OBJECTIVE:To verify the effect of Weichangkang capsule(WCK) on the function of gastrointestinal tract.MET-HODS:The effects on movement of charcoal powder in mice and secretion of digestive enzyme and absorption of D-xylopyranose into serum in rats were studied.RESULTS:WCK capsule markedly increased the movement of charcoal powder in mice,secretion of digestive enzyme and absorption of D-xylopyranose into serum in rats.CONCLUSION:WCK capsule could obviously improve the dysfunction of gastrointestinal tract.

Objective To evaluate the association of Smad2/3,Smad4 and P-Smad3 protein expressions in tissue with liver fibrosis in patients with chronic HBV infections.Methods Liver biopsy was performed to determine the liver fibrosis grades in 131 cases of chronic HBV infections.Immunohistochemistry and semiquantitative analysis were applied to detect the expression of Smad2/3,Smad4 and P-Smad3 proteins in liver tissues.Results Smad2/3,Smad4 and P-Smad3 were detected mainly in fibrous septum,portal areas,myofibroblasts,sinus and cytoplasm in the liver tissue.The expression of Smad2/3,Smad4 and P-Smad3 was increased with the development of fibrosis ( r =0.81,0.58and 0.68,P =0.000),and a strong positive correlation was observed among three proteins (r =0.75,0.87and 0.84,P =0.000).Conclusion The expression of Smad2/3,Smad4 and P-Smad3 is correlated with liver fibrosis in chronic HBV infection,which suggests that the up-regulation of Smad proteins may be involved in the progression of liver fibrosis.

Objective:To observe the relationship of Hyaluronic Acid and transforming growth factor-?1 with different TCM syndromes of liver fibrosis. Methods:All rats of model groups were treated by CCl4 to establish the liver fibrosis model. Besides CCl4,the rats of liver-stagnation and spleen-deficiency group were treated by stimulating tails with forceps clip and gastric infusion of rhubarb decoction,and the rats of qi-deficiency and blood-stasis group were treated by the method of swimming-fatigue. Then every group was intervened by the relevant medicine. After all treatments,the HA and TGF-?1 in serum were examined. Results:The HA and TGF-?1 of model groups were significantly higher than those of the control group(P

BACKGROUND: Apoptosis secondary to ischemia and hypoxia is the main cause of spinal cord dysfunction. Because of the decrease in atmospheric pressure, patients living on the Qinghai-Tibet Plateau are in a hypoxic environment, which is very unfavorable for the recovery of spinal cord injury. Hyperbaric oxygen therapy can improve the postoperative function of patients with incomplete spinal cord injury, and its effect is better on the plateau than at normal altitudes.OBJECTIVE: To observe the effect of hyperbaric oxygen therapy on traumatic spinal cord injury in patients living on the Qinghai–Tibet Plateau.METHODS: This prospective, open-label, randomized controlled clinical trial was performed at the Department of Spine Surgery, Affiliated Hospital of Qinghai University, China. In total, 164 patients with incomplete traumatic spinal cord injury were equally and randomly assigned to a control group and a hyperbaric oxygen therapy group. Patients in the control group were treated with pedicle screw fixation and decompressive laminectomy. In addition to the surgical treatment performed in the control group, patients in the hyperbaric oxygen group underwent hyperbaric oxygen therapy at 0.2 MPa once a day for four treatment courses. Ten treatment sessions constituted one course, and each course was separated by a 5- to 7-day rest interval. The primary outcome was the modified Barthel index to assess activities of daily living. The secondary outcomes were the American Spinal Injury Association (ASIA) impairment scale grade, sensory score, and motor score. The study protocol was approved by the Ethics Committee of the Affiliated Hospital of Qinghai University, China (Approval number: QHC011K). Written informed consent was provided by a relative or legal representative of each patient after they had indicated that they fully understood the treatment plan. RESULTS AND CONCLUSION: The partial results demonstrated that after four treatment courses (55-61 days), the modified Barthel index and ASIA tactile, pain, and motor scores were higher in the hyperbaric oxygen group than in the control group. The ASIA grades were significantly different between the hyperbaric oxygen group and control group. The proportion of patients with ASIA grades D and E was higher in the hyperbaric oxygen group than in the control group. In this trial, we aim to determine the efficacy of hyperbaric oxygen therapy on the treatment of incomplete traumatic spinal cord injury in patients living on the plateau and to provide clinical evidence for treating incomplete traumatic spinal cord injury in these patients.

Objective To evaluate diagnosis and surgical treatment of carotid body tumors.Methods It was retrospectively reviewed that the diagnostic approaches, surgical operation methods and its related complications in 70 carotid body tumor cases treated in our hospital from May 1986 to May 2008.Results Diagnosis was established by computer tomography angiography (CTA) or magnetic resonance angiography (MRA). Surgical excision was successfully performed in 63 cases with 72 tumours. There were no postoperative deaths. Two cases developed hemiplegia following surgery. Temporary cranial nerve palsy occurred in 17 cases while permanent nerve palsy occurred in 4 cases. Sixty-two cases were followed-up from 6 months to 5 years. There were no deaths in operative cases, with local tumor recurrence in 2 cases and 3 cases died due to remote metastasis. Conclusion CTA or MRA is sufficient for the diagnosis and preoperative assessment of carotid body tumor and its related structures. Surgical modality should be adjusted according to the relationship between the tumor and the carotid artery. Full exposure of the surgical area,careful control of intraoperative bleeding and persistent maintainance of blood flow to the brain are important measures for successful surgery.

Objective: We present our preliminary experience of using a homemade transumbilical single-port access for performing transumbilical single port access (SPA) laparoscopic surgery for gastrointestinal disease and its perioperative nutritional management.Methods: During Nov.2009-Dec.2009,five patients received SPA surgery and nutritional management following the protocol of fast track surgery.A patient with stomach GIST received partial gastrectomy,a patient with ascending colon lymphoma received right hemicolectomy,a patient with rectal cancer received anterior resection,a patient with jejunum GIST received partial small bowel resection,and a patient with early gastric cancer received distal subtotal gastrectomy (D1+α). Results: Transumbilical SPA surgery were successfully done in five patients without conversion.The mean length of incision was 3 cm,the mean time for operation was 138 (60-240)min,and the mean blood loss was 50 (10-100)ml.All patients could mobilize and orally drink on the 1st day after operation,have soft diet the 3st days after operation,their mean postoperative hospital stay was 4 days.No complication occurred.Mean body weight loss was 2.6 kg on discharge compared with at admission.Conclusion: Transumbilical SPA surgery with the protocol of fast-track surgery had advantages including shorter incision,less trauma,faster recovery,and less body weight loss.

Objective To compare the short‐term clinical effects of single segment and two segments of Dynesys dynamic in‐ternal fixation system for treating lumbar degenerative disease .Methods 40 cases of degenerative lumbar disease treated by the Dynesys dynamic fixation system combined with posterior approach decompression from 2009 July to March 2012 were selected and performed the evaluation on the clinical effects by the waist and leg pain visual analogue scale (VAS) ,the Oswestry disability index (ODI) and the orthopaedic spinal association of North America (NASS) index .The imaging method was used to observe the mobili‐ty of operative segment and proximal adjacent segment and the degenerative change of intervertebral height .Results All of the 40 cases were followed up .The VAS score and ODI score at postoperative 3 months and last follow‐up were significantly decreased when compared with the pre‐operative scores (P<0 .05);there was no statistically significant differences in the VAS score and ODI score at 3 months and last follow‐up between the single segment group and the 2‐segment group (P> 0 .05) .The NASS index showed no statistically significant difference in the postoperative effect satisfaction between the two groups (P>0 .05);there was no statistically significant difference in the variation of the intervertebral height between before operation and at the last follow‐up (P>0 .05) .There was statistically significant difference in the motility of proximal adjacent segment at the last follow‐up between the two groups (P<0 .05);but comparing the motility of proximal adjacent segment between the last follow‐up and pre‐operation , only the single segment group showed statistically significant difference (P< 0 .05) .Conclusion The Dynesys dynamic fixation system combined with posterior approach decompression operation has good clinical effect in the treatment of lumbar degenerative disease .Meanwhile ,the single segment method has more significant effect on the motility of proximal adjacent segment than the double segments method .

BACKGROUND: Absorbable material is a hotspot in orthopedics, which is biodegradable, avoids fixation residues and second surgical trauma compared with the traditional internal fixation.OBJECTIVE: To investigate the clinical efficacy and safety of K-wires, screws and absorbable rods for the internal fixation of Mason II-III radial head fractures.METHODS: Totally 45 patients with Mason Ⅱ-Ⅲ radial head fractures were collected from January 2010 to December 2015 admited in Zhangjiagang First People's Hospital and Zhangjiagang Hospital of Traditional Chinese Medicine, and were then divided into three groups (n=15 per group), followed by implanted with K-wires (group A), screws (group B)and absorbable rods (group C), respectively. The baseline data, operation time, blood loss, healing time, Mayo and Broberg-Morrey scores were compared among groups.RESULTS AND CONCLUSION: (1) There were no significant differences in the baseline data, operation time, blood loss,and healing time among groups (P > 0.05). (2) The Mayo scores in the groups A, B, and C were (88.45±6.22),(92.37±5.60), and (90.82±6.58), respectively; the Broberg-Morrey scores in the groups A, B, and C group were ((90.82±6.83), (93.05±6.54), and (91.68±7.15), respectively; all above scores showed no significant differences among groups (P > 0.05). (4) The total incidence rate of complications in the groups A, B, and C was 20％ (2/15), 13％ (2/15),and 7％ (1/15) respectively, showing no significant difference among groups (P > 0.05). (4) These results indicate that the absorbable rods can obtain satisfactory treatment outcomes for Mason II-III radial head fractures, which is equivalent to the traditional internal fixation. Moreover, it can avoid secondary operation for removing internal fixators and the adverse impact of stress shielding, so it is recommended to be used in clinic.

Objective: To investigate the biological significance of CerbB-2 expression in nasopharyn-geal carcinoma. Methods: The expression of CerbB-2 was detected in 90 nasopharyngeal carcinoma tissues and 22 nasopharyngitis tissues by SP immunohistochemical method. The relationship between CerbB-2 ex-pression and clinicopathological characteristics of nasopharyngeal carcinoma was investigated. Results: The positive expression rate of CerbB-2 protein was 65.56% in nasopharyngeal carcinoma tissues, and 31.82% in nasopharyngitis tissues, with a significant difference (P<0.05). The ratio of expression was 81.0% in patients of N_2 and N_3 lymth node stage, significantly different from that in patients of N_0 and N_1 lymph node stage (52.1%, P<0.05). The expression of CerbB-2 gene was not correlated with age, gender, clinical stage, T stage and distant metastasis of nasopharyngeal carcinoma (P>0.05). Conclusion: There is a high expression of CerbB-2 in nasopharyngeal carcinoma tissues, which might be an important event in the pathogenesis and progression of nasopharyngeal carcinoma.

Objective:To investigate the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT metabolic parameters for occult lymph node metastasis (OLM) in non-small cell lung cancer (NSCLC). Methods:A total of 183 patients (72 males, 111 females; age (61.5±8.4) years) who underwent 18F-FDG PET/CT and preoperatively diagnosed with clinical N0 stage (cN0) in Third Affiliated Hospital of Soochow University from January 2013 to December 2018 were retrospectively enrolled. All patients underwent anatomical pulmonary resection with systematic lymph node dissections within 3 weeks after 18F-FDG PET/CT examinations. According to the presence or absence of lymph node metastasis, patients were divided into OLM positive (OLM+ ) group and OLM negative (OLM-) group. Parameters of primary lesions, such as the maximum diameter (D max), tumor sites, morphological features, maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), metabolic total volume (MTV), total lesion glycolysis (TLG), tumor SUV max to liver SUV mean (TLR max), tumor TLG to liver SUV mean (TLR TLG) were analyzed. Mann-Whitney U test and χ2 test were used to compare the parameters between groups. Multivariable logistic regression was used to analyze the independent risk factors for OLM. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different parameters. Results:Among 183 patients, 25 (13.7%, 25/183) of them were diagnosed as OLM. In OLM+ group, 46 lymph nodes were pathologically positive for metastasis, including 15 N1 disease and 31 N2 disease. D max (2.9(2.3, 3.7) vs 2.3(1.7, 2.8) cm), lobulation ((76.0%(19/25) vs 37.3%(59/158)), SUV max (11.1(7.9, 17.7) vs 4.7(2.3, 9.2)), TLG (41.5(10.2, 91.1) vs 15.6(6.5, 23.8) ml), TLR max (4.7(3.5, 7.6) vs 2.1(0.9, 4.0)) and TLR TLG (18.1(5.0, 44.3) vs 6.1(3.0, 11.4) ml) of the primary lesions in OLM+ group were significantly higher than those in OLM-group ( z values: from -4.709 to -3.247, χ2=13.190, all P<0.05). Multivariable logistic regression analysis showed that TLR max (odds ratio ( OR)=15.145, 95% CI: 3.381-67.830, P<0.001) and D max ( OR=3.220, 95% CI: 1.192-8.701, P=0.021) were independent risk factors for OLM. TLR max yielded the highest area under curve (AUC; AUC=0.794) with the threshold of 3.12, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value for predicting OLM were 92.0%(23/25), 63.3%(100/158), 67.2%(123/183), 28.4%(23/81) and 98.0%(100/102), respectively. Conclusions:TLR max of tumor is the independent risk factor for OLM in NSCLC patients. TLR max can sensitively predict OLM preoperatively in patients with NSCLC.