Objective To investigate the changes and clinical significance of the platelet parameters in tumor patients before or after radiochemotherapy.Methods The platelet parameters(PLT,PCT,MPV,PDW)were detected in 65 cases of tumor patients before and after radiochemotherapy by the Sysmex XN-1000 automatic hemacytology analyzer.Then the detection results were com-pared with those in the control group.Results Compared with the control group,PLT and MPV before therapy in the tumor pa-tients were significantly increased(P <0.01),but PCT and PDW had no statistical differences between the two goups(P >0.05). PLT,PCT and MPV after radiochemotherapy in the tumor patients were significantly lower than those before treated(P <0.01 ), but no statistically significant difference in PDW was found(P >0.05).Conclusion The measuration of platelet parameters in the tumor patients with radiochemotherapy has certain clinical significance to observe the status of the bone marrow suppression and es-timate the state of illness.

Objective To investigate the separation rate ,clinical distribution ,antibiotic susceptibility rate of Staphylococcus au‐reus from skin and soft tissue infections and provide the reference for clinical diagnosis and treatment .Methods Retrospective sta‐tistical analysis of 214 strains of Staphylococcus aureus from skin and soft tissue infections from September 2011 to August 2014 by Whonet 5 .6 .Results 1 228 pathogens were isolated from 2 152 cases of the secretion of operative and skin wound ,of which there were 214 strains of Staphylococcus aureus ,which accounted for 17 .43% ,48 strains of MRSA ,which accounted for 22 .43% ;Mainly distributed in bone surgery ,burns orthopaedic ,breast surgery ,with skin venereal division ,accounting for 40 .2% ,22 .3% ,12 .1% , 8 .4% respectively .The resistance rate of Staphylococcus aureus to penicillin ,erythromycin ,clindamycin were 96 .3% ,46 .7% , 37 .4% respectively ,high sensitivity to vancomysin ,linezolid ,fusidic acid ,mupirocin .Conclusion Surgical infection rates of SSTIs are high in our hospital .It should be according to SAU susceptibility analysis results to choose high sensitivity of the first and sec‐ond generation cephalosporins for treatment in clinic ,and vancomycin ,linezolid only in severe Staphylococcus aureus(including MR‐SA) infection to choose .

0.05. Conclusions Radical nephrectomy remains the cardinal method for the treatment of primary renal cell carcinoma. Extensive retroperitoneal lymphadenectomy does not improve the survival.

ObjectiveTo study the diagnosis and therapy of circumcaval ureter.MethodsFifteen cases of circumcaval ureter were studied retrospectively.The cardinal symptoms include discomfort over the back and loins,nephrocolic and bloody urine.The diagnosis mainly depends on IVU and retrograde urography.12 patients underwent ureteroureterostomy,2 ureteropyeloneostomy and 1 nephrectomy.ResultsAll the patients have been follewed up from 1 to 15 years by IVU and ultrasonography,and no nephrohydrosis or stenosis of the anastomosis site has been noted.All the patients have been free from any complaints.ConclusionsIVU and retrograde urography are the cardinal means for the diagnosis of circumcaval ureter,and operation is indicated in order to improve the renal function.It is important to choose a proper time and an adequate surgical technique.

Objective To provide clinical evidence for the relationship between epithelial-mesenchymal transition (EMT) and colorectal cancer(CRC) by detecting the expression of TGF-β, Smad-3 and Smad-7 in serum from CRC patients. Methods We detected the expression levels of TGF-β1 , Smad-3 and Smad-7 by ELISA method. Results The expression levels of TGF-β1 , Smad-3 were significantly higher and the Smad-7 was significantly lower in CRC patients than those in control group(P<0. 01). The expression levels of TGF-β1 and Smad-3 were signifi-cantly higher in Dukes D than those in Dukes B,C. The Smad-7 was significantly lower in Dukes D than that in Dukes B,C(P<0. 01). Conclusion TGF-β1 and Smad-3 and Smad-7 may play an important role in the develop-ment of CRC.

Objective To review the diagnosis and causes of iatrogenic injury to the distal choledochus at operation. Method The case notes of the patients with bile duct injuries that were treated in my Department from 1990.2-2005.2 were reviewed. Results To detect distal bile duct injuries, a sound in the bile duct had an accuracy rate of 95 % while injection of water into the bile duct to detect leakage had an accuracy rate of 100%. Using a long arm T tube in the common bile duct was an effective method to treat the injury. In 18 patients with an average follow-up time of 20. 8 months, the results were satisfactory. Conclusions Injecting water into the bile duct to diagnose distal common bile duct injury at operation was an effective way to detect distal bile duct injury. Adequate exposure of the opeative field is the best method to prevent bile duct injury.

Objective To assess three-dimensional color Doppler energy (3D-CDE) in the diagnosis of liver tumors.Methods Vascular pattern of 2D- and 3D-CDE were used to analyze 106 tumors of 96 patients,and their sensitivity and specify were calculated respectively.Three-dimensional volumetric measurement was used to calculate the volume,vessel counts of tumor,as well as the ratio of vessel counts and volume,whereas vascular index (VI) of both benign and malignant lesions were assessed.Results ①Using the vascular pattern of IE as diagnosis standard of liver malignant,the sensitivity and specificity of 2D-CDE and 3D-CDE were 21.33%,100% and 81.33%,100%,respectively) using the vascular pattern of II and Ⅲ,the sensitivity and specificity were 73.33%,67.74% and 100%,45.16%,respectively.②Mean VI was 0.38 counts/cm~3 of malignant tumors and 0.18 counts/cm~3 of 31 benign tumors (P<0.05),The sensitivity and specificity in diagnosing malignant tumors of liver was 78.67% and 87.10%,respectively with VI>0.30 counts/cm~3.Conclusion The vascular pattern of 3D-CDE HI and VI>0.30 counts/cm~3 may be taken as parameters for the diagnosis of malignant liver tumor.

Objective To explore the management of perioperative period on the effect of alimentary tract fistulas after gastric cancer operation.Methods The clinical data of 25 patients with alimentary tract fistulas after gastric cancer operation were reviewed.The location and time of alimentary tract fistulas,and perioperative period of patients were analyzed.Results Of the 25 patients,13 cases(52.0％) were anastomotic fistulas,1 case(4.0％) was bile fistula,2 cases (8.0％) were pancreatic fistulas,4 cases (16.0％) were small intestinal fistulas,and 3 case (12.0％) were duodenal stump fistulas,1 case (4.0％) was anastomotic and duodenal stump fistula,1 case (4.0％) was small intestinal and duodenal stump fistula.The alimentary tract fistulas generally occurred within the first or second week after gastric cancer operation.The incidence rate of gastrointestinal leakage was 64.0％ in gastric cancer with diabetes patients,56.0％ in gastric cancer with elderly patients,40.0％ in gastric cancer with anemia patients,36.0％ in gastric cancer with hypoproteinemia patients,16.0％ in gastric cancer with multivisceral excisions.21 cases of gastrointestinal leakage were healed after conservative treatment.2 cases with gastrointestinal leakage by operation treatment were healed.2 patients died,one died of intra-abdominal hemorrhage,one case died of MODF.Conclusion Strengthening the management of patients with alimentary tract fistulas after gastric cancer operation can promote the healing of fistula in perioperative period.

Objective To investigate the clinical value and effect of spinal nerve medial branch ablation through transforaminal endoscopic in treatment of lumbar zygapophysial joint pain. Methods From August 2008 to October 2013 ,96 patients diagnosed as lumbar zygapophysial joint pain were included in the research. 36 patients were treated by spinal nerve medial branch ablation through transforaminal endoscopic ,while 60 patients received conservative treatment. The visual analogue scale (VAS) and Japanese Orthopedics Association(JOA) scores before treatment,1,3,6 and 12 months after treatment were recorded and analyzed. The MacNab scores were recorded and analyzed 12 months after treatment. Results The VAS and JOA scores of surgical treatment group showed significant improvement compared with that before operation (P < 0.05),and there were no significant difference at each time point after surgery. The VAS and JOA scores of conservative treatment group in showed significant improved at 1 months after treatment compared with that before treatment(P<0.05),but there were no significant difference at each time after treatment compared with pretreatment. The VAS and JOA scores of surgical treatment group showed significant improvement compared with conservative treatment group at each time after treatment(P<0.05). The MacNab scores of surgical treatment group(94.44%)was significantly higher than that of conservative treatment group(33.33%). Conclusion The spinal nerve branches ablation under transforaminal endoscopic is an effective and safe minimally invasive spine surgery technique with important clinical value in the treatment of lumbar zygapophysial joint pain.

Objective To study the volume of lateral cerebral ventricle in neonates with threedimensional ultrasonography(3F-US),and to investigate the influence of sex,body weight(BW),head circumference(HC)and gestational age(GA) on it. Methods A total of 255 healthy neonates (GA 28~40 weeks) were examined with 3D cranial ultrasound. The ultrasonography was performed with anterior fontanel as the acoustic window,and the data were aquired at the deck of third ventricle on coronal section.The 3D image on the screen was constructed automatically and the volume of lateral cerebral ventricle was (P=0.809),and there was negative correlation between the volume of lateral cerebral ventricle and GA(r=-0.971). The correlation between the volume of lateral cerebral ventricle and HC was positive(r≥According to the relationships among HC(X 1),GA(X 2)and volume of lateral cerebral ventricle(Y),a linear regression equation Y=2.298-0.011 X1-0.04 X2 was obtained(the determinate coefficient R2 was accurately,which would be helpful to the evaluation on the cerebral maturity and the diagnosis of cerebral desease in neonates without wound.