The multi drug resistance(MDR) of tumor cells has become a difficult problem in the chemotherapy of tumor, meanwhile, the mechanism of MDR are various:relevant drugs with reversal effects have been discovered. This review will provide the most impossible mechanisms of MDR and some prospecting reversal drugs.

In order to explore the value of assessment in measuring S-100 beta protein (S-100B protein) and neuron-specific enolase (NSE) present in cerebrospinal fluid (CSF) from patients with brain insult in central nervous system infections, S-100B protein and NSE in CSF were measured dynamically by ELISA in 42 patients with Herpes Simplex Encephalitis (USE), 19 patients with purulent meningitis, 17 patients with cryptococcus meningitis and 22 unrelated control patients. It was found that the levels of CSF S-100B protein in all the three groups were higher than that of the control group (P0. 05). There were dynamic changes of CSF S-100B protein and NSE concentrations in all three groups correlating with the severity of disease. It is suggested that elevated concentrations of S-100B protein and NSE in CSF related to the damage of glia and neurons could be used as CSF markers of brain insult in patients with central nervous system infections.

ObjectiveTo assess activated carbon in the standard lymphadenectomy of gastric cancer.Methods183 cases undergoing radical gastrectomy before 1997 served as control group,87 consecutive cases after 1997 received intumour injection of activated carbon(AC) before undergoing gastrectomy.The areas and number of dissected lymph nodes,operative complication and hospital stay in subtotal gastrectomy and total gastrectomy were analyzed respectively.ResultsIn subtotal gastrectomy,the ratio of D 1 ,D 2 ,D 3 and D 3 +PAL over the total cases was 4 7%,10 3%,14 9% and 16 1% respectively in AC group and 25 7%,21 3%,9 9% and 2 7% respectively in control group.In total gastrectomy,the ratio of D 1 ,D 2 ,D 3 and D 3 +PAL was 3 4%,5 7%,21 9% and 23% respectively in AC group and 15 8%,14 8%,8 7% and 1 1% respectively in control group.The differences of the four procedures were all statistically significant between the two groups.The number of dissected lymph nodes in each case in AC group was more than that of control group.ConclusionsLocal injection of activated carbon is a simple,easy and safe method to increase the dissection of lymph nodes in radical gastrectomy.

Objective To investigate the clinical effect of acellular allogenic dermis combined with split-thickness autogenous skin graft for coverage of wound in extremity joint. Methods After contraction scar, giant pigmented nevus and capillary hemangioma being removed, acellular allogenic dermis with split-thickness autogenous skin graft was used to repair 25 cases of wounds of elbow, ankle, knee and wrist joints. The area of wounds was from 7cm?11cm to 12cm?19cm. Out of 25 wounds, there were 4 in wrist, 8 in elbow, 7 in ankle and 6 in knee joints. The survival rate of graft skin and improvement degree of joint function were observed. Results All grafts survived and had the smooth surface without obvious pigmentation and wound contraction. The function of joint was significantly improved after operation. Conclusion Tissue-engineered dermis with autogenous epithelium is an ideal graft for coverage of various wounds in extremity joint.

Opioid peptides and their receptors play an important r ole in the pathophysiologic process of stroke. The concentration of endogenous o pioid peptides elevates, while the density of opioid receptors decreases in CNS during cerebral ischemia; on the other hand, opioids influence the development o f stroke through regulating the contraction of cerebral vessel, immuno-endocrin e system and neuroprotection against injury. Thus, drugs that regulate the opioi d system may be a new therapeutic approach for prevention and treatment of cereb ral ischemia.

Objective To investigate the effect of nerve growth factor(NGF)in the process of muscular neurotization of denerva- ted vascularized skeletal muscle.Method By using NGF(0.5 ?g/d) to transplanted skeletal muscle,muscular neurotization was exa- mined with histological,histochemical,electron microscope and immunohistochemical methods at various time.Result NGF was effective in promoting muscular neurotization and diminishing denervated muscle atrophy in grafted denervated skeletal muscle.Conclusion NGF can promote the muscular neurotization and diminish denervated muscle atrophy.

Objective To study clinical and histopathological features of high-risk small renal carcinoma and provide theoretical basis for the individualized treatment.Methods This retrospective study analyzed the clinical and histological data of 21 patients of high-risk small renal cell carcinomas which were highly aggressive or advanced stage, admitted from Jan 2000 to July 2015.There were 15 males and 6 females,and the average age was (61.5 ±7.1) years (ranged 27 to 75 years).The mean diameter of tumors was 3.3cm (ranged 2.0 to 4cm).The study mainly focused on pathological character and stage, Fuhrman grading, existence of perirenal tissue or vascular invasion, venous embolus and distant metastasis.Results Of all these 21 cases, 17 cases were clear cell carcinomas, 1 was papillary carcinoma, 2 were hybrid cellular tumor ( malignant rhabdoid tumor and sarcomatoid carcinoma) and 1 was sarcomatoid carcinoma. Among the 17 clear cell carcinoma cases, 12 were Fuhrman grade Ⅱ, 5 were grade Ⅲ and one was gradeⅣ.Tumor infiltrated renal vein or its branches and renal vein embolus were found in 7 cases.The tumor infiltrated perirenal or renal sinus fat were found in 11 cases.Synchronous lung and local lymph nodes metastasis were found in 3 patients respectively.Moreover, there was 1 case with metastasis to the brain (FuhrmanⅣ).The final clinical stage were T3a N0M0 in 14,T1a N1M0 in 3 and T1a N0M1 in 4 cases. Conclusions Small renal tumors are heterogeneous in its biological behavior and the minorities are aggressive with infringement of perirenal fat or simultaneous local lymph node or distant metastasis.When the tumor is greater than 3.0 cm in diameter and with high grade in Fuhrman classification, sarcomatoid carcinoma are more likely to be highly aggressive and advanced stage.

Objective To evaluate the efficacy and safety of low energy intracardiac cardioversion in persistent atrial fibrillation. Methods Low energy intracardiac cardioversion was performed by delivering R wave synchronized biphasic shocks in 7 patients(4 men, 3 women) with persistent atrial fibrillation. Prior to the procedure, all patients underwent transesophageal echocardiographic examinations to rule out the presence of intracardiac thrombus and received subcutaneous injection of low molecular weight heparin for 3 5 days. Two custom made 6 Fr catheters(Rhythm Technologies of Getz, USA) were used for de fibrillation shock delivery. One catheter was positioned in the lower right atrium so that the majority of the catheter electrodes had firm contact with the right atrial free wall. The second catheter was placed randomly either in coronary sinus through right internal jugular vein or in the left pulmonary artery through femoral vein. In addition, a standard diagnostic 6 F quadropolar catheter was placed at the right ventricular apex for ventricular synchronization and postshock ventricular pacing. Shocks were delivered by Implant Support Device(Model 4510, Teleceronics). After conversion, all patients were treated with intravenous amiodarone in the first 24 hours followed by oral administration. Results In all 7 patients cardioversion of atrial fibrillation to sinus rhythm was successfully obtained. A mean of 2?1 shocks per patient has been delivered with a total amount of 13 shocks. The average delivered energy was 7.8?2.2 Joules. No complication occurred. At a mean follow up of 18?9 months, 4 of the 7 patients treated successfully showed sinus rhythm there after. Atrial fibrillation recurred in 3 patients at the second, fifth day and eighth month after cardioversion. Conclusions Low energy intracardiac cardioversion is effective and safe, and can be easily performed in patients without geneal anesthesia. It offers a new option for restoring sinus rhythm in patients with persistent atrial fibrillation.

Objective: To study the epidemiological of social anxiety disorder in pupils of Zhanjiang urban districts. Methods:2409 pupils from 5 elementary schools in Zhanjiang city completed the SASC. Those with a total score higher than 2 standard deviation away from the mean were interviewed. SADC was diagnosed according to the standard of CCMD-3.Results:The overall prevalence rate of SADC was 2.74 in Zhanjiang urban districts, prevalence rate for boys was 2.6, while 2.9 for girls. No sex difference was found (?~2=0.11,P=0.744). There was no significant difference among different grades (?~2=5.47,P=0.361).Conclusions:SADC exists in pupils of Zhanjiang city, we should pay more attention to this disorder for children's mental health.

Objective To discuss the value of preoperative digital design of struetund bone graft for acetabular wall defects. Methods The . dieom data from spiral CT scans were imported into Mimics 10.0 to build the 3D solid model of the pelvis of an old female patient with left acetabular wall defects. The 3D solid model of the defect area was built by Mirror and 3D mask editing. A simulated bone graft was conducted on the 3D model by segmentation and trimming according to the data measured on the reconstructed model. Results The reconstructed 3D model of the patient's pelvis could be presented in different colors, transparenees, or combinations of interested tissues. The acetabular wall defects could be visualized very clearly at different angles. The geometric data of the bone graft could be measured to ensure the bone graft would fit the defects accurately. Conclusion Preoperative digital design based on 3D com-puterized reconstruction of acetabular wall defects may provide a valuable aid to clinical treatment, because it is a simple, rapid, and accurate method of increasing the fitness of bone graft and the defects,