Objective To investigate an effective method of autologous arteriovenous fistula formation for the elderly uremic patients with diabetic nephropathy.Methods The nest in the elbow above the median cubital vein at the curved incision 1-2 cm,inline high Fistula,namely arm cephalic vein and brachial artery bifurcation of the upper portion of the distal radioulnar side anastomosis in 20 cases over 75 years elderly uremic patients with diabetic nephropathy.And compared the effect of 16 cases of patients with similar conventional fistula.Results Twenty cases over 75 years elderly uremic patients with diabetic nephropathy were successful in all high dynamic fistula intravenous,blood flow was (1 007±131) ml/m,the immediate opening rate of 16 patients similar to conventional instant fistula was 12.5％,and a year after the opening rate was 6.25％ Conclusion High fistula are more easy to shape conventional,easy mature,full blood flow characteristics comparing with commom fistula,so elderly uremic patients with diabetic nephropathy fistula making difficult situation has been effectively improved.

5-lipoxygenase-activating protein Gene (ALOX5AP) on chromosome 13q12-13 encodes 5-lipoxygenase-activating protein (FLAP). The latter plays a key role in regulating the synthesis of leukotriene. Studies have suggested that the subjects who carry this gene may increase stroke risk by two times. Therefore, ALOX5AP plays an important role in the pathogenesis of stroke.

Objective To evaluate therapeutic effects of portal azygous devascularization on patients with portal hypertension. Methods In this study, data of 212 patients with portal hypertension who underwent devascularization were analyzed retrospectively. Among them 52% patients had a history of variceal bleeding. Preoperative Child A accounted for 15% patients, B for 57% and C for 27%. Emergent operation and selective operation were performed in 11% and 89% cases, respectively. Hassab procedure was performed in 176 cases (83%), whereas modified Sugiura procedure in 36 cases (17%). Results Portal vein pressure decreased from (40?6) cm?H 2O to (36?7) cm?H 2O. The re-bleeding rate of 3, 5,10 years were 2%, 6%, 11%, and the survival rates of 3, 5, 10 years were 97%, 92% and 89%, respectively. Conclusions Devascularization is an effective procedure in controlling bleeding with low incidence of liver failure, operation mortality and encephalopathy. Emergent operation should be avoided as it causes high morbidity and mortality. The decreased portal pressure following devascularization may result in a reduced blood supply to the liver. Persistent exasperation of the liver function caused by chronic hepatitis and the development of hepatocellular carcinoma are the two major factors endangering long-term survival.

AIM: To examine whether reactive oxygen species (ROS) is involved in the neuroprotection by mitochondrial ATP- sensitive potassium channel (mitoKATp) in rat hippocampal slices during hypoxia. METHODS: The technique of elec-trophysiology was used, and the latency to hypoxic depolarization (HD) and the amplitude of population spike (PS) in the stratum pyramidale of the CA1 region were measured. RESULTS: Pretreatment of the slices with diazoxide (DIA, a mitoKATP opener, at concentration of 300 ?mol/L) , prolonged the latency to HD, delayed the onset of PS disappearance and improved the recovery of PS after reoxygenation. The effects induced by DIA were attenuated by 5 - hydroxydecanoic acid (a mitoKATP blocker, at concentration of 200 ?mol/L). Pretreatment with N - 2 - mercaptopropionyl glycine (MPG, a ROS scavenger, at concentration of 500 ?mol/L), also abrogated the effects induced by DIA, while treatment of MPG alone had no effect on PS and HD. CONCLUSION: ROS participates in neuroprotection offered by mitoKATp opener during hypoxia.

With the development of peaple's life and the change of diet,the incidence rate of colorectal cancer is increasing. There are Twenty-five percent of patients were found liver metastases in the first diago-sis. Surgical resection of liver metastases from colorectal cancer is known to be associated with long term sur-vival. So it is the key to increase the resection rate for colorectal cancer patients with liver metastases. The in-curruence of neoadjuvant therapy may be useful in therapy of colorectal cancer patients with liver mtastases.

BACKGROUND:Evaluation of the newly formed bone at the distraction site by the imaging technologies is the cornerstone for terminating the limb lengthening successfuly.In the early stages of the distraction, the X-ray cannot detect any evidence of new bone formation within the distraction sites, whereas ultrasound can acquire wealth information about new bone and surrounding soft tissues. OBJECTIVE: To explore the application value of Doppler ultrasound in the evaluation of limb lengthening in order to promote its clinical application. METHODS: A computer-based search was performed on the CNKI database and PubMed database for articles related to ultrasound in the evaluation of limb lengthening published from January 1989to October 2014. The keywords of distraction osteogenesis, ultrasonography, external fixation, fracture healing in English and Chinese were used to search the articles by title and abstract. Finaly, a total of 24 articles were included to review. RESULTS AND CONCLUSION: Ultrasound is an effective method to evaluate the limb lengthening in early stage. It can not only detect the formation and maturation of the new calus, but also can evaluate the forming speed and the quality of the new cals. Moreover, ultrasound can be used to evaluate the situation of the soft tissue near the distraction site. Complications associated with the limb lengthening can be observed timely by the ultrasound. Ultrasound is of great significance in the evaluation of distraction osteogenesis.

Objective:To understand the awareness of students of medical colleges sperm behavior, attitudes and prac-tical factors. Methods:Used convenient sampling method to select 300 college students of 4 medical colleges in Shanghai conducted a questionnaire survey and used Epidata 3. 1 and SPSS 18. 0 to count and analyse. Results: 251 question-naires. 39. 8% of respondents were willing to sperm, the primary reason was considered to be an act of charity, helping others;willing sperm donors only distributed among schools statistically significant (P<0. 05) proportions, and for the various professional and grades , showed no significant difference ( P>0 . 05 ) . Conclusion:Students of Shanghai Medical Colleges sperm voluntary rate was not high, so the survey analyzed related factors affecting sperm donation and put forward practical proposals to provide reference data and methods for sperm bank sperm recruiting for volunteers in the universities.

In recent years, with the advances in life cycle of hepatitis C virus (HCV) and the approval of direct-acting antiviral agents (DAAs), great progress has been made in treatment of chronic hepatitis C (CHC).This article reviews the research progress of DAAs in CHC management, showing the possibility of the elimination of HCV infection by DAAs.DAAs have not been widely clinically used due to high medication costs, but can be used as a supplement for the combination therapy of pegylated interferon and ribavirin.

AIM:To explore the possible alteration of refraction and estimate the potential impact of visual quality, investigate the impact of intraocular structure between the simple operation and the combination of phacoemulsification and intraocular lens implantation, and observe the influence among various tamponade materials application.
METHODS: Ultrasound biomicroscopy ( UBM ) and intraocular len ( IOL ) Master were measured for simple vitrectomy patients ( the simple group, 37 eyes ) and vitrectomy combined with cataract surgery patients ( the combined group, 11 eyes ) . Several parameters were measured such as the anterior chamber depth ( ACD ) , angle opening distance ( AOD ) , trabecular iris angle (TIA), axial length (AL), et al . The simple group was further divided into three sub - groups by various tamponade materials in vitreous: silicone oil group, gas group and equilibrium liquid group. All patients were measured including ACD, AOD250, AOD500, TIA500, AL and corneal curvature (K1, K2) parameters preoperatively and 2wk postoperatively.
RESULTS: AOD250, AOD500, TIA500 and AL were decreased 0. 13±0. 21mm, 0. 16±0. 22mm, 8. 68o±9. 72o and 0. 18±0. 24mm ( all P<0. 05 ) respectively in the simple group postoperatively. ACD, AOD250, AOD500, TIA500 and AL in combined group increased 0. 95±0. 54mm, 0. 13±0. 12mm, 0. 22±0. 20mm, 11. 49o±11. 06o, and 0. 45±0.30mm ( all P < 0. 05 ) respectively after operation. Alteration of ACD, AOD250, AOD500, TIA500 and AL were different between simple group and combined group ( P<0. 05). Of data from various tamponade materials sub-groups, ACD, AOD250, AOD500 and TIA500 of the gas group reduced 0. 19±0. 17mm, 0. 14±0. 09mm, 0. 20±0. 12mm, and 12. 02o±6. 64o respectively after operation ( P<0. 05), the AOD250, AOD500, TIA500 and axial length of silicone oil group decreased 0. 19±0. 25mm, 0. 21±0. 26mm, 10. 44o±9. 67oand 0. 23±0. 19mm respectively after operation ( P < 0.05 ) , while equilibrium liquid group had no significant changed in all intraocular structure (P>0. 05). However, neither the corneal thickness nor curvature (K1, K2) were changed postoperatively (P>0. 05).
CONCLUSION:Alteration of anterior segment and axial length in combined group are different from that of the simple group, while the corneal thickness and corneal curvature ( K1, K2 ) are not obviously changed in all groups. Meanwhile, various tamponade materials can also cause different impact on intraocular structure and refraction. In brief, alterations of intraocular structure might cause discrepant refractive changes and potential influence of visual quality.