Objective To investigate the risk factors related with postoperative complications following radical gnstrectomy for gastric cancer in cirrhotic patients. Methods In this study, 1474 cases underwent radical gastrectomy for gastric carcinoma in the past six years and the postoperative complications were retrospectively reviewed. The risk factors related with postoperative complications of cirrhotic patients were analyzed by Logistic regressive analysis. Results The postoperative morbidity rates of the 2 groups with or without liver cirrhosis were 51.22% and 23.94% (X2 = 15.955, P<0.01), and the mortality rate was 7.32% and 0.91% (P = 0.009), respectively. The main complications of the group with liver cirrhosis were postoperative aseites (5 cases), hepatic failure (4 cases), wound infection or dehiscence (4 cases), intra-abdominal infection (4 cases), etc, and three patients in the group died from extensive bleeding, jejunal fistula and hepatic failure respectively. Univariate Logistic analysis revealed that age (OR = 1.277, 95% CI:0.991 ～ 1.646), preoperative nscites (OR = 20.900,95% CI: 2.349 - 185.933), the albumin level (OR =0.160,95% CI:0.041 ～ 0.629), Child classification (OR = 9.500,95% CI: 1.046 ～ 86.261), portal hypertension (OR = 4.000,95% CI: 1.057 ～ 15.138), esophageal variees (OR = 4.400,95% CI: 1.095 ～ 17.676), transfusion (OR =3.714,95% CI: 1.021 ～ 13.511) and blood loss (OR = 1.442, 95% CI:1.023 ～ 2.034) were the main factors associated with postoperative complications of the group with liver cirrhosis. Muhivariable Logistic analysis showed that preoperative ascites (OR = 19.213,95% CI: 1.569 ～ 231.255), Child classification (OR = 12.661,95% CI: 0.721 ～ 222.458), esophageal varices (OR =6.008,95% CI:0.857 ～42.097) and blood loss (OR = 1.574,95% (7,1:0.938 ～ 2.640) were the independent risk factors. Conclusion Gastrectomy for gastric carcinoma in cirrhotic patients engenders considerably high postoperative mortality and morbidity. Preoperative ascites, Child classifation, esophageal variees and intraoperative blood loss were factors closely related with postoperative complications.

Objective To study the level of cyclooxygenase-2 (COX-2) and platelet-activating factor acetyl-hydrolase(PAF-AH) and high sensitive C reactive protein(hsCRP) on peripheral blood mononuclear cells in Acute Coronary Syndrome(ACS) patients and the effect of atorvastatin on them and the clinical significance. Methods To measure and compare the content of COX-2,PAF-AH and hsCRP in normal control group and ACS group(before and after treatment). Result The content of COX-2,PAF-AH and hsCRP are significantly different between normal con-trol group and ACS group (before treatment) (P < 0.05), and between ACS group (before treatment) and ACS group (after treatment) too(P < 0.05). Conclusions The inflammatory cytokines COX-2,PAF-AH and haCRP have sig-nificant correlation with the occurance of ACS. Atorvastatin can decrease COX-2 and hsCRP level, and can increase PAF-AH level. So atorvastatin takes an important role in lessening inflamatory reaction level in ACS patients.

Objective To evaluate the effect of fast track surgery on immunologic functions and clinical outcome in patients with gastric cancer during perioperative period. Methods Thirty-six gastric cancer patients receving radical operation were randomly divided into two groups: fast track group (18, fast track surgery) and conventional management group (18, non-fast track surgery). Serum levels of IgA、IgM、 IgG and C reaction protein (CRP) in 36 patients were assayed preoperatively and postoperatively on 1st, 3rd, 7th day. The postoperative hospital stay, duration of fever, inhospital expense, postoperative time of flatus and postoperative complications were recorded respectively. Results On the postoperative 3rd day, serum levels of IgA [(1.57 ± 0. 40) g/L vs. (1.27±0.49) g/L, P <0. 05],IgG[(9.99 ± 2. 12) g/L vs.(8.53±2. 15)g/L, P<0.05]and IgM [(0.92 ± 0.18) g/Lvs. (0.78 ± 0.20) g/L, P<0.05]in patients of fast track group were significantly higher than those in patients in non-fast track group. On the postoperative 1 st, 3rd , 7th day, serum levels of CRP [d1 (56 ± 10) g/L vs. (79 ± 9) g/L,P < 0. 05];d3[(140±15) g/L vs. (170±15) g/L, P<0.05)];d7 [(52±11) g/L vs. (78±12) g/L,P<0.05]in patients of fast track group were significantly lower than those in patients in non-fast track group. The duration of fever [(2. 4 ± 0.9) d vs. (3.8 ± 0. 8) d, P < 0.05], passage of gas by anus [(3. 1 ± 0. 8) d vs. (4.4±0.7) d,P<0.05], time of hospitai stay [(6.3 ± 1.2) d vs. (8.2 ± 0.9) d,P<0.05]and treatment expense in patients of fast track group[(25 260 ± 2910) $ vs. (30 651 ± 3578) $ ,P <0. 05]were also significantly lower than those in non-fast track group (P < 0. 05). Patients in fast track group had no more complications than those in non-fast track group (P > 0. 05). While discharged from hospital, the quality of life score [(14. 8 ± 1.9) vs. (16. 1 ± 1.6), P < 0. 05]in patients of fast track group was significantly higher than that in patients in non-fast track group (P < 0. 05). Conclusions Fast track surgery mitigates the immunologic impairment of gastric cancer patients during perioperative period, and accelerates postoperative rehabilitation.

Objective To explore classification methods and Surgical techniques of the squama occipitalis deformities.Methods A retrospective analysis from 2001 to 2008 treated 16 cases of squama occipitalis deformties,according to MR findings,put forward classification method of the squama occipitalis and diagnostic criteria of foramen magnum trailing edge and the occipital scale department hypertrophy.Results All patients after the use of median incision posterior fossa decompression,the clinical symptoms in patients with varying degrees to resume.Conclusion It is important to the squama occipitalis deformities on reasonable classification has obvious clinical instruction value on preoperative assessment and the operation.

Objective To study lymph node metastasis in early gastric carcinoma. Methods From July 2001 to July 2007, 177 patients with early gastric carcinoma underwent radical gastrectomy and the clinicopathologic data were analyzed by binary logistic regression. Results The overall rate of lymph node metastasis in early gastric carcinoma was 13%, involving 13% and 3% in level I (NI) and level Ⅱlymph nodes (N2), respectively. The rate of lymph node metastasis was 22%(20/89) in cases of submucosal lesion (SM), which was significantly higher than 3%(3/88) in cases of mucosal lesion (M) (X2=14. 222, P<0.01). The rate of lymph node metastasis was 3%(4/117) when the primary tumor was ≤2cmin diameter compared with 32%(19/60) when the tumor was >2cm (X2=27.992, P<0.01). The lymph node metastasis rate was 4%(3/81) and 21%(20/96) in differentiated and undifferentiated lesion (X2=11.402, P=0.001), and it was 33%(2/6)、8%(7/99) and 19% (14/92) in macroscopic type I, Ⅱ and Ⅲ (X2=8.172, P=0.014). Binarylogistic analysis found that the tumour diameter greater than 2.0cm (OR=8.408, P<0.01), infiltration of the submucosal layer (OR=5.926, P=0.009) and undifferentiated lesion (OR=4.880, P=0.020) were the independent risk factors. Conclusion Lymph node metastasis in early gastric carcinoma is significantly cantingent on the depth of infiltration, tumor size and histological type.

Objective: To investigate the influence of fast tract surgery on the humoral immunity and the chief clinical index of gastric cancer patients.Methods: 56 patients with gastric cancer from December 2007 to June 2008 were randomly divided into two groups: experiment group(fast tract surgery group, n=28)and control group(conventional treatment group, n=28 ). The changes of serum levels of humoral immunity and the chief clinical index were analysed and compared.Results: The serum levels of humoral immunity in both group were decreased. The serum levels of C3 and C4 on the postoperative 1st day were(0.845±0.126)g/L and(0.212±0.070)g/L respectively(P<0.05) in FTS group.The serum levels of IgA, IgM and IgG on the postoperative 3rd day were(1.603±0.468)g/L,(0.845±0.187)g/L,(9.548±1.920)g/L respectively(P<0.05) in FTS group. The duration of antibiotic use, first passage of flatus, the lengh of hospital stay, the occurance of postoperative complications in FTS group were also significiantly lower than those in control group (P<0.01, P<0.05).Conclusion: Fast tract surgery affectes on the humoral immunity of gasrtic cancer patients, and it might contribute to the improved outcomes of postoperative patients.

Aim To investigate the effect of intrathecal injection of fluorocitrate(Fc)on mechanical and thermal hyperalgesia induced by complete Freund's adjuvant(CFA)injection in rats.Methods The mechanical withdrawal threshold(MWT)and thermal withdrawal latency(TWL)were measured before and after CFA or Fc treatment.The changes of glial fibrillary acidic protein(GFAP)and OX-42(a microglial marker)expression in the spinal cord dorsal horn were evaluated by immunohistochemistry analysis.Results Rats with CFA-induced arthritis showed mechanical allodynia and thermal hyperalgesia,which was correlated with the increased GFAP and OX-42 expression in the spinal cord dorsal horn.Intrathecal injection of Fc markedly suppressed CFA-induced thermal hyperalgesia and mechanical allodynia.Fc significantly attenuated the activation of GFAP and OX-42 in the spinal cord dorsal horn.Conclusions The glia activation in spinal cord is closely related to the progress of CFA-induced peripheral hyperalgesia.Fc may exert antihyperalgesic effect by inhibiting the activation of astrocyte and microglia.

Objective To investigate the effect of propentofylline on nerve growth factor (NGF) and IL-1βrelease from rat cerebral cortical astrocytes. Methods Primary cultured rat astrocytes from SD rats (1-3 d,weighing 6-8 g) after 4 passages were randomly divided into 8 groups ( n = 6 wells each): group Ⅰ control (group C); group Ⅱ , Ⅲ, Ⅳ the astrocytes were exposed to propentofylline 10, 100 and 1000 μmol/L respectively (group P1, P2, P3 ); group Ⅴ the astrocytes were exposed to LPS 1 μg/ml and group Ⅵ, Ⅶ, Ⅷ the astrocytes were exposed to propentofylline 10, 100 and 1000 μmol/L in addition to LPS 1 μg/ml (group P1 + LPS, P2 + LPS,P3 + LPS). The astrocytes were then incubated for 3 days in all 8 groups. The concentrations of IL-1β and NGF in the supernatant were detected at 1 and 3 days of incubation using ELISA. Results LPS activated astrocytes resulting in decrease in NGF release and increase in IL-1β release. Propentofylline significantly increased NGF release and decreased IL-1β release from astrocytes incubated alone or with LPS by suppressing activation of astrocytes. Conclusion Propentofylline can enhance NGF release and inhibit IL-1β release from rat cerebral cortical astrocytes.

Objective To investigate the expressions and clinical significanees of suppressors of cytokine signaling-1 (SOCS-1) and SOCS-3 in myocardium of patients with sudden cardiac death (SCD). Method This study included myocardial autopsy specimens of 24 patients admitted between 2005 and 2006. Of them, 9 cases had the findings of autopsy examination consistent with coronary atberosclerosis (non-myocardial infarction) leading to SCD (non-MI group), 7 patients died of acute myocardial infarction (MI group) and 8 patients died of traffic accidents and trauma The expressions of SOCS-1 mRNA and SOCS-3 mRNA in the myocardium of non-MI and con-trol group were detected by using RT-PCR. The levels of SOCS-1 protein and SOCS-3 protein were detected by us-ing immunohistochemistry. Statistical analysis were performed by using SPSS version 13.0 software and the data were processed with ANOVA test. Results The expressions of SOCS-1 mRNA and SOCS-3 mRNA in non-MI and MI groups were were significantly higher than those in control group (0. 788±0. 101) and (0. 741±0.111) vs.(0.436±0.044) (P <0.01); (0.841±0.092) and (0.776±0.070) vs.(0.454±0.076), P <0.01, re-spectively). The antibody-positive cells of SOCS-1 protein in myocardium of non-MI group and MI group were significantly higher than those in myoeardium of control group (320.00±48.48) and (347.14±70.88) vs.(42.50±10.35) (P < 0.01), respectively. The antibody-positive cells of SOCS-3 protein in myoeardium of non-MI group and MI group were significantly higher than those in myocardium of control group (381.11±59.25) vs.(40.00±10.69), (P < 0.01)and (332.86±111.91) vs. (40.00±10.69), (P =0.001). Conclusions The expressions of SOCS rnRNA and SOCS-3 mRNA in myoeardium of patients with SCD from coronary diseases are significantly increased contributing to the pathogenesis of SCD.

OBJECTIVE:To compare therapeutic efficacy and safety of different chemotherapy regimens in the treatment of small cell esophageal cancer. METHODS:In retrospective analysis,58 patients with small cell esophageal cancer were divided into group A(18 cases),B(26 cases)and C(14 cases)according to chemotherapy regimens. Group A was given Cisplatin injection 75 mg/m2 intravenously,d1-3+Paclitaxel injection 175 mg/m2,d1-3. Group B was given Cisplatin injection 30 mg/m2 intravenously,d1-3+Et-oposide injection 100 mg/m2,d1-3. Group C was given Vinorelbine tartrate injection 25 mg/m2 intravenously,d1-3+Gemcitabine hydro-chloride for injection 1000 mg/m2,d1-3. A treatment course of 3 groups lasted for 21 d,and they all received 2 cycles of treatment. Clinical efficacies,1,2,3-year survival rate and the incidence of Ⅲ-Ⅳ degree toxic reaction(cough,fever,expectoration,short-ness of breath,fatigue,chest pain,bone marrow suppression,gastrointestinal reactions) were compared among 3 groups. RE-SULTS:Total response rate and 1,2,3-year survival rate were in descending order:group C>group B>group A;the incidence of Ⅲ-Ⅳ degree cough,fever,expectoration,shortness of breath,fatigue,chest pain were in ascending order:group C0.05). CONCLUSIONS:Therapeutic efficacy and 1,2,3-year survival rate of vinorelbine combined with gemcitabine are significantly higher than those of cisplatin combined with paclitaxel or etoposide with better safety.