[Perioperative immunomodulatory therapy does not decrease postoperative recurrence rate of rectal cancer].

OBJECTIVE: To study the effect of perioperative immunomodulatory therapy on postoperative recurrence of rectal cancer. METHODS: This prospective study was conducted among 238 rectal/anal cancer patients undergoing intersphincteric resection at our center between January, 2010 and January, 2011, among whom 150 were eligible to be included and completed the study. The 150 patients were randomized in a double-blinded fashion into 3 equal groups to receive immunomodulatory therapy with 8 mg/kg celecoxib (group A), 0.4 mg/kg Sou-Medrol (group B), or placebo (group C), given daily from 5 days before surgery to 5 days after surgery, and the postoperative cancer recurrence were compared. RESULTS: At 3 days after the operation, the 3 groups showed significantly different C-reactive protein (CRP) levels, which decreased obviously in all the 3 groups compared with those at 1 day following the operation (P=0.022), especially in group B. The levels of interleukin-6 (IL-6) at 3 days after the operation also differed significantly between the 3 groups but were lower in all the 3 groups than those at 1 day after the operation (P=0.046), and this reduction was the most obvious in group A. COX-2 expression differed significantly between the 3 groups (P=0.017), among which group A showed the most obvious suppression of COX-2 expression. During the follow-up for a mean of 45 months, no significant difference in the recurrence rate was found between the 3 groups (P=0.549). CONCLUSION: With a lower efficacy than Sou-Medrol in decreasing postoperative inflammation, celecoxib produces a better effect in inhibiting COX-2 expression, but it does not lower postoperative recurrence rate of rectal cancer.

[Start-up Characteristics of Four-zone Integrated Reactor for Nitrogen Removal in Winter and Analysis of Nitrobacteria Community].

The treatment of decentralized sewage has gained more and more attention in China in recent years. A four-zone integrated reactor was designed by combining biofilm system and activated sludge system and start-up by gradient shorten the HRT. The removal of COD, NH4+ -N and TN were studied at 8-15°C. Fluorescence in situ hybridization(FISH) was used to detect nitrobacteria population (AOB,NOB) so as to study the relationship between the reactor effect and functional micro-bacteria. The results showed that, when the HRT was 9.2 h, the removal efficiencies of COD, ammonia and TN were 92. 11%, 99. 21% and 61. 63%, respectively. Compared to the initial stage, the numbers of AOB and NOB in the late phase were increased by 5. 82 and 6. 14 times, respectively. In addition, the proportion of nitrobacteria was increased from 6. 12% to 16. 38% , which became the dominant bacteria in biofilms. Moreover, the nitrification efficiency was increased from 78. 49% to 97. 52% , while the number of NOB was 5. 61-fold increased and the value of AOB/NOB was optimized to 1. 47. The effluent quality is guaranteed by the enrichment of AOB and NOB and suitable value of AOB/NOB.