Objective To improve the diagnosis and therapeutic efficacy of primary gallbladder carcinoma.Method A retrospective clinical analysis was made in 36 cases of gallbladder carcinoma treated in our hospital from 1986 to 2001.Results 74.3% cases were definitely diagnosed before operation. 64% patients were accompanied with gallstone.17% cases were misdiagnosed.Ultrasonography and CT were the main method of diagnosis of gallbladder carcinoma.26 cases underwent surgical treatment with a resection rate of 55.6%.Postoperative 1 and 5 years survival rate of resection were 36% and 10%.Conclusions Radical resection is the mainstay for stage Ⅰ,Ⅱ,Ⅲ gallbladder carcinoma,and comprehensire treatment is fit for stage Ⅳ,Ⅴ.Early diagnosis and radical resection are the efficient methods for long-term survival of the patients with gallbladder carcinoma.Cholecystectomy on the time is necessary to the high-risk gallstone.

Objective To explore the method of laparoscopic splenectomy and pericardial devascularization . Methods Hand - assisted laparoscopic megalosplenic resection and portozygos disconnection (HLMRPD) was perfor medin 2 patients with portalhy pertension and hypersplenism from August 2 0 0 1to May 2 0 0 2 . Results Theoperation was completedsucces sfully in both patients.The intraoperative blood losswas 30 0ml and 35 0ml,respectively ,and the operation time ,2 35 min and 2 6 5 min ,respectively .Both patients recovered smoothly without posto perative complications . Conclusions HLMRPD is a safe ,minimally invasive and effective procedure.

Fast-track recovery emphasize applicating a series of effective measures confirmed in the perioperative care of patients,the optimized combination generates synergy effect to maximize alleviating various physical and mental stress reaction in order to expedite patient recovery.Most successful example is the application of fast track colon surgery program.Its safety and effectiveness have been widely confirmed,but the report on pancreas surgery is limited.FTRP is aiming to improve medical and health work efficiency,reduce hospitalization time and hospitalization expenses,improve life quality of patients.Based on the application of FTRP in pancreatic cancer,the relation of morbidity,re-admission and peri-operative mortality rates and clinical significance are reviewed.

As a tool, cholelithiasis animal models have become an important platform for pathogenetic, preventative, diagnostic and therapeutic research. As biliary calculus formation has a close relationship with dysfunction of hepatic and biliary systems, inability of lipid metabolism homeostasis and impairment of immunologic barriers, increasing studies have been carried out with the use of animal models in these fields. Animal genetic susceptibility to cholelithiasis has greatly attracted people's attention in recent years and cholelithiasis animal models have been used in Chinese traditional medicine development and authentication. Furthermore, reports on invasive and traumatic research have been published in which large animal models were used. It is supposed that technical progress and scientists' demands would result in wide application of more kinds of cholelithiasis animal models.

Purpose: To investigate the effect of gum chewing on the cognitive function of attention. Methods: Based on gum chewing habit, trait-anxiety variable, and different treatments(with or without gum chewing) during experiment,181 college students with good health were assigned to four groups GH (with chewing gum treatment and habit), GL (with chewing gum treatment, no habit), CH (no treatment,has habit) and CL (no treatment,no habit). Two attention tasks: Continuous Performance Test (CPT-AX) and Conjunctive Search Task (CST) were performed by all subjects in the laboratory.Results: Chewing gum during experiment had positive effect on attention performance, and the habit of gum chewing played an important role. Conclusion: Gum chewing had positive effect on attention performance, suggesting the effects mainly came from the familiarity of gum-chewing.

Elastic stable intramedullary nailing (ESIN) is a well-accepted fixation method of long bone fractures in children.The advantages of ESIN include primary bone union with avoidance of growth plate injury and minimum invasive surgery.The good results of ESIN are obtained when surgeons have a good knowledge of the principle of the correction of the fracture and its stability, especially in the understanding of the unique pathophysiology characteristics of pediatric fractures.This review discussed the biomechanical mechanisms of ESIN, and the principles,indications and contraindications of ESIN in the treatment of pediatric long bone fractures.The article also comprehensively introduced the application of ESIN in femur,tibia,fibula,humerus, ulna, radius,clavicle and metacarpal bone fractures.The technique details of nailing, preoperative planning, positioning of the patient, sizing of the nail, entry points for the nail, reduction maneuvers for safe passage of nails through the fracture site, and postoperative management were also introduced in this review.

Objective To discuss the clinical effect of aspirin combined with clopidogrel therapy in pa?tients with transient ischemic attack( TIA)/light stroke. Methods One hundred and forty?eight cases with tran?sient ischemic attack/light stroke were divided randomly and voluntarily into the control group( n=74) and ob?servation group( n=74) . The patients of the control group were given aspirin based on conventional treatment while the observation group were given clopidogrel based on control group treatment. The serum C?reactive pro?tein(CRP),incidence of early neurologic deterioration(END),recurrence rate within 90 days,degree of nerve function defect score (NIHSS score),clinical effect after treatment and the complications during treatment be?tween the two groups were compared. Results After one week treatment,the serum CRP level of observation group decreased obviously compared with pre?treatment ( ( 6. 24 ± 1. 63 ) mg/L vs. ( 12. 03 ± 2. 46 ) mg/L , t=5. 625,P=0. 027),and the control group((9. 34±1. 24) mg/L,t=4. 348,P=0. 036),and there was not sig?nificantly reduced in the control group( t=2. 647,P=0. 186) . The incidence of END and recurrence rate within 90 days of observation group were evidently lower than that of control group(6. 76%(5/74) vs. 21. 62%(16/74) ,1. 35%( 1/74) vs. 8. 12%( 6/74);χ2=6. 737,5. 742,P=0. 022,0. 029) . The NIHSS score at 2 weeks af?ter treatment of observation group evidently lower than that of control group,the differences were statistically sig?nificant((2. 31±1. 03) points vs. (5. 34±1. 25) points;t=4. 663,4. 928). The effective rate of observation group was obviously higher than that of control group,the differences were statistically significant(93. 24% vs. 63. 51%,χ2=6. 253,P=0. 029) . There was no statistically significant differences about complications during treatment in both groups. Conclusion Aspirin combined with clopidogrel therapy can obviously improve nerve function,reduce progress of stroke and improve the clinical effect in patients with transient ischemic attack/light stroke,it is worth popularization and application.

Objective To analyze influence of atorvastatin calcium on blood lipid and high-sensitivity C-reactive protein (hs-CRP) in patients with acute cerebral infarction.Methods One hundred and forty patients with acute cerebral infarction were randomly divided into the control group (n =70) and observation group(n =70).Patients in the control group were given simvastatin calcium,and in the observation group were given calcium beside control therapy scheme.The course was four weeks.The serum levels of blood lipid and hsCRP of before and one week and four weeks after treatment were measured and compared between the two groups.Results The total cholesterol(TC),glycerin trilaurate(TG) level and low density lipoprotein cholesterol (LDL-C) in control group before and after treatment were (6.4± 1.6) mmol/L and (6.4± 1.6) mmol/L,(3.3±0.6) mmol/L and (2.2±0.5) mmol/L,(4.7±0.8) mmol/L and (3.3±0.6) mmol/L,and the difference was significant (t=7.364,5.872,5.692;P=0.028,0.042,0.035).The TC,TG levels,LDL-C in observation group before and after treatment were (6.4±1.4) mmol/L and (3.5±0.6) mmol/L,(3.2±0.8) mmol/L and (1.8±0.5) mmol/L,(4.6±0.6) mmol/L and (2.4±0.5) mmol/L,and the differences were significant (t =8.657,6.264,6.674;P =0.015,0.029,0.043).Meanwhile,observation group decreased more significantly (t =4.264,4.827,4.874;P＜0.05).The HDL-C in control group before and after treatment were (1.3±0.4) mmol/L and (1.6± 0.7) mmol/L,in observation group were (1.2 ± 0.5) mmol/L and (2.4 ± 0.5) mmol/L,and the differences were significant (t =5.976,6.743;P =0.039,0.031).Meanwhile,observation group increased more significantly(t =5.363,P＜ 0.05).The hs-CRP of all groups significantly reduced after treatment,and the differences were statistically significant,and the degree of decline was more significant in observation group (treatment effects and time effects of the F values were 24.565 and 15.675,P ＜ 0.05).Conclusion Atorvastatin calcium can effectively reduce the blood lipid and hs-CRP of patients with acute cerebral infarction and the incidence of cerebrovascular disease,and it is worth popularization and application.

Objective To discuss the clinical significance of change of serum uric acid (UA),C-reactive protein(CRP) and fibrinogen(Fg) levels in patients with acute cerebral infarction.Methods Ninetysix patients with acute cerebral infarction were divided into the mild group (n =52),middle group(n =32) and heavy group(n =12) according to illness degree,and 90 healthy person were selected as the control group.The serum UA,CRP and Fg of all groups were compared.Correlation analysis of serum UA,Fg and CRP in patients with acute cerebral infarction was carried.Results The level of serum UA((423.6±46.5) μmol/L vs.(302.4±28.7) μmol/L,t=4.758,P＜0.05),CRP((15.6±2.3) mg/L vs.(1.9±0.8) mg/L,t =14.547,P＜0.05) and Fg((4.6± 1.4) g/L vs.(3.1 ±0.9) g/L,t =3.936,P＜ 0.05) of acute cerebral infarction group were all obviously higher than that of control group,the differences were statistically significant(P＜0.05).The levels of serum UA((366.2±23.5) μmol/L,(398.4± 32.7) μmol/L and (457.4± 56.2) μmol/L,F =7.646),CRP ((7.4±1.6) mg/L,(14.6±1.9) mg/L and (22.8±4.6) mg/L,F=9.837) and Fg((3.3±1.4) g/L,(3.9 ± 1.5) g/L and (5.2 ± 2.1) g/L,F =5.757) of mild,middle and heavy groups rise with illness degree,differences were all statistically significance(P＜0.05).Correlation analysis showed that serum UA,CRP levels and Fg,CRP were positively correlated (r =0.683,0.564),the differences were statistically significant (P ＜0.05).Conclusion Serum UA,CRP and Fg levels in patients with acute cerebral infarction obviously increase and they can be regarded as to predict risk factors of cerebral infarction.

Objective To study the genetic diversity of rDNA ITS sequences in the root tuber of Polygonum multiflorum from various habitats and to analyze the utility of ITS sequences in molecular authenticating the genuineness, identifying the varieties of wild resources, and studying the germplasm resources. Methods Firstly, total DNA in the root tuber of P. multiflorum from various habitats was extracted. Secondly, the ITS sequence was amplified by PCR with universal primer of ITS and sequenced after purification. Results The total length of ITS sequence is 648 bp in the different samples, such as 5.8S, 18S, and 26S rDNA. The lengths of three fragments, ITS1, 5.8S, and ITS2, are 195 bp, 164 bp, and 189 bp, respectively. There are seventeen variable sites among the sequences. Conclusion ITS Sequence can be used to authenticate the genuineness and identify the varieties of wild resources in the root tuber of P. multiflorum.