Objective To compare the clinical curative effect between transjugular intrahepatic portosystemic stent-shunt (TIPS) and TIPS together with gastric coronary vein embolization (GCVE) in treating cirrhosis portal hypertension (PHT) associated with upper gastrointestinal hemorrhage (UGH),and to discuss the necessity,feasibility and clinical curative effect of TIPS plus GCVE.Methods The clinical data of 38 PHT patients with UGH,who were admitted to authors' hospital during the period from April 2010 to May 2012,were retrospectively analyzed.Only TIPS was employed in 15 patients (group A),and TIPS plus GCVE was adopted in 23 patients (group B).Before and after operation,the indexes,hemodynamics of portal vein and spleen,the morphology of spleen,and the degree of gastrointestinal varices were determined and analyzed.The patients were followed up to observe the occurrence of postoperative complications.Results In both groups,the postoperative portal vein pressure showed an obvious reduction with accelerated velocity of flow,and the splenic venous congestion index was decreased,these changes were statistically significant when compared with the preoperative ones (P＜0.05),and which was more obvious in group B than in group A (P＜0.05).After the treatment,the esophagogastric varices (EGV) was obviously improved,the improvement rates of group B and group A were 94.7％ and 66.6％ respectively,the emergency hemostasis rates of group B and group A were 100％ and 75.0％ respectively,The rates of re-bleeding were 4.3％ and 28.5％ respectively;the above results of group B were statistically better than those of group A (P＜0.05).No statistically significant differences in liver function indexes existed between preoperative values and postoperative ones in the same group as well as in group comparison (P＞0.05).The differences in the postoperative hepatic encephalopathy (HE) occurrence and in primary patency rate of stent between the two groups were not statistically significant (P＞0.05).In both groups,the re-intervention patency rate was 100％.The incidence rate of HE in patients in whom the distal end of stent was located in the left branch of portal vein was strikingly lower than that in patients in whom the distal end of stent was located in the right branch of portal vein (P＜0.05).Conclusion For the treatment of PHT associated with UGH,TIPS combined with GCVE carries reliable curative effect,this therapy is superior to simple use of TIPS.

Possessing the unique feathers of high targeting and inducing the active immunity of patients,magnetic-mediated hyperthermia(MMH)has been regarded as a very promising cancer-treatment approach.Researches about in-stent MMH for esophagus cancel have been widely carried out with focusing on heating mechanism,feasibility studies and clinical trials.

OBJECTIVE:To discuss the importance of essential drug supply system for national drug policies and the role of public governance theory in the supply of essential drugs.METHODS:In view of the status of the construction of medical insurance system in China for residents in city and countryside,some strategies for the improvement of the health service system were put forward from aspect of public governance.RESULTS:Taking service as orientation,changing the government administration to service administration,introducing non-profit organization and bringing the function of non-public ownership into full play can help improve the national essential drug policy and drug supply ensuring system and guarantee the people's accessibility to essential drugs and medication safety.CONCLUSION:It is urgent to establish the supply and marke-ting system of essential drugs.

Objective To establish the mouse model of sclerotic skin. Methods The sclerotic skin was induced by local injections of bleomycin (BLM) in C3H and BALB/c mice. The injection solution was prepared with BLM at the concentration of 200?g/mL in PBS. In the test group 0.1 mL BLM solution was injected daily into the back of the mice for 3 weeks. For the control mice same amount of PBS was injected daily for 3 weeks. After 3 weeks, the histology of the skin and lungs was compared between the different groups, also the changes of skin thickness and quantity of collagen. Results After the treatment of BLM sclerotic skin was observed in both C3H and BALB/c mice, in which the thickness of skin and the quantity of collagen (6 mm ? 6 mm) were higher than those in the control mice (P

Objective To investigate the predictive value of serum histone deacetylase 3(HDAC3) ,cystatin C(CysC) and albu‐min levels on a large area of myocardial infarction .Methods According to whether heart failure and (or) cardiogenic shock occur‐ring during hospitalization ,102 patients with acute myocardial infarction(AMI) were divided into the two groups :the non - compli‐cating heart failure and (or) cardiogenic shock group(n= 63) and the complicating heart failure and (or) cardiogenic shock group(n= 39) .Then according to whether the creatine kinase(CK‐MB) peak value was greater than 200 IU /L ,102 AMI patients were di‐vided into two groups :CK‐MB peak values ≥ 200 IU /L group(n= 58) and the CK‐MB peak values < 200 IU / L group(n= 44) .The serum HDAC3 ,CysC and albumin levels were detected at early morning on 2 d of admission in all patients .Results Compared with the non - complicating heart failure and (or) cardiogenic shock group ,serum HDAC3 and CysC levels in the the complicating heart failure and (or) cardiogenic shock group were significantly increased(P< 0 .01) ,while serum albumin protein level was significantly in the occurrence of heart failure and(or)cardiogenic shock group .Compared with the CK‐MB peak value < 200 IU /L group ,serum HDAC3 and CysC levels in the CK‐MB peak value > 200 IU /L group were significantly increased (P< 0 .01) ,while serum albumin level was significantly decreased(P< 0 .01) .Conclusion Serum HDAC3 ,CysC and albumin levels have certain predictive value on a large area of myocardial infarction and conduce to judge the prognosis of patients .

Minimal hepatic encephalopathy (MHE)is defined as early hepatic encephalopathy without grossly evident neurologic abnormali-ties,but with cognitive deficits that can be revealed by psychometric testing.However,numerous studies have shown a lack of obvious clini-cal manifestations in MHE patients,and there is no international unified diagnostic gold standard for this disease.Affected patients′quality of life and ability to work are markedly impaired,and some even gradually progress to symptomatic hepatic encephalopathy.The treatment methods for MHE mainly include eliminating the precipitating factors for this disease and medication.This review presents the options for treatment of MHE and gives an objective evaluation of the efficacy of each treatment scheme.Currently,several treatment methods are used together,but no studies have demonstrated that combined use of treatment methods can improve the treatment outcome.

OBJECTIVE:To optimize the formulation of indomethacin-loading solid lipid nanoparticle(SLN). METHODS:Us-ing indomethacin as model drug,glyceryl behenate as oil phase,poloxamer 188 and polyethylene glycol-12-hydroxystearic acid as emulsifier,with turbidity,entrapment efficiency and drug loading amount as index,Box-Behnken response surface methodology was used to optimize the amount of oil phase,emulsifier-oil phase ratio,drug-oil phase ratio. The physicochemical properties of SLNs were characterized by SEM and DSC. RESULTS:The optimal formulation was as follows as oil phase of 0.91%,emulsifier-oil ratio of 1∶1,drug-oil phase ratio of 1∶5. The turbidity,entrapment efficiency and drug loading amount of prepared nanoparticle were 1 025-1 030 NTU,98.94%-99.08%,2.43%-2.46%,respectively;particle size and polydispersity index(PDI)were 181.5-182.3 nm and 0.340-0.341(n=3). The results of DSC showed that indomethacin was not present in crystalline state dispersed into SLNs. CONCLUSIONS:The optimal formulation is screened successfully,and indomethacin-loaded SLNs have been prepared.

Objective To investigate the dual-direction regulation of Tongxie Yaofang on gastrointestinal movement by studying its effect on gastrointestinal movement of mice in various functional states. Methods Adopting diarrhea model induced by rhubarb,constipation model by compound diphenoxylate and normal mice,the effect of different doses of Tongxie Yaofang on loose stool quantity,degree,diameter,diarrhea rate,loose stool incidence rate,loose stool grade,diarrhea index of every group were observed. By esta blishing hyperfunction of small intestinal function in mice by neostigimine,inhibition of small intestinal function in mice by atropine sulfate and small intestinal propellant function in normal mice,the effect of Tongxie Yaofang on intestinal movement of mice were studied. Results Tongxie Yaofang could inhibit gastrointestinal movement of diarrhea model and hyperfunction of small intestinal function in mice by neostigimine. It could promote gastrointestinal movement of constipation model and inhibit small intestinal function in mice by atropine sulfate. But it had no obvious action on natural mice and its intestinal movement. Conclusions Tongxie Yaofang has dual-direction regulation on gastrointestinal movement of mice in various functional states,which has a good agreement with formula-syndrome in traditional Chinese medicine,conforms to treatment based on syndrome differentiation.

Objective To investigate the feasibility of laparoscopic repair for ingunal hernia after peritoneal dialysis. Methods Laparoscopic repair of inguinal hernia was conducted in 26 patients with chronic renal insufficiency who had received peritoneal dialysis for a long time. For indirect inguinal hernia, a piece of mesh was placed in the abdominal cavity and the internal ring was sutured and ligated under laparoscope. For direct inguinal hernia, the hernia sac was high suspended and then the mesh onlay was placed under laparoscope. Results The laparoscopy was successfully performed in all the 26 patients, without conversions to open surgery. No postoperative hematoma of scrotum or refractory neuralgia was observed. Follow-up examinations for 6~12 months (mean, 9 months) showed no recurrence. Conclusions Laparoscopic herniorrhaphy for inguinal hernia after peritoneal dialysis is feasible, effective, and safe.

Objective To stuey effects of coloprotectomy under colonoscopy combined with laparoscope on exfoliated tumor cells in abdominal cavity.Methods 42 cases of colorectal cancer proved by pathologic histology were devided into two groups randomly: Laparoscope Group(laparoscopic surgery) and Combined Group(colonoscopy combined with laparoscope surgery).Operation time,the positive rate of exfoliated tumor cells in abdominal cavity after and before operation,the positive rate of residual tumor cells in resection of operation specimen and postoperative complications between 2 groups were compared.Results Operation time of the Combined Group was shorter than that of the Laparoscope Group [(160.5?12.6) min vs.(201.2?18.4) min,t=-8.363,P=0.000].The positive rate of exfoliated cells in abdominal cavity before operation had no significant difference between the 2 groups[9.5%(2/21) vs.19.0%(4/21),?2=0.194,P=0.659],but the postoperative positive rate of exfoliated cells in the Combined Group was significantly lower than that in the Laparoscope Group[14.3%(3/21) vs.42.9%(9/21),?2=4.200,P=0.040].There were no residual tumor cells in resection of operation specimen of 2 groups.No infection of incisional wound and lung occurred.A follow-up for 6-24 months in the Laparoscope Group showed abdominal metastasis in 1 case.Conclusions Coloprotectomy for colorectal cancer under colonoscopy combined with laparoscope can decrease exfoliated tumor cells in abdominal cavity and shorten operation time.