Treated 28 cases of obesity by electroacu-puncture plus auricular-press therapy, and 15 cases got significant effect, 10 cases got effectiveness, 2 cases got improvement and 1 case had no effect.

With the development of imaging technology,the reports of spontaneous isolated superior mesenteric artery dissection become more frequently,but there is no consensus on the therapeutic plans which consist of conservative therapy,endovascular treatment and surgical treatment.Therefore,the related questions of the spontaneous isolated superior mesenteric artery dissection will be discussed in order to improve the diagnosis and treatment of vascular diseases of digestive tract with a review of literatures.

Objective To explore the effects of insulin pump on pancreatic ?-cells in type 2 diabetes mellitus accompanied with hyperglycaemia.Methods We treated 46 cases of newly diagnosed type 2 diabetes mellitus with fasting blood glucose≥10.0 mmol/L by insulin pump for 2 weeks.Their blood sugar and insulin were determined before and after treatment by oral glucose tolerance test and insulin releasing test.We then calculated the function index,morning secretion of pancreatic ?-cells and insulin resistance index.The patients were followed up for 6 months and the blood glucose was monitored.Results After treatment,insulin,function index and the morning secretion were increased significantly,while the blood sugar and resistance index were decreased.In all the patients,16 could maintain ideal blood glucose only by alimentary control and exercise.Conclusion With the insulin pump in a short term,patients with type 2 diabetes mellitus can rapidly control blood glucose,obviously improve pancreatic ?-cells,and reduce insulin resistance.

Since Reich completed the first laparoscopic hepatectomy (LH) in 1991,LH has been developed rapidly with the continuous improvement of surgeons' technique and the technological changes in devices and related processes.This article elaborates on the safety and efficacy of LH,the value of 3D visualization,3D printing technology,and 3D laparoscopic technology in guiding precise hepatectomy,control of hemorrhage during LH,and safety and efficacy of robotic hepatectomy.

Anopheles dirus was fed with the mice of Kunming strain infected by plas-modium yoelii yoelii (By265 strain) for three or four days. Then the midgut and the salivary glands of the mosquitoes were examined. It was found that the infection rate of the malaria parasite of the midgut was 78.57% (44/56), but that of the salivary glands was only 4.88% (2/41) . After two passages of the malaria parasite through the mice and the mosquitoes, the infection rate of the salivery glands could be increased up to 13.96% (6/43).

Anopheles dims Peyton et Harrison, 1979 is an important malaria vector in Southeast Asia and China particularly in forested hilly zones. To establisha a laboratory mating colony for this mosquito is one of the subjects to be solved urgently in malaria research.This paper is to report our experience on breeding this mosquito. Ecological environment is created to simulate the natural conditions. The room-temperature of the insectary is 25?-28℃ and its relative humidity is around 80%.Mosquitoes are kept in cages with the si2e of 50 ? 50 ? 100cm. The larvae are fed with a mixture of de-fatted pig liver powder and yeast with a ratio of 1:3. The adults are fed with a mixture syrup containing 4% of orange juice, 10% of sucrose and other materials. The insectary is illuminated with a 3o w fluorescent light in the day time and a 15 w blue light in the night continuously to induce mating.The mating rate of the fourteenth generation reached 68% and the descendants bred can be used in research work now.

Objective To observe on the variance of serum IL-18 level and lymphocyte subpopulations in the patients with obese diabetic(T2DM).Methods The diabetic obese group contained 31 cases,the non-diabetic obese group contained 33 cases,healthy normal body weight group contained 23 cases,the blood glucose(FPG),insulin (FPI),blood total cholesterol(TC),triglyceride(TG),IL-18 and the cell population of lymphocyte subpopulations CD3+and CD4+、CD8+ in peripheral blood were determined,the insulin sensitivity index were calcnlated.Results Compared with the healthy normal body weight group,the blood fat,FPG,FPI,IL-18 of T2DM patients significantly increased,there were significant statistical difference(P ＜ 0.05 or P ＜ 0.01).The ISI significantly decreased(P ＜ 0.01).Compared with the non-diabetic obese group,the blood fat and IL-18 of T2DM patients significantly increased (P＜0.05).Compared with the diabetic obese group,the subpopulations cell population of CD3+、CD4+、CD8+ in the non-diabetic obese group significantly decreased,the ratio of CD4+/CD8+ significantly increased,there were significant statistical difference(P＜0.05 or P＜0.01)in the two groups comparison.Compared with the non-diabetic obese CD4+/CD8+ significantly increased(P＜0.05).Conclusion T2DM patients should prevent the hyperinsulinemia,control blood sugar,reduce insulin resistance,sustain normal lipid metabolism,boost immune function.

Objective To investigate the value of three-dimensional visualization system in the treatment of hilar cholangiocarcinoma.Methods The clinical data of 10 patients with hilar cholangiocarcinoma who were admitted to Chenggong Hospital of Xiamen University from January 2012 to September 2012 were retrospectively analyzed.The two-dimensional computed tomography images were converted to three-dimensional images with the three-dimensional visualization system,and then the volume of liver and tumor size,volume of liver to be resected,remnant liver volume were measured.Surgical procedure was planned based on the three-dimensional images,and the difference between the actual and planned surgical procedures was analyzed.The correlation between actual liver resection volume and predicted liver resection volume was analyzed by calculating the Pearson correlation coefficient.Results The mean liver volume,tumor size,predicted liver resection volume and remnant liver volume of the 10 patients detected by the three-dimensional visualization system were (1496 ± 162) ml,(67 ± 18) ml,(335 ± 241)ml and (1140 ± 197)ml,respectively.The average error rate of predicted liver resection volume was 6.4％.Surgical plan was made in accordance with the principle of curative hepatectomy,including 4 cases of left semihepatectomy,2 cases of right semihepatectomy,3 cases of partial liver resection and 1 case of palliative liver resection.The coincidence rate between the planned and actual surgical procedures was 9/10.R0 resection was performed on 7 patients,R1 resection on 1 patient and palliative resection on 2 patients.One patient received restrictive portal vein arterialization.Preoperative evaluation of the anatomy of blood vessels,bile ducts and tumors based on three-dimensional images was confirmed with operative findings.The accuracy of tumor typing by the three-dimensional visualization system was 8/10.The actual liver resection volume was (325 ± 258) ml,which was positively correlated with the predicted liver resection volume (r =0.902,P ＜ 0.05).Conclusion The three-dimensional visualization system is helpful in the treatment of hilar cholangiocarcinoma.

Objective Recent studies have shown that inflammatory cytokines are involved in the occurrence and development of diabetes mellitus .The article aimed to investigate the effects of anti-inflammatory drug--diacerein on hepatic PPAR-γand GLUT-2 protein expression and its role in the regulation of glucose and lipid metabolism in rats with type 2 diabetes mellitus ( T2DM) . Methods 55 male SD rats were randomly divided into 4 groups:normal control group (n=10), T2DM group (n=15), pioglitazone intervention group(n=15), and diacerein treatment group(n=15) .Rats in normal control group were fed with normal diet , the other 3 groups were fed with high fat diet .At the end of 8th experi-ment week, rats in 3 groups fed with high fat diet were treated with intraperitoneal injection of 30mg/kg streptozotocin ( STZ) solution, while rats in normal control group were injected with the same volume of sterile sodium citrate solution .At the end of 10th week, OGTT modeling rats were screened .Rats in pioglitazone intervention group were treated with 10 mg/kg pioglitazone by intragastric administra-tion, rats in diacerein group was treated with 50mg/kg diacerein by intragastric administration , and rats in normal control group and T2DM group were given the same volume of normal saline .The intervention lasted 4 weeks.At the end of 8th, 10th and 14th week, the blood examination of glycolipid , FINS, IL-1βand liver function indexes was done on fasting rats .Fourteenth weeks later , after getting blood samples , all rats were sacrificed and liver tissues were isolated .Western blot was applied in the detection of PPAR γand immu-nohistochemistry was applied to detect GLUT-2 protein in livers. Results At the end of 8th week, the FBG level in pioglitazone in-tervention group increased compared with normal control group ( P<0.05) , and the levels of TC , TG, FINS, LDL-C, ALT, AST, IL-1βin the other 3 groups increased significantly compared with normal control group (P<0.05).At the end of 10th week, in comparison with normal control group , the levels of FBG , FINS, TC, TG, LDL-C, ALT, AST and IL-1βincreased significantly ( P<0.05) , while the levels of HDL-C and ISI decreased significantly (P<0.01).Moreover, the levels of FINS, TC, TG, LDL-C, ALT, AST and IL-1βat 10th weekend increased significantly compared with those at 8th weekend(P<0.05).At the end of 14th week, the FBG levels in T2DM group, pioglitazone intervention group and diacerein treatment group were higher than that of normal control group (P<0.01), while compared with T2DM group, the FBG level in pioglitazone intervention group decreased and the levels of HbA 1c, TC, TG, LDL-C and ALT in pioglitazone intervention group and diacerein treatment group decreased ( P<0.05) along with the increased ISI and HDL-C levels ( P<0.05) .Compared with the results at 10th weekend , the levels of FBG , HbA1c, LDL-C, ALT, AST in T2DM group in-creased (P<0.05) while the levels of HbA1c, TC, ALT, AST and IL-1βin pioglitazone intervention group and diacerein treatment group decreased significantly at 14th weekend(P<0.01).The expression level of PPAR-γin pioglitazone intervention group (0.91± 0.03) was significantly higher than normal control group (0.82±0.15), T2DM group(0.75±0.28) and diacerein treatment group (0.83± 0.34) ( P<0.01) , and no significant difference was found between diacerein treatment group and normal control group( P>0 .05) show-ing higher levels compared with T 2DM group ( P<0.01).At 14th weekend, the GLUT-2 expression levels in normal control group (0.209±0.023), pioglitazone intervention group (0.226±0.017) and diacerein treatment group (0.232±0.012) were higher than that of T2DM group (0.173±0.009,P<0.01);and the GLUT-2 expression levels in pioglitazone intervention group and diacerein treatment group were higher than that of normal control group (P<0.05).The expression level of liver PPAR-γwas in positive correlation with those of GLUT-2 protein, HDL-C, FINS, ISI ( r=0.815, 0.780, 0.747, P<0.01) and in negative correlation with those of FBG , HbA1c, TC, TG, AST, ALT, IL-1β(r=-0.465,-5.716,-0.615,-0.675,-0.617,-0.521,-4.827, P<0.05). Conclusion Diacerein can enhance liver PPAR-γand GLUT-2 expression levels and reduce the levels of IL-1β, HbA1c and blood lipid, thus im-prove insulin resistance in T 2DM rats.

Objective To investigate the rational method of treatment of rectal carcinoid and its outcome.Methods The clinical data of 36 cases of rectal carcinoid were retrospectively analysed.Results During a follow-up of 82.6+/-63.4 months,there were no cases with recurrence among the 20 patients with tumor size2cm.Conclusions Tumor diametar can be used to estimate the degree of malignancy of rectal carcinoid.TNM staging is simpler and practical for deciding the method of surgical treatment.