Bugbane rhizome is a traditional Chinese herb as a common used in clinic. It has the function of dispersing evils from the superficies and promoting eruption, dispelling evil heat and expelling the virulent factors, ascending Yang-Qi or the vital energy of the spleen. Black cohosh is called Cimicifuga racemosa. It is used for the treatment of the symptoms of perimenopausal female. The origin and function of bugbane rhizome and black cohosh are different and should pay attention to the use.

Objective To investigate the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD). Methods Clinical data of 9 patients who underwent LPD operation from September 2014 to February 2017 in the first hospital of Shanxi Medical University were analyzed retrospectively. Results 9 patients attempted LPD, while one required conversation to open procedure. Two cases underwent hand assisted laparoscopic surgery .The average operative time was (553 ± 86.1) minutes, the average amount of bleeding was (333.3 ± 304.1) ml, and the average hospitalization time after operation was (25.3 ± 8.9) d. Postoperative bowel sound recovery time was (3.5 ± 1) d. Postoperative complications included pancreatic leakage in 4 cases (A grade pancreatic leakage in 1 cases, B grade in 3 case), lymph leakage in 1 case, abdominal hemorrhage in 1 case , gastric emptying in 2 cases , and bile leakage in 1 case. All patients with postoperative complications were cured by non operative treatment. Postoperative pathological examination showed that 5 cases had duodenal papillary adenocarcinoma, 1 case had pancreatic ductal carcinoma, 2 cases had common bile duct disruption differentiation of carcinoma, and 1 case had pancreatic head retention cyst. Patients were followed up 3 to 24 months after operation. 1 case of pancreatic duct died 17 months after operation. One case of middle bile duct carcinoma 12 months after surgery had liver and retroperitoneal lymph node metastasis. The remaining 7 cases had no complications. Conclusions laparoscopic pancreaticoduodenectomy is minimally invasive, safe and feasible.

ObjectiveTo explore the therapeutic effects and value of endoscopic variceal ligation and tissue glue injection therapy in esophageal and gastric fundal varices.Methods184 patients with severe esophageal varices underwent endoscopic variceal ligation treatment,and 32 cases of those accompanied with gastric fundal varices were treated with tissue glue injection therapy.All patients were followed-up for 6-months to observe the therapeutic effects and complication of endoscopic variceal ligation and tissue glue injection therapy.ResultsThe effective rate of endoscopic variceal ligation in severe esophageal varices was 71.74 ％ ( 132/184 ),the rate of acute hemostasis was 95.00％(57/60)and the rate of complication was 2.17 ％ (4/184).The effective rate of tissue glue injection in gastric fundal varices was 100％ (32/32) and the rate of complication was 21.88％ (7/32) (7 cases with refractory ulcers in injection site,2 of refractory ulcers cases with bleeding).There was no perforation and severe infection complications.ConclusionEndoscopic variceal ligation and tissue glue injection therapy have good therapeutic effects in esophageal and gastric fundal varices.

Objective To evaluate the efficacy and safety of atorvastatin in treatment of patients with non-alcoholic fatty liver disease(NAFLD).Methods Of 72 patients with NAFLD6,8 patients with elevated alanine transaminase(ALT)and cholesterol levels at baseline had completed the study.The patients were randomly divided into treatment trial group(n=38)and control group(n=30,ithout any treatment).The patients in trial group were orally received 10 or 20 mg of atorvastatin daily according to basal serum cholesterol levels being≤or＞6.5 mmol/L,respectively.The parameters including body mass index,serum cholesterol level and ALT level were tested and liver density was assessed by echography at baseline and 6 months after treatment.Results There was a significant difference in syndrome scores between baseline and 6 months after treatment[(11.05±1.29)vs.(6.08±0.87)]in trial group(t=1.96,P＜0.05).Six months after treatment,11 patients in trial group were presented with normal ALT levels.whereas only 2 patients in control group had normal ALT levels (P＜0.05).There was a significant differenee in cholesterol level between baseline and 6 months after treatment[(6.6±0.54)ramol/L vs.(5.4±0.5)mmol/L]in trial group(t=1.72,P＜0.05).In addition,there was no differenee in body mass index between baseline and 6 months after treatment both in rial group[(26.8±2.9)kg/m~2 vs.(26.4±2.8)kg/m~2]and control group[(26.5±2.3)kg/m~2 vs.(26.4±2.2)kg/m2~](P＞0.05).There was no significant difference in liver density of two groups before and after treatment(P＞0.05).No side effect was reported.Conclusions Serum ALT and cholesterol levels are reduced significantly in all patients treated with atorvastatin.It is effective and safe for atorvastatin in treating NAFLD patients with hypercholesterolemia.

Tumor metastasis and recurrence have become a key to curative effect and long-term survival, and a hotspot of eurrent clinical oncology research. Recently, a survey of extracellular matrix protein 1 (ECM1) expression in different tumors indicated that ECM1, although not tumor specific, is significantly el-evated in many malignant epithelial tumors that gives rise to metastases, emphasizing its relevance in the cancer process. Herein, this article reviews the research progress of ECM1 in tumor.

Objective To explore the instructive value of preoperative splenic artery CTA examination on Laparoscopic splenectomy (LS). Methods From January 2008 to February 2010,36 cases requiring Laparoscopic splenectomy (LS) were selected randomly and divided into two groups: CTA group and non-CTA group, 18 cases in each group. As for the CTA group,splenic artery CTA examination was performed before operation,to understand splenic artery and its branches anatomy type and track and then individualized surgical treatment was developed. As for the non-CTA group,a routine surgical procedure was performed. The indices before and during the operation were recorded and compared through χ2 test The operating time and the amount of bleeding in the two groups were compared using t-test Results There were no significant difference between the indices recorded by splenic artery CTA examination and those by laparoscopic splenectomy intraoperation ( P > 0. 05 ) . The operating time was (124. 32 ±21.43) mins in the CTA group, which was significantly shorter than that in the non-CTA group ((148.27 ±28. 36)mins) (P <0. 05). The amount of blood in the CTA group was significantly less than that in the non-CTA group( ( 80. 50 ± 16. 42) ml vs. (101. 35 ± 26.25 ) ml). Conclusions Splenic artery CTA can identify splenic artery and its branches anatomy type and track before LS,therefore guide the development of individualized surgical treatment It increases the safety of LS, reduces bleeding and shortens the operational time. It has an instrutive value to laparoscopic splenectomy.

Objective To detect the expression of extracellular matrix protein 1 ( ECM1 ) in primary liver cancer tissues, and explore its clinical significance in liver cancer metastasis. Methods Sixty cases of primary liver cancer tissues and adjacent tissues from 60 patients who were admitted to the Affiliated Provincial Hospital of Anhui Medical University from June 2008 to December 2009 were collected, and nine cases of normal liver tissues were collected from patients with liver trauma as control. The expression of ECM1 and the relationship between ECM1 and clinicopathological features of liver cancer were detected and analyzed using the immunohistochemistry and Western blot. All data were analyzed using the chi-square test, Fisher exact test and t test. Results ECM1 was mainly expressed in the cytoplasm of liver cells. The positive expression rate of ECM1 in liver cancer tissues was 73%, which was significantly higher than those in adjacent tissues (20%) and normal liver tissues (22%)( x2 = 34.286, 7. 044, P ＜ 0.05 ). The expression of ECM1 was correlated with liver cancer metastasis and TNM stages ( x2 = 5. 455, 4.275, P ＜ 0.05), while not with sex, age, size, capsule and differentiation of the tumor,alpha fetoprotein level and the expression of hepatitis B surface antigen ( x2 = 2. 841, 0. 014, 0. 000, 0. 734,0.075, 0.000, 0.031, P＞0.05). The result of Western blot indicated that the relative content of ECM1 in the liver cancer tissues was 25.49 ± 4.61, which was significantly higher than those in adjacent tissues (3.00 ±0.37) and normal liver tissues (2.94 ± 0.21 ) ( t = 31. 962, 31. 699, P ＜ 0. 05 ). Conclusions The expression of ECM1 in liver cancer tissues is higher than those in adjacent and normal liver tissues, and ECM1 expression is correlated with metastasis of liver cancer and TNM stages, which indicate that ECM1 may play a role in the metastasis of liver cancer, and it could be used as an indicator for liver cancer metastasis.

A cadmium column reduction-azo dyes spectrophotometric method based on micro sequential injection lab-on-valve was established for the determination of total nitrogen in seawater. The experimental parameters were optimized, and the interference experiment was carried out. The results showed that the interference of the main components and salinity in sea water could be eliminated by using a series of standard solution prepared by national standard seawater with certain salinity. The concentration of total nitrogen in seawater was linear with the absorbance in the range of 0 . 03-1 . 00 mg/L with a correlation coefficient of 0. 9993. When determining the national standard seawater at nitrogen concentration of 0. 20 mg/L, the relative standard deviation (RSD) was 4. 9%, the detection limit was 0. 010 mg/L, and the recoveries were 99. 5%-101 . 1%. There were not significance differences between the results of this method and national standard method in the t-test analysis. The method is suitable for the determination of total nitrogen in seawater.

Objective To investigate the pathogen and drug susceptibility in appendical intracavity with appendicitis, and guide clinically the selection of reasonable antibiotics. Methods Germicultures and drug susceptibility tests were conducted for the secretions from appendical intracavity of the 71 patients with appendicitis. Result (1) Totally 9 species (63 cases) of bacterium were isolated from clinical samples, positive rate of isolation was 88.7%. The first one was escherichia coli (49 cases). (2) The positive rates of germiculture were no differences in patients with different types of appendicitis. Age and BMI were associated with the results of germiculture. Gender, temperature, neutrophil, fecalith were not associated with the positive germiculture. (3) The curative effect of the third and the fourth generation cephalosporins and carbapenems were well. The curative effect of the first generation cephalosporins, quinolones and penicillins were not well. Conclusion (1)In all samples,escherichia coli are the dominant species of bacterium. The distribution of isolation is no difference in patients with different types of appendicitis. (2) The third generation cephalosporins are commonly used in clinical treatment with the obvious anti-bacteria effects, The fourth generation cephalosporins and carbapenems can act as the optimal drug for serious infection. Quinolones is not the optimal antibiotics. Penicillins antibiotic is not proposed to be used.

Objective To summarize the clinical experiences of liver transplantation.Methods Of the nine patients, four operation was standard orthotopic liver transplantation,the latter five were the piggyback liver transplantation.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti. Meanwhile intravenous antihepatitis B immunoglobulin and Lamivudine were used to prevent hepatitis B recurrence.Results All patients were cured.Conclusion Liver transplantation can be employed for liver disease both cirrhosis and carcinoma as a conventional surgery.It is an effective way for the treatment of no metastatic liver carcinoma.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti,it can prevent immune rejection.