Objective To compare the clinical curative effect between transjugular intrahepatic portosystemic stent-shunt (TIPS) and TIPS together with gastric coronary vein embolization (GCVE) in treating cirrhosis portal hypertension (PHT) associated with upper gastrointestinal hemorrhage (UGH),and to discuss the necessity,feasibility and clinical curative effect of TIPS plus GCVE.Methods The clinical data of 38 PHT patients with UGH,who were admitted to authors' hospital during the period from April 2010 to May 2012,were retrospectively analyzed.Only TIPS was employed in 15 patients (group A),and TIPS plus GCVE was adopted in 23 patients (group B).Before and after operation,the indexes,hemodynamics of portal vein and spleen,the morphology of spleen,and the degree of gastrointestinal varices were determined and analyzed.The patients were followed up to observe the occurrence of postoperative complications.Results In both groups,the postoperative portal vein pressure showed an obvious reduction with accelerated velocity of flow,and the splenic venous congestion index was decreased,these changes were statistically significant when compared with the preoperative ones (P＜0.05),and which was more obvious in group B than in group A (P＜0.05).After the treatment,the esophagogastric varices (EGV) was obviously improved,the improvement rates of group B and group A were 94.7％ and 66.6％ respectively,the emergency hemostasis rates of group B and group A were 100％ and 75.0％ respectively,The rates of re-bleeding were 4.3％ and 28.5％ respectively;the above results of group B were statistically better than those of group A (P＜0.05).No statistically significant differences in liver function indexes existed between preoperative values and postoperative ones in the same group as well as in group comparison (P＞0.05).The differences in the postoperative hepatic encephalopathy (HE) occurrence and in primary patency rate of stent between the two groups were not statistically significant (P＞0.05).In both groups,the re-intervention patency rate was 100％.The incidence rate of HE in patients in whom the distal end of stent was located in the left branch of portal vein was strikingly lower than that in patients in whom the distal end of stent was located in the right branch of portal vein (P＜0.05).Conclusion For the treatment of PHT associated with UGH,TIPS combined with GCVE carries reliable curative effect,this therapy is superior to simple use of TIPS.

Objective To study the effects of the soil factors on the yield and quality of Angelica dahurica originated from Sichuan Province.Methods The yield and contents of imperatorin,isoimperatorin,and other 11 different inorganic elements of A. dahurica,gathered from 15 different habitats of Suining in Sichuan Province were determined.And the basic soil nutrients and other 11 different mineral elements of the soil were analyzed.The effects of the soil factors on the yield and quality were analyzed through correlation analysis.Results The weight,length,circumference,and the contents of imperatorin and isoimperator in the roots of A.dahurica from different habitats were different.And the basic soil nutrients and other 11 different mineral elements of soil were different.The positive correlation between root length of A.dahurica,and soil available P content,root circumference of A.dahurica,and soil organic matter content,root weight of A.dahurica,and soil available P and K contents were all significant.The soil total nitrogen content had negatively significant correlation with the content of isoimperatorin.The correlation among the imperatorin,isoimperator contents of A.dahurica,and 11 other soil inorganic elements was not significant.Conclusion The soil factors have effects on the yield and quality of A.dahurica to some degree.

ObjectiveTo investigate the effort of MHA-bBMP implantation combined with limited contacted titanium net duct fixation on femoral shaft bone defect of rabbit.Methods48 rabbits were divided into the experimental group (treated with bionic bone MHA-bBMP plus titanium net duck) and control group (treated with iliac autograft plus titanium net duct) with 24 animals in each group. The rabbit femoral shaft bone defect model was established by cutting 10 mm bone fragment off. After operation, bionic bone MHA-bBMP/iliac autograft was implanted into bone defect area and fixed with limited contacted titanium net duck. The general condition, serum alkaline phosphatase, X-ray, histopathologic examination and electron microscope were performed.ResultsThe fixation stability of titanium net duck in two groups was good. The bone defect of two groups was repaired. The results of phosphatase, X-ray, histopathologic examination and electron microscope of two groups were not significantly different.ConclusionBionic bone MHA-bBMP is a high bioactivity substitute, and can obtain therapeutic effect equal to iliac autograft when repairing rabbit's femoral shaft defect.

Objective: This work aimed to investigate the negative prognostic factors of bronchioloalveolar carcinoma (BAC) and adenocarcinoma with BAC characteristics, based on the 2004 pathological classification by the World Health Organization (WHO), which were further verified with the new pathological classification of lung adenocarcinoma (WHO 2011), to identify crucial factors that determine the prognosis of BAC and adenocarcinoma with BAC features, and to prove the coherence of the two pathological classi-fications in assessing clinical prognosis. Methods: Upon pathological diagnosis, some of the 193 cases of BAC or adenocarcinoma with BAC features were categorized into adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA), based on the 2011 WHO classification. Gender, age, tumor size, familial cancer history, smoking history, TNM stage, symptoms, duration of symp-toms, and the choice of treatment were recorded and analyzed for prognosis. The survival rate was calculated by Kaplan-Meier method. Log-rank test was introduced to compare the survival rate. Univariate and multivariate factors for the survival rate were analyzed by Cox proportional hazards regression model. Results:The overall 1-, 3-and 5-year survival rates were 84.3%, 60.6%, and 45.6%, respec-tively. Cox univariate analysis revealed that the tumor size, symptoms, TNM stage, pathological outcomes, and the choice of treatment were all prognostic factors. Cox multivariate analysis revealed that TNM stage was an independent prognostic factor for patients with BAC. Data from patients with AIS and MIA revealed better survival. Conclusion:The overall survival rate of BAC and adenocarcino-ma with BAC features are superior to that of other non-small cell lung cancer (NSCLC). The clinical symptoms are non-specific com-pared with other types of NSCLC. Clinical stage at diagnosis is a key prognostic factor, such that early correct diagnosis significantly improves survival. The new classification criteria of WHO, released in 2011, is more elaborate and more conducive to clinical practice.

To understand the continuing medical education status of Beijing Shijitan Hospital,so as to continue to reform and improve the teaching management of continuing medical education.,literature and information retrieval methods were used and relevant personnel was interviewed about the content,form,time and suggestions of continuing medical education.The results indicate the presence of training content is too wide,training methods are too simple,and there is lack of medical humanities quality training and other issues in continuing medical education.Variety of training methods should be increased,the quality of medical humanities education and training should be enhanced,featured training should be developed to make the continuing medical education more scientific,standardized and highly efficient.

Objective To investigate the effects of DNMT1 on neuropathic pain behavior and neuropathic pain modulation.Methods Thirty-two male SD rats, weighing 200-250 g, were randomly assigned into 4 groups (n =8 each):sham operation group (group S),chronic constrictive injury group (group CCI),CCI+ DNMT1-siRNA group (group CDS),CCI+ control-siRNA group (group CCS).Group CDS were intrathcally injected of DNMT1-siRNA (2 μg/10 μl),and group CCS were intrathcally injected of control-siRNA 7,8,9 days after operation.Mechanical withdrawal threshold (MWT)and thermal withdrawal latency (TWL)were measured before operation and on day 3,5,7,9,12,14 after operation.The rats were then sacrificed and L4-L6 segments of the spinal cord were removed for determination of SOCS1,p-ERK,p-CREB expression using Western blot on day 14.Results Compared with group S,MWT and TWL in group CCI and CCS were significantly decreased on day 3,5,7,9,12,14 after operation (P <0.05).Compared with group CCS,MWT and TWL in group CDS were significantly increased on day 9,12,14 after operation (P < 0.05 ). Compared with group S and CDS,SOCS1 was significantly downregulated,p-ERK and p-CREB were significantly upregulated in group CCI and CCS (P <0.05 ).Conclusion Intrathcal injection of DN-MT1-siRNA significantly relieves neuropathic pain by upregulating SOCS1,downregulating p-ERK and p-CREB in rats spinal cords.

Objective To investigate the neuralprotective effect of Rho kinase inhibitor fasudil hydrochloride in cerebral ischemia/reperfusion injury in rats.Methods The SD rats were randomly divided into four groups:the sham group,the ischemia/reperfusion group,the fasudil hydrochloride group and the physiological saline group.Fasudil hydrochloride were injected intraperitoneally 30 minutes before ischemia.And the physiological saline group were treated with the intraperitoneal injection of the same volume of saline.The phosphorylation and protein expression of GluR6 at 6 hours during reperfusion were detected using immunoprecipitation and immunoblotting analysis to examine the effect of Fasudil hydrochloride.Furthermore,TUNEL staining was used to examine the apoptosis of neurons in rat hippocampal CA1 regions after 3 days reperfusion.Results 1.Immunoprecipitation and immunoblotting analysis were used to analyze the phosphorylation of GluR6 in serine site.The results showed that the GluR6 serine phosphorylation level increased significantly at 6h of reperfusion compared with the sham group (P＜0.05).Fasudil hydrochloride group could inhibit the increased phosphorylation of GluR6 at 6h of reperfusion compared with the ischemia/reperfusion group and saline group,respectively (P ＜ 0.05).2.TUNEL staining was used to examine the apoptosis of neurons in 3 days after reperfusion in CA1 regions of hippocampus.The results indicated that significant numbers of TUNEL positive cells (40.20 ± 2.77) were observed 3 days after ischemia/reperfusion.The numbers of viable neurons per 1 mm length of CA1 pyramidal cells were quantitatively analyzed.Fasudil hydrochloride markedly decreased the neuronal loss compared with the ischemia/reperfusion group (19.80 ± 2.86) (P＜0.05).Conclusion Fasudil hydrochloride can inhibit induced phosphorylation of GluR6 by the ischemia/reperfusion.Fasudil hydrochloride can reduce the neurons apoptosis in hippocampal CA1 regions,and perform a neuralprotective effect on ischemia/reperfusion injury in rats.

Objective To investigate the effects of the FKBP51 · PHLPP · AKT signal module on the phosphorylation of Akt and hippocampal neuronal injury after the cerebral ischemia / reperfusion induced neuronal death in rat hippocampus.Methods Transient(15 min)brain ischemia was induced by the four-vessel occlusion in Sprague-Dawley rats.6 rats were used in each group.The antisense oligodeoxynucletides(AS ODN)of PHLPP2 (PH domain and leucine rich repeat protein phosphatases) was used to suppress the assembly of FKBP51 · PHLPP · Akt signal module by intracerebroventricular infusion once per day for 3 days before ischemia.After 6 hours reperfusion,interactions of PHLPP2 and FKBP51 (FK506 binding protein 5) with Akt were detected by immunoprecipitation (IP) and the phosphorylation of Akt was detected by western blot (IB).After 5 days reperfusion,rats were perfusion-fixed with paraformaldehyde and Hematoxylin-Eosin staining was used to examine the survival number of CA1 pyramidal cells of hippocampus.Results Compared to PHLPP2 MS ODN group(1.24±0.24,1.68±0.11,0.58±0.01),PHLPP2 AS ODN suppressed the assembly of the FKBP51 · PHLPP · Akt signaling module(1.06±0.01,1.04±0.13),and increased the phosphorylation of Akt(0.76±0.02) (P＜0.05).Furthermore,compared to PHLPP2 MS ODN group (20.1±2.5),the number of surviving neurons significantly increased in PHLPP2 AS ODN group(88.3±2.7)(P＜0.05).Conclusion The increasing assembly of FKBP51 · PHLPP · Akt signal module can damage CA1 pyramidal cells of hippocampus by inhibiting the phosphorylation level of Akt.

Objective To summarize the clinical experience of laparoacopic cholecystectomy(LC) for acute cholecystitis. Methods LC was performed in 68 cases of acute cholecystifis for 2004 to 2007. The operation was completed under CO2 pneumoperitoneum by using 4-port technique. Results The LC was successfuUy accomplished in 64 cases, while a conversion to open surgery was required in 4 cases. A drainage tube at the foramen of Winslow was placed in 1 cases. Conclusion Strict adhesion to surgical indications of LC, standard performance of the proce-dure, timely conversion to open surgery, and proper placement of drainage tube are key factors to ensure a successful operation.

Objective: To observe the effect of moxa-stick moxibustion plus recombinant human granulocyte-colony stimulating factor (rhG-CSF) in preventing chemotherapy infection in gastric cancer and its effect on immune function. Methods: A total of 70 patients with gastric cancer treated by chemotherapy were randomly divided into an observation group and a control group, with 35 cases in each group. The control group was given rhG-CSF, and the observation group was given additional moxa-stick moxibustion on the basis of rhG-CSF. Both groups were treated for 2 chemotherapy cycles, totally 6 weeks. The number of patients with infection, the duration of infection and the duration of continuous use of antibiotics were observed. The leukocytes and granulocytes counts, the levels of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were measured before and after treatment, and the levels of CD4, CD8 and natural killer (NK) cells were analyzed. Results: The infection rate of the observation group was significantly lower than that of the control group (P<0.05), and the duration of infection and the duration of continuous use of antibiotics were also shorter (P<0.05). After treatment, the leukocytes and granulocytes counts in the two groups were higher than those before treatment (all P<0.05). After treatment, the levels of TNF-α and IFN-γ of the patients in the two groups were improved (all P<0.05), and there were significant differences between the observation group and the control group (P<0.05). After treatment, the numbers of CD4, CD8, and NK cells in the observation group increased significantly (all P<0.05), but the changes in the control group were not significant (P>0.05). Conclusion: Moxa-stick moxibustion plus rhG-CSF can significantly reduce the incidence and severity of chemotherapy infection in gastric cancer, increase the leukocytes and granulocytes counts, and regulate the levels of inflammatory factors, which may be related to the improvement of the immune function of the patients.