Objective To explore the clinical efficacy of laparoscopic resection for large volume of adrenal tumor.Methods Eighty patients with adrenal tumor who were treatment by laparoscopic resection were divided into large volume group (diameter ≥ 6 cm) and small volume group (diameter ＜ 6 cm) according to the size of the tumor.The intraoperative and postoperative complications of the two groups were compared.Results The operation time,intraoperative bleeding volume and postoperative hospitalization time of large volume group were significantly higher than those in small volume group:(187.4 ±39.2) min vs.(153.7 ± 31.6) min,(458.2 ± 87.3) ml vs.(105.9 ± 25.1) ml and (10.9 ± 2.7) d vs.(7.3 ± 1.5) d,and the difference were statistically significant (P ＜ 0.05).The postoperative complications in two groups had no significant difference:10.3％ (4/39) vs.7.3％ (3/41),P ＞ 0.05.Conclusion The laparoscopic resection for large volume of adrenal tumor have the advantages of less invasion,faster recovery and less complications,and it has become the main mode of treatment.

Objective To investigate the influence on the behavior of withdrawal and relapse after deep brain stimulation of bilateral nucleus accumbens in morphine-dependent rats. Methods The rats with a strong unconditioned preference were discarded in preconditioning test, the selected rats were distributed into five groups randomly. After operation,morphine hydrochloride was injected subcutaneously into SD rats for 12 days (once every day,initial 5 mg/kg,increasing by 5 mg/kg per time,stable in 20 mg/kg ). A modified electrical circuit was used to procedure the DBS,the parameter was 130 Hz,150 A,60 s,l h/d,14 d. CPP test was used to exam the effect of DBS. A minor morphine dose (3 mg/kg) was injected to induce the behavior of relapse, and CPP was tested again after 24 h. Two-way ANOVA was performed on the data with Bonferroni posttest. Result ①After CPP training,CPP score of group morphine, morphine + sham and morphine + DBS was ( 155. 87 ± 20. 45 ) s, (107.33 ± 18.10)s,(135.45 ±22.09)s,and had significant difference with group of control( ( -70.34 ± 15.40) s)(t = 9.45,P＜0.01; t = 6.94,P＜0.01;t = 8.04,P＜0.01).②After 7 days' DBS,the CPP score in group of morphine + DBS reduced significantly compared to group of morphine( t = 4.21, P＜0.01) and morphine + sham( t=1.10, P＜0.05).0n the 14th day,there was more pronounced reduction ( t = 5. 15, P＜0.01; t = 3.92, P＜ 0.01). ③ 24 hours after the minor morphine dose was injected,the CPP score in morphine + DBS didn't increase significantly, and had significant difference with group of morphine ( t = 4.04, P＜0.01) and morphine + sham ( t= 4. 13, P＜0.01). Conclusion DBS bilateral nucleus accumbens in morphine-dependent rats can interfere the behavior of morphine-induced CPP and relapse.

Objective To investigate the reason and prevention of complications of head and neck expander implant.Methods From May,2003 to October,2007,patients with expander implant in the skin soft tissues of head and neck were retrospectively reviewed.Results A total of 139 expanders were implanted in 68 patients.Complications caused by the expander included appearance(1 case),leaking(1 case),haematoma(2 cases)and infection(2 cases).Conclusion The complications induced by expander implanted in head and neck are more commonly occurred.The prevention and early detection of the complication are important to decrease its ineidence and the degree of damage.Moreover,surgeon's procedure and operational methods are main factors in the prevention of complications.

Objective To study the influence of hemodialysis on inflammatory state and immune function by analyzing the change of serum protein components in uremic patients before and after hemodialysis.Methods 75 cases of uremic patients confirmed by the Nephrology from October 2013 to May 2014 were selected as the observation group,and 15 healthy volun-teers at the same time as the control group.Then the serum protein electrophoresis pattern of observation group beford the first hemodialysis,after the first hemodialysis,after one month’s treatment and control group were compared with each oth-er.Results In the observation group before and after the first hemodialysis,the ALB levels were lower,α1 and α2 globulin levels were higher than those in control group.There was a statistically significant between the observation group before and after the first hemodialysis and control group (P <0.001).After the first hemodialysis,there were differences inα1 globulin levels compared with before the first hemodialysis (P <0.01).ALB was no significant difference after one month’s hemodi-alysis compared with before the first hemodialysis,andα1,α2 globulin were significantly reduced and the difference was sta-tistically significant (P <0.001),ALB was lower than the control group and was statistically significant (P <0.001).After one month’s hemodialysis,the levels ofγglobulin were higher than those in control group,before the first hemodialysis and after the first hemodialysis.There were significant differences (P <0.001 or P <0.01).Conclusion Regular and effective hemodialysis can improve inflammatory state and immune function of uremic patients.

Objective To analyze the relationship between fasting plasma glucose (FPG) level and complexity of coronary artery lesions in patients with coronary stenosis by angiography. Methods The data of clinic and coronary angiogram (CAG) were retrospectively collected in 929 patients with established coronary stenosis by coronary angiography at Peking University Third Hospital from January 2009 to January 2011. The patients were grouped according to SYNTAX score, and the relationship between FPG level and SYNTAX score were analyzed using bivariate, Multivariate stepwise regression and logistic regression analysis. Results ①929 patients were devided into three groups:47 cases into low risk group (score<22), 189 into moderate risk group (score≥22 and<33) and 639 into high risk group (score≥33). Intergroup analysis showed that age (P=0.000), FPG level [5.20 (4.70,6.30) mmol/L, 5.70 (4.90,7.15) mmol/L, 5.80 (5.30,7.60) mmol/L, P=0.000], proportions of FPG abnormality [283 (40.8%), 100(52.9%), 28(59.6%), P=0.001] and patients with diabetes history (P=0.003) were increased along with SYNTAX score elevated.②Correlation analysis showed correlativity (r=0.167, P=0.000) between SYNTAX score and FPG. In non-diabetes history subgroup, correlation between SYNTAX score and FPG remained signiifcant (r=0.149, P=0.000). However, in diabetes history subgroup, the correlation was not significant. ③ Multivariate stepwise regression analysis showed an independent correlation between FPG and SYNTAX score (β=0.452, P=0.002). In non-diabetes history subgroup, the correlation remained significant (β=1.039, P=0.000).④ When moderate-high risk group serve as dependent variable, and age, gender, CAD risk factors and FPG serve as independent variables, logistic regression analysis screened out two variables:age (whole group:OR 1.033, 95%CI 1.017 ~ 1.049, P=0.000;non-diabetes history subgroup:OR 1.039, 95%CI 1.020 ~ 1.059, P=0.000) and FPG (whole group: OR 1.114, 95% CI 1.038 ~ 1.195, P=0.003; non-diabetes history subgroup:OR 1.299, 95%CI 1.088 ~ 1.387, P=0.001). Conclusions FPG is likely to relfect complexity of coronary artery lesions and predict SYNTAX score in patients with coronary stenosis, especially in patients without diabetes history.

Objective: To observe the midterm outcomes of“2-staged”hybrid coronary revascularization (HCR) for treating the patients with multi-vessel coronary artery disease (CAD) and to evaluate the feasibility, safety and effcacy of“2-staged”HCR.
Methods: A total of 73 relevant patients received elective “2-staged” HCR in our hospital from 2012-01 to 2014-06 were studied. There were 50 (68.5%) male and 23 (31.5%) female at the age of (61.1±10.7) years and all patients had multi coronary artery lesions including left anterior descending (LAD) artery. The key points of“2-staged”HCR were as follows:double-chamber intubation with general anesthesia, small incision between 4-5 ribs of left front thorax, take left internal mammary artery (LIMA) by direct view and make anastomosis of LIMA and LAD with heartbeat. At (3-5) days post-minimally invasive direct coronary artery bypass (MIDCAB), coronary angiography (CAG) was conducted to confirm that LIMA-LAD bypass vessel was unobstructed; then percutaneous coronary intervention (PCI) was performed in non-LAD coronary artery for stent implantation. Post-operative echocardiography, chest X-ray and ECG were examined in each year;coronary CTA or CAG would be taken if the patients with myocardial ischemia.
Results: All patients finished“2-staged”HCR smoothly and no operative death occurred. The average surgical time was (152.9±43.8) min and (2.6±0.5) coronary branches were treated, total post-operative drainage volume was (558.6±441.3) ml, red blood cell transfusion was (0.8±1.9) U, mechanical ventilation time was (10.5±13.0) h. The interval between MIDCAB and PCI was (5.3±2) days and (1.6±0.7) stents was implanted. During post-operative follow-up period, there 1 (1.4%) patient died, 3 (4.1%) with recurrent myocardial ischemia, 1 (1.4%) with in-stent restenosis and received PCI again, 4 (5.5%) with MACCE.
Conclusion: “2-staged”HCR is a safe and feasible operation with satisfactory peri-operative and mid-term outcomes;it is suitable for the patients with multi-vessel CAD including severe LAD lesions.

The high-performance liquid hromatography-quadrupole-electrostatic field orbital well high-resolution mass spectrometry method was developed for the analysis of p-methoxymethamphetamine(PMMA)and its metabolites in rabbit blood.Hypersil Gold aQ(2.1 mm×100 mm,1.9 μm)was used as the chromatographic column.The mobile phase was gradient elution with 0.1%formic acid aqueous solution(A)and 0.1%formic acid acetonitrile(B)at a flow rate of 0.3 ml/min.Electrospray ionization(ESI)with positive and negative mode scanning was used to determine p-methoxymethamphetamine and its metabolites based on excimer and secondary fragment ions.PMMA and its metabolites were characterized by high-performance liquid chromatography-high resolution mass spectrometry,which lays a foundation for the study of its pharmacodynamic substance and prevention.

Objective:To investigate the effect of pelvic rotation around coronal axis on the placement angle of acetabular prosthesis after total hip arthroplasty.Methods:According to Murary's definition, the angle between the acetabular axis and the sagittal plane was defined as the acetabular abduction angle, and the angle between the acetabular axis and the coronal plane as the anterior inclination angle. A simple mathematical solid geometry model was established by using the mathematical software GeoGebra to simulate the dynamic changes of the acetabular prosthesis when it rotated around the coronal axis, and the calculation formula of the dynamic changes of the anterior inclination and abduction angle of the acetabular prosthesis was derived. MatLab software was used to generate the function graph of pelvis forward inclination and abduction angle and deduce the motion of acetabular prosthesis.Results:The dynamic changes of acetabular tilt angle and abduction angle when the pelvis rotated around the coronal axis were functionally related to the anterior-posterior tilt of the pelvis in a nonlinear pattern. When the pelvis rotates around the coronary axis, the anterior inclination angle formula is α 1=arcsin (sinβ 1×cosα×cosθ+cosβ 1×sinα); When the acetabulum axis faces downwards the abduction angle formula is θ 1=arccot (cosβ 1×cotθ-sinβ 1×tanα/sinθ); When the acetabulum axis faces upwards the abduction angle formula is θ 1=π-abs[arccot (cosβ 1×cotθ-sinβ 1×tanα/sinθ)] withα being the initial acetabular forward angle, θ being the initial acetabular abduction angle, α 1 being the forward angle of the acetabular prosthesis after pelvic rotation, θ 1 being the external expansion angle of the acetabular prosthesis after pelvic rotation and β 1 being the rotation angle of the pelvis around the coronal axis. When the pelvis is tilted backward, the anterior inclination angle of the acetabular prosthesis increases first and then decreases, and the abduction angle continues to increase. When the pelvis is tilted forward, the abduction angle decreases first and then increases, and the anterior inclination angle continues to decrease to negative. Conclusion:When the initial anterior inclination angle and abduction angle of acetabular prosthesis change, the curve of anterior inclination and abduction angle change accordingly. The larger the initial anterior inclination angle is, the faster it reaches its peak value, and the larger the peak value is, the faster the abduction angle changes. The larger the initial abduction angle is, the slower the initial anterior inclination angle and the abduction angle change.