With the change of diet and lifestyle,the development of medical concepts and techniques,the spectrum of disease has changed dramatically. The standardization of gastrointestinal surgery will be the key to further improvement.Endoscopic ultrasonography,computed tomography,magnetic resonance imaging, positron emission tomography-computed tomography and laparoscopy are helpful for preoperative staging of gastrointestinal carcinoma.The standards of operation,such as D2 lymph node dissection for gastric cancer and total mesenteric excision for rectal cancer,are also very important.Creating standards for multi-disciplinary treatment of gastrointestinal diseases will be important factors for improving outcomes.

The purpose of medicine is to cure patients' illness.As an ancient disease which has not been conquered,cancer has always been accompanying with the development of medicine in human history.Separation and progress of medical subspecialties have promoted human's understanding of cancer and propelled the standardization of cancer treatment.Along with the deepening cognition of pathology,early diagnosis,establishment of surgical and adjuvant therapeutic schedules,the standardized treatment of gastric cancer has stepped forward gradually.The coming big data era will further refine the classification of gastric cancer and provide new opportunities for treatment updating.

Since its discovery, the retinoblastoma (RB) tumor-suppressor protein has become a focal point of caner and cell cycle research, and subsequently discovered members(pRB,p107,p103) of the RBfamily have been proved to play a important role in the cell cycle and the development of cancer. RB regulates the cell growth, development and differentiation via the interactions with E2f and some other cytokines,and its alternation even make the tumor formation. In comparison with some other tumors, colorectal cancer(CRC) has the different expression of RB.We may assume that the different causes of CRC and some unique functions of RB in CRC lead to the alternation.

Objective To explore the correlation between adverse childhood experiences, personality characteris?tics and alcohol dependence. Methods A total of 102 patients with alcohol-dependence (Patients group) and 106 volun?teers (control group) were rated by the adverse childhood experience scale (ACEs) and the big five personality scale (BFP). Results The prevalence of ACEs are significant higher in patients group than in control group, especially regard?ing emotional abuse, physical neglect, witness violence and substance abuse. The patients group has lower scores of de?light, conscientiousness and higher scores of psychoticism. Psychoticism and parents abuse alcohol in childhood were the risk factors of alcohol dependence. Conclusions There is a correlation between alcohol dependence with their ACEs, per?sonality characteristics and parents abused substance. The psychoticism increase the risk of alcohol dependence.

Objective Human cytomegalovirus (HCMV) can induce infection in multiple organs, including genitouri-nary system, central nervous system and liver. It can even lead to serious defects and death. China, as a high-incidence area of HCMV, need employ early treatment. However, the sensitivity of present HCMV diagnosis is not satisfied. Methods In the present study, we focused on transcription level of HCMV IE and pp67 mRNA using real-time quantitative PCR. Results IE mRNA was positive even in a portion of patients who were regarded as negative by traditional DNA diagnosis method. On the other hand, pp67 mRNA that were normally expressed at the late stage of HCMV infection was 100%posi-tive in the first-visit patients who were regarded as positive using traditional DNA diagnosis method. Conclusion The pres-ent study indicated that mRNA detection based on PCR method was more sensitive compared with DNA detection for assess-ing HCMV virus infection. Finally, different treatment should be performed upon mRNA transcription profile at different in-fection stages.

Objective To research the best processing method of Rhizoma Atractylodis Macrocephalae stir-fried with bran. Methods L9(34) orthogonal table are decided with three factors:The amount of the adjuvant, heating temperature, heating time. According to the amount of water-soluble extractive, alcohol-soluble extractive and volatile oil, orthogonal design is applied to processing. Results The best processing method is:Rhizoma Atractylodis Macrocephalae were processed by stir-frying with 10 percent of bran for 5 min in a heat of 150 ℃. Conclusion The results can provide basis for establishing the quality standard of this crude drug.

Objective To investigate phases in normal rabbit liver contrast enhancement with the acoustic densitometry(AD).Methods Ten cases of normal rabbit were examined with second harmonic imaging(SHI).The AD curves and data of parenchyma were compared before and after the portal blood flow was blocked,when the contrast agents were administrated through ear veins.The AD curves and data of parenchyma were also investigated when the contrast agents were injected via ear veins and mesenteric veins.Results The curves of normal rabbit liver parenchyma were single-peak-shaped,looking like "a verticle triangle",when the contrast agent was administrated through ear veins.The curve was divided into 3 sections: ascending,summit,descending,with the value of peak intensity ( 18.4 ? 1.7 )dB.Ascending section indicated the arterial phase,and summit and descending sections the portal phase.The AD curves were quite similar before and after the portal blood flow was blocked,only with the peak value slightly decreased,and the values of peak intensity decreasing by 2 dB.Two peaks were seen in the "Hump-like" AD curves in the parenchyma,with the second peak higher than the first,as the contrast agents were administrated through mesenteric veins again 10-15 seconds after administration via ear veins.Conclusions The arterial phase is short and portal phase is long in normal rabbit liver contrast sonography.The enhancement of parenchyma is caused mostly by contrast from hepatic artery,and the contrast from portal veins only plays a minor role.

Objective To investigate the clinlic therapeutic result of detenial sigmoid neobladder after radical cystectomy. Methods 50 patients with bladder cancer (41 males and 9 females;age range from 35 to 82 years) were admitted and underwent radical cystectomy and detenial sigmoid neobladder. Results All the 50 patients were followed up for a mean of 18.6 months(range from 6 to 29 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 2 had unilateral ureteral urine reflux during cystography.Of the 50 patients 45 cases(90%) achieved continence during daytime;10 cases(20%) were incontinent at night,but 8 of the 10 cases could control urination by being woken up at night.The capacity of the neobladder was 220 to 550 ml with a mean of 350 ml and the maximal pressure of the neobladder during filling was 15 to 55 cmH 2O(1 cmH 2O=0.098 kPa) with a mean of 35 cmH 2O. Conclusions As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.

Objective To investigate the value of preoperative risk assessments and countermeasures on ultrasound-guided radiofrequency ablation for benign thyroid nodules.Methods The preoperative risk assessments of 311 benign solid thyroid nodules in 274 patients were divided into level 0-Ⅳ,among which 38 nodules on level 0,69 nodules on level Ⅰ,36 nodules on level Ⅱ,59 nodules on level Ⅲ,109 nodules on level Ⅳ.Treatments were performed by moving shot technique or multiplanar shot technique,using Leverage Displacement or Hydrodissection to prevent the adjacent vital structures from thermal injuries.Results 311 thyroid nodules were completely ablated.In ablating the 59 nodules on risk level Ⅲ,thermal injuries were effectively avoided in 30 cases by using Leverage Displacement,while recurrent laryngeal nerve injuries happened in 2 cases using Hydrodissection for 29 nodules.The difference between these two methods on risk level Ⅲ had no statistical significance(P =0.237).To avoid thermal injuries during ablation for 109 nodules on risk level Ⅳ,using Leverage Displacement for 102 nodules,recurrent laryngeal nerve injuries happened in 1 case,while using Hydrodissection for 7 nodules,recurrent laryngeal nerve injuries happened in 2 cases.The difference between the two methods on risk level Ⅳ had statistical significance(P =0.010).No thermal injury happened during ablation for 143 nodules on risk level 0-Ⅱ.Conclusions Preoperative risk assessment on thyroid nodules is helpful in preventing potentially avoidable complications.Proper use of Leverage Displacement can protect adjacent vital structures from thermal injuries during ablation for nodules,which is easy and simple to handle and has a certain practical application value.

Objective To study gastroscopic features and clinical diagnosis of prepyloric mem-brane. Methods Clinical characteristics,gastroscopic manifestation and operational findings of 18 pa-tients,whose prepyloric membrane have been confirmed by operations,were retrospectively reviewed. Results Gastroscopie findings showed that all the 1 8 patients suffered gastric retention and pyloric obstruc-tion to some degree,with 4 cases of esophageal erosion and/or esophageal ulcer,five cases of erosive hemor-rhagic gastritis,one case of ulcer at gastric antrum,gastric comer and pylorus respectively. There were 2 ca-ses of aperture like narrowing in prepyloric region. And there were 9 cases that showed obvious congestion and edema in the prepyloric mucus,with uniform circular mucusal protrusion around the stenosing stoma,and volcano-like depression in the middle,three cases of which showed mucosal membrane standing out to the gastric cavity. The membrane found in the above 11 cases located in pyloric exit or tube,and they under-went membrane excision and py|oroplasty. The other 7 cases showed thick mucosal folds at the distal antrum with radial arrangement. Round or irregular stenosing stoma were observed. These cases proved to be antral membrane,1-3 cm away from the duodenum and pylorus,and underwent simple membrane resection. Conclusion Congenital prepyloric membrane is rare and it likely mis-diagnosed. The onset and the degree of symptoms depend on the diameter of aperture of the membrane. Early endoscopy,in addition to barium contrast,should be performed on those children who have intermittent bilious vomiting,where false-positive radiological findings can be avoided,therefore,to facilitate right diagnosis and appropriate operation.