Objective To investigate the difference in detection results of electrolytes and glucose among arterial blood plasma , venous blood plasma ,arterial blood serum and venous blood serum .Methods Arterial and venous anticoagulation blood and coagu‐lation blood were collected from 54 patients at the same time ,1 tube for each blood sample .The corresponding plasma and serum were isolated .The levels of K+ ,Na+ ,Cl-and glucose(GLU) were determined by using the Johnson VITROS 5600 automatic dry biochemical analyzer .The detection results were performed the comparative analysis by using the statistical method .Results When the sample was serum ,the concentrations of Na+ ,Cl- ,GLU and serum K+ had statistically significant difference between arterial and venous blood(P<0 .05) ,when the sample was plasma ,the concentrations of Na+ ,Cl- and GLU had statistically significance between arterial and venous blood(P<0 .05);but the K+ concentration had no statistically significant difference between serum and plasma(P>0 .05) .In addition ,the GLU and K+ detection results had statistical difference between arterial serum and plasma(P<0 .05) ,while the Na+ and Cl- detection results had no statistically significant difference(P>0 .05);similarly ,the GLU and K+ de‐tection results had statistical difference between venous plasma and serum (P<0 .05) ,while the Na+ and Cl- detection results had no statistical difference(P>0 .05) .Conclusion Some differences in the detection results of electrolytes and glucose exist among ar‐terial plasma ,venous plasma ,arterial serum and venous serum ,clinic should pay attention to make a difference among different types of sample and establish the suitable reference ranges .have certainly difference in different types of specimens even detected by the same system .So we recommend that appropriate reference range is necessary for various kinds of specimens .

Objective To evaluate and compare open and retroperitoneal laparoscopic adrenalectomy.Methods Clinical data of 30 cases undergoing open adrenalectomy and 119 cases undergoing retroperitoneal laparoscopic surgery were retrospectively analyzed. The 2 groups were compared in terms of these aspects: operation duration, intraoperative blood loss, postoperative analgesic use, time to remove drainage tube, time to resume eat, postoperative hospitalization time, complications, and tumor recurrence. In open surgery group, tumor diameter was between 0.5 cm -10.8 cm, 4.57 cm in average. 18 tumors were located on the left side and 12 tumors on the right side. In laparoscopic group, tumor diameter was between 0.8 cm -14.5 cm, 2.78 cm in average. 59tumors were located on the left side and 60 tumors on the right side. Patients in open surgery group were followed up for 6-72 months and retroperitoneal laparoscopic group 4-20 months. Results Open adrenalectomy were successful in all the 30 cases. 12 cases in laparoscopic surgery group converted to open surgery among whom 8 cases were due to poor visibility, 1 case due to renal artery injury, 1 case due to large tumor size, 1 case because of diaphragmatic injury and 1 case because of pleural injury. Laparoscopic surgery was superior to open surgery in terms of operation duration, intraoperative blood loss, postoperative analgesic use, time to start food taking, time to remove drainage tube, and postoperative hospitalization time. The difference had statistical significance (P ＜0.05 ). Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages such as less trauma, less blood loss, and shorter recovery time, which make this procedure the modern golden standard for treatment of benign adrenal neoplasm.

Objective To investigate the better radiation modalities for single and multiple brain metastases.Methods Between July 2005 and July 2008,50 patients with single or multiple brain metastases were retrospectively analyzed.The primary cancer of all patients were controlled.Thirty patients with whole brain radiotherapy and stereotactic radiosurgery were included in the combination group,and 20 patients with stereotactic radiosurgery were included in another group.Stereotactic radiosurgery prescription doses of 45％-75％ isodose line were used to wrap around the planning target,which was 15-20 Gy in edge and 30-45 Gy in center.Stereotactic radiosurgery was performed once.Whole brain radiotherapy total dose was 40 Gy,which was given to patients by 2 Gy in 1 fraction,1 fraction every day,5 times every week.Results The efficient rate of combination group was 90％ (27/30),and single group was 60％ (12/20).It was obviously higher in combination group (x2 =6.294,P =0.012).For combination group,the 1-year survival rate was 50％ (15/30) and the 2-year survival rate was 30％ (9/30).However,for another group,the 1-year survival rate was 35％ (7/20) and the 2-year survival rate was 15％ (3/20).The survival rates of two groups were no difference (x2 =1.096,P =0.295 ; x2 =1.480,P =0.224).There were no patients survived more than 3 years in both groups.Stratified analyses showed that the l-year survival rates of the patients with single brain metastasis were no difference in two groups (100.0％ vs 66.7％,x2 =1.556,P =0.212).Whereas the 1-year survival rate in combination group of the patients with multiple brain metastases was higher than that in single group (42.3％ vs 29.4％,x2 =11.023,P =0.001).There were no statistically significant differences in 2-year survival rates in both groups with single and multiple brain metastases (75.0％ vs 66.7％,x2 =1.200,P =0.273 ; 23.1％ vs 5.9％,x2 =3.782,P =0.052).Conclusion Whole brain radiotherapy and stereotactic radiosurgery are important treatment modalities for single or multiple brain metastases.The optimal treatment modality for single brain metastasis is stereotactic radiosurgery,while it is a good choice to make whole brain radiotherapy and stereotactic radiosurgery for multiple brain metastases.

Objective To investigate therapeutical methods on lumbar disc herniation with posterior edge separation of the vertebral body. Methods Different methods were applied to 31 patients, including 24 males and 7 females whose ages ranged from 18 to 61 years. Except that 2 patients with mild lumbar pain were treated with conservative therapy, the other 29 patients were treated with operation. The operations were made according to the relationship between compressive hernia and vertebral canal. For instance, for cases that the herniated mixtures were lateral, decompression with fenestration or amplified fenestration was applied to the trouble side; for cases that mixtures were central or paracentral, the same treatment was applied to both sides; and posterior lumbar interbody fusion(PLIF) or transforaminal lumbar interbody fusion (TLIF) was applied to those that the mixtures occupied most part of the front canal. Results The follow-up studies were made for all the patients for 1 to 4 years with an average period of 2.6 years. For the two patients treated with conservative therapy, one was fully recovered and the other, who took no effect from former therapy, was finally recruited after decompression with fenestration on the trouble side. Among the patients who were treated with operation, those with lateral herniated mixtures received significant effect, while only 60% of those with central or paracentral mixtures recovered (the unrecovered or even worsened patients after operation finally recruited by PLIF), and for those with mixtures occupying most part of the front canal, satisfactory effect were achieved. Conclusion Operation treatment should be applied to patients as early as possible when conservative therapy has no obvious effect. Different operation methods should be taken according to the relationship between compressive hernia and vertebral canal: 1) Decompression with fenestration or amplified fenestration on the trouble side be applied to those with lateral herniated mixtures; 2) Decompression with fenestration on both sides be applied to those with paracentral mixtures but no lateral crypt narrowness, and PLIF or TLIF to those with central mixtures or lateral crypt narrowness; 3) PLIF or TLIF be applied to those with mixtures occupying most part of the front canal.

Objective To explore the effect of low calorie metabolism on the survival of HeLa cells exposed to X-rays,and the influence of starvation on the antioxidative factors in the blood of rats after irradiation.Methods MTT method was used to evaluate the impact of different concentration glucose on the proliferation of HeLa cells.Colony formation assay was employed to detect the influence of glucose ( 1,5,10 and 25 mmol/L) on radiosensitivity of HeLa cells. Flow cytometry assay was used to analyze distribution of cell cycle and apoptosis.60 male SD rats were randomly divided into 6 groups with 10 rats each.Rats in every two groups were fed ad libitum,fasted for 24 h and fasted for 48 h,respectively.Rats in one group of each approach were respectively exposed to whole-body X-rays at 11 Gy. At 2 h after irradiation,all of rats were sacrificed and their venous blood was collected.Elisa kits were used to detect superoxide dismutase (SOD) and total antioxidant capacity (T-AOC).Results An increased viability was observed in HeLa cells treated with the glucose at low concentration ( ＜25 mmol/L),while HeLa cell growth was inhibited by glucose at doses of ＞25 mmol/L. Relevant to cells treated with 1 mmoL/L glucose,SERs (sensitive enhancement ratio) in cells exposed to 5,10 and 25 mmol/L glucose were 1.07,1.10 and 1.23,respectively. A reduction of G2/M and S arrests and apeptosis caused by 6 Gy X-ray irradiation were observed [(49.68 ±1.88)％ and (35.54±1.45)％ at G2/M phase,(16.88 ±1.22)％ and (10.23 ±1.65)％ atS phase,t=10.42,5.61,P＜0.05]and in the cells treated with 1 mmol/L glucose compared with cells treated with 25 mmol/L glucose [ ( 25.50 ± 0.95 ) ％ and (7.56 ± 1.07 ) ％,t =21.72,P ＜0.05 ].Without irradiation,calorie restriction exhibited a negligible influence on SOD and T-AOC in rats.However,after 11 Gy irradiation,compared with rats fed ad libitum,the levels of SOD and T-AOC were significantly increased in rats with calorie restriction ( t =40.32,42.78, P ＜ 0.05 ).Conclusions Calorie restriction has a certain radioprotective effect in vivo and in vitro.

Objective: To investigate into the etiological factor,distribution of syndrome(patterns),pathogenesis features as well as the curative effects of small compound prescriptions of(Traditional) Chinese Medicine(TCM) in the treatment of acute stroke in stroke unit.Methods:(Cases) corresponding to diagnosis standards were randomly divided into control group(102 cases) and treatment group(156 cases).Conventional treatment methods were given to cases in control group.On the base of control group,small compound prescriptions were added to in treatment group,successively 14-21 days.The relation between types and time and TCM scale(TCMS),the NIH stroke scale(NIHSS) and Barthel index(BI) were observed in the two groups.Results: Stroke was age-related,the older,the more stroke patients.Stroke was closely related to hypertension.Ascending hyperactivity of liver yang was main type in the previous three days,this type(decreased) with the time going on.On the contrary,the type of wind phlegm and blood stasis was secondly main type in the previous three days,it increased with the time going on.Types of ascending hyperactivity of liver yang,wind phlegm and blood stasis as well as phlegm heat and constipation covered 95 per cent of all patients in the previous 21days.In the two groups,the mean scale of TCM and NIH decreased,and BI increased after treatment,this statistical difference could also be seen between the two groups.Conclusion: Excessive types are main types in the acute stage of stroke.Types of ascending hyperactivity of liver yang,wind phlegm and blood stasis as well as phlegm heat and constipation are its main types.Transferring of ascending hyperactivity of liver yang into endogenous wind may be trigger of reaction link of wind,fire,phlegm and blood stasis in TCM theory.Small compound prescriptions of TCM aiming to clearing away liver fire to stop wind,to activate blood for removing blood stasis and phlegm,to removing phlegm and heat from discharge can reduce scale of TCM and NIH,increase BI in the treatment of patients in stroke unit,which provide beneficial proofs for evaluation of effects of TCM.

Objective To establish a high performance liquid chromatography method to detect the concentration of lamotrigine in blood dialysate and investigate in vitro recovery of lamotrigine and the factors.Select the microdialysis conditions that apply to the animal experiment and guide the stability study of in vivo recovery.Methods Positive dialysis and retrodialysis were used for the examination of lamotrigine in vitro recovery and the influencing factors such as flow rate, concentration, temperature and time.Filtered out the best conditions that apply to the in vivo experiment.Used the retrodialysis to determine the in vivo recovery and its stability.Results There was no significant difference between relative recovery and relative loss in the same flow rate.The concentration had no obvious effect on relative recovery.At the same condition,relative recovery decreased with the increase of the flow rate and increased with the temperature.The in vivo recovery had a good stability of 6.5 hours when the flow rate and stabilization time were set at 2μL/min and 1.5 h, respectivily.Conclusion Microdialysis technique can be used for the pharmacokinetic study of lamotrigine.Retrodialysis can be used for the determination of the lamotrigine in vivo recovery.

? AIM: To investigate the differences between synoptophore and triple prism strabismometry and its possible cause.?METHODS: There were 347 patients with horizontal concomitant strabismus involved, in which 76 patients were esotropia, 37 patients were male while 39 were female, with average age of 13. 27 ± 7. 77 years old. There were 271 patients with exotropia, 131 cases were male while 140 were female, with average age of 15. 43 ± 8. 42 years old. All the patients were examined by synoptophore and prism plus shaded strabismometry in a long distance of 6m. Datas were analyzed by SPSS 17. 0.?RESULTS:In the exotropia patients, the conversions of circular degree(°) and prism degree(△) were:1°=0. 29△ ~1. 78△, which was statistically significant with intermittent strabismus (P=0. 001). While in the esotropia patients, the conversions were:1°=2. 01△ ~2. 15△.?CONCLUSION: The diversity between the two methods is enlarged with the increase of squint angle for exotropia patients. While in esotropia patients, the diversity decreased with the increase of squint angle. Synoptophore equipped with +7. 00D, defects of the triple prism itself and proximal convergence during exam may be the reasons for the diversity.

Background Diabetic retinopathy (DR) is a chronic inflammatory disease,with pathological changes of retinal microvessels.Studies demonstrated that sericin has anti-inflammation and anti-oxidation effects,inferring that sericin might play a protective effect on diabetic microangiopathy.Objective This study was to investigate the effects of sericin on intercellular adhesion molecule-1 (ICAM-1),vascular cell adhesion molecule-1 (VCAM-1) and Cx43 expressions in retina and explore the protection of sericin to retinal microangiopathy in diabetic rats.Methods Forty-eight specific pathogen free male SD rats were randomly divided into normal control group,diabetic model group,sericin-treated group and calcium dobesilate-treated group,with 12 rats for each group.The diabetic models were established by intraperitoneal injection of streptozotocin (STZ) for 3 consecutive days and feeding up with high lipid foods.Normal saline solution,2.4 g/(kg · d) sericin solution and 0.2 g/(kg · d) calcium dobesilate were used by gavage administration in the rats of the diabetic model group,sericin-treated group and calcium dobesilate-treated for 3 months group,respectively.The rats were sacrificed and retinal sections were prepared,and the retinal morphology was examined by hematoxylin-eosin staining.The expressions of ICAM-1,VCAM-1 and Cx43 proteins and mRNA in retinas were detected by Western blot assay and reverse transcription PCR.The use and care of the rats complied with Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission and ARVO statement.Results The retinal structure was normal in the normal control group.The swell and rupture of inter limiting membrane (ILM),scatter vascular endothelial cell nuclei breakthrough ILM and decrease of retinal ganglion cells (RGCs) were displayed in the diabetic model group;while in the sericin-treated group and calcium dobesilate-treated group,the mild thickening of ILM and disorder of retinal cells were obtained.The relative expression levels of ICAM-1 and VCAM-1 were significantly raised and those of Cx43 were reduced in the diabetic model group,sericin-treated group and calcium dobesilate-treated group when compared with the normal control group (all at P＜0.05).Compared with the diabetic model group,the expressions of ICAM-1 and VCAM-1 proteins and mRNA in the sericin-treated group were significantly reduced (ICAM-1 protein:0.834 3±0.032 1 vs.0.918 9±0.042 4;VCAM-Ⅰ protein:0.726 4±0.011 2 vs.1.235 0±0.078 9;ICAM-1 mRNA:0.716 3±0.008 6 vs.0.956 8±0.012 5;VCAM-1 mRNA:0.393 7±0.035 0 vs.0.477 9±0.020 6) and those of Cx43 protein and mRNA were evidently elevated (Cx43 protein:0.133 1 ±0.015 3 vs.0.039 2±0.002 0;Cx43 mRNA:0.676 8 ±0.064 8 vs.0.430 8±0.111 3) (all at P＜0.05).Conclusions Sericin can relieve retinal microangiopathy and protect retina against the pathogenesis and development of DR by down-regulating the expressions of ICAM-1,VCAM-1 and upregulating the expression of Cx43 in retinas of diabetic rats.

Objective To investigate the clinicopathologic and immunohistochemical characteristics of breast carcinosarcoma with osteosarcoma components and its differential diagnosis. Methods The pathologic features and clinical manifestations of the two patients were retrospectively reviewed. Immunohistochemistry was performed and the literature was reviewed. Results Histopathologically, the neoplasm consisted of invasive ductal carcinoma of no special type and poorly ( case 1 ) or well (case 2) differentiated osteosarcomatoid elements. The morphological transition from carcinoma to sarcomatoid elements was seen. Immunohistochemically,the carcinoma cells were positive for CK and EMA , the sarcomatoid elements were stained positive for vimentin, and a few cells of two elements were positive for S-100 protein. Ki-67 and VEGF were over expressed in both elements of Case 1.In case2 Ki-67 expression was low in both elements and VEGF over expression was only seen in sarcomatoid elements. Some of the carcinoma cells were positive for ER. Conclusions Carcinosarcoma of the breast with osteosarcomatoid elements is a rare type of mixed epithelial/mesenchymal metaplastic breast carcinoma. The types and proportion of carcinoma and sarcomatoid elements determine the diagnosis.