益气养阴除结方联合顺铂对肺腺癌A549细胞生长及凋亡的影响

目的探讨益气养阴除结方联合顺铂对肺腺癌细胞（A549细胞）凋亡的影响及其机制。方法选用A549细胞培养,实验分为4组,分别为空白对照组、益气养阴除结方组（简称中药组）、顺铂组、联合组。空白对照组不加药物处理;中药组浓度梯度设定分别为1 000、500、200、100、50、20 mg/L;顺铂组浓度梯度设定分别为4 mg/L和8 mg/L;联合组浓度梯度分别为以上2组之间的组合。应用MTT法检测药物对其增殖的抑制作用;TUNNEL法检测细胞凋亡情况;免疫细胞化学法检测肿瘤细胞Bcl-2及Caspase-3蛋白的表达。结果与空白对照组比较,中药组、顺铂组及联合组的细胞抑制率均有明显增加（P〈0.05~P〈0.001）,其中联合组（中药200 mg/L＋顺铂4mg/L）抑制率最高;各用药组凋亡细胞数量均有明显增加（P〈0.01,P〈0.001）,其中联合组（中药200 mg/L＋顺铂4 mg/L）凋亡细胞数量最多;各用药组bcl-2的表达均降低,其中顺铂组（4 mg/L）、联合组（中药200 mg/L＋顺铂4 mg/L）Bcl-2的表达明显降低（P〈0.01）;各用药组Caspase-3表达的表达均升高,其中中药组（200 mg/L）、联合组（中药200 mg/L＋顺铂4 mg/L）有显著性差异（P〈0.05,P〈0.01）。结论该中药复方能促进A549细胞凋亡抑制肿瘤细胞生长,联合一定浓度顺铂后其效果更明显,其机制可能与抑制Bcl-2和增加Caspase-3的表达有关。

结核性脑膜炎的早期诊断与治疗

结核性脑膜炎(简称结脑)以儿童多见,近年来,成人发病率有所增加。目前尽管有许多抗结核药物,预后有很大改善,但结脑的死亡率和致残率仍较高。最近欧美报告死亡率为15％～36％。早期诊断,早期治疗和规则用药是影响预后的关键。由于该病有不典型临床表现和不典型脑脊液(CSF)改变者较多,因而造成误诊、误治者屡见不鲜。

我国古老的收付复式帐——“四脚帐”

我国自唐宋时期产生“四柱清册”后,明末清初时期又创建了被誉为中国复式记帐开端的“龙门帐”,清朝中期,我国复式记帐又有了新的发展,出现了收付复式帐——“四脚帐”。“四脚帐”又称“天地合帐”,它可以说是我国古老的收付复式帐,虽然前人没有专门著作对其论述,但,在官府民问将其技术传与后人,却是源远流长的。1935年出版的《商业辞典》记载有“中国旧式簿记之复式簿记俗称四脚帐,又称天地合”,这一记载便可佐证“四脚帐”曾广为流传。“四脚帐”对发生的一切经济事项,无论是现金出纳、商品进销以及内外往来转帐等,要求一律在帐簿上登记其相对应的两笔。

Preparation of potassium salt with joint production of spherical calcium carbonate from sintering dust

Several physical and chemical detection methods were used to study the basic properties of sintering dust （ESP dust） collected from Baogang Steel Corporation. The result shows that the major constituents of the ESP dust are KCl, NaCl, Fe2O_3 and Fe3O_4. Water leaching experiment on the sintering dust shows that KCl in the ESP dust can be separated and recovered by water leaching and fractional crystallization. Component analysis of leaching solution indicates that the massive calcium sulfate in the leaching solution should be removed first in order to obtain the pure potassium salt. In order to provide theoretical guidance to inhibit the dissolution of calcium ions from the sintering dust, the water leaching experiment of ESP dust and the dissolution behavior of CaSO_4 in the potassium chloride, sodium chloride, potassium sulfate and their mixed salt solution were studied. It is found that, a lower liquid-solid ratio should be chosen in the leaching process to inhibit the dissolution of calcium sulfate dehydrate. Using sodium carbonate solution as a precipitating agent, the influences of the concentration of sodium carbonate solution, reaction temperature, stirring speed and equilibrium time on the preparation of the spherical calcium carbonate were studied. Spherical calcium carbonate with good dispersing performance and grain size distribution in nanometer range of less than 10 μm was obtained. Furthermore, a potassium recovery process with joint production of spherical calcium carbonate was designed. This process is technically viable and considerable in economic benefit.

第六讲 中国固有复式簿记(二)——“四脚帐”

“四脚帐”又名“天地合帐”、“天地盘帐”、“登销扎彩帐”等,它是近代中式会计发展过程中,受“三脚帐”、“龙门帐”的影响而产生的一种比较成熟的复式帐法,是中华民国以前中式帐法的最高表现形式。本讲拟从“四脚帐”的产生运用过程入手,概要介评“四脚帐”的基本内容,并对其历史地位和作用进行研讨。一、四脚帐的产生与运用过程“四脚帐”由何人所创?如何创立了四脚帐?这些问题还有待于进一步探究,但对于它的产生时期,目前会计史学界的认识是基本一致的,即一般认为“四脚帐”

Security Assurance for One-stage Resection of Left Colon Cancer with Acute Obstruction—Thorough and Prompt Enteral Decompression without Contamination

Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to be resected colon segment” was cut at its lower end, then the proximal cut end was put into a plastic bag which was adhered to one side of the operating table. After releasing the clamp, the content could ?ow into this bag. The operator could squeeze the bowel with two hands by turns, from proximal to farness, and from small bowel to large bowel, until the entire bowel content was fully discharged. Then the upper end of this “to be resected colon segment” was cut, and was removed together with the plastic bag. Results: 31 cases of left colon cancer with acute obstruction were decompressed with this technique. They all recovered smoothly, without anastomosis ?stula. Another 6 cases of hepatic seg- mentectomy with incidental colonectomy were decompressed with this technique and had the same results. This technique was also used in di?erent kinds of acute small intestinal obstruction and gained satisfactory results. Conclusion: This technique could be considered as the preferable choice for intraoperative enteral decompression.

A novel method for comprehensive utilization of sintering dust

A novel process aimed at the comprehensive utilization of sintering dust was developed by combining wetting grinding with sulfidization flotation. The mineralogical characteristics of the sintering dust and products were studied by powder wettability analysis, X-ray diffraction（XRD）, scanning electron microscopy（SEM） and mineral liberation analyzer（MLA）. It was found that the primary lead species was laurionite and most of the particles were overwrapped with KCl. Wetting grinding was shown to accelerate the dispersion of sintering dust and transform the KCl overlay to a leachate with 20.78 g/L of K＋. A lead and silver concentrate consisting of 40.82% of Pb and 0.96 kg/t of Ag was achieved, while an iron concentrate with 60.89% of Fe was gained as tailings among sulfidization flotation. The recoveries of Pb, Ag and Fe were 89.57%, 87.85% and 88.58%, respectively. The results indicate that this method is a feasible and promising process for the comprehensive utilization of sintering dust.

张锡纯应用代赭石经验管窥

张锡纯应用代赭石,平胃降逆以治呕恶,吐衄;平肝镇冲以治癫狂痫、中风;而对赭石通便除结之用,最具特色,颇有发挥。用量恒重,配伍精当,效果显著。

经济信息

国家经贸委主任盛华仁谈今年国企的4项改革 一、改进呆坏账准备金核销办法,除结转项目外,今年要紧紧围绕三年脱困,向重点行业和重点企业倾斜,集中用于兼并和破产。做好“封闭贷款”工作,切实解决重点脱困企业中有销路、有效益产品生产的流动资金贷款。

中外会计发展史说明：收益核算是复式记帐的基本特征

中外会计发展史说明；收益核算是复式记帐的基本特征植锦蓉收益即利润，是企业追求的基本目标，也是企业会计核算的重要内容。从一定意义上说，它又是复式记帐的基本特征。这可以从中外复式记帐的产生和发展过程中得到说明。一、西方复式记帐的产生和发展美国麦克尔著的《...

DFT Study on Molecular Structures and ROS Scavenging Mechanisms of Novel Antioxidants from Lespedeza Virgata

The molecular structure and radical scavenging activity of three novel antioxidants from Lespedeza Virgata, lespedezavirgatol, lespedezavirgatal, and lespedezacoumestan, have been studied using density functional theory with the B3LYP and BhandHLYP methods. The optimized geometries of neutral, radical cation, radical and anion forms were obtained at the B3LYP/6-31G（d） level, in which it was found that all the most stable conformations contain intramolecular hydrogen bonds. The same results were obtained from the MP2 method. The homolytic O-H bond dissociation enthalpy and the adiabatic ionization potential of neutral and anion forms for the three new antioxidants and adiabatic electron affinity and H-atom affinity for hydroxyl radical, superoxide anion radical, and hydrogen peroxide radical were determined both in gas phase and in aqueous solution using IEF-PCM and CPCM model with UAHF or Bondi cavity. The antioxidant activities and reactive oxygen species scavenging mechanisms were then discussed, and the results obtained from different methods are consistent. Furthermore, the antioxidant activities are consistent with the experimental findings of the compounds under investigation.

Distribution of solitary Iymph nodes in primary gastric cancer:A retrospective study and clinical implications

AIM： To investigate the distribution pathway of metastatic lymph nodes in gastric carcinoma as a foundation for rational lymphadenectomy. METHODS： We investigated 173 cases with solitary or single station metastatic lymph nodes （LN） from among 2476 gastric carcinoma patients. The location of metastatic LN, histological type and growth patterns were analyzed retrospectively. RESULTS： Of 88 solitary node metastases cases, 65 were limited to perigastric nodes （N1）, while 23 showed skipping metastasis. Among 8 tumors in the upper third stomach, 3 involved right paracardial LN （station number： No.1）, and one in the greater curvature was found in No.1. In the 28 middle third stomach tumors, 10 were found in LN of the lesser curvature （No.3） and 6 in LN of the left gastric artery （No.7）; 5 of the 20 cases on the lesser curvature spread to No.7, while 2 of the 8 on the greater curvature metastasized to LN of the spleen hilum （No.10）. Of 52 lower third stomach tumors, 13 involved in No.3 and 19 were detected in inferior pyloric LN （No.6）; 9 of the 29 cases along the lesser curvature were involved in No.6. CONCLUSION： Transversal and skipping metastases of sentinel lymph nodes （SLN） are notable, and rational lymphadenectomy should, therefore, be performed.

Learning curve of laparoscopy-assisted distal gastrectomy with systemic lymphadenectomy for early gastric cancer

AIM: To evaluate the nature of the 'learning curve' for laparoscopy-assisted distal gastrectomy (LADG) with systemic lymphadenectomy for early gastric cancer. METHODS: The data of 90 consecutive patients with early gastric cancer who underwent LADG with systemic lymphadenectomy between April 2003 and November 2004 were reviewed. The 90 patients were divided into 9 sequential groups of 10 cases in each group and the average operative time of these 9 groups were determined. Other learning indicators, such as transfusion requirements, conversion rates to open surgery, postoperative complication, time to first flatus, and postoperative hospital stay, were evaluated. RESULTS: After the first 10 LADGs, the operative time reached its first plateau (230-240 min/operation) and then reached a second plateau (＜200 min/operation) for the final 30 cases. Although a significant improvement in the operative time was noted after the first 50 cases, there were no significant differences in transfusion requirements, conversion rates to open surgery, postoperative complications, time to first flatus, or postoperative hospital stay between the groups. CONCLUSION: Based on operative time analysis, this study show that experience of 50 cases of LADG with systemic lymphadenectomy for early gastric cancer is required to achieve optimum proficiency.

Bilateral liver resection for bilateral intrahepatic stones

AIM: To evaluate the shortand long-term outcomes of bilateral liver resection for bilateral intrahepatic stones. METHODS: We reviewed retrospectively 101 consecutive patients with bilateral intrahepatic stones who underwent bilateral liver resection in the past 10 years. The shortand long-term outcomes of the patients were analyzed. The Cox proportional hazards model was used to identify the risk factors related to stone recurrence. RESULTS: There was no surgical mortality in this group of patients. The surgical morbidity was 28.7%. Stone clearance rate after hepatectomy was 84.2% and final clearance rate was 95.0% following postoperative choledochoscopic lithotripsy. The stone recurrence rate was 7.9% and the occurrence of postoperative cholangitis was 6.5% in a median follow-up period of 54 mo. The Cox proportional hazards model indicated that liver resection range, less than the range of stone distribution (P = 0.015, OR = 2.152) was an independent risk factor linked to stone recurrence. CONCLUSION: Bilateral liver resection is safe and its shortand long-term outcomes are satisfactory for bilateral intrahepatic stones.

Two-stage resection for malignant colonic obstructions:The timing of early resection and possible predictive factors

AIM:To study potential predictive factors for early radical resection in two-stage resection for left malignant colonic obstruction.METHODS:Thirty-eight cases of left-sided obstructive colon cancer undergoing two-stage operations were reviewed between January 1998 and August 2008.Patients were classified into two groups(n = 19 each):early radical resection(interval ≤ 10 d) and late radical resection(interval > 10 d).Baseline demographics,post-diversion outcome,perioperative data,tumor characteristics,outcome and complications were analyzed.RESULTS:The baseline demographics revealed no differences except for less pre-diversion sepsis in the early group(P < 0.001) and more obstruction days in the late group(P = 0.009).The mean intervals of early and late radical resections were 7.9 ± 1.3 d and 17.8 ± 5.5 d,respectively(P < 0.001).After diversion,the presence of bowel sounds,flatus,removal of the nasogastric tube and the resumption of oral feeding occurred earlier in the early group.The operation time and duration of hospital stay were both significant reduced in the early group.Complication rates did not differ between groups.CONCLUSION:The earlier recovery of bowel function seems to be predictive of early radical resection.In contrast,pre-diversion sepsis and more obstruction days were predictive of delayed radical resection.

Vagina vasorum dissection during D2 lymphadenectomy for gastric carcinoma

AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.

Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma

AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.

Long-term results of subtotal colectomy with cecorectal anastomosis for isolated colonic inertia

AIM： To evaluate the results of sub total colectomy withI cecorectal anastomosis （STC-CRA） for isolated colonicinertia （CI）. METHODS： Fourteen patients （mean age 57.5±16.5 year） underwent surgery for isolated CI between January 1986 and December 2002. The mean frequency of bowel motions with the aid of laxatives was 1.2±0.6 per week. All subjects underwent colonoscopy, anorectal manometry, cinedefaecography and colonic transit time （CTF）. CI was defined as diffuse markers delay on CTF without evidence of pelvic floor dysfunction. All patients underwent STC-CRA. Long-term follow-up was obtained prospectively by clinical visits between October 2005 and February 2006 at a mean of 10.5 ＋ 3.6 years （range 5-16 years） during which we considered the number of stool emissions, the presence of abdominal pain or digitations, the use of pain killers, laxatives and/or fibers. Patients were also asked if they were satisfied with the surgery. RESULTS： There was no postoperative mortality Postoperative complications occurred in 21.4% （3/14）. At the end of follow-up, bowel frequency was significantly （P〈0.05）increased to a mean of 4.8±7.5 per day （range 1-30）. One patient reported disabling diarrhea. Two patients used laxatives less than three times per month without complaining of what they called constipation Overall, 78.5% of patients would have chosen surgery again if necessary. CONCLUSION： STC-CRA is feasible and safe in patients with CI achieving 79% of success at a mean follow-up of 10.5 years. A prospective controlled evaluation is warranted to verify the advantages of this surgical approach in patients with CI.