Malignant bowel obstruction (MBO) is common in patients with bowel or gynaecological canc-er. Although surgery is the primary treatment for most patients with MBO, it should not be undertaken rou-finely in patients with poor prognosis. Nasogastric drainage is only a temporary measure. Serf-expanding me-tallic stents are optimistic in malignant obstruction of the gastric outlet and proximal small bowel.

Gastrointestinal stromal tumours(GISTs)are the most common primary mesenchymal tumours of the gastrointestinal tract and the disease is occasional and asymptomatic. Though the high rate of recur- rence after surgery, operation remains the firstline treatment of the GIST without metabasis. With the consid- eration the molecular biology of tumor, the treatment including surgery and molecular targeted therapy can im- prove the prognosis of GISTs.

Objective To investigate the association between diabetes and pancreatic cancer to provide the basis for the early di‐agnosis and prevention of pancreatic cancer .Methods By formulating the retrieval stategy ,the databases of PubMed ,EMbase ,Ov‐id 、EBSCO ,CNKI and CBMdisc ,VIP ,Wanfang/database etc .were retrieve by computer from their establishment to July of 2013 .At the same time ,the relevant literature references were also retrieved .All case‐control studies(CCS) on the association between diabe‐tes and pancreatic cancer were included and their quality was assessed .The meta analysis was conducted by using Review Manager 5 .0 software .Results A total of 21 CSC were included ,finally 18 case‐control studies met the inclusion criteria for conducting meta analysis ,including 6 184 cases in the pancreatic cancer group and 10 296 cases in the control group .The meta analysis on the pan‐creatic cancer group and the control group showed that the result of heterogeneity test from all research data was I2 = 74% ,χ2 =65 .38 ,P< 0 .01 ,the random effects model was adopted ,the pooled odds ratio(OR) was 3 .60 and 95% confidence interval(95% CI) was 3 .28 - 3 .94 ,the difference showed the statistic significance(P< 0 .05) ,which indicating that the risk suffering diabetes in the patients with pancreatic cancer was 3 .6 times of the normal population .Conclusion Diabetes is associated with pancreatic cancer and diabetes may be an early clinical manifestation of pancreatic cancer .

Objective To explore the effects of psychological intervention on negative emotions and quality of life in patients with rheumatoid arthritis (RA).Methods A total of 112 patients with rheumatoid arthritis were divided into two groups:the intervention group and the control group.All patients were given drugs for treatment of RA.Additionally,patients in the intervcntion group were received psychological intervention.Zung's self-rating depression scale (SDS),Zung's self-rating anxiety scale (SAS),RA disease activity score (DAS28),visual analog scale (VAS),disability index of health assessment questionnaire (HAQ-DI) were assessed,and the related laboratory parameters such as erythrocyte sedimentation rate (ESR),C reactive protein (CRP),rheumatoid factor (RF)were determined.Results 6 months after the treatment,there were significant differences in SDS and SAS between the treatment group and the control group [SDS:(31.7±4.7)scores vs.(29.6±4.4)scores; SAS:(34.7±5.3)scoresvs.(32.6±5.1)scores; t=2.441,-2.119,both P＜0.05].The patients with tender joints,joint swelling and morning stiffness time were less in the treatment group than in control group [(5±3) vs.(7±4),(4±3) vs.(5±3),(36±16) min vs.(42±19)min.respectively,t=2.054,2.393,1.995,all P＜0.05].The scores of HAQ-DI,VAS and DAS28were lower in the treatment group than in control group [(0.89±0.73) vs.(1.20±0.77),(6.1±1.6) vs.(6.8±1.8),(3.2±1.7) vs.(3.9±1.9),respectively,t=2.136,2.406,2.135,all P＜0.05].There was a significant difference in CRP between the treatment group and the control group [(34±14) mg/L vs.(37± 17)mg/L,t=2.406,P＜0.05].Conclusions Psychological intervention can improve the negative emotions and quality of life in patients with rheumatoid arthritis.

Objective To observe the effect of combination therapies with methotrexate, sulfasalazine and hydroxychloroquine on hyperlipemia of rheumatoid arthritis.Method From 2009 November to 2010 November, 68 RA inpatients and outpatients in the department of rheumatism of our hospital were randomly divided into two groups: A group and B group, 34 cases in each group. The patients in A group were given combination of methotrexate, sulfasalazine, hydroxychloroquine sulfate for the treatment of RA,patients in B group, based on A group's treatment, were treated by xuezhikang. Some indexes were observed in two group before treatment and 6 months after treatment, including cholesterolTC,low density lipoprotein cholesterol LDL-C , triglyceride TG , high density lipoprotein cholesterol HDL-C , swelling index, joint pain index, time of morning stiffness, C-reactive protein CRP , erythrocyte sedimentation rate ESR and DAS28. Results After 6 months’ treatment, the serum levels of TC, TG,, LDL-C, both in two groups of patients, were lower than those before treatment, and HDL-C was higher than that before treatment, there were significant differences (P<0.05 or P<0.01) . After 6 months of treatment,DAS28,ESR,CRP,joint tenderness,joint swelling and morning stiffness time, both in two groups RA patients, significantly reduced compared with before treatment, there were a very significant difference (P<0.05 or P<0.01) .After treatment, the above indexes had no statistically significant difference between two groups (P>0.05) . Conclusion RA patients have abnormal blood lipid levels, disease-modifying anti-rheumatic drugs have effect on blood lipid during remission joint disease in RA patients.

Objective To compare the efficiency and safety of clopidogrel of different loading-dose in acute coronary syndromes(ACS) patients with percutaneous coronary intervention(PCI) therapy, and, give an assessment of security about higher loading dose of clopidogrel. Methods 120 patients from January 2008 to January 2009 in our hospital were included.They were randomly divided into 3 groups(na=nb=nc=40)and were given 600 mg,450 mg and 300 mg clopidogrel on the 6 hour before PCI. There was no significant difference between the three groups' basic clinical information(p>0.05),such as age, sex and so on. Four points were selected to observe: the platelet aggregation induced by ADP with 5umol/L before and two hours、four hours, six hours after taking medicine; Primary endpoint events, which include shock during hospitalization, death, target revascularization, myocardial infarction, recurrent angina, stroke in 30 days,and Postoperative Bleeding events and adverse Reactions after Surgery in 30 days. Results compared to the standard dose of 300 mg clopidogrel, 600 mg doses clopidogrel can give a greater degree of inhibition on platelet activating than 450 mg doses in the pre-6 h after administration. Increase Clopidogrel loading dose can reduce the occurrence of major cardiovascular events rate. Bleeding events and the occurrence of adverse events was no significant difference among three groups. Conclusions compared to the standard dose of 300 mg clopidogrel, a higher loading dose of clopidogrel can produce much more faster, greater platelet inhibition, and similar security.

Urban and periurban agriculture (UPA) is the important part of modern agriculture. It can resolve the food supply to city residents, increase employments and improve the urban ecosystem. But without proper management and reasonable programming, UPA also can carry heavy burden to urban environment and impact people's health. This paper specifically analyzed the potential risks of urban agriculture and suggested preventive and control measures.

To study the significance of the pathological changes of axon and myelin sheath in injured brainstem.The neurofilament and myelin basic protein was demonstrated immunohistochemically,and the pathological changes of axons and myelin sheathes in human brainstem following trauma were observed.In the injured brainstem,irregular swelling and disconnecting axons could be found as early as 0 5h after injury, while pathological changes in myelin sheaths such as tortuous change,partial peeling off from axon and intermittent disappearance could be observed at 19～22h after injury.However,in the normal brainstem,there were no evident changes in axons and myelin sheaths.Pathological changes of axon and myelin sheath in brainstem would occur after trauma,which could be used for postmortem diagnosis of brainstem injury.

Objective To study the false positive of enzyme linked immunoinhibition continuous assays to detect CK-MB in clinic,to reasonably explain the results of detection and to get correctly the project of solving.Methods A total of 125 serum specimen of non-myocardial infarction patients were detected by enzyme linked immunoinhibition continuous assays,in retrospective study.To analyze the factors which made the CK-MB enzymatic activity unit pseudo-rising.Results Total CK-MB enzymatic activity was low in 86 serum specimen of adult patients with non-myocardial infarction,but in the patients with tumor,encephalic infarction and allergic disorder the pseudo-positive ratio of the CK-MB enzymatic activity was high.There were 53 cases, in which CK-MB activity accounted for 6%-21% enzymatic activity of CK, and 6 cases accounted for more than 38% in 59 cases in which the CK-MB activity was more than 5% enzymatic activity of CK.In 38 neonate cases, the enzymatic activity of CK ranged from 145U/L to 1974U/L,In 1 case of neonatal respiratory distress syndrome CK-MB activity accounted for more than 90% enzymatic activity of CK.Another haemolytic sample led to false positive result.Conclusion The phenomenon of enzymatic activity rising in the serum specimen of non-myocardial infarction patients may be caused by the factors of lots CK, CK-BB and AK in serum.Those materials maybe have effects on the action between McAb and M subunit of the CK.Some non-inhibit CK-M and the M subunit with B subunit may participate the enzymatic activity together.Because of the shortcoming of method,the single assay should not be taken as the diagnostic basis.

[Objective]To study the expression of Cad-Ⅱ gene in bone marrow mesenchymal stem cells(MSCs) transfected with Cad-ⅡcDNA after autografted into the bone defects. [Method]The experimental model of ilium segment defect was established in 20 Japanese white rabbits.The rabbit MSCs were isolated,cultured and expanded in vitro,and then the MSCs,transfected with Cad-Ⅱ and compounded with collagen sponge were autografted into the ilium segment defect.At 4 weeks of operation,the MSCs/ collagen sponge were excised,and the expression of Cad-Ⅱ was evaluated with RT-PCR and immunohistochemical methods.[Result]All of the bone defects treated with implants exhibited new bone formation at 4 weeks postoperatively.In the transfection group,Cad-Ⅱ gene mRNA expression was higher than that in the control group(P