ObjectivesTo discuss the safety of surgical treatment and the feasibility of laparoscopic surgery for the elderly patients with gastric cancer. MethodsThe clinical and pathological materials of 104 elderly patients(65 years old or above) undergone surgical treatments retrospectively were analyzed,in order to analysis the postoperative complication incidence and the short-term outcomes in different age groups and different surgical pattern groups.ResultsThere were more preoperative comorbidities in ≥75 years old group than in ＜75 years old group(especially hypertension and diabetes),however,the incidence of postoperative complications was not significantly different.There was no difference of preoperative comorbidities, postoperative complications, surgical time or the amouts of blood loss during surgery between the laparoscopic and the traditional surgical groups,while the laparoscopic groups had short period of postoperative hospitalizing and earlier orally intake of fluid diet. There was also no difference of pathological results.ConclusionThe elderly patients with gastric cancer should have surgical treatments if the conditions are permitted, and the areas of dissection should be standard as far as possible. The old patient undergone laparoscopic surgery may have a shorter hospitalized period after operation, because their recovery of bowel function is more quickly.

ObjectiveTo research collateral pathways and collateral grading through digital subtract angiography(DSA) and their relation to clinical prognosis.MethodsCollateral pathways and collateral grading of 49 cases suffered from severe internal carotid artery (ICA) stenosis (70% -99% ) were assessed through DSA.Incidence of stroke,TIA or cerebral hemorrhage were observed in the following 12 months.Results①In all the subjects,no collateral pathway exist in 9 cases(18.9%),and primary and secondary collateral pathways occurred in 39(79.6% ) and 25(51.0%)cases.Pathway is not related to clinical prognosis.②There were 9 ,15 and 25 cases in 0 grade,1 -2 grade and 3 -4 grade collateral circulation and the complication ratio is 44.4%,50.66% and 24.00% respectively.Incidence of ischemic cerebrovascular disease is significantly higher in 3 - 4 grade patinets than those in 0 and 1 - 2 grade pation(x2 =4.856,3.242;all P ＜ 0.05 ).ConclusionsCollateral levels but not pathway were correlated with clinical prognosis in patients with severe stenosis of internal carotid artery.

There is persuasive clinical and experimental evidence that macrophages promote cancer initiation and malignant progression. The aggregation of macrophages indicates poor prognosis of tumor associated diseases. During tumor initiation, macrophages create an inflammatory environment that is mutagenic to cells and promotes cell growth; as tumors progressing, macrophages create premetastatic niche for the arriving tumor cells at premetastatic sites ; then macrophages provide critical nutrients for these initial metastatic tumor cells.Along with these great achievements in research of macrophage, it is believed that several novel directions of tumor therapy surely occur in the future.

After receiving radical resection of primary rectal cancer,about 4％ to 30％ patients would occur local recurrence.Diagnosis of local recurrence relies on postoperative follow-up,physical examination,tumor markers and imageological examination.For the local recurrent patients,conservative therapeutic regimen had been popular in the past days with poor prognosis and quality of life.Nowadays multimodality treatment with radical resurgery combined with chemoradiotherapy and IORT has been taking the main part in the management of local recurrence.The choice of surgery depends on the site of recurrence and invasion situation inside the pelvic cavity.The aim of the radical reoperation is R0 resection because it leads to an optimistic prognosis.Previously irradiated patients are relatively safe after receiving median-dose reirradiation.For the cases whose recurrence are unavailable for radical resection,palliative operation and chemoradiotherapy may be the wise choice to relieve their symptoms and improve the quality of life.

As a stable marker to reflect the average level of blood glucose,HbA1c is very important in glycaemic control evaluation.However,more and more data from evidence based medicine demonstrated that blood glucose fluctuation can also contribute to diabetic complication and prognosis which can not be neglected.Multiple capillary glucose measurements and continuous glucose monitoring are major methods to detect glucose fluctuation.Apart from insulin,various oral anti-diabetic drugs can reduce postprandial glucose excursion.Representative drugs include ?-glycosidase inhibitors,glinides and short-acting sulfonylureas,each have their own way of acting. Abstract:Summ ary:As a stab le m arker to reflect the average level of b lood glucose,HbA1c is very important in glycaem ic control evaluation.However,more and more data from evidence based m ed ic ine demonstrated that b lood glucose fluctuation can also contribute to d iabetic comp lication and prognosis wh ich can not be neglected.Mu ltip le cap illary glucose m easurem ents and continuous glucose mon itoring are m ajorm ethods to detect glucose fluctuation.Apart from insu lin,various oral anti-d iabetic drugs can reduce postprand ial glucose excursion.Representative drugs inc lude?-glycosidase inh ib itors,glin ides and short-acting su lfonylureas,each have the ir own way of acting.

Objective: To investigate the expression of mage-a mRNA in lung cancer tissues of mice induced by coal tar pitch(CTP) fume and to discuss the above model for lung cancer immunotherapy with mage-a. Methods: Tumor tissue samples of lung cancer and paired non-tumor tissues were obtained from 8 lung cancer mice. Total RNA was extracted and cDNA was synthesized. Nested polymerase chain reaction amplification using mage-a specific primer was performed to detect the expression of mage-a. The 2 clones of mage-a mRNA positive PCR products were sequenced by DNAs sequencer (PE-377). Results: Of 29 mice in the experimental group, 8 were induced to lung cancer.Among which 5 (5/8) expressed mage-a mRNA. The expression of mage-a gene was not found in adjacent lung tissues. The DNA sequencing confirmed that the target gene fragments in 2 samples of PCR products were mage-a cDNA. Conclusion: The mage-a gene is highly expressed in lung cancer in mice induced by CTP fume, suggesting that CTP-induced lung cancer in mice may be an ideal animal model for lung cancer therapeutic experiment with MAGE-A.

BACKGROUND: Diabetes mel itus is one of the most common systemic diseases, which often leads to the changes of the jaw and other bone structure, as wel as the abnormal changes of mineral metabolism. OBJECTIVE: To observe the three-dimensional structure and histopathological changes of the mandible in type 1 diabetes mel itus mice. METHODS: The mice were randomly divided into control group and diabetes mel itus group. The diabetes mel itus group received intraperitoneal injection of 50 mg/kg streptozotocin for 5 days to establish a type 1 diabetes mel itus model, and the control group received intraperitoneal injection of citrate buffer. RESULTS AND CONCLUSION: At 3 weeks after modeling, the micro-CT technique was used to observe the three-dimensional structure of the mandibles in the two groups. The quantitative analysis on the microstructure of cancel ous bone and cortical bone showed that the bone mineral density, bone volume fraction, trabecular number and trabecular thickness of cancel ous bone in the interest region in the mandible of type 1 diabetes mel itus mice were significantly decreased when compared with that in the control group (P < 0.01, P < 0.05), while the structure model index was increased significantly (P < 0.05); the mineral density and area of cortical bone were decreased in the diabetes mel itus group (P < 0.05). Hematoxylin-eosin staining showed that the number and volume of mandibular trabeculae of type 1 diabetes mel itus mice were decreased. The results suggest that the three-dimensional structure of the cancel ous bone and cortical bone in the streptozotocin-induced type 1 diabetes mel itus mice are changed significantly, and the microstructure change of the cancel ous bone is more obvious.

BACKGROUND:Insulin-like growth factor 1 is the key factor during cartilage development, which is involved in the growth and reconstruction of condylar cartilage.
OBJECTIVE:To study the effect of insulin-like growth factor 1 on cel apoptosis and the apopotosis-associated factors of Bcl-2, Bax mRNA and protein expressions of rat condylar chondrocytes.
METHODS:The 1-day-old and 28-day-old rat condylar chondrocytes were cultured and identified in vitro. The condylar chondrocytes with different ages were divided into experimental group and control group. After being starved for 24 hours, chondrocytes in the experimental group were incubated with 100μg/L recombined rat insulin-like growth factor 1 for 48 hours, while the chondrocytes in the control group were incubated normal y. RESULTS AND CONCLUSION:Compared with the control group, after being incubated with recombined
insulin-like growth factor 1, the number of condylar chondrocytes was increased with high speed proliferation (P<0.05). Real-time RCR and western blot analysis revealed that the expression levels of Bcl-2 mRNA and protein were increased after added with recombined rat insulin-like growth factor 1, while the expression levels of Bax and protein were decreased (P<0.05). The results indicate that insulin-like growth factor 1 can promote the
proliferation and reduce cel apoptosis of newborn and adolescent rat condylar chondrocytes, which may be mediated by Bcl-2 and Bax.

Objective To study the preparation and stability of paclitaxel self-microemulsifying drug delivery system ( PTX-SMEDDS) . Methods The formulation of the PTX-SMEDDS was optimized by monitoring the appearance, particle size, concentration, relative substance, and bacterial endotoxin. Influence of different pH and different dosage of activated carbon on PTX-SMEDDS was investigated. Subsequently it was subjected to stability studies. Results The PTX-SMEDDS was a translucent diluted-yellow solution with a mean diameter of 19. 6 nm. High speed centrifugal test indicated PTX-SMEDDS was stable. The result of the influential factor tests showed PTX-SMEDDS was unstable to high temperature and light. In the accelerated tests for 6 months, the quality of PTX-SMEDDS was stable. The samples should be sealed and stored at low temperature and shady place. Conclusion Easily prepared and stable formulation of PTX-SMEDDS is achieved, and further investigation is warranted to develop self-microemulsifying drug delivery system for injection.

Objective: To analyze influence of acute coronary syndrome (ACS) complicated abnormal glucose metabolism on fibrinolytic system. Methods: A total of 135 ACS inpatients were selected. According to glucose metabolism status, they were divided into pure ACS group (n=48), type 2 diabetes mellitus (T2DM) + ACS group (n=46) and impaired glucose tolerance (IGT) + ACS group (n=41); another 35 subjects hospitalized and undergoing physical examination during the same period were enrolled as normal control group. Plamsa DD levels were measured and compared among all groups. Results: Compared with normal control group and pure ACS group, there were significant rise in triglyceride level [(1.12±0.39) mmol/L, (1.52±0.92) mmol/L vs. (2.57±1.17) mmol/L, (2.32±0.96) mmol/L] in T2DM+ACS group and IGT+ACS group, P<0.01 all; compared with normal control group, there were significant rise in plasma DD level in pure ACS group, T2DM+ACS group and IGT+ACS group [(360.50±74.95) ng/ml vs. (795.24±134.10) ng/ml vs. (663.31±116.06) ng/ml, (702.40±126.64) ng/ml] P<0.01 all, and those of T2DM+ACS group and IGT+ACS group were significantly lower than that of pure ACS group, P<0.05 both. Conclusion: Fibrinolytic system function of patients with ACS complicated impaired glucose tolerance is significantly lower than that of pure ACS patients.