Objective To explore the clinical effects of modified longitudinally cut transverse suture operation for patients with chronic anal fissure. Methods 56 patients with chronic anal fissure were randomly divided into two groups ( each group with 28 patients) . The con-trol group received routine longitudinally cut transverse suture operation, and the observation group were given modified longitudinally cut transverse suture operation. The chages of anal canal diameter, postoperation pain, edema, healing time and infection of the two groups were compared. Results The postoperative anal canal diameter were significantly increased (P<0. 05), but there were no significant difference between the two groups (P>0. 05). The observation group were of significantly lighter postoperative pain and edema, significantly shorter wound healing time, lower wound infection rate than the control group (P<0. 05). The follow-up showed there were no serious complications and recurrence. Conclusion The treatment of modified longitudinally cut transverse suture does not increase the difficulty of operation, while it can faster the recovery with fewer complications. It is worthy of promotion.

ObjectiveTo investigate the value of hysterosalpingography in the diagnosis of infertility.MethodsHysterosalpingographic and clinical materials of 1 320 cases with infertility were collected and analyzed retrospectively. ResultsAmong 1 320 cases, the percentage of abnormal uterus was 9.55 ％. Bilateral patency of fallopian tubes cases were accounted for 46.67％, and bilateral obstruction and unilateral obstruction were accounted for 27. 05％ and 26.29％ respectively. The obstruction position of the interstitial portion, the isthmus, the ampulla, the complete fimbrial and the part fimbrial were 23.94％, 16.21％ ,6.13％ ,23.09％ ,30. 63％ respectively. The accidence of tubal obstruction in the secondary infertility group was significantly higher than that in the primary group (P ＜0.01 ) ,and in the secondary infertility group,the bilatral tubal obstruction frequencies for “abortion times ≥3”were significantly higher than those for “abortion times ＜ 3” ( P ＜ 0.01 ). The pregnancy rate was 27.65％ in three months after hysterosalpingography. ConclusionHysterosalpingography was a cost-effective and indispensable method for diagnosing female infertility.

Objective: To evaluate the effectiveness in Group Interpersonal Psychotherapy by alleviating the symptoms and improving social function in depressive inpatients. Methods:60 inpatients meeting criteria of DSM-Ⅵ for Major Depression were randomly assigned to experimental group and control group, 30 cases each. The experimental group received integral intervention including antidepressants and Group Interpersonal Psychotherapy, while the control group received mono-therapy of antidepressants for 12 weeks. Interpersonal problem was identified before the therapy. HAMD, SDSS were administered at the end of screening day and 12 week to both group. Result:1.Interpersonal problems areas (grief, interpersonal disputes, role transition and interpersonal deficit) in depressive inpatients showed a significant difference (5%,55%,30%,10%,?~2=3.187,P

Objective: To investigate the correlation and clinical significance of serum cystatin C (Cys-C) level and ischemic stroke. Methods: A total of 147 patients with acute ischemic stroke were recruited. They were divided into small, medium and large sub-groups according to the infarct volume of the brain. They were also divided into high-risk group (the National Institute of Health Stroke Scale > 8) and low-risk group (NIHSS≤8) according to the scores of NIHSS. Sixty patients without stroke were selected as a control group. A particle enhanced immunoturbidimetric assay was used to detect the serum Cystain C levels, investigate the relationship between Cystain C level and ischemic stroke and analyze the correlation between Cystain C level. Results: Circled digit oneThe serum Cystain C level 1.20 ± 0.40mg/L in the ischemic stroke group was significantly higher than 0.86 ± 0.23 mg/L in the control group. The difference was statistically significant (P < 0.05). With the increase in infarct volume, the serum Cystain C level also increased. The difference was statistically significant (P < 0.05). Circled digit twoThe serum Cystain C level 1.33 ± 0.52 mg/L in a stroke recurrence group was higher than 1.12 ± 0.28 mg/L in a initial stroke group. The difference was statistically significant (P < 0.01). Circled digit threeThe serum Cystain C level has no correlation with the NIHSS score, but the serum Cystain C level 1.37 ± 0.68 mg/L in the high risk group was higher than 1.15 ± 0.27 in the low risk group. The difference was statistically significant (P < 0.01). Circled digit fourThe serum Cystain C level was positively correlated with homocysteine (Hcy) (r = 0.189, P = 0.022) and very low density lipoprotein cholesterol (VLADL-C) (r = 0.255, P = 0.002), however, it was negatively correlated with high density lipoprotein cholesterol (HDL-C) (r = -0.173, P = 0.036). Circled digit fiveMultivariate logistic regression analysis showed that the serum Cystain C was a risk factor for ischemic stroke (OR = 2.646, 95% CI 1.621-4.317, P < 0.01). Conclusion: The increased serum Cystain C level is an independent risk factor for ischemic stroke, it is associated with the lesion size and the severity of cerebral infarction. The serum level may be used as a reference indicator for the occurrence and development of cerebral infarction and disease surveillance.

Objective To investigate the clinical effect of losartan combined with metoprolol tartrate in treat -ment of elderly patients with coronary heart failure and its effect on heart function ,plasma brain natriuretic peptide and hemorheology.Methods 88 elderly patients with coronary heart failure were randomly divided into two groups ,and 44 cases were in each group .All of the patients were given conventional treatment , and the control group was given losartan while the observation group was received metoprolol tartrate on the basis of the control group ,the clinical effi-cacy and effect on cardiac function ,plasma brain natriuretic peptide ,hemorheology indexes were compared between the two groups.Results The total effective rate of the observation group was 95.45% significantly higher than 77.27%of the control group (χ2 =7.728,P<0.05);cardiac function and plasma BNP were significant improvement compared with the control group(t=6.55,6.02,7.41 and 13.24,all P<0.05);after the treatment,except the plate-let adhesion rate ,the hemorheology of the observation group were significant improvement compared with the control group(t=7.84,7.32,6.55,7.02,5.89 and 5.70,all P<0.05).Conclusion Losartan combined with metoprolol tartrate in treatment of coronary heart failure is significant effect ,and it can effectively improve the patient′s cardiac function,plasma brain natriuretic peptide levels and blood rheology ,and it is worth to be applied in clinical .

Objective To analyze the relationship between ambulatory blood pressure (ABP) and cognitive function in elderly hypertensive patients with leukoaraiosis (LA).Methods Eighty elderly hypertensive patients with LA underwent 24 h ABP monitoring to record their 24 h SBPV,DBPV,AASI,and APPI.The patients were scored according to the MMSE Scale.Results The 24 h SBPV,DBPV,AASI,and APPI were significantly higher in degrees 1,2,3 of LA than in degree 0 of LA (P＜0.05),in degrees 2,3 of LA than in degree 1 of LA (P＜0.05),and in degree 3 of LA than in degree 2 of LA (P＜0.05).The MMSE Scale score of memory,attention,counting,recall,language and the total score were significantly lower in degrees 2,3 of LA than in degrees 1,2 of LA (P＜0.05).The 24 h SBPV,DBPV,AASI,and APPI were negatively related with the MMSE Scale score (r=-0.8697,P=0.000;r=-0.6709,P=0.002;r=-0.8373,P=0.000;r=-0.5991,P=0.007).Conclusion The severer the LA is,the higher the 24 h SBPV,AASI and APPI are.The 24 h SBPV and AASI can thus be used as the indicators of LA and cognitive function impairement.

Objective: To establish an HPLC method for simultaneous determination of syringin, schizandrin, deoxyschizandrin and schisandrin B in Shuangwu capsules. Methods: The HPLC method was employed using a Diamonsil C18 column (200 mm X 4.6 mm, 5μm) with a mobile phase of methanol-acetonitrile (1 : 1, A) and water (B). The gradient elution program was as follows, 0-5 min, 35%-60%A; 5-10 min, 60%-70%A; 10-50 min, 70%-90%A; 50-90 min, 90%A. The flow rate was 1 ml/min. The detection wavelength was set at 220 nm and the temperature was at 35°C. Results: The linearity was obtained within the range of 1.28-20.40 μg/ml for syringin (r=0.999 7), 6.30-100.80μg/ml for schisantherin (r=0.999 6), 1.20-19.20μg/ml for deoxyschizandrin (r=0.999 8), and 3.75-60. 00 μg/ml for schisandrin B (r=0. 999 6). The RSD values of precision were less than 1% for all the four components. The results showed that the samples were stable in the room temperature for at least 24 h. The average recovery rates of syringin, schizandrin, deoxyschizandrin and schisandrin B were 99.47%, 102.50%, 99.21% and 101.86%, respectively. Conclusion: Our method is rapid, easy to perform and accurate; it can be used to control the quality of Shuangwu capsules.

Objective To study the method of preparation of donor liver in liver transplantation. Methods The methods and skills of donor liver preparation and the anomaly artery reconstruction of graft in 64 cases of orthotopic liver transplantation (OLT) were retrospectively analyzed. Results All allografts had preparation and were suitable for clinical transplantation. Thirteen cases with hepatic artery anatomy variation were found. Among the 13 cases, 5 cases were reconstructed. Splenic artery (3/5) and gastro-duodenal artery (2/5) were typically used for anastomosis of the variant hepatic arteries. No complications resulted from donor liver preparation. Conclusions Correct preparation of the donor hepatic artery and biliary tracts, can decrease the incidence of hepatic artery and biliary tract complications after liver transplantation, and is the key to ensure successful donor liver preparation.

Acetylcholine ; metabolism ; Acetylcholinesterase ; metabolism ; Animals ; Brain ; enzymology ; metabolism ; Female ; Hypoxia, Brain ; physiopathology ; Ischemic Preconditioning ; methods ; Male ; Memory ; physiology ; Mice ; Random Allocation ; Reperfusion Injury ; prevention & control

OBJECTIVETo explore the relationship of the classification of talus fracture and surgery methods with avascular necrosis.

METHODSFrom March 2009 to November 2013, 78 patients with talus fracture were treated, of them, 43 cases were followed up from 2 to 5 years. There were 27 males and 16 females, aged from 17 to 65 years old with the mean of 38.6 years. Thirty-nine cases had talar neck injury and 4 cases had talar body injury. Different treatments were performed according to different injury conditions. The time from injury to treatment was from 6 to 48 hours. The effect of classification of talus fracture and surgery methods on avascular necrosis was analyzed.

RESULTSIn 43 cases,19 cases occurred avascular necrosis, including talar neck fracture of type I in 2 cases, type II in 5 cases, type III in 5 cases, type IV in 5 cases and talar body fracture in 2 cases (combined with talar neck fracture). And 29 patients were treated with operation, there was no statistically significant differences in avascular necrosis with different operations.

CONCLUSIONCompared with talar body fracture, talar neck fracture is more easily to develop into avascular necrosis. In the 4 types of talar neck fracture, the possibilities of type III and IV were the most ones.

Adolescent ; Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; classification ; surgery ; Humans ; Male ; Middle Aged ; Osteonecrosis ; surgery ; Talus ; blood supply ; injuries