The management of patients with cancer of unknown primary site (CUP) is a notoriously medical problem. The outcome is bad in most patients. The clinical general characteristics, histopathology, im-aging features and endoscopies can provide some useful information, and the primary site can be detected in part of these patients, but most are not. With the application of molecular biology and positron emission tomography-computed tomography(PET-CT) technology, the detection rate of CUP has increased significantly.

BACKGROUND: Numerous studies have shown that Danshen Root can suppress adhesion and aggregation of neutrophils as well as production of oxygen free radical, can activate blood circulation to dissipate blood stasis. However, there are few studies about precise mechanisms underlying protection of vascular endothelium and anti-thrombosis, especially concerning the mechanism of action following coronary artery stent implantation.OBJECTIVE: To investigate the influence of Danhong injection on vascular endothelial function before and after coronary artery stent implantation in patients with acute coronary syndrome (ACS). METHODS: A total of 60 ACS patients were randomly assigned to two groups. The patients in the conventional treatment group were subjected to conventional drug treatment following coronary artery stent implantation. The patients in the Danhong injection group received conventional drug treatment and Danhong injection (20 mL/d) following coronary artery stent implantation. The treatment course was 10 days. Before and after implantation as well as before and after Danhong injection treatment, endothelium-derived blood flow-mediated vasodilation, plasma endothelin, thromboxane B2, 6-keto-prostaglandin levels were determined, and the vascular endothelial function were evaluated. Simultaneously, short-term prognosis was observed in patients of both groups.RESULTS AND CONCLUSION: Plasma endothelin and thromboxane B2 levels were significantly increased, but 6-keto-prostaglandin levels were significantly decreased following stent implantation in patients of both groups compared with that before implantation (P < 0.05). Plasma endothelin and thromboxane B2 levels were significantly reduced, but endothelium-derived blood flow-mediated vasodilation and 6-keto-prostaglandin levels were significantly increased in both groups following treatment compared with that following implantation (P < 0.05, P < 0.01), especially in the Danhong injection group (P < 0.05). During hospitalization, the incidences of cardiovascular events were diminished in the Danhong injection group compared with conventional drug treatment group (P > 0.05). Results suggested that Danhong injection significantly improves vascular endothelial function, induces vasodilatation, improves blood supply, inhibits platelet aggragation, and shows the tendency of ameliorating short-term prognosis.

DBJECTIVE: To evaluate the efficacy of traditional Chinese medicine in the treatment of complications following cerebrovascular stent placement.METHODS: A computer screen was performed for Science Direct database and Ei database between January 1960 and October2009,using key words of"traditional Chinese medicine,stent placement,complication",and the language was limited to English.At the same time,Chinese Journal Full-text database and Chinese Biomedical Literature database between January 1994 and October 2009 were searched for related articles,using key words of"traditional Chinese medicine,cerebral blood vessels,stent placement,complications",and the language was limited to Chinese.In addition,several monographs were manually consulted.The basic and clinical trials addressing the prevention and treatment of traditional Chinese medicine on the complications following cerebrovascular stenting were included.RESULTS: Subsequent to the cerebrovascular stent placement,the traditional Chinese medicine interventions include benefiting Qi,invigorating blood circulation,and eliminating phlegm,which all serve as the basic approach,in addition these interventions are accompanied by relieving Qi and stagnancy in liver,soothing the nerves and benefiting water,cooling blood and stopping bleeding.The commonly used traditional Chinese medicine compound is consisted of Shengmai San,Buyang Huanwu decoction,Xuefu Zhuyu decoction,sini decoction and resist decoction.Modern pharmacological studies have shown that a large number of traditional Chinese medicine and compound which are always used to benefit Qi,invigorate blood circulation,dissipate blood stasis and eliminate phlegm,can effectively prevent the complications following cerebrovascular stent placement through a multi-component,multi-target,multi-channel integration regulatory role.CONCLUSION: The traditional Chinese medicine interventions during the peri-operative period of cerebral vascular stent placement exhibit a feature of Chinese medicine and play an important role for improving the success rate of surgery,preventing and reducting peri-operative period and long-term complications.

Objective To explore clinical curative effect of lamivudine in treatment of HBV reactivation.Methods The clinical data of HBV reactivation patients in immunosuppressive therapy were retrospectively analyzed. Results The clinical symptom and liver function recovery rate, HBV-DNA darkening rate, HBeAg darkening rate and HBe-Ag/anti HBe frequence of seroconversion of detection group were higher than that of control group,the difference was statistically significant( all P ＜ 0. 05 ). Conclusion The clinical curative effect of HBV reactivation in immunosuppressive therapy by Lamivudine was good.

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Objective To evaluate the prevalence of aspirin resistance in old-aged patients with cerebral infarction and to analyze the mechanisms and clinical predictors of aspirin resistance. Methods 300 old-aged patients with cerebra] infarction were selected and the platelet aggregation ratio was determined by nephelometry with CHRONO-LOG PA-meter. And some information of these patients, such as age, sex, smoking, taking non-steroid anti-inflammatory drug (NSAD)or proton pump inhibitor (PPI), obesity, coronary artery disease (CAD), peripheral vascular disease, hyperpiesia, diabetes and hyperlipemia were recorded. Results 112 cases (37.33%) were aspirin sensitiveness, 108 cases(36.0%) were aspirin semi-resistance and 80 cases (26.67%) were aspirin resistance. These cases were divided into two groups. One was aspirin sensitive (AS) group, which included 112 patients of aspirin sensitiveness. The other was aspirin resistant (AR) group, which consisted of 188 patients of aspirin semi-resistance and aspirin resistance. The prevalence of CAD, hypercho]esteremia and RBC count in AR group was higher than that in AS group The percentage of patients who took NSAD, PPI and smoke in AR group was also higher than that in AS group. Conclusion Aspirin resistance existed in old-aged patients with cerebral infarction to great extent, and which was correlated with CAD, hypercholesteremia, smoking, RBC count, taking NSAD and PPI.

Objective To study the current status of morning blood pressure peak in elderly masked hypertension patients and study the correlation between morning blood pressure peak and cognitive function.Methods A total of 72 elderly masked hypertension patients were selected in this study,.Morning blood pressure peak was measured by ABPM examination.The patients were divided into three groups according to the morning blood pressure peak.Morning blood pressure peak ≤ 30 mmHg were divided into non-Morning blood pressure surge group ( NMS group),morning blood pressure peak ＞30 mmHg were divided into Morning blood pressure surge group ( MS group).The cognitive function scale was determined (MMSE and MoCA).T-test and linear regression analysis were performed.Results MMSE score(27.69±2.04) and MoCA scores(24.85 ± 1.52) in MS group were lower than NMS group (28.87 ± 1.34,26.54± 1.53) ( P ＜0.01 ).MMSE and MoCA scores were negatively correlated with the morning blood pressure peak ( r =- 0.308,- 0.447,P ＜ 0.01 ).Conclusions Elderly masked hypertension patients remained the phenomenon of the morning blood pressure peak,the morning blood pressure peak could lead to cognitive impairment.

Silk fiber,as a kind of natural polymer,has been used as surgical sutures in clinic for years.Silk fiber is composed of a filament core protein,termed fibroin and a glue-like coating called sericin proteins.Due to its unique mechanical properties,good biocompatibility and slow degradability,silk fiber has been put in variety of applications as a new kind of biomedical scaffolds in recent years.With the development of the processing technique,silk fiber can be processed through the new versatile processing method to form various forms of scaffolds and its surface could be modified for different purposes.Further more,it could be tailored through genetic recombination to form the silk fibroin-like polymers which has a promising potential in medical applications.

AIM: To observe the influence of rofecoxib, a non steroidal anti inflammatory drug, administrated for a long term on the knee joints cartilage of rats. METHODS: An experimental model of osteoarthritis of left knee in the early stage was induced by cutting achilles tendon in rats, the right knee providing a control. The rats of one group were given rofecoxib orally, and the rats in another group were given saline as a control. After 100 days, the histopathology, ultrastructure, and histochemistry changes on the knee joints cartilage were monitored. RESULTS and CONCLUSION: Rofecoxib, administrated for 100 days, had no harmful influence on chondrocyte and collagen, and could increase proteoglycan of cartilage in some degree in rats.