Hepatocellular carcinoma is the fifth malignant tumor in the world.Most patients who have been diagnosed have been in advanced stage,so mortality of hepatocellular carcinoma is thirdly in malignant tumor of digestive cancers.The effective tumor marks are the main method of early diagnosis or treatment and raising survival rate.This articles reviewed the several tumor marks which have been found in the past few years.

AIM: To analyze the reasons of low vision and blindness in elderly patients and the application of optical aids in rehabilitation.METHODS: Totally 87 elderly patients which had 74 cases of low vision,13 cases of blind,including 53 males and 34 females.Routine internal and external eye examinations should be performed,and special removal examinations should be performed if necessary.Both refractive correction,and try with far and near optical aids,check after wearing a typoscope distant and near vision,distant vision ≥0.05 out the blindness,distant vision ≥0.3 out the disability.Near vision ≥ 0.5 was valid,<0.5 was invalid.RESULTS: Among 87 elderly patients with low vision,high myopia was the leading cause of blindness,followed by macular degeneration,cataracts,glaucoma and diabetic retinopathy.The visual acuity after refractive correction increased ≥ 2 lines in 62 cases (71%),visual acuity was not correct or corrected for ≤ 1 of 25 cases (29%).With aids,far visual was ≥0.3 of the 70 cases (80%),≥0.05 in 10 cases (11%),<0.05 in 7 cases (8%),residue removal rate of 92%.With reading glasses near and near visual acuity was >0.5 effective in 60 cases (69%),<0.5 ineffective in 27 cases (31%).Typoscope was often used in 58 cases,not often used 18 cases,11 cases rarely used or give up.CONCLUSION: High myopia is the leading cause of low vision and blindness in the elderly,followed by macular degeneration.The application of visual aids is still reliable and economical and effective treatment method,patients should be encouraged to use visual aids to improve the utilization rate of aids,so as to improve the quality of life of patients.

Objective Combined with the patients arthritis symptoms and signs,TCM syndrome differentiation of rheumatoid arthritis was undertaken to investigate TCM syndrome distribution.Methods A total of 656 patients of rheumatoid arthritis from October 1st 2010 to January 1st 2012 hospitalized in Shandong Qingdao Combine Traditional Chinese and Western Medicine hospital were untaken TCM syndrome differentiation according to their symptoms and signs.Results The main syndromes of rheumatoid arthritis patients were cold-dampness blockage syndrome and liver and kidney deficiency syndrome,followed by cold-wind blockage syndrome,deficiency of Qi and blood syndrome,and dampness-heat blockage syndrome.The highest scores of ESR and C reactive protein appeared in dampness-heat blockage syndrome group,with ESR being (56.23 ± 13.87) ram/h,CRP being (69.49± 21.56) mg/L.These values showed significant difference than other syndrome group (P ＜ 0.05).There was no significant difference of rheumatoid factor,immunoglobulin IgG,IgA,IgM values among these syndrome groups (P＞0.05).Comparison of age,course of disease showed the liver and kidney deficiency syndrome group (age was 59.3± 12.15,duration was 7.98 ± 3.76)and Qi and blood deficiency syndrome group (age was 52.5± 11.5,duration was 6.56±3.12) were significant higher than cold-dampness blockage syndrome,damp-heat blockage syndrome group and cold-wind blockage syndrome group with the age of (46.2± 11.12) and (45.8± 11.60),(43.5± 12.50) respectively and course of (5.56±2.76),(5.78±2.98),(5.12±2.32) respectively (P＜0.05).Conclusion The main TCM syndromes of rheumatoid arthritis patients in Qingdao area were cold-dampness syndrome,liver and kidney deficiency syndrome,followed by cold-wind blockage sydrome,Qi and blood deficiency syndrome,damp-heat blockage syndrome.Among all syndromes,relatively high age and disease course of patients appeared in liver and kidney deficiency syndrome and Qi and blood deficiency syndrome.

AlM: To investigate the efficacy of photodynamic therapy ( PDT) and intravitreal injection with ranibizumab on macular choroidal neovascularization ( CNV ) of pathologic myopia ( PM) .
METHODS: There were patients ( 32 eyes ) who were diagnosed as PM with CNV. Randomly selected 16 cases ( 16 eyes ) which were given the PDT treatment ( PDT group ) . The remaining were given both PDT and intravitreal injection with ranibizumab ( combination group) . There is no significant difference on macular edema between two groups. We analyzed the changes in the best corrected visual activity ( BCVA) , optic coherence tomograph ( OCT ) and fundus fluorescein angiography (FFA) before and 1, 6mo after treatment.
RESULTS:One month after the treatment in PDT group:the BCVA increased while the CMT decreased compared with that of pretreatment (P<0. 05). One month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment (P<0. 01);the changes of BCVA and CMT showed statistically significant between the two groups ( P<0. 05). Six month after the treatment in PDT group: the BCVA increased while the CMT decreased compared with that of pretreatment ( P <0. 05 ). Six month after the treatment in combination group: the BCVA increased while the CMT decreased significantly compared with that of pretreatment ( P <0. 01 ); compared with changes of BCVA and CMT in two groups, the difference was significant after treatment (P<0. 05). Compared 1mo with 6mo after treatment:there was no significant difference in the BCVA and CMT changes (P>0. 05). One month after treatment: in PDT group, FFA showed no leakage or reduced leakage of CNV in 11 eyes (69%), and the fundus remained leaky in 5 eyes ( 31%); in combination group, FFA showed no leakage or reduced leakage of CNV in 13 eyes (81%);the fundus remained leaky in 3 eyes (19%). Six month after treatment:in PDT group, FFA showed no leakage or reduced leakage in 10 eyes ( 62. 5%); the fundus remained leaky in 4 eyes ( 25%); two eyes ( 12. 5%) relapsed leakage; in combination group, FFA showed no leakage or reduced leakage of CNV in 15 eyes (94%);the fundus remained leaky in 1 eye (6%).
CONCLUSlON: Not only PDT but also PDT and intravitreal injection with ranibizumab can block CNV of pathologic myopia completely or partly, and reduce the danger causing descent of vision. Effects and the stability of the combination therapy is superior to PDT treatment.

Objective To study the efficacy of medial plantar island flap for repairing soft tissue defect of the heel after excision of melanoma.Methods Five patients (including 3 males and 2 females) with malignant melanoma were treated.All lesions were located in the heel and were proved by pathological examination.Local extensive resection was performed in all cases.The surgical margin used for excision of melanoma was 2 cm,and the depth used was deep into periosteum of the calcaneus.Plantar medial artery island skin flaps were applied in the reparation according to the size of heel soft tissue defect and anatomic study.The postoperative follow-up was 8 to 14 months.Results The surgical reparation was successful in all 5 cases.The plantar medial artery was very suitable to cover the surgical wound surface and to recover the function and sense.Before 3 months the sense of flaps remained on the donor area and later went to the heel gradually.All patients remained alive and no tumor recurrence was observed.All the patients were walking normally and had protective sensation in the new heel pad comparable to the opposite normal heel.Two patients with more than 10 years follow-up were reported.Conclusions Plantar medial island flap can be used to repair the wound after malignant melanoma resection in the heel,which is an effective method.

Objective To analysis effect of ShenQi FuZheng injection on peripheral blood angiotensin II(AngⅡ), endothelin-1(ET-1) levels and clinical curative effect in patients with congestive heart failure.Methods 52 patients who were diagnosed with chronic heart failure were collected.All patients were randomly divided into experimental group and control group, 26 cases in each group.Patients in the control group received conventional western medicine treatment, patients in the experimental group were given ShenQi FuZheng injection on the basis of control group treatment, after the treatment, the plasma levels of AngⅡ and ET-1, cardiac function and clinical efficacy were detected in all patients.Results After treatment, compared with control group, the plasma levels of AngⅡ was lower in the experimental group(P<0.05);the plasma levels of ET-1 was lower in the experimental group(P<0.05); the LVEF,CO and SV levels were higher,and the LVED level was lower in the experimental group(P<0.05); the effective rate of patients in the experimental group was higher(P<0.05).Conclusion The ShenQi FuZheng injection can significantly reduce the plasma AngⅡand ET-1 levels in patients with congestive heart failure, improve heart function and clinical curative effect.

Objective To observe the analgesic effects of preoperative tramadol caudal injection in patients after receiving gynaecological laparoscopy under general anesthesia. Methods A total of 60 patients scheduled for gynaecological laparoscopic operations under general anesthesia was randomly divided into two groups with 30 patients each.The Group A was given an injection of tramadol 100 mg,2% lidocaine 5 ml,ondansetron 4 mg,and normal saline 20 ml by caudal route preoperatively,while the Group B was given an intravenous drip of tramadol 100 mg and ondansetron 4 mg at 10 minutes before the end of operation.The Visual Analog Scale(VAS) pain scores and the Ramsay Sedation Scores were recorded after extubation,before the departure from operation room,and at 1,3,and 6 hours after surgery,respectively.Adverse effects of dysphoria,dizziness,drowsiness,nausea,and vomiting were recorded.Results The VAS scores were significantly lower after extubation,before the departure from operation room,and at 1 and 3 hours after surgery in the Group A than in the Group B(t=-5.961,-8.362,-4.038,-3.565;P=0.000), while the difference was not significant between the two groups at 6 hours after surgery(t=-1.403,P=0.166).The Ramsay scores were significantl higher after extubation,before the departure from operation room,and at 1 and 3 hours after surgery in the Group A than in the Group B(t=9.409,10.407,8.167,4.082;P=0.000),while the difference was not significant between the two groups at 6 hours after surgery(t=0.428,P=0.670).Significantly more patients presented dysphoria,dizziness,nausea,and vomiting in the Group B than in the Group A after extubation and before the departure from operation room.Conclusions Tramadol 100 mg caudal injection before operation can produce a better postoperative analgesic effect in patients receiving gynaecological laparoscopic operations.

Objective To research the absorption mechanism of paeoniflorin across Caco-2 monolayer model. Methods Depending on the Caco-2 cell monolayers drug transport model to study the double transport mechanism of paeoniflorin. To explore the effect of paeoniflorin absorption by time and drug concentration, the drug concentration was determined through the use of HPLC instrument and the Papp was calcalatad. Results In the Caco-2 monolayer model, the transport of paeoniflorin form Apical (AP) to Basolateral (BL) is similar to the transport form BL to AP. Conclusion The main mechanism of the paeoniflorin intestinal absorption in the Caco-2 monolayer model is passive transference.

Objective:To establish a mouse model with the main characteristics of asthma and to study the pathogenesis of its airway inflammation.Methods:Mice were given latex by the intraperitoneal sensitization/intranasal challenge.BALF histology were examined 24 hours following tracheal challenge;cytokines and serum total and specific IgE were examined in one month and the expression of IL-5?IFN-? were performed by ELISA ?RT-PCR.Results:After the latex challenge,in experimental group,the number of total BALF cells and the percentage of eosinophils elevated;the histological analysis showed the elevation of mucus production and goblet cell development within bronchial epithelium,spasm and constraction of bronchia ,marked peribronchial infiltration of eosinophils and lymphocytes; the elevation of total and specific IgE;reduction of IFN-? and increase of IL-5 in the BALF and lung.Conclusion:Latex sensitization and challenge can lead to airway eosinophilia,allergen-specific IgE induction and production of Th2 type cytokines, which were the main characteristics of asthma.

Aim To investigate the effects of anti-morphine vaccines on pharmacological actions of morphine in mice.Methods Morphine-6-succinyl and morphine were conjugated respectively with Blue Carrier(BC) in the presence of carbodi-imide.After being immunized with both vaccines(M-BC,M-6-S-BC),the withdrawal syndrome and the abirritation were observed in mice.Results The withdrawal syndrome of the immune mice with M-6-S-BC and M-BC vaccines were reduced markedly compared with the model group,the skipping times were decreased and the latency was longer(P