AIM:We conducted an evaluation of clinical data with meta analysis to investigate the preventive effect of 5-aminosalicylic acid (5-ASA) on inflammatory bowel disease ( IBD)-associated colorectal cancer ( CRC) or dys-plasia (Dys) (IBD-CRC/Dys).METHODS: The information was retrieved from the main databases such as PubMed, Web of Science, the Cochrane Library, etc.All full-text articles about the prevention of IBD-CRC/Dys by 5-ASA were in-cluded if they conformed to the standards.The odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. According to the types of IBD and the treatment course, the subgroup analysis was conducted, respectively.RESULTS:Fifteen articles were selected, including 5 038 IBD patients.Pooled analysis showed a protective association between 5-ASA and IBD-CRC/Dys (OR=0.53, 95%CI:0.37~0.76).Among them, both ulcerative colitis patients (OR=0.45, 95%CI:0.27~0.77) and Crohn disease patients ( OR=0.39, 95% CI:0.16~0.97) with 5-ASA therapy were less likely to develop CRC/Dys compared with those without 5-ASA treatment.5-ASA treatment for 1~20 years shows a pre-ventive benefit (OR=0.43, 95%CI:0.25~0.74).However, a minimum 5-ASA exposure of 2~6 months did not show a preventive benefit (OR=0.59, 95%CI:0.26~1.34).CONCLUSION:5-ASA protects against CRC/Dys in IBD pa-tients.Additionally, the protective effect is treatment time dependent.Treatment course for 1~20 years shows an evident preventive benefit.

Objective To improve and evaluate the diagnosis and treatment of retroperitoeal fibrosis. Methods From February 1975 to December 2001, 36 cases (male: 20, female: 16) of retroperitoneal fibrosis were treated, 12 of whom were primary fibrosis and 10 were secondary to malignant tumors and the others were secondary to radiotherapy of malignant tumors. Surgical intervention was undertaken in 28 patients with preoperative and postoperative administration of corticosteroids. Results The patients were followed up for 6 to 42 months with improved or normal renal function. Most of them had very good results. Death secondary to malignancy was found in 4 cases. Conclusion To relieve the obstruction due to hydronephrosis by surgical intervention is very effective in treatment of retroperitoneal fibrosis.

Recent evidence suggests that, in spite of the redundancy of angiogenic factors involved in pathological angiogenesis , strategies aimed at inhibiting specific endothelial cell angiogenic factors at their release or receptor level may form the basis for effective and safe treatment of angiogenic mediated disease processes. Physiologic angiogenesis is fundamental to reproduction, development and repair. Pathological angiogenesis sustains the progression of many neoplastic and proinflammatory diseases. And endothelial cell is an important target especially for the angiogenesis. The target represents a novel strategy for the treatment of the human disorders where pathological angiogenesis is involved.

Hepatectomy is the treatment of choice for huge ( ＞ 10 cm) hepatocellular carcinoma.However,the resection is more difficult and risky due to a huge space occupied by the tumor and vascular invasion.Precise hepatectomy is a new concept of liver surgery in the 21st century.The goal of which is the least invasive,most parenchymal preserving and optimal recovery.A male patient with a huge hepatocellular carcinoma (diameter =22.5 cm) received precise hepatectomy in the Department of Hepatobiliary Surgery of Fuzhou General Hospital of Nanjing Military Area.By using the digital medical technology and procedure of liver surgery planning system,the tumor and the whole structure of the liver were three dimensionally reconstructed,and the planning of resection was made.During surgery,the right liver artery and the right.porta hepatis were ligated and the right hemihepatic vessels were occluded.We accomplished right hepatectomy by accurate resection according the precisely planned preoperation,with less bleeding or no bleeding surgical field and rapid recovery.

Objective:In investigate the status quo of current physician-patient relationship.Method:A self-designed questionnaire is conducted among the medical staff and patients in 40 hospitals(20 grade 3 hospitals and 20 grade 2 hospitals) located in 10 cities of China.Result:9.3% of the total patient responders consider the current physician-patient relationship dissatisfying,with a counterpart ratio of 31.2% in responders of medical staff.Conclusion:Currently in China,main-stream of physician-patient relationship is harmonious,but it can not be denied that medical staff are suffering tremendous stress from the ever tenser physician-patient contradictions.

ObjectiveTo investigate the effect of anisodamine on the expression of connexin 43 (Cx43) in swine ventricular myocardium after resuscitation from cardiac arrest.Methods The experiment was conducted on healthy pigs, and they were randomly divided into three groups, namely sham group, epinephrine group (control group) and anisodamine group (experimental group, animals were resuscitated combined with injection of 0.4 mg/kg of anisodamine), with 5 pigs in each group. Model of ventricular fibrillation was reproduced by alternating current challenge, and cardiopulmonary resuscitation (CPR) was performed 8 minutes after cardiac arrest. Left ventricular myocardium was harvested at 24 hours after restoration of spontaneous circulation. The expression and distribution of Cx43 were observed by immunofluorescence, Cx43 mRNA expression was assessed with reverse transcription-polymerase chain reaction (RT-PCR), and the protein expressions of Cx43 and phosphorylation of Cx43 (p-Cx43) were analyzed by Western Blot.Results The positive expression of Cx43 in ventricular muscle was distributed uniformly, mostly at the end-to-end linkage of myocardial cells, with a few side-to-side linkage in sham group. The positive expression of Cx43 in control group was significantly weaker than that in the sham group, and the signal intensity was significantly declined (4.35±2.10 vs. 10.02±3.66,P< 0.01). The positive expression of Cx43 at the end-to-end linkage and side-to-side linkage was irregular in experimental group, and the signal intensity was obviously higher than that in the control group (7.91±2.54 vs. 4.35±2.10,P< 0.05), but it was significantly weaker than that in the sham group (7.91±2.54 vs. 10.02±3.66,P< 0.05). For control group and experimental group, the Cx43 mRNA and protein expressions were significantly lower than those of the sham group [Cx43 mRNA (A value): 0.32±0.05, 0.32±0.03 vs. 0.48±0.07; Cx43 protein (A value): 0.43±0.03, 0.50±0.07 vs. 0.65±0.04, allP< 0.01], and there were no significant differences between experimental group and control group (allP> 0.05). The p-Cx43 protein expression of control group was significantly lower than that of the sham group (A value: 0.22±0.03 vs. 0.37±0.06,P< 0.01), and it was significantly higher in the experiment group than that in the control group (A value: 0.29±0.07 vs. 0.22±0.03, P< 0.01), but there was no significant difference with the sham group (P> 0.05). No significant difference in p-Cx43/Cx43 was found among sham, control, and experiment groups (0.57±0.09, 0.51±0.05, 0.58±0.06, all P> 0.05).ConclusionAnisodamine can improve the abnormal expression of Cx43 in ventricular muscle of pigs with cardiac arrest, which may be related to the protection effect of anisodamine on cardiac conduction.

Objective To observe the expressions of CD26, Ki67 and epidermal growth factor receptor(EGFR) proteins in thyroid neoplasms, to explore their value in differential diagnosis between benign and malignant thyroid neoplasms and to search for molecular marker in well-differentiated thyroid carcinomas.Methods The expressions of CD26,Ki67and EGFR proteins were examined by immunohistochemistry in 50 differentiated thyroid carcinomas (TC) and 50 thyroid adenomas (TA) and their relationships were analyzed.Results The positive rate and expression intensity of CD26,Ki67and EGFR proteins in TC were significantly higher than those in TA, and especially higher in follicular TC than those in follicular TA.Conclusion The abnormal expressions of CD26, Ki67and EGFR proteins appear to be valuable in differential diagnosis and predicting prognosis of thyroid carcinomas, especially CD26 can be used as a diagnostic marker in well-differentiated carcinoma of follicular cell origin.

Objective To investigate whether Ki-67 and DNA topoisomerase Ⅱ α (Topo Ⅱ α) are effective prognostic markers in patients with primary hepatocellular carcinoma (HCC) after liver transplantation.Methods This retrospective cohort study included 105 patients with HCC who underwent liver transplantation in a single center from 2001 to 2012.The demographic features,clinicopathological data,expressions of Topo I c and Ki-67 as detected by immunohistochemistry.The long-term survival and the potential prognostic factors,together with standard histologic parameters,were analyzed by univariate and multivariate analyses.Results A positive correlation was found between Topo II α and Ki-67 levels in HCC (r ＝ 0.469,P ＜ 0.01).Multivariate analyses showed that Ki-67 was an independent prognostic risk factor of recurrencefree survival (HR ＝ 2.296,P ＜ 0.05).The 5-year overall survival rate was related to tumor size (HR ＝ 1.743,P ＜ 0.05),AFP (HR ＝ 2.291,P ＜ 0.05),histological grade (HR ＝ 0.283,P ＜ 0.01),and high expressions of Ki-67 (HR ＝ 1.977,P ＜ 0.05) and Topo Ⅱ α levels (HR ＝ 1.883,P ＜ 0.05).The KaplanMeier analysis showed that there was a significant difference in the 5-year recurrence-free survival rate (40.4％ vs.57.6％) between patients with high and low expressions of Ki-67,which were significantly lower in the high Topo Ⅱ α expression patients (13.5％ vs.63.8％) (P ＜0.01).The 5-year overall survival rates were significantly lower in the high Ki-67 expression patients (12.7％ vs.61.1％,P ＜0.01) when compared with the low Ki-67 expression patients,which were significantly lower in the high Topo Ⅱ α-and Ki-67 expression patients (10.7％ vs.54.5％,P ＜0.01) than the low Topo Ⅱ α-or Ki-67 patients.Conclusions Ki-67 was associated with recurrence and metastasis in patients with primary hepatic carcinoma after liver transplantation.High expression of both Ki-67 and Topo Ⅱ α were associated with poor prognosis in these patients.

OBJECTIVE:To explore the regularity and characteristics of anaphylactoid reactions induced by Magnesium iso-glycyrrhizinate injection,and provide reference for clinical rational drug use. METHODS:27 ADR reports induced by Magnesium isoglycyrrhizinate injection from Hunan Center for ADR Monitoring from Jan. 2014 to Mar. 2015 were retrospectively analyzed. RE-SULTS:In the 27 cases,15 were male (55.56%) and 12 were female (44.44%),with percentage of 1.25∶1;ADR mainly oc-curred in patients with 41-60 years old(51.85%);involved organ/system were mainly skin and its appendages(35.85%)and sys-temic damage(26.42%),the main clinical manifestations were rash,itching,fever,chills,vomiting and dizziness;there were 7 severe ADR reports(25.92%),mainly showed chills,fever and other systemic symptoms;most ADR can be cured(40.74%)or relieved(55.56%)by related processing. CONCLUSIONS:There are no risk tips for severe allergic reactions in instruction,it is necessary to strengthen post-marketing surveillance and further improve the drug instructions to reduce the risk of severe ADR in-duced by Magnesium isoglycyrrhizinate injection.

On the basis of the investigation of the status of doctor-patient relationship in ten cities of China,this article ethically analyzes and studies the situation of trust between doctors and patients,clarifies the lack of trust inevitable and the environmental factors of trust,and puts forward the corresponding proposal.