0.05).Compared with the control group,the weight and viscera coefficient of testis in high dosage group,the sperm counts of epididymides in medium and high dosage experiment groups were all decreased significantly(P0.05).The activities of succinate dehydrogenase(SDH) and nitric oxide synthase(NOS) of testis in high dosage group,the activities of acid phosphatase(ACP),alkaline phosphatase(AKP) and Ca-Mg-ATPase of testis in medium and high doseage groups were all decreased significantly compared with the control group(P

From both doctors and patients′different perspectives , this paper analyses the causes of conflict of doctor-patient communication , and from the subjective and the objective , the history and reality , individual and social aspects of light on the restricting factors for good doctor -patient communication , and puts forward strengthe-ning the consciousness of active , rule execution , achieving full coverage , explore ways to standard mode , rich di-verse ways and other countermeasures .

This article was based on the investigation of ethical research in traditional Chinese medicine (TCM) clini-cal trials among 240 ischemic stroke patients and 105 experts specialized in this field. Analysis was given on the re-search results. This article was intended to regulate the ethical review of ischemic stroke, and to protect the rights and interests of the subjects better.

Purpose:To select a better operation approach for esophageal carcinoma. Methods:From 1958 to 1997, 945 patients of the middle third esophageal carcinoma of our hospital were underwent 5 types of operation.namely: left thoracic approach esophagectomy and esophagogastrostomy; right thoractomy anterolateral and abdomen esophagectomy and esophagogastrostomy; right thoractomy anterolateral and abdomen and cervical approach esophagectomy and esophagogastrostomy; right thoractomy posteriolateral, abdomen and cervical approach esophagectomy and esophagogastrostomy; simple right thoracic approach esophagectomy and esophagogastrostomy. The rate of resectability, rate of complication, rate of mortality and rate of survival of the 5 types of operation were using SAS package and significance test of contingency table. Results:The rate of resectability and the rate of 5 year survival in the five groups were 84.19% and 29.00%, 81.69% and 28.57%,83.65% and 26.19%,90.74% and 34.70%, 93.67% and 39.74%, respectively. Conclusions:Right thoracic approach esophagectomy and esophagogastrostomy are considered superior the operation approach of esophageal carcinoma.

Objective To explore the epidemiology, clinical and pathological characteristics,treatment and prognosis of Richter's syndrome (RS). Methods The clinical and laboratory feature,treatment, prognosis of two cases were reported, and the related literature was reviewed. Results The major symptom of two cases suffered with enlarged lymph nodes, and pathological examination indicated a diffuse large B cell lymphoma. A large number of mature small lymphocytes were found in peripheral blood and bone marrow, and the immune phenotype was consistent with chronic lymphocytic leukemia. CHOP regiment was used on two cases. One obtained complete remission, and the other cases partial remission. Conclusion RS may occur at early stage after CLL diagnosis. In some cases, the diagnosis of RS and CLL are concomitant.Prognosis of some patients of RS is unfavourable. It was important to take biopsy at early stage.

Objective To study the distribution characteristics of intraperitoneal free gas and the location value of the site of gastrointestinal perforation using multi-slice CT (MSCT).Methods 60 cases of gastrointestinal perforation were retrospectively collected.The distribution of the intraperitoneal free gas in CT image was analyzed and observed.The digestive tract were divided to the upper digestive tract and the lower digestive tract by Treitz ligament.The distribution of the intraperitoneal free gas was analyzed using χ2 test.The distribution of the intraperitoneal free gas between each different perforational site was analyzed.Results 38 cases of the site of gastrointestinal perforation located in upper gastrointestinal tract and 22 cases located in lower gastrointestinal tract,there was statistically significant difference between the upper digestive tract and the lower digestive tract about the distribution of the intraperitoneal free gas(χ2=22.33,P<0.001).In the cases of upper gastrointestinal tract perforation,13 cases of the site located in stomach and 25 cases located in doudenum,there was no statistically significant difference between stomach and duodenum(χ2=1.97,P>0.05).In the cases of lower gastrointestinal tract perforation,11 cases of the site located in bowel and 11 cases located in colon,there was statistically significant difference between bowel and colon(χ2=8.98,P<0.05).Conclusion The MSCT distribution of the intraperitoneal free gas has important value in localization diagnosis of gastrointestinal perforation.

Objective:To evaluate the clinical efficacy and safety of L-asparaginase (L-ASP) combined with GDP regimen in initial treat-ment of patients with extranodal NK/T-cell lymphoma (ENKL). Methods:A total of 39 patients preliminarily diagnosed with nasal NK/T-cell lymphoma in Zhengzhou University Affiliated Cancer Hospital were retrospectively analyzed from January 2012 to January 2014. All patients received L-ASP combined with GDP chemotherapy. The efficacy of the treatment was observed (L-ASP 6000/m2, qod × 8;gemcitabine 1000 mg/m2, d1, 8;cisplatinum 90 mg/m2, d1;dexamethasone 10 mg, d1-4) every 21 days for one cycle. The efficacy and toxicity of the regimen were evaluated after therapy. Results:Of the 39 patients who received median six-cycle L-GDP regimen treat-ment, 24 achieved complete response, 7 had partial response, 6 had stable disease, and 2 had progressive disease. The rates of overall response (CR+PR), 2-year progression-free survival, and overall survival were 79.5%(31/39), 71.8%(28/39), and 87.2%(34/39), respec-tively. The primary side effects included gastrointestinal reaction, bone marrow suppression, and increased PT and APPT levels. All pa-tients tolerated and completed the therapy without termination of treatment and death. Conclusion:L-ASP combined with GDP regi-men is effective and safe and thus can be used for patients with ENKL.

Objective To analyze the adult hemophagocytic syndrome' s pathogeny,clinical features,prognostic factors and therapeutic options.Methods 18 cases of adult hemophagocytic syndrome were analyzed,the Kaplan-Meier analysis was used to investigate the total survival rate,and 17 clinical pathological factors and clinical treatment methods which may influence survival were analyzed by Log-rank test in the univariate analysis.Results In this group of patients,EBV infection and malignant lymphoma were the most common initiating diseases.The most common clinical features were peripheral cytopenia in two or three lineages (100 ％),fever (83 ％),splenomegaly (78 ％),swollen lymph nodes (56 ％).The mortality rates as high as 66.7 ％.The median survival time was 7.4 weeks.One-way ANOVA results showed that the initial symptoms as fever (P =0.039),age ＞ 30 years old (P =0.031),enlargement of the liver (P =0.041),Hb ＜ 100 g/L and Ph ＜ 50 g/L (P =0.039) were relevant prognostic factors.Conclusion Adult hemophagocytic syndrome patients with fever as the initial symptoms,age ＞ 30 years old,liver enlargement,Hb ＜ 100 g/L,Plt ＜ 50 g/L indicates poor prognosis,thus these patients having HPS risk factors should be given active chemotherapy and supportive therapy.

Objective To investigate the efficacy and adverse events of BACOD regimen for relapsed and refractory non-Hodgkin lymphoma (NHL). Methods Sixty patients with relapsed and refractory NHL received chemotherapy of BACOD regimen: bleomycin 10 mg/m2, intravenous drip on the 2nd and 9th day;cyclophosphamide 750 mg/m2, intravenous drip on 1st day; vindesine 3 mg/m2, intravenous drip on 1st and 8th day; cytarabine 150 mg/m2, intravenous drip on 2nd-5th days; dexamethasone 10 mg/m2, intravenous drip on 2nd-5th days; every 3 weeks was one cycle. Results Eighteen cases (27.7 %) received the complete remission (CR), 30 the partial remission (PR), 13 stable disease (SD) and 4 progressive disease (PD). The overall response (CR+PR) rate was 70.8 %. The median remission time of patients with response was 11 months(2-38 months). The 1-year survival rate was 32.3 % and the 2-year survival rate was 24.6 %. The main adverse events were myelosuppression. Conclusion BACOD regimen can be used as the relief regimen of relapsed and refractory NHL.

Objective To investigate the correlation between the CD40 gene( - 1 C/T)single nucleotide polymorphism(SNP) and acute coronary syndromes(ACS), and the expression of CD40 on platelets. Method A total of 562 patients with ACS canfirmed by coronary angiography were divided into 3 groups according to the clinical characteristics, namely ACS patients( n = 210), stable angina(SA) patients( n = 189) and control group( n = 163).ACS was defined as ischemic chest pain at rest resulting in admission to hospital and > 50% stenosis in a major coronary artery with or without a rise in troponin Ⅰ. SA was defined as stable effort-related angina without change in angina pattern in 3 months. Patients with infection, tumor, or liver or kidney disease were excluded The gene polymorphism was measured by the polymerase chain reaction and restriction fragment length polymorphism(PCR-RFIP) and identiffed by sequencing. The expression of CD40 on platelets was detected by flow cytometry. The frequency, distribution of genotypes was compared using cross-tabulation and standard X~2 test. Result The CC genotype(31% ) and C allele of frequency(57.9%)of CD40 gene in ACS patients were significantly higher than those in SA(15.9%, 43.1% ) and control groups( 16.1%, 42.6% ). No significant difference of the genotypes or allele frequencies was found between SA and control group(X~2 = 0.053, P = 0.974;X~2 = 0.017, P = 0.897). 1he expression of CD40 on platelets in patients with C alleles carries was significandy higher than that of T allele carries in each group( P <0.0001). Conclusions CD40- 1C/T polymorphism was associated with ACS in Chinese Han nationallity.