New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Caudal block has much advantages such as simple operation,less complications,obvious effect,flat and low anesthesia.For those reasons,caudal block is widely used in pain treatment and clinical anesthesia.The traditional way of sacral canal anesthesia is based on osseous marks.However,because of variable anatomical structure in sacral canal and the sacral horns,the traditional method has many defects.In recent years,as a new operation method,caudal block under the guidance of ultrasound has began to be applied gradually.The advantages,application progresses of this method were reviewed in this paper.

Objective:To investigate the effects of two different routes of nutrition support on the treatment of severe pneumonia in elderly patients.Methods:From January 2015 to January 2016,84 elderly patients with severe pneumonia in our hospital were randomly divided into two groups,42 patients in each group.The enteral nutrition (EN) group was treated with nasogastric feeding and another group was defined as combined treatment group.After 4 weeks of treatment,the nutritional status of two groups of patients was compared.The incidence of complications during treatment were documented.Results:After treatment,the hemoglobin was (111.34 ± 20.33) g/L,and the albumin was (23.33 ± 5.09) g/L in the EN group.The hemoglobin was (132.13 ±24.39) g/L,and the albumin was (35.43 ±9.12)g/L.There was significant difference between the two groups (P ＜ 0.05).The cure rates of the two groups were 92.86％ and 95.24％,respectively,and there was no significant difference (P ＞ 0.05).Conclusion:For elderly patients with severe pneumonia,the combination of enteral and parenteral nutrition is more likely to improve the nutritional index,and has a lower incidence of adverse events.

Objective To compare the clinical effects of modified single open-door laminoplasty combined with segmental lateral screw fixation with conventional single open-door combined with continuous screw fixation in the treatment of multilevel cervical spondylotic myelopathy (MCSM).Methods Retrospective analysis was used to analyze the fifty-five cases of MCSM who underwent posterior operation in Lianyungang Hospital Affiliated to Xuzhou Medical University from March 2009 to January 2017.Among them,26 cases in the modified group were treated by modified single open-door laminoplasty combined with segmental lateral screw fixation;29 cases in the traditional group were treated by conventional single open-door combined with continuous screw fixation.JOA score collected before the operation and at the last time of the follow-up,the cervical spine mobility,cervical curvature,cervical axial symptom,C5 nerve root palsy and the incidence rate of screw fracture in both groups were compared.Operation time and the intraoperative blood loss were recorded.Results 55 cases were all followed up.The cervical spine mobility at the last time of the follow-up in the modified group was significantly higher than that of the traditional group ((39.63°±5.98°) vs.(36.14°±6.05°),P=0.036).The cervical curvature in the modified group was higher than that of the traditional group ((19.83°±5.61°) vs.(16.02°±7.05°),P=0.030).The operation time and intraoperative blood loss in the modified group were significantly lower than those of the traditional group ((116.3±13.2) min vs.(128.7±14.3) min,(186.7±39.8) ml vs.(228.7±42.5) ml,P=0.002,0.000).In the modified group,the proportion of patients with postoperative cervical axial symptom was 15.38%,the rate of C5 nerve root palsy cases was 8.69%,compared with 48.27% and 34.48%,respectively in the control group,the difference between the two groups was statistically significant (P=0.011,0.022).In the traditional group,2 cases of screw fracture were found at the last follow-up,while there was no such case in the modified group.Conclusion The modified cervical single open-door laminoplasty combined with segmental lateral screw fixation can obtain good effect of nerve decompression,maintain cervical mobility and cervical curvature,reduce the occurrence of postoperative cervical axial symptom,C5 never root palsy,screw fracture and other complications,is a safe and effective surgical method.

In recent years,the study about the mechanisms of cell apoptosis has been increasingly concerned.Many liver diseases are correlated with caspase family,such as hepatic ischemia/reperfusion injury、inflammation and cancer,etc.In the article,we reviewed the importance of caspase family and the new research on the mechanisms of hepatic cell apoptosis in liver diseases.Meanwhile,we summarized the evidence concerned with apoptosis,and discussed the knowledge of therapeutic strategies.

Suppression subtractive hybridization(SSH),which is feasible and highly specific,is one of the most efficient methods for cloning differentially expressed genes.It has been successfully applied in the study of tumors,stem cells,etc.

Objective:To investigate the the effect of CD151 on Akt-Ser473 and human umbilical veine endothelial cell proliferation.Methods:To construct pAAV-CD151 and transiently transfect to HUVEC(human umbilical veine endothelical) mediated with Lipofectamine 2000.HUVEC were assigned to control group,GFP group,CD151 group.After transfection,the expression of CD151,Akt and phospho-Akt were measured by western blot.Proliferation of HUVEC were measured by MTT colorimetric assay.Results:①The expression of CD151,phospho-Akt of pAAV-CD151 transfected group were significantly increased compared with non-transfected group and pAAV-GFP transfected group(P

Objective To study effect of celecoxib on Wnt/β-catenin signaling pathway and matrix metabolism of chondrocytes in osteoarthritis (OA).Methods Use a modified way of mechanical fixation to make rabbit OA model.Knee OA separated and extractd rabbit chondrocytes were and then culture in medium.The cultured chondroctyes were divided into the Dimethyl sulfoxide (DMSO) control group and the celecoxib group, which were given 1％ DMSO and 10 μmol/L celecoxib respectively.After 48 hours' intervention, the protein expression and gene expression of Wnt/β-catenin signaling pathway related factors, including β-catenin,matrix metalloproteinase (MMP)-3, MMP-13, collagen Ⅱ were detected.T-test was used for the comparison between the two groups.Results Compared with the control group, the levels of type Ⅱ collagen [(275±19) ng/ml vs (202±12) ng/ml, t=-6.21, P＜0.05] and proteoglycan [(58±12) ng/ml vs (30±3) ng/ml, t=-9.23, P＜0.05] significantly increased in celecoxib group (P＜0.05).Meanwhile, compared with the control group, the levels of β-catenin, MMP-3, MMP-13 mRNA and protein in celecoxib group were significantly reduced (P＜0.05).Conclusion In rabbit OA chondrocytes, celecoxib can inhibit Wnt/β-catenin signaling pathway, reduce downstream factors expression including MMPs, thereby increase the cartilage matrix type Ⅱ collagen and proteoglycan levels.

Objective To investigate the expression of uPAR and VEGF-C in hepatocellular carcinoma (HCC) and its effect on the biological behavior of HCC. Methods The expression of uPAR and VEGF-C in liver tissue specimen of 33 patients with HCC was detected by immunohistochemical staining. Results The positive expression of uPAR and VEGF-C in HCC tissues was located in cytoplasma of cancer cells. The positive rates of uPAR and VEGF-C were 69.7 %(23/33) and 78.8 %(26/33) respectively in 33 cases of HCC. The expression rates of uPAR and VEGF-C were significantly higher in HCC with metastasis than in HCC without metastasis(P<0.05). But there were not significant correlation between the expression of uPAR or VEGF-C and tumor size, tumor grade, AFP level, hepatic cirrhosis. There was a close correlation between uPAR and VEGF-C in HCC(r=0.676, P<0.01). Conclusion The expression of uPAR and VEGF-C is correlated with metastasis, uPAR and VEGF-C may be signs of aggressive phenotype for evaluating treatment and prognosis of HCC. Examination of these two proteins may be helpful to .judge biological behavior of HCC.

The medical order number of a blood transfusion is used as the matching number in the full range of clinical blood use. A cycle is built ranging from the application for to the implementation of a medical order for blood transfusion. Such measures as repeated blood types verification by two departments, dual-database management of blood type files, and bar coding are called into play to ensure information correctness. These measures can make sure that the correct blood type is transfused to the correct patient and rule out accidents in blood transfusion. Indications for blood products are set up under real-time surveillance, which makes available limited blood products supply to those in need and minimizes waste and abuse of such products. The full-range and real-time management of clinical blood use will confine blood transfusion indications and ensure patients' safety with 100% match ratio.