Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer / 中国实验方剂学杂志

Colorectal cancer is one of the common malignant tumors with high morbidity， and changes in lifestyle， dietary structure and environment in China in recent decades have been associated with an increase in the incidence of colorectal cancer. A large number of studies have shown that traditional Chinese medicine（TCM） can be used as a complementary and alternative treatment for colorectal cancer after conventional western medicine treatment. TCM physicians have accumulated a lot of clinical experience in the treatment of patients with stage Ⅰ-Ⅲ colorectal cancer， and have proved that TCM has unique efficacy， but there is still a lack of relevant clinical practice guidelines to standardize and guide the diagnosis and treatment of TCM. Based on this， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， under the framework of relevant laws， regulations and technical guidance documents， combined with the evidence of relevant domestic and foreign clinical research in recent years for evidence grading and opinion recommendation， and then the Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer were developed by expert consensus. This guideline introduces the etiology， pathogenesis， syndrome differentiation and treatment of TCM intervention for colorectal cancer， which can provide guiding opinions for TCM clinicians and clinicians of integrated traditional Chinese and western medicine engaged in the prevention and treatment of colorectal cancer.

Efficacy and safety of total aortic arch replacement in elderly patients with Stanford type A aortic dissection / 中华老年医学杂志

Objective:To evaluate the efficacy and safety of total aortic arch replacement in elderly patients with Stanford type A aortic dissection(TAAD).Methods:In this retrospective study, a total of 481 TAAD patients treated with total arch replacement in our hospital from January 2016 to January 2020 were divided into three groups: aged≤59 years, 60-69 years and ≥70 years.The differences between three groups in surgical method, extracorporeal circulation time, blocking time, circulatory time, stopping time, surgical time, ventilator use time, ICU time, hospitalization time, treatment rate of continued renal replacement, fatality rate, and cause of death were statistically analyzed and compared.Results:There were statistically significant differences in the stopping time between any two groups of the three groups(all P<0.05). The older the age, the shorter the circulatory arrest time.The difference of ventilator time and ICU time between ≤59 and 60-69 years was statistically significant( P<0.01). Patients with continuous renal replacement(CRRT)were 19.0%(71/373)in ≤59 years, 23.1%(18/78)in 60~69 years, and 26.7%(8/30)over 70 years.In-hospital mortality was 35/373(9.4%)in the group of ≤59 years old, 11/78(14.1%)in the group of 60~69 years old, and 5/30(16.7%)in the group of ≥70 years old.There was no death in patients undergoing type Ⅱ hybrid surgery. Conclusions:Age is one of the important death factors after total aortic arch replacement in TAAD patients.Total aortic arch replacement is an acceptable surgical method for elderly patients with TAAD.Hybridization may reduce hospitalization death in elderly patients.

Experience for 107 patients with acute type A aortic dissection involving coronary arteries / 中国胸心血管外科临床杂志

@#Objective    To summarize the clinical feature and treatment experience of patients with acute type A aortic dissection involving coronary arteries. Methods    The clinical data of 107 patients with acute type A aortic dissection involving coronary arteries, who received operation between June 5, 2012 and December 31, 2019 in our hospital, were analyzed retrospectively. There were 80 males and 27 females at age of 24-83 (49.8±11.2) years. Results    The right coronary artery was involved in 65 patients, the left in 17 patients, and both coronary arteries in 25 patients. There were 48 (44.9%) patients undergoing coronary artery bypass grafting, 49 (45.8%) patients undergoing coronary artery plasty. Fifteen patients died 30 d after the operation, with a mortality rate of 14.0%. Patients with preoperative cardiogenic shock and postoperative acute renal failure had increased risk of death (P<0.05). Eighty-two (88.2%) patients were followed up for 2 to 71 months, and 1 patient had sudden cardiac death during the follow-up period. Conclusion    Acute type A aortic dissection with coronary involvement is associated with high misdiagnosis rate and mortality rate. Taking proper strategies for surgical treatment of involved coronary arteries based on precise diagnosis may improve the prognosis of patients.

Clinical significance of plasma NT－proBNP in children with bacterial meningitis / 中国基层医药

Objective To investigate the clinical significance of plasma amino －terminal pro －brain natriuretic peptide(NT－proBNP) in children with bacterial meningitis.Methods From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale (GCS).Thirty－five cases who admitted to the hospital in the same period were selected as the control group ,excluding congenital heart disease,chronic cardiac dysfunction ,cardiomyopathy,myocarditis,heart failure,chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT －proBNP, procalcitonin (PCT),C－reactive protein(CRP) and Na ions were determined.Results Compared with the control group ,the levels of the plasma NT－proBNP was significantly increased [(7 123.97 ±6 901.60)ng／L vs.(39.29 ±19.41)ng／L,t＝5.839,P＜0.01],the level of PCT was significantly increased [(25.14 ±2.35) ng／dL vs.(0.63 ±0.15ng／dL,t ＝10.820,P＜0.01],the level of CRP was significantly increased [(97.89 ±4.63mg／dL vs.(5.23 ±1.22mg／dL,t＝21.130,P＜0.01],and the GCS was significantly decreased (t＝18.132,P＜0.01) in children with bacterial meningitis group.The plasma NT －proBNP level of children with GCS ＜8points [( 13 328.08 ±7 938.85 ) ng／L ] was significantly higher than that in children with GCS 8～14points[(3 401.50 ±1 526.75)ng／L](t＝5.816,P＜0.01) and GCS≥15points [(39.74 ±18.64) ng／L] ( t ＝5.816,P＜0.01).There was a significant positive correlation between the level of plasma NT －proBNP and PCT ( r ＝0.969, P ＜0.01), also a significant positive correlation between the level of plasma NT －proBNP and CRP (r＝0.961,P＜0.01),while a significant negative correlation between the level of plasma NT－proBNP and sodium ions(r＝0.886,P＜0.01) in children with bacterial meningitis by Pearson correlation test.Conclusion Detection of the plasma NT－proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis .

Postmortem analysis of vagus nerve pathology and intestinal neuroinflammation in Parkinson's disease / 中华神经科杂志

Objective To investigate the roles of neuroinflammation and pathology of peripheral nervous system in the pathogenesis of Parkinson's disease (PD).Methods Immunohistochemical staining was performed to examine the nodose ganglia (containing vagus nerve) and intestine of an autopsy case of PD.The neuroinflammation and morphological changes of vagus nerve and enteric nervous system were observed.Results The expressions and distributions of glial fibrillary acidic protein and ionized calcium binding adapter molecule 1,two typical glia cell biomarkers,were different in vagus nerve and intestinal mucosa.Tumor necrosis factor α and inducible nitric oxide synthase were expressed in intestinal mucosa and myenteric plexus of the PD patient.There was a strong inflammatory reaction in the myenteric plexus,which distributed diffusely.Conclusion Satellite glial cells and intestinal inflammatory response may play a role in the pathogenesis of PD.

Clinical significance of plasma NT-proBNP in children with bacterial meningitis / 中国基层医药

Objective@#To investigate the clinical significance of plasma amino-terminal pro-brain natriuretic peptide(NT-proBNP) in children with bacterial meningitis.@*Methods@#From April 2013 to March 2017, 32 children with bacterial meningitis in PICU of the Second People′s Hospital of Liaocheng Affiliated to Taishan Medical College were selected.The patients were evaluated the severity of the disease by Glasgow coma scale(GCS). Thirty-five cases who admitted to the hospital in the same period were selected as the control group, excluding congenital heart disease, chronic cardiac dysfunction, cardiomyopathy, myocarditis, heart failure, chronic renal insufficiency.The blood samples were collected from the hospital in 24h, and the levels of the plasma NT-proBNP, procalcitonin(PCT), C-reactive protein(CRP) and Na ions were determined.@*Results@#Compared with the control group, the levels of the plasma NT-proBNP was significantly increased[(7 123.97±6 901.60)ng/L vs.(39.29±19.41)ng/L, t=5.839, P<0.01], the level of PCT was significantly increased[(25.14±2.35)ng/dL vs.(0.63±0.15ng/dL, t=10.820, P<0.01], the level of CRP was significantly increased[(97.89±4.63mg/dL vs.(5.23±1.22mg/dL, t=21.130, P<0.01], and the GCS was significantly decreased(t=18.132, P<0.01) in children with bacterial meningitis group.The plasma NT-proBNP level of children with GCS<8points[(13 328.08±7 938.85)ng/L]was significantly higher than that in children with GCS 8~14points[(3 401.50±1 526.75)ng/L](t=5.816, P<0.01) and GCS≥15points[(39.74±18.64)ng/L](t=5.816, P<0.01). There was a significant positive correlation between the level of plasma NT-proBNP and PCT(r=0.969, P<0.01), also a significant positive correlation between the level of plasma NT-proBNP and CRP(r=0.961, P<0.01), while a significant negative correlation between the level of plasma NT-proBNP and sodium ions(r=0.886, P<0.01) in children with bacterial meningitis by Pearson correlation test.@*Conclusion@#Detection of the plasma NT-proBNP has significant clinical significance for early diagnosis and assessment of the severity of the illness of children with bacterial meningitis.

Surgical therapy analysis of common congenital heart disease in 1 004 infants / 中国医师进修杂志

Objective To analyze the surgery effect of infant common congenital heart diseases. Methods The clinical data of 1 004 infants with common congenital heart disease were retrospectively analyzed, with male in 508 cases, female in 496 cases, age from 0.7 to 12.0 (7.4 ± 3.6) months, and body weight from 2.4 to 11.5 (6.8 ± 2.2) kg. Among them , there were the ventricular septal defect (VSD) in 680 cases, atrioventricular septal defect (ASD) in 92 cases, patent ductus arteriosus (PDA) in 70 cases, pulmonary valve stenosis (PS) in 12 cases, VSD +ASD in 83 cases, VSD + PDA in 27 cases, VSD+moderate to severe mitral insufficiency (MI) in 12 cases, VSD+ASD+MI in 3 cases, VSD+PS in 5 cases, VSD+ASD+PS in 2 cases, VSD+double chamber right ventricle (DCRV) in 3 cases, and ASD+PS in 7 cases, ASD+PDA in 8 cases. Results The extracorporeal circulation time was 21-72 (40.2 ± 28.6) min, and aortic occlusion time was 4-37 (20.7 ± 15.5) min. The in hospital mortality was 0.8%(8/1 004). Postoperative complications included low cardiac output syndrome in 18 cases, bacterial endocarditis in 2 cases, pneumonia in 27 cases, pulmonary atelectasis in 6 cases, pneumothorax in 2 cases, laryngeal edema in 11 cases, incision fat liquefaction in 12 cases, sternal dehiscence in 3 cases, and third-degree atrioventricular block in 1 case. Eight hundred and forty-five infants (84.2%, 845/1 004) were followed up for 6-12 months.The echocardiogram found 9 cases with residual VSD shunt, 5 cases with mild MI and 1 case with moderate. Conclusions In primary hospital, Seizing the opportunity of surgery, attention on protection of myocardium and other important of organ function during operation, and postoperative intensive care and fine processing can achieve satisfactory clinical results in infant common congenital heart diseases surgery.

Clinical research on video-assisted thoracoscopic iodine tincture pleurodesis for treating malignant pleural effusion / 中国肿瘤临床

Objective: To observe the therapeutic effect of video-assisted thoracoscopic surgery (VATS) with iodine tincture pleurodesis on malignant pleural effusion (MPE). Methods:Clinical data from 47 MPE cases were retrospectively analyzed. Based on different treatments, the 47 cases were divided into Groups A (n. 25) and B (n. 22), which used iodine tincture and talc powder as a hard-ener, respectively. Provided that all cases were conclusively diagnosed as MPE, and the patients underwent VATS pleural biopsy and pleurodesis, Groups A and B were comparable. The authors then compared the postoperative effectiveness rates (both complete and par-tial remissions), the volume of chest drainage, the incidence of adverse reactions, and the drainage time of the chest tube between the two groups. Results:Difficulty in breathing was proven to be less severe among all cases after the operation, and none of the patients suffered from acute lung injuries. After the operation, Group A exhibited an effectiveness rate of 96.0%, whereas Group B presented a rate of 95.5%, which indicates that no significant difference was found between the two groups (P>0.05). The total incidence of adverse reactions was 32.0%in Group A and 63.6%in Group B, with a significant difference between the two (P<0.05). Conclusion:VATS io-dine tincture pleurodesis has been proven to be as therapeutically effectual as talc pleurodesis and has resulted in fewer adverse reac-tions. This finding suggests that VATS iodine tincture pleurodesis has a promising potential in clinical practice because of its definite cu-rative effect, simple management, high security, fewer adverse reactions, and reasonable cost.

Metabolic syndrome and colon cancer:a Meta-analysis / 重庆医学

Objective To investigate the association between Metabolic syndrome and colon cancer.Methods A literature search was performed through PubMed,Ovidsp,CNKI and Wangfang Data within the time limit of January 1 990 to May 2014.Ac-cording to the inclusion and exclusion criteria,the studies were screened and the data were extracted.Then Meta-analysis was per-formed using Stata Statistical Software version 12.0.Results A total of 8 studies(6 cohort studies and 2 case-control studies)met the inclusion criteria.Meta analysis showed that patients with Metabolic syndrome had a higher risk of colon cancer incidence com-pared with the control group without Metabolic syndrome(OR =1.43,95%CI :1.23 - 1.66,P <0.05 ).Stratified analysis showed Metabolic syndrome had a higher risk of colon cancer incidence in male(OR=1.50,95%CI :1.22-1.84,P <0.05),but in female, this association was not found(OR=1.39,95%CI :0.98- 1.96,P =0.07).In addition,Meta analysis showed that Metabolic syn-drome was not associated with an increased risk of colon cancer mortality(OR=1.22,95%CI :0.92-1.63,P =0.1 7).Conclusion This Meta analysis indicated a positive association between Metabolic syndrome and colon cancer incidence in male,but not in fe-male.Metabolic syndrome might not be associated with an increased risk of colon cancer mortality,yet it needs more prospective co-hort studies to confirm the conclusion.

Bipolar artificial femoral head replacement for treatment of elderly unstable intertrochanteric fractures / 局解手术学杂志

Objective To investigate the clinical effect of bipolar artificial femoral head replacement in the treatment of elderly patients with unstable intertrochanteric fractures. Methods 82 elderly patients with unstable intertrochanteric fractures were randomly divided into two groups with 41 cases in each group. The control group was treated with dynamic hip screw internal fixation, and the observation group was treated with bipolar artificial femoral head replacement. The operation time, bleeding volume and ambulation time were compared, and all the patients were followed up for one year. Harris scores of the two groups at 1 month, 3 months, 6 months, and 12 months after operation were compared, and the incidence of complications were recorded and compared. Results The operation time, bleeding volume and ambu-lation time of the observation group were less than the control group with a statistically significant difference (P0. 05). The incidence of complication of the observation group was lower than that of the control group, the difference was statistically significant (P<0. 05). Conclusion Bipolar femoral head replacement has the advantages of simple operation, less trauma and complications. It is conducive to the early ambulation of patients and the recovery of hip function, and it is suitable for elder-ly patients with unstable femoral intertrochanteric fracture.

Clinical effects of botulinum toxin type A injection guided by electromyography and electrical stimulation for the treatment of upper limb spasticity after stroke / 中华物理医学与康复杂志

Objective To investigate the clinical effect of botulinum toxin type A (BTX-A) injections guided by electromyography in combination with electrical stimulation in the treatment of upper limb spasticity poststroke.Methods Forty-five patients with upper limb spasticity following stroke were recruited.They received multiple intra-muscular BTX-A injections guided by electromyography and electrical stimulation.Rehabilitation training was administered after the BTX-A injections.The results were assessed using the modified Ashworth scale (MAS),the Fugl-Meyer upper limb assessment (FMA),active range of movement (AROM) and the modified Barthel index (MBI).All the assessments were performed at the baseline,and then 1 week,2 weeks,1 month,and 3 months after the injections.Results Compared with the baseline scores the MAS,FMA,AROM and MBI results had all obviously improved by 2 weeks after the BTX-A injections.Compared with 2 weeks after the injections,the FMA and AROM scores at 1 month were significantly higher and there were further significant improvements at 3 months.No patient demonstrated obvious side effects from the therapy.Conclusion BTX-A injection guided by electromyography and electrical stimulation is safe and has definite beneficial effects on upper limb spasticity after stroke.

The influence of the operation through tubular stomach plus mechanical anastomosis on the life quality of patients with esophageal cancer / 中国基层医药

Objective To study the influence of the operation through tubular stomach plus mechanical anastomosis on the life quality of patients with esophageal cancer.Methods Seventy patients with esophageal cancer were treated by operation,tubular stomach plus mechanical anastomosis were used.They were followed up for six months.The quality of life was evaluated.Results The average time for the operation was 120 min and the average amount of bleeding was 291.3ml.Compared with before surgery,there was significant difference in emotion,activity,sleep and diet ( P ＜ 0.05 ).Conclusion The operation through tubular stomach plus mechanical anastomosis could significantly improve the quality of life of patients with esophageal cancer.

Adopting wedge hepatic venography with CO2 during transjugular intrahepatic portosystemic shunt procedures / 中华放射学杂志

Objective To renovate angiography in identifying portal vein anatomy during transjugular intrahepatic portosystemic shunt (TIPS) procedures,saving the time of TIPS procedures,decreasing the risk of the complications of the post-procedure.MethodsThe difference between the Wedge hepatic venography with Carbon Dioxide in 6 cases and Inferior Mesenteric artery angiography in 7 cases during TIPS procedures were compared in the identification of portal vein anatomy.The quality of images,their effects on the procedures,the complications and the recovery post-procedure were evaluated.Results Using CO2,the portal veins were opacified in all 6 cases.TIPS procedures succeeded in all cases except 1 case because of poor coagulation function.Using Inferior Mesenteric artery angiography,the portal veins were opacified in al1 7 cases.TIPS procedure succeeded in all cases except 1 case because of chronic portal occlusion.Puncture-site hematoma occurred in 1 case after TIPS procedure.ConclusionWedge hepatic venography with Carbon Dioxide is superior,safer and more convenient than Inferior Mesenteric Artery angiography in identifying portal vein anatomy during TIPS.

Laparoscopic versus open hepatectomy: a clinical comparative study / 中华肝胆外科杂志

Objective To compare the feasibility and safety of laparoscopic versus open hepatectomy.Methods The data of 165 patients who underwent laparoscopic hepatectomy were compared with 170 patients who underwent open hepatectomy in our hospital from November 2002 to December 2010.Results Laparoscopic hepatectomy was successfully carried out in 159 patients and 6 patients were converted to open operation because of intra-operative hemorrhage.The 170 patients in the open operative group had open hepatectomy successfully carried out.The hospital stay and cost in the laparoscopic group(7.6±1.3 d,31767.4±220.1(￥))were less than the open operation group(14.6±3.3 d,35127.3±392.2(￥))(t=-12.657,P＜0.001; t=-78.859,P＜0.001).There was no significant difference in Pringle's manoeuvre time,blood loss and postoperative complications(20.6 ±8.5vs.18.6±6.5 min,t=2.108,P=0.068),(420.8±76.5 vs.395.9±96.1 ml,t=2.157,P=0.063),(0 vs.4 cases,t=2.011,P=0.156))between the 2 groups.The operative time in the laparoscopic group was significantly longer than the open group(59.6 ± 12.2 vs.42.7 ± 22.6 min)(t=6.941,P＜0.001).Conclusions Laparoscopic hepatectomy is feasible and safe.It has the advantages of having less trauma and quicker recovery for tumors which were located superficially in the left liver and in the inferior part of the right liver.The operative time was longer than open hepatectomy,but there was no significant difference between the 2 groups in Pringle's manoeuvre time,blood loss and postoperative complications.The hospital stay and total hospital cost in the open operation group were higher than the laparoscopic hepatectomy group.

Expression and significance of caveolin-1 in breast carcinoma / 中华普通外科杂志

Objective To investigate the expression and significance of caveolin-1 in breast carcinoma.Methods Using immunohistochemical method the protein expression of caveolin-1 were analyzed in 105 cases of breast carcinoma and 50 cases of non-cancerous breast tissues.The relationship between caveolin-1 expression and CK5/6,EGFR,and E-cadherin expression was investigated.Clinical data of 105 cases of breast carcinoma were retrospectively analyzed.Results Among 105 cases of breast carcinoma,there were 20 cases of basal-like subtype,22 cases of luminal subtype A,23 cases of luminal subtype B,23 cases of HER2 over-expressing subtype,17 cases of normal breast-like subtype.Positive rate of caveolin-1 was significantly lower in breast carcinoma than in non-cancerous breast tissues (24.8％ vs.88.0％,P ＜ 0.05).Positive rate of caveolin-1 (75.0％) was higher in breast carcinoma than in luminal subtype A ( 4.8％ ),luminal subtype B ( 17.4％ ),HER2 over-expressing subtype ( 17.4％ ) or normal breast-like subtype( 11.8％ ),all P ＜0.05.Caveolin-1 expression was associated with expression of CK5/6 and EGFR(P ＜0.01 ).In univariate analysis,positive caveolin-1 was associated with higher lymph node metastasis rate (18/26,69.2％ )than negative (37/79,46.8％ ),P =0.047,and shorter 5-year-disease-free survival (38.46％ vs.74.68％,P =0.0004 ),but in multivariate analysis caveolin-1 was not an independent predictor of 5-year- disease-free survival (P ＞ 0.05).Conclusions Caveolin-1 can be seen as a screening mark of basal-like breast carcinoma,it may promote the invasiveness of breast cancer cells,but it is not an independent prognostic predictor of breast cancer patients.

Quality testing and quality classification standard establishment of Trollius chinensis seeds / 中国中药杂志

<p><b>OBJECTIVE</b>To study quality test, and establish quality classification standard of Trollius chinensis.</p><p><b>METHOD</b>Seed purity, weight per 1 000 seeds, seed moisture content, seed viability and their exterior parameters of the seed samples from different producing areas were measured, K cluster analysis was applied for the data analysis.</p><p><b>RESULT AND CONCLUSION</b>Quality of T. chinensis seeds from different producing areas was analyzed, and the primary T. chinensis seed quality classification standard was established.</p>

A clinical analysis of risk factor with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy / 中华胸心血管外科杂志

Objective To investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy. Methods The subjects were 82 patients with pN0 esophageal cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005. By using RT-PCR, VEGF-C mRNA was detected in tumor issues, and Mucin l( MUC1 )mRNA was detected in lymph nodes. The Kaplan-Meier method was used to calculate the survival rate and lymph nodal metastatic rate. Log-rank test was performed to compare the recurrence rate, and Cox regression multivariate analysis was performed to determine independent prognostic factors. Results VEGF-C mRNA was identified in 42 patients (51.22%), and MUC1 mRNA was identified in 23 patients(28.05% )from at least 1 lymph node station . The diagnosis of lymph node micrometastasis (LNMM) was based on the detection of MUC1 mRNA. The first recurrence exhibiting lymph node metastasis was recognized in 37 patients (45.1%) at the first 3 years after operation and this was significantly associated with T status ( P ＜ 0. 05 ). Lymph node metastatic rate for patients with VEGF-C mRNA expression in tumor issues was significantly higher than that for patients without VEGF-C mRNA expression( P ＜0. 01 ). And lymph node metastatic rate for patients with LNMM was significantly higher than that for patients without LNMM ( P ＜0. 01 ). The results of multivariate analysis confirmed that T status, VEGF-C mRNA expression in tumor issues and LNMM were independent relevant factors. Conclusion Status,VEGF-C mRNA expression in tumor issues and LNMM in patients with N0 esophageal cancer were independent risk factors for 3-year lymph node metastatic recurrence after Ivor-Lewis Esophagectomy.

Application value of multiphasic MSCT in the diagnosis of small renal carcinoma / 肿瘤研究与临床

ObJective To evaluate the multi-slice spiral CT (MSCT) in the diagnosis of early small renal cell carcinoma (RCC). Methods 32 cases of small RCC proved by pathology were retrospectively analyzed. The relationship of imaging features MSCT with pathology was compared. Results Of the 32 RCC in this study, 19 patients were with low density, 6 medium density, and 5 minimal high density. In 24 patients, the lesion were seen as a mixed enhancement pattern, 8 were with the homogeneous enhancement pattern.In cortical phase, clear cell RCC (25/32) tended to be marked enhancement or mixed enhancement pattern; 2 chromophobe lesions and 2 angsarcomakoid renal cell carcinoma (2/32, 2/32 respectively) tended to enhance moderately, papillary lesions (3/32) were mostly hypovascular and homogeneous enhancement pattern. The detection and characterization as well as accuracy of staging in 32 small RCC on MSCT were 100%, 93.75%, and 84.38%, respectively. Conclusion Muhiphase enhanced MSCT scan was a reliable technique in the dectection and clinical predicting subtype of small RCC.

Discussion on the Ethical Problems of Casualty Triage / 中国医学伦理学

Triage of casualties is very important to rescue large amount of injuries,especially to disasters.This article discusses four problems of triage of casualties from ethical aspects:the accuracy and rapidity,slightly wounded and seriously wounded,the sequence of delivery,the choice of qualified doctor and their training.

hMLH1 protein expression in esophagus squamous cell carcinoma, esophagus atypical hyperplasia, and normal esophagus tissues / 中国肿瘤生物治疗杂志

Objective: To observe the expression of hMLH1 protein in esophagus squamous cell carcinoma, atypical hyperplasia tissue and normal esophagus tissue, so as to discuss the relationship between hMLH1 expression and esophagus carcinogenesis. Methods: The specimens of esophagus squamous cell carcinoma, atypical hyperplasia and normal esophagus tissue were obtained from 92 esophagus carcinoma patients. Immunohistochemistry (IHC) staining technique was used to detect expression of hMLH1 protein. The relationship between hMLH1 expression with clinical parameters, such as gender, age, cancer differentiation level, infiltration depth, tumor stage, lymphatic metastasis, was analyzed. Results: The positive rates of hMLH1 protein in esophagus squamous cell carcinoma, and atypical hyperplasia tissue and normal esophagus tissue were 36.96%,56.52%, and 84.78%,respectively,with the former 2 significantly lower than the latter (P