Neoadjuvant chemoradiotherapy (nCRT) is used to downstage locally advanced rectal cancer before surgery, in order to increase the chance of radical resection, reduce local recurrence, and improve overall survival. Accumulating data suggest that tumor response to nCRT is time dependent. A delay between nCRT and surgery may increase the proportion of patients that achieve a favorable response, and 4-6 weeks are considered to be a universal interval. However, delayed surgery beyond 6-8 weeks may increase the technical dififculty, and the risks of surgical complications and recurrence or metastasis. This article brielfy reviews the relevant literature to evaluate the efifciency and safety of delayed surgery.

Tendon calcification,a common clinical disease,is often complicated after tendon injury or surgery,or as a special manifestation of tendinopathy.It is also one manifestation of acquired heterotopic ossification.However,there are no preventive measures for tendon calcification in clinical treatment as its pathogenesis is still unclear.In addition,the domestic orthopedic surgeons have paid little attention to this issue yet.To enhance understanding of tendon calcification,we have summarized the relevant literature published in recent years.

Objective This experiment will use from yu liquid Elimination hemorrhoids decoction in the treatment of inflammatory external piles,and to evaluate the clinical curative effect analysis.MethodsThe experiment selected the June 2016-December 2016 in our hospital 120 cases of patients with inflammatory external piles as the research object,were randomly divided into control group and observation group,60 cases in each group.Among them,the control group were treated by hemorrhoid better treatment.observation group to adopt the yu fumigation sitz bath liquid Elimination hemorrhoids soup treatment.Recorded before and after treatment in patients with symptoms of 3 days, 7 days, 14 days, including bleeding, anal discomfort, lower rectal mucosa, emergence, defecate unwell, etc., and score four grade three points method.Then compared two groups of patients was improved and the recurrence rate,further to explore the treatment effectiveness.ResultsTwo groups after treatment in patients with the disease were eased,and the observation group has better effect to improve patients,in particular,involves the bleeding,anal discomfort,lower rectal mucosa,hernia,defecate unwell wait for a problem,and group therapy 3 days, 7 days, 14 days total score, respectively (10.2±4.0), (8.6±3.5), (5.3±3.1) and control group corresponding to(11.3±4.2), (9.9±3.5), (6.4±3.2) and significant difference comparing the two groups, with statistical significance(P<0.05).But in comprehensive treatment efficiency,small difference between the two groups,no statistically significant.ConclusionUsing the quasi yu liquid elimination hemorrhoids decoction in the treatment of inflammatory external piles have good improvement effect, eliminate edema, quick effect, medical expenses low salient features, and avoid the operation of psychological pressure and economic pressure, is worthy of popularization and application in the process of clinical treatment.

Objective To explore the relationship between high-risk human papillomavirus (HPV) DNA and biological behavior of cervical carcinoma. Methods Sixty-six patients of cervical carcinoma with cytological examinations and 103 patients of cervical carcinoma followed-up after surgical operation were selected for high-risk HPV DNA test with second-generation hybrid capture technique (HC2 Ⅱ). Results ①HPV DNA was positive in 62 and negative in four of 66 patients of cervical carcinoma with an overall prevalence of 94%. ②There was no significant difference in positive HPV DNA of patients with cervical carcinoma between their varied clinical stages and pathologic grades. But, HPV positivity and HPV DNA load in patients with myometrial invasion were higher than those in patients without invasion (P < 0. 05).③ HPV DNA conversed to negative in 99 of 103 patients (96%) with cervical carcinoma after surgical operation from positivity before operation. Conclusions High-risk HPV infection may correlate with angiogenesis, invasion and metastasis of cervical carcinoma and HC2 Ⅱ can be used as an effective method to detect HPV DNA.

Objective To explore the molecular mechanism of hypophrenia induced by Down syndrome (DS).Methods Ts65Dn mice were used as DS animal model.Three female mice and three male mice of three to twelve weeks old were mated.Among the 17 first-generation mice alive,five mice remained Ts65Dn trisomy and 12 mice were normal.Five Ts65Dn mice and five normal mice were selected randomly as Ts65Dn group and control group,and bred till 16 to 18 weeks old for experiments.Differential proteins in hippocampus of mice were tested by isobaric tags for relative and absolute quantitation (iTRAQ).Expressions of the differential proteins in Ts65Dn group were detected compared with those in control group.Results A total of 2805 proteins were identified in hippocampus of Ts65Dn group and control group,and significant differences were observed in the expressions of 374 proteins.Compared with those in control group,expressions of 195 proteins increased and 179 reduced in Ts65Dn group.Sorted by P value from low to high,the seven proteins with the lowest P value were uncharacterized protein C2orf47 homolog,isoform 2 of filamin A-interacting protein 1-like,zinc finger protein,isoform 1 of pericentriolar material 1 protein,SEC23 interacting protein,BAG family molecular chaperone regulator 3 and serpin H1.Conclusions Differential proteins are observed in hippocampus of Ts65Dn mice,perhaps closely correlating to neurological defects.The new technology of iTRAQ helps to screen and identify differential proteins in hippocampus.

Objective To investigate the clinical characteristics of peptic ulcer in young and middle-aged patients and old-aged patients,and to improve the awareness of clinicians.Methods A retrospective analysis was performed in 351 cases (old-aged group) and 351 cases (young and middle-aged group) of peptic ulcer in our hospital from Jan,2012 to Jan,2013.The clinical data were compared between the two groups,including clinical symptoms,complications,ulcer site,size,concomitant diseases,treatment and outcome.Results (1) Clinical symptoms:the symptoms were not typical in old-aged group compared to young and middle-aged group (80.3％ vs 73％),complications as the initial symptom was more common (46.7％ vs 29.6％,P＜0.001),typical upper abdominal pain were lower than those in the young and middle-aged group (19.7％ vs 37％,P＜0.001);(2) Common complications:old-aged patients with complications was significantly higher than in the young and middle-aged group (46.7％ vs 29.6％,P＜0.05),in which bleeding,perforation and obstruction were common;(3) Ulcer site:gastric ulcer,elevation ulcer werw more common in old-aged patients than young and middle-aged patients (P＜0.05);(4) Ulcer size:giant ulcer (more than 2.0 cm) was more common in old-aged patients than young and middle-aged patients (15.1％ vs 4.3％,P＜0.05);but there was no difference in the infection rate of Helicobacter pylori (HP) between them (90.3％ vs 90.9％,P＞0.05);(5) Concomitant diseases:the incidence of concomitant diseases was higher in old-aged patients,including diabetes,cardiovascular disease,gallstones,cholecystitis,gout (47％ vs 15.7％,P＜0.05);(6) Treatment and outcome:the mortality of old-aged patients with complications was significantly higher than those in the young and middle-aged group (14％ vs 3.8％,P＜0.05).Conclusion The clinical manifestations of peptic ulcer in old-aged patients are atypical,with characteristics of high morbidity,high incidence of complications,high mortality.Early diagnosis and treatment is essential to improve the prognosis and reduce mortality.

Objective The diabetic foot ulcer has high incidence rate,many complications,and is difficult to heal.Methods We summary the treatment expericncc of 156 cases of diabetic foot wounds.On the basis of comprehensive standard medical treatment,according to the wound characteristics,blood supply,and the degree of tissue necrosis,we performed staging gnawing-away debridement for all tbe wounds,combining with pressure suction,new dressing,skin grafts and skin flaps.Results Of all the 156 cases,2 cases died,4 cases were lost to follow-up,the remaining 150 cases healed,with an average time of 56 days.Conclusions The treatment of diabetic foot ulcer must take into account both the systemic therapy and local processing,the wound should be debrided with different stage and progressively.When the wound microenvironment is gradually improved,it can be covered appropriately with skin grafts.The skin flap should be chosen cautiously.

Objective To evaluate the surgical effects of laparoscopic pancreaticojejunostomy in pigs and investigate the learning curve. Methods A total of 40 porcine cases of laparoscopic pancreaticojejunostomy were performed by a single surgical team from September 2012 to February 2013.According to the operation sequence, pigs were divided into 4 groups with 10 in each group.For analyzing the efficacy of surgery in different stages, the operation time and efficacy of anastomoses were compared between these groups. Results The operation was finished successfully in all the 40 cases.There were statistical significances in operation time among the four groups.The group Ⅳ had significant shorter time (112.7 ±8.3) min than those in the group Ⅰ [(145.1 ± 16.6) min, q=9.154, P<0.05], the groupⅡ[(133.0 ±8.7) min, q=5.735, P<0.05], and the group Ⅲ[(137.2 ±9.0) min, q=6.922, P<0.05], respectively.There was no difference between the group Ⅱ and the group Ⅰ in operation time (q=3.419, P>0.05), so as to other groups.The results of anastomoses among the four groups were not significantly different (χ2 =0.586,P=0.900). Conclusions Laparoscopic pancreaticojejunostomy in pigs is feasible.The learning curve of the operation is about 30 cases.

Objective To study the influence of anesthesia methoda on early postoperative cognitive function in elder orthopedics patients. Methods Fifty patients aged more than 65 years old with fractured femur randomly received general anesthesia(group G, 28 cases) or unilateral combined spinal epidural anesthesia(group E,22 cases). The assessment of postoperative cognitive {unction referred to the scores that achieved in neuropsychological testing with mini mental state examination (MMSE) by special psychological person on the day before and the first day after surgery. It was considered to he postoperative cognitive dysfunction (POCD) when the score was ≥1 standard deviation(SD). Results The score of MMSE was lower in group G than that in group E on the first day alter surgery(P<0. 05). The incidence of POCD on the first day after surgery was higher in group G than that in group E(42.9% vs. 13. 6%) (P<0. 05). Conclusion Compared to combined spinal epidural anesthesia, more POCD takes place in the eldedy underwent orthopedic surgery under general anesthesia.

The Retrieval Table of Medicinal Plants is a key tool for identifying plants catogories;under years of teaching experience of medicinal plants and field classification and authentication,it expounds the table,compilation and notes of the said table,and makes examples for application.