Objective To illustrate the relationship between the temporary alteration of renal functions of rats with obstructive jaundice due to ischemia reperfusion injury(RI) and lipid peroxidation and the expression of heat shock protein 70 in rat kidney. Methods Wistar rats were divided into 4 groups of sham operation group(S group), sham operation and renal RI group(SRI group), common bile duct ligation group(J group), common bile duct ligation and renal RI group(JRI group). One week after bile duct ligation, rat bilateral renal arteries were transiently occluded for 10 minutes. The variations of renal function were observed at different time phases after renal reperfusion. Simultaneously, the expression of heat shock protein 70 in kidney was evaluated by immunohistochemistry. Results In JRI group, endogenous creatinine clearance rate(Ccr) decreased progressively along with the prolongation of the duration of reperfusion. In J and JRI groups, the level of malondealdehyde(MDA) in renal tissue increased but superoxide dismutase(SOD) decreased. In JRI group, the expression of heat shock protein 70 reached its peak at the 4th hour after reperfusion and began to decrease at the 12 th hour and became lowest at the 24 th hour. No expression of HSP70 was found in other groups. Conclusion The sensitivity of rat kidneys with obstructive jaundice to ischemia reperfusion injury is significantly elevated. Ischemia reperfusion injury, as well as lipid oxidative stress, may be involved in acute renal failure(ARF) after obstructive jaundice surgery. The expression of heat shock protein 70 is a protective response to RI.

With the child behavioral questionnaire developed by Rutter,39 Chinesechildren(group 1-C),27 Japanese children(group 1-J)and 87 South Korean children(group1-S)were identfied as with behavioral problems,together with matched norman children of27 from China(group 2-C),30 from Japan(group 2-J)and 26 from South Korea(group 2-S)respectively,to engage in this EEG study.In a comparison between behavioral problemschildren and normal ones in each country no significant difference was found in EEG data.However,in the comparison among group 1s,group 2s and ADD-H children(group 3s:41from China as group 3-C,21 from Japan as group 3-J and,29 from South Korea as group3-S)diagnosed clinically with DSM-Ⅲ,significant difference among groups was found inEEG analyses in each country respectively.Some index of slow wave of group 3s'EEG weremuch higher than that of normal ones(group 2s).EEG data from group 3-C and gruop 3-Jshowed that the frequency-peak moved to slow frequency area.This indicates the develop-ment of ADD-H may associate with some functional abnormalities of nervious system.

Objective To compare the curative effects between one‐stage anterior debridement bone graft fusion and posteri‐or fixation fusion combined with anterior debridement bone graft fusion in the treatment of multiple lower thoracic spinal tuberculo‐sis .Methods A total of 62 patients with multiple lower thoracic spinal tuberculosis in our hospital from March 2002 to March 2010 were treated by the anterior debridement bone graft fusion ,including 32 cases of anterior internal fixation by one screw‐rod system (group A) and 30 cases of posterior internal fixation by two nail‐stick systems(group B) .The cure rate ,operation time ,bleeding volume ,the Cobb′s angle and recovery situation of spinal cord injury were compared between the two groups .Results All patients were followed up for 24-36 months (average 28 months) and showed successful bone graft fusion .In the Frankel classification e‐valuation at postoperative 12 months ,the improvement rate of spinal cord injury was 76 .92% (10/13) in the group A and 81 .82%(9/11) in the group B ,showing no statistically significant difference (χ2 =0 .087 ,P>0 .05) .The total cure rate was 84 .38% (27/32) in the group A and 85 .48% (26/30) in the group B ,showing no statistically significant difference (χ2 =0 .066 ,P>0 .05) .The Cobb′s angles before operation ,immediately after operation and at the last follow‐up were (28 .16 ± 4 .16)° ,(5 .03 ± 3 .24)° and (8 .81 ± 2 .44)° in the group A and (26 .83 ± 5 .41)° ,(5 .50 ± 3 .03)° and(8 .06 ± 2 .45)° in the group B ,showing no statistically sig‐nificant difference (t=1 .038 ,t=0 .588 ,t=1 .200 ,all P>0 .05) .The operation time was (171 .31 ± 12 .84)min in the group A and (219 .23 ± 21 .44)min in the group B ,showing statistically significant difference (t=10 .754 ,P<0 .05) .The bleeding volume was (341 .25 ± 76 .10)mL in the group A and (440 .67 ± 67 .16)mL in the group B ,showing statistically significant difference (t=5 .439 ,P<0 .05) .Conclusion One‐stage anterior debridement ,and anterior or posterior internal fixation for treating multiple lower thoracic spinal tuberculosis can obtain the better curative effect ,but selecting case is very important .

Gastrointestinal stromal tumor (GISTs) are a new recognized tumor entity. The incidence increases with time for the greater awareness of GISTs. Latest reports of the epidemiology of GISTs have been collected and sorted. Besides, it is still a controversy on the management of GISTs. While surgical en-bloc resection is the treatment of choice, imatinib is still optimal for patients with recurrent or metastatic GISTs. Preliminary promising effects have been showed on neo-adjuvant and post-operational adjuvant therapies. Imatinib-resistant GISTs become common and more targeted medication have been investigated and tested.
Gastrointestinal Stromal Tumors ; epidemiology ; therapy ; Humans ; Incidence

OBJECTIVE:To establish a RP-HPLC method for the determination of the concentration of moxifloxacin in human serum.METHODS:The separation of sample was performed on Gemini C18 column with a fixed sample injection volume of 20?L.The mobile phase was methanol-water-triethylamine(112.5∶208.9∶0.06) at a flow rate of 1mL?min-1.The UV detective wavelength was set at 289nm;the column temperature was 25℃ and the sensitivity was 0.01AUFS.RESULTS:In the range of 0.312 5～10?g?mL-1(r=0.999 8),moxifloxacin showed a good linear relation in HPLC.The recoveries of moxifloxacin at three concentrations(10,2.5,0.625?g?mL-1) were 99.46%,103.12%,and 96.14%,respectively,with intra-day RSD at 3.27%,3.35%,0.92%,respectively and inter-day RSD at 7.19%,6.25%,6.68%,respectively.CONCLUSION:This method is simple,rapid,accurate and sensitive,and it can be used for the concentration determination and the pharmacokinetic study of moxifloxacin.

In recent years, there were several extreme conflicts between doctors and patients in Otorhinolaryn-gology department. Medical field always contributes the disputes to medical system and patients′quality, however, the public blames the doctors′morality. This article analyzes these incidents in the perspective of ethics and social medicine, trying to find the causes. And it puts forward the countermeasures in terms of medical education, hospi-tal, and the medical personnel.

It has been confirmed that tumor invasion and metastasis is not only dependent on the charac -teristics of the tumor ,but also dependent on the tumor microenvironment .Tumor-associated macrophage ( TAM) , which constitutes a large number of the tumor -infiltrating immune cells,is stimulated into M1 macrophage and M2 macrophage by different signals in the tumor microenvironment .Whereas the vast majority of studies with nu-merous tumor types show that the presence of M 2 phenotypes in the tumor microenvironment is associated with a worse prognosis ,most studies in gastric cancer also claim the same results .Hypoxia and coagulation factors may both contribute to it .It has identified that the function of TAM could be changed with their location of tumor ,but it has nothing to do with cell differentiation and cell type of gastric cancer .In this review,we summarize the differ-ent and controversial effects of TAM in gastric cancer .

With the application of drug eluting stent implantation in coronary intervention, the safety and effectiveness of surgical treatment of obstructive coronary artery disease have has been improved, while the postoperative complications still appear to be a concern. In recent years, studies have found that in-stent neoatherosclosis may be an important factor in the development of late stent failure. And with the development of imaging techniques, the in-stent neoatherosclosis after drug eluting stent implantation has been further recognized. However, the mechanism of the development of in-stent neoatherosclosis is still not very clear.

Objective To discuss the efficacy and safety of decitabine plus aclacinomycin/cytarabine/ G-CSF (CAG) regimen in the treatment of patients with relapsed refractory acute myeloid leukemia (AML).Methods 17 cases with relapsed refractory AML were collected.They were given decitabine (25 mg/d,d1-5) plus CAG regimen (aclacinomycin 20 mg/d,d3-6; cytarabine 10 mg/m2,d3-9; G-CSF 400 μg/d,d0-9).Results After one course treatment by decitabine plus CAG regimen,10 patients (58.8 ％) achieved complete response (CR),1 patient (5.9 ％) achieved partial response (PR) and 6 patients (35.3 ％) displayed no response (NR),the overall response rate was 64.7 ％ (11/17).For karyotyping of chromosomal abnormalities,only 1 case (100 ％) in CR showed normal karyotype.8 cases (66.7 ％) in CR,1 case (8.3 ％) in PR showed medium karyotype.1 case (25.0 ％) in CR showed bad karyotype.Statistical analysis revealed that there were significant differences among different groups (P ＜ 0.05).Follow-up to January 31,2013,15 patients survived,2 patients died early.The median overall survival was 67 d (14-307 d),and the median relapse-free survival was 47 d (14-152 d).Conclusions The combined regimen of decitabine and CAG in the treatment of patients with relapsed refractory AML has a high response rate,little non-hematologic side effects and good tolerance.

Objective To investigate the clinical short-term outcomes after laparoscopic total mesorectal excision (TME)for rectal cancer in China.Methods A systematic literature searching was performed to identify all randomized controlled trial(RCT) studies or well-designed retrospective studies on laparoscopic surgery(LS) and open surgery(OS) for rectal cancer published from January 2003 to October 2010 in China.Two reviewers independently screened and extracted the data.The reports which matched the inclusion criteria were analyzed with Revman 5.2.Results A total of 17 RCT studies and 3 retrospective studies (2246 patients)was included in this study.The basic features of 2 groups were balance.Compared to group OR,the incidence of complications such as postoperative wound infection (RR =0.30,95 ％ CI:0.17 ～0.54,P ＜ 0.01),pulmonary infection (RR =0.47,95％ CI:0.25 ～0.91,P ＜0.05),and ileus (RR =0.41,95％ CI:0.19 ～0.88,P ＜0.05)were significantly lower in group LS.No difference was observed in the incidence of peritoneal abscess(RR =0.78,95％ CI:0.38 ～ 1.60,P ＞0.05),anastomotic leakage(RR =0.66,95％ CI:0.38 ～ 1.16,P ＞0.05),and uroschesis(RR =0.57,95％ CI:0.26 ～ 1.25,P ＞0.05).Furthermore,parameters of postoperative recovery were compared between groups,LS group manifested early recovery.Conclusions Laparoscopic total mesorectal excision for rectal cancer,with minimal invasion,benefits the postoperative recovery and reduces incidence of complications.LS radical resection of rectal cancer is technically feasible,safe,and prospectively favorable.