Objective To determine the effective prognostic parameter and the best prognostic index of gastiric carcinoma.Methods The prognostic relevance of clinical and pathological variables were evaluated in 83 patients with histologically proved stomach carcinoma (including the expression of nm23, c erbB2, microbloodvessel and PTNM) by the multivariate analysis of COX regression.Result PTNM staging was the only parameter to enter the COX model.Conclusion The PTNM staging is the most important, reliable and best varible factor in predicting the clinical outcome of stomach cancer.

Objective To observe the effect of MG132 on the expression of extracellular regulated kinase 1/2 (ERK1/2) and connective tissue growth factor (CTGF) in rat peritoneal mesothelial cells (RPMCs) induced by high glucose.Methods RPMCs were isolated,cultured and passaged by trypsin,then identified.The second generation of cultured RPMCs were used in the experiment.RPMCs were divided into normal control group,high glucose (1.5％,2.5％,4.25％) for 24 hours,high glucose (2.5％) for 0,12,24,48 hours,incubated with MG132 (0.5,1,2 μmol/L) for half an hour and then with high glucose (2.5％) for 24 hours.ERK1/2 protein was detected by Western blotting,and CTGF protein in supernatant was detected by ELISA.Results Compared with the control group,the expression of p-ERK1/2 was significantly increased in the groups stimulated by high glucose (P ＜0.01),reached the peak at 24th hour (P ＜ 0.01),and then the expression decreased at 48th hour,but still was higher than that in the normal control group (P ＜ 0.01).CTGF protein expression of RPMCs induced by high glucose increased,in time-and dose-dependent manner (P ＜ 0.05).MG132 could significantly decrease the expression of ERK1/2 and CTGF induced by high glucose (P＜0.05).Conclusions MG132 can decrease the expression of p-ERK1/2 and CTGF in RPMCs induced by high glucose.The ubiquitin proteasome pathway participates in the development of peritoneal fibrosis,and blocking the way may contribute to the prevention of peritoneal fibrosis.

Objective To discuss the application value of multislice CT (MSCT) in diagnosis of ureteral biology variation and diseases.Methods The MSCT data of 51 patients with suspected ureteral biology variation and diseases were retrospectively analyzed.The data of MSCT images included plain scan,renal cortical phase,renal parenchyma phase and excretion phase.The MSCT images of renal cortical phase,renal parenchyma phase and excretion phase were reconstructed respectively to gain the 3D images of renal arteries,veins and urinary passage.Results Among the 51 patients,1 patient with traumatic ureteral rupture,10 patients with ureteral biology variation diseases,14 patients with stone of ureter,2 patients with polyp of ureter,3 patients with non-specificity ureteritis,3 patients with tuberculosis of ureter,1 patient with endometriosis,17 patients with carcinoma of ureter.Satisfied 3D images of renal arteries,veins and urinary passage could be reconstructed.And the imaging diagnosis of 51 patients were all in accord with their clinical diagnosis or pathologic diagnosis.Conclusion MSCT can obtain high qualified images,and this technique should become the preferred inspection item of ureteral biology variation and diseases.

Objective To study the pathology and treatment of huge nonhepatic tumors in the right upper quadrant of abdomen.Methods The clinical data of 9 patients with huge nonhepatic tumor in the right upper quadrant of abdomen treated surgically at our hospital from May 2004 to December 2009 were retrospectively analyzed.Results Preoperative imaging failed to define the tumors as nonhepatic in original in 7 patients and operation failed to recognize the origin of the tumors in 2 patients.All the tumors were successfully resected,with combined hemigastectomy in 1 patient,partial resection of the lateral wall of the infrahepatic vena cava in 2,complete resection of adipose capsule of the right kidney in 2,pancreatoduodenectomy plus transverse colectomy in 1,and transection of pancreatic duct of the body and tail of the pancreas and pancreaticojejunostomy in 1.The median operation time was 390 min (318-660 min).The median intraoperative blood loss was 2560 ml (400-6000 ml).The median intraoperative blood transfusion was 2450 ml (0 -5250 ml).The average diameter of the resected tumor was 14.5 cm (11-30 cm),and the average tumor weight was 2465 g (960-5100 g).Postoperative pathological diagnoses showed that 8 patients had malignant tumors and 1 had a potentially malignant and undifferentiated tumor (solid pseudopapillary tumor of pancreas).Perioperative pancreatic anastomotic leak occurred in 1 patient,and there were no severe postoperative complications and operative death in this series.Tumor recurrence was detected 5 months following operation in 1 patient.The 1,2-,3-year survival rates were 100％,56％,33％,respectively.One patient survived for more than 5 years.Conclusions Huge non-hepatic tumors in the right upper quadrant of abdomen could easily be misdiagnosed as hepatic neoplasms.The surgical resection rate was high.The prognosis for patients who received resectional treatment was satisfactory.

Objective　To study the effect of minielctrocholecystectomy(MEC) for gallbladder stone. Methods　The clinical data of 4,200 cases(1991-2000) undergoing MEC were analysed restrospectively; the results of different operotors for the MEC were compared. Results　All 4,200 cases were cured. Of them, 41 cases(0.98%) had serious complications, including intraoperative bleeding in 4 cases(0.09%), biliary tract injury in 18(0.43%); stress ulcer in 8(0.19%), and residual stones of biliary tract in 11(0.26%). Conclusions　MEC has the following advantages: less trauma, short operation time, fast postoperative recovery and lower expense. The different operotors on MEC have distinguish difference in the results. It is important to preven the complications of MEC.

Objective To study the effect of minielctrocholecystectomy(MEC) for gallbladder stone. Methods The clinical data of 4,200 cases(1991-2000) undergoing MEC were analysed restrospectively; the results of different operotors for the MEC were compared. Results All 4,200 cases were cured. Of them, 41 cases(0.98%) had serious complications, including intraoperative bleeding in 4 cases(0.09%), biliary tract injury in 18(0.43%); stress ulcer in 8(0.19%), and residual stones of biliary tract in 11(0.26%). Conclusions MEC has the following advantages: less trauma, short operation time, fast postoperative recovery and lower expense. The different operotors on MEC have distinguish difference in the results. It is important to preven the complications of MEC.

Objective To observe the effect of silibinin on the expression of integrin linked kinase (ILK),transforming growth factor β1 (TGF-β1) and α-smooth muscle actin (α-SMA) in rat peritoneal mesothelial cells (RPMCs) induced by high glucose.Methods RPMCs were isolated,cultured and passaged by trypsin,then identified.The second generation of cultured RPMCs were used in the experiment.RPMCs were divided into normal control group,high glucose(1.5％,2.5％,4.25％)for 24 hours,high glucose (2.5％) for 12,24,48,72 hours,high glucose (2.5％) for 24 hours after silibinin (5,10,20 mg/L) preincubate for 2 hours.ILK and α-SMA mRNA were detected by real-time PCR.ILK protein was detected by Western blotting.TGF-β1 protein in supernatants was detected by ELISA.Results Compared with the control group,the expresssion of ILK,TGF-β1 and α-SAM was significantly increased in groups stimulated by high glucose (all P ＜ 0.05).Silibinin could significantly decrease the expression of ILK,TGF-β1 and α-SMA induced by high glucose (all P ＜ 0.05).Conclusions High glucose can up-regulate the expression of ILK,TGF-β1 and α-SMA.Silibinin can reverse these changes.

The reasonable selection of teaching cases is very important in performing PBL in department of nephrology.The department of nephrology in the first affiliated hospital of China medical university has practiced PBL teaching reform from 2004.It was recognized that the selection of teaching cases should meet the joint of the key kuowledge of subjects,should be able to promote the conformity between clinical and basic subjects,and should be able to match with a number of teaching objectives.With the deepening of teaching reform and the transformation of teaching philosophy,PBL teaching cases in nephrology should also be advanced with the updated development.

To make a portable apparatus for the patient self-doing joint voluntarily exercise that is keeping with the training demand of human body potential and muscle strong. Different kinds of spring belts are used for joint exercise apparatus according to the needs of joint exercise. Though active joint extension and flexion by using the method of Chinese physical and breathing exercises, the exercise was done by drawing the spring belt. The extremity multifunctional training box is easy for carrying and sutble for each mussel be trained. Because of the wide range of back spring power, it is easy to reach the best training mount and to do the continually training under the biggest training mount. It is beneficial to the joint active function improvement. From June 2006 to February 2008, this kind of apparatus was used in 30 patients with footdrop at the Beijing Tongren Hospital, Capital Medical University. The design of the extremity multifunctional training box is reasonable, and it is easy for carrying and operating. It is also helpful for the patient to do muscle exercise themselves, and the joint function can be persisted and improved by continual exercise using this apparatus.

Objective To evaluate the effects of pacing in right ventricular septum (RVS) on hemodynamics among atrioventricular sequential dual chamber pacing Methods Twenty patients with high grade or complete atrioventricular block received permanent dual chamber pacemaker ( DDD ),were randomized into right ventricular septum pacing group (RVS)and right ventricular apex pacing group (RVA)according to the ventricular leads position.The QRS duration of the ECG,the left ventricular ejection (LVEF),the interventricular mechanical delay( IVMD )and the plasma levels of brain natriuretic peptide (BNP)were compared before and after operations.Results Compared with the preoperation,the mean QRS duration ( ( 187.00 ± 15.67 ) ms and (94.00 ±9.17 ) ms),the IV MD ( (43.20 ± 6.79 ) ms and ( 15.00 ± 4.08 ) ms ),the level of BNP ( ( 89.70 ± 8.30) ng/L and (40.00 ± 4.73 ) ng/L) increased( P ＜ 0.05 ) and LVEF decreased significantly ( (53.70 ± 1.34) % and (58.60 ±1.65 )% ,P ＜ 0.05 ) in RVA group,but didn't change in RVS group (P ＞ 0.05 ).After three months following up,the mean QRS duration and the IVMD in RVS group( (119.00 ±7.38 )ms,(19.00 ±4.59)ms) were shorter than that of RVA group( ( 187.00 ± 15.67) ms,(43.20 ± 6.79) ms) ( P ＜ 0.05 ),the LVEF was higher and the plasma level of BNP was lower than that of RVA group ( (57.00 ± 2.00) % and ( 53.70 ± 1.34) %,(44.20 ± 9.18 ) ng/Land ( 89.70 ±8.30) ng/L,P ＜0.05).Conclusions The RVS pacing could keep the normal ventricular activation sequence and biventricular contraction synchrony farthest without side effects on hemodynamics in comparison with the RVA pacing.The RVS pacing is more approaching physiological rhythm than the RVA pacing.