Gallstone associated with cirrhotic portal hypertension is not uncommon in clinic, and its incidence rate increased year by year, presenting 2- 3 times of the incidence rate of non-cirrhotic patients. Cirrhotic portal hypertension can lead to a variety of local and systemic physiological changes, and it can promote the incidence of gallstones. Due to the dysfunction of the liver and the blood coagulation which are caused by cirrhotic portal hypertension, the surgical difficulty and risk increases significantly. Currently, scholars still have certain controversy in the options of surgical methods and surgical staging. Now let me review and summarize the pathogenesis and surgical treatment of gallstone associated with cirrhotic portal hypertension.

Objective To sum up the problems should be taking care in operations for huge goitres. Methods Retrospectively analyzed the clinical data of 295 cases of huge goitres was made. Results All of the 295 cases had some degree of compress, replacement and bend of trachea by the goitre comfirmed by X ray examination .Among the 295 cases,162(54.9%) had trachea constriction.51(17.3%) had obvious dyspnea. Retrosternal goitres was found in 21 cases.12 complicated with secondary hyperthyroidism. All the 295 cases underwent subtotal or total thyroidectomy. Postoperative pathological diagnosis: nodular goitres was diagnosed in all the 259 cases (100%),including 11 cases(3.7%) with malignancy, 12 cases( 4.1% ) with secondary hyperthyroidism,and 39(15.1%) with adenomas. Conclusions Operation of huge goitres should choice appropriate anaesthetic method.For the main vessels of thyroid, very high position of the upper pole of thyroid, retrosternal goitres, malignancy of goitres etc,appropriate operative measures shoudd be adopted to prevent introoperative massive bleeding and damage of recurrent laryngeal nerve. If the indications of tracheostomy presents,a tracheostomy must be done.

Objective To explore the etiology,diagnosis and treatment of omohyoid muscle syndrome(OMS).Method Clinical data of 34 OMS cases was analyzed retrospectively from 1980 to 2008.In the autopsy of 19 bodies we studied omohyoid muscle,especially the intermediate tendons,sheaths of tendon and projection of omohyoid muscles.Result The symptom of omohyoid muscle syndrome lies in a mass that can be seen on the neek while swallowing,and the patient feels discomfort and dysphagia.The mass disappears immediately after swallowing and cann't be found by palpation.Congenital fascia weakness,intermediate tendon sheath relaxation,atrophy,degeneration and contracture of omohuoid muscle causes OMS.OMS was diagnosed on clinical manifestation.All 34 patients were treated surgically including cutting off the cross part of omohyoid muscle and sternocleidomastoid muscle,separating adhesion of muscle and fascia.Postoperatively symptoms disappeared in all these 34 patients.Conclusions Omohyoid muscle syndrome is a disease that can be easily diagnosed basing on characteristic clinical symptom and sign,the prognosis is good if treated properly by an operation.

Objective:To establish an HPLC method for the determination of paclitaxel and docetaxel in plasma to provide refer-ence for the individualized treatment regimen and the evaluation of curative effect and adverse reactions. Methods:Paclitaxel and do-cetaxel were used as the internal standard for each other. The samples were precipitated by acetonitrile and separated on a DikMA Dia-monsil C18 column with a mixture of acetonitrile-water (55: 45) as the mobile phase. The flow rate was 1. 2 ml·min-1 . The column temperature was set at 25℃. Paclitaxel and docetaxel were detected by UV-detection (λ= 227 nm). Results: A linearity was ob-tained within the range of 0. 078-10. 0 mg·L-1 for paclitaxel and docetaxel. The limit of quantitation was 0. 039 mg·L-1 . The aver-age recovery of paclitaxel and docetaxel was 99. 85% and 100. 35%, respectively. The inter- and intra-day RSD were both less than 5% and the RSD for freeze-thaw stability was below 10%. The plasma concentration of paclitaxel in clinical samples was within the range of 0. 18-6. 16 mg·L-1 and obvious individual difference was shown. Conclusion:Therapeutic drug monitoring is very important due to the obvious differences in plasma concentration of paclitaxel and docetaxel. The established method is sensitive, accurate, con-venient and rapid in r the therapeutic drug monitoring, and is useful for the adverse drug reactions monitoring and pharmacokinetic study.

Objective To investigate the diagnosi s and management of inflammatory abdominal mass after appendectomy. Methods Clinical data of 42 patients wit h inflammatory abdominal mass developing after appendectomy from 1972 to 2004 we re retrospectively analyzed. Results There were two kinds of mass: on abdominal wall (26 cases) and that within the abdominal cavity (16 cases). Diagnosis was established on clinical fi ndings and the barium enema examination. Correct preoperative diagnosis was achi eved in 30 cases, with 12 cases (28.6%) misdiagnosed. Laparotomy was performed in 29 cases. Postoperative pathology revealed inflammatory mass. All the 42 case s recovered from the illness. Conclusions Post-appendectomy abdominal mass is infrequent complication. T he clinical course is most often self-limited. However, laparotomy is indicated in patients when conservative therapy fails or there is a fear of malignancy or tuberculosis.

Objective To evaluate the effect of choledochoduodenostomy for the treatment of bile duct calculi. MethodsClinical data of 420 patients with choledochoduodenostomy from 1962 to 2002 were respectively analyzed. ResultsBefore 1982,this procedure was performed in 230 cases with postoperative cholangitis or sink syndrome found in 46 cases, and mortality in 6 cases. Since 1983,190 cases underwent large-sized choledochoduodenostomy with 7 cases suffering from postoperative cholangitis or sink syndrome and no mortality. The anastomotic stoma was less than 2.0 cm in 110 cases, between 2.0 to 2.5 cm in 184 cases, from 2.5 to 3.0 cm in 107 cases, no record in 19 cases. A total of 358 cases (85.2%) were followed up from 2 to 20 years. Result was excellent and good in 183 out of 190 cases(96.3%) after the year of 1983. ConclusionsCholedochoduodenostomy when the stoma was larger than 2.5 cm in diameter and was put low in position was effective for the prevention of recurrent cholangitis and sink syndrome for the treatment of bile duct calculi.

Objective To investigate the radiosensitiation effect of berberine on human nasopharyngeal carcinoma ( NPC) in hypoxia condition and explore the underlying mechanisms. Methods MTT assay, clonogenic assay and flow cytometry were performed to analyze cell proliferation, colony formation and apoptosis, respectively. Male nude mice inoculated subcutaneously with CNE-2 cells were used to examine the radiosensitization effect of berberine in vivo. The expressions of HIF-1α and VEGF were assessed by Western blot. Results Berberine efficiently inhibited the proliferation of CNE-2 cells in time-dependent and dose-dependent fashions with an IC50 of ( 14?9 ± 2?2 ) μmol/L. Clonogenic survival assay showed that berberine ( 5 μmol/L ) sensitized CNE-2 cells to ionizing radiation in hypoxia and its SERD0 was 1?27. Under hypoxic condition, berberine alone (5, 15 μmol/L) could induce apoptosis (t=5?01, 9?02,P<0?05) and it further promoted 8 Gy radiation-induced apoptosis (t =5?31, 9?91,P <0?05). Moreover, berberine significantly delayed the tumor growth in the combination group (berberine +irradiation) compared with the mice received irradiation alone or PBS (t =2?96, 14?52, P <0?05). Immunobloting assay showed that berberine inhibited the upregulation of HIF-1α and VEGF induced by hypoxia in CNE-2 cells. Conclusion Berberine confers radiosensitivity on hypoxic NPC in vitro and in vivo, which is probably associated with the downregulation of HIF-1α and VEGF expressions.

Objective To explore the cancer incidence in registration areas in Shanxi Province. Methods Data of 8 cancer registration areas in 2011 were taken into account and cancer incidence in different areas with different ages was compared with that in other domestic areas. Results 8 395 new cases in Shanxi all cancer sites were reported in 2011, including 4 810 male and 3 585 female. The incidence of malignant cancer of Shanxi was 207.53/100 000, and the standardized incidence of Chinese population and world population were 125.20/100 000 and 165.72/100 000, respectively. In urban areas, the incidence of Shanxi and the standardized incidence of Chinese population were 202.49/100 000 and 112.81/100 000, respectively. In rural areas, incidence rate of Shanxi was 211.96/100 000 and the standardized incidence of Chinese population was 138.43/100 000. In Shanxi Province, the major malignant cancer sites for males involved stomach, lung, esophagus, liver and colorectum, and cancer sites for females were more on cervix, lung, breast, stomach and esophagus. Conclusions Upper gastrointestinal cancer and uterine cervix cancer are the major cancers in Shanxi registration areas. The incidence of stomach cancer and uterine cervix cancer in Shanxi Province are much higher than national average.

Objective To analyse pathogenesis, types, diagnosis and operation methods of adult intussusception. Methods Clinical data of 150 patients with adult intussusception were reviewed retrospectively . Results Symptom included paroxysmal bellyache (90 0%), abdominal mass (64 7%), nausea and vomit (58 0%), hematochezia (20 7%), constipation (10%) and symptom triad of bellyache , mass and hematochezia (15 3%). Tumor, inflammation, Meckel′s diverticulum and mobile cecum were main cause for intussusception. All 150 patients received operation, 147 patients were cured and 3 patients died. Conclusions Most patients of adult intussusception had pathological basis. The result of surgical therapy is good.

ObjectiveTo explore the mental health status of patients with breast cancer and social support on their influence. Methods260 cases of patient with breast cancer were investigated by using the questionnaire of demographic characteristics and symptom check list 90(SCL-90)and social support rating scale(SSRS). ResultsBreast cancer patients ' mental health condition was worse than normal healthy people and their mood changes were obviously observed. Breast cancer patients achieved good social support.However, the urban patients with breast cancer got better social support than the rural patients and the difference were statistically significant(t =7.91, P =0.000). SCL-90 total score and its factors such as forced symptoms, sensitive interpersonal relationship, depression, anxiety, hostile, terror, paranoid,psychoticism,were negatively related with the social support (r =-0.278,-0.259,-0.165,-0.294,-0.215,-0.177,-0.175,-0.167,-0.219,all P ＜ 0.05).ConclusionThe social support influences breast cancer patients'mental health,therefore,the patients with breast cancer should be given a better social support in order to improve the psychological health level and improve recovery.