Objective:To explore the value of preoperative neutrophil-lymphocyte ratio (NLR),preoperative platelet-lymphocyte ratio (PLR),changes between pre and postoperative neutrophil-lymphocyte ratio(postoperative NLR/preoperative NLR) and changes between pre and postoperative platelet-lymphocyte ratio(postoperative PLR/preoperative PLR) in predicting the occurrence of anastomotic leakage after surgery in patients of rectal cancer.Methods: 187 rectal cancer patients in the Gastrointestinal Surgery Department in the First Affiliated Hospital of Southwestern Medical University during March,2015-March,2016 were included in our study.Preoperative NLR,preoperative PLR,changes between pre and postoperative NLR and changes between pre and postoperative PLR were observed.At the same time we included age,gender,pathological staging,stage of lymph node metastasis,tumor differentiation,distance between tumor and anus in our study.χ2 test or Fisher′s exact value was used in the univariate analysis,while Logistic Regression Analysis was used in the multivariate analysis.Results: The univariate analysis showed that preoperative NLR (Fisher′s exact value=7.242),preoperative PLR (χ2=6.787),changes between pre and postoperative NLR (χ2=15.656),PLR (χ2=9.298),age (χ2=4.813) and distance between tumor and anus(χ2=5.951) were related to anastomotic leakage(P<0.05).Other risk factors such as,gender(χ2=0.001),pathological staging (Fisher′s exact value =2.107),stage of lymph node metastasis(Fisher′s exact value =1.298),tumor differentiation (Fisher′s exact value =2.206),and were not associated with anastomotic leakage (P>0.05).Multivariate analysis showed that the preoperative NLR(OR=1.647,P=0.000),change between pre and postoperative NLR (OR=1.880,P=0.000)and distance between tumor and anus(OR=4.364,P=0.048) were associated with anastomotic leakage.Conclusion: preoperative NLR,change between pre and postoperative NLR and distance between tumor and anus are independent risk factors for anastomotic leakage after rectal anterior resection.

Objective To investigate the mechanism of the kidney injure in the newborn rats with endotoxemia.Methods Eighty Wistar rats aged 7 days were randomly divided into 2 groups:control group (intraperitoneal injection of saline of 0.1 ml;n = 40),lipopolysaccharide(LPS) group(intraperitoneal injection of LPS of 5 mg/kg;n =40).The rats in either group were killed at 1 h,4 h,8 h and 12 hours after intraperitoneal injection,respectively.The expressions of NF-κB and TGF-β1 in the kidney were detected by using the immunohistochemical assay.Renal ultrastructural changes was observed with a CM100 Philips electron microscope.Results The NF-κB in control group had no expression.NF-κB in LPS group mainly expressed in the renal tubular epithelial cell,increased at 1 h after test and peaked at 8 h,and slightly descended at 12 h.The expression of TGF-β1 in control group was slight,and had not show significant difference from control group at 1 h,4 h and 8 h,but significantly higher than that in control group at 12 h.In LPS group,newborn rat renal glomerular basement membrane was complete,part epithelial cell foot processes were fused and renal tubules epithelial cell mild mitochondria vacuolization was found at 4 h.Renal glomeruli epithelial cell foot processes obvious confluenced,quantities of mesangial cells mitochondria vacuole,and renal tubules epithelial cell mitochondria expanded to bubbles at 12 h.Conclusion The NF-κB involves in the pathogenesis of kidney damage induced by endotoxemia,but TGF-β1 may help to repair the damaged kidney,and may repress the production of NF-κB.

Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Severe Acute Respiratory Syndrome ; therapy

In this study, three methods for identification of E.coli were compared. The conventional method was employed to select and identify the suspicious E.coli isolates from a fecal sample. PCR based ARDRA analysis was then carried out to distinguish these E.coli isolates, E.coli MG1655 and other bacterial species. All the potential E.coli isolates and E.coli MG1655 had the identical ARDRA banding pattern while the other bacterial species showed the different patterns.The result indicated that the ARDRA analysis was consistent with the traditional method for identification of E.coli and could be the practical method for distinguishing E.coli from other intestinal bacterial species. The ERIC-PCR analysis provided abundant polymorphism between different E.coli isolates, and might be a powerful approach for elucidating the genetic diversity among isolates of the same species.

Objective To study the role of glucocorticoid (GC) in treating patients with cyto- megalovirus (CMV) pneumonia following renal transplantation.Methods There were 75 cases CMV pneumonia following renal transplantation during one month (3 cases),2-6 months (64 cases) and more than 6 months (8 cases).All patients were subjected to the comprehensive treatments including anti-virus therapy.In 47 cases,GC was given (GC group),and in the rest 28 cases,GC was not administered (non-GC group).Results In GC group,40 cases (85.1%) were cured and there were 7 deaths (14.9%).In non-GC group,17 cases (60.7%) were cured and there were 11 deaths (39.3%).There was significant difference between two groups (P

Objective To investigate and analyze the status quo of professional identity of nursing students with different educational backgrounds.Methods With stratified-cluster random sampling,635 students were surveyed using the nursing students' professional identity questionnaire.Results The total score of professional identity of junior college nursing students was significantly higher than that of undergraduate students.Junior college nursing students had a higher score in professional knowledge dimension than undergraduate and graduate students,while the score of nursing undergraduate students was higher than that of graduate students.Junior college nursing students had a higher score in professional will dimension than undergraduate and graduate students.Nursing graduate students had a higher score in professional expectation dimension than junior college and undergraduate students,while the score of undergraduate students was higher than that of junior college students.Whatever the educational background,professional skill and professional expectation were the top two dimensions,while professional knowledge and professional emotion were the last two dimensions.The difference was statistically significant between the answers of nursing students with different educational backgrounds to the following questions,such as which is the most probable factor affecting your learning enthusiasm,who has the greatest impact on your professional thought about nursing and which nursing field are you most willing to go in for.There was significant difference in professional identity score between different grades of junior college and undergraduate nursing students,while there is no significant grade difference in graduate students.Conclusions There were some differences of professional identity of nursing students with different educational backgrounds.Nursing educators should carry out the professional education according to the student's educational backgrounds.

Objective To observe the effect of early enteral feeding on clinical outcomes and immune function in patients after colorectal cancer surgery.Methods 90 cases of colorectal cancer patients were randomly divided into early enteral feeding group (43 cases) and control group (45 cases).Patients in early feeding group were given small amount of water several times and enteral nutrition early after surgery,while patients in the control group were administrated according to conventional postoperative care protocol.Data were collected on serum IgA,IgG,IgM,CD4 +,CD4 +/CD8 + and CRP on the postoperative first,third and seventh days,postoperative length of stay,complications and quality of life.Results The postoperative fever time [(54 ±6) h vs.(65 ±6) h,t =8.688,P ＜0.01],time to flatus [(58 ±8) h vs.(72±7) h,t=8.573,P＜0.01],postoperative length of stay [(6.9±1.4) dvs.(8.5 ±1.9) d,t=4.277,P ＜ 0.01] and health care cost [(41 868 ± 3 168) RMB vs.(45 950 ± 3 714) RMB,t =5.536,P ＜ 0.01] were significantly in favour of early enteral feeding group than those in control group.Further,the score of quality of life at discharge were significantly higher in early enteral feeding group [(18.4 ± 1.7) vs.(16.4 ± 1.9),t =5.235,P ＜ 0.01],while the complication incidence showed no difference between the two groups [18.6％ (8/43) vs.22.2％ (10/45),t=0.177,P＞0.05].The CD4+,CD4+/CD8+ and IgM on the seventh postoperative day and the IgA and IgG on the third and seventh postoperative day were significantly better in early enteral feeding group while the CRP was significantly lower as compared to the control group (t =3.639,t =2.255,t =2.119,t =2.035,t =2.961,t =2.060,t =2.108,t =7.308,t =3.435,P ＜ 0.05).Conclusions Early oral enteral feeding after elective colorectal cancer surgery can improve patient's immune function,reduce the stress and accelerate rehabilitation.

Objective: To observe the histological changes of lamina extema cranii at both the graft and donor areas after having been grafted in animal experiment. Methods; 4 mini pigs aged from 8 to 12 months were selected. Part of the outer table of skull (2.5 cm × 1.0 cm) was decorticated and was divided equally. Both were implanted on each side of the snouts of animals. 2 pigs were selected randomly and were killed 12 weeks postoperation. Each 1, 0 cm ×0. 5 cm specimen was harvested and histological study was performed. The other 2 animals were killed 24 weeks after operation. Gross inspection of the donor site was performed and histological study was done. Results; In the graft area; bone absorption was obvious 12 weeks postoperation, but bone matrix increased obviously at 24 weeks postoperation. Results of scanning electron microscope showed that interface between bone graft and recipient site was discernment and collagen type I was malaligned 12 weeks postoperation. Collagen fibers were in good order and good mineralization was found 24 weeks postoperation. In the donor area; small amounts of new bone formation could be seen and alignment of cemental line was chaotic 12 weeks postoperation. At 24 weeks, bone formation was obvious and alignment of haversian canal was regular. Scanning electron microscopy showed that structure of the tissue was uneven and disorder at 12 weeks postoperation. Collagen fibers were in good order and good mineralization was found 24 weeks postoperation. On gross view, raw surface of the donor site got complete healing, os-teanagenesis was incomplete and introcession could be observed in the local area. Conclusion; Histological remodeling of lamina exter-na cranii is complete at 24 weeks after having been grafted. The donor site can regenerate but morphologic introcession could be observed.

Objective To study the clinical application of proportional assisted ventilation (PAV) in the treatment of neonatal respiratory failure.Method From March 2011 to October 2013,a retrospective study was conducted on newborns receiving ventilation therapy for respiratory failure.The newborns were assigned into PAV group and synchronized intermittent mandatory ventilation (SIMV) group.Arterial blood pH 、partial pressure of arterial oxygen (PaO2)、partial pressure of arterial carbon dioxide (PaCO2) and oxygenation index (OI) were compared at the time before ventilation and 2 h,6 h,12 h,24 h after ventilation.The frequency of sedative usage and average time of ventilation between the two groups were compared.Result A total of 30 cases were enrolled in the PAV group and the SIMV group respectively.Before ventilation,no statically significant differences existed on blood pH[(7.13 ± 0.12)、(7.14 ±0.11)],PaO2[(41.1 ±8.9),(40.8±8.8) mmHg],PaCO2[(76.4±12.6),(73.2±13.5) mmHg]and OI between the two groups (P ＞ 0.05).2 h after ventilation,the blood pH [(7.25 ± 0.17)、(7.23 ± 0.15)],PaO2 [(51.0 ± 5.6)、(48.6 ± 5.3) mmHg] and OI were significantly improved,while PaCO2 [(66.3 ± 8.7)、(64.0 ± 7.5) mmHg] decreased.Comparing with data before ventilation,those parameters were statistically improved at each time point after ventilation (P ＜ 0.01).But no statistically differences existed between the two groups at the same time (P ＞ 0.05).Sedatives were used (2.3 ± 1.2)times/case in PAV group and (3.9 ± 2.2) in SIMV group,with statistically differences between the two groups (P ＜ 0.05).Average duration of ventilation were (5.1 ± 1.9) d in PAV group and (5.4 ± 2.1) d in SIMV group,with no statistically differences between the two groups (P ＞ 0.05).Conclusion PAV is very effective in treating the neonatal respiratory failure and worth spreading.

Objective To compare the efficacy of laparoscopic gallbladder bed dissection(LGBD)between retrograde plus anterograde and anterograde only manners.Methods All of 575 cases of laparoscopic cholecystectomy(LC)were randomly divided into two groups(group A and group B).Patients underwent LGBD with retrograde plus anterograde mannerin group A(297 cases)oronly with anterograde manner in group B(278 cases)respectively.The efficacy and safety were compared between two groups.Results The operative time were(10.0±3.7)min and(13.0±3.9)min in group A and group B respectively (P<0.05).There were 33 cases of bleeding volume more than 5 ml in group A with 85 cages in group B (P<0.05).Three cases of gallbladder rupture were found in group A compared with 10 cases in group B (P<0.05).Postoperative fluid collection in gallbladder bed occurred in 5 cases in group A compared with 19 cases in group B(P<0.05).The conversion rate was 3.70%(11/297)and 3.96%(11/278)in group A and group B respectively(P>0.05).One cage of abdominal fluid collection was observed in group A whichwas relieved after conservative therapy.No other complications occurred.Conclusions LGBD applying retrograde plus anterograde manner may shorten the operative time,decrease the bleeding during operation and minimize the postoperative complications.Surgeons might benefit from its advantage of easier manipulation.