Objective To investigate the treatment effect of minimally invasive excision in intrahepatic bile duct stones. Methods Ac-cording to different treatment methods, 280 patients with intrahepatic bile duct stones were divided into the treatment group (180 cases) and the control group(100 cases). The control group were given open hepatic lobectomy while the treatment group were given minimally invasive treatment of hepatic lobectomy by laparoscopy. Results All patients had successfully completed surgery and the stones were removed. Compared the operation time,intraoperative blood loss,and blood transfusion of the two groups,and there were no statistically significance (P>0. 05). The postoperative hospitalization,time of drainage tube remove, time of analgestic drug use in treatment group were obviously lower than those in control group,which had statistically significance (P<0. 05). The common postoperative complications of the two groups were bile leakage,wound infection,pleural effusion and subphrenic abscess,et al. The complication rate of treatment group was 2. 2%, while it was 10. 1% in the control group, which had significant difference (P<0. 05). All the patients were followed-up for 6 months, and there was no death in patients. Conclusion Intrahepatic bile duct stones in progress could be treated by hepatic resection surgery. Laparoscopic techniques could accelerate the recovery of patients and reduce the complication rate,and it would become a new treatment option.

Objective:To screen the best extraction process of four medicinal materials in Simiao Junyi ointment by analgesic ex-periments. Methods:The analgesic experiments were performed by the hot-plate test and writhing test in mice to select the best extrac-tion process of four medicinal materials in Simiao Junyi ointment. Results:According to the results of level consistency check, the data of hot-plate test in mice in different groups had no significant difference, and the pesticide effect of Simiao Junyi ointment prepared by different extraction process was similar. However, the data of writhing test had significant difference. The extraction process of the oint-ment with the best analgesic activity was as follows:pepper and rhizoma corydalis were extracted by SFE-CO2 , myrrha and pseudo-gin-seng was extracted by 95% and 50% ethanol, respectively. Conclusion: The optimal extraction process tested by analgesic experi-ments is scientific, reasonable and feasible, and suitable for the research and development of modern traditional Chinese medicine preparations.

Objective: To analyze the reasons of rhabdomyolysis (RM) misdiagnosed with diabetetic ketoacidosis (DKA), to clarify the mechanisms of metabolic acidosis caused by RM and DKA, and to enhance the clinical understanding of RM and metabolic acidosis. Methods: The general situation, clinical manifestation, laboratory examination results of the patient who was admitted with DKA and was diagnosed as RM in our department, were collected. Based on the literatures, the causes and manifestations of RM, as well as the treatments and prognosis of the acute kidney injure (AKD induced by RM, and the reasons of RM of the presented patient were analyzed; the similiarities and differences of the mechanisms and treatments of metabolic acidosis caused by AKI induced by RM and DKA were discussed. Results: The patient who was a 56 year-old female with hyperlycemia for 15 years, and fatigue, nausea and vomiting for 4 d was admitted. The physical examination results showed facial edema, dry tongue, poor skin elasticity, heart rate 110 min-1, severe depressed edema of extremities, muscle strength IT level. The anxiliary examination results demonstrated that the levels of blood muscle enzymes, myoglobin, urea nitrogen and creatinine were increased; the blood gas analysis indicated metabolic acidosis, accompanying with electrolyte disturbance and abnormal blood routine. According to the history, symptoms and signs, as well as the laboratory test results, the patient was diagnosed as RM, AKI, metabolic acidosis combined with respriatory alkalosis, electrolyte disturbance, and so on. The clinical symptoms and signs of the patient were recovered, and the blood creatine kinase, myoglobin and renal fuction were significantly improved after the treatment of adequate volume replacement, alkalization and protection of vital organs; the patient had a good prognosis. Conclusion: The diabetic patients may suffer from metabolic acidosis due to various causes which should be paid attention to differential diagnosis. There are some differences of the mechanisms and treatments of metabolic acidosis caused by AKI and DKA. If given the treatment of adequate volume replacement, alkalization early and aggressively, the metabolic acidosis caused by RM combined with AKI can have an excellent prognosis.

Objective To explore the feasibility and value of treating esophageal thoracic fistula with covered esophageal stent through nasal esophagus drainage tube. Methods Seven patients with esophageal thoracic cavity fistula were enrolled and treated by 5F pigtail side-holes catheter inserting into thoracic cavity for drainage and then again through nasal esophagus and fistula, placing a covered stent in the esophagus to occlude the orifice of the fistula. The abscess cavities were washed and radiographied periodically through drainage tubes. Results The insertion of the drainage tube and the placement of covered stent were all successful. The drainage tubes were placed in abscess cavities for 12-22 days, average 15 days. The radiography through drainage tubes showed that the abscess cavities disappeared or shrank obviously with control of hydropneumothorax before the drainage tubes being pulled out. The esophagogram after withdrawal of the drainage tubes notified that the fistulae were occluded satisfactorily with stents expanded fully without displacement and stenosis. Conclusions Treating esophageal thoracic cavity fistula with covered esophageal stent through nasal esophagus drainage tube is feasible and safe with clinical efficiency.

Objective:To confirm the relative humidity conditions of preparation of Hericium Erinaceus and Lumbricus ( HD) bio-transformation and the longest operation time under the conditions through the study on hygroscopicity of dry extract powder. Methods:The solution was prepared respectively in the environment with various humidity, and the moisture absorption rate and critical relative humidity ( CRH) of dry extract powder of HD biotransformation were measured, and then the mathematical model was built and the curves of moisture percentage vs relative humidity was drawn. The parameters of moisture absorption rate, and the relative humidity and operation time with the moisture percentage up to 5% were calculated. The analytic geometry and linear regression method were used to calculate CRH, so as to determine the air humidity control range and the conditions for the production and storage process. Results:The moisture absorption of HD dry extract powder could reach 5% when exposed to the air respectively with the relative humidity of 66. 0%, 80. 8%, 88. 2% and 99. 0% for 7. 088, 3. 953, 2. 892 and 0. 661 h. When the moisture percentage reached 5%, the rela-tive humidity and the shortest time was 50. 84% and 9. 937 h, respectively. The CRH of the dry extract powder of HD biotransforma-tion was 68. 12%. Conclusion:When the dry extract powder of HD biotransformation is under preparation, the relative humidity of en-vironment should be controlled below 50. 84% with the operation time shorter than 9. 937 h, or the relative humidity is controlled below 68. 12% with the operation time shorter than 6. 810 h. Under the above conditions, the moisture absorption rate of HD dry extract pow-der can be controlled below 5%, which does not affect the preparation.

Objective:To explore the degradation effect of gamma-rays radiation sterilization on the effective constituents in Simiao Junyi ointment and study the changes of fingerprint chromatography before and after the sterilization to provide basis for the feasibility of gamma-rays radiation sterilization for Simiao Junyi ointment. Methods:The contents of tetrahydropalmatine and PNS ( Panax Notogin-seng saponins) in Simiao Junyi ointment were determined by HPLC, and the fingerprint chromatography was established. The content changes of tetrahydropalmatine and PNS in Simiao Junyi ointment before and after the gamma-rays radiation sterilization were compared among the same batch and various batches, and the relative retention time and relative peak area in the fingerprint chromatography were also compared. Results:The content of tetrahydropalmatine had no change basically before and after the gamma-rays radiation steriliza-tion(P >0. 05), and there was no change in the total content of PNS (P >0. 05). Comparing the HPLC fingerprint chromatography at 280 nm, the relative retention time had statistically significant change after the gamma-rays radiation sterilization ((P <0.05), while the relative peak area had no statistically significant change(P >0. 05). The number of characteristic peaks reduced by one, namely the C8 characteristic peak disappeared in the pasteurized chromatography, and the areas of C6, C9 and C14 peak decreased significantly, while that of C12 increased. Conclusion:Gamma-rays radiation sterilization have no notable effect on the content of tet-rahydropalmatine and PNS in Simiao Junyi ointment, it can be used for the sterilization of Simiao Junyi ointment.

Objective:To establish an analytical method for HPLC fingerprint chromatography of Simiao Junyi ointment to provide basis for the quality control standard. Methods:The separation conditions were established to obtain the HPLC fingerprint chromatog-raphy of the main ingredients in Simiao Junyi ointment. The conditions were as follows:the chromatographic column was Ultimate C18-ODS(250 mm ×4.6 mm,5 μm), the mobile phase was acetonitrile-0.1% phosphate solution, the flow rate was 1.0 ml·min-1, the detection wavelength was 280 nm, and the column temperature was 35℃. The common peaks in the chromatography were analyzed for their belongings. Results:Gradient elution was performed under the above optimal separation conditions, the constituents in Simiao Ju-nyi ointment were separated from each other perfectly, and the optimal fingerprint chromatography was obtained. Though the methodolo-gy examination, the indicators such as precision, stability and repeatability of the method were all promising, and the fingerprint chro-matography could be seen clearly and was easy to be analyzed. The relationships between Simiao Junyi ointment and the common peaks of four medicinal materials in the fingerprint chromatography were preliminary determined, which provided important basis for the quali-ty control of Simiao Junyi ointment. Conclusion:The HPLC fingerprint chromatography of Simiao Junyi ointment can be used as an a-nalysis method for the quality control of Simiao Junyi ointment, which provides reference for the quality control standard for the finished product.

BACKGROUNDPulmonary blastoma is a rare primary malignancy of the lung. It is now recognized in two forms: adult type pulmonary blastoma and childhood pleuropulmonary blastoma. The clinical characteristics, diagnosis and treatments of adult type pulmonary blastoma are discussed in this article.

METHODSThe clinical records of 5 patients with adult type pulmonary blastoma admitted in Cancer Center, Sun Yet-sen University from 1964 to 2004 were analyzed and the literature on pulmonary blastoma was reviewed.

RESULTSThree patients were male and two were female with the ages ranged from 22 years old to 70. Their symptoms consisted mainly of cough, hemoptysis and chest pain. The pulmonary blastomas were mainly manifested as a solitary parenchymal mass of the lung on chest radiograph and CT. None of these patients was diognosed by fibrobronchoscopy nor sputum cytology. Three patients underwent lobectomy, one underwent pneumonectomy, and these four patients underwent mediastinal lymph node resection also. The fifth one received wedge resection and postoperative chemotherapy. At the end of follow-up, three patients died and two was alive, and the survival time was from 6 months to 11 years.

CONCLUSIONSPulmonary blastoma is difficult to be diagnosed before operation. Surgery is the best therapeutic choice up to now. It has poor response to radiotherapy and chemotherapy. The prognosis of patient with pulmonary blastoma is variable.

Objective To investigate the effects of baicalein and acitretin on the apoptosis in a human cutaneous squamous cell carcinoma cell line, SCL-12. Methods Cultured SCL-12 cells were treated with different concentrations of baicalein (3.125, 6.25, 12.5 μmol/L) and acitretin (2.5, 5.0, 10.0 μ mol/L), alone or in combination, for 48 hours. Subsequently, cell proliferation was detected by MTT assay, and cell apoptosis by ELISA as well as annexin V-FITC and propidium iodide double staining. Real-time quantitative RT-PCR was used to detect the expression of Fas mRNA in SCL-12 cells. Results The cell proliferation of SCL-12 cells was inhibited by baicalein and acitretin alone or in combination. The combination of baicalein and acitretin at the three tested concentrations, except for that of baicalein at 3.125 μmol/L and acitretin at 2.5 μmol/L, more strongly inhibited the proliferation of SCL-12 cells compared with baicalein or acitretin alone, and the inhibitory effect was in a dose-dependent manner. The early apoptosis rate was 9.39% ± 1.52%, 20.86% ± 2.16%,36.85% ± 3.26% in SCL-12 cells treated with baicalein of 3.125 μmol/L, acitretin of 5.0 μmol/L alone and their combination, respectively, significantly higher than that in untreated cells (4.39% ± 0.64%, all P <0.05); the induction of apoptosis in SCL-12 cells by the combination of baicalein and acitretin was stronger than that by baicalein or acitretin alone (F = 138.44, P < 0.05). Baicalein and acitretin alone or in combination significantly increased the mRNA expression of Fas in SCL-12 cells, and the effect of their combination was stronger than that of baicalein or acitretin alone. Conclusions Baicalein and aeitretin could inhibit the growth of and induce the apoptosis in SCL-12 cells, and the effect is enhanced by the combination of baicalein and acitretin, which may be associated with the upregulation of Fas expression in SCL-12 cells.

Objective Discuss clinical type and treatment of postoperative digestive tract fistula and associate complications of esophageal or cardiac cancer.Methods Analized clinical manifestations and treatment retrospectively of 53 cases of digestive tract fistula after operation of esophageal or cardiac cancer from January,2010 to December,2012.Results All the 10 undergoing surgery are cured by reoperation.2 died of mediastinal infection and sepsis.4 died of respiratory failier,malnutrition,left and right bronchal fistula,respectively.Conclusion There are 4 types of fistula:Ⅰ type of sepsis,Ⅱ type of respiratory failure,Ⅲ type of thoracic infection,Ⅳ type of neck inection.Reoperation within 24 hours is the key of suscessful repairment of intrathoracic anastmotic leakage.Bronchal fistula or respiratory failure caused by multiple thoracic encapsulated effusion is also the indication of surgery.Complete lung reexpansion and complete drainage is the key.Mini-invasive VATS is the method of exact drainage.