Pineal arteries and veins of 46 adult human brains were observed and measured with stero-microscope and light microscope.According to the number of branches, the pineal arteries may be classified into four types: single branched, double branched, three branched and multiple branched types. Among them the single and double branched type occur most frequently. (in 54.55% and 34.09％ respectively), the artery originates mainly from the postcromedial choroidal artery (in 69.72％), and the next more frequent origin is the the quadrigeminal artery (in 28.87%). Some pineal arteries have double origins from abovementioned arteries.Most of the starting points of pineal arteries situate in the recess between the superior colliculus and the pineal body, and less of them on the lateral side of the colliculus or beneath the splenium of the corpus callosum. The artery runs frequently forwards or medially towards the gland and enters it at the middle part of its side. Then it gives branches out of or in the capsule to the surface the gland. The branching patterns may be classified into four types and ten subtypes.The arteries vary in length from 0.2～38.4 mm. The mean external diameter of which is 0.30+0.08 mm, and the internal diameter,0.21?0.07mm.On the pineal body there are a pair of venous stems known as choroidal-pineal veins. They begin from the tela choroidea of the third ventricle. After accepting the dorsal and ventral pineal veins on the ventrolateral side of the pineal body, the two venous stems usually unite to form a single vein which converges into the great cerebral vein.

Objective To investigate the serum lipoprotein (Lp) (a) level in patients with acute ischemic stroke and the prediction for short-term functional outcome. Methods The levels of serum Lp(a) were measured in 210 patients with acute ischemic stroke (within 24 h after onset) and 100 healthy people matched the gender and age. The patients were assessed with National Institutes of Health Stroke Scale (NIHSS) as admission, and modified Rankin Scale (mRS) as discharge. Results The median of Lp(a) was 325 mg/L (IQR: 180~545) in patients,significantly more than 148 mg/L (IQR: 69~265) in the normal controls (P<0.001). Level of serum Lp(a) was an independent variable for functional outcome (OR=1.004, 95%CI: 1.001~1.007, P<0.001) and death (OR=1.006, 95%CI: 1.001~1.008, P<0.001) in patients. In the receiver operating characteristic curve, the area under curve was more in the combined model [Lp(a) and NIHSS] than the NIHSS alone.Conclusion Serum Lp(a) increased in the in patients with acute ischemic stroke, and may predict the short-term outcome independently.

The objects of pediatric service are the children From birth to fourteen. This period is a stage for children's growth and development. so they are weak and need protection,Their health and disease are closely related to their family, social environment and life style,and so on ,In the course of pediatric teaching there ought to be humanism education, especially the combination of the humanities and medical science should be stressed. We should improve knowledge structure of the students and integrative qualities so as to ensure overall development of medical talents and meet the need of the 21st century.

The neuropil in the area of the nucleus intermediolateralis is compossed of dendrites, axons, axonal terminals, synapses and processes of the neuroglia passed through them. The dendrites are scattered and variant in size and shape. Small axons, on the other hand, usually have regular contours and tend to travel in bundles. Three types of synaptic connections were found, the axo-dendritic, axo-sometic and axo-axonic synapses. Some of the synapses form glomerulus in which the dendrite or the axon may be the center. The presynaptic terminals contain numerous synaptic vesicles of various patterns. The pre-and postsynaptic membranes may be asymetrical or symetrical. According to the shape of the synaptic vesicles and the relative thickness of the pre-and postsynaptic membrane the synapses may be classified into three types: 1, spheric vesicle asymetrical type, 2, flattened vesicle symetrical type, and 3, intermediate type.

Objective To compare three kinds of operation method in the treatment of glaucoma with cata-ract indications and clinical efficacy .Methods 90 patients with glaucoma combined with cataract were randomly divided into A,B,C three groups,patients in group A underwent phacoemulsification and IOL implantation therapy , patients in group B underwent phacoemulsification and IOL implantation combined with peripheral iridectomy treat -ment,patients in group C underwent phacoemulsification and IOL implantation and trabecular bite resection ,compared three groups of patients with clinical curative effect The .Results of three groups of patients before treatment and operation visual acuity compared to no significant difference (P>0.05),the treatment after operation,all patients vis-ual acuity was improved ,no significant difference in visual contrast and three group of patients after operation ( P>0.05).Three groups of patients before operation ,1 week after operation,6 months after the IOP had no statistically significant difference ( P>0.05);the same group of patients before and after operation in different time points .The intraocular pressure had significant differences (P<0.05).Three groups of patients with postoperative iris root is rela-tively flat,wide angle increases,and the remaining peripheral iris mucosal area has been narrowed ,visible range be-come larger;no serious complication occurred .Conclusion Glaucoma patients with cataract treated with three kinds of operation mode ,can significantly improve the visual acuity of patients ,so it has high value in clinical application .

Objective To investigate the effect of acarbose on waist circumference (WC) in patients with IGR. Methods A total of 46 subjects with IGT (2 hPG>7.8 mmol/L) were selected in this study. All the subjects were given diet and exercise treatment for half a month and then treated with acarbose for 3 months in combination with life style modification. Self-paired method was adopted to compare islet βcell function and WC before and after the treatment. Results After acarbose treatment for 3 months ,islet βcell function were markedly improved. Insulin secretion of Fins and 2 hIns decreased ,early insulin secretion index (ΔI30/ΔG30 ) significantly increased ,and BMI and WC were reduced significantly (P<0.05) . Multiple regression analysis showed that there was correlation between WC and TG ,insulin resistance index (HOMA-IR) and islet β-cell function index (HOMA-β) (P< 0.05). Conclusion Acarbose in combination with life style modification can improve islet β-cell function in patients with IGR and reduce WC and abdominal fat accumulation as well.

Objectives To explore the changes of serum interleukin-33 (IL-33), IgA anti-endothelial cell antibodies (AECA) and IgA anticardiolipin antibodies (ACA) in acute stage of Henoch-Sch?nlein purpura (HSP) in children and its clinical signiif-cance. Methods Thirty-seven children with acute HSP admitted to hospital were selected from Nov.2012 to Jan.2013. Twenty healthy children were selected as healthy controls. The serum levels of IL-33 were measured by double anti-body sandwich en-zyme-linked immunosorbent assay (ELISA) and the serum levels of AECA-IgA and ACA-IgA were detected by double antigen sandwich ELISA. Results Serum levels of IL-33, AECA-IgA and ACA-IgA in patients with acute HSP were signiifcantly higher than those in healthy controls (P<0.001). According to different clinical types, the serum levels of IL-33, AECA-IgA and ACA-IgA were signiifcantly higher in mixed-type HSP (with joint involvement and gastrointestinal symptoms and/or kidney damage) than those in HSP patients with only joint, abdomen or renal involvement (P<0.05). Serum levels of IL-33 in acute stage of HSP had a positive correlation with AECA-IgA (r=0.752, P<0.001) and ACA-IgA (r=0.788, P<0.001). Conclusions The immune pathological injury in vessels caused by the interaction of IL-33, AECA-IgA and ACA-IgA may be the important pathogenesis of HSP, which may provide a clue for the early diagnosis and treatment for HSP.

Objective To investigate the clinical effect of ulinastatin in preventing pancreatitis after endoscopic retrograde cholangiopancre-atography (ERCP).Methods The Cochrane Library,PubMed,EMBASE,CNKI,VIP,and Wanfang Data were searched for randomized controlled trials (RCTs)on ulinastatin for the prevention of post -ERCP pancreatitis published from 1970 to June 2016.Two researchers se-lected RCTs,extracted data,and evaluated methodological quality independently,and RevMan 5.3 software was used for the meta -analy-sis.The chi -square test was used for the heterogeneity analysis of RCTs included,and the funnel plots were used to evaluate publication bi-as.Results A total of six RCTs with 923 patients were included in this analysis.Compared with the placebo,ulinastatin had significantly better effects in preventing post -ERCP pancreatitis (OR =0.26,95%CI:0.13 -0.53,P =0.000 2),hyperamylasemia (OR =0.47, 95%CI:0.33 -0.67,P <0.001),and abdominal pain (OR =0.56,95%CI:0.34 -0.91,P =0.020).Compared with gabexate,uli-nastatin had similar effects in preventing post -ERCP pancreatitis,hyperamylasemia,and abdominal pain (P =0.52,0.13,and 0.79);low -dose ulinastatin also had similar effects as gabexate in preventing post -ERCP pancreatitis and hyperamylasemia (P =0.49 and 0.25).The funnel plots based on the effect of ulinastatin in preventing post -ERCP pancreatitis were slightly asymmetric,which suggested the presence of publication bias.Conclusion Ulinastatin (≥15 ×104 U)can effectively prevent post -ERCP pancreatitis,hyperlipi-demia,and abdominal pain in the general population and it is recommended to start using this drug before surgery.

Objective To compare the alaryngeal speakers'voice acoustic parameters and intra-tracheal pressure when they spoke different vowels.Methods 24 patients after tracheo-esophageal shunt phonation by the anastomosis of the membranous portion of the tracheal section with the anterior wall of esophagus after total laryngectomy and 16 esophageal speakers enrolled in this study. The voice acoustic parameters were measured when they spoke soft /a/ and soft /i/. The intra-tracheal pressure of 20 TE speakers was measured when spoke /a/ and /i/.Results There were no significant differences between vowel /a/ and /i/ in the two alaryngeal speaker group. The pressure of TE speakers after Shang's procedrue for comfortable /i/ was higher than that for /a/, and there was significant difference.Conclusion There were the same clinical meanings in evaluating alaryngeal voice acoustic aspect. when using vowel /a/ and /i/. However when using different vowel, the intrtracheal pressure was different in TE speakers.

Objective To investigate the value of covered self expending metallic stent in the treatment of malignant esophageal stricture. Methods Thirty two patients with dysphagia due to malignant esophageal obstructions, esophagobronchial and anastomotic stenoses were undergone inserting self expending metallic stents. The procedure was done under fluoroscopic guidance. Sixteen patients underwent radiotherapy and (or) chemotherap after the procedure. All patients underwent esophagography before and after the stent placement, and were followed up to death. Results Thirty two stents were placed in 32 patients without any technical failures, and dysphagia was reduced considerably after stent placement. The recurrence of stenosis ( 6.3% vs 54.5% , P