Objective To evaluate the efficacy of PGE_1 for the treatment of hyperbilirubinemia due to viral hepatitis.Methods A prospective,randomized,single blind and parallel control clinical study enrolled 100 patients with icterohepatitis,who were randomized 1∶1 to two treatment groups;Each group was intravenously infused daily over a six-week treatment period:(1)200?g of PGE_1 injection;(2)20ml of potassium-magnesium aspartate injection.Results The PGE_1 treated patients were more superior in the recoveries of physical characteristics,icteric index and liver functions to the control group.The statistical difference of the PGE_1 group from the potassium-magnesium aspartate in the treatment of icterohepatitis occurred in the 3rd week of the therapy(P0.05).Conclusion PGE_1 is effective in the treatment of the acute or chronic viral hepatitis and the hyperbilirubinemia caused by early stage severe hepatitis.

Objective To study clinical features and its diagnosis and treatment of alcoholic cirrhosis.Methods 68 cases with alcoholic cirrhosis were retrospectively analyzed,with cirrhosis from hepatitis B as control.Results Alcoholic cirrhosis accounted for 8.5% of in-patient cirrhosis in the correspomding period,mean age being(53.5?14.6),and with more than 135g alcohol intake per day which persisted over 10 years.Such signs significantly increased as dark complexion,liver palms,spider naevi,hepatomegaly,ynecomastia,hypertrophy of parotid gland,?-glutamyltansferase(GGT),ratio of aspartate aminotransferase(AST) to alanine aminotransferase(ALT),mean corpuscular volume(MCV),uric acid(UA),serum ferritin(SF) rose apparently,usually combined with hepatogenic diabetes,peptic ulcer,hyperuricemia,hyperlipemia.Peculiar complication were alcohol withdrawal syndrome,gort,gouty arthritis,aseptic necrosis of femur.Among them,53 cases(77.9%) improved clinically,9 cases(13.2%) showed no effect,6 cases(8.8%) died.Conclusions Occurrence of dark complexion,liver palms,spider naevi,hepatomegaly,ynecomastia,hypertrophy of parotid gland and test of GGT,AST/ALT,MCV,UA,SF are helpful to clinic and differentiation diagnosis of alcoholic cirrhosis,abstinence are not able to prevent its development.Long-term therapy aiming at endotoxin toxemia might improve prognosis of alcoholic cirrhosis.

AIM: To study the expression of laminin and survivin in primary gallbladder carcinoma(PGC),and their correlation with clinicopathologic characteristics of PGC.METHODS: Forty-nine specimens with PGC,21 with cholecystoadenoma and 13 with chronic cholecystitis were included in this study.Laminin and survivin expression in gallbladder tissues were detected by immunohistochemistry.The relationship between laminin or survivin expression and clinico-pathologic data were also analyzed.RESULTS: An intact basement membrane(BM) with well-delineated,smooth and continuous line-like laminin staining was identified in the tissues from chronic cholecystitis,adenoma of gallbladder and gallbladder carcinoma in situ.Submucosal BM,which was interrupted in PGC specimens in NevinⅡstage,was almost lost in tumor tissues in Nevin Ⅲ,Ⅳ and Ⅴ stage.Meanwhile,a distinguishing feature of the tumor tissue was broken or discontinuous line-like laminin staining in the matrix to tumor cells.These lines were detected to be weak,or even entirely absent in some neoplastic tissue sections.Sometimes,a faint cytoplasmic staining of laminin was also found in tumor tissues as classified to Nevin Ⅲ,Ⅳ and Ⅴ stage.Expression of survivin in PGC tissues was significantly higher than that in adenoma of gallbladder and chronic cholecystitis.However,survivin expressions had no specificity and positive predictive value for cell differentiation and grade as well as clinic stage of PGC by using statistical analyses.Furthermore,no correlation was confirmed between the staining features of laminin and survivin expression.CONCLUSION: Laminin expression is strongly associated with the malignancy and invasiveness of PGC,and survivin might play an important synergistic role in the development of PGC.

BACKGROUND: The normal clinical index and the standard error of ultrasonic bone density in the population of normalchildren aged 6-12 years have not yet been established. OBJECTIVE: To investigate the status of ultrasonic bone density in the population of normal children aged 6 to 12 years old in Shenzhen City and establish a normal reference index of ultrasonic bone density of this population. DESIGN: Cross-sectional survey. SETTING: Ultrasound Department of People's Hospital in Longgang District of Shenzhen City. PARTICIPANTS: The volunteers for ultrasonic bone density detection were chosen froma kindergarten, an elementary school and a middle school between March 2002 and April2003. Excluded were those who had bone fracture and received medication of hormone and other drugs within 6months that affected bone metabolism, and menstrual history. Altogether we chose 697 normal children, 367 boys and 330 girls whose age ranged from 6 to 12 years old. METHODS: SAHARA ultrasonic bone density apparatus (the US) was used, and corrected according to the standard body model after the operation began.The error of precision was below 1％ and the error of accuracy was 3％. Bone density of the left heel of the children was detected and body mass (kg) and height (cm) were also measured using the same height and weight scale. MAIN OUTCOME MEASURES: The correlation between bone densityof the heel and sex, age and body mass in the population of normal children aged 6 to 12 years. RESULTS: The normal reference values of bone density in the population from 6 to 12 years old were (0.445±0.166) g/cm2 in 6-year-old group,(0.509±0.151) g/cm2 in 7-year-old group, (0.510±0.133) g/cm2 in 8-year-old group, (0.519±0.132) g/cm2 in 9-year-old group, (0.520±0.153) g/cm2 in 10-year-old group, (0.53±0.175) g/cm2 in 11-year-old, and (0.545±0.206) g/cm2 in 12-year-old group. There were differences in bone density between boys and girls (P ＜ 0.001), and after correction by body mass, the difference disappeared. Bone density of the boys and girls had increasing linear correlation with age (male r=0.722, P ＜ 0.001; female r=0.785, P ＜ 0.001), and had significant relationship with body mass (r=0.984, P ＜ 0.001). CONCLUSION: In normal children aged 6 to 12 years old, bone density of the heel has no association with sex, but has increasing linear correlation with age and significant relationship with body mass.

BACKGROUND:A variety of cel lines participate in the construction of animal models of osteosarcoma. OBJECTIVE:To compare the abilities of subcutaneous tumorigenesis of human osteosarcoma cel lines MG63, U2OS and 143B in nude mice, and to establish the basis for experimental studies on osteosarcoma. METHODS:A total of 18 nude mice were randomly divided into MG63, U2OS and 143B groups. The back of nude mice was subcutaneously injected with MG63, U2OS and 143B cel lines in corresponding groups, and the process of tumorigenesis was observed. RESULTS AND CONCLUSION:MG63 and U2OS could not induce subcutaneous tumorigenesis in nude mice. Tumors were observed after injection with 143B cels for (6±1) days, with the tumor formation rate of 100% (6/6). The tumor grew very fast. The mean volume of tumors was (3 475±1 544) mm3 at 2 months. The survival time of nude mice burdened with tumors was (68±10) days. Hematoxylin-eosin staining revealed that in tumor tissue, cancer cels formed nest shape, nuclei were big and darkly stained, and split mostly. These results suggested that 143B cel line could wel induce subcutaneous tumorigenesis, which could be used for animal research of osteosarcoma.

Objective To assess the methodology of papers on systematic reviews and meta-analysis of interventions published in Journal of Evidence-Based Medicine .Methods Basic data were extracted from 70 papers on systematic reviews and meta-analysis of interventions published in Journal of Evidence-Based Medicinefrom 2001 to 2011 .Methodology used in these papers was assessed according to the AMSTAR Scale.The data were input into the Excelland analyzed using the SPSS7.0 and Meta-Analyst software.Results The methodology used in 34 papers (48.6%) was assessed using the Cochrane bias risk assessment tools.Fund support, number of authors and their affiliated institutions did not sig-nificantly affect the total score of methodology used in the 70 papers .Conclusion The methodology used in papers on systematic reviews and meta-analysis of interventions published in Journal of Evidence-Based Medicine is not quite valid as its early design program and retrieval strategies are imperfect , and it does not provide the excluded literature list and the interest conflict.

Objective To observe the survival rate of free flaps and incidence of vascular crisis following the perforator flap transfer in end-to-side microvascular anastomosis compared with the traditional method and investigate the scientificity and practicability of this scheme.Methods From February, 2012 to October, 2013, 152 cases of free flaps (including superficial illiac circumflex perforator flap, lateral arm flap, peroneal perforator flap, and anterolateral thigh flap) were performed.The end-to-side anastomosis were performed in 72 cases while end-to-end anastomosis in 80 cases;All patients were followed up for 6-24 months.The occurrence of vascular crisis in all cases were observed and recorded.The results of the two groups were conducted statistical analyzed.Results The average anastomosis time for end-to-side anastomosis (21.3 ± 3.8 min) was significantly higher than the end-to-end anastomosis (14.4 ± 3.2 min) (P ＜ 0.05).The incidence of anastomotic vasospasm after end-to-side anastomosis (5.6％) was significantly lower than traditional method (16.3％) (P ＜ 0.05).There was no significant difference in the survival rate of the free flaps between the end-to-side anastomosis group (97.2％) and the traditional group postoperatively (96.3％) (P ＞ 0.05).Conclusion Although anastomosis times were increased in the end-to-side group, this technique showed lower spasm rate and similar flap survival rate.Therefore, this technique is a reliable and technically feasible method and should be considered first as a choice when facing vessel discrepancy and for preserving the recipient artery and vein system.

Objective To study the curative effect and prognosis of malignant pleural effusion treated by staphylotoxoid injection and its effect on immune system.Methods A total of 65 patients with malignant pleural effusion from August 2012 to 2014 November in Lishui City Central Hospital were selected,and divided into observation group(n=33) and control group (n=32) in terms of different treating methods,two groups were implemented with thoracic closed drainage to drain pleural effusion up.The observation group was completely drained after 2 500 U intrapleural injection of staphylotoxoid injection,the control group to the traditonal method of bleomycin 1 mg/kg injection.The efficacy,prognosis and immune system were compared.Results The effective of rate of the observation group was significantly higher(72.7%) than the control group(43.8%);the adverse reaction rate of observation group was lower and its median survival time was longer;white blood cells counts of observation group was significantly more than control group ( P<0.05).Conclusion Compared with the traditional method of bleomycin intrapleural injection treatment of malignant pleural effusion, staphylotoxoid injection can be more effective control of the disease , reduce adverse reactions, and can improve their immunity and improve the body tolerance .

Objective To compare the pharmacological actions of Liandai Tablet(LT) and its main active components on apoptosis of gastric cancer cells and DNA damage. Methods Effects of Liandai Tablet(LT) and its main active components,berberine and indirubin,on growth and apoptosis of gastric cancer cell strain MGC_803 were explored and their effects on DNA damage were also studied. Results LT serum in high and low dosages and berberine could inhibit the growth of MGC_803 as compared with the control group,and typical morphological features of apoptosis were found in the MGC_803 by methyl green pyronin stain assay.But indirubin at various concentrations showed no obvious inhibitory effects. Agarose gel electrophoresis assay revealed that the MGC_803 cell DNA was split into large fragments when treated with berberine. Conclusion LT serum exerts a similar inhibitory effect on the growth and apoptosis of gastric cancer cells as compared with berberine.The effects of LT at various serum concentrations on MGC_803 DNA was less than that of berberine,and indirubin at the given concentration had no this effect.

Objective To evaluate the significance of surgical exploration for the refractory arterial crisis daring the hypersensitive period (48 h to 96 h) after replantation of severed fingers.Methods One hundred and seventy-one patients experienced refractory arterial crisis during the hypersensitive period after replantation of the proximal thumb from February 1995 to February,2005 in our department.Eighty-seven of them were managed with surgical exploration,including incision injury (n=6),saw injury (n=17),rotation and avulsion injury (n=30), and crush injury (n=34).Eighty-four cases received conservative treatment,including incision injury (n=6),saw injury (n=16).rotation and avulsion injury (n=29),and crush injury (n=33).In the surgery group,the e- mergent explorations were performed as soon as the refractory arterial crisis arose,If arterial spasm or/and thrombosis were found,the involved parts were resected before the artery ends were anastomosed or the finger artery was repaired by cubital vein graft.In the other group,conservative managements were carried out by using intramuscular injection of 30 mg Papaverine and intravenous injection of 20,000-unit Urokinase in 20 mL normal saline.If symptums were not alleviated after half an hour,the procedures were repeated.The conservative managements also included abirritative antipsychotics and analgesia of anodyne.Meanwhile,the survival state of all the digital replants was observed. Results In the surgery group,78 fingers survived,the surviving rate being 89.7%.In the conservative group,41 fingers survived with a surviving rate of 48.8%.The difference was statistically significant (P＜0.01).No obvious complications happened in the two groups.Conclusion Since surgical exploration is crucial to management of refractory arterial crisis during the hypersensitive period after replantation of severed fingers,it should not be readily abandoned.