Objective To observe the law of removing dampness, melting phlegm and tonifying spleen on blood lipids in hyperlipidemia rat and its vascular endothelial protective effect. Methods Animals were randomly divided into 6 groups, the high-fat diet of 35 d, 16 d orbital check blood lipids to confirm modeling success and gavage was given by different experimental requirements. NOS and vascular endothelial gene expression were determined at 3rd and 7th day. Results After treatment, NOS expression in experimental rats compared with the normal group, P

Objective To investigate the quantitative analysis method of pathological nature of the tongue fur, and explore the relationship between quantitative value of tongue fur and diseases and syndromes. Method Take tongue picture by Nikang 5000 digital camera and input computer to built database of tongue fur nature and diseases and syndromes, then take a quantitative analysis. Result There was significant difference of quantitative value between thick and thin fur, moistening and dryness of tongue fur, exfoliating and non-exfoliating tongue fur (P

Objective To sunmarize the clinical experience of emergency laparoscopic choledocholithotomy plus T-tube drainage for acute calculous cholangitis.Methods We retrospectively analyzed the clinical data of 98 cases with acute calculous cholangitis undergoing emergency laparoscopic choledocholithotomy between Mar 2007 to Jul 2011 at our hospital.Results In this study,93 cases with definite diagnosis of acute calculous cholangitis underwent at their acute stage totally laparoscopic choledocholithotomy and T-tube drainage,2 cases received laparoscopic transeystic common bile duct exploration and 3 cases were treated with primary closure of the common bile duct following laparoscopic common bile duct exploration and intra-bile duct stent.All procedures were successful without conversion to open surgery.The average of the operative time and the hospital stay was 96 minutes and 12 days respectively.The major complications included residual stones in 8 cases,bile leakage in 4 cases and intraperitoneal bleeding in I case.All were cured by conservative therapy.Conclusions For most patients of acute calculous cholangitis,emergency T-tube drainage after laparoscopic chuledocholithotomy is safe and effective.

Background and purpose:Tamoxifen is the main endocrine therapy of premenopausal breast cancer with positive hormone receptors but numerous patients have developed advanced refractory breast cancer due to drug resistance.Our study investigated the role of combining oophorectomy and exemestane in the treatment of advanced refractory breast cancer.Methods:Oophorectomy was carried out in all patients.Exemestane was administered orally (25 mg/d) one week after the operation.The median time of progression (TTP),the median survival time as well as the survival rate were calculated using the Kaplan-Meier methods.Results:Seventeen patients ranging between the ages of 26 and 44 years (median:36 years) were treated resulting in an overall response rate of 64.70%,TTP was 8 months and the median survival time was 31 months.The survival rates for 1 year,3 years and 5 years were 88.24%,64.71%,29.41%,respectively.No grade Ⅲ and Ⅳ side effects appeared.Conclusion:Oophorectomy when combined with exemestane showed antitumor activity for advanced refractory premenopausal breast cancer through positive hormone receptor and it is also well-tolerated.

Objective To investigate the technical difficulties and the avoidance of complications in delayed laparoscopic cholecystectomy (LC) for acute cholecystitis (AC).MethodsThe results of LC carried out on 133 consecutive patients with AC between February 2004 and August 2008 were retrospectively studied.The outcomes were compared between patients who received LC for AC within 72 hours (the early group) and those after 72 hours (the delayed group).There were 34 patients in the early group and 99 in the delayed group.During LC,Calot's triangle was carefully dissected,and the relationship of the cystic duct to the CBD and common hepatic duct was clearly identified.Retrograde cholecystectomy in 2 patients was used when the Calot's triangle was poorly identified.Laparoscopic subtotal cholecystectomy was carried out in 4 patients whose inflammation or fibrosis precluded dissection of the Calot's triangle.ResultsThere was no conversion to open cholecystectomy,biliary tract injury,biliary leak,or any other intraoperative or postoperative complications.There was no 30day readmission in the 2 groups.Patients who received delayed LC had a significantly longer operation time [(44.1±5.32) vs (66.4±3.05)rnin,P＜0.01].There was no significant difference in wound infection rates in the 2 groups (1/34 2.94 ％ vs 2/99 2.02 ％,P＞0.05).ConclusionsDelayed LC was as feasible and safe as early LC in the treatment of AC.Delayed LC was technically more demanding than early LC.

Objective: Blue dye was one of the methods for sentinel lymph node biopsy in breast cancer, but the success rate was affected by multiple factors. This study was to determine the related factors contributing to the success of sentinel lymph node biopsy in breast cancer using blue dye method. Method:From Jan. 2007 to Aug.2008, sentinel lymph node biopsy was performed by periareolarly injecting 1% methylene blue in 141 breast cancer patients followed by axillary clearance. Pathological diagnosis was performed for all of the lymph nodes by conventional HE staining. Unconditional logistic regression was applied to make both univariate and multiva-riate analysis. Results:Sentinel lymph node was successfully detected in 126 patients. But the biopsy was failed in the 15 patients. The success rate was 89.4% and the false negative rate was 6.82%. Univariate analysis showed that success rate of biopsy was in association with patients' age, body mass index (BMI), tumor size, preoperative axillary node's status, pathological grade as well as ≥4 positive axillary lymph nodes involved. Multivariate analysis indicated that the patients'age (OR=4.587, P=0.024), BMI (OR=4.882, P=0.011) as well as 4 or more of the axillary nodes involved (OR=3.143, P=0.013) were independent predicting factors for the success of sentinel lymph node biopsy. Conclusions:Methylene blue dyeing is a reliable method for sentinel lymph node biopsy. The rate of success is associated with patients' age, BMI as well as the number of metastases in axillary lymph nodes.

Objective To evaluate the effectiveness and safety of open tension-free hernioplasty and two kind of laparoscopic hernia repair for the treatment of primary unilateral inguinal hernia. Methods Patients suffering from primary unilateral inguinal hernia were randomly divided into 3 groups to undergoopen operation with mesh-plug and patch or transabdominal preperitoneal hernioplasty (TAPP) or totally extraperitoneal hernioplasty (ZEP). Results From February 2006 to February 2009, a total of 164patients were divided into 3 groups, with 62 undergoing open tension-free mesh-plug hernia repair, 50receiving TAPP and 52 receiving TEP. Postoperative patients were then followed up for a period of(16±8)months. The average operating time for the patients in the open mesh repair group was significantly shorter compared to the other two groups (P＜0.01 ). The cost in the open mesh repair group was also significantly lower than the other two groups (P＜0.01). The pain scores in open mesh group were significantly higher than those in the other two groups (P＜0.01). The hospital stay and the recovery time were both significantly longer in the open mesh repair group (P＜0.01) compared to the other two groups. No major complications and recurrence was found in neither groups. Conclusions Open tension-free mesh-plug hernia repair, TAPP and TEP are all safe and effective for the treatment for patients with primary unilateral inguinal hernia. TAPP and TEP are superior to open tension-free mesh-plug hernia repair as these two procedures involve less postoperative pain and fast recovery.

Objective To compare the efficacy of endovascular interventional treatment and surgical clipping in posterior communicating artery aneurysm (PCoAA) patients with fetal-type posterior cerebral artery (fPCA).Methods The PCoAA patients with fPCA were enrolled.Their baseline clinical data were collected.The modified Rankin Scale (mRS) was used to assess the clinical outcomes at six months after procedure.The mRS score 0-2 was defined as good outcome.Results A total of 35 PCoAA patients with fPCA were enrolled into the study,23 were treated with interventional embolization therapy and 12 were treated with craniotomy clipping.There were no significant differences in age,gender,preoperative Fisher grade,Hunt-Hess grade,baseline GCS scores,and aneurysm typing between the 2 groups.The good outcome rate of the interventional embolization group at 6 months was higher than that of the surgical clipping group,but there was no significant difference (65.22％ vs.41.67％;P =0.282).Results The efficacy of PCoAA using interventional embolization therapy combined fPCA is almost the same as craniotomy clipping.

Objective To investigate the availability and strategy of breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.Methods From January 2007 to May 2011,12 cases of breast reconstruction with caesarotomy scar were carried out with pedicled TRAM flaps.All the patients that were classified as the class Ⅱ that was 0.5 or less by score were operated on by using the inverted trapezoid incision,of which the upper edge was 2 or 3 cm down to the umbilicus.Double pedicles were adopted for the patient with the longest vertical scar; single pedicle of the breast contralateral side and the muscle sheath of the breast ipsilateral side were harvested for the rest of the patients.A synthetic mesh was used for the enforcement of the muscle and sheath defect.Results No flap necrosis or abdominal complications were observed.With the follow-up from 3 months to 4 years and 4 months,the overall satisfactory rate was 100 ％.Conclusions The strict patient selection and the operating strategy are the keys to the successful breast reconstruction for patients with caesarotomy scar using pedicled TRAM flap.

AIM To explore the role of nitric oxide (NO) mediators in seizure behavior and the related expression of interlukin 6(IL 6). METHODS The IL 6 immunoreactivity (IL 6 ir) and behaviour were observed in kainic acid (KA) induced seizure following pretreatment with L nitroarginine( L NNA), a inhibitor of nitric oxide synthase(NOS), or the same number of moles of L arginine( L Arg). RESULTS The results showed that time dependent seizures were induced on animals after administration of KA (10 mg?kg -1 ), accompanied by the immediate enhancement of IL 6 ir in hippocampal structure, piriform area and cortex. The behaviors of rats were not markedly altered by chronic pretreatment with L NNA (50 mg?kg -1 ) or L Arg (40 mg?kg -1 ). However, after the administration of KA, the seizure behaviors were obviously different in the group of L NNA and L Arg respectively. Seizure was agrevated in the animals with L NNA pretreatment and many rats died at KA 3 hours, whereas seizure was alleviated after KA in the group of L Arg. IL 6 expression was apparently up regulated in some brain areas such as hippocampus in the group of KA pretreated with L NNA, but opposite effects appeared in the group pretreated with L Arg before KA injection. CONCLUSION These results indicate that endogenous NO mediators may alleviate the seizure behaviors and may down regulated the early expression of IL 6 in KA challenged seizure, but it the mechanism of the early expression of IL 6 with the homeostasis of endogenous NO mediator merits further study.nismoftheearlyexpressionofIL 6withthehome