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.

Child ; China ; Evidence-Based Medicine ; Humans ; Pediatrics

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 compare pharmacokinetic parameters of the common tablets and sustained-release melatonin tablets in beagle dogs in vivo.METHODS:The blood concentration of melatonin of6Beagle dogs was determined by HPLC and the pharmacokinetic parameters were calculated with3p97software after administered random crossover with single dose of sustained-release melatonin tablets6mg or the common tablets3mg.RESULTS:The concentration-time curves of both the common tablets and sustained-release melatonin tablets were in conformity with two-compartment model,C max of common tablets and sustained-release tablets were(11.27?3.77)ng/ml and(8.31?5.11)ng/ml respectively,t max of which were(0.50?0.18)h and(1.00?0.37)h respectively,t 1/2ke of which were(1.21?0.52)h and(3.27?0.89)h,AUC 0～t of which were(25.23?7.71)(ng?h)/ml and(38.03?16.45)(ng?h)/ml respectively.CONCLUSION:Compared with the common tablets,the sustained-release tablets showed slower absorption,longer peak time,lower peak concentration,slower elimination and longer duration.

Objective This study was designed to evaluate the biomechanical properties in tendons across the joints when Palmar or dorsal stitches were used. Methods Twenty porcine tendons were transected and then repaired in zone Ⅱand divided into two groups,using modified Kessler by placing the stitches in volar or dorsal part of tendons.The repaired tendons were placed on a joint model with flexion of 60?. An instron tensile testing machine was used to investigate 2 mm gap formation force and ultimate tensile strength. Results 2 mm gap formation force and ultimate tensile strength were both higher when dorsal placement of stitches was used. Conclusions Dorsal placement of stitches was recommended for repairing the tendons across the joints because it can offer greater tensile strength.