Objective To study the relationship between serum macrophage migration inhibitory factor (MIF) levels and clinical features in the patients with colorectal cancer. Methods Enzyme-linked immunosorbent assays was used to detect the concentration of MIF in sera of 75 patients with colorectal cancer (35 case with primary colorectal cancer and 40 cases with lymphnode metastasis of colorectal cancer) and 40 healthy controls. The relationship between serum MIF levels and clinical features was analyzed. Results Serum MIF was found to be significantly elevated in the patients with colorectal cancer(mean value 31.2ng/ml) compared with healthy subjects (mean value 13.6ng/ml) (P <0. 001). The levels of MIF in colorectal cancer were significantly correlated with advanced clinical progression pathology stages (P <0. 05) and lymph node metastasis (P < 0. 05). Conclusions Increased expression level of MIF in serum may promote the pathogenesis of colorectal cancer and M1F is closely associated with the stages and lymph node metastasis of colorectal cancer.

MicroRNAs (miRNAs)are closely associated with the development,invasion,metastasis and prognosis of cholangiocarcinoma (CCA).The abnormal expressions of miRNA play important roles in regulating the genetic variation,cell cycle,invasion and metastasisability and apoptosis of CCA.MiRNAs are hopeful for being used as the biological markers of early diagnosis,prognosis and treatment target.

Objective To investigate the efficacy of interferon alpha (IFNα) plus adefovir dipivoxil (ADV) and tebivudine (LdT) monotherapy for patients with HBeAg positive chronic hepatitis B (CHB) who have poor response to IFNα treatment.Methods A total of 86 HBeAg positive CHB patients admitted to the Sixth People' s Hospital of Shaoxing during February 2010 and April 2013 were enrolled in the study.All the patients received IFNα monotherapy for 24 weeks and had poor responses.The patients were voluntarily divided into three groups:IFNα monotherapy group (n =21),IFNα plus ADV group (n =30) and LdT monotherapy group (n =35).Chi-square test was used to compare ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates among three groups.Results After 48 weeks of treatment,the ALT normalization rate in IFNα monotherapy group was 52.6％ (10/19),which was lower than those in IFNα plus ADV group (86.7％,26/30) and LdT monotherapy group (84.8％,28/33) (x2 =6.913 and 6.361,P ＜ 0.05).The rate of HBV DNA load ＜500 copies/mL in IFNα monotherapy group was 26.3％ (5/19),which was lower than those in IFNα plus ADV group (60.0％,18/30) and LdT monotherapy group (54.5％,18/33) (x2 =11.33 and 3.895,P ＜0.05).No HBeAg negative conversion or seroconversion was observed in IFNα monotherapy group,but it was observed in 6 (20.0％,6/30) patients in IFNαt plus ADV group and 7 (21.2％,7/33) patients in LdT monotherapy group (x2 =4.330 and 4.657,P ＜ 0.05).No HBsAg seroconversion was observed in three groups.There were no statistical significant differences in ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates between IFNαt plus ADV group and LdT monotherapy (x2 =0.042,0019 and 0.064,P ＞ 0.05).Conclusion For patients with HBeAg positive CHB who had poor response to IFNα treatment,IFNα plus ADV therapy and LdT monotherapy have the same efficacy in improvement of both liver function and virological response.

Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 ％ (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,＜29 ml/min.The incidences of CIN for the subgroups were 2.2％(1/45),4.4％(6/135),17.3％(14/81) and 50 ％ (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR＞ 6.07),preoperative e-GFR(＜60 ml/min) (OR＞3.27),volume of contrast medium (≥200ml) (OR＞3.26),chronic kidney disease(CKD) (OR＞2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P＜0.05). Conclusions Loop diuretic use,preoperative GFR (＜60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.

Objective To assess the operation time of laparoscopic operation for acute cholecystitis by Meta analysis.Methods The methods of computer literature retrieval and manual search were used to collect the research on the timing of laparoscopic surgery for acute cholecystitis in recent years,and the random effects model was used to conduct the Meta analyze.The quality of the literature was evaluated,and then the RevMan5.0.21 software was used to calculate the RR value and 95%CI of the operation time,bleeding volume and postoperative complications.Results A total of 13 articles were included in the Meta analysis,9 in Chinese,4 in English,2535 for a total number of cases,1401 in the early operation group,1134 in the delayed operation group,and 10 papers for low risk of bias,3 papers for bias risk.Meta analysis of the random effects model showed that the operation time of the early operation group was significantly shorter than that of the delayed operation group(P=0.00,RR=-20.25,95%CI=-24.97~15.33),and the intraoperative blood loss was also significantly reduced(P=0.00,RR=-12.58,95%CI=-29.36~5.78),then the postoperative complications were also significantly reduced(P=0.00,RR=0.63,95%CI=0.47~0.84).Conclusion The use of laparoscopic operation in the treatment of acute cholecystitis in patients with 72h could not only shorten the operation time and reduce the amount of bleeding,but also had a significant effect on reducing postoperative complications.

Objective: To report a newly designed method for treating supracondylar fracture of the humerus,and to inquire into the problems of cubitus varus deformity and joint stiff.Methods:Based on a review of anatomy,a new method which called tension band with sphenoid-shaped osteotomy through posterior approach was designed and applied for 46 cases of patients in clinic.The clinical effect was compared with effect of crossing Kirchner's wire.Results:The tension band with sphenoid-shaped osteotomy was a better method and can abide by anatomical and biomechanical principles.After follow-up for 12-36 months,curative effect was estimated as follow:30 cases were excellent,14 cases good and 2 cases poor according to Home's evaluation.Conclusions:It is a better methods in treating supracondylar fracture of the humerus following advantages including simple,reliable fixation and early mobilization etc.

Objective To find out the defects existing in the rinsing and sterilizing process of the automatic bottle washer and to put forward an improvement measure and efficiency assessment.Methods To make the washer more effective,an automatic brush pre-washing process and a rotary spraying device were designed and used.The total bacteria amount,the total coliform group and the disinfectant (ClO2) residual level were employed as the assessment parameters.Results An external automatic pre-washing machine was installed on the bottle washer;the bottle washer was innovated so that its spray nozzle could be in directions and the rinsing and sterilizing process could be enhanced.The results showed that the improved machine ran well in treating the polluted and recycled bottles and all the assessment indexes were better than that of before improvement.Conclusion The improved automatic bottle washer is considered effective in cleanout and sterilization of bottles with a satisfactory result.

OBJECTIVE:To explore the effects of dual-phase insulin aspart with different dosing regimens on the related indica-tors of type 2 diabetic (T2DM) patients with poor glycemic control. METHODS:70 T2DM patients with poor glycemic control were randomly divided into group A and group B. All patients were given metformin and stopped other antidiabetic drugs;based on it,group A was additionally given Dual-phase insulin aspart injection,0.5 U/(kg·d),in the morning and evening before a meal by subcutaneous injection;group B was given Dual-phase insulin aspart injection,0.5 U/(kg·d),once before lunch time for 6-10 U and other twice in the morning and evening before a meal by subcutaneous injection. Both groups were treated for 12 weeks. Glu-cose control rate,glucose control time,and glucose indicators,daily fluctuations of glucose before and after treatment and incidenc-es of hypoglycemia and adverse reactions in 2 groups were observed. RESULTS:Glucose control rate in group B was significantly higher than group A,glucose control time was significantly shorter than group A,incidence of hypoglycemia was significantly low-er than group A(P<0.05). After treatment,glucose indicators and daily fluctuations of glucose in 2 groups were significantly lower than before,and group B was lower than group A(P<0.05). There were no obvious adverse reactions during treatment. CONCLU-SIONS:Conpared with 2 times a day,Dual-phase insulin aspart with 3 times a day for administration can effectively improve the glucose control rate and glucose levels in the treatment of T2DM patients with poor glycemic control,with good safety.

Gadd45a, a p53 and BRCA1-regulated growth arrest and DNA damage gene, plays important roles in suppressing cell transformation and tumor malignancy. Gadd45a maintains the genomic stability through inhibiting the cell growth and promoting the DNA repair etc, by which it suppresses the tumor development. Additionally, Gadd45a is involved in some important signaling pathway, contributing to its function in tumor suppressing.

OBJECTIVE To survey the varieties of microorganism on nurse hands and probe into its controlling measure in general hospital.METHODS We sampled microorganism of nurse hands during intravenous fluids infusion in the Respiratory Department,the Cardiovascular Department,the Department of Digestion,Gynecology and Obstetrics Department,the Department of Thoracic Surgery and the Department of Organ Transplantation in our hospital.All samples carried out co-cultures of fungi and bacteria.RESULTS The varieties of microorganism included not only opportunistic pathogens such as Acinetobacter,Corynebacterium,Pantoea agglomerans(Enterobacter agglomerans) former,and Escherichia coli,but also strong pathogenic microorganisms such as Staphylococcus aureus,and it is so common that finding meticillin-resistant coagulase-negative staphylococci.CONCLUSIONS Nursing staff's hands contamination is serious in the process of manipulating operation in general hospital,emphasis should be placed on prophylaxis and control for nosocomial infection.