0.05).The operation time was longer,volume of bleeding was less,and postoperative time of bowel gas passage and hospital stay were shorter in laparoscopic group compared to those in open group(P0.05).Conclusions This study reveals that totally laparoscopic D2 gastrectomy is safe and feasible for advanced gastric cancer,and it presents the superior character of minimal invasion.

[Objective] To investigate the clinical effect of treatment of lumbar vertebral instability with posterior interbody fusion using autogenous bone and pedicle screw fixation.[Methods]Thirty-seven cases of lumbar instability were treated with posterior spinal canal,nerve root canal decompression,pedicle screw fixation and autogenous bone grafting,and results were evaluated.[Results]Postoperative follow up time was average 25 months(ranged,12-32 months).Excellent fusion was achieved in 29 cases and good fusion was achieved in 8 cases,with good-to-excellent rate of 100%.According to JOA standard efficacy evaluation,postoperative JOA score improved significantly than preoperative one(P

Objective By analyzing the effect of adopting the responsibility system for entrusted asset management targets in some public hospitals the paper aims to explore the feasibility of doing so as to provide lessons for the reform of public hospitals in China. Methods Interviews of focus groups and surveys through questionnaires were conducted to find out about reform in the management of public hospitals in Wuxi City of Jiangsu Province, including successes and problems. Results Some problems remain to be solved while effects have been achieved in the entrusted management of public hospitals. Conclusion Reform of hospitals through entrusted management is currently a way of deepening the reform of public hospitals. Some preliminary conditions are already in place for reform in the system of public hospitals, yet support is stili needed in terms of sound policy and environment. In future reform should go a step further in personnel and distribution systems, supervised asset management, and the estabh'shment and perfection of the Corporation management structure. More efforts need to be made by the state in encouraging explorations and strengthening guidance.

Objective:To investigate the effect of simvastatin on expression of pluripotent markers Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells. Methods:Quantitative reverse transcription-polymerase chain reaction (qRT-PCR), immunofluo-rescent staining, flow cytometry, and Western blot were used to detect the expression of pluripotency markers Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells treated with different doses of simvastatin. Results:qRT-PCR revealed the more signifi-cant inhibition of gene expressions of Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells when subjected to high doses of simvastatin (10, 50, and 100 μmol/L) compared with the control group (P<0.05). By contrast, no significant difference was observed be-tween the expressions of low-dose simvastatin treatment (1 μmol/L) and control (P>0.05). The inhibitory effect of simvastatin on the gene expressions of Oct3/4 and Nanog was more significantly apparent at 50 and 100 μmol/L dosages than at 10 μmol/L (P<0.05). By contrast, no significant difference in the inhibitory expression of Sox-2 was observed among the three high-dose treatments (P>0.05). Between the two higher-dose treatments (50 and 100 μmol/L), no significant difference in the inhibitory expressions of Oct3/4, Nanog, and Sox-2 in MCF-7 cells was found. Meanwhile, in the 10 μmol/L simvastatin treatment, immunoflurescent staining showed a marked reduction in the protein expression of all three pluripotent markers in MCF-7 cells, and flow cytometry demonstrated a decrease of Oct3/4-, Nanog-, and Sox-2-positive cells (P<0.05). Western blot further revealed that the protein expression of Oct3/4, Nanog, and Sox-2 in MCF-7 cells was significantly declined by the same simvastatin dose (P<0.05). Conclusion: Simvastatin can inhibit the expression of pluripotent markers Oct3/4, Nanog, and Sox-2 in human breast cancer MCF-7 cells, proving the anti-cancer properties of simvastatin.

Objective To explore the role of nuclear factor-kappa B(NF-?B)in regulating tumor necrosis factor-?(TNF-?)expression in acute pancreatitis (AP)in rats.Methods Sixty-four Wistar rats were randomly divided into two groups:the control group(n=32)and the AP group(n=32).Acute pancreatitis was induced by introperitoneal injection of caerulein,and the animals were killded at 12 hours,24 hours,36 hours,and 72 hours respectively.The activity of NF-?B and expression of TNF-? mRNA in the pancreas were determined by flow cytometry (FCM) method and semi-quantitave RT-PCR analysis,respectively,and the correlation coefficients were analyzed.Results The levels of activated NF-?B protein and TNF-?mRNA were all significantly higher in the AP group than those in the control group at any time point(P

Objective To evaluate the correlation of chemosensitivity of cancer cells and peripheral blood lymphocytes to 8 chemotherapy agents in vitro,which was helpful to guide clinical chemotherapy for patients with lung cancer. Methods The chemosensitivity of the peripheral blood lymphocytes and tumor cells to 8 clinical routine che-motherapeutic agents was tested in 40 cases of lung cancer by using MTT method. SPSS 10. 0 was used to analyze the above indicators. Results There was no significant difference in the sensitivity of 8 clinical routine chemotherapeutic agents between peripheral blood lymphocytes and tumor cells of patients with lung cancer(P > 0. 05) ,which was posi-tive correlated to chemotherapeutic drugs between peripheral blood lymphocytes and tumor cells. Conclusion The chemosensitive test of the peripheral blood lymphocytes with MTT method in vitro was valuable for reference of selec-ting anticancer drugs in clinic for patients with lung cancer.

The national examination of doctors' qualification is the examination which assesses the medical students' knowledge and skills for doctors' work. This paper introduced autorities concerned, implementing agencies, examination forms and procedures, examination contents and keypoints, pass-ing criteria and matters needing attention of national examination of doctors's qualification be tween Canada and Australia expecting to provide references for the revolution of Chinese Examination of Doctors' Qualification.

Objective To investigate the value of endoscopic ultrasonograghy (EUS) in diagnosis and treatment of gastrointestinal neuroendocrine neoplasm (GI-NEN).Methods We retrospectively summarized the clinical data of 44 patients with GI-NEN which were confirmed by pathology and immunohistochemistry,and analyzed the EUS features and the follow-up data of patients who received EUS exam and EUS-assisted endoscopic resection.Results A total of 47 neoplasms were detected in 44 patients,in which 41 were confirmed as neuroendocrine tumors (NET) and 6 were neuroendocrine carcinoma (NEC).Under EUS,all 41 NET appeared as hypoechoic lesions with regular edge and homogeneous echographic pattern,and 18 were originated from mucosal layer and 23 from submucosal layer,which was all confirmed by pathological evaluation.All 41 NET lesions received EUS-assisted endoscopic resection,in which 17 were treated by ESD/EMR and 24 by high frequency electrotomy.Follow-up endoscopy was performed at 3-6 and 12 month after operation,which showed no residual or recurrence.Conclusion EUS may accurately determine the invasion depth of GI-NEN lesions,and provide important information for adapting appropriate treatment strategies,which has highly clinical practice value in the diagnosis and treatment of GI-NEN.

Objective To understand the current status of aloneness and analyze the influencing factors,and to provide reference to improve the aloneness among middle?aged and elderly. Methods A total of 994 middle?aged and elderly in Donggang sampled by stratified random sampling method were investigated by UCLA scale. The influencing factors were assessed by t?test and one?way ANOVA. The data were analyzed by SPSS 16.0. Results The average score of UCLA scale among middle?aged and elderly was 41.54 ± 8.91. The results indicated whether living with their children,alcohol drinking,quality of sleep,history of trauma,psychological counseling,monthly income,chronic disease and physical training were the influencing factors of aloneness among middle?aged and elderly,and the differences were statistically significant(P<0.05). Conclusion The aloneness was obvious among middle?aged and elderly in China. Health interventions and effective social support should be provided to improve the physiological,psychological and economic levels that will lead to important influence on the improvement of aloneness among middle?aged and elder?ly in China.

BACKGROUND: Oxygen-derived free radicals are produced during non-enzymatic glycosylation of diabetic protein and accompanied with decrease in nitrogen monoxide (NO) synthesis so as to cause the calcium increase in cell,evacuation of pykno-granule and apoptosis induced by activating endoenzyme.OBJECTIVE: To observe the effects of non-enzymatic glycosylation inhibitor-aminoguanidine on apoptosis of cardiac myocyte and cardiac function in diabetic rats.DESIGN: Completely randomized grouping design and controlled study.SETTING: Pharmacological Department of Jinzhou Medical College.MATERIALS: The experiment was completed at the Central Laboratory of Jinzhou Medical College between September 2002 and March 2003. Totally 54 male SD rats with 2-month old were selected.METHODS: Totally 36 rats were selected to establish diabetic model 60 mg/kg of streptozotocin were injected into the caudal vein. If blood glucose of rats was more than 16.7 mmol/L, the establishment of diabetic model was successful. Model rats were divided into diabetes group and aminoguanidine (AG) group with 18 in each group. Rats in each group were also divided into two 12-week groups with 8 and 12 respectively. Another 18 rats were determined as the control group at 2 time points: 12 weeks (n=8) and 24 weeks (n=10). Rats in each group were fed for 12 and 24in other two groups. Calculation of mass index was [heart (mg)/body mass (g)]. Myocardial tissue of left ventricle was taken out and observed with transmission electron microscope and then stained with in situ end-labeling (ISEL) method. Number of positive nucleus was counted with 10 × 10 ocular lens check system and with 10 fields ISEL method; meanwhile, their average was obtained.MAIN OUTCOME MEASURES: Whether there was apoptosis of cardiac cell and the effect on AG in changes of cardiac structure and function of diabetic rats or not.RESULTS: Eight rats were lost during the experiment because of death mass: That of rats in the 12-week and 24-week diabetic group was higher decrease and increase rate of pressure in left ventricle: That of rats in the 12-week and 24-week diabetic group was lower than that in the control in left ventricle: That in 24-week diabetes group was obviously lower than diabetic group was obviously more than that in AG group (P ＜ 0.01), and that in 24-week diabetes group was obviously more than that in 12-week Apoptosis could be observed in myocardial cell in diabetic group.CONCLUSION: Apoptosis of myocardial cell plays an important role in the development of heart failure in diabetic rats. AG can reduce the apoptosis of myocardial cell and decrease the myocardial pathomorphological abnormality.