Objective To evaluate the application of fast track surgery (FTS) in the rib internal fixation of multiple rib fractures. Methods Forty-eight chest trauma with multiple rib fractures patients from March 2008 to March 2010 were divided into FTS group and traditional care group randomly. Meanwhile two groups accepted FTS and conventional management of perioperative period respectively. The degree and duration of the chest pain, early exercise tolerance, intravenous infusion time, the length of postoperative hospital stay,chest scar and postoperative complications were observed and compared between the two groups. Results The duration of chest pain was significantly shorter in FTS group than in the traditional care group([ 112. 46 ±23. 24 ] mins vs [ 180. 23 ± 51.56 ] mins, t = 4. 23 ,P ＜ 0. 05); the early exercise tolerance was longer([ 68. 35 ±9. 30 ] mins vs [ 33.48± 5. 18 ] mins,t = 2. 87, P ＜ 0. 05) ;the intravenous infusion time was shorter ([ 10. 83 ±1.87 ] d vs [ 13. 30 ± 2. 12 ] d, t = 2. 38, P ＜ 0. 05); the length of postoperative hospital stay was shorter([ 12. 35 ± 2.03 ] d vs [ 16. 48 ± 3. 18 ] d, t = 3.04, P ＜ 0. 05); the less postoperative complications(8.3% vs 37. 5 %, x2 = 5. 005,P ＜ 0. 05); chest pain was relieved([ 3.43 ± 0. 45 ] cm vs. [ 6. 62 ± 0. 62 ] cm, P ＜ 0. 05);the scar healed well. All patients were successfully discharged. Conclusion The perioperative idea of fast track surgery was feasible and effective in the chest trauma with multiple rib fractures patients. FTS can improve the patients long term living quality.

Objective To investigate prognostic factors for gastric cancer patients with liver cirrhosis.Methods The clinicopathological data of 52 gastric caner patients with liver cirrhosis operated on between March 1994 and March 2006 were analyzed retrospectively and the prognostic factors were evaluated.Significant factors were then entered into a Cox regression analysis.Results The postoperative 1-3- and 5- year survival rates for these 52 patients followed up were 78％,44％ and 33％.Univariate analysis revealed that age,Borrmann type,histology timue typing,tumor size,pTNM stage,Child-pugh grade,postoperative complications,ascites,and albumin level were statistical significance for survival rate (P ＜ 0.05 ).Multivariate analysis demonstrated that pTNM stage,Child-pugh grade,ascites were independent prognostic factors affecting prognosis( P ＜ 0.05 ).The risk of Child-pugh grade is 3.005,the risk of pTNM is 1.594.Conclusions Compared with pathological disease stage of the gastric cancer,liver function affects more on the prognosis of cirrhotic gastric cancer patients undergoing gastrectomy.In Child-pugh grade B or C cases,postoperative liver dysfunction was the main concern.While those of Child-pugh grade A should undergo standard D2 gastrectomy.

Objective To evaluate laparoscopy assisted radio frequency ablation (LRFA) and percutaneous radiofrequency ablation ( PRFA ) for the treatment of hepatocellular carcinoma ( HCC ).Methods A total of 525 HCC patients were enrolled,including LRFA group of 78 cases with 106 tumor nodules,and PRFA group of 447 cases with 565 tumor nodules.Results ( 1 ) In LRFA group complete ablation rate was 97.17％ (103/106); in LRFA group complete ablation rate was 93.09％ (526/565)(x2 =2.523,P =0.112).(2)The 1,3,5 year overall survival rate was 96.15％,55.12％ and 38.46％in LRFA group and 93.73％,48.54％ and 31.54％ in PRFA group respectively ( x2 =0.699,1.151,1.447 ; P =0.403,0.283,0.229 ).The 1,3,5 year disease-free survival rate was 94.87％,43.58％ and 28.21％ in LRFA group and 93.73％,48.54％ and 31.54％ in PRFA group respectively (x2 =0.915,0.303,0.174; P=0.339,0.582,0.676).The average disease-free survival time was 22.25 months in LRFA group and 21.53 months in PRFA group respectively.(3)The serious complications was 0％ (0/78)in LRFA group and 1.34％ ( 6/447 ) in PRFA group respectively.( 4 ) Recurrence rate was 23.07％(18/78) in LRFA group,and 34.89％ (156/447) in PRFA group ( x2 =4.189,P =0.041 ).Conclusions The therapeutical effect of LRFA equals that of PRFA,while enjoying lower recurrence rate,no serious complications and higher treatment safety.

Objective To systematically review the current research status of negative pressure wound therapy in China based on method of evidence-based medicine (EBM). Methods A systematic retrieval was undertaken on literatures related to negative pressure wound therapy in China. Evidence grading of EBM and quality rating system of preventive service task force were used for evaluation of the results. Results We finally retrieved five randomized controlled trials (RCT), of which only one RCT was classified as good quality and high grade of evidence, whereas the other four were classified as poor quality and low grade of evidence. Conclusions With relatively wide indications, there still lack sufficient evidences to witness the clinical efficiency of NPWT in China. in the future, we should further researches on NPWT including emphasizing on novelty of research topics and intactness and usefulness of experimental design and standardize clinical application of such technique including standardization of treatment procedures. In the meantime, high quality research papers are needed to provide certain guidance for clinical therapy.

Objective To investigate the allngeneic bone marrow mesenchymal stem cells (mesenchymal stem cells, MSCs) transplantation on cardiac rehabilitation and cardiac function after acute myocardial infarction (AMI). Method Acute myocardial infarction models were made by ligating the left anterior descending coronary artery of rats. A total of 90 rats were randomly divided into the cell transplantation group and control group, 45 rars in each group. Rats in the cell transplantation group were subdivided into 3 groups according to the administration time of the allogeneic bone marrow mesenchymal stem cells (2 weeks, 4 weeks and 12 weeks), and the control group was subdivided the same as in the cell transplantation group. The success criteria included the anterior my-ocardial wall darked and the Sr-segment elevation. The rat femur bone marrow cells were separated using centrifu-gal method, mononuclear cells were isolated by lymphocyte fluid, and the third generation of mesenchymal stem cells were obtained by washing, culture, passage and marked by 4, 6 diacetyl-2-phenyl Indole (DAPI). The ani-mals' chest was opened again a week later, the stem cell suspension was injected into the border zone of infarct area, and the control group was injected with medium. Pre-operative,2 weeks, 4 weeks and 12 weeks after trans-plantation, cardiac function was tested by ultrasonic, myocardial biopsy was observed by HE conventional staining, cardiac stem cells division were observed by immunofluorescence. All data was analyzed by software SPSS 10.0, Independent-Samples T test and Chi-Square test was used, and P≤0.05 was considered as statistically signif-icant. Results The markered hone marrow mesenchymal stem cells were left in the myocardial cells and differen-tiated to eardiomyocyte-like cells. After 12 weeks, the left ventricular internal diameter of rats in cell transplanta-tion group was about (0.58±0.09) mm(P<0.05). Thickness of myocardial infarction zone was (0.25±0.01) mm (P<0.05),ejection fraction was (67.52±0.61) (P<0.05) and left ventricular fractional shortening was (39.86±3.00) (P<0.05). In the transplantation group, the DAPI marked nucleus presented as blue, and the cytoplasm of myocardial cell presented as green. HE staining showed that, in the cell transplantation group, there was less scar tissue and a large proportion of nuclear, similar to the fetal or newhom myocardium cells. Conclu-sions The homogeneus mesenchymal stem cell could repair myocardial infarction and improve cardiac function af-ter infarction.

Objective To explore the feasibility of using Zeocin resistance as a new positive selection marker for the genetic manipulation of Candida albicans (C.albicans).Methods The susceptibility of C.albicans strain CAI4 to Zeocin was determined using a broth microdilution method in pH range from 6.0 to 8.0.The ZeoR expression cassette was amplified from plasmid pGAPZ-α-A by polymerase chain reaction (PCR).An integrated vector used to knockout AAF1 gene was constructed by gene splicing.Then the C.albicans CAI4 was transformed with this integrated plasmid containing the ZeoR expression cassette using lithium chloride method and the target AAF1 gene was replaced.The recombinant C.albicans was screened and the genome was extracted and amplified by PCR with two pairs of primers,then confirmed using genetic method.Results The C.albicans CAI4 was sensitive to Zeocin in pH range from 6.0 to 8.0.And the concentration of Zeoein(100 mg/L) at pH 7.0 was used to select recombined C.albicans.The recombined integrated vector was confirmed by DNA sequencing.The ZeoR expression cassette was detected using PCR method in recombined C.albicans.The AAF1 gene was replaced by ZeoR gene.Conclusion A new vector for targeted gene disruption in C.albicans is successfully constructed.

Objective To study the clinical characteristics of acute asthma during pregnancy,focusing on management of pregnant women presenting with an acute exacerbation.Methods A prospective observational study was conducted in 30 cases of acute exacerbations during pregnancy.Results The prognosis of 25 patients with mild or moderate asthma was good for both mother and fetus;none had severe complications.Among 5 women who had severe exacerbations,there were 4 pulmonary co-infections,1 with respiratory acidosis,1 with respiratory acidosis plus metabolic allkalosis,and 4 with fetal growth-restriction.Conclusions,This study highlights that pregnancy can worsen asthma control in some women.Effective management and prevention of asthma exacerbations during pregnancy is key to ensuring the safety of the mother and the fetus.

Gastric precancerous lesion refers to epithelial dysplasia(atypical hyperplasia or intraepithelial neoplasias),which is associated with increased risk of gastric cancer.It happens to be controlled by multiple factors and/or polygene such as the H.pylori infection,diet and environment which play an important role in the development of gastric precancerous lesions.This article describes the pathogenesis of gastric precancerous lesions as many scholars have studied some of it.

Objective 　To investigate the anatomic characteristics of optic canal in chinese adults. Methods　Twenty chinese cadaveric speciments fixed in formalin of chinese patients without intracranial and intraorbital disease. We measured the width and height of the intracranial opening and the intraorbital opening of the optic canal of all cases. The length of roof, floor, medial and lateral wall of the optic canal, and the width, the height of the middle protion were also measured after unroofing the canal with high-speed drilling. The degree of pneumatization of ethmoidal and sphenoidal sinuses was recorded. Results　The intracranial opening of the optic canal was a horizontal oval shape. The width of it was (5.05±0.42) mm and the height was (4.61±0.27) mm. The length of optic roof, optic floor, medial wall and lateral wall of the optic canal was (9.67±1.51) mm, (5.41±0.84) mm, (9.58±0.72) mm and (9.26±0.66) mm, respectively. The intraorbital opening of the optic canal was a vertical oval shape, the height and width of it was (5.30±0.64) mm and (5.62±0.83) mm respectively. Conclusions　The wall of the optic canal is thinner and there is a narrow portion in the middle of it. Depending on the degree of the pneumatization of sphenoidal and ethmoidal sinus, three types were divided into: 1. reversal U shape, 2. C shape, 3. D shape. The dura fold of the optic canal is long and its edge is sharp.

The paper expounds the humane landscape condition and resource of Zhejiang TCM ,puts emphasis on the evaluation of hu-mane connotation of Hangzhou Huqing Yutang, Yiwu Danxi Lingyuan and Lanxi Zhuge Village Dajingtang pharmaceutical mu-eums, also proposes detailed plan of Hangzhou TCM humane landscape construction.