Objective To evaluate the clinical significance of colonoscopy in the diagnosis of pathological changes of terminal ileum.Methods The clinical characteristics of terminal ileum,endoscopic manifestations and pathological results of 72 cases were retrospectively summarized.Results 72 cases of terminal ileum lesions diag-nosed with terminal ileum 32 cases,28 cases of lymphoid follicles hyperplasia,polyps in 5 cases,crohn's disease (3 cases),intestinal tuberculosis in 1 case,lymphoma in 1 case,small intestinal carcinoma in 1 case,terminal ileum bleeding in 1 case.Conclusion Colonoscopy is the first choice for diagnosis of terminal ileum diseases and effective method,for early diagnosis and treatment of terminal ileum diseases have important clinical significance.

BACKGROUND:Because it can reduce the risk of postoperative bone cement leakage, percutaneous kyphoplasty is increasingly used for treatment of severe osteoporotic thoracolumbar vertebral compression fractures. Studies have found that injection of mixed bone cement with high viscosity can significantly reduce the leakage of bone cement. OBJECTIVE:To compare the therapeutic efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with standard viscosity bone cement in the treatment of severe osteoporotic thoracolumbar vertebral compression fractures. METHODS:Eighty patients with severe osteoporotic thoracolumbar vertebral compression fractures were enroled and randomized into vertebroplasty group and kyphoplasty group, 40 patients in each group. Visual analog scale score and Oswestry disability index score were compared between groups before and after treatment. Incidence rate of bone cement leakage and other complications were also compared between two groups after treatment. RESULTS AND CONCLUSION:No significant difference was found between the visual analog scale scores of two groups after treatment (P> 0.05). Patients in the two groups al presented with good recovery of spinal function after treatment, and there was no difference in the Oswestry disability index scores between groups at 3 months after treatment (P> 0.05). The incidence rate of bone cement leakage was 45% in the vertebroplasty group and 30% in the kyphoplasty group, with a significant difference (P < 0.05). But the patients in both groups showed no obvious clinical symptoms and underwent no treatment. After treatment, al patients had no pulmonary embolism, bone cement toxicity, spinal cord and nerve root injury. These findings show that there is no significant difference between percutaneous vertebroplasty and kyphoplasty with high-viscosity bone cement in the folowing aspects: pain improvement, recovery of the spinal function, incidence rate of bone cement leakage and clinical efficacy.

Objective: To investigate the significance of laminin(LN) and laminin receptor(LN-R) in the proceeding and prognosis of hydatidiform mole.Methods: Immunohistochemical SP staining was used to detect the expression of LN and LN-R in 41 hydatidiform mole cases(13 cases were learned to have turned malignant by following up).20 cases of normal early gestational chorion were detected as control.Results: The strong positive rates of LN and LN-R in normal chorion,hydatidiform mole un-malignant group and malignant group were respectively 90.0%(18/20),71.4%(20/28),38.5%(5/13),and 70.0%(14/20),71.4%(20/28),84.6%(11/13).The strong expression of LN had a significant difference between malignant group and the other 2 groups(P

Objective To explore the etiology of abdominia incision hernia and treatments of giant incisional hernia of abdominal wall. Methods 14 cases with AGIH treated in our hospital from Oct 2003 to May 2008 were analyzed retrospectively. Results The etiology of abdominia incision hernia were very important,and abdominal longitudinal incision was performed, 10 cases ＞ 67y among 14 cases with incision hernia were 71.42%. Infection of incision and essential conditions( diabetes, chronic cough ,hypoalbum inemia)were also easily induced of incisional hernia. All of them chose the marlex patch. The cases were all cured and no serious postoperative complications. None of cases recurred during a follow up of 3 to 56 months. Conclusion The etiology of AGIH related with longitudinal incision,old ( ＞ 60y)and essential conditions. AGIH were repained with polypropylene mesh. Essential conditions should be treated before operation and abdominal wall should be trained comfortablely. Repairing abdominal incision hernial with artifical patch was a safe and simple operation with minimal postoperation pain.

The constitutional medical thoughts in Inner Canon of Huangdi is the foundation for TCM constitution theory, it discusses the influence of constitution on disease in detail. Constitution factors determine the disease onset or not; Constitution factors determine the tendency and character of disease. Constitution factors effect the changes of pathogenesis, the character of syndrome, the therapeutic principle and methods; Constitution factors effect the turnover and prognosis. Constitution therapies are profit to correct the partial body, preventing the development of disease and heal the disease.

Objective To investigate the application value of intraoperative ultrasound (IOUS) in living donor liver transplantation(LDLT). Methods In LDLT, IOUS techniques (gray scale ultrasound and color Doppler flow imaging) were adopted in 26 donors and recipients for parenchymal and vascular examinations. The abnormal sonograms were observed, and the anatomic findings of hepatic veins were recorded. All the reanastomosed blood vessels were examined by gray scale ultrasound and color Doppler flow imaging before the operations were completed. Results A hepatic parenchymatous tumor was revealed by IOUS in one donor. Besides, middle hepatic veins in 13 donors and secondary hepatic veins with diameter﹥0.5 cm in 5 donors were confirmed by IOUS. Furthermore, one operation procedure was changed and one hepatic artery stenosis was established according to IOUS findings. Conclusion IOUS is a very useful means in evaluation of parenchymal and vascular conditions of donors and recipients in LDLT, which helps to select the best cross section and provides evidence for the change of surgical procedures.

Objective To evaluate the value of joint inspection of rheumatoid factor ( RF) and anti-cyclic citrullinated peptide antibodies(anti-CCP antibody) in rheumatoid arthritis( RA). Methods 125 patients with rheumatic disease were selected,including RA 78 cases,non-RA 47 cases. The quantitative ELISA to detect anti-CCP antibody, latex agglutination to test RF,and the data was analyzed. Results Anti-CCP antibody positive rate was 66. 7% ,RF was 74.4% Joint detection was 62.8% , single positive rate of joint detection was not statistically significant, but the specificity of joint detection was 98.6%,positive likelihood ratio was 29.2, significantly improved compared to individual testing;Sensitivity was 49.6%,negative predictive value was 54% ,significantly lower compared to test a-lone. Conclusion Combined detection was able to improve the specificity,positive likelihood ratio and reduce sensitivity , negative predictive value. It was more useful.

Modern pharmacogenomics demonstrates that genetic polymorphisms account for the most important factor of adverse drug reactions and interindividual variations of drug therapy. Personalized medicine aims to choose the appropriate drugs and dosage for increasing the efficacy and safety with minimal adverse effects based on the patients' genotypes. This article introduce the progresses in pharmacogenomics in China, discusse many factors that influence the application of personalized medicine from bench to bedside, and highlighted the challenges and further development of this field in the future.

Objective To investigate the risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS) .Methods 181 cases of patients after TIPS diagnosed in this department from January 2009 to December 2013 were reviewed .The patients were divided into two groups:42 cases with hepatic encephalopathy (HE group)and 139 cases without he-patic encephalopathy(control group) .To evaluate the possible risk factors such as age ,sex ,pathogeny of cirrhosis ,complications [(Child-Pugh score ,portal pressure gradient (PPG ) ,Child-Pugh grading ,fibrinogen ,hemoglobin ,serum natrium ] were recorded and analyzed .Unconditional logistic regression model(W ald test)was used to screen the independent risk factors .Receiver operating characteristic curve was plotted and the area under it was calculated to evaluate the diagnose performance .Results There was no significant statistical difference between HE group and control group about age ,sex and pathogeny of cirrhosis(P>0 .05) .Analysis of unconditional logistic regression model indicated that Child-Pugh score ,PPG ,Child-Pugh grading ,were single risk factors of HE after operation(OR=1 .29 ,1 .06 ,1 .22) ,while fibrinogen ,hemoglobin and serum natrium were protective factors .ROC curve was plotted and the AUC was calculated to evaluate the diagnose performance ,which indicated the sequence was that ,Child-Pugh score> PPG>Child-Pugh grading>hemoglobin>fibrinogen>serum natrium .Conclusion Child-Pugh score ,PPG ,Child-Pugh grading , fibrinogen ,hemoglobin and serum natrium were single hazard factors of HE after operation .

Gastric cancer is a malignant tumor with high incidence and mortality in China.Invasion and metastasis of carcinotissue is one of the main reasons for the death of patients with gastric cancer.The mechanism of gastric cancer invasion and metastasis is very complicated,containing several immunomolecules and genes.Up-or down-regulated expression of these molecules in gastric cancer invasion and metastasis means that these immunomolecules and genes play some important roles in generation and progression of gastric cancer.In this review,we introduced the structure and function of these immunomolecules and genes,and their action during the course of gastric cancer invasion and metastasis.