Objective　To study the influence of Lipofundin vs Intralipid on lipid energy metabolism of cirrhotic patients undergoing surgery.Methods　Twenty-five patients with liver disease were randomly assigned to two PN groups:LCT group(n=12) and MC/LCT group (n=13).Fat energy in group LCT was supplied by 20%-Intralipid,Group MCT/LCT was supplied by 20%-Lipofundin.All patients were on parenteral nutrition for 7 days.Intravenous fat tolerance test (IVFTT) was measured at pre-op,post-op d1、post-op d7.Carnitine （CNT） level in serum and urine,and AKBR were tested at the pre-op、post-op d1、d7.Results　The elimination rate of the MCT was faster than that of LCT at pre-op and post-op d7,the elimination rate of LCT at post-op d1 was faster than that of at pre-op and post-op d7.Serum CNT increased in both groups,urine CNT markedly decreasd at postoperation,but in LCT group CNT was at lower level as compared with MCT group at post-op d7,P＜0.05.AKBR was markedly decreased in both groups post-op,but at post-op d7,AKBR in MCT group was higher than in LCT group,P＜0.01.Conclusions　These results indicated that Lipofundin was an ideal energy source for the cirrhotic patients.

Objective To assess the feasibility of the treatment of unresectable late pancreatic cancer with laparoscopic choledochojejunostomy and gastric bypass. Methods From June 2000 to December 2003, laparoscopic choledochojejunostomy and gastric bypass were successfully performed in 15 patients with unresectable late pancreatic cancer. Endoscopic noso biliary drainage (ENBD) was performed before the operation. Results All procedures were completed laparoscopically. Jaundice and hepatic function of the patients were obviously improved after the bypass. Oral nutrition was recovered after operation. The mean operative time was (100?26) min (range 70-200 min); the mean operative blood loss was (60?15) ml (range 30-120 ml); the bowel function recovery was on the 3rd-5th postoperative day; the average hospital stay was (8.1?0.7) days (range 6-13 days). Incision infection ocurred in one patient. No operative complications occurred in other patients. Conclusion Treatment of unresectable late carcinoma of the pancreas with laparoscopic choledochojejunostomy and gastric bypass aided by ENBD is a minimally invasive technique with less postoperative pain,shorter hospital stay, lower procedure related morbidity,and better oral nutrition. The life quality of patients with late pancreatic cancer can be obviously improved.

With the development of implant,more reliable way of the treatment of posterior teeth loss can be acheived.Dental implants present different biological and biomechanical characteristics from natural teeth and natural teeth with crown.It is important to realize these differences and occlusal adjustment accurately for the improvement of the treatment and prolongation of implant service life.This paper re-views the critical point with a clinical case.

Oxymatrine is the main effective monomer of Radix Sophorae flavescentis( Kushen) , which has a variety of pharma-cological actions and valuable clinical applications. Recently, there are many reports about molecular mechanisms of oxymatrine pharmacological actions, giving highly attention to the anti-in-flammatory, anti-fibrosis and antineoplastic effects. These effects are achieved through resisting of oxidation and free radical, anti- ＜br> virus, and affecting the secretion of inflammatory factor and ap-optosis and so on. This article summarizes the reports on the mo-lecular mechanism of the protection on liver, cardiovascular sys-tem, endocrine system and nervous system, hoping to provide theoretical basis for the practical application.

The relationship of the nutritional and colorectal tumor was reviewed.The epidemiology of oral nutrition and colorectal tumor was investigated.The nutritional support in patients with colorectal tumor was discassed.The use of some amino acids and fatty acids might not only improve the hosts nutritional condition,but also serve as methods to treat tumor.

Objective To study the effect of rosiglitazone (RSG), the agonist of peroxisome proliferator activated receptor γ (PPARγ), on the proliferation and differentiation of rat osteoblasts and the related mechanisms. Methods The identification of rat primary osteoblasts was performed by alkaline phosphatase (ALP) staining and mineralized nodules. The 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide (MTT) assay and p-nitrophenyl phosphate (PNPP) assay were used to observe the effects of different concentrations of RSG on proliferation and differentiation of the osteoblasts. The reverse transcription polymerase chain reaction (RT-PCR) were used to detect the expression of connective tissue growth factor (CTGF) mRNA. The effects of the different concentrations (0,1,2,5,10 and 20 μmol/L) of RSG on TGF-β1-induced CTGF mRNA expression in osteoblasts were detected. Results (1)Different concentrations of RSG could not change the proliferation of osteoblasts (P＞0. 05). (2)Compared with control group, all different concentrations of RSG could suppress ALP activity in osteoblasts (P＜0. 01 ). (3) RSG suppressed the osteoblats CTGF mRNA expression induced by TGF-β1 in a dose-dependent manner (P＜0. 01). Conclusions In vitro, RSG can inhibit the TGF-β1 induced rat osteoblasts CTGF mRNA expression. RSG may play a potential role in preventing the differentiation of the rat osteoblasts.

Objective To evaluate the cost-effectiveness of four therapeutic regimes in the treatment of pa-tients with initial vulvovaginal eandidiasis. Methods 160 patients who were found for the first time with vulvovagi-hal eandidiasis were divided into four groups randomly: group A is clotrimazole (500rag) vaginal tablets; group B is fluconazole eaptica;group C is clotrimazole vaginal tablets combined with flueonazole;group D is nystatin vaginal ef-fervescent tablets. Date was evaluated using clinic economies co,t-effectiveness analysis. Results Among four groups,the costs for group A,B,C and D were 167.20 yuan, 190.23 yuan,237.43 ynan and 216.40 yuan,respec-tively. The tatol effective rates were 90.88 %, 90.12 %, 91.67 % and 67.10 %, respectively. The cost-effectiveness ratio were 1.84,2.11,2.59 and 3.23, respectively. The incremental cost-effectiveness ratios of group B, C and D vs group A were 32.90,87.78 and 2.07. Conclusion Regime A was superior than the other therapeutic regimes.

Objective To optimize the extraction process of Ardisia crenata based on the content of total saponins and to provide a basis for the Ardisia crenata study. Methods Based on the results of the single-factor tests and the Box-Behnken central composite experimental design principles, a response surface methodology which has three factors and three levels was designed to optimize the extraction process of Ardisia crenata based on the content of saponins. Results A maximal extraction yield of total saponins reached 2. 29% under the optimal conditions as follows:70% alcohol was used as extraction solvent with the material to liquid ratio of 116, the extraction time was 3 h at 70 ℃. Conclusion The optimized extraction process is accurate, reliable and practically valuable.

Objective To assess the feasibility and clinical effect of hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma.Methods Hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation was performed in 12 patients with advanced pancreatic carcinoma(pancreatic head,10 patients;pancreatic body,2 patients) between February 2002 and August 2004 in this hospital.Results All the operations were successfully accomplished.The operative time was 104~181 min(122?29 min),the operative blood loss was 45~152 ml(60?18 ml),and the length of hospital stay, 6~17 d(8.5?1.3 d).Postoperatively,the jaundice subsided gradually,and the patient's liver functions recovered to normal in 7~10 days.The abdominal pain disappeared in 3 patients and was obviously remitted in 7.Gastrointestinal dysfunction occurred in 2 patients and was cured with symptomatic therapy.Follow-up checkups with CT scannings in 10 patients for 6 months showed partial remission(PR) in 4 patients,no changes(NC) in 4 patients,and progressed disease(PD) in 2.Conclusions Hand-assisted laparoscopic internal drainage combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma is effective and micro-invasive.