Functional delayed gastric emptying,also calls gastric paralysis,often occurs after abdominal operation,which severely affect patients prognosis.The mechanism,clinical manifestation,diagnosis,preservation and treatment are summarized in this review.

Objective To modify the anterior fixation technique for thoracolumbar fractures so as to reduce blood loss and improve the success rate of the first vertebral screw implantation. Methods Only surface artery of the injured vertebrae was ligated and the discs adjacent to the burst vertebra excised. Then,the mass autograft ilium was harvested with most cartilage terminal lamina left. The bursted vertebra was resected so that the vertebral canal could be decompressed thoroughly. Structural ilium graft was performed,followed by Z-plate being placed and locked. Results The modified operative technique was used to treat 87 cases,of which 76 cases of fresh thoracolumbar fracture had hemorrhage capacity about 400-800 ml (average 560 ml) as well as operation time for 2.5-3 hours,and 11 cases with old fractures had hemorrhage capacity about 800-1 200 ml (average 1 080 ml) as well as operative time for 3.5-4 hours. Eighty-one cases with kyphosis deformity was completely corrected,four cases had kyphosis deformity of 5?-8? and two lordosis. A total of 39 cases with post-operative paralysis basically recovered,28 partially recovered,nine recovered fractionally and 11 was beyond recovery. No aggravation was found in post-operative nerve syndrome. Conclusions The modified anterior fixation technique is excellent in reducing blood loss,shortening the operation time and increasing the success rate of the primary vertebral screw implantation. [

Aim To study the effect of IL-1β on pro-tein expression of vascular endothelial growth factor in glioma cells and plasma membrane microcapsule struc-ture protein caveolin-1 and plasma membrane vesicles in brain microvascular endothelial cells, and prelimi-narity discuss the possible mechanism of IL-1β opening blood tumor barrier. Methods The tumor barrier mod-el was established by transwell in vitro. The effect of IL-1β on the expression of VEGF in glioma cells and caveolin-1 in brain microvascular endothelial cells was dynamically monitored by Western blot. TEM was used to observe the number of plasma membrane vesicles of brain microvascular endothelial cells. Sodium fluores-cein leakage test was used to assess the permeability of blood tumor barrier after IL-1β. Results The tumor barrier model was successfully established by transwell in vitro. When IL-1β treated the model of blood tumor barrier,the expression of VEGF increased,and reached the peak at 60min,and recovered to the initial state at 120min. The permeability of the blood tumor barrier model was the highest at 60min. In addition,our re-sults also found that,the protein expression of plasma membrane microcapsule structure protein caveolin-1 and number of plasma membrane vesicles in brain mi-crocapsule endothelial cells reached peak at 60 min, subsequently reduced and returned to non drug state at 120min. Conclusion IL-1β increases blood tumor barrier permeability,which may be related to IL-1β in-creasing the number of plasma membrane vesicles through VEGF/ caveolin-1 pathway.

Objective To explore the features of subarachnoid hemorrhage (SAH) manifested as crescentshaped high density changes on brain CT.Methods The clinical data of 32 eases of tSAH similar to acute subdural hematoma ASDH were retrospectively analyzed.Results 2 cases of 3 receiving operation procedure were cured and 1 was slightly disabled.28 cases of 29 receiving non-operation treatment were cured and l was slightly disabled. Conclusion Because sometimes tSAH is featured as crescent-shaped high density image on brain CT,which will have a better effect through non.operation,so it is easily misdiagnosed as ASDH.

[Objective]To explore the operative method through the trans-upper-sternal approach in the treatment of the cervicothoracic spinal lesions and evaluate its clinical effects.[Method]From August 1999 to February 2006,11 cervicothoracic patients,8 males and 3 females,age ranged from 17 to 77 years with a mean of 41.5 years underwent the trans-uppersternal approach surgical treatment.There were four traumatic lesions,six tumors and one tuberculosis.The lesions were located at T3,C7~T1 and T1、2 in 1 case respectively,C7 and C6~T1 in 2 cases respectively,T1 in 4 cases.The combined cervicothoracic incision and upper sternotomy were performed for the exposure of the vertebral bodies,then tumor or vertebral body was resected,the spinal cord was decompressed,the spinal column was reconstructed and fixed.Neurologic status was assessed using the Frankel classification.[Result]The duration of follow-up ranged from 10 to 56 months with an average of 31 months.One patient developed chyle leakage of 50 ml one day after surgery and the leakage stopped 2 days after continuous drainage.One patient had transient vocal cord paresis which recovered in 3 months.All patients had their neurological improvement at different level.Nonunion or instrument-related complications were not observed,and the vertebral column had good stability.[Conclusion]The trans-upper-sternal approach gives an excellent exposure of the cervicothoracic junction.It is a technically simple,safe and effective method for anterior decompression,maintenance of anatomic alignment,fusion with bone graft and internal fixation with less complications and trauma.Attention should be paid to avoid injury of the recurrent laryngeal nerve and the thoracic duct.

Objective:To observe therapeutic effect of Xiaoyou Granule on Helicobacter Pylorum(Hp)related chronic gastritis.Methods:120 cases were randomly divided into 3 groups,40 cases in each group.They were treated respectively with Xiaoyou Granule,Weisu Granule and western medicine.Their therapeutic effects were observed.Results:Xiaoyou Granule was superior to the control group of TCM in improving clinical symptoms,eliminating inflammation of mucosa and the long-term therapeutic effect of removing Hp was superior to the control group of western medicine.Conclusion:Xiaoyou Granule has a definite therapeutic effect on Hp related chronic gastritis.

Objective To explore the relationship between methylenetetrahydrofolate reductase (MTHFR) 677C ＞ T and unexplained recurrent pregnancy loss (URPL).Methods All patients were recruited from the outpatient department of Obstetrics/Gynaecology & Genetics of Hangzhou First People's Hospital from January 2013 to May 2014.A case-control study was performed.According to the stochastic indicator method,there were 125 subjects with a history of ≥2 times URPL as the case group,and 905 healthy parous women with no history of URPL as the control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the distributions of the polymorphisms of MTHFR 677C ＞ T,and the results were validated using oligo-chip and direct sequencing.Results The allele and genotype frequencies of MTHFR were 60.0％ for C,40.0％ for T,32.0％ for CC,56.0％ for CT,and 12.0％ for TT in the case group and 67.4％ for C,32.6％ for T,41.4％ for CC,52.0％ for CT,and 6.6％ for TT in the control group,respectively.The prevalence of allele T was significantly higher in the case group than in the control group (OR =1.379,95％ CI =1.051-1.808,P =0.020),the frequency of genotype TT was also significantly higher in the case group than in the control group (OR =2.344,95％ CI =1.220-4.503,P =0.009).Conclusion The fertile women with MTHFR 677T allele and 677TT genotype may be susceptibility to URPL in a Chinese Han population from the Hangzhou area.

Objective To study if tumor retraction assessed by endiscopic uhrasonography (EUS) during radiotherapy has prognostic value in esophageal carcinoma, which may further predict the radiosensi-tivity. Methods The maximal tumor thickness was measured by EUS before radiotherapy and at 40 Gy in patients with esophaged carcinoma. Response was defined as at least 50% reduction in tumor thickness. Re-suits A total of 51 patients were included. The median follow-up time was 28.5 months. The median sur-vival time was 24.3 months. The treatment was radiotherapy alone, concurrent chemoradiotherapy and pre-operative treatment in 35, 10 and 6 patients, respectively. Tumor response was assessed by EUS in 18 pa-tients (34%). The 2-year overall survival (OS) and progression-free survival (PFS) were 69% and 59% for responders, comparing with 37% and 29% for non-responders (χ~2= 5.78, P = 0.016 and χ~2= 3.97, P =0.046, respectively). In radiotherapy alone group, the 2-year OS and PFS were significantly higher in responders (n = 11) comparing with non-responders (n =24)(60% vs 44% ,χ~2 =5.84,P =0.016 and 20% vs 10% ,χ~2 =4.20, P =0. 040). In preoperative radio (chemo) therapy group (n =6), pathological-ly complete response, partial response and minimal response were observed in 4, 1 and 1 patients, respec-tively. EUS detected tumor response in 4 of 5 (80%) patients with tumor regression, and non-response in 1 of 1 patient without tumor regression. Conclusions The prognosis is better in patients with esophageal car-cinoma responding to neoadjuvant treatment identified by EUS than that of non-responders.

A sensitive and reliable liquid chromatography-electrospray ionisation-tandem mass spectrometry (LC-ESI-MS/MS) method was established to simultaneously quantitate four categories of compounds (isoflavonoids, flavonoids, alkaloids and saponins) in Gegen-Qinlian decoction (GQD). These compounds were separated by a Shiseido CAPCELL PAK C18 column with a linear gradient consisting of 0.1% (v/v) formic acid in water (A) and 0.1% (v/v) formic acid in acetonitrile (B), and delivered at a flow rate of 0.3 mL/min. All the analytes were determined by electrospray positive ionization tandem mass spectrometry in a multiple reaction monitoring (MRM) mode. Linearity, accuracy, precision, recovery and stability of the method were evaluated with the validation over the range of 4.0-538 5 ng/mL. The proposed method was applied to the analysis of a Chinese herbal preparation GQD successfully.

AIM: To study the pharmacokinetics of flavonoids in mice after ig administration of Xiexin Decoction (Radix et Rhizoma rhei, Rhizoma coptidis, Radix Scutellariae). METHODS: Mice were given a single ig dose of Xiexin Decoction 4.5, 9.0 or 18.0 g/kg. Flavonoids in plasma were analysed by HPLC and plasma concentration of baibalin was determined. Pharmacokinetic parameters were calculated from the plasma concentration-time data with the DAS software package. RESULTS: After ig administration of Xiexin Decoction in mice, baicalin, baicalein and another flavonoid were detected in plasma and baicalin concentration was the highest of the three kinds of flavonoids in plasma. After a single ig dose of Xiexin Decoction 4.5, 9.0 or 18.0 g/kg, the pharmacokinetic parameters of baicalin were as follows:T_ 1/2 =2.77、5.69、6.20 h,AUC_ 0-∞ =9.09、23.49、39.57 ?g?h/mL,CL= 12.52 、 6.962 、 11.50 L?h/kg,V_d= 50.11 、 79.56 、 102.95 L/kg,C_ max1 =1.89、3.32、4.79 ?g/mL(T_ p1 = 0.08 h ), C_ max2 =1.46、2.57、4.16 ?g/mL(T_ p2 =3 h), respectively. CONCLUSION: Three kinds of flavonoids can be absorbed after ig administration of Xiexin Decoction in mice, of which baicalin is the major component.