Colorectal cancer (CRC) is one of the most common malignancies,and liver metastases become the leading cause of high mortality of CRC patients.Difference in the anatomy between the colon and rectum resulting in different metastatic pattern and treatment methods between the colonic cancer and the rectal cancer.Recently,molecular-based subtyping is becoming the basis of prediction of tumor response and outcomes,replacing clinical and pathological stagings.In this review,clinical characteristics,advances of molecular detection,surgery and adjuvant therapy of rectal liver metastases are summarized.

Objective To explore the feasibility and safety of endoscopic thyroidectomy via axillo-breast approach and the cervical strap muscles. Methods From January to June 2007, endoscopic thyroidectomy was performed on 21 cases in our department via axillo-breast approach and the cervical strap muscles. The operation was carried out under general anesthesia, the anterior cervical muscles was preserved and dragged ahead if necessary. The pressure of CO2 at surgical space was set at 6-8 mm Hg.Results Endoscopic unilateral partial or subtotal thyroidectomy was completed in all the patients without converting to open surgery. No complication occurred in this series. The mean operation time was 70-120 min [mean,(88.3?19.5) min], and the mean blood loss was 2-100 ml [mean, (11.5?21.8) ml]. The drainage tube was removed at 36-48 hours after the operation. And the mean postoperative hospital stay was 2 days. A 3-month follow-up showed good outcomes in terms of sensation at the surgical region and cosmetic effect. Conclusion Endoscopic thyroidectomy via axillo-breast approach and the cervical strap muscles is feasible and safe for unilateral benign thyroid lesions.

Objective To understand current prevalence of fluorosis, of drinking tea type in Pengyang County of Ningxia to offer scientific basis for preventing and curing, monitoring, health education. Methods Four towns were chosen as investigating spots in Pengyang County of Ningxia in 2007, from each 50 children aged 8-12 year old and 50 adults who either had tea or did not were investigated. Dean method was used to measure dental fluorosis of children and adult; meanwhile fluoride content in water, urine and drinking tea was tested using the fluoride ionic electrode method and that in brick tea using water immersion electrode method. χ2 testing, analysis of variance, u test, q test were performed. Results In adult drink tea group, control group, and children, the detaction rate of dental fluorosis were respectively 24.75%(99/400),9.5%(38/400)and 15.96%(71/445), obviously higher in drink tea group than the control group(χ2= 32.73, P<0.05). Urine average concentration of fluoride was (3.38±2.37), (2.09±1.33 ). (1.41±0.67)mg/L, obviously higher in drink tea group than the control group(u= 9.49, P<0.05). In 4 investigation spots tea fluoride averaged at (3.63±2.05)mg/L, fluoride content in drinking water was averagely (1.01±0.49) mg/L, with that of Wangwa Town [(1.31±0.33)mg/L] exceeding the national standard for drinking water (1.0 mg/L), where dental fluorosis rate was higher and fluoride content was higher than that in 3 other investigation spots (P<0.05). Conclusions Residents in Pengyang County in Ningxia who drink brick tea can cause accumulation of fluorine to poison in Ningxia, leading to fluorosis of drinking tea type; Wangwa Town have both drink tea and water fluorine poison.

Objective To explore the clinical effect of laparoscopic colorectal radical resection combined with simultaneous laparoscopic or open major hepatectomy for synchronous colorectal liver metastases (SCRLM).Methods The retrospective cohort study was adopted.The clinical data of 14 patients with SCRLM who were admitted to the Peking University Third Hospital from July 2010 to September 2015 were collected.Seven patients undergoing total laparoscopic colorectal radical resection combined with major hepatectomy (TLCRMH) were allocated into the TLCRMH group and 7 patients undergoing laparoscopic colorectal radical resection combined with open major hepatectomy (LCROMH) were allocated into the LCROMH group.The statuses of colorectal cancer and metastatic lesions were detected by endoscopy and imaging examination,and diagnostic and therapeutic plans were confirmed through the consultation of muhidisciplinary team.During the hepatectomy,total liver ultrasonography was performed and the extent of liver resection was above 3 hepatic segments.The follow-up of outpatient reexamination was applied to all the patients once every 3 months within postoperative year 2 and once every 6 months after 2 years till December 2015.(1) During operation,method of liver resection,radiofrequency ablation (RFA),operation time,volumes of intraoperative blood loss and blood transfusion,pathological results of primary lesions (T stage,N stage,nerve invasion and canalis haemalis invasion) were collected.(2) After operation,duration of intensive care unit (ICU) care,time for fluid diet intake,postoperative alanine transaminase (ALT),total bilirubin (TBil),complications and duration of hospital stay were collected.(3) Survival of patients and recurrence of tumor were followed up.Count data were analyzed by the chi-sqaure test.Measurement data with normal distribution were presented as x ± s and analyzed using the t test.Measurement data with skewed distribution were described as M(Qn) and M(range) and analyzed using the Mann-Whitney U test.The survival curve was drawn by the Kaplan-Meier method,and overall survival rate and tumor-free survival rate were calculated.The survival analysis was done using the Log-rank test.Results (1) The status of operation:1 and 6 patients in the TLCRMH group underwent respectively left and right hemihepatectomies and 7 patients in the LCROMH group underwent right hemihepatectomy.Four and 6 patients in the TLCRMH and LCROMH groups received local resection of liver metastatic lesions or RFA at segment Ⅱ,Ⅲ or Ⅳ of liver,respectively.The operation time,volumes of intraoperative blood loss and blood transfusion were (651 ± 218)minutes,(1 387 ± 871)mL,(914 ±641)mL in the TLCRMH group and (535 ± 83) minutes,(1 357 ±991)mL,(857 ± 360) mL in the LCROMH group,respectively,with no significant difference between the 2 groups (t =1.320,0.060,0.206,P ＞ 0.05).The numbers of patients in T2,T3,T4,N0,N1,N2 stages,with nerve invasion and canalis haemalis invasion were 1,5,1,3,4,0,3,2 in the TLCRMH group and 0,4,3,1,4,2,2,3 in the LCROMH group,respectively,showing no significant difference between the 2 groups (x2=2.111,3.000,0.311,0.311,P ＞ 0.05).(2) After operation,time for fluid diet intake,ALT,TBil,number of patients with complications and duration of hospital stay were (4.3 ± 1.0) days,(105 ± 47) U/L,(34 ± 25) μmol/L,3 (Ⅲ a,Ⅲ b and Ⅳ a grades of Dindo-Clavien grade),(27 ± 21)days in the TLCRMH group and (4.3 ± 1.1)days,(113 ± 57)U/L,(26 ± 11) μmol/L,4 (Ⅰ,Ⅰ,Ⅱ and Ⅳ a grades of Dindo-Clavien grade),(19 ± 9)days,respectively,showing no significant difference between the 2 groups (t =0.079,-0.286,0.806,X2 =0.286,t =0.856,P ＞ 0.05).The duration of ICU care in the TLCRMH and LCROMH groups were (2.1 ± 1.6) days and (1.0 ± 0.6) days,with a significant difference between the 2 groups (t =1.804,P ＜ 0.05).(3) The status of follow-up:all the patients were followed up for 3-54 months,and the median follow-up time was 15 months (range,3-39 months) in the TLCRMH group and 30 months (range,11-54 months) in the LCROMH group.The 1-,3-year overall survival rates were 100.0％ and 100.0％ in the TLCRMH group and 85.7％ and 64.3％ in the LCROMH group,respectively,showing no significant difference between the 2 groups (x2 =0.676,P ＞ 0.05).The postoperative 1-,2-year cumulative tumor-free survival rates and overage cumulative tumor-free survival time were 64.3％,64.3％ and 20.5 months in the TLCRMH group and 42.9％,14.3％ and 10.9 months in the LCROMH group,respectively,showing no significant difference between the 2 groups (x2=3.160,P ＞ 0.05).Conclusion TLCRMH is safe and feasible for patients with SCLM,and it is comparable with LCROMH in the incidence of postoperative complication and long-term outcomes.

Aconitine ; poisoning ; Aconitum ; chemistry ; poisoning ; Cardiopulmonary Resuscitation ; Charcoal ; therapeutic use ; Female ; Hemoperfusion ; Humans ; Male ; Middle Aged ; Poisoning ; drug therapy

Source data and its source documents are the foundation of clinical research. Proper source data management plays an essential role for compliance with regulatory and GCP requirements. Both paper and electronic source data co-exist in China. Due to the increasing use of electronic technology in pharmaceutical and health care industry, electronic data source becomes an upcoming trend with clear advantages. To face new opportunities and to ensure data integrity, quality and traceability from source data to regulatory submission, this document demonstrates important concepts, principles and best practices during managing source data. It includes but not limited to: (1) important concepts of source data (e.g., source data originator, source data elements, source data identifier for audit trail, etc.); (2) various modalities of source data collection in paper and electronic methods (e.g., paper CRF, EDC, Patient Report Outcomes/eCOA, etc.); (3) seven main principles recommended in the aspect of data collection, traceability, quality standards, access control, quality control, certified copy and security during source data management; (4) a life cycle from source data creation to obsolete is used as an example to illustrate consideration and implementation of source data management.
China ; Data Collection ; standards ; Documentation ; standards ; Information Storage and Retrieval ; methods ; standards

Objective To summarize our experiences in the diagnosis and treatment of giant colonic lipoma,and enhance awareness of the disease and avoid misdiagnosis.Methods We retrospectively analyzed the clinical data of 5 cases of giant colonic lipoma that were mistaken for colon cancer,and evaluate the possible reasons of misdiagnosis.Results Colonic lipoma is an uncommon benign tumor.Most cases with larger tumor size were misdiagnosed as colon cancer when they suffered from the symptoms of abdominal pain,bloody stool,abdominal mass,even bowel obstruction and intussusception.Barium enema and colonoscopy are important diagnostic means.Contrast enhanced CT scan can provide definitive topographical information identifying a colonic lipoma.Surgical resection was performed in all the 5 cases.Conclusion Giant colonic lipoma with intussusception can mimic a colonic carcinoma leading to misdiagnosis.

Objective:To compare the clinical characteristics in primary hyper(-) parathyroid hormone (PHPT) of the different patholog-ic types. Methods:Clinical data of 140 patients with PHPT proved by operation and pathology during January 2010 to June 2016 were retrospectively analyzed. Results:A total of 140 PHPT patients, including 13 (9.29%) cases of parathyroid carcinoma (PC), 27 (19.29%) cases of parathyroid hyperplasia (PH), and 100 (71.43%) cases of parathyroid adenoma (PA). The duration of the PC group was longer than the PH group and the duration of the parathyroid adenoma (PH) group was longer than the PA group (P<0.05). The percentage of young patients with PC was higher than in the other two groups (P=0.003). The diameters of the PC group were larger than those of the other two groups, and those of the PA group were larger than those of the PH groups (P<0.05). Blood calcium, parathyroid hor-mone (PTH), AKP, fasting blood glucose (FBG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamete transpepti-dase (GGT), blood urine nitrogen (BUN), creatine (CRE), urinary calcium, and phosphorus of the PC group were higher than in the oth-er two groups (P<0.05). The blood calcium, PTH, alkaline phosphatase (AKP), urinary calcium of the PH group were lower than those in PA group (P<0.05). The proportion of ostalgia was 46.15%(6/13), 44.44%(12/27), and 49.00%(49/100). No statistical difference was observed (P>0.05). The postoperative calcium level of PC group was lowest (P<0.001), and the highest was of PTH (P<0.001). The pro-portions of clinical manifestation of the urinary system, digestive system, and nervous system in the PC group were 76.92%(10/13), 76.92%(10/13), and 15.38%(2/13), respectively, and these values were the highest in the three groups (P<0.05). The proportion of the clinical manifestation of the urinary system of the PH group was higher than that of the PA group. The fracture rate (30.77%, 4/13) and constipation rate (38.46%, 5/13) of the PC group were the highest among the three groups (P<0.05). Conclusion:The duration of patients with PC was the longest among the three groups. The percentage of young patients with PC was the highest. The abnormal parathyroid glands in the PC group were the heaviest. The PC group exhibited the lowest postoperative calcium level and the highest PTH level. The biochemistry and clinical manifestations of PC were obvious.

Objective To observe the inhibition of transforming growth factor-alpha(TGFa) anti-senseoligodeoxynucleotides on the malignant proliferation of HR8348 cell line. Methods Using the TGFa anti-sense oligodeoxynucleotides, composed of 23 and indifferent oligodeoxynucleotides, to affect the HR8348cell. By observing the cell growth inhibiton, 3H-TdR incorporation,mRNA hybridization and the cell cycleanalysis to identify the inhibiting effects of TGFa anti-sense oligodeoxynucleotides and its mechanism.Results TGFa anti-sense oligodeoxynucleotides can Inhibit the proliferation of HR8348 cell, DNA0synthesis,mRNA expression,and defer the transition period of G,/G, phase to S phase. Conclusion TGFaanti-sense oligodeoxynucleotides can inhibit the malignant proliferation of HR8348 cell effectively.

Objective To explore the application of continuing nursing model in life of puerperae with preterm infants and evaluate its effects.Methods Based on continuous nursing model of Ahmadi,puerperae's continuing nursing program was constructed.Randomized controlled trail design was used,and totally 110 puerperae in a hospital in Beijing were recruited from August 2016 to March 2017.The experimental group received continuing nursing intervention model,and the control group received routine nursing care.Parenting knowledge and psychological evaluation of the two groups were collected 3 days before discharge,1 month,3 months and 6 months after discharge.Results Ninety-eight puerperae completed the study.In the experimental group,the score of parenting knowledge was higher than that of the control group(P＜0.01),and the total score of mental health assessment and scores of depression and anxiety were lower than those in the control group (P＜0.05).Conclusion Puerperae's continuing nursing program based on the continuous nursing model of Ahmadi improved maternal ability and positive emotion,and promoted quality of life.