Objective To investigate the clinical efficacy of radical operation for gastric cancer with liver cirrhosis.Methods The clinicopathological data of 56 gastric caner patients with liver cirrhosis performed on between Jan 2000 and Dec 2013 were analyzed retrospectively.Results The morbidity rate was 71％.The main complications of the group with liver cirrhosis were postoperative ascites (7 cases),delayed gastric emptying(6 cases),pulmonary infection(8 cases),intra-abdominal infection (5 cases),anastomotic leakage (3 cases).wound infection (2 cases)and,astrointestinal bleeding(1 cases).Postoperative complications of gastric cancer with liver cirrhosis were associated with age (＞ 60 yrs),Child-pugh grade(B),lymph node dissection(D2).There were no mortality.The 1-,3-and 5-year survival rates of the 56 cases were 73.2％,41％ and 26.7％.Conclusion Multi-disciplinary treatment,complete preoperative evaluation,correct perioperative management,individualized principle were the best mode on effective treatment of the patients with liver cirrhosis.

Objective To investigate the clinical outcomes of radical surgery for pancreatic body and tail tumors accompanied with sinistral portal hypertension (SPH).Method The clinicopathological data of 35 patients with pancreatic body and tail tumors accompanied with SPH operated from January 2004 to December 2014 were retrospectively analyzed.Results Of 35 patients,22 patients had body and tail pancreatic carcinomas,10 patients had malignant solid pesudopaillary tumors and 1 patients had a neuroendocrine tumor.All these patients developed splenomegaly and varices in the gastric fundus with normal hepatic function.The splenic vein pressure was (27.3 ±3.8)cmH2O (1 cmH2O =0.098 kPa),its average diameter was (1.3 ± 0.3) cm,and the speed of splenic vein blood flow was (8.9 ± 0.8) cm/s.Of the 35 patients with pancreatic body and tail tumors who underwent radical resectional operations,22 patients in addition underwent devascularization.There were 13 of these 22 patients who underwent pericardical devascularization and the remaining 9 underwent total or proximal gastrectomy.The main complications were pancreatic fistula (n =5,14.2％),intra-abdominal infection (n =4,11.5％),delayed gastric emptying (n =1,2.8％),lymphatic fistula (n =1,2.8％) and gastric perforation (n =1,2.8％).The post-complication morbidity rate was 34％.All these patients were followed-up for 6 to 60 months after operations.There was no upper gastrointestinal bleeding which occurred within 6 months of operation.Conclusion Multi-disciplinary treatment,complete preoperative evaluation,correct perioperative and individualized management enhanced efficacy in the surgical treatment of patients with pancreatic body and tail tumors with SPH.

OBJECTIVE:To observe the clinical efficacy and transdermal absorption of Suhong bone-penetrating massage drug for rheumatic arthralgia. METHODS:Suhong bone-penetrating massage drug(Chinese medicine) was applied in 300 cases with rheumatic arthralgia characterized by various symptoms such as bone spur, injury, scapulohumeral periarthritis, acute injury or chronic strain of articular surrounding soft tissue; Suhongtougu powder was used as control to treat another 120 cases with the same disease. The curative efficacies in two groups were compared. The effects of the effective components such as Muskone,Borneo Camphor,Menthol in Suhong bone-penetrating massage drug on the transdermal absorption of this preparation was investigated by transdermal test on mice. RESULTS:The total effective rate in the treatment group was 93.24% as compared with 80.00% in the control group, showing significant difference between two groups(P

6 hours). The APACHE Ⅱ and POSSUM scoring system during perioperative period was in positive correlation with postoperative morbidity and mortality. Conclusions Pancreatoduodenectomy for the treatment of periampullary carcinomas is with high risks. Postoperative mortality and morbidity were in close correlation with the risk factors.

Objective:To investigate the clinical value of serological test indicators in the identification of primary and metastatic liver cancers. Methods:We detected the serum levels of ALT, AST, ALP, TBIL, DBIL, GGT, CHE, 5'-NT, CA199, CEA, and AFP in primary hepatic carcinoma (PHC;120 cases), metastatic hepatic carcinoma (MHC;135 cases), and no liver metastatic control (135 cas-es) groups. The methods used were variance analysis and Scheffe test. ROC curve analysis was used to determine the diagnostic value of CA199 , CEA, and AFP in PHC and MHC. Results:The difference between the serum levels of AST, ALP, GGT, 5'-NT, AFP, and CEA of the PHC and MHC groups was statistically significant (P<0.05). The AFP, CEA, and CA199 areas under the ROC curve of the PHC and MHC groups revealed that AFP diagnosis of primary liver cancer had certain accuracy, whereas CEA and CA199 have some diagnostic value in differentiating primary and metastatic liver cancers. Conclusion: The detection of serum levels of AST, GGT, 5'-NT, AFP, CA199, and CEA in malignant tumor was a preliminary diagnosis of liver metastasis and can provide evidence for the dif-ferential diagnosis of PHC and MHC.

Objective To study the surgical treatment of the primary retroperitioneal sarcoma(RPS). Methods The treatment and prognosis of 63 patients with primary retroperitoneal sarcomas (liposarcomas and leiomyosarcomas) from Jan 1992 to Dec 2000 were analyzed retrospectively. Results The rate of complete tumor resection was 88.2%, and concomitant resection of involved adjacent organs was 21.6%. There was no operation death. The median survival time(MST) in liposarcomas that for was 36.5months, and leiomyosarcomas was 27.6 months. The MST in highly differentiated tumor was 34.7 months,and that of intermiade and low differtiated tumors was 18.1months(P

Objective:To identify the vision care access in rural primary health institutions and the utilization of vision inspections among rural residents. Methods:Survey data was collected from primary health institutions ( town-ship health centers and village clinics) and households. The descriptive statistics and multivariate regression analysis were applied to analyze data. Results:The household survey data shows that 33. 2% of rural residents self-reported having poor vision, and 22. 1% of rural residents stated that they had ever used vision care (vision screening or vison examinations) . The health facilities survey data shows that 84% of township health centers and 44% of village clinics can provide vision care. The multivariate analysis shows that the vision care access in township health centers is sig-nificantly correlated with the probability of residents’ utilization of vision care, but there is no significant correlation between the provision of vision care in village clinics and its utilization. Conclusions:The vision care access is low in rural China though there is a huge demand therefore. Inadequate supply of primary vision care services in primary health institutions may result in low utilization among rural residents. It is suggested that the government further pro-mote the National Public Health Service Program and strengthen the capacity of primary health facilities to provide primary vision care. To do so, an increase in the utilization of vision care among rural residents can be expected, which would thereby reduce potential losses caused by further vision impairment.

BACKGROUND:Some studies indicate that PI3K/Akt signaling pathway is associated with the expression of glucose transporter 4 (GLUT4) and the function of cAMP response element binding protein (CREB) in skeletal muscle. However, it is stil unclear whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in skeletal muscle of the rats with high-fat diet and treadmil exercise. OBJECTIVE:To investigate whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in gastrocnemius muscle of the rats with high-fat diet and treadmil exercise. METHODS:A total of 70 rats were fed with normal diet for 2 weeks, and randomly divided into common feed group (n=20) and high-fat feed group (n=50). Rats in both groups were respectively fed with common feed and high-fat feed for 8 weeks. The rats in the common feed group were equaly assigned to common feed quiet group and common feed exercise group. 20 rats from the high-fat feed group whose body weight was 1.4 times of common rats were randomly and equaly assigned to obese quiet group and obese exercise group. Rats in the quiet groups did not do exercises. Rats in the exercise groups received adaptive sports for 1 week and medium-intensity treadmil exercise for 8 weeks. RESULTS AND CONCLUSION:(1) Impairments of PI3K/Akt signaling pathway appeared in obese rats, however, the quantity of GLUT4 expression did not change obviously in gastrocnemius muscles of obese rats. The reasons for the decrease of the nuclear protein CREB level of gastrocnemius muscles of obese rats might be related to the decrease of pAkt-Ser473 level. (2) The increase of the quantity of GLUT4 expression was accompanied by significantly up-regulated pAkt-Ser473 level by exercise intervention in gastrocnemius muscles of obese rats. Exercise intervention significantly increased the expression of nuclear protein CREB in gastrocnemius muscles of chow-fed rats and obese rats, which was consistent with the changes of pAkt-Ser473. These findings suggest that pAkt-Ser473 can play an important role in the effects of high-fat diet and exercise intervention on GLUT4 and CREB protein expression in gastrocnemius muscles of obese rats.

Objective To establish an LC-MS/MS method for the detection of landiolol concentration in human blood.Methods After pretreatment with neostigmine and a deproteinization procedure, landiolol and the internal standard venlafaxine were eluted isocratically using a mobile phase consisting of acetonitrile and 10 mmoL·L-1 ammonium acetate with 0. 1% formic acid in a ratio of 3664 ( V/V ) . Separation of the respective compounds was achieved on a Waters XTerra? RP18 column (150 mmí4. 6 mm,5 μm). Quantitative analysis of landiolol was conducted by a triple-quadrupole mass spectrometer with positive-electrospray ionization source,monitored under a multiple reaction monitoring ( MRM) mode. The extracted ions monitored following MRM transitions were m/z 510. 5→423. 1 for landiolol and m/z 278. 2→215. 1 for the internal standard venlafaxine. ResultsThe calibration curve of landiolol in human blood showed good linear relationship in the range of 1. 010-2 020 μg·L-1 . The lower limit of quantitation was 1. 010 μg · L-1 . The RSD of within-day and between-day precision was less than 6. 5% and 4. 8%, respectively. The recovery rate was 92. 6%-100. 9%. Conclusion The method is proven to be simple,rapid and reliable,and can be applied to study the pharmacokinetics of landiolol hydrochloride in healthy Chinese volunteers.

Objective To investigate the effect of dexmedetomidine on the serum concentrations of S-100 β protein and neurone specific enolase (NSE) in elderly patients undergoing surgery.Methods One hundred ASA Ⅱ or Ⅲ patients,aged 65 ～75 yr with a body mass index of ＜25 kg/m2,scheduled for elective hip joint replacement surgery under general anesthesia,were randomly divided into 2 groups (n =50):control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.5 μg/kg was infused intravenously over 15 min before anesthesia induction in group D and was maintained 0.4 μg/(kg·h) until 30 min before operation end,while the same volume of normal saline was infused in group C.Anesthesia was induced by iv injection of sufentanil 0.4 μg/kg and propofol 1 ～ 2 mg/kg until loss of consciousness.Tracheal intubation was facilitated with 0.6 mg/kg rocuronium bromide and the patients were mechanically ventilated.Anesthesia was maintained with sevoflurane by target controlled inhalation (TCI) (end-tidal concentration set at 1％～3％) and sufentanil 0.2 μg/(kg·h) in both groups.BIS was maintained at 40～60 during operation.Venous blood samples were obtained for determination of serum concentrations of S-100β protein and NSE before anesthesia (baseline),operation end and at 12h after operation.Patients were sent to Intensive Care Unit when operation end.All the patients were assessed for the development of delirium by experience research staff using Confusion Assessment Method for Intensive Care Unit.The incidence of postoperative delirium within 24h after operation were recorded,and compared between the two groups.Results The serum concentrations of S-100β protein and NSE was significantly increased at T1～2 than at T0 in two groups.The total dose of each anesthetic (propofol,sevoflurane),the serum concentrations of S-1005 protein and NSE,and the incidence of postoperative delirium were significantly lower in group D than in group C (P＜0.05).Conclusions Dexmedetomidine can reduce the serum concentrations of S-100 β protein and NSE,and can also reduce the occurrence of postoperative delirium in elderly patients undergoing hip joint replacement surgery.Dexmedetomidine can provides cerebral protection in elderly patients undergoing surgery.