Objective To explore the treatment resection-line involvement gastric cancer.Method The relationship between resection-line involvement and outcome was evaluated in patients underwebt potentially curative resection for gastric cancer.Results Tumor positive resection-lines were found in 22 of 237 patients (9.3%).Resection-line involvement was associated with tumor location (P=0.01) and tumor differentiation (P =0.02).Positive margins were associated with worse survival.However,according to lymph node metastases,resection line involvement determined a shorter survival only in patients with N 0 stage disease.Conclusion The re operation should be considered only for patients with N 0 stage disease,while patients with metastatic lymph nodes do not need a more aggressive surgical approach.

2-(Dimethylamino)ethyl methacrylate and sodium monochloroacetate were employed to synthesize [2-(Methacryloyloxy)ethyl] dimethyl ammonium acetate (CBMA) functional monomer.CBMA was grafted on the surface of silica by surface initiated atom transfer radical polymerization (SI-ATRP) to obtain silica-CBMA hydrophilic interaction stationary phase.Three silica-CBMA stationary phases with different grafted density of CBMA monomer were synthesized in SI-ATRP progress by changing the concentration of CBMA under the same conditions.The ability to separate organic acid compounds of the synthesized silica-CBMA stationary phases was evaluated under different conditions, including effects of pH value, salt concentration and content of water of mobile phase on retention of solutes.The results showed that the stationary phases could effectively separate organic acid compounds in HILIC mode, which followed a mixed mode of chromatography of ion exchange and hydrophilic interaction.The retention of solutes decreased with the increases of salt concentration of mobile phase, which consistent with the characteristics of ion exchange;the pH value of mobile phase had significant influence on ionization of the stationary phase and solutes, i.e., the retention of solutes increased as the increasing of pH value of mobile phase.However, the retention of solutes decreased with the increasing of the content of water in mobile phase, which was the typical characteristic of HILIC.The method of hydrophilic interaction chromatography combined with silica-CBMA stationary phases could conveniently determinate the content of vitamin C and rutin in rutin tablets, providing a new method for the separation and determination of strong polar samples.

The clinical data of 118 patients with bacterial liver abscess admitted to a tertiary hospital from January 2007 to December 2009 were analyzed retrospectively.Etiology study showed that 45.8％(54/118) cases of bacterial liver abscess were cryptogenic,40.7％ (48/118) were biliary source and 13.5％ (16/118) were hematogenous.The positive rate of pus culture was 57.1％ (36/63),among which klebsiella pneumoniae accounted for 72.2％ (26/36).The positive rate of blood culture was 31.2％(20/64) and klebsiella pneumoniae accounted for 95％ (19/20).One hundred and sixteen patients (98.3％) underwent color ultrasound examination with an accuracy rate of 93.2％.84 patients (71.2％)underwent the CT scan with an accuracy rate of 95.3％ and 20 patients underwent MRI with an accuracy rate of 85％.Seventy five patients (63.6％)accepted ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotic therapy; 40 patients(33.9％)were treated with antibiotics alone.On the discharge 27 patients(22.9％) achieved clinical cure,87 patients (73.7％) were classified as effective,4 patients (3.4％) had no effect and no death in this group of patients.The average length of hospital stay was 16 days.Cryptogenic was the most common cause of bacterial liver abscess,biliary source took the second place.Kleibsiella pneumoniae was the predominant organism.Detailed medical history inquiry,physical examination and assistant examination may increase the accuracy rate of diagnosis.Needle biopsy should be performed if necessary.Ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotics should be the first-line treatment.

Total 118 patients with pyogenic liver abscess admitted to Zhongshan Hospital were classified into pypgenic liver abscesses of cryptogenic origin (PLAC,n =54),pyogenic liver abscesses of biliary origin (PLAB,n =48) and pyogenic liver abscesses of hemagenous origin (PLAH,n =16)according to the causes.The clinical features of three groups were compared and analyzed.The results showed that no statistically significant difference existed among three groups in clinical manifestation and signs.Compared to PLAB,the abscesses in right lobe of liver were more common in PLAC,diabetes mellitus was more prevalent in PLAC,but the co-existing diseases including chronic liver disease,non biliary malignant tumor and ALP elevation were less in PLAC.Klebsiella pneumoniae was frequently detected in PLAC,but there was no significant difference comparing to other two groups.No significant difference was found among three groups in the choice of therapeutic methods,the course of antibiotics,length of hospital stay and the days from admission to diagnosis.

In order to assess colonic motility of chronic constipation, colonic transit test was carried out in 34 patients with chronic constipation and in 20 healthy subjects. 20 radiopaque markers are ingested at 8 am before the day test, and plain abdominal films were obtained at 24 h, 48 h and 72 h. The normal value of colonic transit test was 16(80%), or more markers passed after 72 h. By means of transit time study, 34 constipated patients were classified into 2 groups: 12 normal transit patients and 22 slow transit patients. There was no difference in colonic transit time between normal transit patients and controls (P＞0.05). Patients with slow transit had more markers left in right colon, left colon and rectosigmoid colon at 48 h (P＜0.01, respectively) and 72 h (P＜0.01, respectively). According to the transit index, 22 slow transit patients were divided into 3 types: 10 cases colonic stasis, 8 cases outlet obstruction and 4 cases colorectal stasis. The study suggests that chronic constipated patients have abnormalbilities of colonic transit.

Paeonol is an nerb which has been used us an anodyne. The analgesic action of Paeonol has been shown in this paper by using the following methods: Mice licking hind paw on hot plate (55℃); mice wring evoked by ip 0. 7% acetic acid 10 ml ? kg-1; continuous pain stimuli elicited by sc 2. 5% formaldehyde 0. 03 ml in fore paw of mice.No tolerance of analgesic effect was found after daily sc of Paeonol 100 mg ? kg-1for 7 d in mice assayed with hot plate method. In naloxone-challenge test, no jumping response was observed in mice treated with Paeonol 690mg ? kg-1, the maximal tolerance dose. The results indicate that Paeonol induced no morphine-like tolerance norphysical dependence.The analgesic action of Paeonol was not an-tagonizd by naloxone, but was eliminated by in-traperitoneal injection reserpine 3 mg ? kg-1 3 h prior to Paeonol. These results demonstrate that Paeonol belongs to the non-narcotic analgesic, and suggested that the analgesic action of Paeonol may be related to the monoamine level in brain.

Objective To evaluate the value of magnetic resonance imaging in diagnosis aortic diseases.Methods Fourty-nine patients with aortic diseases including 20 cases aneurysm,26 cases aortic dissection and 3 cases pseudoaneurysm were examinated with MRI SE and 9 cases of them underwent FFE cine.Results All cases of both groups showed the part,extent and modality of aortic disease.And mensuration the size of aneurysm.Aortic dissection of 26 cases showed aortic double lumen,18 cases showed intimal flap.Entry tears were 7 cases respectively.The involvements of aortic branches were 20 among 9 cases (including 1 case aneurysm and 8 cases aortic dissection)aortic branches respectively.Conclusion Aortic aneurysm and intraaneurysmal architecture can be clearly showed on MRI.MR is one of the optimal imaging techniques in diagnosing aortic disease.

Objective To study the diagnosis and treatment of bochdalek′s hernia in children, especially to introduce the methods of repairing the defect of diaphragm using rib-flap and terylene fabric.Methods The diagnosis, misdiagnosis and methods of repairing of diaphragm in 10 cases of bochdalek′s hernia were retrospectively reviewed, and the findings of reconstruction of diaphragm in 2 cases of defect of diaphragm were analyzed.Results All of the 12 cases were misdiagnosed for the first time. Ten cases were cured through abdominal surgery and 2 cases were cured through reconstruction of diaphragm.Conclusions Bochdalek′s hernias in children are lack of specific clinical manifestation and often misdiagnosed before operation. Early surgical treatment is necessary once the diagnosis is established, and the defect of diaphragm should be reconstructed. The repairment of diaphragm using rib-flap and terylene fabric is a practical methods.

The Medical Healthcare Service Center,located at the Youxian District,Mianyang City of Sichuan Province,successfully rescued the people affected by the Wenchuan earthquake and the Tangjiashan barrier lake with great help from the senior hospitals.We suggest that the community healthcare service center could play an important role in emergency response system.

Objective To investigate the role of opioid receptors and vagus and sympathetic nerves in the remifentanil-induced cardiovascular depression in rabbits. Methods Forty 2-6 months old New Zealand white rebbits of both sexes weighing 1.5-2.5 kg were randomly divided into 5 groups (n = 8 each): group Ⅰ remifentanil (group R); group Ⅱ naloxone + remifentanil (group N+ R); group Ⅲ vagus nerve cut-off +remifentanil (group V+ R); group Ⅳ epidural block + remifentanil (group S+ R) and group V vagus nerve cutoff + epidural block + remifentanil (group V + S + R). The animals were anesthetized, tracheostomized and mechanically ventilated. PaCO2 was maintained at 35-45 mm Hg. Vecuronium 0.3 mg/kg was given iv every 40 min to keep muscle relaxed. Right carotid artery was cannulated for continuous MAP monitoring. ECG was continuously monitored. A bolus of remifentanil 5.0 μg/kg was administered iv in all 5 groups. In group N + R naloxone 40μg was given iv about 2 min before remifentanil. In group V + R bilateral vagus nerves were cut off through neck incision. After HR and MAP had stabilized for 30 min, remifentanil was given iv. In group S + R epidural block was performed at L6.7 interspace with 2% lidocaine to block cardiac sympathetic nerves. When HR and MAP decreased by 20% of the baseline values and stabilized for 30 min remifentanil was given iv. In group V + S + R bilateral vagus nerves were cut off first. Then epidural block was performed before remifentanil administration. MAP and HR were recorded at 1 min before iv remifentanil administration (T0 ), at 30 s (T1), 1,2, 3, 4, 5, 10, 15 and 20 min (T2-9 ) after remifentanil administration. Results Intravenous remifentanil 5.0 μg/kg significantly decreased HR at T1 and MAP at T1-7 as compared with those at T0 in group R. Pretreatmentwith naloxone 40 μg prevented remifentanil-induced decrease in MAP but did not affect remifentanil-induced decrease in HR in group N + R. Vagus nerve cut-off and sympathetic block induced by epidural anesthesia performed before iv remifentanil did not affect remifentanil-induced cardiac depression in group V + R, S + R and V + S + R. Conclusion Opioid receptors and vagus and sympathetic nerves are not related to remifentanil-induced decrease in HR. Remifentanil induces decrease in MAP by activating opioid receptors.