Gastroesophageal variceal bleeding is one of the major causes of death for patients with portal hypertension.The treatment of portal hypertension has evolved from surgery being the only option to the wide range of options currently available,including endoscopic sclerotherapy of varietals ligation,interventional radiology and surgery.Given the shortage of liver transplantation donors,devascularization would be one of the major treatments for portal hypertension for a considerable time.Based on the clinical experience of the People's Hospital of Peking University,we think that peraesophagogastric devascularization without splenectomy is a better option for the treatment of portal hypertension,with less operation time,less intraoperative blood loss and fewer postoperative complications,and better short-and long-term hemostatic effect.

Liver transplantation is the only curative treatment for cirrhotic portal hypertension, especially for the patients with end-stage liver failure. In the era of liver transplantation, when drugs, endoscopy and interventional treatments fail, surgery (not including liver transplantation) is an irreplaceable treatment option for esophagogastric variceal bleeding, which should be individualized, in order not to increase the risk and difficulty of liver transplantation in the future.

Objective To evaluate the safety and efficacy and explore the clinical application value of the enhancement controlla-ble output channel narrowed ileal bladder suspension surgery and traditional ileal neobladder after total cystectomy.Methods From January 2001 to August 2009,42 patients with bladder cancer received enhancement controllable output channel narrowed ileal blad-der suspension surgery after total cystectomy;and 46 patients received ileal neobladder after total cystectomy.Their clinical data, perioperative situation,postoperative complications and tumor progress were analyzed.Results In regard to the blood loss,postop-erative hospital stay,and postoperative recent or far complications,both surgical methods had no significant statistical difference (P >0.05).The group of Enhanced controllable output channel narrowing ileal bladder suspension surgery was good control of uri-nation after operation(P <0.05).Conclusion Enhancement controllable output channel narrowed ileal bladder suspension surgery has good clinical effect and safety.It is especially suitable for the patients who need control inurine and don′t accepted orthotopic neobladder.

Objective To investigate the application of ~(18)F-fluorodeoxyglucose hybrid PET/CT (~(18)F-FDG hPET/CT) imaging in clinical staging of non-small cell lung cancer (NSCLC). Methods Seventy two consecutive patients with NSCLC undergoing ~(18)F-FDG hPET/CT before radiotherapy were analyzed. The results were compared with previous CT scan and conventional clinical staging. The patients were followed-up for at least 6 months. Results Among the 72 patients, the staging grade was changed in 27 patients due to the result of ~(18)F-FDG hPET/CT in whom with 20 patients having their grade raised and 7 lowered. Radical treatment was changed to palliative treatment in view of a raise of staging grade. Because of distant metastasis was detected by ~(18)F-FDG hPET/CT imaging, 14 patients received palliative treatment. Compared with CT, 47 more lymph nodes and 26 distant metastases were found with ~(18)F-FDG hPET/CT imaging, and the patients in question received radiotherapy and palliative treatment accordingly. Conclusion ~(18)F-FDG hPET/CT imaging, by changing the clinical staging in 37.5% (27/72) NSCLC patients, has impact on treatment strategy and treatment planning of radiotherapy in NSCLC patients. Patients were frequently spared unnecessary treatment, and management was more appropriately targeted.

Objective To investigate the effects of Huangqi on the activity of enzyme,in brain mitochondria after brain trauma in rats.Methods The models of laceration of brain incluced by free falling were set up.The Huangqi was intraperitoneally injected immediately after brain trauma. The mitochondria were isolated at 4 h,24 h and 48 h after treatment respectively while the activity of ATPase and SOD and the content of MDA were measured by biochemical technique.Results Activity of ATPase( P

Objective To study the correlation between maternal serum 25‐OH‐VitD concentration and early‐onset severe pre‐eclampsia(EOSPE) .Methods 5 000 early singleton pregnancy women with gestational age 8-12+6 weeks and without any compli‐cations in the outpatient department of the hospital from January 2013 to January 2015 were enrolled in the study .The levels of ser‐um 25‐OH‐VitD were measured by using chemiluminescence method .Only 2 988 women with Vitamin D deficiency went through regular prenatal care and delivery .The 2 988 women were divided into two groups intervention group and non intervention group whose age ,BMI and gestation age were matched .Intervention group(n=1 490) received vitamin D supplementation ,the non inter‐vention group did not received the supplementation .Those patients who developed EOSPE were counted .Finally ,Patients diagnosed with EOSPE and were Vitamin D deficient(n=118) were divided into two groups late intervention group and non late intervention group .The late intervention group were treated with vitamin D supplementation ,The non late intervention group were only treated routinely .Results Patients with Vitamin D deficiency accounted for 63% ,insufficiency 32% ,normal 5% .The levels of serum 25‐OH‐VitD and VEGF in patients with EOSPE were significantly lower than those in normal control group(P<0 .05) .The occur‐rence rate of EOSPE in 2 988 women was 4 .1% (123 women) .The occurrence rate of EOSPE in intervention group and no interven‐tion group were 2% (30/1 490) and 6% (93/1 498) respectively ,which were statistically different(P<0 .05) .The outcome of ma‐ternal and perinatal infant in late intervention group were not significantly different from those in non late intervention group .Con‐clusion Vitamin D deficiency or insufficiency is a common problem in early pregnant women .The risk of EOSPE increases in early pregnant women with Vitamin D deficiency .Vitamin D supplementation in the first trimester in women with Vitamin D deficiency could significantly decrease the occurrence rate of EOSPE .Vitamin D supplementation in women diagnosed with EOSPE could not change the outcome of maternal and perinatal complications .

Objective To discuss about the establishment of mental depression model by traumatic brain injury in rats,and to evaluate the validity of this model.Methods The study was carried out in the experiment center of Wuhan University.A total of 48 male adult Wistar rats were randomized ( random number) into four groups ( n =12,each):( 1 ) in sham operation group,six rats were fed normally in one cage; (2) in model group,the model of the left frontal lobe contusion was made up by hitting with free-fall method on the left cortex of the rat,and subsequently the each of model rats were separately fed in a cage and put them in a lonely environment with chronic stress one week after traumatic brain injury in order to induce them into models of mental depression; ( 3 ) in brain trauma group,the trauma model of the left frontal lobe contusion was set up by the same procedure as in model group,and six rats were fed together in one cage; (4) in CUMS group,each rat was fed normally in one cage in a lonely environment after brain trauma made and chronic mild chaotic stress unpredictable to rats was given to induce mental depression.The consumption of sucrose water and the change of animal behavior were observed and the high performance liquid phase electrochemical with fluorescence detector was used to detect the biogenic monoamine neurotransmitter content (dopamine,serotonin and norepinephrine) in the hippocampus,prefrontal cortex,hypothalamus and striatum area in each group.Experimental data were processed with single factor analysis or t test of variance by Statistical Program for Social Sciences Version 13.0 (SPSS13.0) software.P ＜0.05 was considered as statistically significant difference.Results After modeling,the rats of four groups were examined by behavioral tests.It was found that the amount of sugar-water consumption by the rats in the model group and CUMP group decreased,implying the absence of interest in eating and anhedonia of the rats in these groups.In open-field test,the rats in the model group,CUMP group and brain trauma group showed reduction in square crossing and rearing,implying the under-activity and absence of interest in activity.In the water maze test,it was found that the rats in the model group,CUMP group and brain trauma group needed much time to reach the end-point and made many errors,implying the lowering ability to learn and memorize.Levels of dopamine,serotonin and norepinephrine in the hippocampus,prefrontal cortex,hypothalamus and striatum area decreased in these rats with traumatized brain in three groups especially in model group and CUMP group.Conclusions It is a valid method for establishing the mental depression model in rats by traumatic brain injury with separately feeding in the lonely environment and given chronic mild chaotic stress unpredictable to rats on the setting of the left frontal lobe contusion.

Objective To explore the effect of cell apoptosis and oxidative stress on stressive liv-er injury after traumatic brain injury (TBI) in rats. Methods The model of TBI was duplicated by u-sing modified Allen's mehtods. Forty male Wistar rats were randomly divided into control group and groups at 6,12,24,48 hours after TBI. The serum levels of ALT and AST as well as the levels of superox-ide dismutase (SOD) and malandialdehyde in liver tissue were measured. The index of hepatocyte apopto-sis was detected through flow cytometer. Pathological changes of liver tissues were observed under light and electron microscopes. Results After TBI, the serum levels of ALT and AST were significantly in-creased, while malondialdehyde was increased and SOD decreased in liver tissues. The electron micro-scope showed that the index of hepatocyte apoptosis reached a peak at 6 hours after TBi. Aggressive inju-ries of the liver tissues were observed after TBI, showed by pathological observations. Conclusion Cell apoptosis and oxidative stress may be involved in the pathogenesis of stressive liver injury after TBI.

Objective To study clinicopathological characteristics of hereditary nonpolyposis colorectal carcinoma(HNPCC)-associated endometrial carcinoma(EC).Methods Totally 421 EC patients admitted to General Hospital of Tianjin Medical University from 1981 to 2006 were divided into three groups:group A:sporadic EC;group B:familial aggregation of EC;group C:HNPCC-associated EC.Results HNPCC-associated EC accounted for 6.4%(27/421).Mean age at time of diagnosis was 49.7years in group C,earlier than 56.3 years in group A(P=0.004)and 55.2 years in group B(P=0.035).There were 33.3%(9/27)patients with multiple primary carcinomas in group C.It was higher than 14.3%(9/63)in group B and 5.1%(17/331)in group A respectively(P=0.038,P＜0.01).There was no difference among the three groups in histological type or menopausal status(P＞0.05).The numbers of patients with low grade EC in group C(70.4%,19/27)and group B(61.3%,38/62)were more than that in Group A(P=0.013,P=0.023).Prognosis for group C was better than that in group A(P=0.021),and 5-and 10-year survival rate in groups A,B and C was 80%,70%;88%,85%;and 96%,96%respectively.Conclusions Mean age at time of diagnosis is earlier in HNPCC-associated EC than that in sporadic EC;patients with HNPCC-associated EC are more frequently complicated with multiple primary carcinomas and of low grade;prognosis is better.

Major depressive disorder(MDD) is a kind of mental disorder with depression and decreased interest as the main clinical manifestations. The pathogenesis of MDD is unclear, and MDD is characterized by high incidence, high recurrence rate and high suicide rate. At present, the hypothesis of monomamine mechanism can not fully clarify its pathological characteristics, and a considerable number of patients with depression do not respond well to existing antidepressants. N-methyl-D-aspartate receptor (NMDAR) antagonist and γ-aminobutyric acid A(GABAA) receptor positive allosteric regulator have a potential rapid antidepressant effect, which may be a breakthrough in the pathogenesis and clinical treatment of depression. NMDAR has bidirectional regulation, when proper activation of NMDAR can promote dendrite development, neuronal growth and long-term potentiation, but overstimulation of NMDAR can cause toxic reaction, leading to synaptic atrophy and neuronal death. In addition, inflammation can induce changes in NMDAR function and lead to depressive symptoms. At present, ketamine, a new antidepressant NMDAR antagonist, may plays a role in rapid antidepressant and delayed recurrence of depression by increasing the release of BDNF, activating the signal pathway of mammalian target of rapamycin complex 1(mTORC1), and promoting protein synthesis and synaptic plasticity. Thus, ketamine has the effect of rapid antidepressant and delaying the recurrence of depression. However, due to the large variability of NMDAR gene in patients with MDD, its potential functional polymorphism affects clinical symptoms and drug sensitivity. Therefore, by analyzing the latest research at home and abroad, this review comprehensively summarizes the pathogenesis of NMDAR dysfunction, the pathogenesis of MDD, antidepressant treatment and clinical application status, in order to provide theoretical basis for clinical accurate treatment of MDD patients in the future.