The setups of internal medicine and surgery, confronted with the challenges of the development of modern clinical sciences, must be regrouped so as to conform to the demands of technological development. The set ups of internal medicine and surgery have the following drawbacks in division: ①hindering the scientific research on modern clinical medicine for lacking the theoretical basis of preclinical medicine; ②making it difficult for diseases to get treated systematically; ③affecting innovations in advanced medical technology; ④resulting in a greater number of problems of medical control; ⑤leading to an increasingly worsening situation of hospital economy. It is, therefore, necessary to regroup departments of internal medicine and surgery, set up a mode of treatment by systemic diseases, and readjust the structure of human resources and medical regimens according to this mode. Other departments, such as gynecology and obstetrics, otorhinolaryngology, ophthalmology, hematology, and endocrinology, can be treated as independent medical setups.

Objective To investigate the elationship between the expression of Cathepsin D and Laminin receptors with the invasion and metastasis of gastric cancers.Methods Cathepsin D and Laminin receptors immunoreactivities were evaluated in 96 patients with gastric cancer using streptavaclin pemxidase method.Results Over expression of Cathepsin D in gastric cancer tissue was significantly related with the depth of invasion,lymphnode metastasis and grade of differentiation (P<0.01,P<0.01 and P<0.05, respectively).Moreover,the high expression of Lamninin receptors in gastric cancer had significant correlations with the invasion depth and grade of differentiation(P<0.05 and P<0.01);The positive expression of Laminin receptors were not significantly related with lymph node metastasis(P>0.05).By statistics analysis Cathepsin D had a significant positive correlation with Laminin receptors (P<0.05). Conclusion Cathepsin D and Laminin Receptors play all important role in the invasion and metastasis of gastric Cancers.

Objective To explore the clinical effects of laparoscopic surgery combined with marvelon,gestrinone and leuprolide in treatment of chronic endometriosis.Methods 50 cases of endometriosis were collected.They were randomly divided into observation group and control group,each group having 25 cases.The control group underwent laparoscopic surgery and the observation group underwent laparoscopic surgery combined marvelon,gestrinone and leuprolide for 3 months.The two groups were compared in clinical effects,recurrence and pregnancy rate,as well as the operation situation.Results The effective rate was 92.0％ (23/25) in the observation group and 64.0％ (16/25) in the control group.The effective rate of observation group was obviously higher than that of the control group(P ＜ 0.05).The recurrence rate was 8.0％ (2/25)in the observation group,and 32.0％ (8/25) in the control group.The recurrence rate of combination group was obviously lower than that of the simple surgical group(P ＜ 0.05).The pregnancy rate was 80.0％ in the observation group;and 48.0％ in the control group after treatment.The pregnancy rate of the observation group was obviously higher than that of the control group(P ＜ 0.05).Liver damage or other adverse reactions didn't occur to any group after the treatment.The mean time of leaving bed was (1.4 ± 0.4) d after operation in the observation group vs (3.6 ± 1.5) d after operation in the control group.Length of hospital stay was (7.6 ± 3.5) d in the observation group vs (11.5 ± 3.9) d in the control group.The difference had statistical significance(all P ＜ 0.05).Conclusions Laparoscopic surgery combined with marvelon,gestrinone and leuprolide is superior to pure surgery group in treatment of endometriosis.It can improve the effective and pregnancy rate,and reduce the recurrence rate.No obvious adverse reactions can be found,thus it is worth of clinical promotion.

ObjectiveTo investigate the influence of nateglinide treatment of newly diagnosed patients with type 2 diabetes on the state of inflammatory response. MethodsThe clinical data of 74 newly diagnosed patients with type 2 diabetes were retrospectively reviewed,and treated with nateglinide,before and after treatment,the fasting blood glucose (FBG), postprandial blood glucose 0.5h ( 0.5 hPG), 1 h postprandial blood glucose ( 1 hPG) ,2h postprandial blood glucose(2hPG) ,fasting insulin(FINS) ,0.5h postprandial insulin(0. 5hINS) ,postprandial 1h insulin( 1 bINS),2h postprandial insulin(2hINS),interleulin-2(IL-2) and C-reactive protein(CRP) levels were observed. ResultsAfter treatment,the FBG,0. 5hPG, 1hPG,2hPG, FINS,0. 5hINS, 1hINS,2hINS, IL-2 and CRP of patients were ( 8.0 ± 1.5) mmol/L,(12.0±1.8)mmol/L,(10.2 ± 1.3) mmol/L,(10.5 ±1.2) mmol/L,(168.2 ±11.5) pmol/L,(213.5±23.5) pmol/L,(197.0 ±21.5) pmol/L,(189.5 ±12.0) pmol/L,(14.0 ±1.5) μg/L, (13.5 ±1.5) mg/L,compared with( 10. 5 ± 1.0) mmol/L, ( 14. 5 ± 1.5) mmol/L, ( 12. 5 ± 1.4) mmol/L, ( 11.6 ±2.0) mmol/L,(180.7 ±12.0) pmol/L,(229.8 ±26.0) pmol/L,(218.5 ±23.0) pmol/L, (197.0± 14.5) pmol/L,(12.5 ±2.0) μg/L, (22.8 ±2.0) mg/L before treatment decreased significantly(t =11. 9293,9. 1785,10. 3561,4. 1115,6. 4696,4.0009,5. 8744,3. 4279,5. 2307,32.0006, all P ＜0. 05). There was no serious adverse events in treatment process. ConclusionNateglinide treatment of newly diagnosed patients with type 2 diabetes could significantly improve the patient's inflammatory response state,and there was no serious adverse events in treatment process.

Objective To study multi-slice spiral CT(MSCT) manifestations of spondyloschisis.Methods 40 patients with spondyloschisis were examined with MSCT scan and 3D reconstruction.Results In the 40 cases,CT scans showed spondyloschisis of the lumbar in L_2(1/40),L_3(1/40),L_4(10/40),L_5 spondyloschisis of the lumbar in L_2(1/40),L_3(1/40),L_4(10/10),L_5(28/40).MSCT displayed:the ring-scission sign(100%),the pseudo-bulging of lumbar intervertebral disc and the elongated sign of spinal canal(95%),and the wavered sign of vertebral body(12.5%).The location,shape of spondyloschisis and the degree of spondylolisthesis were demonstrated by MSCT on multiplanar and 3D.Conclusion The ring-scission sign is the specific sign in diagnosing the spondyloschisis of the lumbar by MSCT.It is of significant value in the detection of spondyloschisis

Objective To evaluate the clinical application of multi-slice spiral CT(MSCT) and X-ray plain film in congenital scoliosis.Methods 40 cases with congenital scoliosis were undergone MSCT scan,the imaging data were reconstructed with maximum intensity projection(MIP),multiple planar reconstruction(MPR),surface shaded display(SSD) and surface volume rendering(SVR),the applied value of these various reconstructed images were analysed comparatively with X-ray plain film.Results Based on the preoperative X-ray plain films,the spinal formation failure,segmentation failure and mixed failure of spine were found in 18,15 and 7 cases respecitvely.However MSCT scan showed that 13 cases had formation failure,12 cases had segmentation failure and 15 cases were mixed failure of spine,and in combination with spinal bifida in 6,rib deformity in 8 and bony ridge inside vertebral canal in 4.The relative features of congenital scoliosis could be comprehensively evaluated by SVR images.Conclusion The reformatted images of MSCT is remarkedly superior to conventional X-ray images in judging the classification and area of spinal deformity accurately.

BACKGROUND: Surgery is a main method to reconstruct the stability of spine after compression fracture. But the reconstruction of spinal stability for patients undergoing conventional therapy remains unclear.OBJECTIVE: To explore whether spinal stability training is effective on improving pain and motor function of patients with vertebral osteoporotic fractures.METHODS: Patients with vertebral osteoporotic fractures were divided into two groups. The study group was treated with conventional treatments and individualized spinal stabilization training, while the control group received conventional treatments alone. All the subjects were evaluated before and after treatment by numeric pain rating scale (NPRS), 3-meter timed up and go (TUG) and Oswestry functional limitation index (OFLI). The results were compared between the two groups.RESULTS AND CONCLUSION: A total of 27 patients were included, including 16 patients in the study group and 11 in the control group. After 4-week treatment, TUG and OFLI in the study group decreased significantly compared with the control group (P < 0.05). But there was no statistical significance between the two groups in the level of NPRS and the amount of changes (P > 0.05). Symptoms and function of both groups were improved after treatments. Individualized spinal stability training is effective to restore the motor function and may be helpful for reducing pain for patients with vertebral osteoporotic fractures combined with conventional treatments.

Objective To study the correlation between storage time and the content of 5-hydroxymethylfurfural (5-HMF) in Corni Fructus because of the color change caused by storage time. Methods Corni Fructus samples of different storage time with 0, 1, 2, 3, and 4 years were collected. The contents of 5-HMF were determined by HPLC. Results The HPLC determination method of 5-HMF in Corni Fructus was established. The contents of 5-HMF varied from undetected value to 0.292 8%, with the increase of storage time of 0, 1, 2, 3, and 4 years and the color gradually deepened from red, dark red, reddish brown to brown. The contents of 5-HMF in black wine-prepared Corni Fructus were 0.954 4%-1.837%. Conclusion The browning of Corni Fructus is related to the production of 5-HMF. With the extension of storage time of Corni Fructus, the color gradually deepens and the content of 5-HMF increase significantly. The storage time of Corni Fructus can be suggested to be one year.

Objective To explore the clinical diagnostic value of narrow-band imaging combined with magnification chromoendoscopy for suspicious neoplasia lesions of early gastric cancer.Methods A total of 115 patients which had been diagnosed as having suspicious lesions byconventional endoscopy were enrolled from Jan.2010 to Dec.2012.They were observed by magnifying endoscopy(C-WLI), magnifying endoscopy combined with narrow-band imaging (ME-NBI), magnification chromoendoscopy and magnification chromoendoscopy combined with narrow-band imaging, respectively.The lesion outline sharpness, opening of the gland sharpness and microvascular morphology sharpness were recorded and the subtypes of opening of the gland and microvascular morphology were compared.The histological examination was performed on the most significant changes in lesion site and the accuracy, sensitivity and specificity of the four procedures were calculated.Results The score of outline sharpness was 377 and the score of pit sharpness was 458 by magnification chromoendoscopy combined with narrow-band imaging, higher than those of ME-NBI (340 and 408 respectively) and magnification chromoendoscopy (354 and 386 respectively) (P ＜ 0.05), significantly higher than those of C-WLI (276 and 280 respectively) (P ＜ 0.01).The score of microvascular morphology sharpness was 380 by magnification chromoendoscopy combined with narrow-band imaging,higher than that of ME-NBI (348, P ＜ 0.05), C-WLI (267, P ＜ 0.01) and magnification chromoendoscopy (280, P ＜ 0.01).The detection rate of C type by magnification chromoendoscopy combined with narrow-band imaging was higher than that by magnification chromoendoscopy (93.0％ VS 79.7％, P ＜ 0.05).The accuracy, sensitivity and specificity of magnification chromoendoscopy combined with narrow-band imaging was 92.17％, 88.33％ ,96.36％ respectively.Conclusion Narrow-band imaging endoscopy combined with pigment amplification can yield more clear image of the microvascular morphology and opening of the gland, significantly improve the lesion detection rate, reduce the missing rate, and is worthy of further clinical observation and promotion.

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