Objective To investigate the efficacy of neoadjuvant chemotherapy in patients with stage T3 and T4 rectal cancer and its related influencing factors, and to provide reference for the Locally advanced rectal cancer to choose optimal treatment schemes.Methods Ninetyone patients with locally advanced rectal cancer receiving neoadjuvant chemotherapy from a hospital were selected, and after receiving XELOX chemotherapy, the patients were divided into three groups: complete remission , partial remission and stable disease , according to Response Evaluation Criteria in Solid Tumors.The general characteristics of patients and relevant clinical indicators before and after chemotherapy were collected  to observe the changes of the indicators related to the cancer, and univariate and multivariate analysis were used to analyze the related factors affecting the efficacy of neoadjuvant chemotherapy. Results Of the 91 patients, 18 (19.78%) had complete remission, and 40 (43.96%) with partial remission, 33(36.36%) with stable disease. Multivariate analysis showed that lymph node metastasis before treatment was an independent factor affecting the efficacy of neoadjuvant chemotherapy after adjusting gender (OR=1.731,95%CI: 1.152～2.601).Conclusion Patients with locally advanced rectal cancer can benefit from neoadjuvant therapy, to maximize the efficacy of neoadjuvant chemotherapy, the condition of patients including gender, tumor diameter, and the situation of lymph node metastasis should be considered before chemotherapy.

Object To explore the prognosis and its influence factors of liver primary carcinoma patients after the treatment of transcatheter hepatic arterial chemoembolization (TACE).Methods Totally 142 cases with liver primary carcinoma were carried out followingup survey. The survival time and the survival outcome were taken as the dependent variables, and the correlated influence factors of prognosis after TACE treatment were screened by single factor and multiple factor COX regression methods.Results The threeyear survival rate of liver primary carcinoma patients after the treatment of TACE was 51.4% (73/142). Multiple factor COX regression analysis result showed that the risk factors of prognosis included TNM staging (HR=2.206, 95%HR: 1.473～2.939), distant metastasis (HR=4.730, 95%HR: 3.360～6.100), ChildPugh classification (HR=1.853, 95%HR: 1.236～2.471), SCC positive after operation (HR=2.428, 95%HR: 1.552～3.304) and bilirubin (HR=3.347, 95%HR: 2.224～4.470), while  number of interventional therapy (HR=0.393, 95%HR: 0.056～0.730) was the protective factor of prognosis.Conclusion The survival rate of the prognosis of liver primary carcinoma patients after TACE treatment is still poor. To aim directly at these above risk factors, we should early evaluate and prevent, and raise the effect of TACE treatment, so as to cut down death rate of prognosis.

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Objective To systematically evaluate the efficacy and safety of warfarin in preventing longterm catheter indwelling (TCC) dysfunction in hemodialysis patients. Methods Databases of Medline, Embase, Cochrane library, and Wanfang were searched with the keyword warfarin for the randomized controlled trials of longterm catheter indwelling dysfunction in hemodialysis patients. Quality evaluation was assessed by Cochrane quality evaluation standards and metaanalysis by using RevMan 5.3 was performed.Results Eight studies were included. Metaanalysis showed that the incidence of longterm catheter  indwelling dysfunction in warfarin patients was lower than that in the aspirin and the heparin control group ［RR=0.57, 95% CI(0.38, 0.86), P=0.007］, and the urea clearance index of the warfarin group was significantly higher than that of the aspirin group and the heparin control group ［MD=0.13, 95% CI (0.06, 0.20), P=0.0005］.Compared with the aspirin group and the heparin control group, the bleeding event in the warfarin group was significant higher ［RR=2.74, 95% CI (1.40, 5.34), P=0.003］, and there was no significant difference in catheterrelated infection events between the warfarin group and the aspirin group, the heparin control group ［RR=0.62, 95% CI (0.31, 1.23), P=0.17］.ConclusionWarfarin is more effective than aspirin and heparin in preventing dysfunction of TCC in dialysis patients and improving hemodialysis adequacy. Besides, bleeding events caused by warfarin should also be paid enough attention.

Objective We analyzed the main composition and changes of tuberculosis hospitalization expenses in hospitals of a municipality in Guangxi from 2013 to 2017, which can be taken as the reference for formulating policy to reduce the economic burden of tuberculosis patients and improve medicine resource allocation.Methods To analyze the main components of hospitalization expenses. The degree of structure variation was used to evaluate hospitalization expenses.Results(1) The median of hospital days per capita showed a significant downward trend.The average capita tuberculosis hospitalization expenses has been basically stable for the past five years, and it has remained at about 6,500 yuan. (2) Western drug fees and diagnostic costs are ranked first and second in the composition of hospital expenses, which are 43.66 % and 23.99 % respectively.The composition of integrated services showed a marked upward trend year by year, with annual growth rates of 18.73 per cent.  (3) Western drug expense is the most active factor in each year, with contribution rate of 26.04 %, and most of them are negative changes.Conclusion〓The tuberculosis hospitalization expenses were too high and the composition is unreasonable. Besides controlling the proportion of drugs, other measures should be performed to control the increase of total hospitalization expenses.

objetive To understand the status of the curriculum and explore the factors affecting the post competency of statistical students in a medical college, to provide basic data for adjusting the teaching contents, optimizing the curriculum structure, reforming teaching methods, and establishing a suitable curriculum system, and to provide a scientific basis for cultivating statistical professionals who are responsive to the needs of the time.Methods A selfdesigned questionnaire was used to conduct an onthespot questionnaire survey among 52 junior and senior statistics students in a medical college, and an online questionnaire survey was conducted among 57 statistical professional students who graduated from the college in the past three years.Results According to the survey results, 29.8%, 40.4% and 43.9% of the students were satisfied with the professional curriculum arrangement, public curriculum arrangement and public class time, respectively, while only 12.3% students were satisfied with the professional class schedule. And 21.1% students were dissatisfied with the traditional test mode. The survey results showed that post competency was associated with students' professional knowledge level, statistical logic thinking ability, social ability and practice ability. Compared with the other six medical colleges, the curriculum setting of the college was greatly different in statistical methods, statistical software and mathematics. Compared with the seven comprehensive universities, the number of courses, hours and total credits of the compulsory courses offered by the colleges were significantly lower.Conclusion In the process of formulating and setting up the curriculum for statistical majors, medical colleges need to increase professional course time, reform traditional examination mode, and strengthen practical teaching and assessment. Students' statistical thinking and career planning also should be actively guided in the teaching process. In addition, according to the actual situation of the school, basic courses related to mathematics and statistics will be added.