Objective] To observe the clinical effects of Tianwang Buxin decoction in the treatment of heart Yin deficiency type of Generalized Anxiety Disorder. [Methods] 63 patients with Generalized Anxiety Disorder(heart Yin deficiency type) were randomly divided into three groups: Tianwang Buxin decoction group, paroxetine group, Tianwang Buxin decoction combined paroxetine group, course of treatment for 8weeks.Contrast the scores of three groups by HAMA before and after treatment. [Results] The clinical efficacy was almost the same among the three groups without significant difference, but the decrease of HAMA scores of Tianwang Buxin decoction combined paroxetine group was obviously lower than Tianwang Buxin decoction group and paroxetine group(P<0.05), among which, TCM group and combination group of TCM and WM had less side effect than WM group. [Conclusion]The clinical efficacy of Tianwang Buxin decoction group is almost the same with the paroxetine group without significant difference. The clinical efficacy of Tianwang Buxin decoction combined paroxetine group is more significant.

Therapeutic hypothermia used for clinical purposes has had a long history. With the continuous development in the intensive care and surface cooling techniques, it has made various large hypothermia clinical trials possible. Studies have found that moderate hypothermia (28～35℃) has significant protective effects on important organs such as heart and brain, and it does not have obvious side effects. Recently, mild hypothermia (32～35℃) has been widely used for cardio-pulmonary-cerebral resuscitation, and its effect is satisfactory.

Oncolytic adenoviruses are genetically altered to replicate within tumor cella while exhibiting a high degree of infectivity,good safety and specificity.The use of oncolytic adenoviruses to treat malignant brain tumors has been proved to be a promising mode of cancer therapy.Local injection of adenoviral vectors fails to reach scattered infiltrative tumor cells within the brain parenchyma and the therapeutic effect of intracereberal injections of oncolytic adenoviruses is only seen in the vicinity of the injection site.To remedy this and prevent possible tumor recurrence,stem cells have been explored as vehicles for gene therapy in brain tumors given that they possess an intrinsic tropism for brain glioma.

Oncolytic adenoviruses have been used in cancer gene therapy because of their ability to selectively transfect and repli-cate in tumor cells. However, systemically administering oncolytic adenoviruses is often inefficient because the host's immunity also at-tacks the viruses. Delivering oncolytic adenoviruses by loading them into mesenchymal stem cells effectively solves this problem. Mes-enchymal stem cells have been described to possess a tumor-homing ability, as well as the capacity to deliver oncolytic adenoviruses. This review discusses the current challenges faced by oncolytic adenovirus delivery via mesenchymal stem cells.

Reovirus,a kind of oncolytic viruses, is seldom pathogenic, but is selectively able to replicate in cancer cells through activation of Ras signaling. Pre-clinical studies have demonstrated that treatment with reovirus is associated with significant anticancer activity across a range of tumor types. Further clinical evaluation of reovirus therapy has shown that it is well tolerated when administered locally or systemically. Encouraging anticancer efficacy has been observed with single-agent treatment and in combination with chemotherapy and radiotherapy. High safety and promising efficacy of reovirus has raised hopes that it will become a new anticancqt agent.

Cancer stem cells (CSC) are capable of self-renewal and differentiation, properties that are critical to tumor growth, metastasis, and radioresistance. Eradication of CSC is the key to the success of cancer therapy. Conditionally replicative adenoviruses(CRAd) are a novel class of viral agents which selectively replicate in tumor cells but not in normal cells. CRAd can specifically target and eradicate CSC ,representing a promising cure for cancer.

OBJECTIVE:To establish a method for determination the genotoxicity impurities (methyl methanesulfonate,ethyl methanesulfonate and isopropyl methanesulfonate) in mesylate nafamostat raw materia. METHODS:GC-MS was conducted,and the genotoxicity impurities were extracted by dichloromethane. The column was DB-5 capillary column by programmed tempera-ture,the inlet temperature was 240 ℃,column flow was 3.0 ml/min,purge flow was 6.0 ml/min,sample mode splitless injection, carrier gas was high purity helium,detector is a mass spectrometer detector,ion source temperature was 230 ℃,the interface tem-perature was 230 ℃,the delay time of solvent was 2.5 min,ionization mode was electron impact,detector voltage was respect to the tuning results,scanning(detection)method was selective ion monitoring,electron energy was 70 eV,and the injection volume was 1.0μl. RESULTS:The separation degree of 3 impurities were greater than 2.0;the linear range of 3 impurities were 0.10-20μg/ml (r≥0.999 5);RSDs of precision,stability and reproducibility tests were lower than 2%;recoveries were 97.7%-104.8%(RSD=2.8%, n=9),102.5%-110.7%(RSD=2.6%,n=9)and 103.0%-107.6%(RSD=1.6%,n=9). CONCLUSIONS:The method is simple, accurate,sensitive and rapid,and can be used for the genotoxicity impurities in mesylate nafamostat raw materia.

Oncolytic viruses,a novel class of virus vectors,which selectively replicate only in tumor cells,have excellent tumor targeting and good tansfection efficiency.Many oncolytic viruses have apparent curative effect when administered intratumorally.However,the host immune system remains a critical obstacle to systemic administration of virotherapeutics.It appears that cell-based delivery of oncolytic viruses could offer one solution to this critical problem,which provides a new platform to the biological therapy of cancer.

Objective To analyze the causes of preoperative misdiagnosis of primary gallbladder carcinoma,and the effective measures of prevention of the misdiagnosis.Methods We retrospectively analyzed the clinicalrecords of 52 cases with primary gallbladder carcinoma that had been treated in our hospital in 10 years,and analyzed the causes of misdiagnosis.Results Nineteen cases were diagnosed preoperatively(36.5%),while 33 cases were misdiagnosed before operation(63.5%),including misdiagnsed as cholecystolithiasisin 13 cases,gallbladder polyps in 8cases,atrophic cholecystitis in 4cases,hepatic hilar cholangiocarcinoma in 3 cases,tumor of liver in 4 cases,and Mirizzi syndrome in 1 case.There were 29 casesdiagnosed during operation(55.8%),and 4 cases misdiagnosed intratoperatively(7.7%).Misdiagnosiswas due to several reasons:complicated with other gallbladder disease,lack of distinctive clinical features of gallbladder carcinoma,over dependence on imaging methods,and not doing fast frozen section duringoperation in dubious cases.Conclusions In suspected cases with high risk of gallbladder cancer,imagingstudies should be performed,and,if necessary,invasive studies and even exploratory laparotomy should be done.Also,intraoperative rapid frozen section can result in early discovery and treatment,and is conducive to improvement of prognosis of gallbladder carcinoma.

Objective To explore the diagnosis and treatment of liver trauma.Methods A retrospectively analysis of clinical data of 160 cases of liver trauma, including 96 cases of blunt trauma and 64 cases of open trauma, was made.Results Among the 160 cases, one case with stage IV trauma and severe thoracic injury died 30min after admission. Among the other 159 cases, 45cases (9 cases of stage Ⅰ, 31 cases of stage Ⅱ and 5cases of cases Ⅲ) received nonoperative treatment, and 114cases (7 cases of stage Ⅱ, 67 cases of stage Ⅲ and 50 cases of stage Ⅳ) received operative therapy. In non-operative treatment group, the cure rate was 100 %(45/45). In operation treatment group the cure rate was 98.2 %(112/114), the mortality rate was 1.8 %(2/114), 1 case died of hemorrhage after operation and 1 case died of ARDS. Five patients with postoperative complications were cured, including hepatic abscess in 2 cases, biliary fistula in 2 cases, and hemorrhage after operation in 1 case. Conclusions B-ultrasound is the method of choice for diagnosis of liver trauma, and CT can be used if conditions permit. Cases of lives truma of stages Ⅰ and Ⅱ and some cases of stage Ⅲ that have stable hemodynamics, can receive nonoperative treatment under close observation. Some cases of stage Ⅱ, most cases of stage Ⅲ and all cases of stages Ⅳ to Ⅵ injury should preferably undergo surgical treatment.