With the development of the dialysis technology,the survival time of patients with chronic renal failure is prolonged,while more complications which affect the quality of life or even threat the life of patients are followed.Secondary hyperparathyroidism(SHPT)with a certain incidence and mortality is one of the common complications,and its main characteristic performances ale hyperphosphatemia,hypocalcemia and high level of parathyroid hormone.Most patients Can be cured by the treatment of medicine while surgical treatment is still required by some cases in which the disorder of the parathyroid function can not be well regulated through medicine treatment.The purpose of this paper is to make a review of the recent studies of surgical treatment in patients with SHPT.

Objective To investigate the surgical approach of the reasonable radical resection for carcino-mas of pancreatic head. Method 35 of 110 patients with carcinomas of pancreatic head underwent the surgical ap-proach of the posterior aspect of the radical resection for carcinomas of pancreatic head, and histopathological findings and prognosis were analyzed. Results The rate of curative resection rate was 31.82%. 3 patients underwent pancre-atoduodenectomy with partial resection of SMV for 9 patients with macroscopic suspicion of invasion of the SMV. The survival rate of the 5 years was 17.14% and the patients exceed 10 years. Conclusion Surgical approach of the reasonable radical resection for carcinomas of pancreatic head allows the reasonable radical resection,and may lead to increasing the resectability rate and the prognosis in the patients with carcinomas of pancreatic head.

Objective To study the relationship with internet addiction disorder(IAD)of the youth,the degree of IAD and home environment,attachment.To study the relationship with home environment and attachment.Methods 490 students were assessed with Internet Addiction Disorder Test,FES-CV,Attachment Questionnaire.Results 37 subjects can be defined as IAD according to Internet Addition Disorder test;IAD group have a higher score in contradictoriness(P＜0.05)of home environment and lack of maternal love,lack of fatherly love,father's rejection,parent's passive entangle,angry with parent[the average score of IAD group Was 13.16±4.62,14.18±5.42,14.41±5.44,19.10±4.59,18.89±4.42,12.37±4.80,11.35±4.17;the average score of normal group was 11.77±4.06,11.59±4.02,16.56±4.99,15.78±4.91,9.87±4.52,9.65±4.25,P＜0.05,0.01].Home environment were significantly correlated with all factors of attachment except independence(P＜0.05,0.01).There Was a significant negative correlation between the degree of IAD and lack of maternal love(r=-0.360).Conclusion Contradiction in home environment and passive attachment,that played an important role in internet addiction disorder of the youth.

BACKGROUND: Some researches report that diffusion-weighted imaging (DWI) can appear abnormal signal in minutes after cerebral ischemia.OBJECTIVE: To investigate the manifestation and regularity of diffusion coefficient in middle cerebral artery occlusion (MCAO) of rats after cerebral ischemia.DESIGN: Randomized controlled study.SETTING: Neurological Department of Clinical College of ChongqingMedical University.MATERIALS: The experiment was conducted at the Radiological Department of the First Affiliated Hospital of Chongqing Medical University from April to July 2004. Totally 18 adult Wistar rats with clean grade were randomly divided into three groups: control group, sham operation group and cerebral ischemia group with 6 rats in each group.METHODS: The origin of right middle cerebral artery was blocked with filament into right internal carotid. In the sham-operated group, the filament was just inserted into the common carotid artery not into the origin of middle cerebral artery, rats in normal control group were not treated with anything after anesthesia. MRI experiments were performed on a 1.5 T GE signa Highspeed NMR spectrometer to obtain DWI and ADC values at the time-point of 7, 15, 30, 60 minutes, 3,6, 12, 24 hours, 3, 7, 15 days, 1 and 2 months after operation.MAIN OUTCOME MEASURES: Changes of ADCs in infarct hemisphere and contralateral hemisphere.RESULTS: There was no significant change in MRI T1-and T2-weighted imaging in rats at 7 minutes post-infarction, but abnormal high intensity was emerged during the period of 1 hour to 3 hours, and enlarged over time. Finally, the infarction area located the right basal ganglia and the frontal-parietal lobes at 12 hours and increased less significantly later.Focal abnormal high signal was noted in DWI 7 minutes after cerebral ischemic insult, and the ADC values was decreased at the same time,reduced gradually after significant recover at 30 minutes, dropped to the lowest level at 12 hours and again increased at 24 hours, since then all the ADC values were remained high throughout follow-up, which increased by 5 times at 2 months than that at 12 hours. Correspondingly,rADC values showed the contrary pattern of evolution.CONCLUSION: It is reflected that ADC is highly sensitive not only to onset of cerebral ischemia but also to chronic cerebral ischemia.

To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods　Textual researches of materia medica were carried out and their history in clinical application were traced. Results　T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion　We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

OBJECTIVE:To systematically review the procalcitonin(PCT)-guided therapy in patients with sepsis. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CJFD,Wanfang Datebase,related trails about PCT-guided therapy(test group)versus conventional treatment group(control group)in the treatment of sepsis were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 5 studies were enrolled,involving 826 patients. Results of Meta-analysis showed,use time of antibiotics in test group was significantly shorter than control group, with statistical significance [MD=-2.52,95%CI(-3.07,-1.98,P<0.001];there were no significant differences in the mortality rate [OR=1.14,95%CI(0.83,1.56),P=0.42],ICU treatment days [MD=-0.22,95%CI(-1.40,0.96),P=0.72] and total hospi-talization [MD=-1.81,95%CI(-4.37,0.76),P=0.17]. CONCLUSIONS:PCT-guided therapy can effectively reduce the use of antibiotics and shorten treatment time in the treatment of patients with sepsis.It can be considered as inflammatory markers for guid-ing rational use of antibiotics in clinic.

Objective To provide data support for safe and accurate lower cervical pedicle screw implantation by observing the lower cervical pedicle and its relationship between the adjacent spinal cord, endorhachis, nerve root and vertebral artery, particularly its relation-ship between the endorhachis and epidural sinus. Methods Measured the C3 ~ C7 cervical sample of 32 adult with vernier caliper and pro-tractor, including the distance between cervical pedicle and its upper and lower nerve root, the distance between cervical pedicle and en-dorhachis, the distance between cervical pedicle and vertebral artery, and the distance between cervical pedicle and epidural sinus. Results The distance betweencervical pedicle and its upper nerve root was 1. 18~1. 40 mm, the distance between cervical pedicle and its lower nerve root was 2. 33~3. 11 mm;the distance between cervical pedicle and endorhachis was 2. 75~3. 33 mm;and there was nearly no distance be-tween cervical pedicle and vertebral artery and epidural sinus. Conclusion Cervical pedicle has a very close relationship with spinal cord, endorhachis, vertebral artery and nerve root, and the cervical pedicle is narrow and small. Therefore, it requires fully assess accroding to in-dividualization so as to prevent injury of important anatomical structures.

Objective:To study the effects of acitretin or IFNα-2a or both on the apoptosis and caspases expressions in human-cutaneous squamous cell carcinoma cell line SCL-12.Methods: SCL-12 cells were cultured in vitro in the presence of or acitretin or IFNα-2a or both.Apoptosis was detected by enzyme-linked immunosorbent assay(ELISA) in these cells.Apoptotic cells were observed by acridine orange staining .The protein expressions of caspase-3,caspase-8 and caspase-9 in SCL-12 cells were analyzed by Western blot.Results:The inhibition ratio of the cell growth significantly higher in groups of Acitretin or IFNα-2a or both than control group , and the effects of Acitretin combined with IFNα-2a stronger than the Acitretin or IFNα-2a.Caspase-3,caspase-8 and caspase-9 were significantly activated in combined group .The effects of Acitretin combined with IFNα-2a stronger than the Acitretin or IFNα-2a.Conclusion:Acitretin or IFNα-2a or both plays a central role in the apoptosis of cutaneous squamous cell carcinoma cells ,which may be related to the Fas-way and mitochondria-way.

Objective To evaluate the risk factors of gallstone occurrence after gastrectomy for gastric cancer.Methods Relevant documents published from 1990 to 2014 were retrieved through Pubmed,Cochrane Library,Embase,Web of Science CNKI,Wan Fang and VIP databases search.The Meta-analysis was applied with RevMan 5.3 software for Odds ratio and 95％ CI.Results 24 studies were selected for this Meta-analysis which included 3 randomized controlled trials,13 cohort studies and 8 case-controlled studies.These 24 studies included patient number which ranged from 32 to 893.The pooled OR (95％ CI) and P values of OR (95 ％ CI) for physiologic digestive tract reconstruction were 0.53 (0.44 ～ 0.65,P ＜ 0.05) ;amount of resection of stomach,1.98 (1.29 ～ 3.04,P ＜ 0.05) ; lymphadenectomy,0.38 (0.21 ～ 0.72,P ＜ 0.05) ; vagotomy,0.24 (0.13 ～ 0.45,P ＜ 0.05) ; and pylorus preservation,0.70 (0.48 ～ 1.02,P ＞ 0.05).Conclusions Physiologic digestive tract reconstruction and vagus nerve preservation reduced occurrence of gallstones after gastrectomy.On the other hand,total gastrectomy and extensive lymph node dissection increased the occurrence.There was no significant difference in the occurrence of gallstones whether there was pylorus preservation or not.

Objective To develop an assay of HPLC for the content determination of dryocrassine in Guanye Jinsitao drop pills. Methods The column was Kromasil-C18 (150 mm×4.6 mm, 5μm);mobile phase was acetonitrile-chloroform-isopropanol-0.1% phosphoric acid (52∶8∶30∶10);flow rate was 1.0 mL/min;UV detection was performed at 285 nm;detected drift tube temperature was set at 25 ℃. Results The calibration curves were linear in the range of 0.236-2.124 μg for dryocrassine (r=0.999 9). The average recovery rate of dryocrassine was 99.64% (RSD=1.90%). Conclusion The method is simple and accurate. It is suitable for the determination of dryocrassine in Guanye Jinsitao drop pills.