Objective To study the effects of acute hypervolemi c hemodilution (AHH) on the coagulation and cardiac function in elderly surgical p atients. Method Sixty surgical patients, aged 60 to70, ASA Ⅰ~ Ⅱ, were randomly divided into three groups (n=20 for each group). 6% HES 50 0~1000ml was infused in a rate of 20ml/min during vasodilation with isoflurane i nhalation (group 1), nitroglycerin (group 2), or nicardipine (group3) with the a id of an intravenous injection pump. The blood coagulation and cardiac functions were observed during hemodilution. Results No significant diff erence was found among the three groups on cardiac function and coagulation func tion during 500ml 6% HES infusion. When the volume of infusion was over 1000ml, the parameters of cardiac function increased and those of coagulation decrease d significantly (P

Background and purpose:Ever since the use of anthracycine and /or taxanes-based regimen for the adjuvant and/or neoadjuvnat chemotherapy of breast cancer,there have few sensitive agents for advanced breast cancer(ABC)when it occurs drug resistance to anthracycine and /or taxanes.The aim of this study is to evaluate the effect of gemcitabine plus cicplatin in advanced breast cancer after the failure of treatment with anthracycines and /or taxanes.Methods:From May,2005 to Jan 2007,34 ABC cases with anthracycine and/or taxanes resistance were treated with GEM(1000 mg/m2.day1,day8)and DDP(30 mg/m2,day 1 to day 3)every 3 weeks.A median of 5 cycles(2-6 cycles)of the treatment was delivered.All cases were followed up more than 6 months.Results:3 cases(8.8%)had complete response(CR),13 cases(38.2%)had partial response(PR),while 12 cases(35.3%)had stable disease(SD)and progressive disease(PD)was 6 cases(17.7%);the overall response rate was 47.0%.The median time to progression(TTP)was 6.5 months,grade 3/4 diarrhoea and thrombocytopenia were main side effects.Conclusions:GEM plus DDP are effective in the treatment of advanced breast cancer with anthracycine and/or taxanes resistance.

Objective To compare the clinical efficacy and safety of anemia during pregnancy of Shengxuening tablets and ferrous succinate treatment for clinical treatment in patients with anemia .Methods 212 cases of pregnancy in early pregnancy patients with anemia from March 2015 to February 2016 in our hospital,numbered according to the order of treatment, were randomly divided the patients into group A and group B,106 cases in each group,group A with Shengxuening tablets treatment, group B with ferrous succinate tablets treatment,two groups of patients were treated with the same program of diet guidance,all patients were treated for three months.Each patient was followed up to the end of delivery, and the two groups of patients before and after pregnancy treatment to the end of pregnancy anemia and pregnancy outcomes were compared.Comparison of two groups of patients before and after treatment for one,two and three months of hemoglobin (Hb) level,red blood cell count (RBC),serum ferritin (SF),total iron binding rate (TIBC) changes;finishing treatment of the two groups during the three follow-up of Hb, RBC, SF TIBC, which returned to normal levels at the time and, after three months of treatment and evaluate the clinical efficacy of the two groups were collected and compared during the treatment of adverse drug reactions of two groups were compared.Results After treatment for one,two and three months, levels of Hb,RBC and SF in two groups of patients were significantly higher than those before treatment,TIBC was lower than that before treatment (P<0.05);After treatment for one and two months,RBC,SF and Hb in group B were significantly higher than those in group A,TIBC lower than group A(P <0.05);After treatment for three months,the levels of Hb, RBC, SF and TIBC in two groups were back to normal,and there was no significant difference between the two groups.Hb, RBC,SF,TIBC index recovery time of group B was significantly shorter than the group A (P<0.05).After treatment for three months,there was no significant difference in clinical efficacy between two groups.The adverse drug reaction rate was significantly higher in the group B than in the group A during the treatment period (P<0.05).The end of the treatment to the end of pregnancy, five cases of group A were again the parallel treatment of anemia, 11 cases of group B were again anemia and pregnancy outcome in patients with treatment ,the adverse pregnancy rate in group A was higher than that of group B, the difference was statistically significant (P<0.05).Conclusion Shengxuening tablets and succinate iron treatment of early pregnancy anemia have advantages and disadvantages,clinical can consider the combined treatment of anemia in pregnancy,improve the clinical efficacy and safety.

Extracellular matrix protein-1 (ECM-1) is a secretory glycoprotein. Recent studies found that the protein may be related to the digestive tract tumor growth, invasion and metastasis. In this paper,the basic structure and function, as well as the possible mechanism in gastrointestinal cancer have been reviewed.

Hepatocellular carcinoma is one of the most common cancer with a high incidence and mortality,representing a main type of primary liver cancer.However,the molecular and cellular mechanisms of hepatocellular carcinoma pathogenesis are still poorly understood.Traditionally,the development of hepatocellular carcinoma has been viewed as a process of transforming of normal cells into malignant driven by the genetic alterations in tumor-suppressor gene deactivation and pro-oncogene activation.In recent years,with the deeper understanding of tumor,it has been found that epigenetic alterations are closely related to the occurrence and the development of hepatocellular carcinoma.DNA methylation is one of the most common epigenetic events occurring in human genome,as well as the best studied of the epigenetic changes.This review focuses on the state-of-the-art advancements of DNA methylation in hepatocellular carcinoma.

Epigenetics refers to steady phenotypic changes in gene expression without modifications in the genetic nucleotide sequence.Disorder of epigenetic mechanisms plays an important role in the occurrence and development of human malignant tumors including hepatocellular carcinoma.A large number of gene targets and pathways related to epigenetics were discovered.For instance,DNA methylation,histone modification and RNA regulator gene silencing were associated with the development of hepatocellular carcinoma.Exploring the abnormal epigenetics is of great significance for prevention and treatment of hepatocellular carcinoma.

Objective:To study the significancy of P27 Kip1 expression, cell apoptosis and cell cycle distribution in the evaluation of sensitivity in oral cancer chemotherapy. Methods:40 cases of oral tumor were treated with MTX,CDDP and PYM by subcutaneous implantable drug pump.Operation was performed 2~4 weeks after the induction chemotherapy. Cell cycle distribution, apoptosis and P27 Kip1 protein expression in the removed tumor tissue were detected by fllowcytometry and indirect fluoressent assay pre-and post-treatment.Results:(1)After induction chemotherapy S,G_2M and PI ration in cell cycle distribution decreased,G_0/G_1, AP and FI_ p27 increased(P

Based on high requirement on trainingtarget ofcultivating8-year medical students and combined with the characteristic of general surgical teaching,we applied logical thinking to strengthen students'clinical thoughts and self-analysis ability to make them become the advanced medical talents with good clinical thoughts.

Objective To investigate the clinical, imaging and pathological findings of the primary (CNS) lymphoma in patients without AIDS. Methods The clinical, laboratory, neuroradiological and pathological data of such 15 cases were analysed. Results The clinical features of the primary malignant lymphoma of CNS are variable,however,more than half of patients were presented with an increased intracranial pressure and a neurologic dysfunction, such as weakness of limbs,speech changes and seizures. These symptoms were always misdiagnosed as some other tumors.Examination of CSF revealed a mild or intermediate increase of protein in all patients by way of lumbar punctures. Imaging examinations by CT and MRI both showed solitary or multiple masses of tumor located more likely in the frontal and temporal lobes. Only 20% patients mimiced the demyelineting disease and were misdiagnosed as multiply sclerosis. Conclusions Patients with such CNS lymphoma usually do not present the characteristically clinical manifestations or findings in the imaging scanning. Brain biopsy may be a method more reliable to confirm this disease and be important for improving the prognosis of patients.

objective: To study the effects of induction chemotherapy via subcutaneous implantable drug pump on local immune status. Methods: 47 cases with node negative oral cancer were treated with MTX, CDDP, PYM via subcutaneous implantable drug pump(in 27 cases), or via vein for case control trial(in 20 cases). Local immune status of tumor tissue was detected by immunohistochemical technique before and after treatment. Results: The effectiveness of treatment with the drugs via subcutaneous implantable drug pump (DSIP) was observed in 21 out of 27 cases (77.8%) and that with the drugs via vein(DV) was in 13 out of 20(65.0%) respectively( P 0.05), while the number of positive cells of CD 4 and CD 4/CD 8 in the cases treated with DV was decreased( P