Objective To compare the survival conditions of patients with insulinoma after enucleation of insulinoma or partial resection of pancreas.Methods The clinical data of 99 patients with insulinoma,treated with surgery from May.2003 to Aug.2015 were retrospectively analyzed.Of the 99 patients,38 received enucleation of insulinoma alone and 61 received partial resection of pancreas.The overall data were analyzed by SPSS 21.0 software.Results Average survival of patients after enucleation of insulinoma (103.3 months) was longer than that of patients after partial resection of pancreas (77.5 months),and the difference had statistical significance (P=0.006).The difference of the incidence of most chronic or temporary complications had no statistical significance between the two groups (P＞0.05),except for new-onset diabetes (P=0.004).Conclusion Enucleation of insulinoma should be firstly recommended for patients with insulinoma in suitable size,which can provide patients with better survival condition.

[Objective] To determine the effects and possible mechanism of the thrombin antagonist r-RGD-Hirudin (HIR) on ventricular arrhythmia(VA) after acute myocardial infarction (AMI). [Methods] Seventy adult male Sprague-Dawley rats were randomly subjected to the 10 groups according to duration of left coronary occlusion: HIR 0 min, HIR 5 rain, HIR 10 min, HIR 20 min, HIR 30 min, and normal saline(NS) 0 min, NS 5 min, NS 10 min, NS 20 min, NS 30 min; and the average of every group is 7 rats. Acute myocardial infarction was produced by the occlusion of the left anterior descending coronary artery, then the measurements of arrhythmia and infarction sizing by Evans blue were assessed as well as the expression of three isoforms of inositol 1,4,5-trisphosphate receptors (IP3Rs) mRNA in isehemic myocardium by reverse transeriptase polymerase chain reactions (RT-PCR). [Results] Compared with NS groups, the measurements of VA in HIR were reduced significantly in 5 to 20 minutes after AMI (P<0.05). The incidence of VA was all positive related to the expression of three isoforms of IP3Rs mRNA (P<0.01). Compared with NS groups, the expression of type2,inositol 1,4,5-trisphosphate receptor (IP3R2) mRNA at 10 min and type3, inositol 1,4,5-trisphosphate receptor mRNA (IP3R3) at 10 min and 20 min after AMI were significant decreased (P<0.05) in HIR groups. [Conclusion] The thrombin antagonist r-RGD-Hirudin exerts its myocardial protection against ventricular arrhythmia after acute myocardial infarction possible through IP3R2 and IP3R3 and not typel, inositol 1,4,5-trisphosphate receptor (IP3R1).

OBJECTIVE:To systematically review the effect of organic cation transporter 2 [(OCT2)808G>T] gene polymor-phism on the metformin hydrochloride pharmacokinetics in vivo,and to provide evidence-based reference for clinical medication. METHODS:Retrieved from PubMed,EMBase,Foreign Medical Journey Service,CJFD,VIP database and Wanfang database,re-lated studies about the effect of (OCT2)808G>T gene polymorphism on the metformin hydrochloride pharmacokinetics in vivo were collected,and Meta-analysis was performed by using Rev Man 5.1 statistics software. RESULTS:A total of 5 retrospective studies were included,involving 172 patients. The result of gene type was type GT,type TT and type GG. Results of Meta-analysis showed,compared with type GT volunteers,type TT could prolong the half-time period of metformin hydrochloride;compared with type TT,type GG could increase the peak concentration. However,(OCT2)808G>T gene polymorphism had no effects on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. CONCLUSIONS:(OCT2)808G>T gene poly-morphism has certain effect on the half-time period and peak concentration of metformin hydrochloride in vivo of health volunteer, and has no effect on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. Due to the limit of re-search methodological quality,large-scale and high quality studies are required for further validation of the conclusions.

Objective To investigate the feasibility and effects of endoscopic surgical treatment of lumbar intervertebral disc herniation associated with veitebral osteochondrosis.Methods From June 2008 to December 2015,276 cases of lumbar intervertebral disc herniation associated with vertebral osteochondrosis were treated with endoscopic surgery,including 185 men and 91 women,with an average 39.2 years old (range,16-65 years old).The involved level included L2.3 in 2 cases,L3.4 in 9 cases,L4,5 in 126 cases and L5S1 in 139 cases.On preoperative axial CT,the diameter of ossification was more than half of the transverse or sagittal diameter of the spinal canal in 89 cases,and no more than half of the transverse and sagittal diameter of the spinal canal in 187 cases.All patients were operated on the side with serious symptom,181 cases were operated with mobile microendoscopic discectomy (MMED),and 95 cases were operated with percutaneous endoscopic surgery,including percutaneous transforaminal endoscopic discectomy (PTED) in 61 cases and the percutaneous interlaminar endoscopic discectomy (PIED) in 34 cases.The operation and complications were analyzed.Results The soft herniation,broken disc material and the periphery of compressing ossification were removed under the endoscope in all cases,until the nerve was well decompressed.However,the ossification was not complete resected.Dural sac tear occurred in 3 cases of MMED.In the early stage of PTED,2 cases converted to MMED because of intraoperative pain and difficulty,and one case had exiting nerve root injury.At the final follow-up of 12-60 months (average,20.6 months),visual analogue scale decreased from preoperative 8.5±1.2 to 1.0±0.9,Oswestry disability index decreased from preoperative 40.2±8.6 to 3.1±3.0.According to Macnab scale,the results were excellent in 89,good in 154 cases,moderate in 33 cases.Conclusion For most lumbar intervertebral disc herniation associated with vertebral osteochondrosis,good results can be achieve by removal of herniated and broken intervertebral disc and decompression of nerve with endoscope.Therefore,we speculate that the soft disc herniation and spinal stenosis are main pathogenic factors,and that the complete resection of ossification is not needed.

OBJECTIVE:To systematically review the effect of ticagrelor versus prasugrel on platelet reactivity,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from PubMed,CJFD and Wanfang Database,randomized con-trolled trials(RCT)about the effect of ticagrelor versus prasugrel on platelet reactivity were collected. Meta-analysis was performed by using Rev Man software after data extract and quality evaluation by Cochrane 5.1.0. RESULTS:Totally 17 RCTs were enrolled,involv-ing 2 757 patients. Results of Meta-analysis showed,regardless of Verity Now(VN)detection method [MD=15.43,95%CI(-0.39, 31.25),P=0.06] or vasodilator stimulus phosphoprotein(VASP)detection method [MD=-3.04,95%CI(-8.98,2.90),P=0.32], ticagrelor and prasugrel had the same effects on platelet reactivity under loading dose,the differences were not statistically significant;regardless of VN detection method [MD=-48.94,95%CI(-58.04,-39.84),P<0.001] or VASP detection method [MD=-14.32, 95%CI(-20.45,-8.20),P<0.001],the effects of ticagrelor were better than prasugrel on platelet reactivity under maintenance dose,the differences were statistically significant. CONCLUSIONS:At the loading dose,there was no difference between ticagrelor and prasugrel,but ticagrelor has more benefits than prasugrel under maintenance dose.

Objective To design a measuring system for operative gestures used for the crew in armored vehicles. Methods The MEMS sensor was used to collect gesture parameters of important parts of four crew members,such as the head, neck,trunk,arms,legs.The infrared tracking auxiliary measurement was used to calibrate the gesture parameters of arms of drivers.The wireless transceiver was used to transmit data to the control unit for preprocessing and then send the data to the collector for storage, before being transmitted to the back-end computers.A software system was used to process and display the body posture parameters.Results and Conclusion The system can mesure the operative gestures of the crew and provide means by which to analyze the kinematics for the crew in armored vehicles.

Objective To establish an animal model of annulus fibrosus (AF) partial defect for the repairing of interver?tebral disc (IVD) defect. Methods Image J 1.46r software was used to measure the T12/L1-L6/S1 intervertebral height in ovine lumbar spine X-ray films. AF thickness was measured by axial split disc. A 11 blade was used to make a trapezoid de?fect of upper bottom 3 mm, lower bottom 5 mm, height 5 mm and thickness 3 mm, whose lower bottom toward the nucleus pulposus (NP) in the left front of ovine lumbar IVD in vitro. The minimally invasive lateral approach was used to make the same type of trapezoid defect in the left front of the ovine lumbar IVD in vivo. The trapezoidal defect length of the axial divid?ing disc was measured, AF and a small amount of NP from trapezoidal defect in IVD were weighed, and the production of trapezoidal defect in IVD was evaluated. Results The lumbar intervertebral space height of ovine was (4.45 ± 0.28) mm. There were significant differences in the thickness of AF (4.08±0.50) mm , thickness (3 mm) and height (5 mm) of trapezoidal defect (P<0.05), respectively. There were no significant differences in trapezoidal defects in ovine lumbar IVD in vitro on the upper bottom (3.03 ± 0.09)mm, the lower bottom (5.03 ± 0.09) mm, the height (4.97 ± 0.10) mm, the thickness(3.02 ± 0.06) mm and the trapezoidal defect predetermined value on the upper bottom 3 mm, the lower bottom 5 mm, the height 5 mm and the thickness 3 mm (P>0. 05). The weights of the AF and NP taken out from ovine lumbar IVD in vitro and in vivo were (0.162 ± 0.011) g and (0.166 ± 0.014) g, and there was no significant difference between them (P > 0.05). Conclusion Through the operation of minimally invasive lateral approach, the method of making a trapezoidal defect in the experiments can establish animal model of AF partial defect, which meets the requirements for the repairing of IVD defect, and is simple, safe and reliable.

To investigate the characteristics of traditional Chinese medicine (TCM) syndromes and their elements in people with subhealth fatigue.

Objective:To systematically review the association between P2Y12 genetic polymorphisms and the clinical safety of clopidogrel in the patients with cardiovascular and cerebrovascular diseases. Methods:Retrieved from MEDLINE,Embase,CNKI,Si-noMed and Wanfang Database (from January 1995 to December 2016),array researches about the association between P2Y12 genetic polymorphisms and the clinical safety of clopidogrel were collected including the studies of patients taking clopidogrel with cardiovascu-lar and cerebrovascular diseases and excluding animal experimental studies. The bias of recruited studies was assessed and meta-analy-sis was performed by RevMan 5.1 software. Results:Totally 10 array researches(3 in English and 7 in Chinese) were enrolled invol-ving 5 223 patients. There were no statistical differences between T allele gene carriers and CC genetype patients of C34T in the inci-dence of adverse cardiovascular events (RR=0.95,95% CI:0.82-1.09,P=0.46). The incidence of adverse cardiovascular events in T allele gene carriers of G52T was higher than that in GG genetype patients(RR=1.99,95% CI:1.63-2.44,P<0.000 01). The incidence of clopidogrel resistance in T allele gene carriers of C34T was higher than that in CC genetype patients(RR=2.02,95% CI:1.37-2.96,P=0.000 4). The incidence of clopidogrel resistance in T allele gene carriers of G52T was higher than that in GG gene-type patients (RR=1.56,95% CI:1.04-2.34,P=0.03). There was no statistical difference in the risk of clopidogrel resistance be-tween C allele gene carriers of i-T744c and T allele gene no-carriers(RR=0.99,95% CI:0.78-1.25,P=0.92). Conclusion:T al-lele gene carriers of C34T might be a risk factor of the occurrence of clopidogrel resistance,T allele gene carriers of G52T might be a risk factor of the occurrence of cardiovascular events and clopidogrel resistance,and C allele gene carriers of i-T744c might not increase the danger of the occurrence of clopidogrel resistance.