Objective: To evaluate the efficacy and safety of neoadjuvant concurrent chemoradiotherapy combined with TME (total mesorectal excision) for the treatment of locally advanced middle and lower rectal cancer. Methods: Thirty patients with locally advanced middle and lower rectal cancer were recruited between September 2009 and February 2011, 14 of whom had stage II (T 3-4N0M0) and 16 had stage III (T1-4 N1-2M0). All patients received neoadjuvant concurrent chemoradiotherapy [the total dose of preoperative radiotherapy was 45-50 Gy (1.8 Gy/fx), concurrently combined with two cycles of FOLFOX4 regimen]. The surgical operation was performed 4-6 weeks after concurrent chemoradiotherapy, following the principle of TME. Results: All patients completed the neoadjuvant concurrent chemoradiotherapy. Of these thirty patients, 5 received complete response, 18 received partial response, 7 received stable disease, and 23 patients obtained downstaging (76.6%). Except one patient who receiving complete response rejected the surgical operation, 23 patients received low/ultra-low anterior resection (Dixon), and 6 patients received abdominoperineal resection (Miles) 4-6 weeks after chemoradiotherapy. The sphincter preservation rate was 80.0% (24/30). No perioperative death was observed, and the overall incidence of complication was 20.7% (6/29). Conclusion: Neoadjuvant concurrent chemoradiotherapy combined with TME for treatment of locally advanced middle and lower rectal cancer is effective and safe, which can reduce the tumor stage and increase the complete tumor resection and sphincter preservation rates, and can also improve the quality of life. Copyright© 2011 by TUMOR.

Objective To investigate the value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) in differentiated thyroid carcinoma complicated with Hashimoto's thyroiditis after thyroid ablation.Methods Serum Tg and TgAb levels and the status of illness in 154 differentiated thyroid carcinoma patients with coexistent Hashimoto's thyroiditis and confirmed pathology after surgery followed by remnant ablation were performed during three years follow up.Tg and TgAb levels were assessed by chemiluminescent immunoassay assay.The cases were divided into three groups (according to the level of Tg):Tg ≤ 1 μg/L group,1 μg/L＜Tg ≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group.TgAb＞40 kIU/L was considered as positive,Cox's proportional hazard model was used to analyse prognostic value in different levels of Tg and TgAb for disease-free survival and recurrence.Results Compared with 1 μg/L＜Tg≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group,the relative risk in reflecting cancer recurrence (TgAb＞40 kIU/L) in Tg ≤ 1 μg/L group was 27.000 (95 ％ CI 6.727-108.374).The value of TgAb＞40 kIU/L in Tg≤ 1 μg/L group was greatly increased and highly correlated with metastasis.However,In the condition of Tg＞ 1 μg/L,the disease will be based on the level of TgAb.Conclusion The value of TgAb＞40 kIU/L in Tg ≤ 1 μg/L group seems to be the optimal cutoff value correlated with recurrence and metastasis of differentiated thyroid carcinoma.

Objective To show epidemiological characteristics of adult emergency patients and to provide data support for grading clinics.Methods Adult emergency patients (older than 14 years) from 50 hospitals in Tianjin were included.Name,gender and age of patients,as well as visiting time/department,chief complaint,severity of the disease,prognosis were considered to cross-sectional survey from 8:00,30 Aug 2016 to8:00,31 Aug 2016.Chi-squared test,Fisher's exact test,or t test was used to statistical analysis as appropriate.Results Of 6 569 patients,most originated from medical (n =3 964,60.34％) and surgical (n =2 017,30.31％).Patients' average age was 46.90 ± 18.70 (14-99) years old and there were more patientsaged from 30 to 39 (n =1 285,19.56％).Hospital crowded periods were between 8:00-11:00 and 17:00-22:00.In these periods,average number of patients was more than 300.Concerning the severity of disease,83 patients (1.26％) were in grade 1 (the most severe cases),301 patients (4.58％) in grade 2,1 500 patients (22.83％) in grade 3,and 4 685 patients (71.33％) were in grade 4 (the less severe cases).Most ambulatory patient represented trauma (n =124,35.23％),neurological (n =68,19.32％) and cardiovascular (n =49,13.92％) diseases.However,50.57％ of them were not considered urgent.Conclusions Most patients visited emergency department were nonurgent and originated from medical and surgical department in Tianjin.Crowded periods gathered at 8:00-11:00 and 17:00-22:00.Most ambulatory patients were trauma,neurological and cardiovascular disease;however,half of them was stable and need no emergency intervention.

Objective To explore the relationship between the concentration of t, t-2, 4-DDE in cooking oil fume(COF) and the cooking temperature. Methods The temperature control system of oil heating was developed, the activated carbon was used to collect gaseous pollutants. Six samples were prepared at 60, 90, 120, 150, 180, 210, 240 and 270 ℃. The concentration of t, t-2, 4-DDE in COF was analyzed by GC-FID. Results The concentration of t, t-2, 4-DDE in COF was below the detection limit when the oil temperature was not higher than 120 ℃. Among the 150 ℃ and 270 ℃ groups, the concentration of t, t-2, 4-DDE showed a significant increase. Conclusion The concentration of t, t-2, 4-DDE in COF may obviously increase as the cooking temperature is not lower than 150℃.

Objective To explore clinical effect of nedaplatin combined gemcitabine on chemotherapy of advanced non-small cell lung cancer (NSCLC),and to observe the prognosis and complications of these patients. Methods 106 patients with advanced NSCLC were selected,they were randomly divided into the treatment group and the control group with 53 cases each group,according to the single and double of order registration number.The con-trol group were given cisplatin combined gemcitabine chemotherapy,the treatment group were administrated nedaplatin combined gemcitabine chemotherapy,three weeks repeat.The treatment effect was estimated after two cycles of chemo-therapy,and progression-free survival ( PFS) ,patients quality of life with KPS after treatment,and the adverse reac-tions were assessed.Results The disease control rates (DCR) of the treatment group was 77.36% (41/53),the control group was 71.70%(38/53),there was no statistically significant difference (χ2 =2.46,P>0.05).PFS of the treatment group were (4.26 ±0.38) months,the control group was (3.72 ±0.30) months,there was no statisti-cally significant difference (t=2.94,P>0.05).KPS of the treatment group was (74.48 ±4.04)points,which was higher than (69.76 ±3.28)points of the control group,the difference was statistically significant (t =7.33,P<0.05).The total adverse reaction of the treatment group was 81.13%(43/53),which was lower than the control group 90.57%(48/53),the difference was statistically significant (χ2 =7.61,P<0.05).Conclusion There is preferably clinical effect of nedaplatin combined gemcitabine treatment of NSCLC,the adverse reactions was lower sig-nificantly,the patients prognosis is good,and which is worth clinical promotion.

Objective To investigate the relationship between antibiotic administration and the changes in constituent ratios of preponderant pathogens in infection of burn wounds in our burn unit. Methods The consumption of different kinds of antibiotics [expressed as the number of defined daily doses (DDD)/100 patient-day], as well as the constituent ratio of Staphylococcus aureus and Pseudomonas aeruginosa, and percentage of methicillin-resistant S. aureus (MRSA) among all positive cultures of S. aureus were calculated from 1995 to 2004, and their correlation was analyzed. Results Within this period, it was found that the consumption of first and second-generation cephalosporins and aminoglycosides, including cefazolin and amikacin, was decreased remarkably, while the consumption of antibiotics combined with lactamase inhibitor, third-generation cephalosporins, quinolones, including ceftazidime, levofloxacin and fosfomycin, was increased significantly. At the same time, the constituent ratio of P. aeruginosa declined to certain extent, while the constituent ratio of S. aureus gradually rase, but no increase was found in percentage of MRSA in S. aureus. The constituent ratios of S. aureus and P. aeruginosa were correlated to consumption of more than ten kinds of antibiotics or antimicrobial agents. Conclusions The results suggested that more cefazolin or amikacin and less antibiotics with lactamase inhibitor or third generation cephalosporins were used in the treatment of burn infection might help decrease the infection caused by S. aureus, and that when more carbopenem or cefoperazone/sulbactam were used there might be a tendency of declination of P. aeruginosa infection.

Objective To investigate the effects of inhalation of different concentrations of isoflurane on global and regional cerebral glucose metabolic rate (CMRglu) in healthy volunteers using positron emission tomography (PET) scan.Methods The study was approved by the ethic committee of the hospital. After obtaining written informed consent we studied eight right-handed healthy volunteers (3 male, 5 female), aged 21-28 yrs. Each volunteer underwent 3 PET scans.They were fasted for 8 h prior to study. The PET scan was performed when conscious, at 0.5 and 1.0 MAC isoflurane anesthesia. The interval between two PET scans was 1 week. Scans were obtained with a MASEP CPET Plus scanner (2.0 mm resolution-FWHM) using the 18 fluorodeoxyglucose technique. Results The whole brain CMRglu averaged 30.0?1.1 ?mol?100 mg-1?min-1 when the volunteer was awake. Isoflurane anesthesia significantly reduced whole-brain CMRglu by 24% to 23.3?1.4 ?mol?100 mg-1?min-1 at 0.5 MAC and by 41% to 18.4?0.9 ?mol?100mg-1?min-1 at 1.0 MAC (P

To study the clinicopothologic diagnosis and treatment of small cell neuroendocrine carcinoma of the cervix(SCNCC)in relion to its outcome. Eight cases of SCNCC treated within 10 years in our hospital were reviewed and andlyzed retrospectively and followed up in our clinic. The clinical and pathologic classifications were correct, namely:Ⅰa 1,Ⅰb 2,Ⅱa 2, Ⅱb 1; Ⅲa 1 and Ⅲb 1 case. Three early cases had total hysterectomy with all pelvic lymph nodes removed and 5 late cases had radio therapy only.Of them 5 cases died 13～38 months after treatment,averaging 19 months, 3 liviny,for 3,4 and 5 months,respectively,one case, however,with metastasis to kidney.SCNCC is a rare tumor of high malignancy with early metastasis and poor prognosis.It should be recognized early and treated with Wertheim's operation and total removal of pelvic lymph nodes with postoperative radio or chemotherapy. Late cases might be benefited by radio or chemotherapy.

Objective To evaluate the sensitivity and specificity of DNA micro-array in early detection of infectious pathogens on burn wounds,including 9 species of potential infectious pathogens namely Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa,etc.Methods Serial dilutions of each targeted bacteria in saline were examined with VITEK automated microbial test systems(routine methods) as well as by DNA micro-array to compare the sensitivity between these two methods.Sixty-two strains of infectious pathogens collected from burn wounds,were identified by routine methods,and they were also subjected to DNA micro-array examination to determine coincidence.One hundred and three examinations of smear specimens collected from fresh burn wounds were performed with both methods synchronously.The difference in positive result of identification of bacteria between routine method and micro-array technology in sensitivity and specificity was compared.Results The identification of bacteria by micro-array was more convenient and rapid than that by routine method.A 10 to 100 fold higher sensitivity was found in bacterial identification by DNA micro-array than by routine methods.The positive and negative coincidence of bacterial identification was 100% between these two methods.All the strains found by the routine methods were successfully identified by DNA micro-array.In a few instances,more strains of bacteria were detected with micro-anay method than rowtine method.Conclusion The extremely high coincidence and sensitivity of micro-array method with the routine method was confirmed.The detection of bacteria from burn wounds and other contaminated or infected wounds using micro-array method has a bright prospect though some improvements are still necessary.

Objective To establish a method of GS-MS for determination of polychlorinated biphenyls (PCBs) in human cerumen. Methods The PCBs in cerumen samples was separated by n-hexane extraction, liquid-liquid extraction separation and column chromatography purification, then was analyzed quantitatively by gas chromatography and affirmed qualitatively by mass spectroscopy. Results The detection limit, average recovery rate and precision of this method were 0.15 ?g/g fat, 92.1% and 3.0%-4.6% (n=12) respectively. The contents of PCBs in 90 cerumen samples collected in polluted and control areas were detected. The levels(0.00-18.42 ?g/g fat) of PCBs in cerumen collected in polluted area were significantly higher than that in the control area(P