Objective To investigate the correlation of serum alpha-fetoprotein (AFP) with clinical pathological factors and prognosis of hepatocellular carcinoma ( HCC ).Methods Two hundred and twenty patients with HCC who hospitalized in our hospital from January 2007 to June 2009 were enrolled in this study.The relationship of AFP levels before operation to clinical pathological factors such as pathological grade,tumor size,tumor encapsulation,tumor numbers,portal vein tumor thrombus,TNM stage and postoperative recurrence were analyzed.Results Serum AFP concentration before operation were related with tumor size ( x2 =11.76,P ＜ 0.05 ),tumor encapsulation ( x2 =17.07,P ＜ 0.05 ),portal vein tumor thrombus ( x2 =8.944,P ＜ 0.05 ),higher TNM stage ( x2 =4.929,P ＜ 0.05 ) and early postoperative recurrence rate ( x2 =5.569,P ＜ 0.05 ).However,it had no correlation with pathological edmondson grade tumor numbers.Conclusion HCC patients with high serum AFP concentration often has greater tumor without encapsulation,high occurrence rate of portal vein tumor thrombus and higher TNM stage,they are more likely to early postoperative recurrence.Serum AFP before operation is useful not only for diagnosis,but also as a prognostic biomarker to predict prognosis and recurrence.

Objective To analyze the occurrence rate,positive rate,and other related factors influencing interpectoral lymph nodes in breast cancer patients,and to explore the significance and indications of the surgical dissection of interpectoral lympy nodes.Methods Clinical and pathological data from 148 breast cancer patients were retrospectively analyzed.All patients were subjected to modified radical mastectomy,and interpectoral lympy nodes were pathologically examined.The occurrence rate and metastasis of interpectoral lympy nodes were recorded,and the relationship between the interpectoral lympy nodes positive rate and tumor size,axillary nodes,clinical stages,neo-adjuvant chemotherapy,hormone receptors,human epidermal growth factor receptor-2 (Her-2) expression,and molecular subtypes of breast cancer were determined.Results The occurrence rate,overall metastasis rate,and the positive rate of interpectoral lympy nodes in patients with axillary lymph node metastasis were 13.5％(20/148),4.7％(7/148),and 10.9％ (7/64),respectively.I nterpectoral lympy nodes metastasis was significantly correlated with axillary node metastasis and clinical stages (P＜ 0.05).However,interpectoral lympy nodes metastasis was not significantly related with hormone receptor and Her-2 expressions(P ＞ 0.05).Interpectoral lympy nodes metastasis rate was not affected by neo-adjuvant chemotherapy.Patients with interpectoral lympy nodes metastasis were characterized by larger tumors,more positive axillary lymph nodes,and later chnical stages.Conclusions Interpectoral lympy nodes metastasis usually occurs in patients with larger tumors,more positive axillary lymph nodes,later clinical stages,as well as those with locally advanced cancer that meets the standard of neo-adjuvant chemotherapy.These indications suggest that the surgical dissection and pathological examination of interpectoral lymph nodes should be routinely performed.

Objective:To establish an HPLC method for the simultaneous determination of six active constituents ( ferulic acid, chlorogenic acid,ephedrine hydrochloride,protocatechuic acid,protocatechualdehyde and naringin) in Jizhi syrups. Methods:A Zorbax XDB-C18(4.6 mm×250 mm,5 μm)column was used. The mobile phase consisted of acetonitrile (A)-0.9% acetic acid (B) with gradient elution at the flow rate of 1. 0 ml·min-1 . The detection wavelength was changed as follows:257 nm for 0-22. 0 min, 326 nm for 22. 0-30. 0 min, 320 nm for 30. 0-52. 0 min, 210 nm for 52. 0-58. 0 min and 283 nm for 58. 0-60. 0 min. The column temperature was 30 ℃ and the injection volume was 10 μl. Results:The separation of the six active constituents was good. The linear range ( r>0. 9990) was 2. 817-112. 670, 2. 342-93. 670, 0. 710-28. 415, 0. 776-31. 035, 0. 694-27. 755 and 1. 279-51. 175 ng for ferulic acid, chlorogenic acid, ephedrine hydrochloride, protocatechuic acid, protocatechualdehyde and naringin, respectively. The average recover-ies varied from 99.3% to 99.8%(RSD varied from 0.18% to 0.28%). Conclusion: The method is rapid with high sensitivity, promising accuracy and good specificity, which can provide scientific basis for the quality control of Jizhi syrups.

Objective To observe and evaluate the clinical curative efficacy of perineal stapled prolapse resection in the treatment of complete rectal prolapse.Methods 15 patients of complete rectal prolapse were all treated by perineal stapled prolapse resection,The anal function of the patients were evaluated according to the Wexner incontinence score standard.Results All patients were successfully completed the operation.Postoperative complications:postoperative bleeding in 2 cases,anastomotic stenosis in 2 cases.These symptoms were relieved after symptomatic treatment.The anal sphincter function was improved in all patients after operation.There were no obvious incontinence.The preoperative Wexner incontinence score was 13.5±1.8,andpostoperative Wexner incontinence score was 4.2±1.5,there were significant statistical difference between them(P<0.05).The mean follow-up were 18 months(2-30 months).There was no recurrence during the follow-up period.Conclusion Perineal stapled prolapse resection as a new type of operation had small trauma,simple operation,less complications and short-term curative effect of good characteristics.They can effectively improve the symptoms of anal incontinence in patients with complete rectal prolapse.

Objective:To study the fracture resistance of nanofilled composite resin restoration for the treatment of incisally fractured in-cisors. Methods:30 extracted permanent maxillary central incisors were randomly divided into A, B and C groups (n=10). In group A and B, the teeth were cut obliquely from the mesial incisal angle. Labial reduction of 0. 5 mm for veneer and dovetails in the lingual surfaces were prepared. In group A, additional 2mm of the incisal edge were cut horizontally. The teeth were restored with nanofilled com-posite resin. The samples in group C were unprepared as the controls. The specimens were stored in artificial saliva and underwent 2 000 cycles of thermal cycling test. Fracture resistance of the teeth was measured by a test machine and the fracture mode was observed. Re-sults:The mean fracture load(N) of group A, B and C was 466.93 ±171.68, 444.5 ±173.00 and 474.77 ±97.55 respectively(P>0. 05). All fractures in the 2 test groups but 1 in the control group were in a favorable way. Conclusion:Incisally fractured incisors restored with nanofilled composite resins can achieve the fracture resistance similar to that of intact natural tooth. Failure modes of the restored teeth are in favorable way. Additional cut of 2 mm of the incisal edge dose not affect the fracture resistance of the restored teeth.

It is well documented that vascular tone is the key determinant of blood vessel resistance and blood flow. But vascular tone could be regulated by modulating the activity of potassium channel directly. Potassium channel openers promote vasodilation by inhibiting the activity of voltage dependent calcium channels and reducing Ca 2+ influx. In this case, inhibition results from membrane hyperpolarisation, which arises due to the stimulation of K + efflux through smooth muscle K + channels. While K + channels are blocked, vasoconstriction could be observed as a result of membrane depolarization, which opens voltage dependent calcium channels. The influx of Ca 2+ can promote smooth muscle contraction by making myosin light chain phosphorylation and arising thick myofilament and thin myofilament relative movements. In this article, the gene structure, current character, Pharmacological and physiological effects of the four subtypes potassium channels are reviewed.

Manual Muscle Testing is a widely used muscle power testing method in rehabilitation practice. Although it's a key content in rehabilitation medicine and rehabilitation therapy, there are some disagreements in lots of books introducing the development and rating system of it. This article reviewed the development of Manual Muscle Testing and different rating systems.

Gastrointestinal neuroendocrine tumor is a group of heterogeneous tumors and was considered as a rare tumor.According to the data of recent years,its incidence has been increased significantly.The clinical manifestations of gastrointestinal neuroendocrine tumors are varied,and serum chromogranin-A is considered the most important biomarker of both non-functioning and functioning neuroendocrine tumors.The traditional imaging examination and somatostatin receptor scintigraphy are helpful to diagnosis.Its treatments include surgery,biological treatment,radionuclide therapy and chemical therapy.The aim of this paper is to summarize briefly the clinical symptoms,diagnostic methods and treatment options of gastrointestinal neuroendocrine tumors.

Biliary atresia(BA) is a destructive inflammatory obliterative cholangiopathy of neonates affecting both intrahepatic and extrahepatic bile ducts.BA is more common in east Asia.Genetic susceptibility,viral infections,and immune dysregulation may be related to BA,but immune dysregulation may play a key hole in the pathogenesis of BA.A current view of the pathogenesis of BA is that it may involve both a primary perinatal hepatobiliary viral infection and a secondary generation of an autoimmune-mediated bile duct epithelial injury.The etiology of BA is unknown,but there is evidence for the involvement of immunologic dysregulation mechanisms,which will be discussed in this review.

Ageing of population is now a phenomenon of the world and has considerable consequences for public services.Ageing is always accompanied with dysfunction of multiple organs,including hypothalamic-pituitaryadrenal axis.Here,we summarized alterations of hormone secretion of adrenal glands in the elderly and their relationships with Alzheimer' s disease.Moreover,we discussed characteristics of pheochromocytoma,primary aldosteronism,and Cushing's syndrome in the elderly.Lack of typical manifestations usually makes difficulty in diagnosis.