Professor Zhang Yonghong thinks that the deficiency of lung qi always exists in advanced lung cancer cases. Pathogen infection, phlegm and blood stasis are key factors to the occurrence and development of lung cancer. Clinical treatment in advanced lung cancer should emphasize on the benefiting of qi and supplementing the lung as well as reducing phlegm, removing blood stasis and disintoxication. Attention should be paid to both syndrome differentiation and disease differentiation with the combination of strengthening the body resistance and eliminating evil factors according to different stages of lung cancer.

Objective To investigate the effects of long-and mid-term indwelling AO clavicular hook plate (CHP) on the shoulder function following surgery for acromioclavicular dislocation(from grade Ⅲ to grade Ⅴ by Rockwood's classification).Methods A retrospective study was done of 95 patients with acromioclavicular dislocation who had been fixed with AO CHP from December 2002 to May 2011.They were 80 men and 15 women,aged from 20 to 63 years (average,45.0 years).By the Rockwood's classification,there were 40 cases of type Ⅲ,35 ones of type Ⅳ and 20 ones of type Ⅴ.Time from injury to surgery ranged from 2 to 7 days (average,4.6 days).The CHP was indwelling in 70 patients but removed in 25 patients from 12 to 23 mouths post-surgery (average,16.5 months).The University of California (UCLA) shoulder scoring system was used to compare the shoulder functions between those with an indwelling CHP and those without,as well as between the healthy and affected shoulders among those with an indwelling plate.Results The follow-up time for all the 95 cases ranged from 7.5 months to 9 years,with an average of 38 months.Of those with an indwelling CHP,subacromial bone erosion occurred in 45,internal implant failure in 3,impingement in 13,screw loosening in 2 and frozen shoulder in 5,giving a complication rate of 97.1％ (68/70).Of those without an indwelling CHP,subacromial bone erosion occurred in 3 and no redislocation was found in this group,giving a complication rate of 12.0％ (3/25).The UCLA score for the affected shoulder among those with an indwelling CHP(27.0 ± 11.0 points) was lower than that for the healthy one (34.0 ± 1.0 points) and lower than that for the affected shoulder among those without an indwelling CHP(32.0 ± 6.5 points).Conclusion Long-and mid-term indwelling AO CHP can have a significant adverse impact on shoulder function,leading to a very high rate of postoperative complications.

Objective To investigate the clinical manifestation,pathogenesis and imaging features of hemichorea associated with hyperglycemia in primary diabetes mellitus(DM).Methods Analyze the clinical manifestations,the neuroimaging features and the treatment of the three patients with hemichorea induced by hyperglycaemia in primary DM,and review the literatures about this disease.Results All of the three cases had a long history of uncontrolled diabetes,among whom,two were non-ketotic hyperglycemic patients and one was ketotic hyperglycemic patient.All of them had an acute onset hemichorea which was almost continuous during awakeness and ceased during sleep.The early CT findings in this disorder were high density in the caudate nucleus,putamen and/or globus pallidus on the side contralateral to the involved limbs,but showed decreased attenuation or completely resolved in about a month.T1-weighted MR images in all cases showed high-signal intensities without edema or mass effect in the diseased region which decreased after several months,while the T2-weighted images were more variable.Conclusion Hemichorea induced by hyperglycemia often happens in the patients with poorly controlled DM,and both of the non-ketotic hyperglycemic and the ketotic hyperglycemic state can be the cause.In the major affected region-corpora striata,CT shows hyperdense lesions,T1-weighted MR images show hyperintense lesions and T2-weighted images show variable lesions in the early time.

Objective To probe the surgical approach and effect on upper abdominal malignant tumor infiltrating pancrea. Methods Thirty patients with upper abdominal malignant tumor infiltrating pancreas or tissue around pancrea were treated by radical resection on primary tumor combined pancreaticoduodenectomy. Results Three patients died in 1 month after operation due to multiple organ failure. The patients with gallbladder cancer and metastatic lymph nodes fixed behind caput pancreatis were followed up averaged 35 months. The patients with gastric antrum carcinoma infiltrating caput pancreatis were followed up averaged 31 months. The patients with recurrent gastric cancer infiltrating caput pancreatis were followed up averaged 13 months. The patients with pancreatic and duodenal invasion by cancer of hepatic flexure of colon were followed up averaged 41 months. The patients with hilar cholangiocarcinoma and metastatic lymph nodes fixed behind caput pancreatis were followed up averaged 11 months. Conclusion The patients with upper abdominal malignant tumor infiltrating pancreas should be operated by radical resection on primary tumor combined pancreaticoduodenectomy, which can increase the rate of tumor resection, and be expected to prolong the survival period.

Objective To observe the effect of osteopontin (OPN) and integrin αtvβ3 in collageninduced arthritis (CIA) and the possible mechanism of Tripterygium wilfordii polyglycoside (TWP) in the treatment of rheumatoid arthritis (RA). Methods CIA rats model were developed and were randomly divided into the experimental group and the TWP group.And tissue samples were obtained 4 weeks later.Then the expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of each group were determined by immunohistochemical stain and ELISA.Variance analysis was used for data analysis.Results The concentrations of OPN of the normal controls,experimental group and the TWP group in the serum were (5.7±2.9), (7.8±6.2), (5.0±1.9) ng/ml respectively and there were significant differences between these 3 groups (F=6.74,P=0.016).The concentration of OPN (measured by mean grey value) in the synovium and cartilage of the three groups were 229±15,81±15,93±13 and 211±17,91±19,100±15 and there were significant differences between the three groups (F=52.48,P＜0.01; F=18.98,P=0.01).The concentrations of protein αvβ3 (measured by mean grey value) in the synovium and cartilage were 235±16,91±16,131±14 and 198±10,99±15,113±14,respectively and there were significant differences between the three groups (F=23.03,P=0.002; F=12.04,P=0.008).The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the experimental group were markedly higher than that of the controls.The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the treatment group were obviously lower than the experimental group.Conclusion OPN and integrin αtvβ3 are involved in the hyperplasia of the synovium,cartilage and bone destruction in CIA rats.The underlying molecular mechanism that TWP is effective in treating synovitis and bone destruction of RA is possibly related to down-regulation of the expression of OPN protein and integrin αvβ3.

Objective To study the relationship between Tei index and the myocardial enzymes in newborns with myocardial damage due to asphyxia. Methods Forty-four newborns with mild asphyxia,27 newborns with severe asphyxia and 20 healthy newborns hospitalized in our hospital from January 2005 to December 2008 were enrolled in this study.The peak E and peak A and E/A ratio at mitral valve,the ejection fraction,isovolumetric contraction time,isovolumetric relaxation time and Tei index were measured by conventional echocardiography,and aspartate aminotransferase,creatine kinase,lactate dehydrogenase,hydroxybutyrate dehydrogenase and creatine phosphate kinase isoenzyme,and cardiac troponin T were tested also.One-way ANOVA was used to analyze the difference between groups. Results Tei index,isovolumetric contraction time and isovolumetric relaxation time in the severe asphyxia newborns were 0.62±0.13,(47±7)ms and(52±8)ms,higher than those in the mild asphyxia newborns[0.51±0.14,(41±6)ms and(43±6)ms],those in the mild asphyxia newborns were higher than in the healthy newborns[0.39±0.12,(34±6)ms and (37±6)ms] (all P<0.01).Aspartate aminotransferase,lactate dehydrogenase,hydroxybutyrate dehydrogenase,creatine kinase and its isoenzymes and cardiac troponin T in the severe asphyxia newborns were higher than in the mild asphyxia newborns and healthy group(P<0.01).Tei index,isovolumetric contraction time and isovolumetric relaxation time were positively related to the myocardial enzymes.The positive relationships were more statistically significant in Tel index,creatine kinase,its isoenzymes and cardiac troponin T(r=0.762,0.821,0.778,P<0.01).Conclusions Combination of Tei index and myocardial enzymes can not only be applied to assess the cardiac function in newborns with myocardial damage due to asphyxia,but also to evaluate the degree of cardiac dysfunction accurately and dynamically.

Objective To investigate the possible effects on radiosensitivity in human umbilical vein endothelial cells after transfection of pcDNA3.1+Ape1 plasmid. Methods The expressing vector pcDNA3.1+ Ape1, the control vector pcDNA3.1+or non-transfection cells was irradiated by 2, 4, 6, and 8 Gy photon beam at 48 h post-transfection. The value of initial and residual Oliver tail moment (OTM) under the alkaline single cell gelelectrophoresis assay and the colony forming test were utilized as the markers for the evaluaton of cells intrinsic radiosensitivity. The effect on radiosensitivity in human umbilical vein endothelial cells after transfection of the expressing vector pcDNA3.1+Ape1 was analyzed according to the radio-dose, compared to the empty vecor control and non-transfection cells. Results The initial and residual OTM value of endothelial cells transfected by 3 μg pcDNA3.1+Ape1 plasmid was lower significantly than ones of endothelial cells untransfected at 2 Gy irradiation (P<0.01), but was no significant difference at 8 Gy (P>0.05), and SF2 was higher remarkably in transfected cells than one in untransfected cells (P<0.05), but SF4, SF6 and SF8 were no significant differences (all of P>0.05). Conclusions The transfection of pcDNA3.1+Ape1 plasmid could enhance radioresistance of endothelial cells to the low-dose irradiation.

Objective To detect the changes in the expression of discoidin domain receptor 2(DDR2)and matrix metalloproteinase (MMP)-13 in different stages of cartilage and synovium damage of osteoarthritis rats.The relation between DDR2 and the degree of cartilage damage was explored.Methods Modified papain knee joint injection approach was adopted to establish animal model of OA.The expression and distribution of protein of DDR2 and MMP-13 were checked in articular cartilage and synovium at different stages of OA.Results The expressions of DDR2 in articular cartilage and synovium of experimental groups were different from those of the normal group (P＜0.01).They were higher in cartilage than those in the corresponding synovium.The expressions of MMP-13 demonstrated the same characteristics with those of DDR2,r=0.93(P＜0.01).Conclusions The important role of DDR2-MMP-13 in cartilage damage has been proven in the pathogenic process of OA.The upregulated expressions of DDR2 in articular cartilage and synovium have a detrimental effect on cartilage degeneration.

Objective To build rat orthotopic liver transplantation model and use this model as an experimental animal model for further research about liver transplantation.Methods Based on the classic two-cuff technique,a variety of skills were integrated,such as abdominal aorta perfusion first before ligation,suprahepatic inferior vena cava single continuous suture,preoperative and postoperative rehydration,hepatic portal vein and infrahepatic vena cava blocked by mosquito's haemostatic forceps.At last,the postoperative survival rates of 2 days and 2 weeks were recorded.Results Donors' operation time was (35±2) min,cuffing time was (7.0±1.5) min,receptors' operation time was (80±15) min,anhepatic phase was (21±3) min.The 2-day survival rate was 92 ％ (46/50) and 2-week survival rate was 86 ％ (43/50).Conclusion To some extent,the improved methods can not only reduce the difficulty of orthotopic liver transplantation operation,but also to create a uniform,stable and reliable orthotopic liver transplantation model.

OBJECTIVE: To study the inhibitory effect of Longzhi extracts (extracts from a Chinese herbal compound) on the growth of transplanted hepatoma H22 and sarcoma S180 in mice. METHODS: Certain dosage of Longzhi extracts was dissolved into distilled water to obtain the suspension of definite concentration. The suspension of 0.2 ml was planted on the right forefoot of each mouse. The mice were randomly divided into groups 24 hours later and treated for 7 days. One day after the treatment stopped, the mice were sacrificed and the tumor masses were taken out and weighed. RESULTS: The inhibition rates of Longzhi extracts on the tumor of transplanted H22 and S180 were 63% and 41% respectively. CONCLUSION: Longzhi extracts has antitumor action.