The bed rest has been considered essentialfor the conventional treatment ot acute hepatitis. Previously, it was thought that earlieractivity would prolorng the disease course and exaggerat the disease. The patients should not be allowed to perform physical activity until live -function recoveryed. But clinical practice indicated appropriate exercise can improve immune function the aute hepatitis patients who erformedthe exercise had shorter disease course ,ther quicker recovery of physical strength and they showed trends in recovery of liver function thepatientients who didn perform exercise show no ehanges. Therefore , we considered appropriate exercise therapy is very essential for the treat-ment of acute hepatitis. Exercise should be recognized as an equally impo rtant treatment modality of the infectious hepatitis.

Purpose: To observe the efficacy and the side effects of oxaliplatin( OXA) in combination with vinorelbine (VRB) in the treatment of drug resistant non-small-cell lung cancer( NSCLC) . Methodii: Thirty-five patients with drug resistant lung cancer were treated by OXA + VRB. OXA 100 mg/m2, VRB 25 mg/m , on d 1, which were given by bronchial arteries injection, and VRB 25mg/m2 was given by venous injection on d 8. One cycle was given every 3 weeks and total six cycles was given. Results: There was 1 patient who showed completed remission( CR), 14 patients showed partial remission( PR), 13 patients showed stable disease( SD) and 7 patients showed progress disease( PD) after the sixth cycle. The response rate was 42. 9%. The major toxicities were peripheral sensory neuropathy and leukopenia. Conclusions: The regimen of OXA plus VRB is effective on drug resistant and advanced NSCLC and the side effects are tolerable. There is higher response rate and lower neurotoxicity when the medicines are given by arterial injection than by venous injection.

Objective To investigate the effect of laparoscopic lymphadenectomy in patients with adenocarcinoma of esophagastric junction (AEG).Methods 105 patients with AEG underwent open or laparoscopic surgery from June 2014 to September 2015 were enrolled in the study and divided into minimally invasive group (n = 70) and laparotomy group (n = 35). The baseline data, lymphadenectomy result and perioperative data were compared between the two groups.Results Total number of splenic hilar lymph nodes dissection in minimally invasive group was significantly more than that in laparotomy group (P < 0.05). But there were no significant differences in the total number of lymph node dissection, number of positive lymph node dissection, positive rate of all node, number of positive splenic hilar lymph node dissection and positive ratef of splenic hilar lymph node between two groups (P > 0.05). Operation time, intraoperative blood loss, length of incision, positive proximal margins rate, thoracoabdominal resection rate and spleen resection rate in minimally invasive group were significantly lower than that in laparotomy group, esophagus resection length was significantly bigger than that in laparotomy group (P < 0.05). No death occurred postoperatively in all patients. The time of anus exsufflation, first intake liquid diet and postoperative ambulatory episode in minimally invasive group were significantly lower than that in laparotomy group (P < 0.05). There were no significant differences in the incidence of complications between two groups (P > 0.05).Conclusions Compared with open surgery, laparoscopic surgery is superior in splenic hilar lymph nodes dissection of AEG, with longer esophageal cutting distances, lower thoracoabdominal resection and spleen resection rate. It is safe and feasible, worthy of clinical promotion.

This paper specifically elaborated the ethics committee of China and the United States review meet-ing in the project report , project FAQ, ethical discussion , voting and so on each link , analyzes the ethical review mode difference between the two countries , and according to the mode of ethical review meeting in China and the United States are compared , and the model helps to find their own ethical review meeting , improve their efficiency of ethical review committee meeting .

To develop a patient-reported outcome instrument for chronic gastrointestinal diseases and to select items by analyzing the data from clinical investigation.

Objective To investigate the protective effects of different Chinese medical treatments on myocardial ischemia-reperfusion injury in rats. Methods 60 SD rats were divided into 5 groups randomly: a sham-operated group, a model group, a removing phlegm and enlarging chest group, an activating blood and dissolving stasis group, and a treating both phlegm and blood stasis group. The model of MI/RI of the myocardium was reproduced by ligation of left descending artery for 30min followed by releasing the ligation for 2 hours in rats. Serum contents of LDH-L, CK were measured , TNF-αand ICAM-1 expressions in myocardium were determined with immunohistochemistry and myocardial ultrastructure at the ischemia region was observed with the transmission electron microscope after myocardial reperfusion injury. Results Compared with the model group, LDH-LXK and TNF-αICAM-1 levels were lower, myocardial ultrastructural changes were improved in all the other four groups treated by different Chinese medicine (P<0.01 or P<0.05), especially in the group treating both phlegm and stasis. Conclusion The removing phlegm and enlarging chest method, activating blood and dissolving stasis method, treating both phlegm and blood stasis method can protect myocardium from M1/R1, especially the method of treating both phlegm and blood stasis.

Objective To discuss factors influencing the heterotopic ossifications (HO) after treatment of bi-column acetabular fractures. Methods One hundred and ninety-three cases of bi-column acetabular fractures were followed up, including 147 males and 46 females with an average age of 34. 4 years. Thirty-one cases were associated with craniocerebral trauma. The interval between injury and surgery was less than 1 week in 15 cases, 1 to 2 weeks in 121 cases, 2 to 3 weeks in 34 cases, and over 3 weeks in 23 cases. Factors that might have influenced HO, including surgical method, associated injury, and interval between injury and surgery, were analyzed retrospectively. Results All the cases were followed up for an average of 44. 2 (14 to 84) months. The mean operation time was 238 (150 to 330) minutes, and the average blood loss was 1453 (450 to 4400) mL. The incidence rate of HO was 39. 9% (77 in 193 cases), including 39 cases of degree one, 23 cases of degree two, and 15 cases of degree three. Of the 77 cases associated with HO, 14 had craniocerebral trauma and 63 did not (χ~2 = 0. 019, P = 0. 891) . HO was found in 2 cases that had been operated on in less than 1 week, 38 cases in 1 to 2 weeks, 21 cases in 2 to 3 weeks, and 16 cases in over 3 weeks. The Spearman correlation analysis between HO degree and clinical result showed no correlation ( R = 0. 041, P =0. 722). Only 15 cases (7. 8% ) were associated with HO after the debridement of the necrotic gluteus minimus. Conclusions HO after surgery for bi-column acetabular fractures may not be correlated with craniocerebral trauma, but highly correlated with the interval between injury and surgery. Debridement of necrotic gluteus minimus and other muscles can reduce the incidence of HO.

Objective To probe into the operative techniques and clinical outcomes of treating bi-columnar acetabular fractures. Methods From April 2001 to December 2006, 609 cases undergoing operation for aeetabular fractures were followed up. Of them, 193 eases, 147 males and 46 females with an average age of 34.4 years, were of bi-columnar type. Their complications involved the articular cartilage of the femoral head in 37, eranioeerebral trauma in 31, injury to bladder and/or urethra in 27, injury to thorax and/or abdomen in 68, injury to pelvis and/or sacroiliac joint in 59, and injury to sciatic nerve in 11. The interval between injury and surgery was within 1 week in 15 cases, within 2 weeks in 121, within 3 weeks in 34, and beyond 3 weeks in 23. A single ilioinguinal approach was adopted for 4 cases and combined ap-proaches for 189. Results The mean operating time was 238 (150 to 330) minutes, and the blood loss averaged 1453 (450 to 4400) mL. The mean follow-up period was 44.2 (14 to 84) months. All the eases were evaluated by Matta reduction criteria, X-ray manifestations and the modified Merle d'Aubingne and Postel clinical scoring. One hundred and sixty-eight patients got anatomical reduction, 17 unsatisfactory reduction, and 8 poor reduction. The X-ray manifestations were excellent in 162 patients, good in 16, fair in 8, and poor in 7. The clinic results were excellent in 152 patients, good in 27, fair in 9, and poor in 5. The Kendall coefficient correlation between reduction and clinical outcome and that between reduction and X-ray manifes-tation were 0.74 and 0.77, respectively. Ectopic ossification happened in 77 eases and transient post-operative sciatic nerve paralysis occurred in 3. Conclusions The combined approaches facilitate exposure and synergetie reduction of the bi-colunmar fractures of acetabulum. Reduction of the acetabular roof is essential to restoration of the normal contour of the acetabulum. Reduction bears a positive correlation to the clinical results as well as experience of surgeons.

Objective To investigate the regulation on extracellular signal regulated kinase (ERK )1/2 and p38 signaling pathways and immune expression by moist exposed burn therapy/moist exposed burn ointment(MEBT/MEBO)in diabetic foot and their relationship ,to explore the repair mechanism of MEBT/MEBO on diabetic foot ulcers .Methods Totally 40 diabetic foot pa‐tients were treated by MEBT/MEBO ,to take wound tissue before and after treatment and detect the expression of ERK 1/2 ,p38 , MAPKK6 ,c‐myc ,Akt ,ATF2 ,IgA ,IgM ,IgG ,C3c and C4c by immunohistochemistry ,to investigate their relationship .Results Af‐ter treatment with MEBT/MEBO ,the area of foot wounds in 39 patients was reduced in different degree .Only one patient had no obvious change .14 patients(35 .00% ) were markedly effective ,25 patients(62 .50% ) and 1 patient(2 .50% ) were ineffective .Before andaftertreatment,allpositiveexpression,positiveimmunoreactivity(anyindex)andpositiveexpression(specificindex)ofsignal pathway molecules were statistically significant (P<0 .05) .While the positive rate of molecular expression in wound pathway in‐creased ,the positive expression rate of immune factor increased .Before treatment ,a small amount of immune factors were found in the wound tissue .After treatment ,the immune factors IgA ,IgM ,IgG ,C3c ,C4c were distributed widely and diffusely .Before treat‐ment ,the wound tissue showed a very small number of signal molecules .After treatment ,the signal pathway molecules MEBT/MEBO and p38 ,MAPKK6 ,c‐myc ,Akt ,ATF2 showed broad and diffuse distribution .Conclusion MEBT/MEBO may promote the expression of ERK1/2 and p38 signaling molecules and immune in diabetic foot ,p38 and ERK1/2 signaling pathway may promote the healing of diabetic foot wound by increasing the expression of immune .

Objective:To study the inhibitory effect of deoxyschizandrin on the growth of brain glioma C6 cells, and to explore its mechanism.Methods:The rat glioma C6 cells were cultured and divided into control group,50, 100,and 200 mg·L-1 deoxyschizandrin groups.The proliferation rates of C6 cells were examined by MTT assay;the changes of cell cycles were examined by flow cytometry;the expression levels of CyclinD1,Bax,Bcl-2 and Caspase-3 proteins in supernant were detected by ELISA assay. Results:Compared with control group, the proliferation rates at 24 and 48 h in 50,100,and 200 mg·L-1 deoxyschizandrin groups were significantly decreased (P <0.01),and the proliferation rates at 72 h in 100 and 200 mg·L-1 deoxyschizandrin groups were significantly decreased (P < 0.05 or P < 0.01 ). Compared with control group, the percentage of cells at SubG1 phase in 200 mg·L-1 deoxyschizandrin group was increased (P < 0.05 ), and the percentage of cells at S phase was decreased (P <0.05).Compared with control group,the expression levels of CyclinD1 in 100 and 200 mg· L-1 deoxyschizandrin groups were decreased (P < 0.01 );the expression levels of Bax protein in deoxyschizandrin groups were increased (P < 0.05 or P < 0.01 ), and the expression level of Bcl-2 protein in 200 mg · L-1 deoxyschizandrin group was decreased (P < 0.01 ), and the Bax/Bcl-2 value in deoxyschizandrin groups were increased (P < 0.01 ); the expression level of Caspase-3 protein in 200 mg · L-1 deoxyschizandrin group was increased (P < 0.01 ).Conclusion:Deoxyschizandrin could inhibit the growth of glioma cells through down-regulating the expression levels of CyclinD1 protein and up-regulating the expression levels apoptotic factors Bax and Bcl-2.