目的：探讨在手术治疗的基础上于术后加用大柴胡汤加减治疗胆总管结石的临床疗效。方法将60例胆总管结石患者按随机数字表法分为西医对照组和中西医结合治疗组，每组各30例，西医对照组行择期胆囊切除术＋胆总管探查术＋“T”管引流术，术后给予常规抗炎、补液、抑酸、纠正电解质紊、止痛和胃肠减压等治疗，中西医结合治疗组在上述治疗的基础上于术后24 h 口服大柴胡汤加减方（以大柴胡汤为主方，根据患者具体情况给予辨证施治）。观察2组患者的临床疗效，分别取腹痛缓解时间、住院时间及实验室理化检查（白细胞计数、中性粒细胞比例、总胆红素、CRP 等）恢复正常的时间进行比较。结果中西医结合治疗组住院时间及实验室理化检查恢复正常时间均比西医对照组显著缩短（P ＜0．05）。结论胆总管结石患者在术后加用大柴胡汤疗效确切，采用中西医结合辨证论治的方法治疗该病可取得较为满意的效果。

OBJECTIVETo explore the eff ect of artenisiae scopariae and poriae powder (ASPD) on calpain-2 expression in liver tissue from rats with obstructive jaundice.METHODSThe rat model of obstructive jaundice was established. SD rats was divided into the control group, the obstructive jaundice group, the obstructive jaundice model plus ASPD group, the obstructive jaundice model plus saline group. Th e serum levels of TBIL, ALT, AST and other biochemical indexes were detected. The pathological changes of liver tissue were evaluated by HE staining. The calpain-2 mRNA and protein expression in liver was measured by Real-time PCR and immunohistochemistry or Western blot, respectively.RESULTSThe calpain-2 mRNA and protein expression levels were significantly up-regulated in live tissues from the rats with obstructive jaundice in a time-dependent manner. The ASPD could inhibit the calpain-2 expression in rats with obstructive jaundice concomitant with the decreased liver damage and the improved liver function, suggesting that calpain-2 was involved in endoplasmic reticulum stress-mediated cellular apoptosis and the occurrence of obstructive jaundice.CONCLUSIONASPD could be used for patients with obstructive jaundice to promote the recovery of liver function after operation and to reduce the incidence of complications, which provide a theoretical basis for the reasonable application of traditional Chinese medicine in the peroperative period.

甲状腺癌（thyroid carcinoma，TC）是内分泌系统最常见的一类恶性肿瘤，不同组织学类型的甲状腺癌生物学行为及预后差异很大，术前诊断主要依赖于甲状腺细针穿刺细胞学检查（fine-needle aspiration biopsy，FNAB）。目前对于高侵袭性甲状腺癌传统治疗手段疗效仍然非常有限，随着对甲状腺癌分子发病机制的深入研究，一些如BRAF、RET、PAX8／PPAR＾y 突变基因对于甲状腺乳头状癌、滤泡状癌和甲状腺髓样癌的诊断、预后甚至选择合适的治疗方案均具有关键作用，为甲状腺癌的分子诊断、预后判断及分子靶向治疗提供了新的机遇。尽管存在增加诊断费用、特异性有待提高、部分肿瘤仍缺乏特异性的标志物等不足，但分子诊断技术在甲状腺癌的诊断和治疗上必将扮演越来越重要的角色。

Objective To explore the curative effect of Sodium Aescinate for Injection for prevention and treatment of complications after hemorrhoids operation. Methods 190 cases of hemorrhoids patients were randomly divided into treatment group and control group, 95 cases in each. Two groups of patients with hemorrhoids with milligan morgan hemorrhoidectomy type, were using routine treatment of anti infection, hemostasis, local bath, dressing, symptomatic treatment after operation. After the control group on the basis of conventional treatment of oral Aescuven forte, oral 0.15g, bid, sooner or later each time, 7 d for a course of treatment. The treatment group in the conventional treatment based on the preoperative 1d started using Sodium Aescinate for injection 20 mg in 10%Glucose injection 250 ml, intravenous drip, qd, 7 d for a course of treatment. Evaluated of two groups of patients after 3 d, 5 d, 7 d on anal edema, edema, average time average pain duration time, mean cure time and the total efifciency. Results Anal edema scores in treatment group patients were signiifcantly lower than the control group (P<0.05) after 3 d, 5 d, 7 d, average edema duration time, average pain duration time, mean cure time in treatment group was signiifcantly shorter than the control group (P<0.01). The total effective rate of treatment group was 96.8%, control group was 75.8%, there was signiifcant difference between the two groups (P<0.01). Conclusion Sodium Aescinate injection in treating hemorrhoids postoperative complications can rapid eliminate of hemorrhoids anal edema, reduce postoperative complications, shorten the edema, pain, recovery time, it is economical, effect and safe.

Objective To investigate the security and feasibility of primary closure of the common bile duct after choledochotomy for common bile duct calculi.Methods 50 patients with the evidence of stones in the common bile duct underwent choledochotomy.Among them,22 received primary closure of the common bile duct and 28 T-tube drainage.Results The intraoperative blood lose,operation time and operative mortality are similar in two groups(P>0.05).After surgery,the average hospital stay,and cost of hospitalized are similar in two groups(P<0.05).Conclusion Primary closure of the common bile duct after choledochotomy is safe and effective in selected patients with common bile duct calculi.

目的探讨腹茧症的发病特点及治疗方法。方法分析总结1982~1996年收治的6例腹茧症患者的临床资料。结果6例腹茧症发病均以无腹部手术史的急性不完全性肠梗阻为特征。术前腹平片可以发现以2、3、4、5组小肠梗阻为临床表现。CT检查无特异性发现,外科手术是唯一有效的措施。结论反复出现肠梗阻症状的患者又无腹部手术史,或无其它原因能解释的腹部包块者,应注意腹茧症的可能性。

Objective: To observe the expressions of HER-2 in breast cancer,and explore its correlation with the clinical prognosis of breast cancer.Methods: HER-2 was detected by S-P immunohistochemical technique in 183 patients with breast cancer.Results:(1)The expression level of HER-2 in the breast cancer tissues was 30.05%(55/183).(2)HER-2 was significantly correlated with the tumor size,clinical TNM stage,histological grade,and lymph node status(P<0.05),but had no correlation with age,pathological type,the status of ER and PR.Conclusion:HER-2 can serve as markers for prognosis judgment of breast cancer patients.

近年来尽管胆囊癌手术切除率有所提高,但胆囊切除后胆囊癌的再手术率低,除患者因素外,医生对再次手术的重视以及胆囊癌恶性生物学的特征也是重要因素.因此探论胆囊癌的再手术规范,对提高手术治疗效果及预后有重要意义.