Objective To investigate the value of multi-slice spiral CT(MSCT)in diagnosis of the causes of intestinal obstruction.Methods 49 cases of intestinal obstruction confirmed by surgery or clinical diagnosis underwent abdominal MSCT plain and enhanced scanning,three-dimensional post-processing reconstruction was done in 5 cases.CT features were analysed blindly by two senior radiologists,including the thickness,density and degree of enhancement of intestinal walls at the "transition zone" area of intestine and surrounding mesenteric structure.The causes of intestinal obstruction were analysed in combination with clinical history of the patients.Results The causes of intestinal obstruction were suggested by MSCT in 46 cases(94%),including intestinal adhesion in 13 cases,tumor in 11,hernia in 4,ischemic bowel disease in 4,gallstone in 2,gastrolith in 2,Bezoar in 4.paralytic ileus in 3 and appendiceal abscess in 3.Three cases were misdiagnosed.Conclusion MSCT is of significant clinical value in diagnosis of intestinal obstruction,which should be used as the first means in clinic practice.

Objective To study the relationship between the changes of TRIM16 in hippocampus of type 2 diabetic rats induced by streptozotocin (STZ) and cognitive dysfunction and apoptosis of hippocampal cells.Methods The male Sprague-Dawley (SD) rats of 8 weeks old were randomly divided into diabetic group (DM group) (n=25) and normal control group (NC group) (n=15).NC group were given normal feed, DM rats were fed with high glucose and high fat diet,followed by low dose of STZ (25 mg/kg, intraperitoneal injection), induced compensatory secretion of insulin, five days after the detection of tail vein blood glucose>16.7 mmol/L, and established the STZ.Meanwhile, citric acid buffer was injected to rats in group as control.After successful modeling, the rats in the two groups were fed with 17 weeks.Morris water maze test was used to detect the cognitive function of the two groups of rats.The protein expression of TRIM16, Bax and Bcl-2 protein in fresh hippocampus tissue of DM group and NC group rats was detected using western blotting.Rats in DM group and NC group were perfused with brain, and the hippocampal tissues were stained with immunohistochemistry.TUNEL method was used to detect the apoptosis of hippocampus cells.ResultsCompared with NC group, morris water maze test showed that the escape latency of rats in DM group is longer than NC group, staying at the original platform quadrant time in DM group is less than the NC group.TUNEL assay showed that after injection of 17 weeks, hippocampal CA1 pyramidal cells in type 2 diabetic rats appeared obvious apoptosis, positive neurons in the nuclei were brown, karyopyknosis anachromasis, while control group of neurons in the nucleus without brown coloring.Compared with the NC group, hippocampus immunohistochemistry results showed that the protein of TRIM16 in hippocampus CA1 region of type 2 diabetic rats was increased, cytoplasm brown, coarse granular.Compared with the NC group, the expression of Bcl-2 had no obvious change in hippocampus of type 2 diabetic rats at 17 weeks, while the expression of TRIM16, Bax and the ratio of Bax/Bcl-2 was significantly increased (P<0.05).Conclusion The protein expression of TRIM16 using immunohistochemical and Western blotting in hippocampus of diabetic rats induced by STZ was increased.There is apoptosis in hippocampus of diabetic rats induced by STZ, the expression of Bcl-2 was not significantly changed, the expression of Bax and the ratio of Bax/Bcl-2 were significantly increased.TRIM16 is involved in diabetic cognitive dysfunction by promoting apoptosis of diabetic rat hippocampus.

Objective To compare the efficacies of da Vinci robotic and traditional laparoscopic resection for colorectal cancer.Methods Databases including Pubmed,Cochrane Library,EMBASE,Medline,Wanfang,CNKI,VIP and FMJS were searched,and literatures published before February 2012 were retrieved.Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) focusing the comparison between da Vinci robotic and laparoscopic resection for colorectal cancer were collected.All the literatures retrieved were screened according to preset standards,and the patients were divided into robotic group and laparoscopic group.A meta analysis on the effectiveness of robotic and laparoscopic surgery for colorectal cancer was carried out using the RevMan 5.1 software.Categorical variables were presented by odds ratio (OR) and 95％ confidence interval (95 ％ CI),continuous variables were presented by weighted mean difference (WMD) and 95 ％ CI.Results One RCT and 10 NRCTs including 974 patients with colorectal cancer were screened out and there were 426 patients in the robotic group and 548 patients in the laparoscopic group.Compared with conventional laparoscopic surgery,longer operation time,lower rate of conversion to laparotomy and shorter anal exsufflation time were observed in the robotic group (WMD =25.61,OR =0.32,WMD =-0.21,P ＜ 0.05).There were no significant differences in the operative blood loss,number of lymph node dissected,distal resection margin,morbidity and duration of hospital stay between the robotic group and the laparoscopic group (WMD =-23.14,-0.31,0.14,OR =1.06,WMD =-0.43,P ＞ 0.05).Conclusion The efficacies of da Vinci robotic and laparoscopic surgery for the treatment of colorectal cancer are comparable,while da Vinci robotic surgery has the features of lower rate of conversion to laparotomy and shorter anal exsufflation time.

An introduction to the laws applicable to mental disease patients,and the employment and marriage conditions of these patients,revealing the setbacks including low employment rate,low marriage rate and high divorce rate among these people.In this regard,the paper raised the points as follows:Speed up the legislation on mental health laws by the state,enhance mental health law enforcement to protect legitimate righta of mental disease patients; implement of the Law of the Peoples Republic if China on the Protection of Disabled Persons,Regulations on the Employment of the Disabled,to protect and promote equal rights of disabled persons in employment;enhance mental health communicatioas to awake the society in their care and love for mental health and mental disease patients.

Objective:To select suitable chemotherapy for cervical cancer patients by ATP-tumor chemosensitivity assay.
Methods:Seventy-two hospitalized patients with cervical cancer between July 2007 and October 2009 were enrolled. The patients were randomly divided into a trial group (n=35) and a control group(n=37). ATP-TCA was used to detect the sensitivity of 35 samples of cervical cancer in the trial group to 6 combined chemotherapy regimens. The chemotherapy regimen in the trial group was confirmed by the results of susceptibility testing and that in the control group was confirmed by clinical experience. One-year recurrence rate and 3-year survival rate of two groups were compared after 3 year follow-up.
Results:ATP-TCA was measured in 32 of the 35 patients in the trial group. The sensitive patients for paclitaxel+carboplatin, paclitaxel+oxaliplatin, bleomycin+ifosfamide+cisplatin, bleomycin+vincristine+cisplatin, fluorouracil+cisplatin, and gemcitabine+cisplatin were 20, 18, 17, 18, 17, and 21, respectively. There was no significant difference in the 1-year recurrence between the two groups (P>0.05), while the 3-year survivors in the trial group were more than those in the control group (P<0.05).
Conclusion:ATP-TCA method is good for patients with cervical cancer because it is sensitive, effective, and individualized.

BACKGROUND:It remains controversial in term of efficacy for the lightweight mesh and heavyweight mesh in inguinal hernia repair.
OBJECTIVE:To compare the clinical therapeutic effects of lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair with Meta-analysis.
METHODS:Comprehensive electronic search strategies were developed using the fol owing electronic databases:PubMed, Cochrane Library, EMBASE, Medline, Ovid, CNKI, VIP, Wanfang and FMJS. The Literature published before February 2013 was searched. The randomized control ed trials about comparing lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled using RevMan5.1 software through Meta-analysis.
RESULTS AND CONCLUSION:Eighteen trials with a total of 4 450 hernias met the inclusion criteria. The meta-analysis showed that there was a statistical difference between lightweight mesh group and the heavyweight mesh group on short-term pain [odd ratio (OR)=0.57, 95%confidence interval (CI) (0.43, 0.74), P<0.05] and a reduced risk of developing foreign body sensations [OR=0.49, 95%CI (0.35, 0.69), P<0.05]. No significant differences were found between the two groups in recurrence rate, testicular atrophy, seroma, hematoma, wound infection, urine retention (P>0.5). According to limited evidence, there are some findings as fol ows:the lightweight mesh is of feasibility, safety and effectiveness for inguinal hernia repair. Because of the limits of sample and quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use lightweight mesh for inguinal hernia repair.

Objective To study the possibility of microvascular permeability (PS) value derived from perfusion CT (PCT) in predicting hemorrhagic transformation (HT) in acute cerebral infarction in elderly patients.Methods 52 consecutive patients with middle cerebral artery acute ischemic stroke who received thrombolytic therapy were divided into HT group and control group,and patients in HT group were further divided into hemorrhagic infarction (HI) group and parenchymal hematoma (PH) group.PCT data and Alberta stroke program early CT scores (ASPECTS) from CT angiography source images (CTA-SI) achieved within 6 hours after symptom onset of each group was retrospectively analyzed and statistically processed.Results In 52 patients,there were 22 cases developed HT,14 cases with HI,8 cases with PH.Cerebral blood flow (CBF) and cerebral blood volume (CBV) values were decreased and permeability surface area product (PS) was increased in ipsilateral in HT group and control group as compared with the contralateral (all P＜0.05).PS value in ipsilateral was significantly higher in HT group than in control group (P＜0.01),but CBF and CBV values in affected side showed no significant difference between the HT group and control group.The area under the receiver operator characteristic (ROC) curve of PS Az value was 0.968.When PS ≥5.77 ml · min-1 · 100 g-1,the sensitivity and specificity of predicting HT were 95.5％ and 86.7％ respectively.The ASPECTS was lower in HT group than in the control group (P＜0.01),and ASPECTS was higher in HI group than in PH group (P＜0.01).The differences in PCT results in affected side between the HI group and PH group was not significant.Conclusions The significantly increased PS value can be a reference in predicting HT risk and guiding thrombolytic therapy.

Object To explore the bacteriostatic and anti inflammation activities of ultrasonically nebulized Houttuynai cordata Thunb in patients after pneumonectomy Methods The patients were randomized into 2 groups Patients of the experimental group, inhaled ultrasonically nebulized H cordata, while patients in the control group inhaled ultrasonically nebulized vapors without the addition of H cordata Results Total leucocyte counts on the third and fourth day in the experimental group were significantly lower than that in the control group Neutrophil ratio in experimental group was also lower in all the 5 days of treatment although nonsignificantly Meanwhile, occurrence of Gram negative bacilli colonization in experimental group occurred less than that in the control group But incidence of fungi colonization appeared higher Conclusion Inhalation of ultrasonically nebulized H cordata can ease the inflammation and inhibit the colonization of Gram negative bacilli in respiratory tract

AIM: To investigate that nicotine inhibits HMGB1 expression and release in RAW264.7 cells.METHODS: (1) RAW264.7 cells were cultured in 6 wells plate, treated with 250 μg/L LPS and 1 μmol/L or 10 μmol/L nicotine, in which the cells treated with or without 250 μg/L LPS were regarded as nicotine 1 group (N1), nicotine 2 group (N2), LPS group (LPS) and control group (C), respectively. HMGB1 protein in the cell culture media and in cell nuclear was examined by Western blotting and the cellular HMGB1 mRNA level was detected by RT-PCR. (2) Transfected with antisense RNA or sense RNA of α~7 subunit-containing nicotinic receptor (α~7nAChR), RAW264.7 cells were treated with 250 μg/L LPS and 10 μmol/L nicotine, HMGB1 protein in the culture media was also tested by Western blotting.RESULTS: (1) HMGB1 mRNA level in C group was low (1 659.20±121.05) and no significant statistical difference among groups of N1, N2 and LPS was observed (P>0.05). (2) Higher HMGB1 accumulation in the cell culture media was detected in LPS group (445.34±28.52) than that in C group. Compared to LPS group, both N1 and N2 groups distinctly attenuated HMGB1 accumulation in culture media (P<0.05). (3) Nuclear HMGB1 accumulation was lower in LPS group than that in C group, and two different nicotine concentrations markedly increased the nuclear HMGB1 accumulation compared to LPS group (P<0.05). (4) No significant difference of HMGB1 levels in culture media between antisense RNA group and LPS group was observed (P>0.05). In sense RNA group, however, HMGB1 level was observably reduced compared to antisense group (P<0.05).CONCLUSION: The present results suggest that nicotine dramatically inhibits RAW264.7 cell nuclear HMGB1 translocation and extracellular release, and this effect relies on α~7nAch receptor expression.

OBJECTIVE:To observe clinical efficacy of bevacizumab or cetuxizumab combined with FOLFOX4 regimen in the treatment of advanced rectal cancer. METHODS:114 patients with rectal cancer were randomly assigned to cetuxizumab group and bevacizumab group,with 57 cases in each group,among which one patient of bevacizumab group withdrew from therapy. Both groups received FOLFOX4 regimen:oxaliplatin 85 mg/m2+calcium folinate 200 mg/m2,ivgtt,2 h,and 5-FU 400 mg/m2,ivgtt, last,5-FU 600 mg/m2,ivgtt,22 h. Cetuxizumab group was additional given cetuxizumab 500 mg/m2;bevacizumab group was addi-tionally given bevacizumab 5 mg/kg,ivgtt. A treatment course lasted for 2 weeks. Both groups received 4 courses of treatment,and then clinical efficacy,toxic reaction and progression-free survival (PFS) were evaluated. RESULTS:Objective remission rate (RR),disease control rate(DCR)and median PFS of cetuxizumab group was 45.61%,92.98%and 10.0 months,those of bevaci-zumab group were 48.21%,87.50%and 11.0 months;there was no statistical significance between 2 groups(P>0.05). No signifi-cant differences were found in the incidence of ADR such as sensory neurotoxicity,aleucocytosis,thrombopenia,nausea and vomit-ing,diarrhea and erythra between 2 groups(P>0.05). CONCLUSIONS:Both bevacizumab or cetuxizumab combined with FOLF-OX4 regimen have a similar effect on patients with advanced cancer,with low incidence of toxic reaction.