AIM: To study the adverse reactions of hydroxychloroquine (HCQ) in ophthalmology. 　METHODS: Thirty-nine patients treated with HCQ for more than six months were performed ophthalmic examinations including some specifie retinal function tests. 　RESULTS: There were 3 patients (8%) who presented the visual fields was minified. The visual acuity of one patient was decreased. The cumulative doses of HCQ were more than 100 g in this three patients. 　CONCLUSION: The adverse reactions of HCQ in ophthalmology are related with the cumulative doses of HCQ. The expression is that the visual fields and visual acuity are decreased.

Objective To observe the RASSF1A expression in laryngeal keratosis and laryngeal squamous cell carcinoma and investigate the relationship between the gene and the occurrence and development of this disease. Methods The specimens of keratosis of larynx(43 cases)and laryngeal squamous cell carcinoma(31 cases)in Oto-laryngology-Head and Neck surgery of Anhui provincial hospital from Dec 2009 to Dec 2012 were collected.Nor-mal vocal fold mucosa from the cadaveric head as control group(8 cases)were collected.Immunohistochemical meth-ods were used to detect the expression of RASSF1A protein in these tissues.The diffuse distribution of brown gran-ules in the cell cytoplasm yielded positive results and the nucleus was not coloring.The percentage of positive cells of every section,and the average standard deviation(￣x±s)were calculated.SPSS17.0 statistical analysis software was used to analyze the data,P<0.05 for the difference was statistically significant.ResuIts The RASSF1A expes-sion in laryngeal squamous cell carcinoma,normal laryngeal mucosa,squamous cell carcinoma of the larynx and la-ryngeal keratosis were compared.The differences of RASSF1A expression were statistically significant (P<0.05). The difference of RASSF1A expression in keratosis of larynx and normal laryngeal mucosa was not significant (P>0.05).RASSF1A expression in the clinical stage from I to IV of laryngeal squamous cell carcinoma gradually de-clined.During the clinical stage,the difference had statistics significance (P<0.05 ).In high differentiated squa-mous cell carcinoma,moderately differentiated squamous and poorly differentiated squamous,the differences of RASSF1A expression were insignificant (P>0.05).ConcIusion The reduction of RASSF1A expression correlated with laryn-geal squamous cell carcinoma,which has certain significance for the different ion of carcinoma and laryngeal precan-cerous lesion.

Objective:To analyze Jinxuan Zhike Xunxi powders ( JZX) and an active ingredients group ( AIG) obtained from JZX by GC-MS, and develop a characteristic fingerprint of AIG. Methods: A gas chromatography-mass spectrum ( GC-MS) method was applied to analyze the main compositions in JZX and AIG, and the characteristic fingerprint information in the fingerprint spectrum was determined. Results:Totally 10 batches of AIG were detected, and a promising GC-MS fingerprint spectrum containing characteristic information for AIG was obtained. Conclusion: The developed fingerprint with good repeatability can be successfully applied in the quality control of AIG.

Objective　To evaluate the changes and clinical s ignificances of serum growth hormore (GH) and GH binding protein (GHBP) in patie nts with obstructive jaundice (OJ). Methods　Serum levels of GH, GHBP, insulin-like growth factor-Ⅰ (IGF-Ⅰ), endotoxin, prealbumin concentr ation and liver function in 60 male in patients with OJ were detected 1 d preope ratively and 1, 3, 7 d postoperatively. And 40 male patients with simple gallbla dder stone hospitalized in the same period were served as control. Resu lts　The levels of GH, GHBP and IGF-Ⅰ were significantly lower in pati ents with obstructive jaundice than in control group(P<0.01), which was corr elated with the levels of bilirubin, endotoxin and prealbumin (P<0.01). Conclusion　The obviously downregulation of GH/GHBP axis in patients with OJ probably results from the inbibition of expression of GH receptor due t o nutritional dysfunction and endotoxemia, and further aggravate the nutritional dysfuction and endoxemia, which may be one of the important factors in the path ophysiological changes of OJ.

Objective To investigate the value of continuous occlusion of hepatic artery proper to intermittent Pringle maneuver in partial hepatectomy for ruptured hepatocellular carcinoma(HCC).Methods The clinical data of 36 patients(test group)who received partial hepatectomy for ruptured HCC by adding continuous occlusion of hepatic artery proper to intermittent Pringle maneuver at the Southwest Hospital were retrospectively analyzed.Thirty-six patients(control group)who received intermittent Pringle maneuver only were selected as the control.All data were analyzed using the chi-square test,Fisher exact probability and analysis of variance.Results The mean hepatic artery occlusion time of the test group was 58 minutes(range,36-98 minutes).The median blood loss of the test group was 400 ml,which was significantly less than 750 ml of the control group(F =16.47,P ＜ 0.05);78%(28/36)of patients in the test group did not receive blood transfusion,which was significantly more than 53%(19/36)of the control group(x2 =6.01,P ＜0.05).The levels of postoperative serumaspartate transaminase and total bilirubin of the 2 groups were peaked at postoperative day 2 and then decreased to the normal level 1 week later.There were no significant differences in the incidences and levels of complications between the 2 groups(x2 = 1.83,0.89,P ＞ 0.05).Conclusion The addition of continuous occlusion of hepatic artery proper to intermittent Pringle maneuver significantly reduces intraoperative blood loss and doesn't bring any adverse effects to hepatic function for partial hepatectomy in patients with ruptured HCC when compared with intermittent Pringle maneuver alone.

Objective To evaluate the feasibility of radical liver resection following downstaging of hepatocellular carcinoma (HCC) by transcatheter arterial chemoembolization (TACE). Methods Eleven patients with HCC underwent radical liver resection after downstaging of HCC by TACE from January 1991 to June 2002, then the clinical features, intraoperative blood loss, postoperative complications and survival time were studied. Results All patients received the radical liver resection successfully, and the mean intraoperative blood loss and operative time of all the patients Was 1336.4ml (110-3200ml) and 272.8 minutes (210-390 minutes), respectively. Each of the 6 patients had an amount of blood loss more than 1000ml. The postoperative complications included bile leakage (3 patients) and ascites (1 patient), with total incidence of 36%. The median survival time was 61.5 months, and the number of patients survived for 1, 2, 3 years was 8, 7, 6, respectively. Conclusion Radical liver resection after downstaging of HCC by TACE is safe and feasible.

Objective To evaluate the efficacy of mini-clamp crushing combined with saline-linked diathermy in hepatectomy for giant hepatocellular carcinoma(HCC).Methods The clinical data of 58 patients with giant HCC(diameter≥10 cm)who received hepatectomy with the mini-clamp crushing technique(miniclamp crushing group)at the Southwest Hospital from April 2006 to December 2009 were retrospectively analysed.According to the tumor size,location and Child classification,the clinical data of 58 patients with similar parameters and received hepatectomy with traditional clamp crushing technique(control group)were selected from the database to conduct the matched case-control study.All the peri-and postoperative data were compared and analysed via one-way ANOVA,chi-square test and Fisher's exact test.Results The median blood loss and transfusion of control group were 850 ml and 650 ml,which were significantly higher than 400 ml and 550 ml of mini-clamp crushing group(F=16.23,5.63,P＜0.05).Twenty-four patients in control group needed blood transfusion,which was significantly larger than 6 of mini-clamp crushing group(χ~2=14.57,P＜0.05).The median time for parenchymal transection and portal triad clamping of control group were 45 minutes and 16 minutes,which were significantly shorter than 86 minutes and 35 minutes of mini-clamp crushing group(F=12.76,11.23,P＜0.05).The numbers of patients in control group who had complications and blood loss were 43 and 28,which were significantly larger than 13 and 8 of mini-clamp crushing group(χ~2=18.69,16.11,P＜0.05).The numbers of patients who had bile leakage,encapsulated effusion of the liver cut face and hepatic insufficiency were 8,5 and 2 in control group,and were 2,3,0 in mini-clamp crushing group,with no significant difference(χ~2=3.04,0.54,2.04,P＞0.05).Conclusion Mini-clamp crushing combined with saline-linked diathermy for the treatment of g4ant HCC is mone effective and available than traditional clamp crushing in terms of reducing blood loss and complications.

As a method of choice in the treatment of ampulary carcinoma,pancreaticoduodenectomy often demands open procedure.With the development of minimally invasive techniques,laparoscopic pancreaticoduodenectomy was realized in recent years.Because laparoscopic pancreaticoduodenectomy is high technique-demanding,its popularization is restricted.With flexible robotic arnls and three-dimensional imaging,Da Vinci surgical system has overcome the shortcomings of traditional laparoscope to some extent.In March 2010.a 60-year-old female patient with ampulary carcinoma underwent Da Vinci surgical system-assisted pancreaticoduodenectomy at the Southwest Hospital.The mean operation time and blood loss were 490 minutes and 450 ml respectively,and no blood transfusion was required.Out-of-bed activity began shortly after the operation.The gastric tube was removed and fluid diet was given on postoperative day 3.The patient was discharged on postoperative day 10 without incidence of complications.The Success of this case preliminarily demonstrats that Da Vinci snrgical system-assisted pancreaticoduodenectomy is safe and feasible.

Objective To study the key technology and initial results of laparoscopic liver resection for hepatocellular carcinoma(HCC)with B posthepatitic cirrhosis.Methods From March 2007 to September 2008,37 HCC patients with posthepatitic cirrhosis were treated with laparoscopic liver resection in our hospital.Results Thirty-two patients received successful total laparoscopic liver resection,3 handassisted laparoscopic liver resection,and 2 were converted to open surgery.Anatomic liver resection was performed in 23 patients including 4 left hepatectomy,8 left lateral segmentectomy,1 extended left hepatectomy,2 right hepatectomy,8 segmentectomy.Fourteen patients underwent nonanatomic liver resection.Liver parenchyma was transected under regional hemi-hepatic blood occlusion in 10 patients,under intermittent Pringle's manoeuvre in 15 cases,and without hepatic blood inflow blockage in 12 cases.The mean operative duration was 212 min(76-435 min)and mean blood loss 354 ml(100-1300 ml).Mortality rate was 0%.Six patients developed 9 postoperative complications including intraabdominal hemorrhage in 1 case,ascites and hydrothorax in 3 and encapsulated effusion of liver section in 2.The mean postoperative hospital stay was 8d(4-15d).In a follow-up from 2 to 21 months,3 patients developed intrahepatic tumor recurrence.One of the 3 patients died 6 months after reoperation,and the other 2 received chemoembolization and radiofrequency ablation,respectively.Conclusion Laparoscopic liver resection for HCC with posthepatitic cirrhosis in selected patients is a safe procedure with oncologic efficiency.Its advantages include reduced invasiveness,quick rehabilitation,few postoperative complications and short hospital stay.

Fructose-1, 6-bisphosphatase (FBPase), a rate-limiting enzyme involved in the pathway of gluconeogenesis, can catalyze the hydrolysis of fructose-1, 6-bisphosphate to fructose-6-phosphate. Upon inhibiting the activity of FBPase, the production of endogenous glucose can be decreased and the level of blood glucose lowered. Therefore, inhibitors of FBPase are expected to be novel potential therapeutics for the treatment of type II diabetes. Recent research efforts were reviewed in the field of developing allosteric inhibitors interacting with the AMP binding site of FBPase.