The incidence of rectal cancer has been increasing in recent years .It leads to more attention of scholars at home and abroad ,which the efficacy of rectal cancer has been improved by using neoadjuvant therapy all over the world .It is included preoperative radiotherapy ,preoperative chemotherapy and preoperative chemora-diotherapy .Preoperative radiotherapy ,which can be divided into short radiotherapy and conventional radiotherapy , are evaluated by comparison of T drop rate ,sphincter preservation rate ,complete remission rate and other indica-tors of clinical effect .Although the experience of pure preoperative chemotherapy is not rich enough ,it still has an advantage in lowering the tumour stage and other aspects .Currently, preoperative chemoradiotherapy is a good choice for rectal cancer ,because it could make an obvious advantage in the treatment ,at the same time ,three-di-mensional radiotherapy can make target more evenly distributed and focus treatment more precise .However,neo-adjuvant therapy has insufficient support in clinical in our country.So it needs to get more information for clinical effectiveness of applying preoperative chemoradiotherapy .This study is to summarize the new adjuvant treatment of rectal cancer .

Objective To investigate the correlation between depression, anxiety and sleep disturbance. Methods 93 patients with the main complaint of insomnia were selected and performed a retrospective study. Results Four factors including anxiety factors, manifest anxiety, subjective depression and dominant depression of the insomnia patients were significantly higher than normal people, while the Ego Strength scores are significantly lower than the normal people. Conclusion When confronting patients with sleep disturbance, doctors must pay attention to identifying any psychological disorders including depression and anxiety in the patients, and psychological support should also be strengthened to such patients.

ObjectiveTo study the effect of thought imprint psychotherapy in lower resistant state (a TCM psychotherapy ) treating insomnia accompanied by depression.MethodsIntervened patients by sleep regulating technique of lower resistant state for 6 months.PSQI and PSG were tested prior and post treatment.ResultsThe data from PSQI and PSG indicated the improvement of their sleep quality:PSQI:sleep quality (2.500±0.589) vs (1.416±0.928),initiating sleep time(2.375±0.875) vs (1.416±0.880),sleep time (2.125±0.947) vs (1.500±0.884),sleep efficiency (1.625±1.135) vs (0.958±0.954),sleep disorder (1.875±0.536)vs (1.416±0.775),daytime function (2.416±0.880) vs (1.833± 1.203); PSG:sleep efficiency (0.82±0.11)％ vs (0.88±0.10)％,number of wake (3.92±3.24) vs (2.38±1.21),stage 1 percentage (27.4±11.9)％vs (23.5±7.8)％,stage 3 percentage (10.2±6.8) ％ vs (15.6±5.9)％,REM sleep percentage (23.89±6.84) ％ vs (16.16 ± 6.36) ％,P＜0.05 or 0.01.ConclusionSleep regulating technique in lower resistant state can improve patients' sleep quality.

"Postpartum Body pain"refers to such symptoms as body pain,numbness,heaviness,arthralgia and even paralysis in a woman during the postpartum period.Besides the above symptoms,the patient may also have other symptoms like sleep disorder,emotional hindrance,somatization symptoms such as fatigue,sleepy,and chest distress,etc.This disease may be considered as somatization symptoms due to postpartum depression,but actually it is a psychogenic disorder.Clinical observation showed there were no clinical changes of objective signs such as red,swelling and fever;Laboratory examinations showed there was no ahnormal manifestation.This article primarily discussed"postpagtum body pain"from medicopsychological angle,hoping to help people get a right recognition of this disease.

Objective To evaluate the correlations between CT features and histopathologic subtypes of lung adenocarcinomas presenting as pure ground-glass nodules (pGGN) of 1 cm or less in maximal diameter. Methods CT appearances, pathology and clinical data of 95 patients (97 lesions) who underwent curative resection of lung adenocarcinomas presenting as pGGN≤1 cm in diameter from March 2011 to February 2015 were retrospectively analyzed. Of the 97 lung adenocarcinomas, there were 19 atypical adenomatous hyperplasia (AAH) (19.6%), 31 adenocarcinoma in situ (AIS) (31.9%), 19 minimally invasive adenocarcinoma (MIA) (19.6%) and 28 invasive pulmonary adenocarcinoma (IPA) (28.9%). Fifty (51.5%) were preinvasive (AAH+AIS) and 47 (48.5%) were invasive (MIA+IPA). Lesion size and density were compared among pathologic subtypes using analysis of variance (ANOVA). Lesion size were compared between preinvasive and invasive lesions using 2?independent samples t?test. Lesion location, presence of bubble?like sign, air bronchogram, vessel changes, margin, and tumor?lung interface were compared among histopathologic subtypes using chi?square test. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the cut-off point of size in discriminating preinvasive lesions from invasive lesions. Results Of the 97 lesions, there were no statistically significant differences among histopathologic subtypes in terms of lesion density, presence of bubble?like sign, air?bronchogram, and margin (P>0.05). Mean size of AAH, AIS, MIA and IPA was (0.72 ± 0.19), (0.82 ± 0.14), (0.84 ± 0.11) and (0.85 ± 0.16) cm respectively. There were statistically significant differences among histopathologic subtypes in terms of lesion size (F=3.16, P=0.028). The vessel changes occurred in 2 of AAH, 11 of AIS, 10 of MIA and 17 of IPA. There were statistically significant differences among histopathologic subtypes in terms of vessel changes (χ2=13.22, P=0.004). Lesions with clear tumor?lung interface were in 10 of AAH, 24 of AIS, 17 of MIA, and 26 of IPA. There were statistically significant differences among histopathologic subtypes in terms of tumor?lung interface (χ2=12.67, P=0.005). The optimal cutoff value of lesion size for differentiating preinvasive lesions from invasive lesions was 0.82 cm (sensitivity, 61.7%;specificity, 62.0%). Conclusion Lesion size, vessel changes, and lung?tumor interface may indicate the invasiveness of lung adenocarcinoma presenting as pGGNs of≤1 cm in diameter.

Objective To clarify the effects of Xinfukang containing-serum on stromal cell-derived factor-1α (SDF-1α) translation and protein secretion of bone marrow stem cells (BMSCs).Methods BMSCs were isolated and amplified using bone marrow culture method,and were identified by flow cytometry.mRNA and protein secretion of SDF-1α were detected by quantitative PCR (q-PCR) and enzyme linked immunosorbent assay (ELISA),respectively.Results The expression of SDF-1α mRNA were significantly increased after 72 h in drug-containing serum,and SDF-1α mRNA in the experimental group was approximately 200 times as that in the control group (P＜0.05).Secretion of SDF-1 α in the experimental group (277.561 1 ± 15.651 8) pg/ml was nearly doubled compared with that in the control group (153.107 1±14.765 1) pg/ml (P＜0.05).Conclusions BMSCs from whole bone marrow adherent culture have high purity,and drug-containing serum can promote BMSCs to express SDF-1 α mRNA and secretion of SDF-1 α.

Objective To observe the electronic physiological mechanism of Low Resistance Thought Induction Psychotherapy (TIP) on depression.Methods 48 patients with depression were randomly divided into TIP group and Citalopram group.The observation period was 6 months.The Hamilton Rating Scale for Depression(HAMD) was used to evaluate the efficacy,and Polysomnogram(PSG)was used to evaluate the electronic physiological mechanism.Results TIP had efficacy on reducing numbers of wake [before treatment (3.92±3.24),after treatment (2.38± 1.21),P＜0.05]、REM time [before treatment (86.75 ±28.29),after treatment (63.19±28.11),P＜0.01]、REM％ [before treatment (23.89±6.84),after treatment (16.16±6.36),P＜0.01].Citalopram had efficacy on increasing Sleep time [before treatment (350.52±50.71),after treatment (388.58±43.89),P＜0.01]、number of REM [before treatment (3.71±2.87),after treatment (5.17±5.58),P＜0.05]、S3+4 [before treatment (35.79±32.76),after treatment (56.77±34.21),P ＜0.05]、S3 +4％ [before treatment (10.13 ± 9.20),after treatment (14.53 ± 8.66),P＜0.05]、REM time [before treatment (66.39±29.22),after treatment(78.61 ±30.19),P＜0.05].TIP had superior to Citaloprarn on regulating numbers of wake and REM time.Conclusions Electronic physiological mechanism of TIP treating depression is to regulat numbers of wake,REM time,REM％.

Patient safety management is one of the key of nursing management, and checklist plays an active role in patient safety management. In this paper, the definition and origin of the checklist, creating methods and principles, as well as the research status at home and abroad were summarized to provide references for clinical nursing staff to compile and apply the checklist.

Neoadjuvant chemoradiotherapy (NCRT) is the standard therapeutic strategy for locally advanced rectal cancer (LARC). Due to the different responses of patients to NCRT, the clinical prognosis of patients varies greatly. Therefore, it is important to establish sensitive biomarkers to predict the response of patients to treatments before NCRT. Immune cells in the tumor microenvironment (TME) were closely related to the efficacy of NCRT in patients with LARC. This paper reviewed the research progress on the relationships of cytotoxic T cells, programmed death-ligand 1 (PD-L1), tumor-associated macrophages (TAMs), regulatory T cells (Treg) and neutrophil to lymphocyte ratio (NLR) with chemoradiotherapy sensitivity in rectal cancer, illustrated the potential and limitations of these immune cells in predicting chemoradiotherapy response in rectal cancer, and provided a feasible direction for future researches.

Objective:To observe the lipid-lowering effect of atorvastatin on patients with acute cerebral infarction with different ATP-binding cassette subfamily B member 1(ABCB1) genotypes, and thus to provide clinical research evidence for individual application of atorvastatin in patients with acute cerebral infarction.Methods:From March 2021 to December 2021, 131 patients with acute cerebral infarction admitted to the Department of Neurology of Xuchang Central Hospital were included. The ABCB1 G2677T gene polymorphism rs2032582 of patients was detected by fluorescence staining in situ hybridization.Based on the detection results, patients were divided into GG group, GT group and TT group.All patients were given atorvastatin (20 mg/d) for lipid-lowering treatment.The levels of low density lipoprotein cholesterol(HDL-C), high density lipoprotein cholesterol(HDL-C), total cholesterol(TC)and triglyceride(TG) in serum of patients in the three groups before and 2 months after treatment were recorded and analyzed.The adverse drug reactions in the three groups were recorded. When the serum LDL-C level was less than 1.8 mmol/L, it was considered that the lipid-lowering treatment was effective.The binary Logistic regression analysis was used to explore the influencing factors of atorvastatin lipid lowering therapy.The software of SPSS 25.0 was used for statistical analysis.Results:There were 50 (38.17%), 49 (37.40%) and 32 (24.43%) patients in GG group, GT group and TT group, respectively. The serum TC levels of patients in GG group, GT group and TT group after treatment were (3.47±0.70) mmol/L, (3.59±1.09) mmol/L and (3.48±1.02) mmol/L, respectively, which were lower than those before treatment ((4.27± 0.99) mmol/L, (4.02±0.98) mmol/L and (4.03±1.31) mmol/L), all of which were statistically significant ( t=7.652, 3.092, 5.593, all P<0.01). The serum LDL-C levels in GG group, GT group and TT group after treatment were (1.89±0.53) mmol/L, (2.07±0.92) mmol/L and (1.96±0.79) mmol/L, respectively, which were lower than those before treatment ((2.87±0.92) mmol/L, (2.56±0.89) mmol/L and (2.55±1.11) mmol/L) ( t=9.896, 4.055, 5.980, all P<0.001). The differences of serum LDL-C level before and after treatment in GG group, GT group and TT group were (-0.97±0.69) mmol/L, (-0.50±0.86) mmol/L and (-0.59±0.56) mmol/L, respectively. The difference of serum LDL-C level before and after treatment in the three groups was statistically significant ( F=5.614, P=0.005). The difference of TC, TG and HDL-C before and after treatment was not statistically significant( F=2.783, 0.490, 1.677, all P>0.05). The binary Logistic regression analysis showed that ABCB1 G2677T gene type and staying up late were independent influencing factors for atorvastatin lipid-lowering therapy. The probability of effective lipid-lowering in GT patients with ABCB1 G2677T gene was 27.9% of that in GG patients ( OR=0.279, 95% CI: 0.110-0.709, P=0.007), and the probability of TT type patients was 33.8% of GG type patients ( OR=0.338, 95% CI: 0.121-0.943, P=0.038). The probability of effective lipid-lowering in patients who had the habit of staying up late was 26.4% of the patients who did not stay up late ( OR=0.264, 95% CI: 0.118-0.591, P=0.001). There was no significant difference in the total incidence of adverse drug reactions among the three groups( χ2=0.868, P=0.648). Conclusion:The lipid-lowering effect in patients with GG type of ABCB1 G2677T is better than that of GT type and TT type when atorvastatin is used to treat patients with acute cerebral infarction.