vs. 83.84±16.52, all P < 0.01]. However, there were no significant differences in gender, acute physiology and chronic health evaluationⅡ (APACHEⅡ) at admission, mechanical ventilation time before weaning, albumin, hemoglobin, oxygenation index, RSBI and fluid balance 24 hours before weaning between weaning failure group and weaning success group [male: 51.4% vs. 68.3%, APACHEⅡ: 16.70±6.65 vs. 15.67±6.28, mechanical ventilation time before weaning (days): 6.0 (2.5, 11.0) vs. 5.0 (3.0, 8.0), albumin (g/L): 27.78±4.15 vs. 27.76±4.46, hemoglobin (g/L): 102.43±15.80 vs. 100.61±17.19, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 359.33±79.83 vs. 365.75±78.23, RSBI (times·L -1·min -1): 50.73±24.97 vs. 46.76±15.53, positive fluid balance: 70.3% vs. 69.5%, all P > 0.05]. The results of binary Logistic regression analysis showed that age ≥ 75 years old [odds ratio ( OR) = 3.099, 95% confidence interval (95% CI) was 1.003-9.574, P = 0.049], presence of cardiopulmonary diseases ( OR = 3.599, 95% CI was 1.126-11.498, P = 0.031), BNP within 24 hours before weaning ( OR = 1.002, 95% CI was 1.000-1.003, P = 0.005) were the risk factors of extubation failure, while cough peak flow at the end of SBT was the protective factor ( OR = 0.869, 95% CI was 0.823-0.917, P = 0.000). Conclusions:For patients who had successfully passed SBT, age ≥ 75 years old, the presence of cardiopulmonary diseases and an increased level of BNP within 24 hours were the risk factors of extubation failure. In addition, the higher the cough peak flow at the end of SBT, the lower the risk of weaning failure will be.

Objective:To evaluate the auxiliary diagnosis value of bacterial culture, polymerase chain reaction (PCR) and serum anti-pertussis toxin immunoglobulin G (AntiPT-IgG) level detection in suspected pertussis.Methods:A total of 110 suspected cases of pertussis treated in the Department of Pediatrics of Wuhu No.1 People′s Hospital from June 2018 to May 2019 were recruited for the study.The nasopharyngeal swabs of all cases were collected for Bordetella pertussis culture and specific nucleic acid PCR detection.Serum samples of 78 cases were collected for the detection of AntiPT-IgG level by enzyme linked immunosorbent assays.Results:The positive rates of bacterial culture group and PCR group were 21.8% and 30.0%, respectively, with no statistically significant difference ( χ2=1.198, P>0.05). The culture positive rate of cases with the duration of cough<2 weeks was 32.1%, which was signi-ficantly higher than that of cases with the duration of cough about 2-4 weeks (14.3%) or >4 weeks (9.1%) ( χ2=6.522, P<0.05). The PCR positive rate of cases with the duration of cough <2 weeks was 39.6%, which was also significantly higher than that of cases with the duration of cough about 2-4 weeks (25.7%) or > 4 weeks (13.6%) ( χ2=6.126, P<0.05). The mean value for serum AntiPT-IgG level of 78 cases was (75.727±78.454) IU/mL, the median AntiPT-IgG levels of cases with the duration of cough<2 weeks and about 2-4 weeks were 5.909 IU/mL and 20.948 IU/mL, respectively, and the positive rates were 14.7% and 38.1%, respectively.The AntiPT-IgG level of cases with the duration of cough> 4 weeks and that at convalescent stage were (79.281±68.254) IU/mL and (107.242±75.750) IU/mL, and the positive rates were 39.1% and 57.1%, respectively. Conclusions:In the vaccine era, the results of pathogenic and serological tests should be combined to assist the clinical diagnosis of pertussis.The positive rate of bacterial culture and specific nucleic acid pathogen detection in children with cough duration less than 2 weeks is high, and the serological diagnosis is more effective after the duration of cough is over 4 weeks.