Objective To evaluate the preoperative diagnostic procedures and treatment choice of primary tumor of the duodenum (PTD).Method The clinical data of 52 cases with PTD in the last 10 years was analyzed retrospectively.Results The correct diagnostic rate of auxiliary examination was:duodenal endoscopy of 90.5%,air barium double radiography of 80%.Six primary benign tumors of duodenum (PBTD)were resected completely with a 5 year's survival of 100%.Among the 46 cases of primary malignant tumors of duodenum (PMTD),28 cases underwent pancreatoduodenectomy,4 cases received segmental duodenectomy,the remaining 13 cases in which the tumors were unresectable were treated bypass.The resection rate was 69.6% and the 5 years' survival rate was 32.6%.Conclusions Duodenal endoscopy and air barium double radiography are mainstays for the diagnosis of PTD.Segmental duodenectomy and simple tumor resection are curable for PBTD; while for PMTD,the therapy of choice should be pancreatoduodenectomy.

ObjectiveTo investigate the clinical effect of three-dimensional conformal radiotherapy simultaneously combined with XELOX program(oxaliplatin +capecitabine) for local recurrence of esophageal carcinoma after radiotherapy.MethodsSixty patients with local recurrence of esophageal carcinoma after radiotherapy were divided by random digits table method into treatment group and control group with 30 cases each.The patients in treatment group were treated with three-dimensional conformal radiotherapy simultaneously combined with XELOX program chemotherapy.While control group received three-dimensional conformal radiotherapy.The efficacy between two groups were compared.ResultsThe complete remission rate and efficiency rate in treatment group were significantly higher than those in control group [ 53.3％ (16/30) vs.23.3％ ( 7/30 ),86.7％ ( 26/30 ) vs.63.3％ (19/30) ] ( P ＜ 0.05 ).The 1,2,3-year survival rate and median survival time in treatment group were 65.5％,44.8％,34.5％ and 24.8 months,which were significantly higher than those in control group (48.3％,41.4％,6.9％ and 12.1 months)(P ＜0.01 ).The incidences of radioactive esophagitis,radioactive pneumonia and thrombocytopenia in treatment group were higher than those in control group,but there were no statistical differences between two groups (P ＞0.05).The incidences of nausea,vomiting,leukocyte decrease and anemia in treatment group were significantly higher than those in control group [36.7％(11/30) vs.13.3％(4/30),40.0％(12/30) vs.16.7％(5/30),43.3％( 13/30 ) vs.13.3％(4/30),P ＜ 0.05 ].ConclusionsThree-dimensional conformal radiotherapy simultaneously combined with XELOX program can improve short-term efficacy and long-term survival rate of local recurrence of esophageal carcinoma after radiotherapy.

"Resolving,espulsing and tonifying" three methods are the general outline of endotherapy in surgery of TCM.The author of this article thinks that pelvic inflammation and appendagitis can be classified in internal ulcer and vusceral carbuncle,and it can be treated by "Resolving,espulsing and tonifying" three methods.As the general programme of treating female inflammatory aphoria in different periods,the three methods can avoid exfetatio and promote the probability of pregnancy.Resolving method is applied in acute period of inflammatory aphoria,active period of chronic inflammatory and chronic pelvic inflammation when abdominal mass has formed but vital qi is not deficient.The pathologic character in this period is sufficiency of vital qi and excessive of pathogenic qi.Expulsing method is applied in inflammatory aphoria patients whose pathogenic has not been cleared but the vital qi has been harmed,at this time damp heat pathogen poison remain in uterus meridians and the nvital qi has no power to resist pathogen,and whose corporeity is always week and infects pathogen poison which results in the course of diseases being repeated and prolonged.Tonifying method is applied after the resolving and espulsing methods have been used.In this period,damp heat stasis have been cleared,inflammation and inflammatory matters have been absorbed,disease has been improved and patient has had condition to be pregnant.Tonifying method can promote human generative function and improve the possibility of conception.

Objective To study the factors affecting the accumulation of hydrolysable tannins in cultured mycelia of Inonotus obliquus. Methods Taking dry weight of mycelia and hydrolysable tannin content as index, different carbon and nitrogen sources, pH levels, and metal ions were evaluated for the accumulation of hydrolysable tannins in the submerged culture of I. obliquus. Results The optimal carbon and nitrogen sources were glucose and peptone. Optimal initial pH value was 5.5. The accumulation of hydrolysable tannins was greatly enhanced in the medium with the presence of Cu2+ at 0.8 mmol/L, Co2+ and Zn2+ at 1.6 mmol/L, Mn2+ at 1 mmol/L, and NH4+ at 4 mmol/L when compared to the control. Conclusion The accumulation of hydrolysable tannins is maximized in the medium containing glucose and peptone with pH value at 5.5. Supplementation of Cu2+, Co2+, Zn2+, and Mn2+ into the medium is an effective method for further increasing the accumulation of hydrolysable tannins in cultured mycelia of I. obliquus.

In this article,we explained the pathogenesis of bony paralysis,‘disharmony between bone and muscle',recorded in Huangdi NeiJing,by researching the dependability between bone and muscle both in traditional Chinese medicine and modem medicine.

ObjectiveTo explore the expression of Smad2 in cervical carcinoma and analyze the clinical significance of Smad2.MethodsThe expression of Smad2 in normal uterus group( NE group,n =61 ) and cervical carcinoma group( CC group,n =53 ) were detected by immunohistochemistry to analyze the significance of Smad2 in the cervical carcinoma.ResultsPositive rate of expression of Smad2 protein in NE group was 39.3％,positive rate was 77.4％ in CC group,statistical difference was found between the two groups(P ＜ 0.01 ).The degree of differentiation of cervical cancer was lower,and the Smad2 positive rate was higher,well-differentiated and poorly differentiated were 52.6％ and 91.2％,respectively,and the difference was statistically significante ( P ＜ 0.01 ) ; The invasion of cancer was higher,and the Smad2-positive rate was higher ≤ 1/2 and ＞ 1/2 were 66.7％ and 91.3％,respectively,and the difference was statistically significante ( P ＜ 0.05 ).ConclusionThe expression of Smad2 was less; Smad2 was related to depth of invasion and degree of differentiation of cervical carcinoma,which could be used as clinical diagnosis and prognostic markers.

Objective To analyze the clinical effects, as well as its advantages and disadvantages, of laparoscopic surgery for appendicitis in obese patients. Methods Clinical data of 80 obese patients receiving appendectomy, including 38 cases of open appendectomy and 42 cases of laparoscopic appendectomy, were analyzed retrospectively.The operative time, blood loss, analgesic and antibiotic use, postoperative fever, postoperative complications, length of hospital stay, and hospitalization cost were compared between the two operative methods. Results Conversions to open surgery were required in 2 patients in the laparoscopic group. There was no significant difference in operative time between the 2 groups (P >0.05).Compared with the open group, the laparoscopic group had less blood loss [(14.98 ±12.77) ml vs.(31.58 ±19.00) ml, t=-4.550, P=0.000], shorter time of postoperative antibiotic use [(2.7 ±1.0) d vs.(4.1 ±1.2) d, t=-5.470, P=0.000], less postoperative analgesics needed [5.0%(2/40) vs.26.3%(10/38),χ2 =6.802, P=0.009], less drainage [2.5% (1/40) vs.18.4% (7/38), χ2 =5.367, P=0.021], less postoperative fever [5.0%(2/40) vs.23.7%(9/38),χ2 =5.616, P=0.018], less postoperative wound healing [5.0%(2/40) vs.21.1%(8/38),χ2 =4.493, P=0.034], and shorter hospital stay [(5.9 ±3.2) d vs.(8.7 ±4.1) d, t=-3.345, P=0.001], but the higher cost of hospitalization [(7800 ±396) yuan vs.(4914 ±434) yuan, t=30.716, P=0.000]. Conclusion For obese patients with appendicitis, laparoscopic appendectomy has less surgical trauma, faster recovery, less postoperative pain, fewer complications,and shorter hospital stay, being a preferred method of treatment.

Objective To observe the effects of serum intefleukin-8,-4,-9 levels on the children with bronchus asthma.Methods 186 cases of children with bronchus asthma in our hospital during May 2010 to December 2010 were randomly selected,and given routine clinical therapy for 6 months,observing the serum interleukin-8,-4,-9 levels before and after treatment.Results The serum interleukin-8,-4,-9 levels of the children with bronchus asthma was higher than normal,but after treatment,the levels were totally decreased,there had a significant difference in the indexes.Conclusion The serum interleukin-8,-4,-9 levels was a good kind of reference index of disease progressed and effect determination in the children with bronchus asthma,it can more accurate evaluated the occurrence,development,metastasis and curative effect of asthma.

OBJECTIVE: To study the absorption and transport of pachymic acid (PA) isolated from the sclerotium of Poria cocos (Schw.) Wolf. in human intestinal epithelium. METHODS: By using Caco-2 (the human colonic adenocarcinoma cell lines) cell monolayers as an intestinal epithelial cell model, the permeability of PA was studied from apical side (AP side) to basolateral side (BL side) or from BL side to AP side. The PA was measured by reversed-phase high performance liquid chromatography coupled with UV detector at maximum absorption wavelength of 210 nm. Transport parameters and apparent permeability coefficients (Papp) were then calculated and compared with those of propranolol and atenolol, which were the transcellular transport markers for high and poor permeability respectively. RESULTS: The Papp values of PA were (9.50+/-2.20) 10(-7) cm/s from AP side to BL side, and (11.30+/-5.90) 10(-7) cm/s from BL side to AP side, respectively. Under the condition of this experiment, the Papp values were 1.45x10(-5) cm/s for propranolol and 4.22x10(-7)cm/s for atenolol. CONCLUSION: PA is transported through the Caco-2 cell monolayer in a concentration-dependent manner and the transport was linear with time. The absorption in apical to basolateral direction and secretion in basolateral to apical direction were poor and their Papp values were comparable to atenolol. Besides passive diffusion of PA, ATP is partially involved in its transport.

Objective To investigate the association of the SNP in miRNA146A with genetic prediposion and earlier recurrence after resection for hepatocellular carcinoma (HCC).Methods In the casecontrol study including 173 HCC cases,DNA were exacted from cancer tissue embedded with paraffin and were amplificated by PCR,SNP was explored in gene sequence of miRNA146a (385 base pair including extron).The outcome were analyzed with genetic prediposion and clinical features.Result Only hsa-mir-146a rs2910164 was found.The genetype frequence of C/C 、G/G and C/G at rs2910164 gene locus were separately 61 (35.3％),21 (15％) and 86(49.7％) in cases.Compared to G/G genetype,C/C and C/G genetype were danger factor to onset risk of HCC (OR =3.086,95％ CI:1.289-7.390) ; C/G was danger factor to earlier recurrence after resection(OR =8.179,95％ CI:2.248-29.759).Conclusion rs2910164 may be associated with genetic prediposion and earlier recurrence after resection of HCC in Jiangxi hans