Objective To illustrate the relationship between the temporary alteration of renal functions of rats with obstructive jaundice due to ischemia reperfusion injury(RI) and lipid peroxidation and the expression of heat shock protein 70 in rat kidney. Methods Wistar rats were divided into 4 groups of sham operation group(S group), sham operation and renal RI group(SRI group), common bile duct ligation group(J group), common bile duct ligation and renal RI group(JRI group). One week after bile duct ligation, rat bilateral renal arteries were transiently occluded for 10 minutes. The variations of renal function were observed at different time phases after renal reperfusion. Simultaneously, the expression of heat shock protein 70 in kidney was evaluated by immunohistochemistry. Results In JRI group, endogenous creatinine clearance rate(Ccr) decreased progressively along with the prolongation of the duration of reperfusion. In J and JRI groups, the level of malondealdehyde(MDA) in renal tissue increased but superoxide dismutase(SOD) decreased. In JRI group, the expression of heat shock protein 70 reached its peak at the 4th hour after reperfusion and began to decrease at the 12 th hour and became lowest at the 24 th hour. No expression of HSP70 was found in other groups. Conclusion The sensitivity of rat kidneys with obstructive jaundice to ischemia reperfusion injury is significantly elevated. Ischemia reperfusion injury, as well as lipid oxidative stress, may be involved in acute renal failure(ARF) after obstructive jaundice surgery. The expression of heat shock protein 70 is a protective response to RI.

With the child behavioral questionnaire developed by Rutter,39 Chinesechildren(group 1-C),27 Japanese children(group 1-J)and 87 South Korean children(group1-S)were identfied as with behavioral problems,together with matched norman children of27 from China(group 2-C),30 from Japan(group 2-J)and 26 from South Korea(group 2-S)respectively,to engage in this EEG study.In a comparison between behavioral problemschildren and normal ones in each country no significant difference was found in EEG data.However,in the comparison among group 1s,group 2s and ADD-H children(group 3s:41from China as group 3-C,21 from Japan as group 3-J and,29 from South Korea as group3-S)diagnosed clinically with DSM-Ⅲ,significant difference among groups was found inEEG analyses in each country respectively.Some index of slow wave of group 3s'EEG weremuch higher than that of normal ones(group 2s).EEG data from group 3-C and gruop 3-Jshowed that the frequency-peak moved to slow frequency area.This indicates the develop-ment of ADD-H may associate with some functional abnormalities of nervious system.

Objective To compare the curative effects between one‐stage anterior debridement bone graft fusion and posteri‐or fixation fusion combined with anterior debridement bone graft fusion in the treatment of multiple lower thoracic spinal tuberculo‐sis .Methods A total of 62 patients with multiple lower thoracic spinal tuberculosis in our hospital from March 2002 to March 2010 were treated by the anterior debridement bone graft fusion ,including 32 cases of anterior internal fixation by one screw‐rod system (group A) and 30 cases of posterior internal fixation by two nail‐stick systems(group B) .The cure rate ,operation time ,bleeding volume ,the Cobb′s angle and recovery situation of spinal cord injury were compared between the two groups .Results All patients were followed up for 24-36 months (average 28 months) and showed successful bone graft fusion .In the Frankel classification e‐valuation at postoperative 12 months ,the improvement rate of spinal cord injury was 76 .92% (10/13) in the group A and 81 .82%(9/11) in the group B ,showing no statistically significant difference (χ2 =0 .087 ,P>0 .05) .The total cure rate was 84 .38% (27/32) in the group A and 85 .48% (26/30) in the group B ,showing no statistically significant difference (χ2 =0 .066 ,P>0 .05) .The Cobb′s angles before operation ,immediately after operation and at the last follow‐up were (28 .16 ± 4 .16)° ,(5 .03 ± 3 .24)° and (8 .81 ± 2 .44)° in the group A and (26 .83 ± 5 .41)° ,(5 .50 ± 3 .03)° and(8 .06 ± 2 .45)° in the group B ,showing no statistically sig‐nificant difference (t=1 .038 ,t=0 .588 ,t=1 .200 ,all P>0 .05) .The operation time was (171 .31 ± 12 .84)min in the group A and (219 .23 ± 21 .44)min in the group B ,showing statistically significant difference (t=10 .754 ,P<0 .05) .The bleeding volume was (341 .25 ± 76 .10)mL in the group A and (440 .67 ± 67 .16)mL in the group B ,showing statistically significant difference (t=5 .439 ,P<0 .05) .Conclusion One‐stage anterior debridement ,and anterior or posterior internal fixation for treating multiple lower thoracic spinal tuberculosis can obtain the better curative effect ,but selecting case is very important .

To explore and identify the therapeutic components of traditional Chinese medicine (TCM) as a complex intervention through grounded theory, and the correlation and interaction within this model and the possible effects that they may have on the therapeutic effects of TCM.

Clinical trials play a critical role in medical research. However, only a few clinical trials conducted at present have been registered at various clinical trial registries. Clinical trial registration can prevent bias in these registered trials effectively and avoid unnecessary waste of resources due to meaningless repeats. Moreover, it will benefit the development of evidence-based medicine, and promote human welfare. Great attention has been paid to the importance and necessity of clinical trial registration. This review briefly introduced the definition, justification, contents, history, current status of clinical trial registration, and introduced the information regarding important international clinical trial registries in detail. Clinical trial registration should be developed toward a transparent, compulsory and comprehensive stage.

Objective To investigate the clinical short-term outcomes after laparoscopic total mesorectal excision (TME)for rectal cancer in China.Methods A systematic literature searching was performed to identify all randomized controlled trial(RCT) studies or well-designed retrospective studies on laparoscopic surgery(LS) and open surgery(OS) for rectal cancer published from January 2003 to October 2010 in China.Two reviewers independently screened and extracted the data.The reports which matched the inclusion criteria were analyzed with Revman 5.2.Results A total of 17 RCT studies and 3 retrospective studies (2246 patients)was included in this study.The basic features of 2 groups were balance.Compared to group OR,the incidence of complications such as postoperative wound infection (RR =0.30,95 ％ CI:0.17 ～0.54,P ＜ 0.01),pulmonary infection (RR =0.47,95％ CI:0.25 ～0.91,P ＜0.05),and ileus (RR =0.41,95％ CI:0.19 ～0.88,P ＜0.05)were significantly lower in group LS.No difference was observed in the incidence of peritoneal abscess(RR =0.78,95％ CI:0.38 ～ 1.60,P ＞0.05),anastomotic leakage(RR =0.66,95％ CI:0.38 ～ 1.16,P ＞0.05),and uroschesis(RR =0.57,95％ CI:0.26 ～ 1.25,P ＞0.05).Furthermore,parameters of postoperative recovery were compared between groups,LS group manifested early recovery.Conclusions Laparoscopic total mesorectal excision for rectal cancer,with minimal invasion,benefits the postoperative recovery and reduces incidence of complications.LS radical resection of rectal cancer is technically feasible,safe,and prospectively favorable.

In recent years, there were several extreme conflicts between doctors and patients in Otorhinolaryn-gology department. Medical field always contributes the disputes to medical system and patients′quality, however, the public blames the doctors′morality. This article analyzes these incidents in the perspective of ethics and social medicine, trying to find the causes. And it puts forward the countermeasures in terms of medical education, hospi-tal, and the medical personnel.

It has been confirmed that tumor invasion and metastasis is not only dependent on the charac -teristics of the tumor ,but also dependent on the tumor microenvironment .Tumor-associated macrophage ( TAM) , which constitutes a large number of the tumor -infiltrating immune cells,is stimulated into M1 macrophage and M2 macrophage by different signals in the tumor microenvironment .Whereas the vast majority of studies with nu-merous tumor types show that the presence of M 2 phenotypes in the tumor microenvironment is associated with a worse prognosis ,most studies in gastric cancer also claim the same results .Hypoxia and coagulation factors may both contribute to it .It has identified that the function of TAM could be changed with their location of tumor ,but it has nothing to do with cell differentiation and cell type of gastric cancer .In this review,we summarize the differ-ent and controversial effects of TAM in gastric cancer .

With the application of drug eluting stent implantation in coronary intervention, the safety and effectiveness of surgical treatment of obstructive coronary artery disease have has been improved, while the postoperative complications still appear to be a concern. In recent years, studies have found that in-stent neoatherosclosis may be an important factor in the development of late stent failure. And with the development of imaging techniques, the in-stent neoatherosclosis after drug eluting stent implantation has been further recognized. However, the mechanism of the development of in-stent neoatherosclosis is still not very clear.

Objective To evaluate the effect of permissive hypercapnia on pulmonary function and in-flammatory responses of the collapsed lung of patients underwent video-assisted pulmonary lobectomy after one-lung ventilation.Methods Fifty patients,aged 38-65 years,ASA Ⅱ or Ⅲ,including 30 males and 20 females,scheduled for video-assisted pulmonary lobectomy were selected and divided into two groups ran-domly,with 25 patients in each group.During the surgery,PaCO2 of patients in group C were maintained during 35 to 45 mm Hg,while in group H the value were 55 to 65 mm Hg.The arterial blood samples were collected at 1 min before one-lung ventilate (T1 ),30 min after one-lung ventilate (T2 )and 30 min after re-flow of the collapsed lung (T3 )for arterial blood gas analysis,then the respiratory index of each patient was evaluated.Peripheral venous blood and bronchoalveolar lavage fluid draw from left lower lobar of the col-lapsed lung were collected to evaluate the levels of TNF-α,IL-6,and IL-10 at T1 ,T2 and T3 .The peak in-spiratory pressure,plateau pressure and tidal volume were also recorded to calculate lung dynamic compli-ance.Results Compared to group C,peak inspiratory pressure of group H was significantly higher;the IL-10 level of bronchoalveolar lavage fluid of the collapsed lung and the pulmonary dynamic compliance of group H were significantly higher at T2 and T3 ,and the concentrations of TNF-α,IL-6 of bronchoalveolar lavage fluid,the peak pressure,and respiratory index of group H were lower significantly at the same point of time (P <0.05).Conclusion Permissive hypercapnia would inhibit inflammation response of collapsed lung after one-lung ventilation effectively,improve lung diffusion capacity and pulmonary compliance.