Objective To compare the clinical pathological characteristics in young and old patients with colorectal cancer (CRC) and investigate their relationship with prognosis. Methods A retrospective review was made in 68 CRC patients less than 35 years old and 322 CRC patients older than 65 treated in our hospital from July 1993 to July 2003. Their clinical manifestation, pathological feature, Dukes staging, misdiagnosis rate and results of following-up were compared. Results The main manifestation in young group was abdominal pain (69.1%), but in old group was hemafecia or mucous bloody stools (53.7%). The ratio of poorly differentiated neoplasm was obviously higher in young group (48.5%) than in old group (20.5%) (P

The therapy to different type of breast cancer has resulted in chemoresistance which is induced by auto-phagy.Autophagy, to tumor’s generation, is a double edged sword, and it can result to chemoresistance and auto-phagic cell death through interaction with apoptosis in breast cancer chemotherapy.However, autophagy may be unrelated to chemoresistance.It will be a key research point to further explore the relationship and mechanism be-tween autophagy and chemoresistance.

Objective To investigate drug metabolism distribution of flurbiprofen axetil(FA) in uterine fibroids and its effect on prostaglandin E2 (PGE2).Methods A total of 86 patients with uterine fibroids from January 2014 to February 2016 in The NO.2 Hospital of Ningbo were randomly divided into control group of 44 cases and observation group of 42 cases.The control group and the observation group were given 0.9% sodium chloride solution and 1 mg/kg FA at 15 min before operation,detection of the active metabolite of FA flurbiprofen (FP),and the concentration of PGE2 in tissue homogenate was detected by ELISA.Results The observation group FP concentration of normal and tumor tissue were (0.70 ±0.13)μg/mL and (1.72 ± 0.13)μg/mL,significantly higher than the control group(0.00 ±0.00)μg/mL and (0.00 ±0.00)μg/mL, the difference was statistically significant(P<0.05), the FP concentration of tumor tissue in the observation group was significantly higher than that in the normal group, the difference was statistically significant(P<0.05), the normal tissue and tumor tissue PGE2 concentration in the observation group were (189.29 ±26.38) pg/mL and (260.01 ±46.63) pg/mL,which were significantly lower than those in the control group(210.03 ±35.22)pg/mLand(390.20 ±92.10)pg/mL, the difference was statistically significant(P<0.05), the observation group plasma FP was (5.50 ±0.72)μg/mL,significantly higher than the control group (0.00 ±0.00)μg/mL, the difference was statistically significant(P <0.05),and PGE2 was (602.38 ±84.09) pg/mL,significantly lower than the control group(920.13 ±89.05)pg/mL, the difference was statistically significant(P <0.05).Conclusion FA in the uterine fibroids have a certain distribution of targeted,can reduce the concentration of PGE2 ,so as to alleviate the pain of patients.

Procalcionin ( PCT) is a soluble protein liberated into the circulation of patients in response to severe systemic in-fection, in particular by bacterial infection.It is used as the most accurate biomarker for the diagnosis of sepsis.This review briefly de-scribes the induction of PCT, the comparison of PCT and other markers of sepsis, the application of PCT measurement in confirmation or exclusion of diagnosis of sepsis, the assessment of severity and treatment effectiveness of systemic infection, the application of PCT in guiding individual and specific treatment of antibiotics, and the anormaly situation of elevated levels of PCT in patients who do not have sepsis.

Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Objective To determine the effects of cyclooxygenase-2 (COX-2) on risk stratification and prognosis of patients with gastrointestinal stromal tumor (GIST).Methods Literatures in the Cochrane libraries of clinical comparative trials,PubMed,EMBASE,Cancer Lit and Chinese BioMedical Literature from 1966 to 2012 were retrieved using the Cochrane systematic evaluation method.The original data were extracted and crosschecked by 2 reviewers.The indicator for assessment including positive rates of COX-2 in GIST patients with different tumor diameters (＜5 cm versus ≥5 cm),mitosis of cancer cells (＜5/50 HPF versus ≥5/50 HPF) and National Institute of Health (NIH) risk stratifications (very low + low versus intermediate + high).The relationship between COX-2 expression and recurrence and metastasis of GIST was evaluated.All the data were analyzed using the RevMan 5.1 software with Meta analysis.The heterogeneity between studies was analyzed using the I2.The binary data were presented by odds ration (OR) and 95％ confidence interval (95 ％ CI).Results Seven articles with a total of 415 patients were included in the analysis.The COX-2 expression did not correlate with the tumor diameters,NIH risk stratifications and tumor metastasis and recurrence (OR =0.60,0.72,2.46,P ＞ 0.05),but with the mitosis of cancer cells (OR =0.46,P ＜ 0.05).Conclusion COX-2 expression is partly correlated with risk stratification of GIST,but has no effect on the prognosis.

Total paeony glycoside (TPG) is extracted and purified from a traditional Chinese herbal medicine. It has many biological and pharmacological activities. However, there are few dosage forms of TPG in the market because of its low bioavailability. Self-microemulsifying drug delivery system (SMEDDS) is a vital tool in solving low bioavailability of poor absorption drugs. So the objective of this study is to develop a new TPG-SMEDDS for the oral delivery of poorly soluble TPG. Through the construction of pseudo-ternary phase diagrams, the optimum prescription was obtained, which consisted of 18.70% TPG, 16.27% ethyl oleate as oil, 43.34% Cremophor RH40 as surfactant and 21.73% Transcutol P as cosurfactant. The characterizations of TPG-SMEDDS including morphological characterization, droplet size, zeta-potential, emulsification time, and dissolution study of TPG-SMEDDS were evaluated. The results showed that TPG-SMEDDS is stable and its release rate is high in four different media (0.1 mol x L(-1) HCl, pH 6.8 PBS, pH 7.4 PBS, and water). The relative bioavailability of SMEDDS was dramatically enhanced in an average of 1.52-fold that of TPG-suspension. It is concluded that the bioavailability of TPG is enhanced greatly by SMEDDS.

Acute Coronary Syndrome ; etiology ; Aortic Valve Insufficiency ; Female ; Heart Valve Prosthesis ; adverse effects ; Humans ; Middle Aged ; Prosthesis Failure

Objective To study the incidence of complications of visceral and vascular injury in laparoscopic surgery for gynecologic diseases,and to discuss the ways to decrease the incidence. Methods The data of 2684 patients who received laparoscopic surgery from Januray 2003 to December 2005 in the Department of Obstetrics and Gynecology were reviewed retrospectively.The incidence and treatment of complications of visceral and vascular injury were observed. Results The total incidence rate of complications was 2.53%(n=68),and that of the visceral and vascular injury was 0.37%(n=10).Four cases of injury were related with trocar punctures(injury of omental blood vessel,n=2;postperitoneal vessel,n=2),three took place during the operation (severe bleeding,n=1;bladder injury,n=2),and the other three were observed in the postoperative stage(ureter injury,n=2;intestinal fistula,n=1). Conclusion The complications in laparoscopic surgery for gynecologic diseases are increased with the extension and difficulty of operation,and are closely related with the experience of the surgeons.Proper candidates for the surgery and established operative technique are the key factors in decreasing the incidence.

AIM: To explored the treatment effects of retinal laser photocoagulation and the applications of color Doppler flow imaging(CDFI) in the diabetic retinopathy.METHODS: We collected 60 patients(120 eyes) with diabetic retinopathy(Ⅲ~Ⅳstage) from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department.The health control (HC) group of 55 normal people was established simultaneously.Ocular blood flow velocity of the 55 normal people (110 eyes) and the 60 patients (120 eyes) was examined by CDFI of central retinal artery (CRA) and posterior ciliary artery (PCAs) using the PHILIPS HD6.Peak systolic velocity(PSV) was recorded.The examinations of CDFI, electroretinogram(ERG) and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively.RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of CRA of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the PSV of PCAs of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the PSV of PCAs of the DR group after photocoagulation with the data before, there was a significant difference at 1d postoperatively(P<0.05), there was no significant difference at 7d, 1, 3 and 6mo(P>0.05).Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05).Compared the aA and bA of ERG of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05).Compared the aT and bT of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05);compared the aT and bT of ERG of the group DR after photocoagulation with the data before, there was no significant difference(P>0.05).The vision of 49 cases(98 eyes) was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes) remained constant.CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect.Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic` eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.