ObjectiveTo determine the diurnal variation,moon phase,and seasonal variation in the onset of stroke. MethodsThe time parameters,including the time,the moon phase and the season of the stroke occurrence for 905 in-patients from 1989-2001 were investigated.ResultsThere was a significant difference (D=0.155,P<0.01) for circadian rhythm in the onset of 321 cases with cerebral infarction,and the incidence frequency at dawn was much higher than that at other time,but the difference of the moon phase and seasonal rhythm in the onset of cerebral infarction were not significant(P>0.05).There were not diurnal variation,moon phase and seasonal rhythms in the onset for cerebral haemorrhage(P>0.05).ConclusionsThe cerebral infarction occur more frequently at dawn time.

Toll like receptors(TLRs) , a pattern conservative receptor superfamily are found on mammalian cell surface over the last decade. TLRs recognize distinct pathogen - associated molecular patterns, which can lead not only to the responses of the innate immunity but also to the development of the antigenspecific adaptive immunity. The expression of TLRs have changed in some carcinomas, besides, microbial composition and drugs mediate the tumor immunotherapy by the way of TLRs signal transduction. Consequently , deep studies on TLRs will provide new approaches for tumor immunotherapy.

Tumor marker is a hot subject of research in oncology field,which would promote the diagnosis and treatment in clinic.Tumor markers of children's germ cell tumor include α-fetoprotein,glypican 3,SALL4,glial cell line-derived neurotropic factor receptorα-1(GFRα-1),Ki-67,octamer-binding transcription factor4,CD117,D2-40 and CD30.SALL4 would be used as a new tumor marker for germ cell tumor,specially for yolk sac tumor.GFRα-1 can be helpful for the diagnosis of immature teratoma.

Scirrhous gastric carcinoma is a special type of gastric carcinomas and accompanied with highly interstitial fibrosis and diffuse cellular infiltration.Scirrhous gastric carcinoma is mainly composed of poor-differentiated adenocarcinoma and signet-ring cell carcinoma,with the clinical features of Borramann 4,thickening and stenosis of stomach wall,high peritoneal and lymph node metastases rates and poor prognosis.R0 resection and postoperative chemotherapy with S-1 as a main way are necessary for the patients who are able to undergo curable resection.The palliative operation should be applied to patients with ileus and urinary obstructions caused by peritoneal metastasis because of limited effect of surgical treatment.Chemotherapy is the best choice for patients who are not able to undergo curable resection,conversional therapy can improve the prognosis of patients,and preoperative S-1/CDDP combination chemotherapy is an expectable therapy.Moreover,controlling peritoneal metastasis and effect of intraperitoneal chemotherapy are much anticipated.The efficiency of molecular targeted therapy by bevacizumab and gene therapy by adenovirus remain further study.

Statins are a class of cholesterol-lowering drugs for effectively reducing the risk of cardiovascular events,including myocardial infarction and stroke.Clinical trials and meta-analyses have shown that the treatment with statins may increase the risk of new-onset diabetes mellitus.This article reviews the evidence of statins inducing diabetes mellitus,the possible mechanisms,and clinical significance.

Scirrhous gastric carcinoma is a special type of advanced gastric cancer accompanied by extensive interstitial fibrosis and diffuse cellular infiltration. Scirrhous gastric carcinomas are commonly classified as Borrmann 4 gastric carcinomas. Poorly differ-entiated adenocarcinoma and gastric signet ring cell carcinoma are observed during histologic typing. Thickening of the stomach and stenosis are characteristic of scirrhous gastric carcinomas. The prognosis of this type of gastric cancer is poor because of the likelihood of peritoneal metastasis and lymph node metastasis and the limited cure rates of simple surgery. However, operation should be conduct-ed when scirrhous gastric carcinomas are associated with ileus and urinary obstruction induced by peritoneal metastasis. R0 resection and postsurgical chemotherapy with S-1 are necessary for patients who are able to undergo recoverable operations. Preoperative S-1/CDDP combination chemotherapy is the preferred therapy. Moreover, chemotherapy is the best choice for patients who are unable to un-dergo recoverable surgery. Intraperitoneal chemotherapy is practical for controlling the behavior of scirrhous gastric carcinomas, partic-ularly peritoneal metastasis. Moreover, the efficiency of molecular-targeted therapy using bevacizumab and gene therapy through adeno-virus gene therapy still requires further study.

Resection of the automonic nervous system in the process of lymph nodes dissection is a major factor leading to postoperative gastrointestinal dysfunction.The era of blind expansion of the wide excision has been questioned,and safety first,radical dissection of the metastatic lymph nodes,low invasive rate and organ function-saving surgery have been highly emphasized.Preserving the gastric autonomic nerve effectively reduces postoperative diarrhea,shortens the time for weight recovery,and prevents insulin secretion disorders and postoperative cholelithiasis.In the process of laparoscopic or open autonomic nerve preservation in lymph node dissection for gastric cancer,full understanding of the anatomy of the autonomic nervous system,recognizing the landmark of the nerves,proper designing the surgical space,dissecting according to the extracellular space in the membrane of the nerve fibers and nerve plexus are factors which ensures the quality and effects of the surgery.

Objective To study the effect of optimized disposition of surgical instrument packages on nurses’efficiency. Methods 200 cases of surgeries were randomized equally into an experiment group and a control group: the former used optimized disposition of surgical instrument packages and the control group convention surgical instruments package.The two groups were compared in terms of time for counting the instruments and recirculation treatment of postoperative apparatus as well as the effect of the packages on the operation space for nurses.Results The time for counting the instruments and recirculation treatment of postoperative apparatus in the experiment group was significantly shorter than those in the control group(both P<0.01).The weight,volume and space of the packages in the experiment group were significantly smaller than those in the control group(all P<0.01).Conclusion The optimized disposition of surgical instrument package may shorten the nursing operation time,reduce consumption of energy, improve the operational settings and increase the working efficiency.

This paper is to report the results of comprehensive treatment for 78 patients with severe viral hepatitis(SVH). The overall survival rate was 39.74%, and the survival rates of subacute and chronic SVH were 48.39% and 34.04% respectively. Compared with the survival rate of 10-30% reported abroad and 27.9% of our previous report, the survival rate after comprehensive therapy was slightly improved.After analyzing the results, the authors suggest that besides early diagnosis, prompt treatment, intensive basic treatment, and energetic prevention ' and treatment of the complications, further exploration for new and effective therapeutic agents be of prime importance to improve the survival rate of SVH.

This is a preliminary report using APPLE I type microcomputer to diagnose the nature of intra-cranial tumor (ICT). A computer program was made. All clinical data of 520 cases of intracranial tumors proved by operation and pathology were put into the computer for analysis. The cases were di vided into two groups: the 1st 120 cases were used to make a stepwise regression analysis to get a multiple linear regression equation; and the 2nd 400 cases were tested to prove the reliability of the e quation and diagnose the nature of ICT. The reliability was 85.6%.From the preliminary study, the formula that was derived for clinical purpose to evaluate the nature of ICT depends upon 7 dependent variables. It may be a supplement to evaluate the nature of ICT in early stage.