0.05).Conclusions:Detection of hypermethylation change of BRCA1 promoter promises a definite value in histologic type,malignant metastases and early prognostic in sporadic breast cancer.

Objective To evaluate the effects of ginsenoside Rg3 combined with XELDX regimen on advanced carcinoma of stomach.Methods Totally 93 postoperative patients with advanced gastric cancer were randomly divided into two groups:control group(n ＝ 53) who received only XELDX regimen,and study group (n＝ 40) who were treated with ginsenoside Rg3 + XELDX.The objective response rate,KPS score and serum VEGF levels in the two groups were detected.Results (1) Before treatment,treatment group and control group showed that serum VEGF levels were (387.63±159.74) μg/L and (378.56± 169.36) μg/L,respectively (P＜0.05).After 8 weeks of treatment,serum VEGF of the treatment group decreased to (207.74 ± 115.71) μg/L,the level of the control group VEGF decreased to (246.53 ±107.63) μg/L(P＜0.05).(2) The efficacy rate was 57.5％ (23/40) in treatment group and 45.3％(24/53) in the control group (P＞0.05).(3) KPS score increasing rate was higher in treatment group (65.0％) than in control group (39.6％)(x2＝5.87,P＜0.05).Conclusions Ginsenoside Rg3 combined with chemotherapy in advanced gastric cancer patients can reduce serum VEGF levels and improve the quality of life of patients.

Objective To establish an HPLC method for the simultaneous determination of quercetin and kaempferol inKaempferia galanga L..Methods ODS2 C18 (5μm, 4.6 mm×150 mm) was used as chromatographic column; methanol-0.4% phosphate (47:53) was the mobile phase; the flow rate was 1 mL/min; column temperature was 30℃; the detection wavelength was 367 nm; the injection volume was 10μL.Results Quercetin showed good linear relationship in the range of 0.016 5–1.65μg (r=0.999 7). The average recovery rate was 96.8%, RSD=2.02%; kaempferol showed good linear relationship in the range of 0.014 6–1.46μg (r=0.999 5). The average recovery rate was 97.3%, RSD=1.77%.Conclusion The method is simple, accurate, and with good reproducibility, which can be used for content determination of quercetin and kaempferol inKaempferia galanga L..

OBJECTIVE:To establish a method for the content determination of kaempferol in Kaempferia galanga. METH-ODS:HPLC was performed on the column of Diamonsil ODS2 C18 with mobile phase of methanol-0.4% Phosphoric acid solution at a flow rate of 1 ml/min,detection wavelength was 367 nm,column temperature was 30℃,and injection volume was 10 μl. RE-SULTS:The linear range of kaempferol was 0.001 58-0.158 mg/ml;RSDs of precision,stability and reproducibility tests were low-er than 3%;recovery was 95.52%-99.32%(RSD=1.47%,n=6). CONCLUSIONS:The method is simple,accurate and reproduc-ible,and can be used for the content determination of kaempferol in K. galanga.

Objective To investigate the causes, characteristics, diagnosis and treatment of severe acute pancreatitis (SAP) complicated with mental disorders. Methods The clinical data of 86 patients with SAP complicated with mental disorders who had been admitted to Union Hospital of Tongji Medical College from 2000 to 2007 were retrospectively analyzed. The causes, clinical manifestations, treatment and prognosis were analyzed. Results Of the 86 patients, 38 were caused by internal milieu disorder, 9 by pancreatic encephalopathy, 23 by infectious-toxic encephalopathy, and 16 by Wernicke encephalopathy. The manifestation of the patients with SAP complicated with mental disorders was complex, varied and nonspecific. Individualized treatment was applied to all patients after the analysis of the causes, and most patients recovered except 14 who died of hemorrhage or multiple organ dysfunction syndrome. Conclusions Internal milieu disorder should be first considered when patients have mental disorders which occurred at the early phase of SAP, then pancreatic encephalopathy should be considered. The infectious-toxic encephalopathy and Wernicke encephalopathy should beware of when the mental disorders occur in the late phase of SAP. Individualized treatment according to the causation and comprehensive treatment are effective in preventing and treating mental disorders which occurred in the course of SAP.

Objective To evaluate the effectiveness of domestic exogenous pulmonary surfactant (EPS)-Calsurf in treating full-term neonatal respiratory distress syndrome (RDS).Methods (1) From January 2011 to June 2012,154 full-term neonates with RDS were divided into Calsurf group (74 cases) and Curosurf group (80 cases),comparing differences in changes of arterial blood gas,the length of hospital stay,hospitalization expenses,duration of mechanical ventilation,inspired oxygen time,the incidences of complications and repeated EPS use rates between two groups.(2) In order to compare the effectiveness of different doses of Calsurf in treating full-term neonatal RDS,from July 2012 to March 2013,80 RDS patients who received Calsurf were divided into mild-moderate group (grade Ⅱ ～ Ⅲ on chest X-ray,50 cases) and severe group (grade Ⅳ on chest X-ray,30 cases).Furthermore,each group was divided into two subgroups,which were low-dosage(per-time 30 ～40 mg/kg) and high-dosage group (per-time 30 ～40 mg/kg).Results (1) Before administrating Calsurf and after administrating it at 0.5 h and 6 h,the pH,PaCO2 and PaO2 of RDS patients were no significant difference in two groups (P ＞ 0.05).(2) There were no significant difference between the duration of mechanical ventilation,inspired oxygen time,length of hospital stay in two groups (P ＞ 0.05).But the hospitalization expenses in Calsurf and Curosurf groups were 28.778 versus 31.827 thousand yuan,respectively,with the average reduction of 9.6％ in Calsurf group (P ＜ 0.05).(3) There were no significant difference between the morbidities and mortalities of multiple organ failure,persistent pulmonary hypertension,acute renal failure and pneumothorax in two groups (P ＞ 0.05).(4) In mild-moderate grade RDS patients,the low-dosage or high-dosage of Calsurf had similar effectiveness in improving bloog gas (P ＞ 0.05),the repeated Calsurf use rates of both subgroups were 16.0％ (4/25) and 20.0％ (5/25) (P ＞ 0.05).While in severe RDS patients,high-dosage Calsurf got a better effectiveness in improving bloog gas than low-dosage Calsurf(P ＜ 0.05).Meanwhile,the repeated Calsurf use rates of the low-dosage and high-dosage subgroups were 20.0％ (3/15) and 33.3％ (5/15),with a 40％ reduction in high-dosage subgroup.Conclusion (1) Both Calsurf and Curosurf can significantly improve the conditions of hypoxemia and hypercapnia,moreover,the length of hospital stay and duration of mechanical ventilation of both groups are similar,with less hospitalization expense in Calsurf group.(2) Both low and high-dosage Calsurf have similar curative effect on mild-moderate RDS,but for severe RDS,high-dosage Calsurf works better,reducing the repeated EPS use rate to some extent.

Objective To investigate the clinical efficacy of hemocoagulase for severe hemorrhagic cystitis (HC) following allogeneic hemotopoietic stem cell transplantation (HSCT). Methods Twenty patients undergoing allogeneic HSCT developed severe HC with an onset time of 14 to 70 days, all patients received the treatment of hemocoagulase (1 U ivgtt q12 h × 5 d). The urine speciments reserved before and after hemocoagulase were examined by naked eye and microscope to evaluate the efficacy. Results Twenty patients received the treatment of hemocoagulase. The HC was cured in 18 patients, improved in 1 patient and uncontrolled in 1 patient. For the patients with response, macroscopic hematuria disappeared at a median of 28 days (4-127 days) after the treatment. All procedures were tolerated well and no severe adverse effect was observed. Conclusion Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.

Objective To evaluate the clinical results of femoral-deep femoral crossover bypass in the treatment of long-segment unilateral iliac artery occlusive disease.Methods From July 1995 to December 2010,40 patients (28 males,12 females,aged from 66 to 90,with mean age of 73) with comprehensive unilateral iliac-superficial femoral arteriosclerosis obliterans were enrolled in this procedure.All patients suffered from unilateral common iliac,external iliac,common femoral,and superficial femoral arteriosclerosis obliterans.These patients were treated with femoral-deep femoral crossover bypass.Postoperative ankle-brachial index,blood flow velocity and patency rates in 5,7 and 10 years and limb salvage rates in 5,7 and 10 years were evaluated.Results There was no perioperative mortality nor extremity amputation.35 (87.5％ ) patients were followed-up from 1 to 13 years (mean 5.7 y).Anklebrachial index rose from preoperative 0.23 ± 0.10 to postoperative 0.55 ± 0.11 (t =15.91,P =0.000 ).Popliteal arterial velocity rose from preoperative ( 14 ±6) cm/s to postoperative (34 ± 10) cm/s (t =15.63,P =0.000) ; Tibial arterial velocity rose from ( 10 ±4) cm/s to (22 ±7) cm/s (t =15.71,P =0.000).The primary and secondary patency rates were 60.1％,44.3％,25.3％,and 93.5％,86.8％,57.9％ at 5,7 and 10 years,respectively.Limb salvage rates were 97.5％,95％,and 90％,at 5,7 and 10 years,respectively.Conclusions Femoral-deep femoral crossover bypass is safe and reliable in treating certain unilateral iliofemoral occlusive disease,especially for high-risk old patients or those who are not indicated for endovascular therapies or direct aortic approaches.

Presented in this paper is our experience in the diagnosis and management of abdominal compartment syndrome during severe acute pancreatitis. On the basis of the history of severe acute pancreatitis, after effective fluid resuscitation, if patients developed renal, pulmonary and cardiac insufficiency after abdominal expansion and abdominal wall tension, ACS should be considered. Cystometry could be performed to confirm the diagnosis. Emergency decompressive celiotomy and temporary abdominal closure with a 3 liter sterile plastic bag must be performed. It is also critical to prevent reperfusion syndrome. In 23 cases of ACS, 18 cases received emergency decompressive celiotomy and 5 cases did not. In the former, 3 patients died (16.7%) while in the later, 4 (80%) died. Total mortality rate was 33.3% (7/21). In 7 death cases, 4 patients developed acute obstructive suppurative cholangitis (AOSC). All the patients who received emergency decompressive celiotomy 5 h after confirmation of ACS survived. The definitive abdominal closure took place mostly 3 to 5 days after emergency decompressive celiotomy, with longest time being 8 days. 6 cases of ACS at infection stage were all attributed to infected necrosis in abdominal cavity and retroperitoneum. ACS could occur in SIRS stage and infection stage during SAP, and has different pathophysiological basis. Early diagnosis, emergency decompressive celiotomy and temporary abdominal closure with a 3L sterile plastic bag are the keys to the management of the condition.
*Abdomen ; *Compartment Syndromes/diagnosis ; *Compartment Syndromes/etiology ; *Compartment Syndromes/surgery ; Decompression, Surgical ; *Multiple Organ Failure/diagnosis ; *Multiple Organ Failure/etiology ; *Multiple Organ Failure/surgery ; *Pancreatitis, Acute Necrotizing/complications ; *Pancreatitis, Acute Necrotizing/diagnosis ; *Pancreatitis, Acute Necrotizing/surgery

Objective To observe whether appropriate intermittent exercise at the ischemic threshold can safely promote collateral circulation in an ischemic area of the myocardium through the increased expression of vascular endothelial growth factor(VEGF)and its receptor fetal liver kinase-1(Fik-1). Methods A balloon constrictor was surgically implanted in the first obtuse marginal coronary artery(OM1)of miniature pigs.The subjects were divided into 3 groups:a sham-operation group,a pure ischemia group,and an exercise training group.Subjects in the exercise training group performed individualized treadmill programs 30 min daily,5 d per week,for 8 weeks,including 2 two-minute episodes of exercise-induced ischemia.Two pre-exercise episodes of pure ischemia induced by brief OM1 occlusion were also conducted.Only pure ischemia was induced in the pure ischemia group,and the sham-operation group remained sedentary for the experimental period.Relative myocardial blood flow(RMBF)was measured using microspheres.VEGF and Flk-1 expression levels were measured by Western blotting and real time RT-PCR analyses.Cardiac troponin I(ctnI)levels were determined using an enzyme-linked immunosorbent assay(ELISA). Light and electron microscopy were employed to examine myocardia damage in the ischemic area.Results RMBFs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups. RMBFs in the pure ischemia group were significantly higher than those in the sham-operation group.The expression of VEGF and Flk-1 proteins and mRNAs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups,and the levels in the pure ischemia group were also significantly higher than those in the sham-operation group.After training,no myocardial damage and no ctnI increase was observed in the pure ischemia group.Microscopy revealed no obvious structural changes. Conclusion Intermittent exercise at the isehemia threshold intension can safely promote coronary collateral formation through upregulation of VEGF and Flk-1 expression in the ischemic myocardial area of a porcine model.