ObjectiveTo investigate the effect of subtotal gastrectomy on glucose metabolism in patients with gastric disease combined with diabetes mellitus.MethodsThe clinical data of 126 cases with gastric disease combined with diabetes mellitus receiving subtotal gastrectomy were analyzed retrospectively,including subtotal gastrectomy Billroth Ⅱ type 69 patients (Billroth Ⅱ type group),subtotal gastrectomy Billroth Ⅰ type 57 patients(Billroth Ⅰ type group).The fasting blood glucose,postprandial blood glucose before surgery and 1,3,6 months after surgery and the improvement of glucose metabolism were compared.ResultsThere was no significant difference in the fasting blood glucose,postprandial blood glucose before surgery and 1,3,6 months after surgery in Billroth Ⅰ type group (P ＞0.05).The fasting blood glucose,postprandial blood glucose 3,6 months after surgery [ (10.7 ±2.9 ),(10.4 ± 2.3 ) mmol/L and (12.4 ± 2.6),(12.0 ±3.2) mmol/L] were higher than those before surgery and 1 month after surgery [(14.1 ±3.2),(13.4 ±3.8) mmol/L and(19.0 ±3.9),(18.1 ±4.3) mmol/L] in Billroth Ⅱ type group with significant differences (P ＜ 0.05 or ＜ 0.01 ).The improving rate of glucose metabolism in Billroth Ⅰ type group [ 7.02％(4/57) ] was lower than that in Billroth Ⅱ type group [ 92.75％(64/69)] with significant difference(P ＜ 0.01 ).ConclusionsSubtotal gastrectomy has obvious effect on improving glucose metabolism in patients with gastric disease combined with diabetes mellitus.The use of subtotal gastrectomy Billroth Ⅱ type is prior to subtotal gastrectomy Billroth Ⅰ type.

Aiming at the difficult employment situation of marketing students of higher vocational medicine,we has made an objective analysis of the strengths and weaknesses as well as opportunities and threats based on the trend analysis tools and weigh the advantages and disadvantages to help graduates overcome the deficiencies of individual employment process and find out the existing disadvantages of school,which can provide reference for improving the employment situation of higher vocational medicine marketing.

Objective To explore the applicated value of Doppler ultrasound,X-ray mammography and MRI in early diagnosis and differential for breast cancer.Methods 182 cases examine femaled patients,which were hospitalized to breast lumps as the object of study,they were confirmed by Doppler ultrasound,X-ray mammography and MRI three checks.Caccording to the patient after surgery,the pathology results were used to diagonosed the value of the three detection methods.Results 182 patients with breast cancer and 143 cases(78.7％),benign tumors and 39cases(21.3％),the sensitivity of MRI was significantly higher than the other two,three associated with the accuracy of the examination results was significantly higher than that of each individual(P ＜0.05),the difference was statistically significant.Conclusion Doppler ultrasound,X-ray mammography and MRI are used in breast cancer in the early diagnosis,which have their own advantages,the combination can increase the accuracy to a certain extent.

Objective To explore the clinical effect and adverse reaction on hysteromyoma patients treated with mifepristone of different periods.Methods Forty-seven patients with conservative treatment were treated with mifepristone of 10 mg/d for 9 months,and 1 period was 3 months.Uterine volume,fibroid volume and hemoglobin (Hb) were detected after each period,and clinical effect and adverse reaction were also observed.Results All patients were completed 3 periods,and clinical symptoms improved.Uterine volume and fibroid volume reduced gradually,and Hb increased gradually during treatment.Uterine volume and fibroid volume reduced by 41.54％ and 46.53％ respectively.All indicators had significant changes at first period and second period,compared with without treatment and first period gradually (P ＜ 0.05).There was no significant difference in adverse reaction among different periods (P ＞ 0.05).Conclusions The clinical effect on hysteromyoma treated with mifepristone of long-period was effective,and adverse reaction did not significantly increase.Long-period treatment with mifepristone provide a conservative treatment for near menopausal hysteromyoma patients.

Objective To retrospectively analyze clinical data of 207 patients with gynecologic malignancy.Methods All cases were diagnosed from 2010 to 2012,and were divided into four groups by ages (≤20-year-old age,20-40-year-old age,40-60-year-old age and ≥60-year-old age).Their clinical characters were reviewed and compared.Results The 40-60-year-old age group had the greatest number of cases for the entire cohort 49.8％ (103/207).The most common primary site of the ≤20-year-old age group was ovary (75.0％).Cervix 36.4％(24/66) and ovary 30.3％(20/66) were the common primary site of the 20-40-year-old age group.Endometrium,cervix and ovary were common in the 40-60-year-old age group with 27.2％,26.2％,23.3％,respectively.Ovary,endometrium and cervix were common in the last group with 29.4％,26.5％ and 20.6％,respectively.In the ≤20-year-old age group,the germ cell was the most common histology among ovarian malignancies (66.7％),and the epithelial tumor was the most common tumor in the other groups.Conclusions Carcinoma of cervix,ovary and endometrium are the most common gynecologic malignancies and 40-60-year-old age is the high-risk age.We should strengthen the health education and physical examination for young women.

The changes of serum amino acid metabolism of rat following partial (69%) hepatectomy were investigated by measuring twenty amino acids in sera from blood collected from hepatic vein, portal vein, inferior vena cava and abdominal aorta 72 hours following surgical intervention. The results were as follows:1. The total concentrations of amino acids in sera obtained from above mentioned blood vessels were significantly elevated, especially in that from portal vein.2. The total amount of amino acid released from splanchnic organs accunted for 87% of the total amount of amino acid uptaken by regenerating liver. Both total amounts were significantly increased.3. The enhanccd essential amino acid uptaken by regenerating liver resulted in significant decrease of molar ratio of essential to nonessential amino acids in aortic serum.4. The molar ratio of the branched chain amino acids, valine, leucine and isoleucine, to the aromatic amino acids, phenylalanine and tyrosine in aortic serum was significantly declined, this was due to increased release of tyrosine by splanchnic organs and decreased uptake of this amino acid by regenerating liver.5. The uptake of branched chain amino acids by peripheral tissues was significantly inhibited and their uptake by regenerating liver was significantly increased. Thus, the regenerating liver was well supplied with branched chain amino acids.6. The release of alanine by splanchnic organs was significantly increased and its uptake by liver was simultaneously increased. Therefore, abundant raw matererial was supplied for glyconeogenesis to meet the energy need for rapidly proliferating hepatocytes.

Spherical aberration is the major cause which affects the functional vision of the patients implanted with spherical intraocular lenses (IOLs). Aspheric IOLs are designed to eliminate the aberration like the nature lens, thus they can produce better visual quality. If it is feasible to customize IOL design to the individual cataract patient, aspheric IOLs may substitute the traditional spherical IOLs and become the trend of IOLs.

Twelve patients with huge rhegmatogenous retinal detachment were treated with electrocoagulation and/or cryosurgery supplemented with extrascleral buckling, annular knotting or macular sling technique. 11 cases were cured but failure occurred to one case. After treatment, the vision was improved in various degrees in different patients.It is concluded that even though the rhegma is large and the retina is wholly detached, the cure rate can be increased if careful preoperative examination and preparation is made, appropriate operative measures selected, electrocoagulation and cryosurgery reasonably adjusted, and the rhegma securely buckled.

Total 1049 new cases of blindness were detected by visual acuity survey in a population aged 68 or above in Changning District of Shanghai from 2003 to 2008. Among all eases 21.5% were age-related macular degeneration (AMD) blindness, with a trend of ascending from 17.7% in 2003 to 29. 9% in 2008. Most of the cases were classified as grade 3 (56. 9% ) or grade 4 (41.3%) of blindness. AMD has become one of the leading causes of blindness at present and should be the key eye disease for prevention of blindness.

Recent researches have shown that resectable pancreatic cancer can benefit from post-operative adjuvant chemoradiation, regardless its surgical margins, tumor size, lymph node involvement and the level of cell differentiation. Several phase Ⅱ clinical trials indicated a good tolerance to preoperative chemoradiation. Although there is no gold standard for treating locally advanced unresectable pancreatic cancer, gemcitabine-based chemotherapy or chemoradiation therapy can increase survival rate compared with best supportive care.