Objective:To perform a meta-analysis of randomized controlled trials ( RCTs) in multiple sclerosis ( MS) patients to evaluate the efficacy and safety of alemtuzumab.Methods: We searched PubMed,EMBASE,the Cochrane Library and so on up to February 2015 using the keywords:′multiple sclerosis′or ′MS′and the drug names:alemtuzumab.Two authors independently selected the articles and extracted the data.We performed meta-analysis using Review Manager ( RevMan) version 5.3 software.Results:Three RCTs with a total of 1 695 patients were selected.Compared to the interferon beta,the number of gadolinium-enhancing lesions ( odds ratio (OR)=0.33,95% Confidence interval (CI)=[0.23,0.48],P<0.000 01),the cumulative probability of sustained disability (Or=0.51,95%CI=[0.38,0.69],P<0.000 1) and the proportion of patients who had at least one relapse of MS(Or=0.42,95%CI=[0.34,0.52],P<0.000 1) were significantly less in the alemtuzumab group,meanwhile the number of new T2-hyperintense lesions (Or=0.10,95%CI=[0.01,1.75],P=0.11) showed no significant difference.Comparing adverse events between two groups, alemtuzumab treatment did not increase the frequency of serious adverse events (Or=1.00,95% CI=[0.80,1.26],P=0.99) but increase the frequency of any adverse events (Or=2.29,95% CI=[1.40,3.75],P=0.001).Conclusion: Alemtuzumab is a relatively effective and safe treatment for MS.

Objective To investigate the feasibility and safety of laparoscopic surgical treatment of ulcerative colitis(UC).Methods The clinical data of 5 cases who underwent laparoscopic surgery for the treatment of ulcerative colitis were reviewed.Results All 5 cases successfully underwent laparoscopic surgery.Among them,4 had total proctocolectomy and ileal pouch-anastomosis(IPAA),and 1 had subtotal colectomy plus total proctectomy,and cecum-anal anastomosis.The median operating time was 7.5(6.5-9)h,the median blood loss was 250(150-400)mL,the median time to begin semi-fluid intake after operation was 62(60-86)h,the median time of hospital stay was 12(10-14)d,Postoperative pelvic infection occurred in 1 case,adhesive intestinal obstruction occurred in another case.The median follow-up time was 22(10-34)months,and the average number of daily bowel movement was 6.5(4-10)d;they were relapse-free,and had normal daily living and work at follow-up.Conclusions Laparoscopic surgical treatment of ulcerative colitis is associated with minor trauma and rapid recovery,and is safe and reliable,but further accumulation of cases is required.

Objective To compare effects between the laparoscopic surgery and open surgery for the bigger adrenal adenoma(＞4cm) patients in Qinghai.Methods Altogether 57 cases of bigger adrenal adenoma patients(＞4cm)in the affiliated hospital of Qinghai university and Qinghai People's Hospital from 2012 to 2016 were selected and divided into two groups (A and B) according to surgical programs difference.Group A (23 cases)wcre givcn laparoscopic surgcry and Group B (34 cases)were given open surgery (And 2 cases in group A turned into open surgery were out of statistics).The operative time,blood loss,hospital stay and drainage tube removal time were compared.Results The operative time,blood loss,hospital stay and draiuage tube removal time in Group A were significantly better than those in Group B,with statistical significance (P ＜ 0.05).Conclusion The use of laparoscopic surgery for the bigger adrenal adenoma(＞4cm) patients is safer and more effective than open surgery.

Objective To explore the types and the clinical value of the abnomalities of the gallbladder and cystic duct. Methods The clinical date of the 8 cases associated with the abnomalities of the gallbladder and cystic duct among the 432 patients who underwent cholecystectomy in our department since 1990 January were analyzed relrospectively. Results Of the 8 cases ,1 case was discovered as gallbladder duplication, 1 as left-sided gallbladder, 2 as cystic duct parallel to CBD ,1 as cystic duct joining to the anterior wall of CBD,1 as double cystic ducts (one duct joining to the common hepatic duct, the other joining to CBD ),1 as gallbladder hepatic duct ,1 as right accessory hepatic duct joining to the cystic duct. 4 patients(50.0%) developed postoperative complications.Conclusions The keys to reduce the morbidity rate of cholecystectomy are carefully assessment and dissection of the Calot′s triangular area, correct management of the cystic duct ,cystic artery ,and the "adhesions".

High mobility group box 1 protein (HMGB1), a damage-associated molecular pattern, exists ubiquitously in the cells of mammals. It contributes to maintaining the structure of nucleosome and modulating transcription of gene in nuclei. Extracellular HMGB1 plays two-way roles in promoting inflammatory and tissue repair. Released actively as well as passively following cytokine stimulation during cell death, HMGB1 may act as a late inflammatory factor and an endogenous damage-associated molecular pattern recognized by its receptors. And it may mediate the occurrence, development and outcome of the inflammatory injury of digestive system diseases, such as gastric mucosal injury, inflammatory bowel-disease, liver injury, pancreatitis, and so on. This review mainly concerns the research progresses of HMGB1 in the inflammatory injury of digestive system diseases. At the same time, HMGB1 itself, or as a therapeutic target, can promote tissue repair.
Animals ; Digestive System Diseases ; pathology ; HMGB1 Protein ; metabolism ; Humans ; Inflammation ; pathology

Objective Through the English newspaper reading activities to create the information transmission platform based on the medium of English,so as to improve the students' ability of receiving,understanding,conversion,processing,and output information.Methods Two natural classes of seven-year program students of Grade 2011 with no difference in Englishproficiencywere selected at randomas control group(30) and the experimental group(30).And reform on reading course has been performed in the experimental class by incorporating English newspaper reading into traditional teaching routine,while the control class maintain the traditional teaching routine.After the teaching,through CET 4 test scores to evaluate the teaching effect.Independent t-test was conducted on the performances of CET 4 between the experimental class and controlled class with the level of test α=0.05.Results The control group was higher than the experimental group inthe total scoreof CET 4 and the performance oflistening and reading,and there was significant difference between the two groups(P of totalscore=0.000,P of listening score=0.002,P of reading score=0.001).But there was no statistically significant difference in writing subtests between the two groups(P=0.072).Conclusion By adopting English newspaper reading and broadcasting in class,students' overall ability of using English has been greatly enhanced,especially the listening comprehension and reading comprehension; however,there is no significant change in the development of students' writing ability due to the tasks designed.

Objective To assess the effectiveness of Exenatide on non‐alcoholic fatty liver disease(NAFLD) with diabetes mellitus by evaluating fatty liver index(FLI) variation .Methods One hundred and two NAFLD patients with type 2 diabetes melli‐tus were enrolled and divided into two groups .One group were treated with Exenatide and another with Oral antidiabetic agents . The data of BMI ,blood fat ,HbA1c ,ALT ,AST ,GGT ,FLI and so on were collected at enrollment and the end point of 24 weeks treatment .The effectiveness of Exenatide were analysed by Kolmogorov‐Smirnov and Pearson correlation coefficient (r) analysis . Results The indicators of metabolic disorder ,the parameters of liver biochemistry and fatty liver disease (FLI) were significantly improved (P<0 .05) after 24 weeks treatment by Exenatide .While only BMI showed significant decrease after 24 weeks treatment with Oral antidiabetic agents(P<0 .05) .The rest of the parameters in oral antidiabetic agants group showed no significant differ‐ence (P>0 .05) .Conclusion Exenatide has a positive effect on non‐alcoholic fatty liver disease treatment who with type 2 diabetes mellitus ,especially for liver fat accumulation .

Objective To investigate the change of plasma L-threonine (L-Thr) ,D-threonine (D-Thr) ,L-alanine (L-Ala) and D-alanine (D-Ala) in the patients with primary hepatocellular carcinoma (HCC) by using the reversed-phase high-performance liquid chromatography (RP-HPLC) .Methods The o-phthaldialdehyde (OPA) and N-acetyl-L-cysteine (NAC) column with pre-column derivatization was adopted to perform the separation .The mobile phase was 20 mmol/L sodium dihydrogen phosphate solution and acetonitrile with a programmed gradient elution and the flow rate of 1 .0 mL/min .The excitation wavelength was set at 350 nm and the emission wavelength was set at 450 nm .Results The threonine and alanine enantiomers could be simultaneously determined by this method .The regression equation showed the good linear correlation The limits of detection (LOD) for L-Thr ,D-Thr ,L-Ala and D-Ala were 11 .4 pg/mL ,9 .77 pg/mL ,4 .11 pg/mL and 3 .50 pg/mL respectively .The recovery rate was 90 .22% -105 .7% .With-in-day and between-day RSD was 1 .04% -4 .11% .Conclusion The threonine and alanine enantiomers could be simultaneously de-termined by this method .The regression equation showed the good linear correlation The limits of detection (LOD) for L-Thr ,D-Thr ,L-Ala and D-Ala were 11 .4 pg/mL ,9 .77 pg/mL ,4 .11 pg/mL and 3 .50 pg/mL respectively .The recovery rate was 90 .22%-105 .7% .Within-day and between-day RSD was 1 .04% -4 .11% .

Objective To explore the adjustment and posttraumatic growth of people with spinal cord injury from the community. Meth-ods From January 2013 to May 2015, Semi-structured in-depth interviews were used to interview 12 participants with spinal cord injury from Sunshine Rehibilation Center. Interviews were recorded on audio-tape with participants' permission and then transcribed verbatim. The transcribed interviews were analyzed according to interpretative phenomenological analysis. Results 3 superordinate themes emerged includ-ing struggling in despair, disentangling from the shadow of disability and continuing with life as normal, facing challenge and achieving pos-itive growth. Conclusion It is necessary to explore the process of adjustment and posttraumatic growth of people with spinal cord injury, which contribute to understand their psychological experience, psychological feature, and coping strategies, promote their physical and psy-chological recovery, and provide theory and practice guidance for family and society re-integration.

OBJECTIVEA study was conducted to evaluate the clinical application of sialendoscopy combined with conven tional laparoscopy in a 30 degree angle in depth salivary calculus of submandibular glands.

METHODSA total of seventeen patients were presented with repeated swelling in the unilateral submandibular area from June 2013 to August 2015. All patients underwent CT examinations of the mandible and salivary gland function imaging preoperatively. Sialoendoscopy and conventional endoscopy were applied to do intraoral lithotomy. Among the study group, thirteen cases were males and four cases were females. A total of twelve were left cases and five were right cases. Results Seventeen patients had deep positive calculus in the submandibular glands under CT. Photo technetium function was basically normal, whereas secretion of ipsilateral decreased significantly in salivary function tests. Double endoscope assisted surgeries were performed successfully through the mouth to remove the stones. The operation time was (42+21) min. There were no obvious complications in perioperative periods.

CONCLUSIONIntraoral lithotomy assisted by sialoendoscopy and conventional laparoscopy for deep stones in the submandibular glands is a new technique. This technique will possibly lead to complete avoidance of gland resection because of early deep sialolithiasis.

Endoscopy ; methods ; Face ; Female ; Humans ; Male ; Mandible ; Minimally Invasive Surgical Procedures ; Neck ; Perioperative Period ; Salivary Gland Calculi ; surgery ; Submandibular Gland ; surgery