Objective To discuss the therapy of cholelithiasis complicated with cirrhotic portal hypertension (CPH).Method In this study,clinical data were reviewed on 108 cases with cholelithiasis complicated with hepatic cirrhosis,including 78 cases who underwent surgery.Results Open cholecystectomy,subtotal cholecystectomy,laparoscopic cholecystectomy,open cholecystectomy plus spleectomy,splenectomy plus pericardial devascularization before biliary duct operation,leftlateral hepatectomy with biliary duct operation,and hepatic portal bile duct anaplasty with Roux-en-Y cholangiojejunostomy.10 patients received endoscopic treatment and 20 were treated conservatively.Results 73 patients were cured,with a cure rate of 67.6％; 32 patients were doing well (29.7％);3 patients died (2.8％) of massive hemorrhage and hepatic failure.The operative complications included ascites,jaundice,hemorrhage and hepatic insufficiency.Conclusions Before operation,the conditions of the patient should be accurately evaluated and a correct operative treatment option should be selected.Child C grade patients should be contraindicated for any surgery.

Objective To investigate the role of homocysteine(Hcy)and homocysteine thiolactone(HcyT)in the development of macrovascular complications in patients with type 2 DM.Methods A total of 160 subjects were recruited in this study:40 healthy controls,120 with type 2 DM.Plasma Hcy levels were measured by Polarization Immunoassay(FPIA),and HcyT concentrations were monitored using high-performance liquid chromatography(HPLC)on a reversephase C18 column with ultraviolet detection.Plasma folic acid and Vitamin B12 levels were measured with radioimmunoassay method.Results Plasma Hcy and HcyT concentrations in type 2 DM patients were significantly higher than healthy controls[Hcy:9.28(7.51～11.82)?mol/L vs 5.64(5.17～8.00)?mol/L,P

[Objective]To evaluate outcome of the treatment of unstable distal radius fractures in the elderly patient using a volar T-shape plate.[Method]From January 2001 to April 2003,42 cases with unstable distal radius fractures older than 60 years(range 60～75 years;mean age 65.1 years) were treated with a T-shape plate fixation.The fractures were classified according to the AO classification of distal radius fracture: 4 A2,7 A3,5 B1,3 B3,9 C l,11 C2,3 C3.Artificial bone graft substitutes were used in 28 cases with severe cortex destruction and insufficient buttress.[Result]All patients were followed up(mean 18.2months,range 12～24months).Final volar tilt was averaged 3.66? and radial tilt 20.1?,and radial shortening averaged 1.59 mm in 6 cases.Step-off or gap of the articular surface was found in 6 cases(mean

AIM: To study the effect of selectin on lung injury in rabbits with diabetic ketoacidosis(DKA). METHODS: 12 male New Zealand rabbits were divided into experimental group (DK groups, intravenous injection of streptozocin and alloxan monohydroate, n =6) and normal control group (received same dose of saline, n =6). After 72 hours, all the animals were killed and blood and lung tissue were collected. Blood gases, expressions of selectin-P and selectin-L were detected. RESULTS: The expression of selectin in DK group were higher than that in NS group. CONCLUSION: These results indicate that selectin expression may play an important role in lung injury during diabetic ketoacidosis.

Objective To explore the effect of the rehabilitation of Traditional Chinese Medicine(TCM)and neurophysiological therapy(NPT)on motor function in patients with stroke.Methods62 patients with ischemic or hemorrhagic stroke at the recovery stage were divided into two groups.They were given the routine medical treatment and rehabilitation.The patients in the TCM group were given rehabilitation of TCM,while the patients in the control group were given rehabilitation of NPT.They were evaluated with Fugl-Meyer Assessment(FMA)and the Barthel Index(BI)at the beginning and the end of the treatment.ResultsAfter the treatments,the scores of FMA and BI improved obviously in both groups.The BI of the TCM group improved more than that of the control group after the treatments(P=0.015).But the improvement of the FMA between these two groups was not significant.ConclusionBoth the rehabilitation of TCM and NPT can significantly improve the function of stroke patients during the convalescent stage,and TCM is more effective on activity of daily living.

Objective To establish the cell line from specimens of resectable human gastrointestinal stromal tumors (GIST) and to verify the characteristics of cell biology in vitro. Methods The tissues from biopsies of human GIST were cultured in RPMI 1640 media supplemented with 10% fetal bovine serum. After growing to 90% confluence,the cells were detached for subculture and their characteristics,including morphology,growth kinetics,karyotype analysis,immunohistochemical analysis and tumorigenicity in nude mice were determined. Results GIST named GIST-H1 was successfully established. The cell line was passaged for more than 60 times 1 year. The characteristics demonstrated: The population doubling time calculated in the log phase of growth was 47.5 h. The cloning efficiency in the soft agar averaged 24.8%.Electronmicroscopically,there were rich ribosomes and mitochondrion in the cytoplasm. Immunohistochemical analysis showed CD117(+),SMA(+),dog-1(+),CD34(-),and S-100(-).Karyotype analysis illustrated aneuploidy with the modal chromosomal number 60-98.The GIST cells transplanted in nude mice had high tumorigenicity. Conclusion The immortalized GIST cells are devoloped in vitro and have specific characteristics of GIST.

Objective: To investigate the diagnostic value of serum SCC, NSE, CEA, and CYFRA21-1 for lung cancer patients.Methods" The levels of SCC, NSE, CEA, and CYFRA21-1 were detected by electrochemoluminescence immuno-assay in 132 lung cancer patients, 48 patients with benign lung diseases and 92 healthy people.Results: The levels of NSE, CEA, and CYFRA21-1 in patients with lung cancer were higher than those in patients with benign lung diseases and in.normal controls.The level of SCC in patients with lung cancer was higher than that in normal controls.The levels of CEA and CYFRA21-1 in patients with benign lung disease were higher than those in normal controls.Patients with adenocarci-noma had the highest level of GEA and patients with small cell lung cancer had the highest level of NSE.Patients with squamous cell carcinoma had the highest levels of SCC and CYFRA21-1.The sensitivity sequence of the tumor markers in lung cancer was: NSE>CEA>CYFRA21-1>SCC.CEA showed the highest sensitivity of about 58.8% in adenocarcinoma.CYFRA21-1 showed the highest sensitivity of about 71.4% in squamous cell carcinoma.NSE showed the highest sensitivi-ty of about 50% in small cell lung cancer.ROC curves showed that the under-curve area of NSE, CEA, and CYFRA21-1was 0.928±0.034, 0.957±0.026, and 0.964±0.023, respectively.The combination of NSE, CEA, and CYFRA21-1 presented with the highest sensitivity (75.6%) and good specificity (90.7%) for the diagnosis of lung cancer.The combination of SCC, NSE, and CEA detection presented with the highest sensitivity (73.5%) for the diagnosis of adenocarcinoma.The combina-tion of NSE, CEA, and CYFRA21-1 showed the highest sensitivity (87.5%) for the diagnosis of squamous call carcinoma.The combination of SCC, NSE, and CYFRA2.1-1 showed the highest sensitivity (75.0%) for the diagnosis of small cell lung cancer.Conclusion: The assay of SCC, NSE, CEA and CYFRA21-1 is useful for the diagnosis of lung cancer and the ex-pression of the four tumor markers is closely correlated with pathological types.The suitable combination of tumor markers is helpful for differential diagnosis of lung cencar.

Hyperthyroidism and acromegaly formed an unusual association.An acromegaly patient with a toxic thyroid adenoma was reported here,including clinical features,treatment,and final outcomes.The association of thyroid disease with acromegaly was reviewed.

Background and objectives Hyperhomocysteinemia is an independent risk factor for cardiovascular disease. Homocysteine thiolactone (HcyT), one of the homocysteine metabolites in vivo, is toxic both in vivo and in vitro. The aim of this study was to investigate the effect of HcyT on apoptotic damage in human umbilical vein endothelial cells (HUVECs) and the role of antioxidants in the reduction of HcyT-induced apoptosis. Methods HUVECs were cultured in DMEM supplemented with 20% heat inactivated fetal bovine serum cell cultures were maintained in a humidified 5% CO2 atmosphere at 37 ℃. Cytotoxicity was determined by MTT assay,which consists of hypodiploid cells with propidium iodide labeling and intracellular reactive oxygen species levels using 2',7'-dichlorofluorescein diacetate as the probe by flow cytometry. Results HcyT (250-2000μM) induced HUVECs apoptosis in a time- and concentration-dependent manner. Reactive oxygen species levels rose in response to increasing HcyT concentrations at 24-h incubation.The reduction of cell apoptosis by N-acetylcysteine, vitamin E, or pyrrolidine dithiocarbamate, occurred simultaneously with a significant decrease in intracellular reactive oxygen species levels. Conclusion HcyT exerts its cytotoxic effects on endothelial cells through an apoptotic mechanism involving cellular reactive oxygen species production. The capacity of N-acetylcysteine, vitamin E, and pyrrolidine dithiocarbamate to scavenge HcyT-induced cellular reactive oxygen species correlates well with their efficiency to protect against HcyT-promoted apoptotic damage. The protective effect of pyrrolidine dithiocarbamate on cell apoptosis indicates HcyT-generated hydrogen peroxide may provoke cell apoptosis via activating nuclear factor-kappa binding protein.

Objective To describe a case of female sexual abnormality with 46, XX caused by an androgen-producing adrenocortical tumor and to explore the mechanism of abnormal androgen secretion from the tumor. Methods The tumor tissues as the experimental group were compared with the normal adrenal tissue. The LH/human chorionic gonadotropin ( hCG) receptor was determined by immunohistochemisty, the activity of 3β-hydroxysteroid dehydrogenase ( 3β-HSD ) , 17α-hydroxylase ( CYP17 ) , and 17β-hydroxysteroid oxidoreductase ( 17β-HSD ) by enzyme linked immunosorbent assay(ELISA) and the expression of mRNA of 3β-HSD2, 17β-HSDB3, CYP17, and LH/hCG receptor by real-quantitative polymerase chain reaction ( RQ-PCR ) . Results The immunohistochemisty results showed that the LH/hCG receptor was negative in the experiment group, but positive in control. The activity of 3β-HSD and CYP17 of the experiment group was higher than that in the control (P<0. 01), while the activity of 17β-HSD was lower(2 638. 798±70. 551 vs 9 148. 174±382. 836, P<0. 01) according to ELISA results. The relative contentof3β-HSD2mRNAoftheexperimentgroupwashigherthanthatinthecontrol(P<0.05),andtherelative content CYP17 mRNA of the experiment group was much higher than that in the control (P<0. 01). However, the relative content of 17β-HSDB3 mRNA and LH/hCG receptor mRNA were much lower than those in the control ( P<0. 01) by RQ-PCR. Conclusion Sexual abnormality and virilization could be caused by the excessive androgen secreted by androgen-producing adrenocortical tumor, which is an extremely rare disease. The mechanism of the secretion of androgen from the tumor remains unknown so far. It may be related to the increased activity of 3β-HSD and CYP17, but has no relationship with the expression of LH/hCG receptor.