Objective:To retrospectively evaluate the prognostic risk factors of patients with gallbladder carcinoma and the effect of normal prognostic nutrition index (PNI) on the survival. Methods:We retrospectively analyzed 63 patients with gallbladder carcino-ma treated in our hospital between January 2008 and December 2012. The independent prognostic factors of the patients were calculat-ed by the Cox proportional hazards model. The benefit of normal PNI status on the prognosis was further explored in the patients using survival analysis. Results:Lymph node metastasis, PNI≤50, squamous carcinoma, liver invasion and choledoch invasion were the risk factors of overall survival (OS) in the univariate analysis, while only lymph node metastasis (HR=4.495, 95%CI 2.380~8.488, P<0.001) and PNI(HR=0.195, 95%CI 0.098~0.389, P<0.001) were the dependent influential factors of the prognosis and OS in the multi-variate analysis. The effect of PNI on OS was even more statistically significant different in the younger patients (≤65y) than in the el-der (>65y) (younger group:P=0.011;elder group:P=0.078). Conclusion:The gallbladder carcinoma patients with normal PNI status (>50) have better OS compared to the patients with PNI≤50, with statistical differences between the two. And it is more significant in the patients of the younger group (≤65y), comparing with the elder group. PNI could be taken as a potential prognostic evaluation factor for the gallbladder carcinoma patients and can provide a more comprehensive evaluation of patients' conditions to clinician.

Objective To observe clinical efficacy of Banxiaxiexin tonga for the treatment of helicobacter pylori related peptic ulcers.Methods 110 patients were randomly divided into two groups.60 cases received Banxiaxiexin tonga for the treatment.50 cases in the control group received omeprazole triple therapy.Results The improvement in symptoms and signs,negative ulcer healing and Hp have made a good effect in treatment group.The total efficiency is 91.6% ,the total effective rate in control group is 78.0%.There was significant difference between the two groups(P <0.01).Treatment group had no adverse reaction,the control group was 24.0% ,the difference between the two groups was significant(P < 0.01).There was no significant difference between the two groups in hpclearance(P >0.05).Conclusion Banxiaxiexin tonga had good effect on the treatment of Hp-related peptic ulcer.

High altitude retinopathy ( HAR ) refers to the body which can't adapt to the hypobaric hypoxia environment at high altitude leading to retinal diseases, which typically manifested as retinal hemorrhages, optic disc edema and cotton wool spots. With the development of high altitude medicine, HAR become a hot topic of eye research in recent years. New researches show a significantly higher incidence of HAR, and HAR has a close contact with acute mountain sickness, high altitude cerebral edema and high altitude pulmonary edema. A further study in pathogenesis and prevention measures of HAR will promote the prevention of altitude sickness. Traditional Chinese Medicine has achieved good effects in the prevention of altitude sickness, but the effect and mechanism of herbs on HAR has not been reported. Through read and summarize the relevant literatures and reports, the author will give an overview of the research advances on HAR's pathogenesis and application of Traditional Chinese Medicine.

Objective To analyze the main causes of physical disability in adults in Guangdong province in China, and to provide prevention and treatment strategies. Methods Data on Guangdong from China's Second Na-tional Sample Survey on disability in 2006 were carefully collected. Physical disability was categorized according to different causes. In each category or group, multiple factors including the severity, distribution in urban or rural are-as, and the age of onset were analyzed with appropriate statistical methods. Prevention and treatment were then for-mulated based on the data. Results The severity of disability, distribution in rural and urban areas, and the age of onset were significantly different in different groups. The main cause was cerebral vascular diseases (16.7%). The incidence of physical disability was much higher in rural areas than that in urban areas (31.8% vs 68.2% ) except for brain trauma and toxication. The main cause for physical disability among young and middle-aged people was poly-myelitis (17.1% and 14.8% respectively) ; in old people it was osteoarthrosis (35.7%). Conclusions In order to lower the incidence of physical disability and to alleviate its severity, more work should be done in the prevention and treatment of cerebral vascular disease, spinal injury, cerebral palsy, polymyelitis and osteoarthrosis. In addition more financial and technical support is needed in rural areas.

Objective:To establish a method for the determination of ethyl pyruvate by GC. Methods:A Varian CP7502 capillary column(25 m × 0. 25 mm,0. 25 μm)was used. The carrier gas was nitrogen with the flow rate of 30 ml·min-1 ,the gas was hydrogen with the flow rate of 40 ml·min -1 and the oxidant gas was air with the flow rate of 400 ml·min-1 . The detector was an FID and the inlet temperature was 210℃ . The temperature program was as follows:the initial column temperature was 40℃, and then risen to 200℃ with a rate of 15 ℃·min -1 . The split ratio was 100 ∶1 and the injection volume was 1μl. Results:Ethyl pyruvate had a good linear relationship within the range of 0. 025 6- 8. 192 8 mg·ml -1 ,and r was 0. 999 8. The average recovery was99. 99% and RSD was 1. 38%(n = 9). Conclusion:The method is accurate,simple and rapid with good stability and high sensitivity,which can be used to determine the content of ethyl pyruvate.

Objective To study the feasibility and safety of performing nephrectomy together with the removal of complicated inferior vena cava tumor thrombus under profound hypothermia and arrested circulation. Methods After made the median thoraco-abdominal incision, the exploration of the abdominal organs was done. The right kidney, inferior vena cava and renal pedicle were well exposed then. After the whole body heparinization, cannulas were put into ascending aorta, superior vena cava, aortic root and right superior pulmonary vein. The body temperature was reduced to 20℃ with cardiopulmonary bypass unit and the extracorporeal circulation was stopped then. Cut open the inferior vena cava at vena renalis dextra ingress and the F16 urinary catheter was inserted into atrum dextra through inferior vena cava and inflated. The tumor thrombus was pulled out and the right kidney was removed. The inferior vena cava incision was sutured to close and the extracorporeal circulation was resumed and patient was re-warmed.Results The operation time was 330 min and the extracorporeal circulation time was 90 min, while the profound hypothermia with circulatory arrest time was 20 min. The estimated blood loss during operation was 400 ml and 6 unit red cells and 600 ml blood plasm were transfused. The patient was awaked 2.5 h after the operation, food intake resumed 4 days after operation and the patient was discharged on day 10 post-operatively. After 6 months'follow-up, there were no local recurrence and metastasis occurred. Conclusion The technique of profound hypothermia and circulation arrest could improve the safety and efficacy in the treatment of renal cell carcinoma with suprahepatic (level Ⅲ) caval tumor thrombus.

Objective To evaluate the maneuvre of curettage and aspiration(LTCA) in laparoscopic hepatectomy. MethodsWe used Peng′s multifunctional operative dissector(PMOD) to perform laparoscopic liver transection by maneuvre of curettage and aspiration in 20 cases undergoing laparoscopic hepatectomy. Results Procedures were all successful. The recovery was uneventful without any complications. Mean operative time was 105 minutes, the average bleeding volume was 420 ml, the largest excised sample size was 10 cm?9 cm?7 cm. All patients were discharged within one week. ConclusionsThe new technique-LTCA can be used in laparoscopic hepatectomy, it has the advantages of clear anatomy, good exposure of canal construction, rapid liver transection, satisfactory hemostasis and clear operative field.

The tracheocutaneous fistula after tracheostomy is a complex clinical problem. An ideal fistula closure is still difficult at present though a variety of fistula-closing methods have been reported in the literature. We used a turnover skin flap to cover the fistula. All the procedures were completed at bedside under local anesthesia. The fistula was successfully closed and well healed without complications within 7-9 days. It has been proven that this operation is simple, effective, and safe.
Aged ; Aged, 80 and over ; Cutaneous Fistula ; etiology ; surgery ; Female ; Humans ; Male ; Postoperative Complications ; surgery ; Respiratory Tract Fistula ; etiology ; surgery ; Surgical Flaps ; Tracheal Diseases ; etiology ; surgery ; Tracheotomy ; adverse effects

AIMTo investigate the variation of CYP2C9 isoenzyme activity in the microbial model in response to inhibitors of CYP2C9.

METHODSUsing C. blakesleeana AS 3. 910 as a model strain, the impact of CYP2C9 inhibitors on the metabolites yields of CYP2C9 substrates was determined and the drug-drug interactions among CYP2C9 substrates were evaluated. Liquid chromatography-mass spectrometry was used to analyze biotransformation products.

RESULTSBenzbromarone decreased the yield of 4'-hydroxytolbutamide from 100% to 14.5%; sulfaphenazole decreased the yield of O-demethylindomethacin from 75.2% to 9.9%; valproic acid decreased the yield of 4'-hydroxydiclofenac from 98.6% to 2.7%, separately. Tolbutamide, indomethacin and diclofenac interacted with each other, resulting in the decreased formation of metabolites catalyzed by CYP2C9.

CONCLUSIONThree CYP2C9 inhibitors inhibit the activity of CYP2C9 isoenzyme in C. blakesleeana AS 3. 910 differently, and there are drug-drug interactions among CYP2C9 substrates.

Aryl Hydrocarbon Hydroxylases ; antagonists & inhibitors ; metabolism ; Benzbromarone ; pharmacology ; Biotransformation ; drug effects ; Catalysis ; drug effects ; Chromatography, High Pressure Liquid ; methods ; Cunninghamella ; enzymology ; metabolism ; Cytochrome P-450 CYP2C9 ; Diclofenac ; analogs & derivatives ; metabolism ; pharmacology ; Dose-Response Relationship, Drug ; Drug Interactions ; Fungal Proteins ; antagonists & inhibitors ; metabolism ; Indomethacin ; pharmacology ; Isoenzymes ; antagonists & inhibitors ; metabolism ; Spectrometry, Mass, Electrospray Ionization ; methods ; Substrate Specificity ; Sulfaphenazole ; pharmacology ; Tolbutamide ; analogs & derivatives ; metabolism ; pharmacology ; Valproic Acid ; pharmacology

Objective To explore the genetic interactions between angiotensin-convertingenzyme (ACE) I/D and methylenetetrahydrofolate reductase (MTHFR) C677T genotypes in middlecerebral artery stenosis (MCAS) among the asymptomatic residents in Foshan area of China. MethodsUsing a cluster sampling method, 2500 subjects were randomly selected from the residential communitiesof Rongqi town of Foshan area, Guangdong Province. By means of epidemiological questionnaire survey,physical examination, examination of the biochemical markers and transcraniai color Doppler (TCD), 897eligible subjects (306 males and 591 females) were selected from this population and subsequentlydivided into MCAS group and control group according to the TCD results. ACE and METHFR genepolymorphism analyses were conducted using amplified fragment length polymorphism-polymerase chainreaction (AFLP-PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP). Chi-square test, t test, Mann-Whitney test and logistic regression analysis were used to analyze the data. ResultsGender, age, waist-to-hip ratio (WHR) and Ⅱ+CC genotype distribution in the subjects with MCAS weresignificantly different from those in the control subjects. Logistic regression analysis identified age andACE Ⅱ+ MTHFR CC genotype as the independent factors that affected MCAS. Conclusion There aregenetic interactions between ACE I/D and MTHFR C677T genotypes, and the ACE Ⅱ+MTHFR CCgenotype is an independent genetic factor for protection against MCAS in the asymptomatic residents inFoshan area of China.