Malignant obstruction of the stomach or duodenum is a preterminal event in patients with ad-vanced malignancies of the upper gastrointestinal.It severely limits the quality of life in affected patients.Most patients are in bad conditions and have an short expecting live time,so they not only can not bear but also do not need such an invasive operation.Because of this,a minimally invasive but effective palliative treatment is quite necessary.This paper makes a summary and contrastive analysis of several ways of pallia-five treatment which are widely used for malignant gastroduodenal obstruction in recent years.

Objective To study the effect of knee joint replacement on the elderly patients with osteoarthritis and the influence on the quality of life.Methods This study selected 68 patients(72 knees)with knee joint replacement, followed up for three months,with the aid of HSS scoring method,the function of knee joint and the change of quality of life before and after operation were compared.Results Compared with preoperation,the symptoms of pain[(25.1 ± 1.8)points vs.(13.1 ±1.9)points],activity[(13.1 ±1.3)points vs.(8.1 ±1.5 )points],functional recovery [(23.1 ±1.4)points vs.(9.1 ±3.9)points],muscle strength[(7.9 ±1.7)points vs.(2.1 ±1.3)points]and stability[(8.1 ±1.9)points vs.(4.1 ±2.9)points]were significantly improved after 3 months of operation,the differences were statistically significant(t =7.23,5.75,8.96,6.82,9.71,all P <0.05).Evaluation of the quality of life of the patients after the end of the follow -up period,the scores were significantly improved compared with the preoperation,the scores were increased,the differences were statistically significant(t =5.43,4.48,4.87,3.96, 2.57,2.79,all P <0.05).Conclusion The knee joint replacement can achieve the goal of effective treatment of senile osteoarthritis and can significantly improve the quality of life of the patients and patients'satisfaction.

Objective To investigate the diagnosis、 treatment and prognosis of hashimoto's disease(HD) complicated with thyroid multiple nodules.Methods Clinical data of 129 cases of HD complicated with thyroid multiple nodules under want surgery in three years were analyzed retrospectively and followed up.Results All patients were received different scope of thyroidectomy according to the situation of thyroid nodules.The histologic examination after operation indicated there are 36 cases(27.9%) complicated with nodular goiter;23 cases(17.8%) complicated with thyroid cancer;3 cases(2.3%) complicated with thyroid adenomas;1 cases(0.78%) complicated with toxic goiter.Conclusion HD complicated with thyroid multiple nodules patients had difficulty in preoperative diagnosis of nodular nature and should be operate.

The genetically modified mice , as a helpful model , have been widely used in life scientific research . However, several new issues appeared subsequently with the wide application of the genetically modified mice .Here, we mainly discussed and analyzed the problems in the management and usage of genetically modified mice , which underlies the foundation for establishing management practice of the genetically modified mice .

Astrocytes were traditionally be deemed as supportive cells in the central nervous system.However,recent researches proved astrocytes exerted more important neurophysiological functions,such as regulation of synaptic transmission and integration of neural information.This paper summarized the researches on the functions of astrocytes related to synaptic transmission and analyzed the new features of astrocyte excitability,the communication between neurons and astrocytes and the effect of general anesthetics on astrocytes.Based on these new findings,this paper also suggested the underlying relationship between astrocytes and the loss of consciousness during general anesthesia.

Objective To observe the effect of superficial radial nerve transplanting to repair musculospiral nerve defection and using end-to-side neurorrhaphy to reconstruct the function of the donor site. Methods Thirtyfour cases underwent superficial radial nerve transplanting to repair musculospiral nerve defection and end-to-side neurorrhaphy was performed to reconstruct the function of the donor site. Results All cases were followed-up for 6 to 18 months,the functional recovery of the recipient of musculospiral nerve was excellent in 23 cases and good in 5 cases,with an excellent and good rate of 82. 53 %. Sensory recovery of donator nerve was excellent in 27 cases and good in 5 cases,with an excellent and good rate of 94. 12%. Conclusions Superficial radial nerve transplanting to repair musculospiral nerve defection and functional reconstruction of donor site is a better choice in treating neurologic defect.

Objective:To observe the changes of glyeemia, urine protein, serum creatinine, blood urea nitrogen and glycosylated hemoglobin in diabetic nephropathy rats and treating effects of Xiaokekang. Methods: Streptozotocin (STZ) was abdominally administered and was feeded by high lipid diet to establish diabetic nephropathy model in rats. Animals were divided into three groups: model group, Xiaokekang treatment group and normal group. Changes in glycemia, serum lipids, serum creatinine, blood urea nitrogen were measured at the 8th, 12th and 16th week after STZ injection. Glycosylated hemoglobin was measured at the 16th weeks after STZ injection. Results: Glycemia, serum lipids, serum creatinine were higher at the 8th, 12th and 16th week compared with normal group. Serum creatinine was higher at the 12th and 16th week, and glycosylated hemoglobin was also highter than that of the normal group. Xiaokekang reduced these changes. Conclusion: Xiaokekang can reduce glycemia, serum lipids and protect renal function.

ObjectiveTo explore the expression of N-cadherin and β-catenin mRNA in human brainstem and supratentorial gliomas. MethodsN-cadherin and β-catenin mRNA expression in 18 cases of brainstem gliomas and 18 cases of supratentorial gliomas tissues were detected with PT-PCR. Resultsβ-catenin mRNA expression was more in human brainstem gliomas than in supratentorial gliomas （t=2.255,P<0.05）, but was not significantly different of N-cadherin mRNA (P＞0.05). The expression of N-cadherin mRNA in human brainstem gliomas of grades Ⅰ～Ⅱ were less than those in human gliomas of grades Ⅲ～Ⅳ (t=2.711，P<0.05), but was not of β-catenin mRNA (P＞0.05). N-cadherin mRNA expression was positively correlated with the β-catenin mRNA expression in either brainstem gliomas or supratentorial gliomas （r=0.480，r=0.809 respectively, P<0.05）. ConclusionThe over expressions of N-cadherin and β-catenin may play an important role in the invasion and malignant progress of human brainstem gliomas.

Objective:To understand the etiology and clinical characteristics of hospitalized severe community-acquired pneumonia(SCAP) in Changchun, and provide scientific basis for its etiology diagnosis and targeted treatment.Methods:The study subjects included 618 children with clinical diagnosis of SCAP who were hospitalized from January 2016 to December 2019.We collected pharyngeal swabs and alveolar lavage fluid from children.Virus isolation, bacterial culture, time-of-flight mass spectrometry, PCR/RT-PCR, colloidal gold method and Optochin test were used to detect the antigen, nucleic acid and protein profiles in the specimen.Results:There were more boys than girls in hospitalized children with SCAP.The peak age of onset was 7 to 12 months.Most cases occurred in winter and spring.The highest detection rate of SCAP virus was 56.15%(347/618); 73.49%(255/347) were positive for one virus, among which the top five were respiratory syncytial virus (27.8%), influenza A virus (23.9%), influenza B virus (16.1%), rhinovirus (12.2%) and metapneumovirus (10.2%). Two viruses were positive for 19.88%(69/347); three viruses were positive for 4.32%(15/347); four viruses were positive for 2.31%(8/347). Atypical microbial infections were 29.77%(184/618), of which Mycoplasma pneumoniae accounted for 95.65%(176/184). Bacterial infections were 17.31%(107/618), mainly Streptococcus pneumoniae(39.25%, 42/107) and Staphylococcus aureus(24.30%, 26/107). The mixed infection of multiple pathogens was 7.61%(47/618), among which the mixed infection rates of Mycoplasma pneumonia with Streptococcus pneumoniae, virus were 40.43% and 34.04%, respectively.High fever, faster breathing, and perioral cyanosis were risk factors for SCAP, with OR and 95% CI of 7.71 and 4.56-13.04, 2.43 and 2.02-2.93, 3.53 and 2.56-4.86, respectively.Viral co-infection occurred in 36.96%(34/92) of complications such as heart failure, toxic encephalopathy, and myocardial damage; Mycoplasma pneumoniae and other pathogens co-infected 35.29% of children with pleural effusion. Conclusion:The pathogens of SCAP in Changchun are mainly viruses notably, respiratory syncytial virus is the dominant pathogen, followed by Mycoplasma pneumoniae.The bacterial pathogen is mainly Streptococcus pneumoniae.High fever, faster breathing, and cyanosis around the mouth are risk factors for severe pneumonia.Multi-pathogen mixed infection is prone to serious complications.

Objective To learn the clinical manifestations and pathogenic situation of hand foot and mouth disease (HFMD) in Changchun children's hospital from 2009 to 2010.Methods We collected the faeces specimen and oropharyngeal swabs of 1 862 children patients who consulted in Changchun children's hospital from May 2009 to Nov 2010.The enterovirus 71 ( EV71 ) and Coxsackie virus A16 (CoxA16) of 1 514 faeces specimens were amplified with RT-PCR,and 530 oropharyngeal swabs' virus were isolated with rhabdomyosarcoma cell.Results The total HFMD patients were 1 175 in 2010,687 in 2009.The rate of serious patients was 6.26％ (43/687) in 2009,and 16.51％ ( 194/1 175 ) in 2010.The season of peak incidence in 2009 was June,and in 2010 were June,July and August.The gender distribution was 1 241 males and 621females.The average age of HFMD patients was ( 28.32 ± 15.22 ) months.And the distribution in city and countryside was 1:1.05.Total of 1 862 cases ( 100％ ) had rash,55.69％ ( 1 037/1 862) had fever,6.07％(113/1 862) had neurologic symptom and 1.41％ (26/1 862) had vomiting when the patients admitted in our hospital.And there were 547 cases ( 29.41％ ) emerging myocardium injury,548 cases (29.43％ ) emerging neurologic complications and 82 cases (4.39％ ) emerging respiratory complications during treatment.There were 166 positive with positive rate 31.32％ in virus isolation.The positive rate of EV71 and CoxA16 were 9.62％ and 10.57 in 2009,and 32.52％ and 39.53％ in 2010.Conclusion There were more HFMD patients in 2010 than 2009,and the proportion of serious patients was increased too.In summer and autumn,we should pay more attention to HFMD for fever children.HFMD could damage digestive system,respiratory system,circulatory system and nervous system.The nervous system of serious patients is more likely to be damaged.The pathogens of HFMD are diversity,but mainly are EV71 and CoxA16,and the pathogen of serious patients is mostly EV71.