Objective To explore the diagnosis and treatment of unsuspected gallbladder cancer (UGC)related with laparoscopic cholecystectomy(LC).Methods From January 1995 to Dece m ber 2008,4520 cases of LC were performed,UGC waS discovered in 15 cases.Clinical data of the 15 cases were analyzed retrospectively.Results Among the 15 cases of UGC,7 were discovered intraoperatively,and 8 were diagnosed postoperatively.Postoperative pathological examination showed Nevin stage I in 4 cases,stage Ⅱin 7 cases,stage Ⅲ in 3 cases,stage Ⅳ in 1 case.LC was carried out in the patients of Nevin stage I.Radical resection of gallbladder cancer was performed on the patients at stage Ⅱ and stage Ⅲ.One patient at stage Ⅳ received extended radical resection.The patients were followed up from 6 months to 5 years,during the period 3 cases were died and 12 cases were still alive,the 5-year survival rate wag 80.0%.Conclusions Most of LC-related UGC cases are early cancer.Frozen section examination should be performed for high-risk groups and suspicious persons,which contributes to the discovery of UGC.LC can achieve the radical purpose of Nevin stage I patients,Nevin stage Ⅱ-Ⅳ requires open radical operation.

Inflammatory bowel disease(IBD)is a kind of chronic and non-specific inflammatory disease comprising Crohn’s disease(CD)and ulcerative colitis(UC),the etiology has not yet been clarified. Endothelin-1(ET-1)is an active polypeptide composed of 21 amino acid residues,which can constrict blood vessels by activating voltage-dependent Ca2 + channels in vascular smooth muscle cells. Studies have shown that ET-1 plays an important role in the pathogenesis of IBD. This article reviewed the progress in study on ET-1 in the pathogenesis of IBD.

Objective:To investigate the influencing factors in acidity test in the quality standard of lactasin. Methods:The acid-ity was tested under the conditions of milk from different sources, various inoculation amount and preservation conditions. Results:The acidity was not stable under the conditions of milk with different brands and batches. The current quality standard could not truly reflect the influence of preservation conditions on the sample quality. Conclusion:The unreliable acidity test results are caused by the quality problem of milk culture media and the current unreasonable standard method.

Proteasome pathway is another major pathway of protein degradation in addition to lysosome in eukaryotic cell ,which involved a number of physiological functions regulation in cell .Prokaryotic ubiquitin-like protein was found in My-cobacterium tuberculosis in 2008 .With the effect of co-factor Dop ,PafA and Mpa ,Pup can mark a variety of protein ubiquitina-tion followed by importing them into proteasomal degradation .The target protein of Pup-proteasome system like FabD ,PanB , Ino1 ,Icl ,SodA ,and MtrA are involved with metabolism ,signal transduction pathways ,virulence factors ,pathogenicity and the persistence of bacteria in the host cell .Proteasome inhibitor make the function of proteasome restricted and the accumula-tion of Pup’s labeled substrate result in changes in the expression of gene indirectly ,which impacted the ability of resistance to outside pressure and the pathogenicity of Mycobacterium tuberculosis . The finding Pup-proteasome system reveals a novel mechanism of protein degradation in prokaryotes ,which is expected to become a new target of treatment of anti-TB drugs . Here ,we summarize the progress on the Pup-proteasome system in Mycobacterium tuberculosis .

Lung opportunistic infections are most common pulmonary complications in patients with advanced AIDS .A variety of pathogens can cause lung infections .Lung CT findings show the complexity and diversity for these complications .Analysis of CT fea-tures of pulmonary infection caused by different pathogens has an important clinical significance on strengthening the awareness of AIDS complicated with pulmonary opportunistic infection and improving the clinical treatment effect .

Objective To detect neurotransmitters function in the brain and the brain functional index of outpatients with methadone maintenance treatment,and understand the change features of brain function.Methods Collect brain electrical power signals were collected from 58 outpatients with methadone maintenance treatment (MMT) and 44 healthy adults,and the correlations between the power of the neurotransmitters and the brain functional status were analyzed.Results (1) In MMT group,all neurotransmitters were lower generally than those in the control group,and the differences of GABA ((17.73±3.54) μV2 vs.(121.48±44.64) iμV2,P＜0.01),Glu ((42.18±12.84) μV2 vs.(105.31 ± 34.95) μV2,P＜0.05) were significant.(2) The relative powers of GABA ((17.10±51.72) μV2 vs.(78.67± 10.93) μV2,P＜0.001) and Glu((30.48±21.61) μV2 vs.(69.23±42.26) μV2,P＜0.001) reduced significantly,while 5-HT((297.18±31.54) μ V2 vs.(280.18±31.54) μV2,P＜0.01),ACh ((235.08±37.72) μV2 vs.(217.23±40.60)μV2,P＜0.05),NE((164.11±33.05) μV2 vs (146.39±30.80) μV2,P ＜0.01),DA((98.87±22.48) μV2 vs.(91.49±21.04)μV2,P＜0.05) rised significantly in MMT group.(3)The global power was lower((1012.01± 195.09)μV2 Vs.(1775.94±458.99) μV2,P＜0.01),and the excitement-inhibition index(2.19± 1.46 vs.0.99±0.47,P＜0.001) and the relative entropy((89.45±9.71) ％ vs.(75.48±9.97) ％,P ＜0.01)were higher than those in the controls.(4) In MMT group,there were positive correlation between all neurotransmitters and global power,as well as that between Glu and excitement-inhibition index (r=0.264,P＜0.05),NE and Vasomotor index(r=0.269,P＜0.05),but negative correlation between relative entropy and 5-HT(r=-0.276,P＜0.05) as well as DA(r=-0.375,P＜0.01)significantly.Conclusion The brain function of outpatients with MMT are lower than the normal significantly,and there are clearly imbalance between the excitement and inhibition among the brain neurotransmitters.

Objective: Pemetrexed (PEM) is a multi-targeted chemotherapeutic agent for antifolate drugs. PEM has become the standard agent for the second-line treatment of advanced non-small cell lung cancer (NSCLC). This study aims to review and analyze the clinical efficacy and adverse reactions of PEM combined with carboplatin with respect to NSCLC treatment. Methods: A total of 40 patients suffering from NSCLC were selected and confirmed by pathology. On the first day of treatment, the conventional 500 mg/m2 dose of pemetrexed disodium was infused intravenously. On the second day, a combined therapy with carboplatin was conducted based on the conventional dose for a 21-day cycle with at least two cycles for each patient. The therapeutic efficacy and adverse reactions were evaluated and were compared with the proposed regimen of gemcitabine (GEM) combined with carboplatin. Results: After two cycles of the treatment, the curative effects of the PEM and GEM groups were 50% and 45%, respectively. The main adverse reactions are bone marrow suppression and gastrointestinal reactions. The incidence rates of bone marrow suppression, gastrointestinal reactions, amisulpride/AST, urea nitrogen, rash, and hair loss were obviously lower in the PEM group than in the GEM group. Statistically significant differences in adverse reaction were found between the two groups (P<0.05). Conclusion: The use of the combination regimen of PEM with carboplatin showed significantly more clinical effects and less adverse reactions for NSCLC treatment.

Objective To observe the effects and mechanism of ischemic postconditioning(IPo) on alleviating injuries of small intestine and remote organs induced by intestinal ischemia-reperfusion (IR).Methods A total of 48 rabbits were divided randomly into three groups(n =16 in each):the Sham group,the IR group and the IPo group.After 2 hours of reperfusion,arterial and venous blood and tissues of intestine,liver and lung were harvested.The levels of TNF-α,IL-1β,IL-6 and IL-10 in arterial blood and levels of ALT,AST,BUN,Cr,LDH,CK-MB activity and endotoxin in venous blood were tested.MDA, CAT,SOD and MPO levels in serum,small intestine,liver and lung were also measured.HE staining was performed for observation of injured intestinal mucosa.Bacterial translocation rate was calculated after bac-teria culture.Results Compared with the IR group,MDA and MPO levels in serum,small intestine,liver and lung decreased in the IPo group,while CAT and SOD levels increased obviously.Compared with the IR group,ALT,AST,LDH,CK-MB and BUN levels in the venous blood,and TNF-α,IL-1β,IL-6 and endotox-in levels in arterial blood were all decreased.IL-10 increased and the intestinal mucosal injury score de-creased obviously.Conclusion Ischemic post conditioning can decrease the damage of intestinal mucosa, reduce endotoxin translocation,promote activation of anti-inflammatory cytokines,inhibit excessive release of inflammatory mediators,enhance the antioxidant capacity of intestine and remote organs,reduce injuries to the small intestine and remote organs.

Ample evidences have showed that the failure of early regeneration of the central nervous system(CNS) in adult mammals is mainly due to the growth inhibitory factor.Efforts have been made to promote neuron regeneration and neurological function recovery by damaging myelin and removing myelin-associated inhibitors.At present,the Nogo protein associated drugs and gene therapy have become a novel effective way to promote axon regeneration after CNS injury;here we reviews the recent progress on the related issues.

Objective To analyze retrospectively the result of nonspecific mastitis diagnosed by mammography and color Doppler's ultrasonic, and to improve the diagnosis accuracy of nonspecific mastitis as well as the ability to identify with breast cancer.Methods 31 cases of nonspecific mastitiswere examined by mammography and color Doppler's ultrasonic.All cases were punctured by biopsy or surgery, and confirmed by pathology.Results The coincidence rates between mammography and color Doppler's ultrasonic with pathology were 64.5% and 67.7% respectively.The coincidence rate between the combined mammography and color Doppler's ultrasonic with pathology were 87.1%.There was no statistically significant difference between the two separate inspection methods (P>0.05).Conclusion Mammography and color Doppler's ultrasonic have their own advantages in the diagnosis of nonspecific mastitis, and are easy to be confused with breast cancer.Combining mammography with ultrasonography can improve the accuracy of unspecific mastitis diagnosis and the ability to identify breast cancer.