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.

Education and Legal System are the first two approaches needed to be fully applied to strength- en the construction of medical morality and medical manners.Much attention shall be paid to the theory and ideological education of the professional morality.Meanwhile,medical staffs shall keep their medical behaviors and economic behaviors within the bounds of laws.Three points shall be emphasized in the course of strength- ening construction of medical morality and medical manners: a)change of minds; b)strict compliance with the rules and regulations; and c)big efforts to strengthen the construction of medical quality as its core.In order to further strengthen the construction of medical morality and medical manners,outline of the relevant teaching material shall be compiled; regulation mechanisms to both the medical staffs and patients shall be amplified; and current pricing systems in hospitals of high drug expenses and low charge of medical service shall be re- formed.

Objective: To improve the database of medical equipment archives system and manage medical equipment more scientifically and efficiently. Methods:According to the needs of medical equipment management, the problems of medical equipment archives system would be analyzed and addressed. Results:In recent medical equipment archives system, the database of usage rate, cost-effectiveness, maintenance costs and property management should be improved. Conclusion:The improved archives system could provide reliable basic data and multi-faceted sharing for medical equipment dynamic management.

Apoptosis ; Inhibitor of Apoptosis Proteins ; Myocytes, Cardiac ; cytology

OBJECTIVETo observe the therapeutic efficacy and safety of gonadotropin-releasing hormone agonist (GnRHa) combined Wenshen Xiaozheng Decoction (WXD) in auxiliary treating endometriosis after laparoscopy.

METHODSOne hundred and thirty-four endometriosis patients with confirmative pathological diagnosis were assigned to three groups depending on whether they would receive adjuvant therapy or Chinese medicine treatment, i.e., the control group, the observation 1 group, and the observation 2 group. The 22 patients in the control group received no adjuvant therapy after laparoscopy. The 42 patients in the observation 1 group were treated with GnRHa 3.6 mg by subcutaneous injection starting from the 1st day to the 5th day of menstruation, once per 28 days. The 70 patients in the observation 2 group were treated with GnRHa 3.6 mg by subcutaneous injection in combination with WXD starting from the 1st day to the 5th day of menstruation, once per 28 days. They also took WXD for 7 doses, one cycle per every 28 days. The treatment lasted for three to six months. Serum levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and cancer antigen 125 (CA125), as well as clinical efficacy, and adverse drug reactions were observed before and after treatment.

RESULTSThere was statistical difference in serum levels of E2, FSH, or LH between the control group and the observation 1 and 2 groups (P < 0.05). There was no statistical difference in serum levels of E2, FSH, or LH between the observation 1 group and the observation 2 group (P > 0.05). There was statistical difference in the clinical efficiency among the 3 groups (P < 0.05). There was statistical difference in the pre-post difference of CA125 levels among the three groups (P < 0.01). Compared with the control group, there was no statistical difference in the pre-post difference of CA125 levels between the observation 1 group and the observation 2 group (P > 0.05). No obvious adverse reaction occurred during the treatment.

CONCLUSIONSGnRHa combined WXD showed confirmative clinical efficacy in treating endometriosis after laparoscopy. It also could lower serum levels of E2, FSH, and LH levels. So it was an ideal solution for treatment of endometriosis.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; drug therapy ; surgery ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Laparoscopy ; Treatment Outcome

Objective To analyze the dose‐effects of different doses of dexmedetomidine for sedation and sleep of the patients under epidural nerve block anesthesia .Methods A total of 82 patients undergoing elective lower limbs surgery(ASA grade Ⅰ - Ⅱ) were randomly divided into 4 different doses of dexmedetomidine groups(group 1 ,n=19 ;group 2 ,n=22 ;group 3 ,n=20;group 4 , n=21) ,under continuous epidural nerve block ,the loading dose of dexmedetomidine 0 .7 ,0 .8 ,0 .9 ,1 .0μg · kg -1 · h-1 was intrave‐nously pumped for 30 min ,then pumped at a rate of 0 .7 ,0 .8 ,0 .9 ,1 .0 μg · kg -1 · h-1 in the group 1 ,2 ,3 and 4 respectively .If any patient in 4 groups fell asleep at less than half an hour ,the loading dose was stopped and the continuous dose was changed to pump , the drug administration was discontinued at wound dressing after operation .Whether the patient falling asleep was recorded ,and the mean arterial blood pressure ,heart rate at 4 time points of 10 ,30 ,60 ,90 min after infusion of dexmedetomidine were also recorded . The 50% effective dose(ED50 ) ,ED95 and 95% confidence interval(CI) were calculated by using the Probit method .Results ED50 and ED95 of dexmedetomidine were 0 .65μg/kg(95% CI:0 .36-0 .73μg/kg)and 1 .00 μg /kg(95% CI:0 .90-1 .74μg/kg) ,which could decrease the heart rate and increase the arterial blood pressure .Conclusion Although dexmedetomidine can decrease the heart rate and increase the arterial blood pressure ,but the patients quietly fall asleep without discomfort and pain occurrence by the intra‐venous administration under continuous epidural nerve block .

Objective To evaluate the therapeutic efficacy of laparoscopic splenectomy (LS) for patients with idiopathic thrombocytopenic purpura (ITP) and to investigate the change of parameters of platelets.Methods Twenty-one patients with ITP after LS were studied, including the following paramenters: the operation time, intraoperative blood loss and postoperative complications, and compared perioperative platelet count(PC), packed platelet volume(PPV), mean platelet volume(MPV), and platelet distribution width (PDW) with the postoperative results.Results The mean operation time was 1.5 h. Intraoperative mean blood loss was 60 mL, postoperative hospitalization time was 5 d and with no case of delayed healing of incision. Accessory spleen was found in 19 % of patients . The incidence of complication was 4.8 %, and with no deaths. Platelet count and packed platelet volume increased with fluctuation, but mean platelet volume and platelet distribution width decreased with fluctuation. The parameters were in multipoint dynamic equilibrium with fluctuation and coordinated restoration. All patients were followed-up. No case had recurrence at 1.5~5.5 y, and platelet-associated antibody was in normal range. Bone marrow examination was normal.Conclusions The treatment of ITP with LS is safe and effective. The selection of therapeutic plan should depend on the changes of platelet parameters.

AIM: To study and analyze the clinical efficacy of diclofenac sodium eye drops combined with sodium hyaluronate eye drops in treating dry eyes after ophthalmic surgery.METHODS: Totally 94 eyes from 94 patients with dry eyes were slected, and they were randomly divided into orbervation group and control group.Fouty-seven patients in the control group using conventional treatment combined with sodium hyaluronate eye drops.Other 47 patients in orbervation group were treated with diclofenac sodium eye drops on the basis of control group.We compared symptoms, fluorescein station, tear film break time, Schirmer Ⅰ test between the two groups.RESULTS: Compared with before treatment, patients of both groups with sympotom, fluorescein station score, BUT, and Schirmer Ⅰ test were significantly improved(P<0.05).At the same time, sympotom, fluorescein station score, BUT and Schirmer Ⅰ test of control group were better than observation group(P<0.05).The cure rates of the orbervation group (98%) were more significant than control group (74%)(P<0.05).CONCLUSION: Diclofenac sodium eye drops combined with sodium hyaluronate eye drops have significant efficacy in treatment of dry eyes after ophthalmic surgery, which can effectively relieve clinical symptoms, improve BUT and Schirmer Ⅰ test.

ObjectiveTo study possible differences in cognitive dysfunction between left hemisphere injury(LHI) patients and right hemisphere injury(RHI) ones.MethodsCognitive function of 55 LHI patients and 43 RHI patients were examined by aphasia screening test and the Loewenstein Occupational Therapy Cognitive Assessment Battery(LOTCA).ResultsThe scores of RHI group were significant higher than that of LHI group in orientation in place,overlapping figures,spacial perception,praxis(P<0.001-0.005),but significant lower than that of LHI group in visual identification of shapes and visuomotor organization(P<0.001-0.02).The possibilities of RHI group were significant more than that of LHI group in disorientation in time,shape agnosia,disorder in figure-ground identification,unilateral neglect,disordered attention(P<0.005-0.025),but significant fewer than that of LHI group in aphasia,ideomotor apraxia(P<0.005-0.01).The possibilities were no significant differences in disorientation in place,objects agnosia,colour agnosia,spacial agnosia,motor apraxia,constructional apraxia,thinking disorder between RHI group and LHI group(P>0.05).Conclusions There is characteristic cognitive dysfunction after right or left hemisphere injury.

Objective To study the different ultrasonic features in patients of polycystic ovary syndrome (PCOS) with or without obesity based on body mass index (BMI), and to investigate whether certain hormonal factors correlate with ovarian morphology and blood flow, and to discuss the role of ultrasound combined with hormone test in the diagnosis of obese PCOS. Methods One hundred and five women with PCOS were recruited. Patients were divided into two groups according to BMI;obese PCOS group (OB-PCOS, n=32, BMI≥25 kg/m2) and non-obese PCOS (NOB-PCOS, n=73, BMI<25 kg/m2). The ultrasonic parameters of follicle number (FN), ovarian volume (Vol), resistance index (RI) of ovarian stromal blood, RI of uterine artery and serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), the ratio of luteinizing hormone and follicle-stimulating hormone (LH/FSH), progesterone (P), estradiol (E2), free testosterone (FT), prolactin (PRL), sex hormoe binding globulin (SHBG), fasting plasma glucose (FPG), fasting insulin (FINS), the extent of insulin resistance and hyperandrogenism (HOMA-IR) were measured and compared. The correlation of the ultrasonic parameters and hormonal factors were analyzed. Results The Vol of OB-PCOS group was significantly higher than NOB-PCOS group [(12.25±4.89) ml vs (10.73±2.30) ml, t=2.20, P < 0.05]. FN and uterine artery RI of OB-PCOS group had a rising trend and RI of ovarian interstitial was on a reducing trend compared with NOB-PCOS group. But the differences were not statistically significant. The levels of FINS and HOMA-IR in OB-PCOS group [(14.82±6.45) mU/L and (3.91±3.30)] were significantly higher than those in NOB-PCOS group [(8.04±4.57) mU/L and (1.64±1.20)] (t=4.87, 3.47, respectively, both P < 0.01). And FSH in NOB-PCOS group was significantly higher than OB-PCOS group [(5.95±1.91) U/L vs (4.65±1.88) U/L, t=-2.77, P<0.01]. In POCS patients, FN was significantly associated with LH/FSH (r=0.35, P<0.01), and FT (r=0.38, P<0.01). Vol was significantly associated with LH/FSH, BMI, HOMA-IR and FPG (r=0.27, P<0.05;r=0.25, P<0.05;r=0.40, P<0.01;r=0.32, P<0.01). RI of ovarian stromal blood flow was significantly associated with SHBG (r=0.28, P<0.05). In OB-POCS group, RI of uterine artery was significantly associated with PRL (r=-0.58, P < 0.05). Vol was significantly associated with HOMA-IR (r=0.47, P < 0.05). In NOB-POCS group, FN was significantly associated with LH/FSH (r=0.33, P<0.05), and FT (r=0. 56, P<0.05). Vol was significantly associated with FT (r=0.31, P < 0.05). Conclusion There are some differences in the ultrasound and endocrine parameters between obese and non-obese PCOS patients, and some correlations exist between them.