The advancement of medical technology has led to significant progress in the research of standardized surgical procedures for colorectal cancer, resulting in enhanced treatment regimens from preoperative to postoperative stages. Standardized surgical procedures are crucial for improving patient survival rates, reducing recurrence rates, minimizing complications, and improving quality of life. This article summarizes the latest research results on the classification, surgical methods, and adjuvant therapy of colorectal cancer surgery; analyzes and explores standardized surgical treatment strategies; and aims to provide reference and guidance for the clinical management of colorectal cancer.

In this work, starting from 4-hydroxycoumarin, three series of 22 coumarin derivatives, among which 8 have not been reported in the literature, were synthesized and their in vitro anti-inflammatory activities and mechanisms of action were preliminarily investigated using mouse macrophage model. The results showed that most of the derivatives could significantly inhibit the production of pro-inflammatory factor NO, with compounds 2e, 2f, 2g, 2h, 2i, 2j, 4e, and 4f showing better anti-inflammatory activity than the positive control drug dexamethasone. Further experiments showed that compounds 2h and 4f significantly inhibited the production of pro-inflammatory factors IL-6, TNF-α and IL-1β in RAW264.7 macrophages, and could, therefore, be used as lead compounds for further studies.

It is the current confusion encountered by integrated Chinese and Western medicine that how to find the breakthrough direction of integrating Chinese and Western medicine， from crossover to integration to innovation， and open up a new horizon of integrated Chinese and Western medicine. The progress of Chinese medicine lay in expanding the scope of diagnosis and treatment with the help of modern diagnostic and therapeutic equipments and developing “micro” identification， while the progress of Western medicine lay in looking at “macro” and developing systemic medicine and integrated medicine， both of which are in the direction of each other. The “state-target identification and treatment” may become an important way to build a modern diagnosis and treatment system of integrated Chinese and Western medicine， and the thinking mode of “from target to state” is a further refinement and development on the basis of the theoretical system of “state-target identification and treatment”， which provided a clearer solution for the current stage of the integrated Chinese and Western medicine model， and pointed out the important development direction for the future integrated Chinese and Western medicine. From the perspective of strategic level and diagnosis and treatment practice， it integrated the “target-state” thinking mode into the modern diagnosis and treatment model of the integrated Chinese and Western medicine， i.e.， “Western medicine as the basis and treating with Chinese medicine； Chinese medicine as the basis and treating with Western medicine”. On the one hand， Western medicine should strengthen the reference to the traditional theories and holism of Chinese medicine， and advocate a higher level of education on the integrated Chinese and Western medicine under the guidance of the traditional theories of Chinese medicine. On the other hand， the “from target to state” mode of thinking should be applied to guide the establishment of diagnostic and treatment strategies and clinical selection of medicines in clinical practice， so as to locate the target and adjust the body state in a gradual and orderly manner， and to provide practical methods for the modern clinical work of the integrated Chinese and Western medicines. Chinese and Western medicine systems can learn from each other， combine organically， give full play to their respective strengths， and form an internal law， so as to make breakthroughs and innovations in the integrated Chinese and Western medicine model.

Objective To observe the clinical characteristics of 2 patients with mucolipidosis type Ⅲ. Methods Two sibling patients (a sister and a brother) with mucolipidosis type Ⅲ symptoms and other family members were the research objects, and the changes of their features of hand bone imaging, blood indexes [blood glucose, cholesterol, triacylglycerol (TG), total protein (TP), albumin (Alb)] and body composition were analyzed. Results Except the 2 patients, the bone morphology, blood indexes and body compositions in other 7 family members were under normal conditions. The phalanx intervals of both hands in 2 patients with mucolipidosis type Ⅲwere widened significantly, among them the thumb manifestation was more obvious; the distal segments of phalanxes in both hands became pointed and curved presenting a "claw-like hand" deformity; the metacarpal and distal carpal metaphysis were obviously enlarged, and scaphoid, lunate, trianglar, orbicular, and trapezium and trapezoid bones were loosely arranged at the wrist; the distal ends of ulna and radius were markedly enlarged. Compared to healthy people, the triglyceride levels of serum in the 2 patients were obviously reduced (the percentage of reduction: 57.14% and 41.07% respectively); body mass indexes (BMI), total fat and visceral fat were significantly lowered (BMI reduction percentage:26.81% and 14.55%, total fat reduction percentage: 38.12% and 44.95%, visceral fat reduction percentage: 62.25% and 67.74%, respectively) in the two patients. Conclusion The purpose of studying the biochemistry indexes, imaging characteristics and body compositions is to more deeply understand the clinical symptoms and signs of the 2 sibling patients with mucolipidosis type Ⅲ in a family to provide a theoretical reference.

Objective:To investigate the changes of gene or protein expression and activity of matrix metalloprotein9 (MMP9) and tissue inhibitor ofmetalloproteinasel (TIMP1) in the carotid artery (CA) of 4 wk hindlimb unweighted rat.Methods:A 4 weeks(wk) hindlimb unweighted (HU) rat model was used to simulate the effect of weightlessness on the cardiovascular system.Transmission electron microscopy was used to detect the content of ECM.Reverse transcriptase polymerase chain reaction(RT-PCR) was conducted to measure the mRNA content MMP and TIMP1.Immunohistochemistry and Western blot technique were used to measure the protein abundance.Gelatin zymography was carried out to detect the activity of MMP9.Results:Compared to the control group (CON),the area of ECM was enhanced (P＜0.05) and the content of collage fiber was increased (P＜0.05) in the CA of HU rats;moreover,HU did not affect the mRNA expression of MMP9,but significantly reduced the protein content (P＜0.05) or enzymatic activity (P＜0.05).Accordingly,the mRNA or protein expression of TIMP1 in the CA was significantly increased by HU (P＜0.05).Conclusion:Simulated weightlessness caused imbalance between MMP and TIMP1 expression,which might contribute to the ECM aggregation and stiffness of CA.

Objective To investigate the sensitivity of common carotid arteries of the rats to ceramide (Cer) regulation after simulated weightlessness.Methods Fourty-eight male Sprague-Dawley rats that matched for weight were randomly assigned to suspended group (n=24) and control group (n =24).Tail suspension of rats was carried out for 4 wk to simulate the effect of weightlessness.Isometric force recording system was used to detect the vasoconstriction and vasodilation response of common carotid arteries ring.Dihydroethidium fluorescent probe was used to evaluate the level of superoxide anion (O2-·) in arteries.Results Vasoconstriction response and vasodilation response showed insignificant difference between suspended group and control group.Incubation with C6-ceramide (C6-Cer) or Cer antibody (anti-Cer) did not change the vasoconstriction response and O2-· level of CA in control group but increased Cer level,vasoconstriction response to KCl and O2-· level of common carotid arteries in control group,and did not change the vasodilation response of common carotid arteries both in control and suspended group.In suspended group,C6-Cer incubation increased vasoconstriction response of common carotid arteries both to potassium chloride and phenylephrine,as well as the O2-· level (t=6.077-12.630,P＜0.05) but less to acetylcholine and nitroprusside sodium.The anti-Cer incubation decreased response vasoconstriction of common carotid arteries in suspended both to potassium chloride and phenylephrine,as well as the O2-· level (t=11.582 32.130,P＜0.05) but the vasodilation response.The incubation of superoxide dismutase or hydrogen peroxide depressed the changes of vasoconstriction response caused by C6-Cer or anti-Cer.Conclusions Cer regulation increases the sensitivity of common carotid arterial constriction in the simulated weightless rats and the mechanism is concerned with reactive oxygen level.

Objective To investigate the sensitivity of common carotid arteries of the rats to ceramide (Cer) regulation after simulated weightlessness.Methods Fourty-eight male Sprague-Dawley rats that matched for weight were randomly assigned to suspended group (n=24) and control group (n =24).Tail suspension of rats was carried out for 4 wk to simulate the effect of weightlessness.Isometric force recording system was used to detect the vasoconstriction and vasodilation response of common carotid arteries ring.Dihydroethidium fluorescent probe was used to evaluate the level of superoxide anion (O2-·) in arteries.Results Vasoconstriction response and vasodilation response showed insignificant difference between suspended group and control group.Incubation with C6-ceramide (C6-Cer) or Cer antibody (anti-Cer) did not change the vasoconstriction response and O2-· level of CA in control group but increased Cer level,vasoconstriction response to KCl and O2-· level of common carotid arteries in control group,and did not change the vasodilation response of common carotid arteries both in control and suspended group.In suspended group,C6-Cer incubation increased vasoconstriction response of common carotid arteries both to potassium chloride and phenylephrine,as well as the O2-· level (t=6.077-12.630,P＜0.05) but less to acetylcholine and nitroprusside sodium.The anti-Cer incubation decreased response vasoconstriction of common carotid arteries in suspended both to potassium chloride and phenylephrine,as well as the O2-· level (t=11.582 32.130,P＜0.05) but the vasodilation response.The incubation of superoxide dismutase or hydrogen peroxide depressed the changes of vasoconstriction response caused by C6-Cer or anti-Cer.Conclusions Cer regulation increases the sensitivity of common carotid arterial constriction in the simulated weightless rats and the mechanism is concerned with reactive oxygen level.

Objective To investigate the clinical application of early postoperative enteral nutrition in patients undergoing colon cancer operation.Methods 90 patients suffering from colon cancer were randomly divided into the enteral nutrition group,indwelling stomach tube group and the control group.The control group was given conventional treatment and the indwelling gastric tube group was received postoperative intermittent clamping of stomach tube and enteral nutrition.Moreover,patients in the enteral nutrition group were pulled out the tube on the first postoperative day while giving enteral nutrition.All patients were observed for exhaust defecation time,length of hospital stay postoperative and nutrition indicators.Results Exhaust defecation time,length of hospital stay postoperative had significant difference among three groups.Indwelling stomach tube group set minimum length of stay and first passage of flatus and defecation in the three groups [the enteral nutrition group:(50.07±11.59) h,(76.75±27.37) h,(10.1 1±1.57) d,the control group:(62.03±12.31) h,(90.67±25.64) h,(11.80±1.83) d,indwelling stomach tube group:(43.53±11.94) h,(61.17± 22.67) h,(8.70±1.53) d (P ＜ 0.05)].The levels of hemoglobin and plasma albumin one week after operation were statistically lower than pre-operation,while that the level of these nutrition indicators were higher in indwelling stomach tube group compare to control group (all P ＜ 0.05).The same result was observed between enteral nutrition group and control group.Whereas,the change of nutrition indicators between the enteral nutrition group and the control group was not statistical significant (P ＞ 0.05).Conclusion Indwelling stomach tube combined with enteral nutrition is a reasonable choice for patients after colonic cancer surgery.

Objective To evaluate the clinicophatholgic benefits and safty of antivirus therapy in patients with liver cirrhosis resulting from hepatitis B.Methods 80 patients with HBV-ralated liver cirrhosis were divided into three groups by the histopathology of liver:group of lamivudine treated with lamivudine 100 mg once daily;Adefovir group treated with Adefovir 10 mg once daily;control group treated with liver protective treatment only.Liver and renal function,PTA and HBV DNA were regularly measured.The Child push-Turotte sore and histopathology wag compared before and after treatment.All courses of treatment were 36 weeks.Results The scores of Child Pugh-Turotte sore in groups of lamivudine and Adefovir were lowered sinificantly (3.9 and 2.1 respectively),the load of HBV-DNA was decreased also[(4.1±0.9) copies/ml and(2.8±1.0) copies/ml],liver inflammmation decreased by more than 2 scores and liver fiber was improved by more than one score,with obviously significant difference(P<0.05) as compared with control group.Conclusion Patients with HBV-related cirrhosis treated with lamivudine and adefovir for antivims are improved and antivirus is important and safe to those during cirrhosis decompensation.

OBJECTIVEMucopolysaccharidosis(MPS) is a congenital hereditary disease. Only a few patients with this disease can be controlled by enzyme replacement therapy. Most of them are short of effective interference. To exploit the effect of treatment with allogenic hematopoietic stem cell transplantation, two children were treated with the transplantation.

METHODSThe two patients included a 23 month MPS-IH and an 18 month old MPS-VI at the time of transplantation. Busulfan of 20 mg/kg plus 200 mg of Cyclophosphamide were used as the conditioning regimen. Peripheral stem cells were collected from a 9/10 high resolution matched unrelated donor and a matched sibling carrier donor, respectively. The heart and lung were affected in the patient with MPS-IH. Medium obstructed pulmonary impairment was found by pulmonary function test at the time of transplantation. Medium mitral valve countercurrent and patent ductus arteriosis(PDA) were found by Doppla examination.

RESULTSThe number of hematopoietic stem cells was comparative between the two donors with total nucleated cells and CD34+ cells of 11 x 10(8)/kg and 17 x 10(8)/kg, and 7.6 x 10(6)/kg and 7.2x 10(6)/kg respectively. Neutrophil engrafted at day 11. The process of transplantation in the MPS-VI patient went smoothly with grade II graft versus host disease(GVHD) briefly and only 1 U RBC and 2 U platelet were transfused. For the MPS-IH patient, the process of transplantation was tough with platelet reaching to 20 x 10(9)/L till day 40 and 5 U RBC and 7 U platelet were transfused during transplantation. Grade III GVHD was resolved by steroid, mycophenolate mofetil (MMF) and CD25 antibody. Pneumonia recurred 3 times with 2 times rescued by trachea intubation and mechanical ventilation because of accompanying acute heart failure. At day 14 the lymphocytes in both patients were 100% from donors as evidenced by short tandem repeat-PCR(STR-PCR). MPS associated enzyme activity was increased to 70 nmol/h.mg and 66 nmol/h.mg at 3 month and still remained 50.9 nmol/h.mg and 44.5 nmol/h.mg at 2 years post transplantation. Till now the 2 patients have been followed up for 25 months and 28 months with good general condition. The cardiac and pulmonary functions have improved obviously in the MPS-IH patient. The cornea became clear in this patient.

CONCLUSIONAllogeneic hematopoietic stem cell transplantation is an effective measure to treat patient with MPS-IH and MPS-VI. Transplantation at earlier stage of age can decrease transplant related complications. It requires longer time follow up for observing the clinical effects for these patients.

Female ; Follow-Up Studies ; Graft vs Host Disease ; drug therapy ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Infant ; Intraoperative Complications ; drug therapy ; etiology ; Male ; Mucopolysaccharidoses ; enzymology ; pathology ; physiopathology ; surgery ; Recovery of Function ; Transplantation, Homologous