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Objective To investigate the efficacy and safety of sacubitril valsartan in the treatment of heart failure(HF)of midrange ejection fraction(HFmrEF)in patients after acute myocardial infarction(AMI).Methods A total of 102 patients with HFmrEF after AMI were divided into the control group and the experimental group,with 51 cases in each group.The control group was given conventional treatment for AMI and anti-HF treatment,and the angiotensin-converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB)was used without contraindications.The experimental group was replaced by ACEI/ARB with sacubitril valsartan on the basis of the control group.After 6 months of treatment,the total effective rates of the two groups after treatment were analyzed,and the cardiac function,N-terminal pro-brain natriuretic peptide(NT-proBNP)and serum inflammatory factor C-reactive protein(CRP)were compared before and after treatment.The occurrence of adverse reactions after treatment was recorded.Kaplan-Meier method was used to analyze the cumulative cardiovascular mortality,HF rehospitalization rate and end-event-free survival after 6 months of treatment in two groups.Results After treatment,there was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).The total effective rate was higher in the experimental group than that of the control group(P<0.05).Compared with before treatment,left ventricular ejection fraction(LVEF),stroke volume(SV),mitral diastolic blood flow velocity E peak and A peak ratio(E/A)and 6 min walking distance(6MWD)were increased in the two groups,and left ventricular end-diastolic diameter(LVEDD)and left atrial diameter(LAD)were decreased in the two groups after treatment(all P<0.05).After treatment,LVEF,SV,E/A and 6MWD were higher in the experimental group than those in the control group(P<0.05).LVEDD and LAD were lower than those in the control group(all P<0.05).Compared with results before treatment,NT-proBNP and CRP were decreased after treatment in the experiment group than those in the control group(P<0.05).There was no significant difference in the cumulative cardiovascular mortality between the experiment group and the control group(3.9％vs.5.9％,P=0.524).The cumulative HF rehospitalization rate was lower in the experimental group than that of the control group(9.8％vs.23.5％,P=0.042).The cumulative end-point-free survival rate was higher in the experiment group than that of the control group(86.3％vs.70.6％,P=0.037).Conclusion Sacubitril valsartan is safer and more effective than ACEI/ARB in the treatment of AMI patients with HFmrEF,and it is worthy of clinical promotion.

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Circular RNA (circRNA) is a widely present endogenous noncoding RNA that is covalently bonded at the 3' and 5' ends via trans-splicing to form a closed-loop structure with high stability, biological evolutionary conservatism,and tissue expression specificity. CircRNA has important biological functions, such as playing the role of microRNA (miRNA) sponge, regulating the expression of a par-ent gene, and improving transcription and translation levels. In gastrointestinal tumor, circRNA mainly plays the role of miRNA sponge, which affects the proliferation, differentiation, apoptosis, and invasion of cancer cells. In addition, circRNA was specifically expressed in the tumor, and the expression level significantly differs from that of paracancer. Therefore, a highly conserved and stable circRNA se-quence is expected to be an early diagnosis and prognostic marker for gastrointestinal tumor. In this study, we review research advanc-es on circRNA and its relationship with gastrointestinal cancers (esophageal, gastric, colorectal, and liver cancers).

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<p><b>OBJECTIVE</b>To explore the effect of body mass index (BMI) on postoperative short-term prognosis and survival rate of gastric cancer patients.</p><p><b>METHODS</b>Clinical and follow-up date of 153 gastric cancer cases undergoing radical operation in our hospital from January to June 2010 were retrospectively analyzed. According to BMI, patients were divided into low group (BMI<18.5, 23 cases), normal group (18.5≤BMI<25.0, 95 cases) and high group (BMI≥25.0, 35 cases). Clinicopathological features and outcomes were compared the among three groups.</p><p><b>RESULTS</b>Among three groups, the differences in operation time, intraoperative blood loss, number of lymph node retrieved, postoperative hospital stay, lymph node metastasis rate, tumor staging and postoperative complication morbidity were not statistically significant (all P>0.05). Preoperative hemoglobin in the low group was significantly lower as compared to normal and high groups [(106.1±13.8) g/L vs. 113.5±5.2) g/L and (123.5±8.7) g/L, F=3.265, P=0.041], and so was the preoperative albumin [(38.7±2.5) g/L vs. (41.3±0.8) g/L and (43.5±1.4) g/L, F=8.516, P=0.000]. The ratio of gastric cardiac cancer in the low group was significantly lower as compared to the normal and high groups[34.8%(8/23) vs. 68.4%(65/95) and 62.9%(22/35), χ(2)=8.913, P=0.012]. Five-year survival rate of the low, normal and high groups were 43.5%, 50.5% and 65.7% respectively(P=0.189). Subgroup analysis showed that the 5-year survival rate of patients with gastric cardiac cancer in the low group was significantly lower as compared to those in the high group (25.0% vs. 84.6%, P=0.004).</p><p><b>CONCLUSIONS</b>BMI dose not generally play a role in short-term outcomes and long-term survival of the gastric cancer patients. Nutritional improvement and body weight maintenance may be beneficial to low BMI patients, especially those with gastric cardiac cancer.</p>

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Objective To explore the experience in treatment of primary retroperitoneal tumors (PRPT).Methods The clinical data of 62 cases with primary relroperitoneal tumors from 2001 to 2007were studied retrospectively.Results The abdominal mass was the main symptom in PRPT.There were 29 cases of benign tumors and 33 cases of malignanat tunlors respectively.Complete resections were performed in 47 patients(76%),partial resection was conducted for 10 patients.Resection could not be performed in 5 patients so only biopsy was conducted,12 patients accepted combined organ resections,2 patients died.Conclusion Adequate preoperative preparation and excellent surgical technique are the keys to compele tumour resection.

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Objective: To observe the antiasthmaf ic, anti-inflammatory and immunological effects of Gubenchuansoukang Granule. Methods: The rats asthma model was established by ovalbumin sensitization. The model was identified by the study of the asthma incubation period and the total white cells counts in bronchoalveolar lavage fluid (BALF). The anti-inflammatory effect was observed by the acute inflammation and chronic inflammation induced xylene and agar. To observe the effect of Gubenchuansoukang Granule on humoral immunity and cellular immunity induced by chicken red blood cell and 2, 4-dinitrochlorobenzene. Results: Gubenchuansoukang Granule could lengthen the asthma incubation period, reduce the quantity of total white cells in BALF, against the acute inflammation and chronic inflammation, and restrain the humoral immunity and cellular immunity. Conclusion: Gubenchuansoukang Granule had antiasthmafic, anti-inflammatory and immunosuppression effects.

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Objective To evaluate the diagnosis and surgical management for pancreatic duct stones (PDS). Methods The clinical data of 19 PDS patients admitted to our hospital from Jan. 1985 to Sep. 2003 were analyzed retrospectively. Results Epigastric pain was the first symptom in all patients,and chronic pancreatitis was associated, pancreatic carcinoma coexisted in 6 cases. Fifteen cases were found to have PDS or pancreatic duct dilation by B-type ultrasonography. Twelve patients underwent pancreatolithotomy plus side to side Roux-en-Y pancreaticojejunostomy. Pancreatoduodenectomy was performed on four patients ,caudal pancreatectomy and pancreatolithotomy on three patients. Six pancreatic carcinoma patients died during follow-up of 9～26 months. Abdominal pain was relieved completely in 11 cases and partially in 1,stones and pain recurred in one patient. Conclusions B-type ultrasonography、CT and endoscopic retrograde cholangiopancreatography(ERCP) are most useful diagnostic methods;Surgical procedures should be selected according to the following factors: (1) location of the pancreatic duct stones. (2) stenosis of the main pancreatic duct.(3) pancreatic duct stones associated with or without pancreatic carcinoma.