Objective To observe the influence of Zhibitai capsule combined with atorvastatin calcium tablet on blood lipid and inflammatory factors in elder patients with dyslipidemia. Methods Sixty-four elder patients with dyslipidemia were randomly divided into control group and treatment group, with 32 cases in each group. Patients of the control group were treated with atorvastatin calcium tablet (10 mg, qd, bedtime administration), while patients in the treatment group were given Zhibitai capsule (240 mg, bid) for 6 weeks. Serum levels of TC, TG, HDL-C, LDL-C, tumor necrosis factor-alpha ( TNF-α) and interleukin-6 (IL-6) were measured before and after treatment. Results After treatment, compared with the control group, TC [(5. 18±0. 57) mmol·L-1 vs. (5. 73±0. 65)mmol·L-1], TG [(1. 52±0. 43) mmol·L-1 vs. (1. 86±0. 48) mmol·L-1], LDL-C [(3. 36±0. 48) mmol·L-1 vs. (3. 85±0. 53)mmol·L-1], TNF-α[(5. 37±2. 21) ng·L-1 vs. (7. 63±2. 59) ng·L-1] and IL-6 [(12.27±2.75) ng·L-1 vs. (15. 63±2. 92) ng·L-1] were significantly decreased (P<0. 01 for all); however, HDL-C [(1. 26±0. 25) mmol·L-1 vs. (1. 13±0. 23) mmol·L-1] was significantly increased in the patients of treatment group (P<0. 05). Conclusion Zhibitai capsule combined with atorvastatin calcium tablet may not only regulate blood lipid level, but also decrease serum tumor necrosis factor-alpha and interleukin-6 so as to inhibit inflammation reaction in elder patients with dyslipidemia.

Peritoneal carcinomatosis after operation is a major cause of treatment failure in gastric cancer with few options for treatment.Preoperative intraperitoneal chemotherapy seems to be an effective therapy for maximal containment of the malignant process of gastric cancer.Thus we reviewed the background,clinical efficacy a,drug selection,other issues of the infusion chemo theropy.

To study the diagnosis of pulmonary stenosis (PS) in patients with the secundum atrial septal defects(ASD) by the measurement of maximal velocity through pulmonary valve (Vpv max ). There were 98 cases with secundum ASD, and 27 cases with secundum ASD and PS diagnosed by echocardiography(TTE). All the cases with secundum ASD were confirmed by surgery. The diagnosis of 19 cases out of 27 cases as diagnosed by TTE were confirmed by surgery, and the other 8 cases were simple secundum ASD. These results suggested that the two dimensional echocardiography and Vpv max should be utilized in order to achieve a better diagnostic accuracy in the diagnosis of PS in the patients with ASD, and PS should be considered if the Vpv max increased to 2 65 to 3 25m/s.

Objective To compare and analyze the effect of laparoscopic surgery and open toperation of rectal can﹣cer in middle or lower positions. Methods 128 patients with middle or lower rectal cancer were randomly divided into observation group and control group, 64 cases in each one, Laparoscopic surgery for observation group and con﹣trol group using traditional open surgery. Operative time, blood loss, ambulation time, length of stay, postoperative complications, anus-preserving, the recurrence during follow-up were compared between the two groups. Results Blood loss, ambulation time, length of hospital stay, the observation group were significantly less than the control group (P< 0.05), operation time between the two groups have no obvious differences (P> 0.05). Nine patients in control group with complications, the rate was 14.1 %; postoperative complication were observed in 2 cases, the rate was 3.1 %; complication rate in observation group was significantly lower than the control group (P< 0.05). Anus-preserving rate was significantly higher in the observation group (P<0.05);followed up for 8-47 months with an av﹣erage follow-up (23.1 ± 6.4) months, relapse rates of the two groups have no significant difference (P> 0.05). Con﹣clusions Compared with open operation,laparoscopic surgery is safe and effective, can reduce the surgical trauma and complications, shorten hospitalization time, improve the anus-preserving rate, worth clinical promotion.

Objective To improve the diagnosis and treatment of renal mucinous spindle cell carcinoma,and the knowledge of the type of kidney cancer.Methods The clinical date of 1 case of renal MTSCCa was reported.The case of patient was a 38-year-old women with abdominal discomfort and hematuresis.Ultrasound tip:the upper pole of the right kidney mixed echo placeholder,tumor and the surrounding is obvious blood flow signal.CT revealed a low density shadow in the upper pole of the right kidney,involving the right renal vein,partial filling defect,visible in the inferior vena cava are visible low density shadow,uneven enhancement after the reinforcement,and has delayed reinforcement.MRI shows:the upper pole of the right kidney huge soft tissue mass,T1WI shows low signal,T2WI show slightly higher signal,uneven enhancement and have delayed reinforcement.Preoperative diagnosis:right renal clear cell carcinoma with right renal vein and inferior vena cava tumor emboli.With kidney cancer radical resection and take out inferior vena cava tumor emboli,in the operation right kidney tumor,about 10 cm × 20 cm,right renal vein and inferior vena cava tumor emboli in formation,inferior vena cava tumor emboli within about 8 cm,the clinical and pathologic feature was analyzed and discussed with litcrature review.Results The operation smoothly.Pathological findings suggested higher grade mucinous tubular and spindle cell carcinoma;microscopically a large number of ingredients mixed bundle arrangement of spindle cells,nuclear fission as easy to see.Immunohistochemical staining:Vimentin ±,Syn +,NSE +,CD99 +,Ki-67 + 70％.According to the 2010 AJCC for kidney cancer TNM staging,the pathological pT3c N0M0.According to the Robson stage]].The patient reserved interferonα-2a associate with interleukin-2 theraph after a month.During treatment in patients with fever and other flu symptoms,weekly review of routine blood,liver and kidney function has no obvious abnormalities.The patient died of pulmonary embolism,liver,lung multiple metastases two months later.Conclusions Renal mucinous tubular and spindle cell carcinoma is a rare cell types in the kidney pathological classification,women in high incidence,higher pathological types,worse prognosis.

Objective To explore the usage of anatomic al M-mode echocardiography in observing pulmonary artery motion curve of pulmonary hypertension patients.Methods The subjects included 21 pulmonary hypertension patients complicated with tricuspid valve insufficiency, and 21 controls whose age and gender matched with the patient group. The inner diameter of main pulmonary artery and right atrium, acceleration time of pulmonary valve Doppler signal and maximum velocity of tricuspid insufficiency (ACTpv) were measured during routine echo examination. From the maximum velocity of tricuspid insufficiency the pulmonary artery systolic pressure (PASP) was calculated. The pulmonary artery motion curve and pulsating amplitude of pulmonary artery wall (PAWPA) was observed and measured with a home-made anatomical M-mode echocardiography with instrument. Results PAWPA in the patient group was lower, and simultaneously complicated with broader pulmonary artery, larger right atrium and shorter ACTpv in comparison with normal group (all P

The current mental health of college students can not be optimistic.This paper summarized college students' psychological crisis from the perspectives of psychological crisis and crisis intervention,came up with updated research outcomes and deficiencies,and pointed out the direction of its future research and development.

Objective To review and sum up the clinicopathologic features and surgical therapeutic efficacy of intrathoracic Castleman′s disease (CD). Methods 14 patients with intrathoracic Castleman′s disease, 7 in each sex, aged from 19 to 52, admitted during 1982 to 2005, all underwent surgical treatment, among which 11 with localized type and 3 with multicentric type, were retrospective analyzed on their clinicopathologic features, radiological signs, treatment and prognosis. Results Clinically, 3 patients of localized type were with systematic symptoms; all the patients of multicentric type were with various severity systematic symptoms. Pathological type: 9 cases with hyaline vascular type (HV), 2 cases with Plasma type (PC), and 3 cases with Mixed type (Mix). A different pattern of pathologic alterations existed between HV、PC and Mix types of CD. Radiological features: in localized type of CD, the lesion presented as a solitary soft-tissue mass with a mean diameter of 5.05cm, the mean CT value was 37.39HU. In 3 cases with multicentric type of CD, diffuse mediastinal lymphadenopathy and pleural effusion were observed. All patients survived after surgical resection, long-term survival was achieved in 11 cases with localized type and 2 cases with multicentric type, no recurrence occurred in the 13 patients. Recurrence occurred twice in a patient with multicentric Mix type in the fourth and the ninth year after surgery, respectively, thus the operative treatment followed. Conclusions The diagnosis of CD is based mainly on its histopathological features. The patients with intrathoracic localized type of CD and part of the patients with multicentric type CD could be cured, while part of the patients with multicentric type CD got a poor therapeutic efficacy and unfavorable prognosis even underwent with radiotherapy and integrated treatment.

Objective:To investigate the changes of circulating tumor cells in locally advanced esophageal squamous cell carcinoma pa-tients treated with concurrent chemoradiotherapy. The effect of these alterations on the patients’prognosis was also analyzed. Meth-ods:Circulating tumor cells were detected by immunomagnetic enrichment and fluorescence in 48 cases of locally advanced esopha-geal carcinoma patients treated with concurrent chemoradiotherapy. The dynamic changes of circulating tumor cells were compared between pre-and post-chemoradiotherapy. Moreover, the association of these changes with the clinical characteristics and two-year survival rate were analyzed. Results:The positive rate of circulating tumor cells was closely associated with the T stage, lymph node metastasis, and clinical stage (P<0.05), and the positive rates in pre-and post-chemoradiotherapy were 52.1%(25/48) and 20.8%(10/48), respectively. The difference was statistically significant (P<0.05). Kaplan-Meier analysis showed that the positive rate of circulating tumor cells predicted an adverse two-year survival rate in both pre-and post-chemoradiotherapy (P<0.05). Cox regression analysis showed that the clinical stage and circulating tumor cells after concurrent chemoradiotherapy were independent prognostic factors in the patients with esophageal carcinoma. Conclusion:Circulating tumor cells can reflect the disease progression in patients with locally advanced esophageal cancer. These cells can also predict the prognosis of esophageal cancer patients treated with concurrent chemo-radiotherapy.

BACKGROUND:Studies have shown that chitosan and other natural polysaccharides have heparin-like anticoagulant function after sulfonated modification. Sulfonated chitosan has good anticoagulant property because the sulfonate group formed by sulfonated chitosan is similar with the active group of heparin. OBJECTIVE: To prepare the anticoagulant chitosan nanoparticles and to detect its morphology, physical and chemical properties and biological security. METHODS: Chitosan nanoparticles were synthesized by emulsion-chemical cross link. Sulfonated chitosan nanoparticles were synthesized by sulfonation reaction. Its morphology was described by transmission electron microscope. The peak-value change of its specific groups was observed by infrared spectroscopy. (1) Coagulation experiment: Heparin, chitosan nanoparticles and 10, 30 and 50 mg of sulfonated chitosan nanoparticles were added into the blood of Spraque-Dawley rats. The coagulation indicators were detected. (2) Hemolysis experiment: deionized water, physiological saline and 10, 30, 50 g/L sulfonated chitosan nanoparticles extracts were added into 2% red blood cel suspension of rabbits. The hemolysis rate was detected. (3) Cytotoxicity experiments: DMEM medium containing fetal bovine serum and 10, 30, 50 g/L sulfonated chitosan nanoparticle extracts were used to culture human umbilical vein endothelial cels. Cel relative growth rate and toxicity grading were detected after 72 hours. RESULTS AND CONCLUSION: Scanning electron microscopy showed that sulfonated chitosan nanoparticles had good morphology, with a diameter of 50 nm. Infrared spectroscopy showed that the sulfonated replacement occurred.In vitro coagulation experiments showed that sulfonated chitosan nanoparticles had significant anticoagulant effects in a dose-dependent manner. Sulfonated chitosan nanoparticles meet the national safety standard for hemolysis rate of less than 5%, non-induced hemolysis property. Cytotoxicity assays showed that sulfonated chitosan nanoparticles extracts had no significant cytotoxicity, and its biological safety was in line with the national standards.