ObjectiveTo retrospectively investigate the incidence,outcome and risk factors of HBV reactivation in HBsAg-positive a patients with gastric carcinoma during cisplatin-based adjuvant chemotherapy.Methods We retrospectively reviewed the records of 2,538 patients with gastric carcinoma who received adjuvant chemotherapy from January 2005 to December 2010.Among these patients,146 HBsAg-positive patients were analyzed for the HBV reactivation in this study.The HBV serology and biochemical tests of the 146 patients were performed.The data were analyzed by chisquare test.Results Among 146 HBsAg-positive patients with gastric carcinoma,43 patients (29.5％) developed hepatitis,of which 29 (19.9％) were related to HBV reactivation.Univariate analysis showed that age ≥51 years (P=0.029) and abnormal liver uhrasonography findings such as fatty liver or early cirrhotic changes (P=0.031) were associated with HBV reactivation.However,gender,HBeAg positive status and the use of corticosteroids were not related with HBV reactivation.Conclusions HBV reactivation occurs in a significant proportion of HBsAg-positive patients with gastric carcinoma during adjuvant cisplatin-based chemotherapy.Once hepatitis developed,most patients could not finish the chemotherapy as planned despite lamivudine treatment.Therefore,HBsAg-positive gastric carcinoma patients should initiate prophylactic antiviral treatment before chemotherapy.

Objective To investigate the characteristic,diagnosis and treatment of the nipple discharge.Methods The clinical data of 174 cases who were diagnosed as nipple dlscharge from January 2001 to December2006 were collected and analyzed retrospectively.Results Among those 174 cases,136 cases were confirmed histopathologieally to be intraduetal papilloma.The confirmed diagnosis rate of intraduetal papilloma by galaetograghy was 85.00%.Carcinoma-charge rate of the intraduetal papilloma was 5.17%.Conclusion Nipple discharge was the most common symptom in the intraductal papillomatesis.The galaetography was a valuable method in the diagnosis of the intraduetal papilloma.There was carcinoma-charge possibility in the intraduetal papilloma.

In 2015 , policy reforms on centralized drug purchasing system have been released one by one , and the quality of medicines has been highly valued .Centralized drug purchasing system distinguishes different qualities of drugs mainly through bidding grouping , in order to achieve “uality priority”.However , there are yet some existing problems in group bidding policy at present , such as lack of a unified hierarchy , no scientific indicators and so on , which inevitably weaken the leading role of centralized purchasing policy over the quality of medicines .This paper , focuses on the study of group bidding , and the existing main problems are found through the statistical analysis of rel-evant policies introduced in different provinces .Finally, it explores some optimization strategies for “Group Bidding”which is of paramount importance .

Objective:To construct nucleotide vaccine based on HSP65 gene of mycobacterium tuberculosis.Methods:The gene encoding heat shock protein 65 kilodalton was amplified from genome of mycobacterium tuberculosis H37Rv strain by polymerase chain reaction(PCR) and correctly inserted into corresponding sites of eukaryotic expression vector pcDNA3.1(-) after restriction endonuclease digestion.The experimental mice was vaccined by this recombinant plasmid DNA.Results:The gene fragment inserted into the vector pcDNA3.1(-) was the HSP65 gene of mycobacterium tuberculosis H37Rv strain,which was confirmed by partial nucleotide sequencing.There was specific antibody produce in experimental mice vaccined by the recombinant plasmid DNA and this could protect mice against infection of mycobacterium tuberculosis.Conclusion:The successful construction of recombinant eukaryotic expression vector based on HSP65 gene of mycobacterium tuberculosis,such recombinant plasmid DNA induced specific antibody production in experimental mice,lays the foundation for further researching in prevention and treatment of tuberculosis.

Objective To evaluate the clinical efficacy of microwave ablation and surgical resection for the treatment of early primary hepatocellular carcinoma (HCC).Methods The Cochrane Library, Medline,PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang database, VIP database were searched with the key words of tumor, liver cancer, primary hepatic carcinoma, hepatocellular carcinoma, HCC,surgery, surgical, surgical resection, liver resection, hepatic resection, thermal ablation, percutaneous thermal ablation, microwave coagulation, microwave ablation, 肝癌, 原发性肝癌, 肝细胞癌, 手术, 切除, 手术切除, 肝切除, 微波, 热消融, 微波治疗, 微波凝固, 微波消融 between the database establishment and February 2015.Chinese and English literatures on microwave ablation and surgical resection for the treatment of early primary HCC were retrieved, and data were extracted and analyzed by 2 independent researchers.All the patients were divided into the microwave ablation group and the surgical resection group.Measurement data were represented by the standardized mean difference (SMD) and 95％ confidence interval (CI), and count data were represented by the odds ratio (OR) and 95％ CI.Heterogeneity of the publication was analyzed using the I2 test.Results Seven literature including 6 retrospective cohort studies and 1 randomized controlled trial were retrieved, and total sample size were 993 patients including 648 in the microwave ablation group and 345 in the surgical resection group.There were significant differences in the volume of blood loss and duration of postoperative hospital stay between the2groups (SMD=-5.03,-1.74, 95％ CI:-6.21-3.85,-2.21--1.28, P＜0.05).There were no significant difference in the incidence of postoperative complications, 1-, 3-year overall survival rates, 1-, 3-year tumor-free survival rates and 1-, 2-, 3-year recurrence rates between the 2 groups (OR =1.57, 1.10, 1.20,0.77, 1.23, 1.32, 2.31, 1.39, 95％CI: 0.25-9.78, 0.43-2.86, 0.70-2.06, 0.19-3.12, 0.54-2.81,0.62-2.80, 0.96-5.55, 0.47-4.14, P ＞ 0.05).Conclusions The safety, feasibility and clinical efficacy of microwave ablation for the treatment of early primary HCC is comparable to surgical resection, and microwave ablation has the advantages of lesser blood loss and shorter duration of hospital stay.

Objective To examine the white matter microstructure alternations in the patients with generalized anxiety disorder (GAD) with diffusion weighted imaging.Methods 19 patients with GAD and 20 matched healthy controls were assessed using apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) in the regions of interests (ROIs) approach.The ROIs were the white matter of bilateral cingulate and bilateral hippocampus.Results Significantly increased ADC values were found in GAD patients (0.78±0.02,0.79±0.03) with respect to normal controls in the right and left anterior cingulate white matter.Significantly decreased eADC values were found in GAD patients (0.46±0.01,0.45±0.01) in the right and left anterior cingulate white matter.Conclusion Diffuse cingulate white matter alterations on DWI in GAD denote the disruption of white matter integrity.

Objective To study the changes of portal vein pressure before and after interventional embolization with α-cyanoacrylate alkyl and their clinical significance. Methods Thirty five patients with esophageal-gastric variceal bleeding were included. Esophageal-gastric fundal varices were embolized with e-cyanoacrylate alkyl in 35 patients, and 10 of them were treated with combination of partial splenic emblization. Portal pressure was measured directly before and after interventional embolization. The patients were followed up for 3-18 months. The changes of the liver functions and complications after the embolization were observed. Results All bleeding were controlled successfully. The main portal pressure in those who received variceal embolization only increased significantly from (32.54±5.23) cm H2O (1 cm H2O=0. 098 kPa) to (37.45±5. 11) cm H2O; superior mesenteric vein pressure increased from (31.46±4.35) cmH2O to (34.33±4.68)cm H2O; and the level of serum albumin raised from (30.45±5.78) g/L to (34.57±6.84) g/L 3 weeks after embolization. Whereas the main portal pressure in those who received both variceal and partial splenic embolizations, decreased significantly from (32. 68±4. 89) cm H2O to (28. 70±4. 58) cm H2O; superior mesenteric vein pressure decreased from (31.46±4.35) cm H2O to (28.03±4.12) cm H2O; and splenic vein pressure decreased from (32.89±4.79) cm H2O to (28.81±5. 12) cm H2O.Conclusions Esophageal-gastric variceal embolization is effective for varieeal bleeding. The increase of main portal pressure after embolization may be benefit for liver function, while the rise of superior mesenteric vein pressure may increase the risk of portal hypertensive gastrointestinal re-bleeding.Esophageal-gastric variceal embolization combined with partial splenic embolization may reduce the incidence of portal hypertension and gastrointestinal re-bleeding, but will increase the risk of ascites.

AIM: To investigate the effect of FAK - related non - kinase ( FRNK) on the expression of membrane - type matrix metalloproteinase -1 ( MT1 - MMP) in hepatic stellate cells ( HSC). METHODS:FRNK were trans-fected into HSCs by cationic liposome method. The protein levels of FRNK in HSC were assayed by Western blotting. The levels of MT1 - MMP were determined by RT - PCR for mRNA and by Western blotting for protein, respectively. RESULTS: The up -regulated expression of FRNK protein was observed and it was at 48 h after transfection that the FRNK protein content was the highest ( P < 0.05 ). The expressions of MT1 - MMP mRNA and protein were also up - regulated by the transfection of FRNK, and it was at 48 h after transfection that the MT1 - MMP protein content was significantly increased. CONCLUSION: The mRNA and protein of FRNK were over - expressed in HSC transfected with the gene of FRNK. The inhibitory effect of FRNK on the collagen synthesis in HSC may be through the up - regulation of MT1 - MMP.

Objective To observe the clinical curative effect of ginseng cream stickon in patients suffering from lack of lactation after parturition .Methods Ninety patients suffering from lack of lactation after parturition were divided into three groups :the treatment group (patients with ginseng cream stick by acupoint application ) ,and 2 control groups (control with lactation elixir ,and control with decavitamin) .The treatment last for 5 days for each group .And the breast filling degree ,the lactigenous volume ,the neonatal weight ,artificial feeding times ,the artificial feeding volume and the prolactin level before and after the treatment were all recorded .Results Ginseng cream stick by acupoint application dramatically improved breast filling ,the lactigenous volume ,the neo‐natal weight ,artificial feeding times ,the artificial feeding volume and the neonatal urination frequency ,there was a significant differ‐ence between the treatment group and the two control groups (P<0 .05) .Conclusion Ginseng cream stick by acupoint application could significantly relieve lack of lactation ,meet the need of breastfeeding ,and increase the breast‐feeding rate .

Background and purpose: As the most common tracer used for PET/CT to detect malignant tumors. ~(18)F-fluorodeoxyglucose (~(18)F-FDG) can reflect the metabolism of glucose. However, there exists physiologic uptake in the intestinal tract of healthy people. Because ileocecal foci is predilection site of malignant tumors and inflammatory disease, the purpose of this study was to investigate the discrimination of PET/CT detection of incidental ileocecal high FDG uptake. Methods: We retrospectively analyzed 28 unexpected ileocecal focal uptake of ~(18)F-FDG localized by PET/CT, and then semi-quantitatively analyzed the extent of radioactive uptake in ileocecal foci. After PET/CT, the etiology of the findings was confirmed histologically by surgery, endoscopic or by long-term follow-up. All the data were assessed for statistical significance using one-way ANOVA. Results: In all the ileocecal foci, there were 14(50%) physiologic FDG uptake, 8 (28.6%) benign diseases and 6 (21.4%) malignant tumor. Maximal standardized uptake value was 5.2±1.6 in physiologic uptake, 6.8±4.1 in benign lesions and 12.8±5.5 in malignant lesions. There was statistically significant difference between malignant tumors and the other 2 groups. According to ROC analysis, when SUN_(max) was 6.75, the sensitivity and specificity of ileocecal malignant tumor were 100% and 86.4%, respectively. Conclusion: The significant value of discrimination between benign and malignant lesions of ileocecal focal FDG uptake by PET/CT was affirmative. It is very important to recognize physiologic uptake of ileocecal conjunction in the interpretation of image. Semi-quantitative analyze was not helpful to identify benign lesions from physiologic uptake.