Tumor metastasis, the main characteristic and important indication of malignant tumor, is also the primary cause of death for most cancer patients. The tumor metastasis is a multistep process involving various factors, multiple interactions of many genes as well as the microenvironment. To investigate the mechanism of tumor metastasis will help us understand the essences of metastasis process, therefore exploring molecular targets for clinical diagnosis and treatment of cancer.

Objective To study the indication and the feasibility of laparoscopic cholecystectomy (LC) combined with laparoscopic appendectomy (LA). Methods Following routine LC under general anasthesia,a dissecting forceps was introduced from the 10 mm trocar on the right McBurney point.The appendix was excised outside the abdomen,or removed by using an electrotome after the mesoappendix and the appendix root were dipped. Results The operation time was 29～76 min (mean, 48 min) and the length of hospital stay was 2～7 days(mean,3 days).Complications occurred in 3 cases: 1 case of transection of the common bile duct, 1 case of appendicular artery bleeding, and 1 case of right lower abdominal pain with unknown causes. Conclusions LC combined with LA is feasible and applicable to cholecystic benign diseases accompanying simple or suppurative appendicitis.

This article was aimed to discuss the mechanism of lactulose enema therapy to improve efficiency among maintenance hemodialysis (MHD) patients with uremic pruritus (UP) from the intervention of parathyroid hormone (PTH) and micro-inflammation state. A total of 60 cases of chronic kidney disease (CKD) stage 5, MHD patients with UP were randomly divided into 3 groups according to different intervention methods, which were the control group, loratadine and lactulose group. The integration of kidney disease treatment was adopted in the control group. In the loratadine group, on the basis of the control group medication, oral administration of loratadine, 10 mg/time, once a day, was combined. In the lactulose group, on the basis of the control group medication, lactulose enema, 30 mg/time, twice a day, was combined for 30 days. The pretreatment and posttreatment clinical curative effects were e-valuated among patients from 3 groups. Observation was also made on their itchy visual analogue scale (VAS) and serum PTH, high-sensitivity c-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) lev-el, respectively. The results showed that there were significant improvements on VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) before and after treatment (P< 0.05 or P< 0.01). Compared to the control group, the posttreatment clinical total curative effects were significantly increased in both the loratadine group and lactulose group (P< 0.05); VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) were significantly decreased (P< 0.05). There was no statistical difference of indexes mentioned above in the loratadine group and lactulose group. It was concluded that lactulose enema therapy improve PTH and micro-inflammation state among MHD patients with UP. It is one of the mechanisms to relieve skin itching.

Objective To observe the intervention effect of different compatibility of aconite and peony in Zhenwu Decoction on experimental nephritis in rats, and explore the connotation of suitable fire and evil fire. Methods Sixty experimental rats were randomly divided into blank group, model group, valsartan group, high aconite and low peony group, aconite and peony equivalent group, low aconite and high peony group. All rats except the blank group were made glomerulonephritis model by tail vein injection of monoclonal antibody 1-22-3. Rats were gived continuous gavage administration (blank group and model group were lavaged with NS) after modeling, and killed 2 weeks later. The morphological change of kidney tissues and serum hs-CRP, TNF-α, IL-6 levels were observed. Results The valsartan group, aconite and peony equivalent group, low aconite and high peony group inhibited the rats mesangial cell proliferation and extracellular matrix expansion significantly, so as the level of hs-CRP, TNF-αand IL-6. The effect of aconite and peony equivalent group was better than low aconite and high peony group, but inferior to valsartan group, while high aconite and low peony group accelerated the progress of the disease. Conclusion The different compatibility of aconite and peony in Zhenwu Decoction has resistance and proinflammatory effect on renal inflammation.

Objective]To research the regulation of L-type calcium channels by Xuanfu Daizhe soup in the lower esophageal sphincter(LES) smooth muscle of rabbit reflux esophagitis model induced by mixed perfusion of hydrochloric acid and bile. [Methods]Established the rabbit model of mixed reflux esophagitis, nifedipine was used to block L-type calcium channel.The muscle tension of L-type calcium channel were compared among groups in the experiments. [Results]The calcium releasing and flowing phase of LES in the model group was higher than that in the normal group, the whole recipe group, sweet-scending group, the getting rid of bitter-reducing group and the getting rid of lifting and declining group( P<0.01). There was no significant difference between the model group and bitter-reducing group, the lifting and declining group and the getting rid of sweet-ascending group( P>0.05). There was no significant difference between the normal group and the whole recipe group in calcium releasing and flowing phase of LES( P>0.05). [Conclusion]The decreasing of reflux esophagitis model LES tension was relevant with the L-type calcium channel dysfunction;Xuanfu Daizhe soup could improve the LES tension by regulating L-type calcium channels. The sweet-ascending group had a remarkable effect among those dismantle prescription groups.

Objective To compare the effect between computer assisted navigation total knee replacement and conventional total knee replacement on rotation alignment,mechanical axes,comPOnent position and clinical outcomes.Methods Eighty-two patients were recruited into this pmspoctive study according to entry criteria and were randomly selected into either control group which treated with standard knee replacements or navigation assisted group which operated with navigation assisted total knee replacements.To analyze the rotation of the femoral component and the tibial component in the transverse plane.the combined rotation of both components and mismatch between two components,the mechanical axes,which were measured from postoperative radiographs and computed tomography images.To compare the functional outcomes at 6 weeks and 6 months.Results There were significant diffefences(P＜0.05)in following parameters between control group and navigation assisted group:average rotation of femoral component were 1.51°±3.55°in control group and-0.63°±3.04°in navigation assisted group,the combined rotation of both components were 2.85°±4.07°in control group and 0.28°±3.43°in navigation assisted group,mismatch between components were 1.44°±4.55°in conlrol group and-0.43°±2.86°in navigation assisted group.There were no significant differences between two groups in rotation of tibial component.In addition,analysis showed that patients in navigation assisted group had significantly better mechanical axes and functional outcomes at 6 weeks.Conclusion The use of navigation can help avoid malrotation and errors in axial rotation,and provides improved alignment accuracy as well as better functional outcomes at 6 weeks.

Objective To evaluate intra-arterial catheter directed thrombolysis in combination with artery angioplasty for chronic long superficial femoral artery occlusion.Methods Clinical data were reviewed on patients of chronic long superficial femoral artery occlusion treated by endovascular therapy from September 2010 to September 2012.In 19 patients,catheter-directed thrombolysis was initially carried out,which was followed by endovascular angioplasty balloon dilatation or stent placement.The other 37 patients were treated by upfront endovascular angioplasty balloon dilatation or stent placement.Results In the thrombolysis group,the occluded length of the artery before and after thrombolysis was (16 ± 5) mm and (10 ± 6) mm(t =3.598,P ＜ 0.05).The length and the number of stents used in thrombolysis group was lower than stent group [(10±5) cm、(1.6±0.8) vs.(12±4) cm、(2.1 ±0.7),t=2.102,P＜0.05].There were no significant difference in primary patency rate assisted,primary patency rate and secondary patency rate between thrombolysis group and stent group.Conclusions For patients of chronic long superficial femoral artery occlusion,a successful catheter directed thrombolysis with artery angioplasty reduces the number of stents for angioplasty.

Objective To provide a method for identifying the seeds of Astragalus membranaceus var.mongholicus(AMM) and A.membranaceus(AM) and to provide basic research data for establishing relevant Standard Operating Practice(SOP) in accordance with GAP of traditional Chinese medicinal materials.Methods The seed morphologic characteristics and microcosmic structures were observed by eyes,light microscopes,and electron microscopes;the seed germination rates of AMM and AM were also compared.Results There was no obvious discrimination of the seed morphology between AMM and AM.There was obvious discrimination on the characteristic of germination-hole,the microcosmic structures of seed-umbilici and seed-coats of seeds between AMM and AM.The hard seed percentage for AMM was higher than that of AM,and its sprouting was not even and sprouting peak appeared later than that of AM.(Conclusion) The seeds of AMM and AM can be identified accuratly with electron microscopes.The patterns of germination-hole,microcosmic structures of seed-umbilici and seed-coats can be used as indices to identify the seeds of AMM and AM.The hard seed percentage and germination characteristics can be used to(identify) the seeds of AMM and AM subsidiarily.

Objective To compare the dosimetric differences of permanent prostate braehytherapy utilizing 131Cs,125 I and 103 Pd seeds.Methods Twenty-five patients with T1-T2c prostate cancer who had previously implanted with 125I seeds were randomly selected in our study.The patients were re-planned with 131 Cs,125 I and 103 Pd seeds by using the Prowess Brachytherpay 3.1 planning system to the prescription doses of 115 Gy,145 Gy and 125 Gy,respectively.The seed strengths were 1.8 U,0.5 U and 1.8 U,respeetively. The prostate,prostatic urethra and anterior wall of the rectum were contoured on trans-rectal ultrasound ima ges.PTV was outlined based on the prostate volume with no margin applied.The attempted planning goals were that V100(tbe percentage volume of the prostate receiving at least 100% of the prescription doses)= 95%,D90 (the minimum percentage dose covering 90% of the prostate volume) ≥100% ,and prostatic ure thra UD10 (the maximum percentage dose receiving by 10% of the contoured urethra)≤150%.For the plan comparison,we also computed prostate V150,prostatic urethra UV120,rectum RV100,and the number of implan ted seeds and needles.The significance of the differences was tested using one way analysis of variance. Results The average V200 in the 103pd,125 I and 131 Cs plans were 28.7% ,20.9% and 19.6% (F=42.50, P =0.000) ;the average V150 were 51.9% ,42.1% and 39.4% (F=26.15,P =0.000) ;the average UV120 were 26.9% ,29.5% and 23.8% (F = 0.37,P =0.691) ; and the average rectum RV100 were 0.31 cm3, 0.22 cm3 and 0.19 cm3(F=0.43,P=0.652).For 103 Pd,124 I and 131 Cs,the average number of implanted seeds per cm3 prostate were 2.02,2.01 and 1.87(F = 1.92 ,P =0.154) ,and the average number of needles were 33.6,32.9 and 31.6(F=0.26,P=0.772). Conclusions Comparing to 124 I and 103 pd seeds used in permanent prostate brachytherapy ,131 Cs seeds has better dose homogeneity,and possible better sparing of the urethra and rectum,with comparable or less implanted seeds and needles.

This study was aimed to reveal the relationship of bronchioloalveolar carcinoma (BAC) syndromes and metastasis, in order to provide new scientific basis for syndrome differentiation, treatment and prognostic assessment, which proved the scientificity and feasibility of internal and external inspection. A total of 60 BAC cases were divid-ed into two groups according to the syndrome of deficiency and excess. Another 30 cases of benign pulmonary nod-ules were simultaneous collected in the physical examination as control group. The quality of life (FACT-L) was scored one day before operation for patients in each group. The thoracoscopic technique was used in the biopsy of targeted tissues, in order to reveal indicators related with metastasis. The results showed that the comparison of FACT-L score of patients from two syndromes of BAC and that of the control group indicated that the score of physi-ological state, social/family condition, emotional condition, functional situation, additional situation and total score of the previous one were obviously higher than the latter one (P < 0.01). And the score of patients in the deficiency syndrome group was higher than that of the excess group with statistical significance (P< 0.01). The comparison be-tween the tumor tissues of patients from two syndromes of BAC and the benign pulmonary nodules showed that the VEGF, MMP-2, MMP-9 of the previous one were higher than the latter one (P< 0.01). The comparison between two syndromes showed that all indexes of the deficiency syndrome were higher than the excess syndrome (P < 0.01). It was concluded that syndromes of BAC was related with metastasis.