By means of a planimeter and skulls adjusted in the eye-ear plane, measurements of areas of the foramen ovale, spinosum, lacerum, jugulae and orifice of the canalis caroticus on both sides of the external surface of the skull base have been taken on 100 adult skulls collected in Chengdu. The symmetry of these areas has been studied. The main results of the study are given below: 1. In 4% of the whole series, the area of the foramen ovale is approximately equal on the two sides and the difference in area between the two sides is less than 1%. In 44%, the right side is larger, and in 52%, the left is larger. 2. In 5% of the whole series, the area of the foramen spinosum is approximately equal on the two sides. In 42%, the right side is larger, and in 53%, the left is larger. 3. In 4% of the whole series, the area of the foramen lacerum is approximately equal on the two sides. In 46%, the right side is larger, and in 50%, the left is larger. 4. In 3% of the whole series, the area of the foramen jugulae is approximately equal on the two sides. In 76%, the right side is larger, and in 21%, the left is larger. 5. In 3% of the whole series, the area of the anterior part of the foramen jugulae is approximately equal on the two sides. In 50%, the right side is larger, and in 47%, the left is larger. 6. In 17% of the whole series, the area of the intermediate part of the foramen jugulae is approximately equal on the two sides. In 37%, the right side is larger, and in 46%, the left is larger. 7. In 2% of the whole series, the area of the posterior part of the foramen jugulae is approximately equal on the two sides. In 79%, the right side is larger, and in 19%, the left is larger. 8. In 5% of the whole series, the area of the orifice of the canalis caroticus is approximately equal on the two sides. In 58%, the right side is larger, and in 37%, the left is larger. Moreover, a quantitative analysis of the bilateral areas has been carried out. The foramen area is highly positive in correlation With the product of its length and width. Therefore, the regression formulas of the areas are as follows: The foramen ovale-right, ■=1.5129+0.6699x (r=0.9417); left, ■=0.3695+0.6876x(r=0.8949). The foramen spinosum-right, ■=0.7827+0.6089x (r=0.8755); left, ■=0.3499+0.6695x (r=0.9207). The foramen lacerum-right, ■=9.4190+0.4480x (r=0.9147); left, ■=13.5198+0.4082x (r=0.8493). The foramen jugulaeright, ■=18.3913+0.5092x (r=0.8843); left,■=11.3561+0.5744x (r=0.9193). The anterior part of the foramen jugulae-right, Y=3.3141+0.4858x (r=0.8330); left, ■=3.2294+0.4854x (r=0.8452) The intermediate part of the foramen jugulae-right, ■=2.5434+0.4311x (r=0.7942); left, Y=1.7547+0.5227x (r=0.8366). The posterior part of the foramen jugulae-right,■=1.3470+0.6311x (r=0.8273); left, ■=0.9110+0.6586x (r=0.9480). The orifice of the canalis caroticus-right, ■=1.0986+0.6794x (r=0.9128); left, ■=1.5038+0.6590x (r=0.9219). (x is the product of the length and width of its foramen).

A number of biosimilars will be soon marketing due to the expiration of patent protection of their originators.Unlike classical chemical drugs,biotherapeutics are proteins with large and complex molecules produced by biological high-tech with sophisticated manufactural procedures.This leads to the difficulties of the copy of biosimilars from their originators,and the almost inevitable distinctions between the two products.Thus biosimilars are only similar but not identical to their reference drugs in terms of stracture,action,and safety.It is important for physicians to understand these differences before using biosimilars.Optimal management by a national regulatory authority with rigorous standards is very important in all aspects of authorization of the development,production,marketing,and postmarketing surveillances for biosimilars.

Objective To systematically review the prognostic factors of intrahepatic cholangiocarcinoma (ICC) and clinical significance of abdominal lymphadenectomy.Methods PubMed was queried with the terms of intrahepatic cholangiocarcinoma,survival,surgery,lymph or vascular invasion to find all studies published from January 2005 to December 2015.Authors were contacted by letters for the publications that were initially ineligible due to insufficient information for data extraction,responses were received,so these publications were included.Data were analyzed and evaluated by 2 independent researchers.Prognostic factors of ICC (vascular invasion,bile duct invasion,lymphatic vessel invasion,lymph node metastasis and peripheral nerve invasion) and related-factors of surgical method (R0 resection and lymph node dissected) were analyzed.The 3-,5-year survival rate,tumor-free survival rate and effect of lymph node dissected for prognosis of patients were extracted.Heterogeneity was analyzed by the chi-squared test and I2 test.The hazard ratio (HR) and 95％ confidence interval (CI) were transformed to Log (HR) and standard errors (SE) Log (HR).HR and 95％ CI of clinical factors associated with outcomes were done using univariate COX regression models.Publication bias was evaluated by the Egger's method,visualizing with funnel plot.Results A total of 48 publications including 7 868 patients with ICC were eligible to be included in this analysis,12 of 48 publications were included in the Mata analysis.Of 7 868 patients with ICC,vascular invasion,bile duct invasion,lymphatic vessel invasion,lymph node metastasis,peripheral nerve invasion,R0 resection and lymph node dissected were detected in 30％ (5％-98％),40％ (11％-59％),45％ (35％-65％),28％ (9％-100％),25％ (7％-55％),79％ (35％-100％) and 64％ (9％-100％),respectively.The 3-,5-year survival rate and 3-,5-year tumor-free survival rate were 39％ (16％-65％),29％(5％-60％) and 34％ (3％-60％),23％ (0-52％),respectively.The results of meta-analysis showed that lymph node metastasis and vascular invasion were factors affecting the prognosis of patients with ICC (HR =2.30,1.92,95 ％ CI:1.94-2.73,1.64-2.25,P ＜ O.05).Among the patients without lymph node metastasis,5-year survival rate in patients with and without lymphadenectomy was 17％-64％ and 15％-64％,respectively,showing no statistically significant difference (P ＞ 0.05).Among the patients with lymph node metastasis,5-year survival rate in patients with and without lymphadenectomy was 48％ and 11％,respectively,showing a statistically significant difference (P＜0.05).Conclusions Lymph node metastasis and vascular invasion are the risk factors affecting the prognosis of patients with ICC.Routine lymphadenectomy for ICC cannot show survival benefit,while routine lymphadenectomy should be applied to patients with ICC and uncertain lymph node metastasis.

AIM:To investigate the role of Shengmai Powder (Radix Ginseng, Radix Ophiopogonis and Fructus schisandrae) (SMP) in treatmen of hemorrhagic shock in rabbits. METHODS: The concentrations of endothelin (ET), tumor necrosis factor (TNF), ? endorphin (? EP) and nitric oxide (NO), the activity of nitric oxide synthase (NOS) in plasma were respectively tested by different biochemical assays in hemorrhagic shock in rabbits. RESULTS: SMP could obviously decrease the ET,TNF,NO level and NOS activity ( P

Objective To explore the value of anatomical liver resection in the treatment of bilateral intrahepatic biliary lithiasis. Methods We collected the clinical data of 32 patients with bilateral intrahepatic biliary lithiasis who received anatomical liver resection and 25 patients who recevied non-anatomical liver resection from May 2010 to May 2012 in our hospital and Sun Yat-sen Memorial Hospital. We comapred the therapeutic efficacy of these two operative modalities in the diagnosis and treatment of bilateral intrahepatic biliary lithiasis. Results The intraoperative blood loss was 436 ±48.162 mL in patients who received anatomical liver resection, and was significantly less than that in the control group (763 ± 37.645ml) ( < 0.05 ) . Postoperative liver function status:for patients who received anatomical liver resection,on the third day after operation,the total bilirubin and AST were significantly lower than those in the control group ( <0.05), and the postoperative hospitalization time was also shorter than that of the control group ( <0.05 ) . The two groups in the operation time, postoperative complications and residual calculus had no significant difference ( >0.05 ), but there 1 patients died of liver failure in the control group. Conclusions Anatomical liver resection is a favorable method to completely remove the lesions under the premise of retaining the residual liver function as much as possible. The rate of remnant biliary lithiasis and recurrence is lower and the recovery is quicker in these patients after anatomical liver resection. Thus, anatomical liver resection is worthy of promotion.

Objective The effect of electronic cigarettes (e-cigarettes) on smoking reduction,cessation and human health remains controversial,meanwhile,studies tocused on e-cigarettes are limited.We conducted this meta-analysis in purpose of helping figuring out the controversy.Methods PubMed, Medline,Embase,Cochrane library,CNKl and Wanfang Databases were searched for articles published up to May 2014.All studies discussing the relationship between e-cigarettes and smoking reduction,smoking cessation or human health were included.The fixed or random-eftect model was used to pool the relative risk(RR).Outcome 4 articles were included based on the inclusion and exclusion criteria,there were totally 7 002 subjects.Meta-analysis indicated that there was significant difference in e-cigarettes and smoking reduction,RR=1.88,95％ CI:1.07-3.32,P=0.09.The Meta-analysis showed that e-cigarettes were available in smoking cessation.RR=1.55,95％ CI:1.24-1.95,P=0.001.Conclusion Tiffs meta-analysis indicated that e-cigarettes were helpful in smoking cessation.Nonetheless,the articles included were too few to credibly support the outcome.Hence,more high-quality,randomized blind and large sample experiments are needed to verify the results.

Objective To analyze the risk factors for traumatic cerebral venous sinus occlusion (CVSO)and to investigate the strategies of early diagnosis of traumatic CVSO. Methods The clinical data of 212 patients with moderate to severe closed traumatic brain injury from January 2012 to December 2015 were analyzed retrospectively. Logistic regression analysis was used to evaluate the risk factors for traumatic CVSO. Results Of the 212 patients with traumatic brain injury, 16.5%(35/212) patients had CVSO. Ten patients had CVSO of thrombotic type (typeⅠ), 16 patients had CVSO of compression type (typeⅡ), and 9 patients had CVSO of mixed type (typeⅢ). Logistic regression analysis showed that skull fracture (OR = 8.141; 95%CI: 3.224-20.840) and epidural hematoma of crossing venous sinus (OR = 3.179; 95%CI: 1.470-7.037) were the risk factors for CVSO, and the former was more significantly correlated with CVSO. Female gender was the risk factor for CVSO typeⅠ(OR =10.425; 95%CI: 1.831-30.053), epidural hematoma of crossing venous sinus was the risk factor for CVSO typeⅡ(OR = 5.766; 95%CI: 1.885-18.197), and skull fracture, epidural hematoma of crossing venous sinus, and the previous history of vein thrombosis was the risk factors for CVSO type Ⅲ(OR =18.005, 4.596, 11.394; 95%CI: 2.021-58.836, 1.144-19.525, 1.436-46.558). Conclusions In the early diagnosis of traumatic CVSO, the crossing venous sinus fracture line and epidural hematoma should be given attention. Attention should be paid to the history of venous thrombosis. MR venography and CT venography contributes to early diagnosis of CVSO.

Objective Direct amplification of length polymorphism (DALP) as a new molecular marker was used to establish a set of stable DALP reaction system for the plants of Rhodiola L. Methods Some significant parameters of DALP reaction procedure were investigated and optimized by taking the DNA genome for the plants of Rhodiola L. as template. Results The reaction system was : 20 ?L reaction system containing 2. 5 mmol/L Mg2+ , 1. 25 mmol/L dNTPs, 60 ng DNA template, 1 ?L 5 pmol/L selective primer, 3 ?L 5 pmol/L reverse primer, selective primer: reverse primer is 1 : 3, and 2 U Taq DNA polymerase. Amplification program is 95℃ pre-denatured for 5 min, 94℃ denatured for 30 s, 50℃ annealed for 30 s, 72℃ extending for 1 min; after 30 cycles, and then 72℃ extending again for 10 min to the end of PCR reaction. Conclusion This DALP reaction system is efficient to identify the species and local populations for the plants of Rhodiola L. repeatedly with the stronger stability and reliability.

Objective To investigate the molecular mechanism of the glucocorticoid?induced osteoblasts apoptosis,and to develop the effective intervention measures. Methods The MC3T3?E1 cells were treated with different concentrations of dexamethasone for 24 hours,then the apoptosis rate was detected with TUNEL analysis,the intracellular expression of Bim and Bax were determined by Westen blot. In addition,MC3T3?E1 cells were randomly divided into Bim?siRNA group,negative control siRNA group and control group. Twenty?four hours after transfection,10-4mmol/L dexamethasone was added to each group of cells for another 24 hours administration. The apoptosis rate was analyzed using the TUNEL,the mito?chondrial transmembrane electric potential was detected by flow cytometry after JC?1 staining,the expression of Bax,Bcl?2 in mitochondrial and Cyt?C,AIF in cytosolic were determined by Western blot. Results The rate of osteoblast apoptosis and Bim expression in cells were both significantly in?creased with the dosage of dexamethasone,there was no significant difference between the groups in the expression of Bax;the rate of osteoblast apop?tosis after the expression of silence Bim was significantly lower than the negative control siRNA group and control group,the expression of Bax and Cyt?C,AIF in cytosolic were significantly reduced,and the mitochondrial transmembrane electric potential was increased. Conclusion Bim is the key molecules in hormone?induced apoptosis of osteoblasts ,the expression of silence Bim can inhibit dexamethasone induced osteoblasts apoptosis through the mitochondrial pathway.

Objective To evaluate the effectiveness of aspirin in preventing peripherally inserted central venous catheter (PICC) -related thrombosis. Methods Totally 360 cancer patients who had undergone routine PICC placement were equally randomized into aspirin group (receiving conventional PICC maintenance plus oral administration of aspirin; 100 mg/d, for consecutively 21 days) and control group (conventional PICC catheter maintenance). The incidences of phlebitis and thrombosis were observed in both two groups. Results The incidences of phlebitis and thrombosis were 3.3% and 0 in aspirin group, which were significantly lower than those in control group (8.9% , P = 0. 025; 1.7% , P = 0. 025). Conclusion The oral administration of aspirin after the PICC placement can reduce PICC-related thrombosis and phlebitis.