Objective To investigate the correlation of intima-media thickness (IMT) of the lower peripheral arteries and maximal shear rate (SR) in diabetic (DM) patients and to analyze the related risk factors.Methods A total of 84 diabetic patients and 46 controls were recruited in the study.Color Doppler ultrasonography technique was applied to observe the IMT,diameter(D) and hemodynamics of the lower peripheral arteries and the comparison with biochemical parameters was carried out in order to reveal their correlation to the pathological changes of vascular in DM patients.ResultsIn DM group,the SR was lower than that in control group (P＜0.05).The risk factors related to the lower peripheral arteries of DM patients also were significant difference to that of control group (P＜0.05).Conclusion The decrease of SR in diabetes patients can cause the thicker IMT,which is one of the important factors leading to atherosclerosis and is correlated to various risk factors for metabolic syndrome.

Objective To investigate the prevention and treatment strategy of bile duct injury (BDI) in laparoscopic cholecystectomy (LC). Methods Latest progress was reviewed based on recent documents and the experience on BDI in LC in our department. Results With the popularity of LC, BDI in LC is increasing. The reasons include illegibility and variability of local anatomy in gallbladder trigone,injury caused by galvanothermy, as well as operator’s over confidence. In order to prevent BDI, we should apply more blunt dissection, not to use electrocogulation if possible and to study local anatomy and its variance clearly. The common bile duct and common hepatic duct should be clearly identified. Intraoperative cholangiography, laparoscopic ultrasonography and hepatobiliary scintigraphy are selections as necessary.The treatment of BDI depends on the type of BDI and its site and local condition.The treatment includes end to end anastomosis, repairing the defect, choledochoduodenostomy, Roux en Y choledochojejunostomy and so on. T tube should be maintained in place for more than half a year after operation.Conclusion The key to improve the prognosis of BDI is prevention and treatment in proper time and in correct way.

The vast majority of traumatic cranial nerve injuries are associated with compression of fragment fracture, and microsurgery outside the epidural can be used for most of the cases. Therefore, early and accurate diagnosis of cranial nerve injury is especially important. As the cranial nerves go out of the cranial cavity through the holes and cracks of the skull base, and there are a number of special structures through which cranial nerve goes into the human skull, and they include the optic canal, superior orbital fissure, facial nerve canal, jugular foramen and so on. Most traumatic cranial nerve injuries are associated with these structures; however, the common imaging examination is very difficult for these structures due to their deep location. To further study the imaging diagnosis of cranial nerve injury associated with traumatic brain injury, this paper reviews the radiological technology for examination of the special positions in the skull.

One hundred kinds of excellent books on basic medicine were selected from Wanfang Data Knowledge Platform to develop a books-papers citation database.Their academic levels of the selected books were evaluated by PageRank algorithm.The chapters and sections of the books were divided into 4 parts according to their PageRank value and the distribution characteristics of their citation frequencies to study the PageRank and the top 20 cited chapters and sections of the books.The advantages and disadvantages of PageRank algorithm in book evaluation were described.

High mobility group A1 belongs to the family of high mobility group. It is widespread in human,and involved in the physiological and pathological situations. It is overexpressed in many human cancers including haematological malignancies as the oncogene.

Objective To illustrate a method of lifting the upper-lip to alleviate the aging face,and to evaluate its effects and risks.Methods In the past two years,53 cases of overlong upper-lip were performed with this procedure.The recovery periods,lifted effects,side effects and the total satisfactions were evaluated.Results As for recovery periods,edema roughly reduced in 6-20 months,reddish scar faded in 1-11 months,expression restored in 2-8 months,and numbness disap peared from 4 to over 18 months.The lifted effects showed that 37 cases (78.7％) were satisfactory,7 cases (14.9％) of the lifting was not enough and still complained a long upper-lip,2 cases (4.2％) was ineffective,and 1 case (2.1 ％) considered an excessive lifting.The long term follow-up showed that 3 cases (6.4％) had obvious scar (visible at a distance of more than 1 m),14 cases (29.8％) had depression of columella/base of nostril alar or with increased exposure of nostril,3 cases (6.4 ％) had expansion or morphological changes of alar,6 cases (12.8％) had increased thickness of the upper lip and prominent vermilion tubercle,1 case (2.1％) had changes of expression,1 case (2.1％) had asymmetry,1 case (2.1％) had arching sagging,and 35 cases (74.5％) had numbness or insensitivity of upper-lip.Overall results showed very satisfied in 29 cases (61.7％),satisfied in 15 cases (31.9 ％) and dissatisfied in 3 cases (6.4 ％).Conclusions The technique for upper-lip lifting displays a significant effect with few complication.It is recommended for further clinical application.

Objective To investigate the effect of tetramethylpyrazine injection on serum ion and β2-GPI/ox-LDL in patients with IgA nephropathy.Methods 58 IgA nephropathy patients were randomly divided into two gorups with 29 cases in each group.The control group were treated by benazepril and conventional treatment of dipyridamole, the experiment group were treated on the basis of the control group with tetramethylpyrazine injection.10 days of 1 courses, 2 courses of treatment.The serum ion,β2-GPI/ox-LDL and renal function related indexes were tested.Results Compared with before treatment, the serum inorganic phosphorus,β2-GPI/ox-LDL, Scr, BUN, CysC levels and 24 h urinary protein quantitation were lower( P<0.05), the blood calcium level were higher(P<0.05).Compared with the control group, the serum inorganic phosphorus,β2-GPI/ox-LDL, Scr, BUN, CysC levels and 24 h urinary protein quantitation were lower(P<0.05), the blood calcium level were higher(P<0.05), the clinical effect were higher (P<0.05).Conclusion Tetramethylpyrazine injection can effectively decrease the serum phosphorus, β2-GPI/ox-LDL, SCR, BUN, CysC levels and urinary protein amount of patients with IgA nephropathy, elevate blood calcium levels, significantly improve renal function and with less adverse reactions.

OBJECTIVE To investigate the applicability of 3DMIA software to upper airway modeling in children with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS A total of 30 children diagnosed with OSAHS by polysomnography were included in this study. Data regarding upper airway structure were collected via spiral CT while sleeping and awake, from which a three-dimensional model of the upper respiratory tract from the nasopharynx to the supraglottic region using 3DMIA software was constructed. The upper airway volume and airway minimum cross-sectional area were measured employing software algorithms. RESULTS The upper airway volume and airway minimum cross-sectional area of the 30 children during sleep were significantly less than those while awake (P<0.01). CONCLUSION 3DMIA software modeling and software algorithm measurement are more objective than traditional radiology (e.g. Fujioka) with respect to evaluation of the extent of the upper airway narrowing in OSAHS children, and has good applicability to study upper airway morphology and function in children with OSAHS.

Objective To observe the morphology of thoracolumbar spinal nerve roots and their surrounding structures, in order to find out their anatomical relationship and to improve surgical procedures as well as to reduce the operative injury and complications. Methods 16 adult cadavers were studied anatomically. The diameters of spinal nerve roots from T10 to L3 at the outlet of intervertebral foramen, the percentages of the distance from spinal nerve roots to the upper border of corresponding vertebral bodies in vertebral height, the angles between spinal nerve roots with lateral border of vertebrae were measured and analyzed. The surgical incision and procedure for the treatment of thoracolumbar fracture were designed and applied in 58 patients of thoracolumbar injury. Results The diameters of spinal nerve roots increased gradually from T10 to L3 in the intervertebral foramen. The percentages of the distance from spinal nerve roots to the upper border of vertebrae in vertebral height gradually became larger too. The angles between spinal nerve roots with vertebral bodies diminished gradually. Around intervertebral foramen, the pattern of spinal nerves and blood vessels was arranged in order as vein, nerve and artery from above down below. The nerves and vessels extended out of the intervertebral foramen together. In clinical practice, 58 cases of thoracolumbar injury were surgically treated with traditional anterior approach and "renal" incision in 35 cases, and with modified anterior approach in "┑" shape in 23 cases. Prior to the modification of surgical techniques, the mean amount of blood loss was 670 ml, the mean operation time was 199 min; however, by the modification of surgical procedures, the mean amount of blood loss decreased to 435 ml, and the mean operation time reduced to 137 min. In an average follow-up of 9 months, the spine recovered to normal curvature and alignment in all cases; the fusion rate was 100%; no failure of implant occurred; neurological function was improved at least one grade in 94.5%. Conclusion Modified anterior approach is helpful to reduce operative injuries and complications. It makes surgical manipulation feasible comparing to the traditional approach.

Objective To analyze the long- term results of vascularized fibular graft to repair defects of long bone. Methods Nineteen patients undergone vascularized fibular graft were followed- up for 5－ 20 years(mean 10.79 years). Limb function was graded with Enneking s system, and presented as percentage of normal limb function. The changes of the vascularized fibular graft were evaluated radiographically according to the International Symposium on Limb Salvage. Results The long term results of the vascularized fibular graft varied in different types of bone defects. Nine patients with congenital pseudoarthrosis of tibia had the limb function restored in 65％ and one had nonunion of fibular graft, 3 fractures(7 times), and 5 angular deformities. Three patients with congenital radial deficiency had 62％ restoration of the limb function. All of them showed early closure of epiphyses of the grafted fibulae. Five cases with osteomyelitis and bone defects combined soft tissue deficiency had 94％ restoration of the limb function, and only one occurred fracture of fibular graft. One case with soft tissue defect and concomitant ulnar defect, ulnar nerve and median nerve injury, 67％ function of limb was recovered, and union of fibula graft was good. 100％ function of limb was recovered in 1 case with cavernoma of radius and without occurring valgus deformity of donor site. Conclusion The vascularized fibular graft is a good method for repairing long segmental defects of bone. Combined with other tissue flap, the operation can reconstruct bone defect and fulfil the cover of soft tissue. For congenital tibia pseudoarthrosis and radial deficiency, the long- term results are not so satisfactory.