For a qualified surgeon,a good mastery of basic medical skills is the baseline of his professional career.Besides diligent study,delicate manipulation,and constructive thinking in order to enhance his qualification,he should also pay much attention to the teamwork with his collegues,sincere treatment with his patients to build up a harmonious doctor-patient relationship,and also combine the theoretical learning and clinical practice.

Objective By detecting microsatellite instability(MSI) and loss of heterozygosity(LOH) in FHIT gene in sputum specimen,we intended to evaluate the sensitivity of FHIT gene detection to early diagnosis of lung cancer and explore effective method to screen lung cancer.Methods Based on liquid-based cytology,we collected and isolated sputum specimens in high risk group,abstracted DNA,and detected MSI and LOH in FHIT gene.Results The positive rate of MSI or LOH at single locus was between 41.6% and 49.5%;the site D3S1300 was the highest and it was 49.5%.At least 1 site out of 3 sites that had abnormal microsatellite accounted for 72.3% in lung cancer patients,two sites that appeared to change accounted for 45.5%,which was significantly different compared to non-lung cancer patients(P

Objective To study the mechanism of 5 fluorouracil(5 FU) in the treatment of severe acute pancreatitis(SAP). Methods SD rats were randomly divided into three groups:acute pancreatitis group (AP group,n=12), 5 FU treatment group( 5 FU group,n=10),and control group (n=10). In 5 FU group,5 FU(1mg/100g) were injected immediately after AP was induced.12h after the AP was induced, blood samples were taken to determine nitric oxide(NO) and interleukin 6(IL 6). Results Compared with AP group,in 5 FU group, the survival rate increased,mean survival time prolonged,ascites volume decreased significantly,and the inflammatory mediators subsided. Conclusions NO and IL 6 may play an important role in the pathogenises of acute pancreatitis. The treatment effect of 5 FU for AP may through inhibit the inflammatory mediators.

Objective To summarize our experiences in the diagnosis and treatment of traumatic splenic rupture (TSR), in order to improve the diagnosis and treatment effect of TSR. Methods Retrospective (analysis) of the diagnosis and treatment of 184 patients with traumatic splenic rupture in recent 9 years was made. Results The preoperative correct diagnosis rate was 96.7% and was established on the history of (injury), clinical presentation, abdominal paracentesis, abdominal ultrasonography and CT. All the 34 of (patients) treated nonoperatively were cured. Of the 150 patients treated by operation, two died during operation and 148 patients were cured. Conclusions Combination of obtaining a detailed history of injury, physical examination, abdominal paracentesis, abdominal ultrasonography and CT can improve the accuracy rate of (preoperative) diagnosis.Under the ensurrance of the safety of the patients' life, preservation of the spleen should be performed if possible, especially for children. Both splenorrhaphy with or without ligation of splenic artery are simple, safe and effective methods to salvage the spleen.

Objective To evaluate and compare the different result in hypertrophy of remained live lobe after double and single embolization. Methods Combined hepatic arterial embolization(HAE) with portal venous emboliza tion(PVE), HAE and sham operation were carried on the median and left lobes of the livers in normal and cirrhotic rats respectively. Three days later, the volume of the right lobe of the liver and its mitotic index and GPT content per gram protein were measured. Results In hormel rats, the indications mentioned increased significantly in experimen tal rats compared to control rats. The indications mentioned above also increased significantly in HAE+PVE group compared to HAE group. However, they increased more slightly in cirrhotic rats than in normal rats. Enlargement of the nonembolized part of the liver after double embolization is a result of hypertrophy, which enhanced the reserve function of the liver. Considering various degree of hypertrophy of liver cell and enhancement of reserve function, double embolization is more excellent than single embolization when the same volume liver is embolized.

OBJECTIVE: To investigate the curative effect and mechanism of beta-elemene interventional treatment on VX2 carcinoma transplanted on kidney in rabbits. METHODS: The rabbits were all transplanted with VX2 carcinoma on kidney. Fifty-five rabbits were randomly divided into 11 groups. Rabbits in these groups were administered interventional treatment of normal saline, iodinated oil, mitomycin, 5-fluorouracil, beta-elemene, cisplatin, carboplatin, adriamycin, thiotepa, cyclophopsphamide, and vincristine, respectively. After corresponding intervention, the tumor volume in each group was measured by ultrasonography and spiral computed tomography, and the tumor growth rate (TGR) was calculated. Nenal and hepatic functions of the rabbits in each group were compared 1 day, 7 and 14 days after the interventional treatment. Morphologic change of the tumor was observed by a light microscopy and a transmission electron microscopy 14 days after interventional treatment. The expressions of Bax and Bcl-2 were measured by immunohistochemical straining. RESULTS: There was statistical significance in the effects of different medicines intervened on VX2 kidney transplanted carcinoma. The VX2 carcinoma of rabbits had high-sensitivity to iodized oil embolism, mitomycin, cisplatin and carboplatin, which showed serious damage to the kidney function, medium-sensitivity to beta-elemene, adriamycin and 5-fluorouracil, in which beta-elemene showed slight damage to the kidney function, and resistance to thiotepa, cyclohosphamide and vincristine. Most tumor cells displayed apoptosis in the beta-elemene interventional treatment group under light microscopy and transmission electron microscopy, and only few tumor cells displayed necrosis. The Bax expression was up-regulated (P<0.05) and the Bcl-2 expression had no significant difference (P>0.05) in the beta-elemene interventional treatment group. CONCLUSION: Intervention treatment of beta-elemene has significant effect on VX2 kidney transplanted carcinoma and little side effect on the kidney function. Its mechanism is related to enhancing the apoptosis of tumor cells, and Bax gene participates in this action.

OBJECTIVE: To investigate the radiosensitization of beta-elemene on VX2 carcinoma transplanted on kidney in rabbits in vivo. METHODS: The rabbits were all transplanted with VX2 carcinoma on kidney. The appropriate dose of beta-elemene infusion via renal artery for further study on radiosensitization was determined. Then fifty-five rabbits were divided into three groups: untreated group, radiation group and radiation plus beta-elemene-treated group. After corresponding intervention for each group, the tumor volume was measured by ultrasonography and spiral computed tomography. The sensitization enhancement ratio (SER) of beta-elemene was calculated. The pathological change of tumor tissue in kidney was observed by light microscopy and electron transmission microscopy. The apoptotic index was also examined by TdT-mediated dUTP-biotin nick end labeling method. RESULTS: The most significant radiosensitivity was observed in the radiation plus beta-elemene-treated group with 6 Mev X-ray radiation dose of 3 Gy.Fx(-1).d(-1) x 5 d and beta-elemene dose of 10 mg.kg(-1).d(-1). The average time delayed for tumor growth was obviously longer in the radiation plus beta-elemene-treated group than those in the untreated group and radiation group. The SER of beta-elemene was 1.89. The apoptotic index of tumor cells in the radiation plus beta-elemene-treated group was also significantly higher than those in the untreated group and radiation group. CONCLUSION: The beta-elemene can enhance the effects of irradiation on VX2 carcinoma transplanted to kidney in rabbits in vivo by inducing apoptosis of tumor cells.

OBJECTIVE: To observe the efficacy of modified acupotome combined with blocking therapy in patients with carpal tunnel syndrome (CTS). METHODS: Fifty-five patients with CTS were divided into three groups, which were modified acupotome group including 26 CTS patients with 28 lesions treated by modified acupotome combined with blocking therapy, traditional acupotome group including 14 CTS patients with 16 lesions treated by traditional acupotome combined with blocking therapy, and blocking therapy group including 15 CTS patients with 15 lesions only treated by local blocking. The treatment outcome and one-year recurrence rate were observed. RESULTS: The response rate and one-year recurrence rate after operation in the modified acupotome group were 85.7% (24/28) and 20.8% (5/24) respectively, which had no significant differences as compared with 81.3% (13/16) and 38.5% (5/13) in the traditional acupotome group. The response rate and one-year recurrence rate after operation in the above two groups were both improved significantly as compared with those in the blocking therapy group which were 46.7% (7/15) and 85.7% (6/7) respectively. There were no acupotome-related adverse effects and injuries observed in the modified acupotome group. CONCLUSION: The modified acupotome is a considerable treatment method for CTS with respect to its simple manipulation and high effectiveness.

To observe the effects of resveratrol on proliferation of human hepatocellular carcinoma cell line SMMC-7721 cells and expression of matrix metalloproteinase-9 (MMP-9) in vitro.

Objective To evaluate the safety and tolerance of the first-line hiighly active antiretroviral therapy(HAART)regimen in Chinese HIV/AIDS patients.Methods The clinical data and laboratory results were retrospectively reviewed in 95 HIV/AIDS outpatients receiving first-line HAART regimen of zidovudine,lamivudine and efavirenz(or nevirapine)in Public Heahh Clinical Center Affiliated to Fudan University during January 2005 and August 2008.Mixed effects model and X2 test or Fisher test were used to analyze panel data and ratio data respectively.Results Totally 81%(77/95)patients had adverse events in the course of treatment,11.6%(11/95)developed grade 3 or higher adverse effects.Hematological adverse events and hepatotoxity were the most common in term of laboratory events with the total incidence of 46.3%(44/95)and 27.4%(26/95)respectively;8.4%(8/95)and 6.3%(6/95)were grade 3 or higher.In clinical events,30.5%(29/95),37.8%(36/95)and 27.4%(26/95)patients had dermatological,gastrointestinal and neurological adverse events respectively,however,only 1.1%(1/95)experienced grade 3 or higher dermatological adverse events.Conclusion The first line HAART regimen is safe and well tolerated in Chinese HIV/AIDS patients.