Gastric bypass surgery for type 2 diabetes in the world,especially Europe,the United States,and other western countries have been widely carried out.The data of type 2 diabetes mellitus treated by weight loss surgery at home and abroad in recent years were collected and analyzed.It was found that gastric bypass Roux.en-Y gastric bypass (RYGB) after type 2 diabetes remission rate of 80％ to 85％,and the treatment effect can be maintained for long time.Therefore,the RYGB in the treatment of type 2 diabetes has been more and more recognized by the authors.This present article summarizes the gastric bypass (Roux.en-Y gastric bypass) in the treatment of type 2 diabetes mellitus (DM).

Objective: To study the injury characteristics of blast injury in maxillofacial region wounded by spherical explosive. Methods: Spherical explosive was used to wound maxillofacial region in rabbits , after gross observation of the trauma , bone tissue specimens were collected from 0.5 or 1.0 cm to the boundary of wound 6 hours, 3 and 7 days after wounding respectively, the samples were prepared and stained with HE and modified Mallory's trichrome staining and observed under light microscope . Microcirculation in wounded bone was studied by ink injection and observed in ground bone sections. Results: No changes were found 6 hours after injury. Inflammatory infiltration were found 3 days after injury.Osteonecrosis was observed 7 days after injury, the structure of bone beyond 0.1 cm of the wound was found to be normal and restoration of bone was observed. Conclusion : Pathological changes of mandible injured by spherical explosive are similar to those of usual fracture except that the wound of blast injury is seriously polluted.

0.05).The operating time in group A was 106?22.3 min,94.1?29.3 min in group B and 81.6?22.3 min in group C.There were no significant differences between group A and B,or between group B and group C,but there was significant difference(P=0.009) between group A and group C.The was Two cases of dura tear occurred at operatiom and one case was converted to open discectomy in group A.There were three cases of reoperation in group B.There were no intra-and postoperation complications in group C.[Conclusion]From the learning curve of lumbar microendoscopic discectomy,surgeons can master such skill only after performing 30 or more cases of lumbar microendoscopic disecetomy.

Objective:To design a new elastic implant-distraction apparatus. Methods:The implant-distraction apparatus consists of tow units, a TiNi shape memory alloy spring and an implant, made of pure titanium TA2.Spring was put into the hollow implant.After horizontal osteotomy, the implant-distraction device was placed into the partial edentulous area of mandible of 6 dogs to distract the alveolar bone.Results: The apparatus was manufactured.It could implement continual autodistraction and kept stable in the in vivo experiment. 10 weeks after application of the apparatus the transport bone segment was vertically augmented by 4.7 mm on average.Conclusion: The implant-distraction device is functional in distraction osteogenesis.

?Objective: To design a new implant distraction apparatus.Methods:The implant distraction apparatus was designed on the bases of Ilizarov theory,made of pure titanium TA 2 and prepared as a set including distractor and accessories.Inferior edge of a dog's mandible was prepared for implantation. After horizontal osteotomy, two implant distraction devices were applied.Results:The transport bone segment was vertically augmented 3 5 mm successfully,and the ditraction apparatus was stable.Conclusion: The implant distraction device is functional in distraction osteogenesis.

Objective: To estabish an animal model with blast injury in maxillofacial region and to study the biomechanical property of the model.Methods: Spherical explosive at different distances was used to make wound in maxillofacial region in dogs. The pressure on tissue at different level, the variation of horizontal acceleration and strain of the mandibular and temporal bone were dynamically measured.Results: About 3.5 cm?3.0 cm soft tissue defect and madibular splintered fracture occurred in maxillofacial region when the spherical explosive exploded on the surface of the dog's face and the animal survived. The pressure on mandible was respectively 3.6%?2.9% of the surface of dog's face when the spherical explosive exploded 0 and 1.00 cm away from the dog's face while the ratio of horizontal acceleration of cranium to mandibular was 1/8?1/6. Splintered fracture occurred in mandible when the mandibular strain was 11 375 ??.Conclusion: The model can be applied as an animal model with blast injuries in maxillofacial region.

Objective: To investigate the distraction osteogenesis technique in correction of severe retro-maxillary deformity following the repair of cleft palate. Methods:10 patients were included in the study. Orthodontic treatment was used as a regular procedure before operation. Distraction osteogenesis technique was used to correct the deformity and malocclusion. 4 of patients applied with the external distractor and others with internal distractor. Latency period was 7 days. Distraction rhythm is 0.8~1 mm/d,2~4 times/d. Consolidation period was 8~12 weeks. Orthognathic surgery was done after distraction finished when necessary. Results:The treatment process was smooth and no severe complication occurred. The maximum of distraction distance is 22 mm, and the minimum of distraction distance was 15 mm. No malunion or ununion occurred in all 10 patients. All the patients were satisfied with the results. Conclusion:Distraction osteogenesis is more suitable for correction of severe retro-maxillary deformity following the repair of cleft palate. Bone transplantation is unnecessary during the operation process with easier handling and lower risk.

Objective To sum up our experience in the preoperative management for anticoagulated valve replacement patients undergoing selective biliary tract surgery Methods Thirty eight patients were divided into normal liver function group of 23 cases (group A) suspending anticoagulant 3 days before the surgery and group B of 15 cases with abnormal liver function suspending anticoagulant plus VitK 1 injection 12 hours before the surgery Prothrombin time was measured, and result was compared with 115 normal controls Results There were no significant difference in prothrombin time between the two groups Conclusion A biliary tract surgery could be safe if anticoagulated patients receive adequate preoperative management

Objective:To evaluate the effect of orbital floor mesh plate in the treatment of orbital floor fracture. Methods:27 patients with orbital margin fractures were treated by surgical operation with orbital floor mesh plates or medial wall plates. All patients were observed for 3 months after operation.Results:It was observed that all patients with enophthalmos were cured and the patients with nerve injury recovered satisfactorily.Conclusion:Orbital floor mesh plate is effective in the treatment of orbital floor fracture.

Objective To investigate the acoustic characteristics of snoring sound in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and with simple snoring. Methods 22 patients with OSAHS and 15 with simple snoring were included in this study. Natural overnight snoring was digitally recorded and portable sleep mo-nitoring was performed simultaneously. 10 snores, which were the 1st snores after 10 cycles of obstructive apnea, from each patient in OSAHS group, and 10 snores from each patient in simple snoring group were analyzed in the time and frequency domains. Results The sound waves of snoring in the two groups exhibited different patterns both in the time and frequency domains. The snoring spectrum of patients with simple snoring showed distinct fun-damental- harmonic structures which were not clear in patients with OSAHS. The central frequency of the patients with OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with simple snoring. In the OSAHS group, the central frequency of the patients with moderate-to-severe OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with mild OSAHS. The differences of the two parameters were of statistical significance. Conclusion The snoring sounds in patients with OSAHS and with simple snoring have dif-ferent characteristics in time and frequency domains, indicating that it is feasible to research the OSAHS by way of snore monitoring and analyzing technique.