Objective To investigate the feasibility and clinical significance of D2 lymphadenectomy for distal gastric cancer in which the pancreas were regarded as the central landmark. Methods 26 patients of advanced distal gastric cancer were performed D2 lymphade-nectomy centered on the pancreas from March 2012 to February 2013. The operation time, amount of bleeding,number of lymph nodes,and postoperative complications were recorded. Results All the 26 patients underwent the operation successfully. The amount of bleeding was 50~200 mL(averagely 110 mL),and the number of lymph nodes which were cleaned was 16~35 (averagely 26). One patient had intra-ab-dominal hemorrhage and one patient had lymphorrhagia after the operation,and they were cured finally. There was no local recurrence,no dis-tant metastasis,and no death case occurred during the follow-up. Conclusion D2 lymphadenectomy for distal gastric cancer with pancreas as the central landmark is safe and feasible, and it is of lower incidence of complications .

Objective ToanalyzethedistributionanddrugresistancesituationofKlebsiellapneumoniae(KPN)isolatedfromour hospital during 2014 .Methods The drug susceptibility test was carried out by the Siemens fully automatic bacterial identification /drug susceptibility test analyzer .The drug susceptibility test results were judged according to the (CLSI) M100‐S22 document (2012) .Results A total of 291 strains of KPN were detected from 8 486 submitted specimens ,in which 20 strains were multi‐drug resistant Klebsiella pneumoniae(MDR‐KPN)isolates were 213 strains ,48 strains were extended‐spectrum beta‐lactamases producing Klebsiella pneumoniae (ESBLs‐KPN) and 10 strains were carbapenem‐resistant Klebsiella pneumoniae(CR‐KPN) .The KPN detec‐tion rate had statistical difference among different specimens (P= 0 .000) .The constituent ratio of KPN isolation in the sputum specimen was highest(P=0 .000) .The KPN detection rate had statistical difference among different departments (P=0 .000) ,the constituent ratio of KPN isolation in the respiration department was highest (P=0 .000) .The resistance and sensitivity of KPN to different antibacterial drugs had statistical difference(P=0 .000) ,carbapenems had the lowest resistance rate .Conclusion KPN has relatively low resistance rate to commonly used antibacterial drugs ,its multi‐drug resistant strains are in the higher level ,which should arouse clinic and hospital infection management department must to pay attention to and adopt corresponding supervision measures .

Objective To study the retrieved human allografts pathologically in order to probe into the histological changes of implanted allograft. Methods The specimens were retrieved from seven cases between February 2003 and March 2004, and the allografts had been in situ from two to 16 months. Of seven cases, four were diagnosed primarily as malignant fibrohistocytoma of proximal humerus, osteosarcoma of femoral shaft, bone giant cell tumor of distal femur and bone giant cell tumor of proximal tibia each, which were treated with wide resection of tumor and massive allograft transplantation and internal fixation of plate or inter-locking nail; two were open comminuted fracture of distal femur, treated with massive allograft transplantation and internal fixation, underwent autograft bone transplantation because of united massive allograft, had a punch biopsy of allografts for observation; one was tibial open fracture being fixated with inter-locking nail and small segment allograft transplantation, sustained infection at two weeks after primary operation and underwent debriment, removal of internal fixation and external fixation. Results Of seven cases, five were found with bone absorption radiographically, and were classified into three types:1)sever bone absorption; 2)bone absorption associated with sinus and effusion of the wound; 3)bone absorption accompanied by pyogenic infection. The later condition was caused by bacterial infection without a relationship of allograft. And the former two conditions could be classified into two subtypes: 1)osteoclastic absorption, which was followed by new bone formation; 2)inflammatory absorption, which was found with infiltration by round inflammatory cell, preponderantly lymphocytes, and mononuclear phagocytes with few osteoclasts, osteoblasts or new bone formations. Moreover, in sever bone absorption, vascular lesions such as vasculitis, swelling of endothelial cells or proliferation changes in the vessels, and obliteration of the arteries. Conclusion An intensive infiltration accompanied by vascular lesions may be the evidences of histological changes suggestive of an immune reaction directed against the grafts, and the failure of the clinical outcomes.

Objective To establish a transfer model for excess relative risk (ERR) for radiation-related leukemia from Japanese population to Chinese population.Methods Combined ERR of several subtypes of leukemia published in 1994, with the corresponding leukemia baseline incidence rates obtained from Cancer Incidence in Five Continents Vol.Ⅸ (CI5-Ⅸ) for Japanese population and Chinese population, a weighted risk transfer model was employed between an additive model and a multiplicative model, to execute ERR transfer.Results A range of weighing factors was proposed for risk transfer models:weighing factor was 0.4 for male and 0.3 for female, acute lymphoblastic leukemia, acute myeloid leukemia and chronic myeloid leukemia.The uncertainty for ERR transfer was characterized by lognormal distribution.Conclusions Based on the difference of baseline incidence rate for subtypes of leukemia between Japanese population and Chinese population, the transfer model and these weighing factors discussed in the present study could be applicable to transfer ERR for radiation-related leukemia from Japanese population to Chinese population.

Objective To investigate the clinical efficacy of TongluoShu Liquid in treating rheumatoid arthritis at early stage. Methods 100 cases were randomly recruited into a control group and a treatment group with 50 cases in each group. The treatment group was given TongluoShu liquid, 150ml / time, twice a day; and the control group was given Diclofenac Sodium Sustained Release Tablets (Deegan), one granule for each time, twice a day, and Methotrexate 7.5mg / time, once per week. Results In the treatment group, symptoms, signs and biochemical indicators were significantly improved, and the swelling of the soft tissue around the joints in stage Ⅰ and Ⅱ were also reduced. Besides, osteoporosis was controlled and the progress of destruction to the cartilage of stage Ⅲ was detained, though there was no statistical difference between the two groups after the treatment. Conclusion ShuTongluo liquid is a safe and effective medicine with less adverse reactions in treating rheumatoid arthritis.

Objective To explore the effect of botulinum toxin type A(BTXA)in the treatment of early hypertrophic scars(HTS).Methods BTXA was injected into and around the eady HTS,and then the modal and histological changes of the scars as well as the clinical reaction were observed in the patient.BTXA was also injected into muscle around the incision and effect on the cicatrization observed.Results Injection of BTXA could obviously alleviate ache and pruritus of eady HTS and could impel the atrophy and inteneration of eady HTS.Changes were found in paraffin-embedded tissue section by the hemetoxylin and eosin(HE)staining.Injection of BTXA into muscle around the cut could can reduce occurrence of HTS.Conclusion BTXA can help prevent the early HTS to a certain extent.The mechanism underlying this effect may be related to the reducing the tension around scars and proliferative activity,interfering with the signal transduction of small nerves,affecting the proliferation and apoptosis of fibroblasts and subsequently decreasing the collagen synthesis.

Objective To investigate the feasibility of spleen-preserving splenic hilar lymph nodes dissection on the radical resection for advanced proximal gastric cancer. Methods Six patients with advanced proximal gastric cancer were performed D2 lymphadenectomy from May 2012 to May 2013 in our hospital. The operation time,bleeding quantity,the number of lymph nodes,postoperative complications were re-corded. Results The surgery was successful. The intraoperative blood loss was 50 ~250 mL,with the average of 120 mL. The number of lymph nodes was 3~9 after the operation with the average of 5. One patient supervened with lymphorrhagia and recovered after treatment. During the follow-up period from one month to one year, no local recurrence and distant metastasis occurred, nor the death. Conclusion Conducting theD2 lymphadenectomy for the patients with the advanced proximal gastric cancer can preserve the spleen while safely and throughly dissect the splenic hilar lymph nodes.

Background and purpose: It has been reported that some low dose chemotherapy drugs have antiangiogenetic effects. The purpose of this study was to investigate the effect of inhibiting angiogenesis by low dose hydroxycamptothecin on H22 hepatoma transplantation tumor mouse models. Methods: H22 transplantation tumor mouse models were established, CTX was administrated in abdominal cavities as positive control group. 0.9%NaC1 solution was administrated as negative control group. Intra abdominal cyclophosphamide and hydroxycamptothecin (0.2 and 0.4 mg/kg) were injected for 10 days continuously. The growth of tumor were observed and measured. The tumor inhibitory rates were tested in animal tumor model with experimental treatment. The expression of VEGF and CD34 were measured by means of immunohistochemistry. Results: Hydroxycamptothecin had effect on tumor growth. Tumor weight inhibitory rates of hydroxycamptothecin with 0.2 and 0.4 mg/kg were 23.53% and 43.25% respectively. The difference was significant when compared with the negative control group (P<0.05). The expression of VEGF and MVD can be suppressed significantly than negative control group in vivo (P<0.05). Conclusion:Hydroxycamptothecin have inhibitory effect on tumor growth and the expression of VEGF and MVD with H22 hepatoma transplantation tumor mouse models in low dose. The mechanism possibly involved inhibiting the angiogenesis.

This paper was aimed to study effects of different preparation methods on the content of ginsenosides Rg1,Re and Rb1 in Yi-Xin-Shu (YXS) tablets by HPLC-ELSD.HPLC-ELSD was used as the detection method.The separation and content of ginsenosides Rg1,Re and Rb1 were used as indexes.The influences of three different preparation methods (i.e.,defatted alcohol extraction and butanol extraction,alcohol extraction and butanol extraction,alcohol extraction and butanol extraction ammonia solution washing) on the effect of YXS tablets were studied.Then,the same content determination method was used to compare the influence of alkali washing treatment to ginsenosides Rg1,Re and Rb1 among different batches of Panax ginseng.The results showed that a good separation of ginsenosides Rg1,Re and Rb1 component peak of YXS tablets was achieved by three kinds of separation methods.The separation degree was greater than 1.5.Ammonia solution washing had some effect on ginsenosides Rg1,Re and Rb1 content,which made the content of ginsenosides Rg1,Re and Rb1 be 1.5-1.8 times to those without alkali washing.No effect was shown on the content of ginsenosides Rg1,Re and Rb1 during ammonia solution washing.It was concluded that some other ginsenosides can be transferred into ginsenosides Rg1,Re and Rb1 in YXS tablets solution after ammonia solution washing.

This study was aimed to improve the transfer rate of sinomenine in the intermediate product of Caulis Sinomenii in order to optimize the purification process of intermediate product ofCaulis Sinomenii fromTong-An (TA) injection. The transfer rate of sinomenine and the stability of fingerprints in the intermediate product of Caulis Sinomenii were used as indexes for the investigation on the impact from different pH ofCaulis Sinomenii extract before extraction. The transfer rate of sinomenine was used as an index for the investigation on the impact by different pH of hydrochloric acid created to dry extract solution. The transfer rate of sinomenine was used as an index for the investigation of four separation ways, which included the vacuum filtration, plate and frame filters, high-speed tube separator, and flat direct centrifuge, on the liquid separation of sinomenium acutum acid. The results showed that the pH ofCaulis Sinomenii extract before extraction was 10-11; the transfer rate of sinomenine was the highest in the extraction process and the fingerprints of TA injection was stable. The pH of hydrochloric acid was 2.0-2.5; and the highest transfer rate of sinomenine in acid dissolution process was 92.94%. The high-speed tube separator had the best separation to sinomenium acutum acid-dissolving liquid. The highest transfer rate of sinomenine was 93.34%. It was concluded that the optimized process can effectively improve the transfer rate of sinomenine in the intermediate product ofCaulis Sinomenii. Meanwhile, fingerprints of the product were stable. The process was simple with good repeatability.