Objective To investigate the feasibility and significance of the re-operation for patients with recurrent primary liver cancer.Methods The clinical data of 58 patients with post-operative recurrence after initial operation for primary liver cancer in our hospital from January 2003 to December 2008 were analyzed.They were divided into re-operation group and the other treatment group,and the 1-and 3-year survival rates were compared.Results The 23 cases of re-operation group were all treated by local radical resection plus hepatic arterial chemotherapy pump implantation,and postoperative chemotherapy was given via hepatic artery chemoembolization pump line.The 35 patients of the other treatment group underwent radiofrequency ablation plus transcatheter hepatic arterial chemoembolization via femoral artery.The 1-and 3-year survival rates in re-operation group was 100% and 82.6% respectively,which was significantly higher than that of the other treatment group(82.9% and 45.7% respectively).Conclusions Re-operation is the treatment of choice for patients with tumor recrrrencr after radical resection of primary liver cancer,provided that the conditions are suitable and the timing of operation is appropriate.

Background: Postoperative gastroparesis syndrome (PGS) is a common complication after abdominal surgery in patients with primary liver cancer. However, surgeons usually do not have effective treatment for them. Objective: To explore the effects of acupuncture applied to Zusanli and other acupoints on PGS in patients after abdominal surgery. Design, setting, participants and interventions: Sixty-three PGS patients of abdominal surgery, from Eastern Hepatobiliary Surgical Hospital, were randomized into acupuncture group (32 cases) and metoclopramide group (31 cases). The patients in acupuncture group were treated with acupuncture applied to Zusanli and other acupoints once a day, while the patients in metoclopramide group were intramuscularly injected 20 mg metoclopramide three times a day. Main outcome measures: Volume of gastric drainage, number of treatment and cure rate in the two groups were measured and evaluated. Results: Acupuncture and metoclopramide could significantly reduce gastric drainage volume. In acupuncture group, the cure rate was 90.6% and the number of treatment was 6.58+/-4.26, while in metoclopramide group, the cure rate and the number of treatment were 32.3% and 10.13+/-3.60 respectively. There were significant differences in gastric drainage volume, cure rate and number of treatment between the two groups (P<0.05, P<0.01). Conclusion: Acupuncture is a good treatment for PGS, with fewer treatments, high cure rate and rapid effect.

Objective To research the early effects and side-effects of the local advanced nasopharyngeal carcinoma patients using intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy.Methods From January 2005 to January 2007,60 patients with nasopharyngeal carcinoma of stage m-IV b were received IMRT combined with concurrent chemotherapy in our center.Sixty patients were divided into paclitaxel concurrent group(32 patients)and cisplatin concurrent group(28 patients).The prescribing doses of the primary tumor were 68-72 Gy for each group.The patients of paclitaxel concurrent group patients of the cisplatin concurrent group got earlier radiodennatitis and radiation-induced mucositis but also got significantly higher rate of radiodermatitis,radiation-induced mucositis,radiation-induced leucopenia and gastrointestinal toxicity,as well as the loss of weight.No significant difference was found on liver and renal funcfons between two groups.Four patients(12.5%)of the paclitaxel concurrent group were broken-off,which was much better than the cisplatin concurrent group.There was no significant difference on the specific length of break-off time,the 2-year overall survival rate and the 2-year diseaee-free survival rate between two groups.Conclusions IMRT combined with concurrent chemotherapy of paclitaxel liposome for local advanced nasopharyngeal carcinoma results in less side-effects and better tolerance than IMRT combined with concurrent cisplatin chemotherapy.

Objective To evaluate the application value of T cell infected with Mybacterium tuberculosis assay in diagnosis of smear and culture negative pulmonary tuberculosis .Methods In total ,145 patients with smear and culture negative pulmonary tu‐berculosis and 45 patients with non‐tuberculosis lung disease were enrolled in the study .All patients received T cell infected with Mybacterium tuberculosis test and sensitivity ,specificity ,positive predicted value ,negative predicted value of testing for the diagno‐sis of smear and culture‐negative TB patients were calculated .Results The sensitivity of specificity T cell infected with Mybacteri‐um tuberculosis assay in diagnosis of smear and culture negative pulmonary tuberculosis was 85 .5% ,the specificity was 84 .4% , positive predicted value was 94 .7% ,negative predicted value was 64 .4% .No statistical significance in age‐dependent groups(P>0 .05) .Conclusion T cell infected with Mybacterium tuberculosis assay has high positive predicted value in diagnosis of smear and culture negative pulmonary tuberculosis and is suitable for clinical auxiliary diagnosis .

BACKGROUND: In the field of organ transplantation, patients often take immunosuppressants after organ transplantation, such as CsA, FK506, DEX and MPA. However, their mechanisms of immunosuppression are different. The effect of immunosuppressive drugs on monocyte chemoattractant protein-1 (MCP-1) remains poorly understood. OBJECTIVE: To investigate the effects of different immunosuppressants on the secretions of MCP-1 in whole blood. METHODS: The whole blood of healthy volunteers was mixed with different immunosuppressants for 6 hours, such as CsA, FK506, DEX and MPA, which included low, middle and high concentrations, followed by PMA and IONO stimulation for 6 hours. MCP-1 levels in whole blood samples were compared. The whole blood cultured alone served as control. RESULTS AND CONCLUSION: MCP-1 secretion was inhibited by DEX (1, 10 mg/L) and CsA (0.25,1.25 mg/L)- However, FK and MPA exhibited no such effect. Therefore, DEX and CsA may inhibit the function of monocytes and macrophages in immune system by diminishing the secretion of MCP-1. The combination of FK (5 μg/L), MPA (10 mg/L) and DEX (1 mg/L) or CsA (0.25 mg/L), MPA (10 mg/L) and DEX (1 mg/L) can inhibit the secretion of MCP-1, but only DEX among all the immunosuppressants mentioned above exhibited significant effect on inhibiting the secretion of MCP-1 when using alone.

Objective - To analyze the relationship between cobalt level of post shift urine and individual exposure level of ， cobalt and its compounds in cobalt exposed workers and to explore the feasibility of using urine cobalt as a biomarker. Methods - A total of 148 occupational cobalt exposed workers from a new material company were selected as the exposed ， - - group and 44 non occupational cobalt exposed workers from the company were selected as the control group using the typical sampling method. The exposure concentration of time weighted average of cobalt and its compounds in the workplace air of the - two groups was determined by inductively coupled plasma mass spectrometry as the individual exposure level. The cobalt levels - - of pre shift and post shift urinary samples of the two groups were detected by this method. The linear relationship between the - cobalt level of post shift urine and the individual exposure level of cobalt and its compounds in the air of the workplace was Results - 3 analyzed. The individual exposure level of cobalt and its compounds in the exposed group was 1.10 131.71 μg/m with （M） 3 the median of 12.23 μg/m. No cobalt and its compounds were detected in the workplace air in the control group. The cobalt - - levels of pre shift and post shift urines in exposed group were higher than those in the control group at the same time point （M： vs ， vs ， P ） - - 1.54 0.56 μg/L 8.77 0.83 μg/L all <0.01 . The cobalt level of post shift urine was higher than that in pre shift （M： vs ，P ）， urine in the exposed group 8.77 1.54 μg/L <0.01 and it was positively correlated with the individual exposure level （ ，P ） ， of cobalt and its compounds Spearman correlation coefficient=0.86 <0.01 . After common logarithm conversion the linear regression equation of the cobalt level of post shift urine and the common logarithm of individual exposure level of cobalt and （x） ：ŷ x（ ；F ， its compounds in the exposed group was as follows = −0.178 + 0.988 coefficient of determination=0.72 =374.75 P ；t ， P ） Conclusion - <0.01 = - 19.36 <0.01 . There was a linear correlation between cobalt level of post shift urine and occupational cobalt exposure level of cobalt exposed workers. Urinary cobalt can be used as a biomarker of occupational cobalt

Objective To evaluate the association between methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism and depression risk.Methods Available studies containing genotype frequencies of MTHFR C677T were chosen,and pooled odds ratio (OR) with 95％ confidence interval (CI) was used to assess the strength of the association.Results Twenty-five eligible studies including 4 048 cases and 12 827 controls were identified.Meta-analysis showed a significant effect in the co-dominant model (T vs.C:OR 0 =1.25; Z=3.82,P=0.000;TTvs.CC:OR1=1.55,Z=3.79,P=0.000 ; except CT vs.CC:OR2=1.13; Z=1.78,P=0.076).Stratified analysis denoted that there was significantly higher risk in depression onset before 60 years old than depression onset after 60 years old.In subgroup analysis stratified by regressive meta-analysis,MTHFR C677T variant was statistically significantly relevant to depression risk in Chinese populations (OR 0 =1.58,Z=3.95,P=0.000; OR 1 =2.55,Z=3.92,P=0.000; OR 2 =1.43,Z=2.72,P=0.007),but not in no-Chinese populations (OR 0 =1.12,Z=2.10,P=0.035 ; OR 1 =1.23,Z=2.23,P=0.025 ; OR 2 =1.06,Z=0.74,P=0.456).Evidentiary strength rated by GRADE showed that 1 study moderate,3 studies low and 7 stdudies very low.Conclusion Our study provides evidence for a hereditary association between the MTHFR C677T variant and depression susceptibility,whereas there is an obvious variety in different regions,ethnicities and onset age.

Objective To explore the role of hydrogen peroxide in mesenteric artery contraction of cirrhotic rats with portal hypertension,which was induced by bile duct ligation.Possible mechanism in RhoA/ROCK signal pathway was also part of the focus.Methods The bile duct ligation-induced cirrhotic rats and normal rats (control group) were treated equally with PEG-catalase(10 000 U/kg-1 · d-1,ip.) or by its vehicle for 8 days.Then the level of H2O2 in mesenteric arteries was detected.The contractile response to norepinephrine of arterioles was analyzed by vascular perfusion system.The protein expressions of the α1 adrenergic receptor,β-arrestin-2 and Rho kinase-1 (ROCK-1),and the activity of ROCK-1 were measured by western blot.In addition,the interaction of α1-adrenergic receptor with β-arrestin-2 was assessed by co-immunoprecipitation.Results Compared to normal rats,the dose-response curve of the mesenteric arterioles in response to norepinephrine shifted to the right,and the EC 50 increased in the rats with portal hypertension.PEG-catalase treatment can decrease the hydrogen peroxide level in arteries,thus significantly lowered EC50 and improved the reactivity to norepinephrine of the mesenteric arterioles in portal hypertension rats.No significant difference in the α1-adrenergic receptor amounts was observed among groups.There was remarkable decreases in the protein expressions of β-arrestin-2 and its interaction with the α1-adrenergic receptor in cirrhotic rats with PEG-catalase treatment.PEG-catalase also increased the amount and activity of ROCK-1 in cirrhotic rats.Conclusions The level of hydrogen peroxide increases in the mesenteric arteries in bile duct ligation-induced cirrhotic rats.And it enhances the β-arrestin-2 expression and its interaction with the α1-adrenergic receptor,which subsequently decreases the amount and activity of ROCK as well as the contractility of mesenteric arteries in response to vasoconstrictors.