In recent years, the medical graduates who take part in postgraduate examination have been increasing each year. The preparation for postgraduate examination affects the clinical practice, but not yet has a quantitative report. This article studied the students in general surgery, which were divided into postgraduate examination group and clinical practice group. By comparing the theoretical knowledge results and the clinical practice skills between the two groups we found that there was no difference between the two groups in the theoretical and operating skill when they were just in the department, and the operating results in the clinical practice group were better than the postgraduate examination group when they were out of the department.

As the active ingredient of traditional Chinese medicine Scutellaria baicalensis Georgi, baicalin has a variety of pharma-cological effects. In recent years, baicalin has made significant achievement in the prevention and treatment of central nervous system diseases, such as ischemic brain injury, hemorrhagic brain injury, Parkinson' s disease and spinal cord injury. Numerous studies showed that baicalin could prevent oxygen free radical injury, inhibit nerve cell apoptosis, inhibit inflammation factor expression, pro-tect the mitochondrial energy metabolism, inhibit thrombin receptor and adjust the balance of excitatory amino acid and inhibitory amino acid. Based on the neuroprotective effect of baicalin, it may be a potential medicine for the treatment of central nervous system disea-ses.

Objective To improve clinicians'understanding of nephrotic syndrome and myasthenia gravis as adverse events of penicillamine(D-PA).Methods Two patients were reported to develope adverse reaction after taking D-PA.The related literature were reviewed.Result The first case was a systemic sclero- sis(SSc)patient treated with D-PA who developed nephrotic syndrome and blepharoptosis.The second case was a rheumatoid arthritis patient treated with D-PA who developed dysphagia and drinking bucking.The clinical symptoms were improved after disconting D-PA.Their conditions were stable up to now.Conclusion D-PA is used widely for various of autoimmune diseases.Clinicians should pay attention to these special and rare adverse effects.

AIM: To study the effect of breviscapine on the oxidative stress in the liver and kidney in diabetic rats. METHODS: Diabetes was induced by injection of streptozotocin (ST Z). Rats were randomly divided into three groups: control group, model group, mo del group treated with breviscapine. 8 weeks after STZ injection, liver lesion w as evaluated using HE, oil red O staining and kideny lesion using PAS staining. Malondiadehyde (MDA) levels and antioxidant activities in liver and kidney tissu e were determined by spectrophotometric method. RESULTS: Light microscopy in HE staining showed that liver fatty score was significantly lower in the breviscapine group compared with model ani mals (0.55?0.43 vs 1.54?0.65, P

Objective To evaluate the efficacy of ancient classical prescriptions treating middle and advanced primary liver cancer.Methods Articles were searched from Pubmed, Embase, SCI, Cochrane Liarary and CNKI, VIP, WanFang Data, CBM databases. Randomized controlled trials about ancient classical prescriptions treating advanced primary liver cancer were collected. Results 17 studies were included, a total of 994 patients. The recent efficiency of ancient classical prescription combined with symptomatic therapy increased by 28% compared with single supportive and symptomatic therapy;the stable rate of life quality increased by 23%;the efficiency of TCM syndrome increased by 29%;the survival rates of 3 months, 6 months and 1 year increased by 16%, 36.7% and 58.5% respectively;the life quality score of later increased by 6.29 on average. Conclusion Ancient classical prescription combined with supportive and symptomatic therapy in advanced primary liver cancers is superior to single supportive and symptomatic therapy on recent efficiency, survival rate (3 months/6 months/1 year), quality of life and TCM syndrome. The conclusion of this study needs randomized controlled trials with larger samples, multicenter and high quality for further verification.

Objective To explore the efficacy of laparoscopy-assisted radical gastrectomy for patients with gastric cancer. Methods The clinical data of 726 patients who received laparoscopy-assisted radical gastrectomy for gastric cancer at the Southwest Hospital from January 2004 to April 2010 were retrospectively analyzed. The operation time, operative blood loss, number of lymph nodes dissected, length of hospital stay and mobidity were evaluated using t test or chi-square test. The survival of the patients were evaluated by Kaplan-Meier method.Results Laparoscopy-assisted radical gastrectomy was successfully carried out on 707 patients, and 19 patients were converted to open surgery. The mean operation time, operative blood loss, number of lymph nodes dissected were (179 ±52)minutes, (87 ±51) ml and 33 ± 14, respectively. The average distances of proximal and distal resection margin to the tumors were (6.3 ± 1.9)cm and (5.6 ± 1.7)cm, respectively. The average time to flatus, time to fluid diet and length of hospital stay were (2.9 ± 1.4) days, (3.1 ± 1.7) days and (7.9 ± 3.5) days,respectively. The peri- and postoperative mobidities were 2.2% (16/726) and 4.0% (29/726), respectively. A total of 685 patients were followed up for 6-82 months (mean, 48.3 months), and the 5-year survival rate was 58.4%. Conclusions Laparoscopy-assisted radical gastrectomy is a feasible procedure with minimal trauma, low morbidity and quick recovery of patients.

Objective To discuss the clinical features and prognostic factors of primary testicular lymphoma (PTL). Methods A retrospective review was performed based on the clinical records of 33 PTL cases treated at Tianjin Medical University Cancer Hospital from June 1977 to May 2009.Drawing survival curves by Kaplan-Meier method, using Log-rank test to the univariate analysis, and multivariate analysis by COX regression model to evaluate independent prognostic factors. Results The median age of patients was 62 years at presentation(range 33-81 years). Painless testicular swelling was the initial symptom. The majority of histological subtype was B cell lymphoma, 48% of which was diffuse large B-cell non-Hodgkin's lymphoma. By postoperative chemotherapy and/or radiotherapy, 23 patients achieved complete remission and 7 achieved partial remission, with a median follow-up of 23 months (4-231 months). The 5 years and 10 years of overall survival was 39.1% and 19.5%. The effect of patients who received chemotherapy≥4 cycles and B cell lymphoma patients combination with Rituximab were better. In multivariate analysis, Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival. Conclusions Primary non-Hodgkin lymphoma should be treated with multi-modality strategies. Treatment with doxorubicin-based chemotherapy after orchiectomy should be recommended. Ann Arbor stage, B symptoms, age of patient and number of extranode site were independent prognostic factors of survival in PTL.

The operation path, lymph node dissection and reconstruction of the alimentary tract are the three most technical difficulties of laparoscopy-assisted gastrectomy. The essential difference between laparoscopy-assisted gastrectomy and open gastrectomy is the operation path. Based on our clinical experience, we investigated reasonable paths for laparoscopyassisted gastrectomy. Patients were placed in a supine position with their legs apart, and the operator stood on the left side of the patient. Five trocars were placed in the abdominal wall in a curved line. The operation was carried out in the order of greater gastric curvature, the lower region of the pylorus and antrum,the upper region of the pancreas, omentum minus, cardia, and arcuate diaphragm. From May 2004 to April 2010, we successfully carried out 761 laparoscopy-assisted gastrectomies with satisfactory outcomes.

With the development of instrumentation and surgical techniques,laparoscopic gastrectomy has become a promising surgical option for the treatment of gastric cancer.While laparoscopic gastrectomy is high technique-demanding,which hampered its popularization.Compared with traditional laparoscopes,Da Vinci surgical system has more special features,such as flexible robotic arms and three-dimensional imaging,which facilitates surgical procedures.A 58-year-old male patient with gastric cancer underwent Da Vinci surgical system-assisted radical total gastrectomy at the Southwest Hospital in March 2010.The mean operation time and blood loss were 270 minutes and 60 ml,respectively,and the number of dissected lymph nodes was 21.The short-term clinical effect was perfect without postoperative complications.Da Vinci surgical system-assisted radical total gastrectomy is safe and feasible,and it brings challenges to conventional laparoscopes.

Objective To investigate the predictive factors of progressive motor deficits (PMD) after isolated pontine infarction. Methods Consecutive patients with isolated pontine infarction admitted to hospital within 48 hours after onset were enroled. They were divided into either a PMD group (increase ≥1 within 7 days) or a non-PMD group according to the clinical course and the changes of motor scores of the National Institutes of Health Stroke Scale (NIHSS). The pontine infarction patterns were classified as basal surface infarction and deep infarction, the sides were divided into left and right, the infarct levels were divided into upper, middle, and lower according to diffusion-weighted imaging. The demographics, baseline clinical data, and imaging features were compared between the two groups. Multivariable logistic regression models were used to analyze the predictive factors of PMD after isolated pontine infarction. Results A total of 101 patients with isolated pontine infarction admitted to hospital within 48 h of onset were enroled, including 16 in the PMD group and 85 in the non-PMD group. The proportions of pontine infarction involving the basal surface (87. 5% vs. 47. 1% , χ2 = 8. 851, P = 0. 003), the infarcts on the middle levels (56. 2% vs. 24. 7% , χ2 = 4. 851, P = 0. 028), and basilar artery stenosis or occlusion (62. 5% vs. 27. 1% ,χ2 = 7. 689, P = 0. 006) of the PMD group were significantly higher than those of the non-PMD group, while the proportions of the infarcts on the left sides (18. 8% vs. 56. 5% , χ2 = 7. 664, P = 0. 006) and the infarcts on the upper levels (37. 5% vs. 72. 9% , χ2 = 7. 689, P = 0. 006) of the PMD group was significantly lower than those of the non-PMD group. Multivariate logistic regression analysis identified that pontine infarction involving the basal surface (odds ratio 5. 650, 95% confidence interval 1. 011 - 31. 580, P = 0. 049) and basilar artery stenosis or occlusion (odds ratio 4. 075, 95% confidence interval 1. 127 - 14. 741, P = 0. 032) were the independent risk factors for PMD after isolated pontine infarction. Conclusions Infarction involving the basal surface and basilar artery stenosis or occlusion may be the predictors for PMD after isolated pontine infarction.