Objective To Research the efficacy and side effects of intra-abdominal chemotherapy immune to the abdominal cavity after colorectal cancer liver metastasis and local recurrence.Methods 172 eases of colorectal cancer patients after radical operation were randomly divided into conventional regulation 86 cases of abdominal chemotherapy group(control group) and the immune abdominal chemotherapy group of 86 cases(observation group).The control group received 5-FU1.0,MMC8mg intraperitoneal chemotherapy The observation group at the grass-rcots level to add IL-2 50 million U.Results Observation group effective rate .was 70.9% higher than 55.8% (P ＜0.05) ;the obsenation gionp the three-year survival rate 83.7%,dlsease-free survival rate was 44.2% higher than the 62.8%,22.1% (P＜0.05) ;observation group three-year recurrence rate of 25.6% and 34.9% lower than the rate of liver metastases in the control group of 37.8%,48.9% (P＜0.05) ;two groups of gastrointestinal reaction,ⅠⅡ or degree of bone marrow suppression,liver function mildly abnormal ( elevated alanine amiuotransferase) had no difference.Conclusion For advanced colorectal cancer patients with early immune abdominal chemotherapy,the effective prevention and treatment of abdominal cavity and liver metastasis planting to improve the survival rate,side effects of light,fewer complications,the extension of survival,worthy of clinical application.

Objective To evaluate the clinical application value of MR/DSA- 3D fusion software. Method Fusion imaging was made with fusion software after performing MR and DSA examinations on nine cerebrovascular diseases sufferers. Results The fusion image of six sufferers could display the exact part having pathological changes to cerebral vessel and specify the relationship between the tissue of pathological changes and cerebral vessel, offering a scientific basis for clinics and the fusion images of three sufferers were not ideal. Conclusion MRDSA-3D fusion software can provide image with high diagnostic accuracy and treatment precision.

Objective:To investigate the prognostic value of systemic inflammatory score (SIS) in prognostic assessment of patients with unresectable metastatic colorectal cancer (mCRC).Methods:The clinical data of 130 patients with unresectable mCRC in Affiliated Haikou Hospital of Xiangya Medical College of Central South University from January 2014 to December 2016 were retrospectively analyzed. The relationship between SIS and clinicopathological characteristics of unresectable mCRC patients was also analyzed. The survival analysis was made by using Kaplan-Meier. The risk factors affecting the prognosis of unresectable mCRC patients were analyzed by using Cox regression model to make univariate and multivariate analysis.Results:According to SIS results, patients were divided into 0-score group (40 cases), 1-score group (58 cases), and 2-score group (32 cases). There were no significant differences in different SIS constitution patients stratified by age, gender, primary tumor location, functional status score, tissue type, RAS gene status, number of metastatic organs, peritoneal spread and molecular targeted therapy (all P > 0.05). Kaplan-Meier survival analysis showed that the 5-year overall survival rates of SIS 0-score, 1-score and 2-score group were 37.5%, 19.0%, 6.3%, respectively; and the difference was statistically significant ( χ2 = 3.152, P<0.01). Cox regression survival analysis showed that female, primary tumor location in right side and SIS (scores of 1-2) were independent risk factors for overall survival in patients with unresectable mCRC (all P<0.05). Conclusion:SIS may be an important indicator for prognostic assessment of patients with unresectable mCRC, and patients with high SIS have poor prognosis.

Objective To research ischemic postconditioning on heart function after myocardial ischemia-reperfusion(I/R),and the protective mechanisms. Methods Thirty-two rats were divided into four groups:I/R group ( n = 8 ) , ischemic postconditioning group (n=8),myocardial ischemic postconditioning+ NSC-74859 (STAT3 inhibitor) group(n=8),and control group(n=8). Establish a model of rat to observe changes of the heart rate,LVSP,+dp/dtmax,-dp/dtmax,coronary flow and myocardial enzyme spectrum in each group un-der different conditions. Results Compared with ischemia-reperfusion group,heart rate of the reperfusion period,CK and LDH of coronary ef-fluent in the ischemic postconditioning group were obviously lower,while left ventricular systolic pressure,change of intraventricular pressure, and coronary effluent volume increased obviously. And after inhibition of STAT3 expression,this protective effect decreased significantly. Con-clusion Ischemic postconditioning can provide potent cardioprotective effect in which STAT3 mediates the cardioprotective effects.

There is autonomic nerve dysfunction after cervical spinal cord injury. Fluctuation of blood pressure and heart rate was found as orthostatic hypotension and bradycardia.

Objective To investigate the ability of different standards on the evaluation of vascular invasion of pancreatic carcinoma. Methods The MSCT imagings of 56 cases of pancreatic carcinoma confirmed by surgery were analyzed retrospectively. The vascular invasion degrees of 5 large vessels around the pancreas were evaluated according to Loyer classification standard, Lu classification standard and the Changhai standard, the surgical result was used as the gold standard. The accuracy of different standards was evaluated, and the Kappa coefficient were calculated. Results The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Loyer classification standard were 86.79%, 86.27%, 86.90%, 59.46% and 96.60%, respectively, and the Kappa coefficient was 0.623. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Lu classification standard were 93.21%, 84.31%, 95.20%, 79.63% and 96.46%, respectively, and the Kappa coefficient was 0.777. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of Changhai standard were 95.36%, 84.31%, 97.82%, 89.58% and 96.55%, respectively. The Kappa coefficient was 0.841. Conclusions The Changhai standard was feasible to evaluate the vascular invasion of pancreatic carcinoma.

OBJECTIVE:To provide reference for promoting the rational use of Dexamethasone sodium phosphate injection in the clinic. METHODS:Special comment criteria and evaluation rules was formulated,medical records of 1273 inpatients receiving Dexamethasone sodium phosphate injection were collected from our hospital during Jul. 2014-Jun. 2015. Rationality of drug use was evaluated and analyzed retrospectively. RESULTS:The most use amount and case number of Dexamethasone sodium phosphate injection were in the departments of blood/oncology,obstetrics,emergency minimally invasive surgery,gastrointestinal surgery,emergency trauma of orthopedics and thyroid breast surgery;while much less were in departments of new pediatrics, infection and rehabilitation. There were 138 cases of irrational use of Dexamethasone sodium phosphate injection found in special comment, and the total irrational use rate was 10.84％ . The types of irrational use included inappropriate indication (contraindication,59.42％),inappropriate drug combination(18.84％),inappropriate drug selection (15.94％),inappropriate usage and dosage(3.62％)and inappropriate drug dosage forms or drug delivery methods(2.17％),etc. The irrational use rate of Dexamethasone sodium phosphate injection monthly declined steadily by month from 30.35％ in Jul. 2014 to 7.81％ in Jun. 2015 through the special comment;then a consensus of 5 points for the drug use formed in our hospital. CONCLUSIONS:There are irrational situations in the clinical use of Dexamethasone sodium phosphate injection in our hospital,especially in the cases of inappropriate indications. The rationality of the drug can be improved by the development of the special comment. This work should continue to be carried out in the future and perfected.

Objective:To analyze the risk factors of first endotracheal extubation failure and the related poor outcomes of extubation failure in intubated very low birth weight (VLBW) and extremely low birth weight (ELBW) infants.Methods:The VLBW/ELBW infants intubated in the first 24 hours, and admitted from June 2016 to December 2017 in Neonatal Intensive Care Unit of the Children′s Hospital of Fudan University were recruited in the study, and they were divided into 2 groups of the extubation-failure group and the extubation-success group based on whether being reintubated in 72 hours after the extubation.The clinical data of all children were collected, and risk factors and the short-term outcomes were compared between the 2 groups.Results:One hundred and twenty-six VLBW/ELBW infants including 25 extubation-failure infants and 101 extubation-success infants were recruited, the extubation fai-lure rate was 19.8%.Extubation-failure infants had lower gestational age and lower birth weight compared with those of extubation-success group [gestational age: (27.9±2.1) weeks vs.(28.9±1.6)weeks; birth weight: 990(847-1 200) g vs.1 170(1 060-1 350) g], and the differences were statistically significant (all P<0.05). The multiple Logistic analysis demonstrated that lower gestational age was the independent risk factor of extubation failure( OR=0.92, 95% CI: 0.86-0.99, P<0.05). The outcome analysis showed that the combined outcomes of moderate-to-severe bronchopulmonary dysplasia(BPD) and death in the extubation-failure group were significantly higher than those in the extubation-success group ( OR=3.33, 95% CI: 1.28-8.63, P<0.05)after being adjusted by gestational age.The secondary outcomes of brain magnetic resonance imaging(MRI) abnormality rate in the extubation-failure group was significantly higher compared with the extubation-success group ( OR=3.93, 95% CI: 1.22-12.60, P<0.05), and the mechanical ventilation duration was significantly longer as well in the extubation-failure group compared with that in the extubation-success group[10.1 d (6.9 d, 20.9 d) vs.3.6 d(1.1 d, 8.6 d)], and the difference was statistically significant( P<0.05). The rest secondary outcomes were not significantly different between the 2 groups(all P>0.05). Conclusions:A high rate of extubation failure in VLBW/ELBW infants was a common issue, and the lower gestational age is the independent risk factor for extubation failure.Extubation failure potentially increases the risk of moderate-to-severe BPD or death in VLBW/ELBW infants.

Objective To explore the application effect of based-learning problem (PBL) combined with role playing method(playing teaching role,RPT)in clinical practice teaching of skin diseases. Methods 112 clinical undergraduate interns were randomly divided into experimental group (PBL teaching combined with RPT teaching group, n=56) and the control group (PBL teaching group, n=56). After the internship, clinical probation theory examination, clinical skills assessment and questionnaire survey were used to evaluate the two teaching modes,using SPSS 13.0 software for statistical analysis of the data. Results The results showed that theory examination and clinical skills examination scores in the PBL+RPT group were significantly higher than the PBL group, i.e. (74.29±3.17) vs. (66.14±2.17); (16.66±1.11) vs. (14.50± 1.51), and there were statistically significant differences. The survey showed that the experimental group was better than the control group in learning interest, doctor-patient communication ability and humanistic concern. Conclusion The teaching mode of PBL+ RPT improved the students' enthusiasm for learning, cultivated and improved the humanistic quality, clinical thinking and practical ability of medical and ob-tained the satisfactory teaching effect,It will has a good application prospect.

Objective:To explore the risk factors of lymph node metastasis (LNM) in early gastric cancer (ECG), and establish a risk-prediction model based on LNM.Method:Four hundred and twenty-seven EGC patients undergoing curative radical gastrectomy were enrolled in this study. The risk factors for LNM of ECG were analyzed with Logistic regression. LNM risk was stratified and risk-predicting model was established. The risk-predicting model was measured by area under ROC curve. According to the same standard, clinical data of 133 patients with EGC who underwent radical surgery were selected for external verification of the model.Results:The frequency of LNM was 13.3% (32/427) in EGC patients. The LNM ratio of intramucosal carcinoma and submucosal carcinoma was 1.3% (3/237), 15.3% (29/190) respectively. Ulcer presence, tumor size >2 cm, undifferentiated tumor, submucosal invasion, neural invasion, and vascular tumor thrombus were significantly associated with LNM in EGC patients ( χ2=3.408, 16.379, 4.808, 29.804, 25.305, 47.120, respectively P<0.05). Multivariate analysis suggested that ulcer presence, tumor size >2 cm, depth of invasion, neural invasion, and vascular tumor thrombus were independent predictors of LNM in EGC patients, ( OR=0.326, 2.924, 11.824, 13.047, 7.756, respectively P<0.05). LNM predicting model is established, P=e^x/(1+e^x),x=-4.792-1.122 ulcer presence+1.073 tumor size+2.470 depth of invasion+2.569 neural invasion+2.048 vascular tumor thrombus,ROC-AUC of risk-predicting model was 0.845, the best cut-off was 0.094, the sensitivity was 72.70%, the specificity was 77.20%. The external verification result revealed the AUC of ROC was 0.840. The four-grid table is constructed by predicting model results and the postoperative pathological examination. The sensitivity and specificity of the model are calculated to be 82.35% and 68.96%, respectively. Conclusions:EGC patients with ulcer presence, tumor size >2 cm, depth of invasion, vascular tumor thrombus, and neural invasion have higher risk of LNM, the risk-predicting model can identify the high probability of LNM .