Objective To explore a convenient and safety way for surgical treatment of juxtra-papillary duodenal diverticulum.Methods A total of eighteen patients with juxtra-papillary duodenal diverticulum admitted to Hunan Provincial People's Hospital from May 2011 to May 2013 were involved in this study for retrospective analysis.Results Most of patients were old people and the average age was (55.5 ± 11.2) years in this group.All 18 patients accepted diverticulectomy without operation-mortality.No postoperative complications such as bleeding,duodenal fistula,biliary fistula and traumatic pancreatitis were happened.The average operation time was (2.5 ±0.6) hours.The average blood loss was (35.1 ± 14.2)ml.A total of 16 patients had been accepted follow-up survey.Mean length of follow-up was (10.5 ±2.0)months.Good result rate was 100％.Conclusions Do-not-open the duodenum diverticulectomy is the ideal surgical treatment of juxtra-papillary duodenal diverticulum.

Objective To establish the methods for TLC identification and contents determination of Compound Yantongxiao Spray.Methods Flos Lonicera,Borneolum Syntheticum and Menthol in the spray were identified by TLC,and the content of chlorogenic acid was determined by HPLC.Results The TLC characteristic spots of Flos Lonicera,Borneolum Syntheticum and Menthol can be identified.For content determination,the linear range of chlorogenic acid was in 0.08～0.28 ?g(r=0.999 0),the average recovery of chlorogenic acid was 102.34 %(n=6)and RSD was 2.03 %.Conclusions The methods are simple,accurate,specific and reproducible,can be used for the quality control of Compound Yantongxiao Spray.

Bladder pain syndrome or interstitial cystitis (BPS/IC) is a clinical diagnosis based primarily on refractory suprapubic pain,which is lack of effective treatment and a broad consensus of diagnostic criteria,because its etiology and pathophysiology remains unclear.In this review,it was discussed that recent research advancement regarding to definition,etiology,diagnosis and treatment of BPS/IC,through referring to the latest guidelines and literature on this disorder.

Objective To discuss the relativity between serum procalcitonin(PCT) level and renal impairment (RI) in critically ill patients. Methods A perspective study was performed in 60 critically ill patients. They were divided into 2 groups on the serum PCT level within 24 h: abnormal group (PCT ≥ 0.5 μg/L,38 cases) and normal group(PCT < 0.5 μg/L,22 cases). The serum creatinine (SCr) and blood urea nitrogen (BUN) were observed. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) of the patients were recorded. Calculated the sensitivity and specificity for prediction of RI as well as acute renal dysfunction (ARD). Results SCr [(188.91 ± 199.48) μmol/L]and BUN [(13.03 ±9.19)mmol/L]in abnormal group were significantly higher than those in normal group [(67.40 ± 15.35) μ mol/L and (6.91 ± 2.06) mmol/L](P< 0.01). The sensitivity of PCT forecast RI was 71.79%, and specificity was 52.38%. The sensitivity of PCT forecast ARD was 91.67% , and negative predictive value was 95.45%. Conclusion Serum PCT level has an important value for judgement of RI and ARD in critically ill patients.

Objective To analyse the clinical effect and mechanism of hirudin in the treatment of patients with lower limb venous thrombosis after fracture.Methods 56 patients who were diagnosed with lower limb venous thrombosis after fracture in our hospital were collected.All patients were randomly divided into experimental group (n:28) and control group (n:28).12h after fracture operation, patients in control group were treated with subcutaneous injection of low molecular weight heparin calcium, patients in experimental group were treated with Maixuekang capsule ( hirudin) orally on the basis of control group.Before and after the treatment, the plasma levels of thrombin antithrombin complex ( TAT) , thrombin activated fiber soluble inhibitor (TAFI), D-Dimer (D-D), fibrinogen (FIB), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and clinical effect were detected in all patients.Results After treatment, the total effective rate of experimental group ( 92.86%) was significantly higher than that of the control group ( 71.43%) ( P<0.05 );compared with control group, the plasma levels of TAT, TAFI were lower in the experimental group (P<0.05); the plasma levels of D-D, FIB were lower in the experimental group (P<0.05); the plasma levels of TT,PT,APTT were higher in the experimental group ( P<0.05 ) .Conclusion The hirudin could inhibit thrombin activation and coagulation function in fracture patients with lower limb venous thrombosis, decrease the plasma D-D and FIB levels for improving blood hypercoagulable state and preventing thrombosis,thus improve the clinical efficacy.

Syndrome of cachexia,which is a common feature of many types of cancer,characterized by loss of adipose tissue and skeletal muscle,is responsible not only for a poor quality of life and poor response to chemotherapy,but also a decreased survival time.It can not be fully explained by the accompanying anorexia,because increasing nutrient support is unable to reverse the wasting syndrome.Although patients with cachexia frequently show an elevated resting energy expenditure,cachexia can occur with a normal energy expenditure.Lipid mobilizing factor and proteolysis inducing factor,two tumor-derived factors,can directly mobilize fatty acids and amino acids from adipose tissue and skeletal muscle respectively.It is important of the knowledge about the roles and mechanism of LMF and PIF in the development of cancer cachexia,which should lead to the development of new therapeutic methods.

In order to evaluate appropriately the role of lipid metabolism by the refined konjac meal (RKM), a new source of dietary fiber, the effects of RKM on the level of serum and liver lipids, hepatic histopathology and on the composition and output of fecal bile acids in comparison with pectin, algin and agar were studied.The RKM contained about 75-80% of glucomannan. All four kinds of dietary fiber "were given at a level of 5% in the diet to the young male Wistar rats fed on a lipid-rich diet containing 5% lard, 1% cholesterol and 0.25% chplate. The control group was fed on a lipid-rich diet alone withput fiber. The normal group was fed on a basal diet without extra lipid added. Feeding period was 9 weeks.The results obtained were as follows;1)All the dietary fibers tested have the similar effects on serum lipid composition. At the end of 2-week of the experiment, the serum total cholesterol levels of the four experimental groups were only 62% to 75% of that of the control group, and at the end of 7-week they were lowered to the same level of the normal group. The level of the triglyceride in serum did not change in all groups during the experiment.2)Relative liver weights were lower in four experimental groups than in control group. Hepatic hisiopathological examinations showed lipotropic effect in RKM, pectin and algin groups. Both of the above effects appeared most significantly in RKM group. The concentrations of total cholesterol and triglyceride in liver in RKM group were lower than those in control group as well as other three experimental groups.3)No harmful effects on the intake of food and growing of rats were found when feeding these four kinds of dietary fiber at the level of 5%.4)The daily output of fecal bile acids (CDCA + GDCA) was significantly increased in four experimental groups.The increase of fecal output of bile acids, especially CDCA, may be one of the mechanisms of hypocholesterola-emic effect of dietary fibers.It could be concluded that RKM has the same significant hypocholestero-lemic effect as the pectin, algin and agar, but its lipotropic effect is more potent.

Objective To investigate the value of ureteropyeloscopy and B-type ultrasonography in the treatment of staghorn calculi. Methods Pneumatic lithotripsy was performed and the residual stone and stone fragments were removed under the assistance of ureteropyeloscope and B-type ultrasonograph in 40 patients. Results The stone fragments were small enough to remove and the calculi removal rate was 92.5% (37/40). The rate of complications mainly including hemorrhage and residual stones was 7.5% (3/40). Conclusion The application of ureteropyeloscopy and B-type ultrasonography in the treatment of staghorn calculi is safe and less invasive, and can reduce effectively the incidence of residual stones.