The curative effects of multi-disciplinary and comprehensive treatments for colorectsl cancer have been widely recognized in recent years.Because of the diversification of colorectal cancer treatment and the relatively mature technology,the current treatment of colorectal cancer could embody the multi-disciplinary and comprehensive treatment.The curative effect of neo-adjuvant chemoradiotherapy has been validated by several recent clinical trials.Other treatment methods such as Chinese medicine,radiofrequency ablation and hepatic artery infusion therapy are also involved in the comprehensive treatment,which provide considerable curative effects.

Objective To established a bacteriemia model of BALB/c mice after infection with a ST-239 methicillin-resistant staphylococcus aureus(MRSA) strain, which was isolated and identified from Shanghai Huashan Hospital. Methods We monitored the clinical signs and gross observations of MRSA-infected mice, and examined the histopathology among different groups. Results This isolated MRSA strain ST-239 can induced a typical bacteriemia in BALB/c mice, including the severe mortality and extensive histopathologic injury. However, higher survival rate and slight inflammatory injury were observed in vancomycin-treated mices. Conclusion The solid results obatined in this model will benefit us to study the pathogenic characteristics and patholgenesis in MRSA-induced bacteriemia, and propeled us to seek a safety cure approaches in the future.

Objective To investigate the effect of sodium citrate on the efficacy of oral midazolam premedication in children with congenital heart disease. Methods Forty ASA Ⅱ or Ⅲ children, aged 2-6 yr, weighing 12-20 kg, undergoing cardiac surgery, were randomly divided into 2 groups (n = 20 each): control group (gronp C) and sodium citrate group (group S). Group S received oral mixture of midazolam 0.12 ml/kg (0.6 my/kg), ketamine 0.12 ml/kg (6 my/kg), glucose 0.12 ml/kg (60 mg/kg) and sodium citrate 0.12 ml/kg (3 mg/kg), total volume 0.48 ml/kg. Group C received oral mixture of midazolam 0.12 ml/kg, ketamine 0.12 ml/kg and glucose 0.24 ml/kg, total volume 0.48 ml/kg. Hydrochloric acid (pH value 1.75) was mixed with the mixtures in the two groups and pH values were measured. Preoperative anxiety scale and the onset time,sedation score and parental separation score after receiving oral drugs were recorded in preparation room for anesthesia. After entering the operating room, HR, MAP and SpO2 were monitored, and the response to venepuncture in children and the adverse effects associated with oral drugs were also observed and recorded. Results The pH value was 1.97 in group C and 4.52 in group S. The parental separation score, sedation score and response score were significantly lower and the onset time was significantly shorter in group S than in group C. HR, MAP and SpO2 were in the normal range after entering the operating room. There was no obvious adverse effect after administration of oral drugs in the two groups. Conclusion Application of sodium citrate in the oral premedication in children with congenital heart disease can raise the pH value, shorten the onset time of midazolam, and enhance the sedative efficacy.

Objective To explore the role of defoamer enema combined with bellym assage on the colonic preparation in elderly patients with constipation. Methods One hundred patients were divided into two groups by random number table method, the experimental group and the control group with 50 cases each. Patients in the control group were told to drink polyethyleneglycolelectrolytesolution 3000 ml. Patients in the experimental group were told to drink polyethyleneglycolelectrolytesolution 2000 ml. After medicinepre paration, the patients of experimental group were given defoamer enema. After that, they were undertaken counterclockwise massage for10 mins, then massageing clockwise until defecation. Results 14 patients with oral catharsis drugs failed to give up check, 46 cases of intervention group and 40 cases of control group finally complete intestinal preparation and colonoscopy. Intervention group patients after bowel preparation before the incidence of abdominal distension, abdominal pain were 6.52% (3/46), 8.70%(4/46), lower than the control group 65.00% (26/40), 25.00% (10/40), the difference was statistically significant (χ2= 32.74, 4.17, P< 0.05). Percent of pass was 65.22%(30/46) for intestinal preparation intervention group, significantly higher than the control group 35.00% (14/40), the difference was statistically significant (χ2= 7.82, P< 0.05). Intervention group intestinal cleanliness ratings of Ottawa total score was 4.00 (4.00), which was lower than the control group 7.00 (4.50), the difference was statistically significant (Z= 3.80, P< 0.05). Endoscopic check process, the intervention group arrived at the terminal ileum and mirror back time were 7.00 (3.00) and 9.00 (1.00) min, were less than 9.00(6.50) and 10.50 (3.00) min in the control group, the difference was statistically significant (Z= 2.09, 4.53, P< 0.05). Intervention group of colons polyps detection rate was 67.39% (31/46), higher than that of control group 30.00% (12/40), the difference was statistically significant (χ2 = 11.97, P< 0.05). Conclusions The bowel preparation with defoamer enema will enhance the intestinal tract cleaness and the detection rate of polyps in elderly patients with constipation.

AIM: To investigate the cardioprotective effects of monophosphoryl lipid A(MLA) and its molecular mechanisms.METHODS: In the ischemia/reperfusion(I/R) model of porcine hearts, the effect of MLA on myocardial infarct size was observed. The protein levels of extracellular signal regulatory kinases (ERKs) and heat shock protein (HSP) 86 were detected by using western blotting method. RESULTS: MLA pretreatment significantly limited the infarct size in the porcine hearts subjected to I/R. It is also found that MLA pretreatment upregulated the protein levels of HSP86 and ERKs. CONCLUSION: MLA pretreatment can attenuate I/R injury in porcine hearts. The protective mechanism might be associated with ERKs-induced upregulation of HSP86 synthesis.

ObjectiveTo discuss the perioperative nursing of sigmoid colon cystoplasty in neurogenic bladder patients after spinal cord diseases. Methods31 patients with neurogenic bladder due to the spinal cord diseases and received sigmoid colon cystoplasty were reviewed and followed up. ResultsThere were 2 cases complicated with bowel obstruction, 1 case with acute alleosis and 1 case with mycotic infection in bladder after the operation, who were all cured. After discharge, 2 cases lost the follow-up. During the follow-up period of 6 months to 4 years, 29 patients recovered well and kept in self-intermittent catheterization. ConclusionPreoperative psychological nursing and intestinal and bladder preparation, postoperative gastrointestinal and urinary drainage catheters nursing, intermittent catheterization training, regular follow-up and health guiding were the key nursing contents and the important step for ensuring an excellent outcome for the operation.

Objective To investigate the needs of the main caregivers of children with cerebral palsy and probe into the nursing strategies. Method One hundred and fifteen main caregivers of children with cerebral palsy participated in the survey by a general state questionnaire and the family needs questionnaire. Results The score by the family needs questionnaire was (96.13 ± 19.47), with an average score of (3.00 ± 0.61). And the top needs of the main caregivers were information and econony need. Conclusions The needs of the main caregivers of children with cerebral palsy are high. More attention should be paid to community and family-based rehabilitation and supports to those care-givers.

Objective To evaluate the effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia.Methods One hundred patients of both sexes,aged 18-70 yr,weighing 42-88 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to 2 groups using a random number table:fentanyl-propofol group (group FP) and propofol-fentanyl group (group PF).In FP group,fentanyl 3 μg/kg was injected intravenously over 3 s,and then propofol 1.5 mg/kg was injected intravenously.In PF group,propofol 1.5 mg/kg was injected intravenously,and then fentanyl 3μg/kg was injected intravenously over 3 s.The development,intensity and onset time of cough were recorded within 1 min after fentanyl injection.Results Compared with FP group,the incidence of cough was significantly decreased,and no significant change was found in the intensity and onset time of cough in PF group.Conclusion Administration in the propofol-fentanyl sequence can reduce the development of fentanyl-induced cough as compared with that in the fentanyl-propofol sequence during induction of general anesthesia.

Objective　To evaluate the direct economic costs of four major kinds of nosocomial infections such as nosocomial pneumonia,urinary tract infection, deep surgical wound infection and intracranial infection. Methods　A matched case-control study was conducted among 95 pairs of hospitalized patients to investigate the direct economic costs of nosocomial infections. Results　The average medical cost for patients in the case group was 38 741 RMB Yuan, 20 365 Yuan more than that in the control group patients (P＜0.000 1). The largest part of extra costs was found in drug expenses, taking up 62.07%, while other extra costs such as non-drug therapies, blood transmission and laboratory examinations, accounted for 10.32%, 7.40% and 5.72% respectively. Extra economic burden caused by nosocomial infections varied in different degrees with different departments, with the heaviest found in the department of tumourology and hematology at an average extra cost of 34 944 Yuan. The average extra charges in case group caused by nosocomial pneumonia,urinary tract infection, deep surgical wound infection and intracranial infection were 31 940 Yuan,7 436 Yuan,17 332 Yuan and 17 349 Yuan respectively. The average length of hospital stay was 50.57 days in case group and 25.22 days in control group, showing a 25.53 extra days (P＜0.000 1) of hospitalization due to nosocomial infections. Conclusion　Nosocomial infections had significantly added to the economic burden of managing the underlying diseases, led to prolonged hospitalization of the patients and lowered the turnover rate of hospital bed. There is a need to call for better infection control program, which would bring tremendous social and economic profits.

Objective To observe the ultrastructure of pancreas in the bustard( Otis tarda limaells) . Methods Three bustard's pancreas were observed with electron microscope. Results The exocrine secretory units of bustard's pancreas contain a lobulated tubulo acinar gland in which the lobulation is not so distinct as that of the mammalian gland due to the lack of interlobular connective tissue septa.The space between lobular pancreas is lined directly with pancreatic cells as the duct.Single long spindle shaped connective tissue cell could only be seen among three lobules and its cytoplasm becomes slender and stretches into the space between lobules as a distinct intermediate dense line.The exocrine secretory cells can be divided into two kinds of dark and light.In the light cell,particularly in swelled up rER with very little density are filled the greater part of the cytoplasm and made the cell appearance much lighter than other cells.\;The endocrine cells are divided into two types that are dispersed in pancreatic singly and clustered into pancreatic islets.The dispersed endocrine cells contain a lot of moderate dark electron dense granules in their process near basement membrane.There are two types of islets——A islet and B islet in the bustard pancreas.A islets comprise only one cell type with moderate electron density that contains dark endocrine granules.B islet contains two cell types:B and D cell.B cells are the most numerous cells with a long ovoid nucleus and contains two or three types of granules in the cytoplasm.D cells are relatively rare and can be seen in the periphery nearby basement membrane.Cells keep close to each other and desmosomes can be seen within the islet.The endocrine cells closely contact exocrine cells without basement membrane in the periphery partly.Conclusion\ These are some structural characteristics that adapt to fly and that are different from other animal in bustard's pancreas.