Objective To study CT findings of the giant mass in lesser peritoneal sac.Methods Thirty cases of the giant mass in lesser peritoneal sac proved by surgery and biopsy were examined by CT scan.Results There were four cases of gastrointestinal stromal tumor (three in stomach and one in duodenum) , two cases of pancreatic cancer , one case of pancreatic cyst-solid papilloma , three cases of non-function neuroendocrine carcinoma in pancreas , two cases of pancreatic peudocyst and one case of mesenterial lymphoma. Conclusion Based on the typical imaging findings ,CT can accurately diagnosis the giant mass in lesser peritoneal sac.

Objective To study CT findings of duodenal malignant tumor.Methods Plain and contrast-enhanced CT date of 20 patients with duodenal malignant tumor proved by pathology were retrospectively analysed.Results There were three adenocarcinomas, two lymphomas, three malignant gastrointestinal stromal tumors, three ampulla carcinomas, eight carcinomas of head of pancreas, one pancreatic nonfunction neuroendocrine cell carcinoma. Duodenal adenocarcinoma manifested as local irregular constriction of cavity accompanied with soft tissue mass. After enhancement, the mass manifested as moderate enhancement. Lymphoma manifested as extensive duodenal wall thickening or extracavity mass,after enhancement,the mass was manifested as mild enhancement. Malignant gastrointestinal stromal tumor manifested as massive mass with heterogeneous marked enhancement,ileus was not obvious. Ampulla carcinoma manifested as local soft tissues mass with mild and moderate enhancement in the media of duodenal descent part, intrahepatic and extrahepatic biliary duct dialated. Carcinoma of head of pancreas involving duodenum manifested as duodenal medial wall roug,mass in the head of pancreas with no enhancement, intrahepatic and extrahepatic biliary duct dilated. Pancreatic nonfunction neuroendocrine cell carcinoma involving duodenum manifested as massive mass with marked enhancement in the head of pancreas,there was indistinction between mass and duodenum, intrahepatic and extrahepatic biliary duct were non-dilation.Conclusion CT scan plays an important role in the diagnosis of duodenal malignant tumor.

groupL(P0.05). (3)Histopathologic changes in the liver:They were significantly milder in group H than in groups C and L, and the changes in group H were similar to group N. The changes in group L were the most severe. Conclusions(1)Prophylactic increase of hepatic glycogen storage could counteract the injury of hepatic functional reserve that occurs during warm ischemia and reperfusion. (2)The changes of hepatic functional reserve that occurs during warm ischemia reperfusion can be earlier and more sensitively reflected by ICGR_(15) and GLT than by the (routine) enzyme parameters of hepatic function.

Objective To establilsh the quality standard for Qingfei Yihuo tablet. Methods TLC was performed to identify Sophora flavescens Ait, Peucedani and Cortex Phellodendri. HPLC was used to determine Baicalin. ODS column was used. The mobile phase consisted of methanol-water-phosphoric acid (47∶53∶0.2). The flow rate was 1.0 mL/min and column temperature was at 25 ℃. The detecting wave length was at 280 nm. Results The characteristic for identification by TLC was distinct and hightly specific. Baicalin could be determined by HPLC. The linearity of Baicalin was good in the range of 0.163～0.975 ?g (r=0.999 9). The average recovery of Baicalin was 97.43% and RSD was 1.97% (n=6). Conclusion The methods of identification and quantification is simple and reproducible. It can be used effectively for the quality control of Qingfei Yihuo table.

Objective:To study the effect of trigonelline on the change of indicators of serum transaminase, lipoprotein and liver lipid of model rats with non-alcoholic fatty liver diseases and on the expression level of Bcl-2 and Bax proteins.Methods:A total of 45 SD rats were randomly divided into Fthe control group, model group and trigonelline intervention group. Rats in the control group were fed with the common diet, while rats in the model group and intervention group were fed with the high fat diet. 8 weeks later, the intervention group received the intragastric administration of trigonellin e (with the dosage of 40 mg/kg/d) for 8 weeks; while control group and model group received the intragastric administration of saline with the equal dosage. Blood was taken from the abdominal aorta of rats 8 weeks later, detecting the level of a series of indicators of ALT, AST, TG, TC, HDL-C and LDL-C in the serum. After the rats were sacrificed, detect the indicators of TG, TC, SOD and MDA in the liver tissue of rats, as well as the expression of Bcl-2 and Bax in the liver tissue.Results: Results of histopathologic examination showed that the damage degree of liver for rats in the trigonellineintervention group was smaller than the one in the model group, with significantly reduced hepatic steatosis and the partially visible hepatic lobule. The levels of ALT, AST, TC and LDL-C in the serum of rats in the trigonelline group were significantly reduced, while the change in the levels of TG and HDL-C was not significantly different. The levels of TG, TC and MDA in the liver tissues were significantly decreased, while the level of SOD significantly increased; the expression of Bcl-2 protein in the liver tissues of rats in the trigonelline intervention group was significantly increased, while the expression of Bax protein significantly decreased.Conclusions: The trigonelline contributes to the therapeutic effect of non-alcoholic fatty liver diseases. It can also increase the expression of Bcl-2 protein and decrease the expression of Bax protein in the liver tissues, which can protect the liver.

Matrix metalloproteinases (MMPs) degrade extracellular matrix,participate in the atherosclerosis (As) formation and plaque rupture.They are associated with the stability of plaque.Tissue inhibitor of metalloproteinase (TIMP) is a specific natural MMP inhibitor.The disequilibrium between MMPs and TIMP is closely associated with the formation and development of AS.Therefore,it is a new approach for the prevention and treatment of cardiocerebrovascular diseases by regulating the equilibration between MMPs and TIMP, delaying the development of AS and preventing plaque rupture.

Objective To investigate the value of ultrasound in typing of epididymal tuberculosis on the clinical treatment . Methods The sonographic characteristics and treatment outcomes were analyzed in 125 patients with epididymal tuberculosis . Results In 125 patients with epididymal tuberculosis ,5 types were divided:( 1 ) Diffusive type ( 37 cases ) presented images of the epididymal diffuse enlargement , abnormal shape ,not smooth surface and inhomogeneous reduced in echogenicity ,13 cases were treated conservatively and 24 cases underwent surgical treatment after failure of conservative treatment . (2) Mass type (24 cases) showed images of hypoechoic mass lesion of caput epididymidis or cauda epididymidis ,4 cases were treated with surgical operation and 20 cases were treat with conservative therapy . (3) Abscess type ( 33 cases) manifested images of irregular liquid anechoic of caput epididymidis and cauda epididymidis , poor ultrasound penetration ,and unclear border . (4) Ulcer‐fistula type (9 cases) revealed images of liquid hypoechoic caput epididymidis or cauda epididymidis extend to the surface of the scrotum . ( 5) Testicular involvement type (22 cases) detected inhomogeneous hypoechoic mass lesion within the testicle and unclear border . The patients of abscess type ,ulcer‐fistula type and testicular involvement type were all treated surgically . Conclusions Ultrasonic diagnosis of epididymal tuberculosis provided a reliable basis for clinical treatment scheme and it was worth recommending .

OBJECTIVE: To discuss the development direction for hospital pharmacists in the medical reform and to promote rational use of drugs.METHODS: The status quo for the medical reform was analyzed based on the practicality of hospital and the author's perspectives on how to improve pharmaceutical care level was presented.RESULTS & CONCLUSIONS: Hospital pharmacists should change pharmaceutical care model to face up to the challenges in the medical reform by establishing clinical pharmacists' team and setting up pharmaceutical care center to improve pharmaceutical care level and adapt to the development of medical reform.

OBJECTIVE Identify the effect of Brandt-Daroff exercises for positional vertigo with atypical positioning nystagmus.METHODS 11 cases of positional vertigo during 2006～2007 with atypical positioning nystagmus when carrying Dix-Hallpike and roll test,the nystagmus had the follwing characters:poly-positions,atypical direction,long lasting(more than 3 mins),no fatigue.After ruling out centrul neural system disorders,the patients were instructed to do Brandt-Daroff exercises 2-3 times/day,and 6-10 times every time.RESULTS After doing the exercises for 3-4 days,the vertigo of all the 11 cases were all relieved.After 1-2 weeks,10 cases were cured,syptom of the other 1 was relieved significantly,and the nystagmus was alleviated.CONCLUSION Cases with atypical positioning nystagmus may present a different kind of BPPV related with the otolith and vestibular nerve disease.Brandt-Daroff exercises was a good method for the atypical positioning nystagmus cases.

Background and purpose:Advanced and metastatic colorectal cancer is the second leading cause of cancer death. In the past ,the standard treatment for patients with advanced CRC was fluorouracil(5-FU) biochemically modulated by leucovorin(LV), which demonstrated a response rate of about 23% .In 1990s, a number of new treatment options have been available. In particular, one new cytotoxic agent ,irinotecan (CPT-11), which is a specific inhibitor of topoisomerase I, have been proven to have efficacy in the tretment of CRC .Furthermore, several first-line phase Ⅲ trials show a significant improvement in result with the addition of CPT-11 to FU-LV combination therapy (FOLFIRI).We observed the survival situation, efficacy and safety of irinotecan plus 5-FU/LV after first-line chemotherapy failure for Chinese patients with advanced or/and metastatic colorectal cancer. Methods:Twenty-four patients with metastatic colorectal cancer whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics were included to receive biweekly FOLFIRI regimen (irinotecan 180mg/m~ 2 on day 1,with LV 200mg/m~ 2 adiministrated as a 2-hour infusion before 5-FU 400mg/m~ 2 administrated as an intravenous bolus injection and FU⒉4g/m~ 2 as 46-hour infusion immediately after 5-FU bolus ).All the patients were planned to receive at least 6 cycles of chemotherapy .They were assessed on the basis of WHO evaluation standard of objective therapeutic effect for solid tumor.Results:24 patients were assessable to observe the efficacy and safety. No case was CR.5 case were PR, response rate was 20% (5/24). 17 case were SD , rate was 70% (17/24). 2 case were PD, rate was 8%(2/24). Median time to progression (TTP) were 6.6 months (6 to 24 months ),median overall survival was 10.7 months. The majority of adverse reaction were nausea, vomiting, anorexia, diarrhea, leucopenia, alopecie. Most of them were Ⅰ/Ⅱ degree, only 6 cases reached III/IV degree. 3 cases had diarrhea with leucopenia and fever.Conclusions:The biweekly regimen of irinotcan in combination with 5-FU/LV results in significant and clinically meaningful improvement in survival and quality of life among patients with metastatic colorectal cancer. Toxicity is manageable.