Adjuvant and neoadjuvant therapy are the important therapeutic methods for rectal cancer.Neoadjuvant concurrent chemoradiotherapy and postoperative adjuvant chemotherapy play a crutial role in rectal cancer treatment.New chemotherapy drugs and targeted therapy drugs could further improve the therapeutic effect of rectal cancer.

Objective To assess the awareness of nutrition issues among patients with type 2 diabetes mellitus (T2DM) and to find effective nutrition education models. Methods According to cluster random sampling method,256 T2DM patients from 2 hospitals in Zhengzhou City were enrolled and randomly assigned to the study or control group. The participants in the study group received traditional nutrition education and real object-based diabetic diet guidance, and those in the control group received traditional nutrition education only. Awareness about nutrition and blood glucose levels were compared between the two groups by using independent t test and Chi-square test Results After the intervention, the study group showed significantly higher nutrition scores ( 86. 5 ± 3.8 vs 71.5 ± 4. 6, P ＜ 0. 05 ) and lower 2 h postprandial glucose level ( ( 9. 15 ± 1.06 ) mmol/L vs ( 11.32 ± 0. 84) mmol/L, P ＜ 0. 05 ). Conclusion Real object-based diabetic diet teaching could foster the awareness in nutrition and decrease postprandial blood glucose level in T2DM patients.

Objective To investigate the clinical value of non-invasive atherosclerosis detection technology for the early diagnosis of young type 2 diabetic patients with lower extremity vascular disease .Methods 78 young patients with type 2 diabetes( T2DM group) and 80 cases in the healthy control group were detected some indicators , including upstroke time(UT)%,mean artery pressure(%MAP),the pulse wave speed(baPWV) and ankle-brachial index(ABI) by Omron arteriosclerosis detector.Those items were comprehensively used to evaluate the diabetes patients of lower extremity vascular disease .Results There were statistically significant differences in UT ,%MAP, baPWV and ABI between the T2DM group and the control group(t=4.218,8.798,-3.392,5.136,all P<0.01). ABI of 6 patients was less than 0.9.Moreover,five of these 6 patients examined by color Doppler ultrasound had arte-rial plaque formation.As to patients of ABI >0.9,2 cases of them were promoted lower extremity arterial stenosis and occlusion,and then they were certified by color Doppler ultrasound .Conclusion Non-invasive atherosclerosis detec-tion technology has better accuracy to the diagnosis of young type 2 diabetes patients with atherosclerosis ,and may find patients with blocked arteries earlier ,provide better value for early clinical intervention .

Objective To analyze the clinical and pathologic features in patients with ldiopathic cytopenia of undetermined signif-icance (ICUS) ,and provide the diagnostic basis .Methods 10 ICUS patients who did not fulfil minimal diagnostic criteria for MDS but suffered from constant (>6 months) progressive cytopenia ,with no marked dysplasia (<10% in three-major cell lineages) and abnormal karyotype were reported .Results 2 of 10 patients transited to MDS ,bone marrow review showed that ≥2 cells appeared diagnostic pathology development .Karyotype analysis showed that 1 case was still normal ,1 case lost a normal chromosome 20 (20q-) ,the rest 8 cases had been efollowed up for 6 to 25 months and still maintain ICUS .Conclusion Patients with MDS who fail to meet the diagnostic criteria of ICUS ,must carry out regular follow-up .There are some patients can transition to public MDS after a certain incubation period ,in fact it is Pre-MDS or MDS-early before ,which shows that ICUS should cause clinical attention ,so that avoid missed diagnosis .

Objective To evaluate the value of plastic-embedded bone marrow (BM ) biopsy sections in diagnosing myelodysplas-tic syndrome(MDS) .Methods HGF and Gomori stained .Glycol methacrylate(GMA) embedded BM biopsy specimens were detec-ted from 125 MDS patients with 25 cases in good health as control .Dyshematopoiesis and abnormal stroma cell responses were se-lected as main observed projects .Results Bone marrow biopsy sections gave an exact assessment of cellularity ,19 cases (15 .2% ) showed a decrease of cellularity as hypocellular MDS .66 cases(52 .8% ) of these cases did show abnormal localization of erythro-blastic clusters ,biopsy of 64(62% ) of low risk group 103 cases did show abnormal localization of immature precursors such as blasts and promyelocytes(ALIP positive) .Numeration of megakaryocytes and mast cells within 1mm2 acre of BM tissue were all much in MDS group than in control group .Gomori′s stain revealed moderate increase in reticulin fibres in 65 cases ,10 cases(8 .0% ) showed degree of myelofibrosis were + + + as hyperfibrotic MDS .Among 125 cases ,33 cases(26 .4% ) of bone marrow biopsies showed different types of erythrocytic and granulocytic immature cells with unusual intrasinusoidal bone marrow infiltration .Con-clusion It is clear that GMA embedded BM biopsy section is helpful in making diagnosis of MDS ,and has important clinical appli-cation value .

BACKGROUND:Bone ultrastructural destruction is an important cause for bone strength decrease,bone friability and bone fracture incidence increase in osteoporosis.OBJECTIVE:To observe the ultrastructural changes of distal femur cancellous bone in glucocorticoid (GC)-treated rats by scanning electron microscopy (SEM).METHODS:A total of 32 female Sprague-Dawley rats,aged 3.5 months old,were respectively treated with methylprednisolone 3.5 mg/kg per day by subcutaneous injection to induce osteoporosis and normal saline.At 4 and 9 weeks,the distal femurs were coronary sectioned and rinsed with distilled water,dehydrated in graded ethanol,coated with gold,and observed by SEM.RESULIS AND CONCLUSION:Compared to the control,the number of bone trabeculae in the GC group was significantly decreased,and the bone trabeculae became thin,fragile,discontinuous;network structures of bone trabeculae were destroyed,and bone resorption surface increased,with disorderly arranged collagenous fibers and increased micro-damage.Rats treated with GC for 4 weeks maintained better bone ultrestructure compared with rats treated with GC for 9 weeks.Results show that GC can induce bone mass lost,destroy network structures of bone trabeculae,accelerate bone resorption in rat cancellous bone,and accordingly lead to increased bone brittleness and decreased bone functional of biodynamics.

Objective To study a novel method for the high-dose-rate brachytherapy (HDR) CT image to the intensity modulated radiation therapy (IMRT) CT image deformable image registration and dose accumulation.Methods The applicator in the HDR CT image is first segmented and removed,then a deflation step is performed on the applicator-free HDR CT image by solving the Navier-Stokes equation.Demons algorithm is utilized to register the deflated HDR CT image to the IMRT CT image,along with the HDR dose.The deformed HDR dose is then added on the IMRT dose and yield the final accumulated dose.Results The HDR CT image and IMRT CT image,as well as the corresponding dose distribution,from five cervical cancer patients are used for evaluation of the proposed algorithm,the results show that the proposed method can effectively get rid of the influence of the applicator and produce an accurate accumulated dose.Conclusions Dose accumulation and supervision is an important step in adaptive radiotherapy for accurate dose delivery and treatment plan re-optimization.The proposed method in this study can effectively accumulate the HDR dose to the IMRT dose domain,and the accuracy is proved to be sufficient for clinical needs.

Objective To investigate mortality risk factors in patients with severe cardiorenal syndrome treated with continuous hemofiltration therapy. So we can optimally select patients who may benefit more from this therapy. Methods The clinical data of 68 severe cardiorenal syndrome patients admitted to the ICU of Beijing Shijitan Hospital from May 2012 to May 2015 were retrospectievly analyzed and evaluated. These patients were divided into two groups based on survival or death during hospitalization. Logistic regression analysis was employed to identify independent risk factors for death of patients with severe cardiorenal syndrome during ICU stay. Results There were 36 cases in the death group and 32 cases in the survival group. In the death group, the age,mechanical ventilation rates, vasoactive drug application rates, leukocytes, neutrophils, C-reactive protein,left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly higher than those in the survival group,while hemoglobin, serum creatinine, left ventricular ejection fraction, average single amount of dehydration in continuous hemofiltration process were significantly lower than those in the survival group. Logistic regression analysis showed that age, vasoactive drug application rates, APACHEⅡscore and leukocytes were independent risk factors of mortality. Conclusions Cardiac function, mechanical ventilation therapy, average single amount of dehydration in continuous hemofiltration, hemoglobin, C-reactive protein were closely related to the prognosis of severe cardiorenal syndrome patients. The patient′s age,infection, vasoactive drug application, APACHEⅡ score were important risk factors of mortality during hospitalization.