Objective To observe the short-term efficacy and adverse drug reaction of Photofrin photodynamic adjuvant therapy for advanced colorectal cancer in young persons.Methods Selected 23 cases consecutives diagnosed as advanced colorectal cancer in young persons from September 2010 to February 2014 arriving in the Central Hospital of Jiangmen as the experiment group who were received Photofrin photodynamic therapy,and chose 30 consecutives diagnosed as advanced colorectal cancer as the control group who were received radiotherapy and chemotherapy.Using Photofrin in 2 mg/kg photosensitizer, the speed of intravenous infusion,48 hours after endoscopic into optical fiber, laser irradiation and treated with 630 nm intensity,2 days after endoscopic removal of necrotic tissue and the original lesions and new lesions were found to give according to the specific circumstances, after the removal of necrotic tissue lesions.Then compare the effects and complications.Results The total efficacy rate in experiment group was significantly more than control groupthe differences were significant (69.57％ vs.40.00％, P =0.035).The in-hospital time in experiment group was significantly less((13.47±4.46) h vs.(19.72± 5.21) h, P =0.036).The adverse drug reaction rate in experiment group was significantly lower thant the control group (30.43％ vs.50.00％ ,P=0.021).Conclusion The Photofrin photodynamic therapy for advanced colorectal cancer in young persons may greatly improve clinical effect and decrease complication.

ObjectiveTo investigate the clinical and imaging features of nonaneurysmal perimesencephalic subarachnoid hemorrhage (NAPSAH).MethodsThe patients with NAPSAH were retrospectively enrolled, and their clinical and imaging features were collected and analyzed.Results In 489 patients with subarachnoid hemorrhage treated over the same period, a total of 23 (4.7%) with NAPSAH were diagnosed with cranial CT and CT angiography.Subarachnoid blood centered in the prepontine cistern in 4 patients (17.39%), interpeduncular cistern in 8 (34.78%), ring pool in 7 (30.43%), and quadrigeminal cistern in 4 (17.39%).Two patients were transferred to other hospital for treatment, and the remaining 21 patients had a good outcome without complications and neurological deficits.Among them, the modified Rankin scale scores in 17 patient were 0, and 4 were 1.Their cardinal symptoms were forgetfulness, irritability, anxiety, and other subjective symptoms.They were improved after receiving psychological counseling and anti-anxiety treatment.ConclusionsThe incidence of NAPSAH is low.The clinical symptoms in patients with NAPSAH are mild, the outcomes are better without obvious complications.

Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2681 type 2 diabetic patients who visited our hospital between January,2007 to December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-＜ 1.3) in 2362 cases (88.1％),while below 0.9 in 277 cases (10.3％) and equal or over 1.3 in 42 cases (1.6％).The elderly patients (≥ 60 years) had a higher prevalence of low ABI than the non-elderly patients(20.41％ vs.4.10％,P ＜ 0.01).The prevalence of DF was 25.63％,3.05％,26.19％ in ABI ＜ 0.9,0.9-＜ 1.3 and ≥ 1.3 groups,respectively,and the prevalence in groups ABI ＜ 0.9 and ≥ 1.3 was higher than that in group ABI 0.9-＜ 1.3.Similar U-shape distribution was observed in the prevalence of abnormal ABI and DF.ABI was negatively correlated with age,diabetes duration,uric acid (UA),24 hours microalbuminuria,while positively correlated with body mass index (BMI),diastolic blood pressure,triacylglyceride,total cholesterol and glycosylated hemoglobin A1c (HbA1c).Abnormal ABI was independently correlated with age,diabetes duration,HbA1c,UA,24 hours microalbuminuria,diabetic kidney disease,diabetic retinopathy,diabetic peripheral neuropathy and diabetic vascular diseases.Conclusion The prevalence of abnormal ABI is higher in the elderly patients with type 2 diabetes.Abnormal ABI could be an early predictor for DF.

[Summary] Type 2 diabetic patients often have risk factors such as hyperglycaemia ,dyslipidaemia , hypertension ,obesity and insulin resistance ,which increase the risks of vascular endothelial dysfunction and cardiovascular events. GLP-1 analogue and its receptor agonist ,is a novel therapy on diabetes targeting at incretin ,which can effectively control blood glucose and improve vascular endothelial dysfunction. Here we summarize the protective effect of GLP-1 analogue and its receptor agonist on vascular endothelial cell.

Objective To investigate the adverse reaction of gastric cancer patients after inquiry application of bevacizumab combined with chemotherapy,and put forward some corresponding preventive measures.Methods Sixty-five cases patients with gastric cancer who were treated with advanced gastric cancer radical operation application of bevacizumab in combination with chemotherapy in the Central Hospital of Jiangmen from January 2012 to January 2014,including 41 male,24 female,with the average age of 48.7 years old.The adverse reactions were observed,and give the corresponding prevention and control measures on the basis of the adverse reaction conditions,the experience in the prevention and treatment were summarized according to the therapeutic effect with clinical and related literature.Results The adverse reactions caused by bevacizumab combined with chemotherapy in patients with gastric cancer including proteinuria (a total of 24 cases(37％),including 18 cases(27.8％) of (+),6 cases(9.2％) of (+ +)),gastrointestinal reaction(a total of 10 cases (15.4％),including 8 cases (12.3 ％) of grade Ⅰ,2 cases (3.1％) of grade Ⅱ),thrombosis (a total of 20 cases(30.7％),including 13 cases of grade Ⅰ (20％),7 cases(10.7％) of grade Ⅱ) and hypertension(a total of 11 cases(16.9％),including 9 cases(13.8％) of grade Ⅰ,2 cases(3.1％) of grade Ⅱ).Bevacizumab combined with chemotherapy in the treatment of gastric cancer patients with partial remission in 41 cases (63.1％),10 cases (15.4％) of stable disease progression,14 cases (21.5％) of disease progression,the complete remission rate was 63.1％.For adverse reactions of proteinuria,patients with asymptomatic proteinuria,if patients with urinary protein detection results for (+),without special treatment,when patients with urinary protein detection for (+ +),given the observation,if patients with urinary protein was more than or equal to 2 g/24 h,paused bevacizumab until proteinuria＜2 g.When the patients with digestive system damage,such as ALT and AST elevation,given the treatment of liver until the two hepatic enzymes returned to normal;patients with gastrointestinal reactions were nausea and vomiting,asked patient to light diet and regular esophagoscopy,if the patients appeared visceral fistula immediately.stopped bevacizumab.For patients with thrombosis,should be closely monitored in patients with signs,once found regardless of any level of embolism events,all immediately stopped the chemotherapy drugs.For the main adverse reactions of hypertension,given patients with proper medication explain before the treatment to reduce the fear,tension,and avoiding mood disorders which lead to an increase in blood pressure,blood pressure should be regularly detected in patients who use drugs,if patients occurred a sharp rise in blood pressure during the treatment,immediately stopped bevacizumab and given antihypertensive treatment.Conclusion Clinicians should take the possible corresponding prediction in patients underwent application of bevacizumab in combination with chemotherapy on the possible different adverse reactions according to the actual situation of patients,and take corresponding preventive measures,can to some extent avoid serious adverse reaction occurred,and improve the quality of life of the patients.

Pancreatic cancer is one of the most malignant diseases.With the development of biology,its pathogenesis has become more and more clear.There are a lot of signal pathway aberrant in pancreatic cancer cell including Notch signal pathway,k-ras signal pathway,hedghog signal pathway,NF-κB signal pathway and so on.Because of the widespread of NF-κB signal pathway aberration in pancreatic cancer cell,we think that NF-κB play a key role in the various kinds of aberrant signal pathways.So the NF-κB relative sighal pathways in pancreatic cancer are reviewed in this atticle.

Objective To investigate the clinical application of procalcitonin (PCT),pre-albumin (PA)and white blood cell (WBC)detections in children infectious diseases.Methods 116 children inpatients of infectious diseases in our hospital were select-ed for conducting the study and divided into the non-bacterial infection group (56 cases)and the bacterial infection group (60 cases) according to the different pathogenic microorganisms.Other 64 children with healthy physical examination in the outpatient depart-ment were taken as the control group.The blood PCT,PA levels and WBC count were detected in 3 groups,and which before and after treatment in the bacterial infection group were detected.The differences in PCT,PA levels and WBC count were compared a-mong the groups.Results The blood PCT level and WBC count in the bacterial infection group and the non-bacterial infection group were all higher than that in the control group,while the PA level in the bacterial infection group was lower than that in the non-bacterial infection group and the control group,the differences had statistical significance (P <0.05);the PCT level and WBC count after treatment in the bacterial infection groups were lower than those before treatment,while the PA level after treatment was higher than that before treatment with statistical difference (P <0.05).Conclusion The detection of PCT,PA and WBC count can be used as the indexes for diagnosing infectious diseases in children,and provides reference for the judgment of prognosis.

Objective To evaluate the surgical management of pancreatic fistula caused by pan-creatic trauma and pancreatitis through surgical drainage. Methods A series of 45 patients with pancreat-ic fistula undergoing Roux-en-Y surgery with or without fistulectomy from 2004 to 2014 was analyzed. Pa-tients were divided into two groups:patients in group A(n=21)underwent external drainage of pancreatic secretion by Roux-en-Y surgery,and patients in group B(n= 24)underwent Roux-en-Y surgery with fistu-lectomy. The surgery was performed at 4~6 months after formation of the fistula,and somatostatin was used postoperatively. Results Patients in group A developed more severe side effects than patients in group B, including chronic abdominal pain(6/21 vs. 1/24),pancreatic leakage(8/21 vs. 2/24),digestive bleeding (5/21 vs. 5/24)and incision infection(9/21 vs. 3/24). Conclusion Resection of the fistula plus Roux-en-Y surgery can significantly reduce the incidence of surgical complications,which is a safe and efficient management for pancreatic fistula.

The right of informed consent is composed of two closely connected rights-the right to know and the consent right.The right to know is prerequisite and foundation that the consent right depends on,and the consent right is also the value embodiment of the right to know.The main purpose of emphasizing patient's informed consent right lies in through entrust with the medical establishment and the medical staff's corresponding informing obligation,helping patients understand potential risks,cost so that they can make free choice.It can maintain patient's benefit,change patient's weak-trend status.Medical consent right is the patients' right to accept treatment or not and chooses options after they are fully aware of the information about their diagnosis and treatment options.Medical consent as an important right of patients is receiving increasing attention.Based on the achievements of predecessors,this article discusses how to protect patient's right of informed consent better.

Objective:To study the changes of serum advanced oxidation protein products(AOPP) in patients with diabetic nephropathy(DN) and its correlationship with superoxide dismutase(SOD) and glutathione peroxidase(GPx). Methods: Eighty-five diabetes mellitus (DM) patients were divided into 4 groups: non-DN group(DM, n=25), early-stage DN group(DN3, (n=24), )significant DN group(DN4, n=17) and end-stage DN group(DN5, n=17). The concentration of serum AOPP was measured spectrophotometerically, serum SOD was determined by xanthine oxidase test and GPx by DTNB reaction test. (Results:) The concentrations of AOPP in patients of DN5 group (-[117.8?64.8-] ?mol/L) and DN4 group (-[80.0?23.0-] ?mol/L) were significantly higher than that in DM group (-[58.2?17.7-] ?mol/L,P0.05) and negatively correlated with SOD and GPx(r=-0.217, r=-0.374, P