ObjectiveTo delineate the anatomy of left gastric artery (LGA) by CT imaging before radical gastrectomy in gastric cancer patients to facilitate intraoperative N07 lymph node dissection.MethodsPreoperative 64 spiral CT angiography (CTA) was applied to observe the origin and course of LGA in gastric cancer patients.ResultsThere were 731 gastric cancer patients undergoing preoperative image evaluation with LGA origin identified from celiac axis in 635 cases. Among those, LGA originated respectively at the crotch of splenic artery and common hepatic artery in 176 cases, from the proximal 1/3 in 292 cases, middle 1/3 in 135 cases and distal 1/3 in 32 cases. There were 9, 28, 27, 4, 4, 1, 4 and 1 cases in whom LGA originates respectively at the angle between celiac trunk and abdominal aorta, from the abdominal aorta, arteria gastrolienalis, splenic artery, common hepatic artery, left hepatic artery, artery gastrohepatica and superior mensentaric artery. LGA has not been observed in 15 cases and the origination of LGA could not be delineated in 3 cases. ConclusionsBeing familiar with the anatomy of LGA as visualized by preoperative CTA in gastric cancer patient, facilitates lymph node dissection around the LGA and decreases iatrogenic injury to vital blood vessels.

Objective To observe the efifcacy of rosuvastatin in patients with unstable angina and its impact on the levels of lipids, high sensitive C-reactive protein (hs-CRP), homocysteine(Hcy) and troponin I (cTnI). Method 384 patients with unstable angina, from January 2010 to December 2012, were randomly divided into observation group and control group, each group had 192 cases, the control group received simvastatin, the observation group were gave rosuvastatin. The efficacy, and the levels of lipids, hs-CRP, Hcy and cTnI were observed after treatment. Results The total effective rate was 92.19%in observation group which was signiifcantly better than 81.25%in control group (χ2=9.044, P<0.01). Before treatment, the levels of TG , TC, LDL-C, HDL-C, Hcy, hs-CRP and cTnI showed no signiifcant difference, after treatment the levels of TG , TC and LDL-C, Hcy, hs-CRP and cTnI were signiifcantly lower than those before treatment (P<0.01), while, the levels of HDL-C signiifcantly increased than those before treatment (P<0.01), the reducing or increasing levels in observation group were more signiifcant compared with the control group (P<0.01). Conclusion Rosuvastatin treatment in unstable angina not only can reduce plasma lipid, but also reduce their inflammation, and stabilize the arterial plaque for unstable angina, it play an important role in development and prognosis.

[Objective]To evaluate our protocol with the extensile lateral approach to open reduction and internal fixation in the treatment of displaced intra-articular calcaneus fractures.[Method]From 2001 to 2005,35 patients(41 feets)were treated with open reduction and internal fixation using extensile lateral approach,with 25 right feet and 16 left feet and with plate fixation using in 40 cases,single screw fixation using in 1 case.[Result]Evaluated with postoperative plain radiographs,90%(37/41) fracture had anatomic or near anatomic reduction of posterior facet.73%(30/41) Bhler angle above than 20? in 28 cases,32 feets among the patients were followed up at a mean of 14 months(ranged,9 to 24 mouths) and evaluated according to hind foot and ankle score system of AOFAS,average score was 87.The function were satisfactory.It took average 4 month to come back normal action,none of nerves injury,4 patients had wound hematoma.Two cases developed surgical wound edge necrosis and dehiscence among them,who were treated in initial phase in the treat group,the 2 cases were managed with dressing changes and healed in 1 month,whitout skin flaps and grafts.[Conclusion]Open reduction and internal fixation using lateral approach is a better choice to treat intra-articular calcaneal fractures,because it can correct directly the pathology of calcaneal fractures.Anatomical reduction of joint congruity and the shape of the calcaneus are important prognostic factors.

AIM: To investigate the effect of hyperhomo cysteine on endothelial cell function. METHODS: By establishing hyperhomocysteinemia model, 18 male New Zealand rabbits were divided into control group (control group) and high-methi o nine-diet group (M group). At the end of 3 weeks, M group was divided again into M+0 group (continuing high methionine-diet) and M+F group (high-methionine-diet plus folic acid, vitamin B 12). At the end of 6 weeks, isolated aortic rin g s were made and the maximum vasodilation of the aortic rings to Ach was investig ated. Meanwhile, the plasma concentrations of Hcy, NO, ET-1, Ang II at 0 week, 3 weeks and 6 weeks and the contents of NO 2-/NO 3-, Ang Ⅱ, ET-1, NOS i n regional vascular tissue at 8 weeks were also measured. RESULTS: (1) In contrast to M+F group and control group, the max imum vasodilation to Ach were decreased (E max=26.73?4.51 vs 47.84 ?5.62, 56.42?7.82, P

RNA interference (RNAi) is a newly developed technology. It is the different levels of gene silencing induced by specific degradation of targeted genes in vivo, and both exogenous and endogenous double-stranded RNAs could induce the specific degradation. RNAi has been applied in tumor therapy, viral infection, hepatitis B and many other diseases. siRNA is the effector molecule which induces the RNAi in vivo. But naked siRNA is easily degradated by RNases in vivo, and the half-life is short. Meanwhile, the transfection efficiency of the naked siRNA is comparatively low. So the naked siRNA needs the help of vectors to penetrate the cell membrane and take action. Viral vectors have the potential immunogenicity and mutagenicity in gene therapy. Therefore, non-viral vectors are drawing more and more attention. The latest development of the non-viral vectors is summarized in this review.

Diterpenes, an important class of natural compounds, are widely distributed in nature. As the valuable diterpenoids continue to be found, diterpene synthase in the course of diterpene synthesis get as much attention as possible. The multiformity of end-product-diterpenoids were also due to the diversity of diterpene synthase. This paper focuses on the advances in recent biosynthesis pathway of diterpene and types, cloning, catalytic mechanism, synthetic biology application.

Objective To investigate the influence of neutrophil-lymphocyte ratio (NLR) on radiosensitivity and prognosis,the relationship between NLR and clinical features,and the clinical value of NLR in patients with nasopharyngeal carcinoma (NPC).Methods 2006 to 2011 in the cancer center of Zhongshan University admitted to the newly diagnosed nasopharyngeal cancer patients in 266 cases.The association of pretreatment NLR with radiotherapy doses 20,40,and 60 Gy and therapeutic effect at 3 months after radiotherapy was analyzed,as well as the influence of NLR on overall survival (OS),local recurrence-free (LRF),and distant metastasis-free (DMF) rates.The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used for survival difference analysis.Results NLR showed differences across patients with different T stages and sexes (P=0.039,0.032).The patients with NLR≤3 had significantly higher OS,LRF,and DMF rates compared with those with NLR＞ 3 (P=0.004,0.025,0.045).As NLR increased,the radiosensitivity in patients with NPC was reduced gradually,and radiosensitivity showed a significant difference between sensitive group and moderately sensitive group (P=0.043).When the radiotherapy dose was 40 Gy,the tumor regression group had a lower NLR than the residual tumor group (P=0.025).Conclusions In patients with NPC,an increased pretreatment NLR is an adverse prognostic factor,and NLR can be used as a simple and convenient method to evaluate the prognosis of patients with NPC.

Objective To analyze the treatment effect and factors affecting the prognosis in young people of papillary thyroid carcinoma (PTC).Methods A total of 69 PTC patients were reviewed retrospectively in Sun Yatsen University Cancer Center from Dec 1996 to Oct 2005.The prognostic status were compared using the Kaplan-Meier methods,the factors were analyzed by Log-rank test and the multiple factors were estimated by the Cox regression models.Results There were 26 males and 43 females.The median age was 24 years (mean:23.1 years).The average follow-up time was 113 months ranging from 73 to 174 months.20.3％ patients (14/69) experienced recurrence during follow-up time and 1.4％ patient (1/69) died.All the patients received levothyroxine after operation.The 10 year disease-free survival (DFS) rate of patients with or without extra thyroidal extension (ETE) of PTC was 29.6％ and 80.1％,respectively (P ＜ 0.01).Multivariate analysis showed that young PTC people with ETE had a worse prognosis (P =0.004).Conclusions Young papillary thyroid carcinoma patients had a favorable outcome.Surgical procedure was the first choice for this kind of patients.ETE was an independent factor for the recurrence of young PTC patients.

Objective To observe the effect of a variety dosage of dexmedetomidine on circulatory and cognitive func?tions in elderly patients who underwent hip orthopedic surgery. Methods A total of 120 patients who underwent hip ortho?pedic surgery, with age over 65 years old were recruited from 06/2013 to 09/2014 and were administered intravenously dex?medetomidine after epidural anesthesia. Based on the dosage of dexmedetomidine, patients were randomly divided into 3 groups with 40 cases in each group:Group A were given 0.2μg·h-1·kg-1 dexmedetomidine;Group B were given dexmedeto?midine 0.4μg · h-1 · kg-1, and group C were given 0.6μg · h-1 · kg-1. The heart rate (HR),mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) were recorded at 6 time points, including the time entering operating room (T0), 10 min (T1), 20 min (T2) after drug administration, the time of drug withdrawal (T3), 10 min after drug withdrawal (T4) and the terminal time of surgery (T5) respectively. Cognitive function was evaluated by mini-mental state examination (MMSE) at the time points of 24 hours before surgery (t1), 12 hours (t2), 24 hours (t3), and 72 hours (t4) after surgery. Results All 3 groups of pa?tients show no significant difference of MAP, HR and SpO2 at T0 (P>0. 05).A significant decrease in MAP and HR were ob?served in Group C at T2 and T3 time points compared to those in Group A or Group B (P<0.05). There was no significant dif?ference in MMSE at time point T1 among all three groups (P > 0.05). However, compared to that in group A or group C, MMSE increased significantly at time point T2, T3 in group B (P<0.05). In addition, compared to group A or group C, the pa?tients in group B exhibited lower incidence of postoperative cognitive function disorder (P < 0.05). Conclusion Continu?ous intravenous infusion of Dexmedetomidine can be used in elderly patient who underwent hip orthopedic surgery at the dose of 0.4μg·h-1·kg-1 safely with little interference to circulatory and cognitive function in perioperative period.

Objective To study the effects of using the dropping retention-enema in the clinical practices.Methods Divided 60 cases who need retention-enema into the experimental group and the control group,there were 30 cases in the each group.The traditional retention-enema method was used in the control group,while the dropping retention-enema method was used in the experimental group.Compared the related factors between the two groups.Results All the factors which can indicated the clinical effects in the experimental group were better than those of in the control group,P