Objective To evaluate the application value of multi-slice spiral CT(MSCT)in D2 radical total gastrectomy for gastric carcinoma.Methods CT and clinical data of 353 cases with D2 radical total gastrectomy for gastric carcinoma was analyzed retro-spectively.Results Operative time was 236 (1 91-35 1)mins VS.245 (189-308)mins,no significant difference was observed be-tween the CT scan group and the non-CT scan group(P >0.05).The number of lymph nodes dissected was (27 ±3)VS.(20±2), there was significant difference between the CT group and the non-CT group (P <0.05).The blood loss in the CT group and no CT group was less 168 (110-600)mL and 280 (150-720)mL respectively(P<0.01).Postoperative hospital stay was shorter (11.2±2.1)days in CT group than no CT group (14.5±2.0)days (P <0.01).Postoperative complications developed in 1 7 patients in the CT group and in 29 patients in the non-CT group.The difference didn’t show statistically significant between the two groups (P >0.05).Conclusion Multi-slice computed tomography scanning has a great value in D2 radical total gastrectomy for gastric carcinoma.

Objective To observe the effects of postoperative patient controlled epidural analgesia(PCEA) on plasma neuropeptide Y(NPY) Methods Fifty eight patients scheduled for thoracic surgery, were randomly divided into PCEA group(n=28) and control group(n=30) After operation, patient controlled epidural analgesia was applied in PCEA group and in control group pethidine I M was given intermittently The plasma NPY and serum cortisol concentrations were measured at pre anesthesia,the end of operation,and 24h and 48h after operation by radioimmunossay Results Compared with the baselines, plasma NPY and serum cortisol levels increased significantly at the end of operation in both groups ,without the obvious differences between both groups The plasma NPY level restored to the baseline in PCEA group 24h after operation, and in control group was significantly higher 24h after operation than the besaline and restored to the besaline 48h after operation The serum cortisol level was kept higher level 24h after operation and restored to the baseline 48h after operation in PCEA group, and in control group increased significantly 24h and 48h after operation as compared with the baseline The plasma NPY level 24h after operation and serum cortisol level 24h and 48h after operation were lower markedly in PCEA group than those in control group Conclusions The PCEA can effectively depress the increase of plasma NPY and serum cortisol induced by postoperative pain in patients undergoing thoracic surgery

Objective To evaluate the changes in the expression of neuron-restrictive silencer factor (NRSF) in the spinal cord of mice with bone cancer pain.Methods Forty-eight pathogen-free adult male C3H/HeJ mice,aged 4-6 weeks,weighing 20-25 g,were randomly divided into 2 groups (n=24 each) using a random number table:sham operation group (group S) and bone cancer pain group (group BCP).Bone cancer pain was induced by injecting 2× 105 NCTC2472 osteolytic sarcoma cells in α minimal essential medium into the medullary cavity of the right distal femur in group BCP.Only α minimal essential medium was injected into the medullary cavity of the right distal femur in group S.The mechanical and thermal pain thresholds were measured on 5,7,10 and 14 days after inoculation (T1-4).Six mice in each group were randomly selected after measurement of pain thresholds at T1-4 and sacrificed,and the lumbar enlargement segments of the spinal cord were harvested to detect the expression of NRSF.Results Compared with group S,the mechanical pain threshold at T2-4 and thermal pain threshold at T3.4 were significantly decreased,and the expression of NRSF was significantly down-regulated at T1-4 in group BCP (P＜0.05).Conclusion The mechanism underlying the development of bone cancer pain is probably related to down-regulation of NRSF expression in the spinal cord of mice.

Objective:To investigate the clinical effect of surgical procedures on patients with chronic sinusi-tis. Method: 104 patients with chronic sinusitis were treated by endoscopic and Caldwell-Luc's approaches. Thelesions were cleared away completely. Result:The clinical cure rate was 96.1％ after 6～12 months (average 9months ) follow up. Conclusion:It suggests that patients with severe maxillary sinus diseases might be cured byendoscopic and Caldwell-Luc's procedure.

Objective:To analyze the long-term curative effect of endoscopic sinus surgery (ESS), and to study the factors related to the defeat of endoscopic sinus surgery.Method:201 cases（353 sides）of chronic sinusitis and nasal polyps were treated with ESS，and were treated by taking the nasal cavity as a whole unit.Result:Following up survey from 12 months to 24 months postoperatively，it was found that 108 cases were cured （53.7%），82 cases achieved symptomatic relief（40.8%），11 cases remained failure （5.5%）.Conclusion:It is very important to improve the ESS technique in order to reduce the recurrence of nasal polyps and sinusitis and to improve the curative effect of ESS，in addition，the treatment after operation is also indispensable to successful surgery.

Objective:To investigate the clinicopathlogical significance of the CyclinE,p21WAF1/CIP1 and p53 expression in laryngeal carcinogenesis.Method:The expression of CyclinE,p21WAF1/CIP1 and p53 was examined by using immunohistochemical method in normal epithlia (20),dysplastic epithlia (40) and laryngeal cancers (60).Result:①In normal epithlium,dysplastic squamous epithlium and in squamous cell carcinoma of the larynx,the positive immunostaining rate of CyclinE protein was 5.0%(1/20),20.0%(8/40) and 45.0%(27/60) respectively (P＜0.001),and p21WAF1/CIP1 protein was 95.0%(19/20)，75.0%(30/40) and 63.3%(38/60) respectively (P＜0.01),while the rate of p53 was 0,30.0%(12/40) and 61.7%(37/60)(P＜0.001) respectively.②p21WAF1/CIP1 positive expression in highly、moderately and poorly differtiated carcinomas were 76.2%(16/21)、66.5%(19/29) and 30.0%(3/10) respectively (P＜0.05),p21WAF1/CIP1 protein expression was significantly associated with tumour cell differentiation.③The positive expression of CyclinE closely related with the positive expression of p53 (P＜0.05).No correlation was found between p21WAF1/CIP1 expression and p53 expression.Conclusion:①CyclinE and p53 could be an early molecular event in the carcinogenesis of larynx.②p21WAF1/CIP1 expression is associated with tumour cell differentiation.③The mutual mechenism of cell cycle regulators (CyclinE、p21WAF1/CIP1 and p53) play an important role in the laryngeal carcinoma.

Objective To study the effects of PTEN and missense mutations in PTEN phosphotase domain on AKT phosphorylation in AGS and BGC-823 cells. Methods The plasmids of wtPTEN,PTEN-C124S which PTEN mutant is in both lipid and protein phosphotase domain and PTEN-G129E which PTEN mutant is only in lipid phosphotase domain were respectively transfected into AGS and BGC-823 cells. The cells were stimulated with insulin or rhEGF after serum starvation overnight. The levels of AKT phosphorylation were detected by Western blot. Results Both insulin and rhEGF can activate AKT phosphorylation in gastric cancer cells. Overexpressed PTEN inhibitedAKT phosphorylation induced by insulin or rhEGF(P < 0.05). PTEN mutants C124S or G129E could not inhibitAKT phosphorylation(P > 0.05). Conclusions PTEN can inhibit AKT phosphorylation induced by insulin or rhEGF in gastric cancer cells. Missense mutations in the 124th or 129th amino acid of PTEN phospho-tase domain do not exert inhibitive function.

Purpose To find the reasons and explore the appropriate countermeasures for failure ureteroscopy operation.Methods The clinical data of 74 cases with failure ureteroscopy operation for ureteral calculi were analysed respectively.Results The failure reasons including the difficult of ureteroscopy insert (46 lateral),difficult of calculi disposal (12 lateral) and ureteral injure (15 lateral).ESWL(34 sides) and open surgery(44 sides) were remedial measures after failure ureteroscopy and the success rates were 85 3%, 100% respectively.nephrectomy were carried out in and 1 case died from serious uriaemia.The mortality was only 1.4%.Conclusions The reasons of failure including unable approach the stone, difficult to disposal calculi and ureteral injury. The effect is related to applicances, experience, indications . ESWL and open surgery are the suitable remedy measures according to the failure reason.

A 15-year-old female patient presented with orthostatic erythema in the limbs for half a year. Skin examination revealed that diffuse reticular erythema appeared in the limbs after standing with her arms hanging down for 30 seconds, while the erythema disappeared and skin color returned to normal after raising her arms or lying flat for 30 seconds. The rash in the limbs was reproduced by inflating a sphygmomanometer cuff to 60 mmHg for 2 minutes with the limbs in the horizontal position. Antinuclear antibodies were positive at a titer of 1 ∶1 000. Histopathological examination showed dilated small vessels in the superficial dermis without obvious inflammatory cell infiltration. The patient was diagnosed with gravitational erythema.

Objective To investigate the clinical efficacy of electroacupuncture plus acupoint application in treating diabetic constipation of yin deficiency and blood stasis type.Methods One hundred and fifty-six patients with diabetic constipation of yin deficiency and blood stasis type were randomly allocated to treatment and control groups, 78 cases each. The treatment group received electroacupuncture plus acupoint application and the control group, oral administration of mosapride citrate tablets. The TCM syndrome scores were recorded in the two groups before and after treatment. The clinical therapeutic effects were evaluated using the Constipation Scoring System (CSS), the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire and the TCM syndrome scores.Results There was a statistically significant post-treatment difference in the total efficacy rate based on CSS, PAC-QOL and the TCM syndrome scores between the two groups (P<0.05,P<0.01). There were statistically significant pre-/post-treatment differences in the TCM syndrome scores in the treatment group (P<0.05). There were statistically significant pre-/post-treatment differences in TCM syndrome dry mouth and tongue, thirst and dry stool scores in the control group (P<0.05). There were statistically significant post-treatment differences in TCM syndrome short breath, weakness, lassitude, stabbing pain, scaly dry skin, fixed pain, sore and weak loins and knees, and chest, palm and sole vexing heat scores between the two groups (P<0.01,P<0.05).Conclusion Electroacupuncture plus acupoint application is an effective way to treat diabetic constipation of yin deficiency and blood stasis type.