0.05).The operation time was longer,volume of bleeding was less,and postoperative time of bowel gas passage and hospital stay were shorter in laparoscopic group compared to those in open group(P0.05).Conclusions This study reveals that totally laparoscopic D2 gastrectomy is safe and feasible for advanced gastric cancer,and it presents the superior character of minimal invasion.

[Objective] To investigate the clinical effect of treatment of lumbar vertebral instability with posterior interbody fusion using autogenous bone and pedicle screw fixation.[Methods]Thirty-seven cases of lumbar instability were treated with posterior spinal canal,nerve root canal decompression,pedicle screw fixation and autogenous bone grafting,and results were evaluated.[Results]Postoperative follow up time was average 25 months(ranged,12-32 months).Excellent fusion was achieved in 29 cases and good fusion was achieved in 8 cases,with good-to-excellent rate of 100%.According to JOA standard efficacy evaluation,postoperative JOA score improved significantly than preoperative one(P

Objective:To investigate the effect of simvastatin on expression of pluripotent markers Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells. Methods:Quantitative reverse transcription-polymerase chain reaction (qRT-PCR), immunofluo-rescent staining, flow cytometry, and Western blot were used to detect the expression of pluripotency markers Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells treated with different doses of simvastatin. Results:qRT-PCR revealed the more signifi-cant inhibition of gene expressions of Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells when subjected to high doses of simvastatin (10, 50, and 100 μmol/L) compared with the control group (P<0.05). By contrast, no significant difference was observed be-tween the expressions of low-dose simvastatin treatment (1 μmol/L) and control (P>0.05). The inhibitory effect of simvastatin on the gene expressions of Oct3/4 and Nanog was more significantly apparent at 50 and 100 μmol/L dosages than at 10 μmol/L (P<0.05). By contrast, no significant difference in the inhibitory expression of Sox-2 was observed among the three high-dose treatments (P>0.05). Between the two higher-dose treatments (50 and 100 μmol/L), no significant difference in the inhibitory expressions of Oct3/4, Nanog, and Sox-2 in MCF-7 cells was found. Meanwhile, in the 10 μmol/L simvastatin treatment, immunoflurescent staining showed a marked reduction in the protein expression of all three pluripotent markers in MCF-7 cells, and flow cytometry demonstrated a decrease of Oct3/4-, Nanog-, and Sox-2-positive cells (P<0.05). Western blot further revealed that the protein expression of Oct3/4, Nanog, and Sox-2 in MCF-7 cells was significantly declined by the same simvastatin dose (P<0.05). Conclusion: Simvastatin can inhibit the expression of pluripotent markers Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells, proving the anti-cancer properties of simvastatin.

Objective To explore the role of nuclear factor-kappa B(NF-?B)in regulating tumor necrosis factor-?(TNF-?)expression in acute pancreatitis (AP)in rats.Methods Sixty-four Wistar rats were randomly divided into two groups:the control group(n=32)and the AP group(n=32).Acute pancreatitis was induced by introperitoneal injection of caerulein,and the animals were killded at 12 hours,24 hours,36 hours,and 72 hours respectively.The activity of NF-?B and expression of TNF-? mRNA in the pancreas were determined by flow cytometry (FCM) method and semi-quantitave RT-PCR analysis,respectively,and the correlation coefficients were analyzed.Results The levels of activated NF-?B protein and TNF-?mRNA were all significantly higher in the AP group than those in the control group at any time point(P

Objective By analyzing the effect of adopting the responsibility system for entrusted asset management targets in some public hospitals the paper aims to explore the feasibility of doing so as to provide lessons for the reform of public hospitals in China. Methods Interviews of focus groups and surveys through questionnaires were conducted to find out about reform in the management of public hospitals in Wuxi City of Jiangsu Province, including successes and problems. Results Some problems remain to be solved while effects have been achieved in the entrusted management of public hospitals. Conclusion Reform of hospitals through entrusted management is currently a way of deepening the reform of public hospitals. Some preliminary conditions are already in place for reform in the system of public hospitals, yet support is stili needed in terms of sound policy and environment. In future reform should go a step further in personnel and distribution systems, supervised asset management, and the estabh'shment and perfection of the Corporation management structure. More efforts need to be made by the state in encouraging explorations and strengthening guidance.

The national examination of doctors' qualification is the examination which assesses the medical students' knowledge and skills for doctors' work. This paper introduced autorities concerned, implementing agencies, examination forms and procedures, examination contents and keypoints, pass-ing criteria and matters needing attention of national examination of doctors's qualification be tween Canada and Australia expecting to provide references for the revolution of Chinese Examination of Doctors' Qualification.

Objective To evaluate the correlation of chemosensitivity of cancer cells and peripheral blood lymphocytes to 8 chemotherapy agents in vitro,which was helpful to guide clinical chemotherapy for patients with lung cancer. Methods The chemosensitivity of the peripheral blood lymphocytes and tumor cells to 8 clinical routine che-motherapeutic agents was tested in 40 cases of lung cancer by using MTT method. SPSS 10. 0 was used to analyze the above indicators. Results There was no significant difference in the sensitivity of 8 clinical routine chemotherapeutic agents between peripheral blood lymphocytes and tumor cells of patients with lung cancer(P > 0. 05) ,which was posi-tive correlated to chemotherapeutic drugs between peripheral blood lymphocytes and tumor cells. Conclusion The chemosensitive test of the peripheral blood lymphocytes with MTT method in vitro was valuable for reference of selec-ting anticancer drugs in clinic for patients with lung cancer.

Objective To study the application of ultrasonically activated scalpel in laparoscopic intestinal adhesion release.Methods Intestinal adhesion release with ultrasonically activated scalpel under laparoscope was performed in 29 patients suffered from intestinal adhesive obstruction after gynecological operation. Results All operations were successfully performed, and none of them converted into open surgery. Intestinal disruption occurred durring operation in 2 patients with extensive intestinal denseadhesion which were mended successfully under laparoscope. The operative duration was 30-150 min (mean 45 min). Postoperative complications such as bowel leak age, bleeding, abdominal infection were not experienced. Postoperative hospital stay was 3-7 days (mean 4 days). No case had relapse symptom such as abdominal distention or pain after 1-24 months of follow up. Conclusion Compared with electric scalpel, ultrasonically activated scalpel can improve the operative safety, lessen tissue damage, shorten operative time, and reduce the chance of relapse in laparoscopic operation in gynecology.

Objective To investigate the value of endoscopic ultrasonograghy (EUS) in diagnosis and treatment of gastrointestinal neuroendocrine neoplasm (GI-NEN).Methods We retrospectively summarized the clinical data of 44 patients with GI-NEN which were confirmed by pathology and immunohistochemistry,and analyzed the EUS features and the follow-up data of patients who received EUS exam and EUS-assisted endoscopic resection.Results A total of 47 neoplasms were detected in 44 patients,in which 41 were confirmed as neuroendocrine tumors (NET) and 6 were neuroendocrine carcinoma (NEC).Under EUS,all 41 NET appeared as hypoechoic lesions with regular edge and homogeneous echographic pattern,and 18 were originated from mucosal layer and 23 from submucosal layer,which was all confirmed by pathological evaluation.All 41 NET lesions received EUS-assisted endoscopic resection,in which 17 were treated by ESD/EMR and 24 by high frequency electrotomy.Follow-up endoscopy was performed at 3-6 and 12 month after operation,which showed no residual or recurrence.Conclusion EUS may accurately determine the invasion depth of GI-NEN lesions,and provide important information for adapting appropriate treatment strategies,which has highly clinical practice value in the diagnosis and treatment of GI-NEN.