The value of surgery in the diabetes mellitus treatment receives much attention in the medical field,however,Chinese metabolic surgeons adopt the surgical experience from surgeries for morbid obesity in western countries.There are many controversies on the operative indication,operation method and postoperative follow-up of surgery for diabetes mellitus with low body mass index (BMI).Our nation has a large number of patients with diabetes mellitus and low BMI,in which uncheckedoperative indication,unstandard operation method and non-systematic follow-up are common problems.It has profound significance to investigate operative indication,operation method and efficacy evaluation for patients with diabetes mellitus and low BMI.

Objective To investigate the change of S-100B in serum in rats at varions times after exposure to different whole-brain irradiation doses and to explore the characteristics of the S-100B change in early radiation-induced brain injuries. Methods A model of brain radlation-induced injuries was estabhshed in the rat after whole-brain irradiation with a single dose of 2, 10, or 30 Gy of 4 MeV electron. The concentration of S-100B in serum was detected by means of enzyme-linked immunoserbent assay (ELISA) at different time points (1,6,12,24,3 days, 1 week, 1 month) after exposure. Results In terms of measuring time points, the serum concentration in all groups reached the fwst peak 6 hours after irradiation, declined after 12 hours, rose again after 24 hours, and started to decline again until the last time point (1 month), with the exception of the 2 Gy group, which reached the second peak at 3 days after irradiation. Conclusions The S-100B serum concentration was changed in the rats after whale-brain irradiation and these changes are positively related to the irradiation amount. It seems that the higher the dose, the higher the serum concentration and the differences between the dose groups are significant (via multiple regression models). The S-100B may be a valuable serum marker for the brain irradiation injury.

Eighty elderly patients undergoing elective resection for the prostate were randomly divided into two groups, the levobupivacaine (observe group) and bupivacaine (control group) were used for spinal anesthesia, respectively. The level of sensory block and maintain time were T7±4 and (224 ±28) min in observed group, those in control group were T6±3 and (227 ±30) min, respectively ( both P＞ 0. 05). The mean arterial blood pressure of control group was (71 ±8) -(72 ±8) mm Hg (1 mm Hg = 0. 133 kPa) from 5 to 30 min after injection; meanwhile that of observed group was(75 ± 9) mm Hg (P ＜ 0. 05). The incidences of hypotension and nausea were 10% (4/40) and 0% (0/40) respectively in observe group, and those were 30% (12/40) and 15% (6/40) respectively in control group (both P＜0.05). The results indicate that levobupivacaine and bupivacaine have similar anesthetic effects, but levobupivacaine has fewer side effects and is more suitable for elderly patients.

Despite the progress in the comprehensive management of colorectal cancer,locally advanced (T3 and T4 stages) and metastatic colorectal cancer is still a challenging problem.Although researches on neoadjuvant therapy and targeted therapy have obtained many encouraging results,many unanswered questions still remain.These include the indication of multivisceral resection for locally advanced colorectal cancer,the optimal management of patients with hepatic and (or) pulmonary metastasis.R0 resection was the first choice for the treatment of metastatic colorectal cancer,but it is only suitable for selected patients.Chemotherapy and targeted therapy are effective in converting some unresectable liver metastasis into resectable disease.This review focuses on recent improvements in the management of locally advanced colorectal cancer,as well as the management of hepatic and (or) pulmonary metastasis.

Objective To assess the efficacy of submucosal injection of thiotepa for the prevention of recurrence of superficial bladder cancer. Methods Sixty-six patients with superficial bladder cancer were chosen, they were randomly divided into injection group(33 cases)and control group(33 cases). In injection group, 33 patients had submucosal injection of thiotepa, after 30 minutes resection of bladder tumor were treated by PKRBt, after one week, they were given perfusion 27 mg BCG. In control group, 33 patients after the PKRBt were given perfusion BCG. Results The recurrence rate in injection group was 15.2%, and that of the control group was 27.3%. There was significant difference between the twO group (P<0.05). Con-clusions The submucosal injection of thiotepa , PKRBt and perfusion BCG could prevent tumor recur-rence,it has the following advantage,such as simple , safe, less side effect ,more economical. The submu-cosal injection is a practical method to prevent tumor recurrence and is worth popularizing.

Objective To investigate the outcome of microsurgical treatment and its influencing factors in patients with aneurysmal subarachnoid hemorrhage.Methods The consecutive patients with aneurysmal subarachnoid hemorrhage treated with the early or ultra-early microsurgery were enrolled retrospectively.The Glasgow outcome scale (GOS) was used to assess the outcomes of patients at discharge.GOS 4-5 was defined as good outcome,and GOS 1-3 was defined as poor outcome.Results A total of 147 patients with aneurysmal subaraclnoid hemorrhage were enrolled.One hundred and twelve patients (76.2％) had good outcomes.There were significant differences in the proportions of preoperative Glasgow Coma Scale (GCS) scores (12.8 ± 2.8 vs.7.5 ± 3.8;t =7.525,P ＜0.001),low Hunt-Hess grade (83.0％ vs.31.4％;x2 =34.318,P ＜ 0.001),size of aneurysm (x2 =9.531,P =0.009),preoperative rebleeding (6.3％ vs.25.7％;x2 =8.506,P =0.003),preoperative brain herniation (4.5％ vs.40.0％;x2 =26.846,P ＜ 0.001),initial CT scan showing intracerebral hemorrhage (19.6％ vs.48.6％;x2 =11.449,P =0.002),and intraventricular hemorrhage (8.9％ vs.40.0％;x2 =18.846,P ＜0.001) between the good outcome group and the poor outcome group.Multivariate logistic regression analysis showed that the larger aneurysm (odds ratio [OR] 3.194,95％ confidence interval [CI] 1.458-6.999;P =0.004),older age (OR 1.054,95％ CI 1.013-1.097;P=0.010),lower preoperative GCS score (OR 0.539,95％ CI 0.410-0.724;P ＜ 0.001),and preoperative brain herniation (OR 3.633,95％ CI 1.039-12.700;P =0.043) were the independent risk factors for poor outcomes.Conclusions After active surgical treatment,most of the patients with aneurysmal subarachnoid hemorrhage have good outcomes,however,patients with older age,larger aneurysms,lower preoperative GCS scores,and preoperative brain herniation usually have poor outcomes.

ObjectiveTo assess whether intravenous contrast medium would result in acute kidney injury (AKI), and to determine the risk factors associated with contrast induced AKI (CI-AKI) and its outcome.Methods A retrospective observational study was conducted in intensive care unit (ICU) of Fuyang People's Hospital in Zhejiang Province from January 1st 2011 to December 31st 2014. All enrolled critically ill patients had accepted CT scan, and the hospital length of stay was longer than 48 hours, and the patients who needed renal replacement treatment were excluded. Patients were divided into contrast medium group and control group. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria (serum creatinine content over 26.4μmol/L or 50% increase of it from baseline within 48 hours). The incidence of AKI was compared between the two groups, and risk factors for CI-AKI were determined by multiple logistic regression analysis. The relationship of CI-AKI and outcomes were also analyzed. Results A total of 2 370 critically ill patients were enrolled during the period. 474 (20.0%) of the 2 370 patients received contrast medium, and 70 of them suffered from CI-AKI (14.8%). In 1 896 patients who did not receive contrast medium, 235 of them suffered from AKI (12.4%). There was no significant difference in the incidence of AKI between two groups (χ2= 1.905,P = 0.168). After several confounding factors were adjusted, multiple logistic regression analysis showed that contrast medium was not found to associate with AKI in critically ill patients [odds ratio (OR) = 1.66, 95% confidence interval (95%CI) = 0.72-3.90,P = 0.201], and high acute physiology and chronic health evaluationⅡ (APACHEⅡ) score (OR = 1.70, 95%CI = 1.33-2.40,P< 0.001), sepsis (OR= 8.06, 95%CI =3.28-17.80,P< 0.001), shock (OR= 3.57, 95%CI = 1.73-8.01,P< 0.001) and use of nephrotoxic agent (OR= 1.96, 95%CI = 1.25-2.63,P = 0.015) were risk factors of CI-AKI. Ten of 70 patients with CI-AKI died (14.3%), and 21 out of 404 patients without CI-AKI, died (5.2%). There was no significant difference in the mortality rate (χ2= 8.060, P = 0.005). It was shown by multiple logistic regression analysis that age (OR=1.30, 95%CI = 1.05-1.71,P = 0.027), male sex (OR = 1.13, 95%CI = 1.05-1.20,P = 0.039), APACHEⅡscore (OR = 1.07, 95%CI = 1.03-1.18,P< 0.001), and sepsis (OR = 3.29, 95%CI = 1.92-6.46,P< 0.001) were highly associated with mortality of critically ill patients in whom contrast medium was used. However, the occurrence of CI-AKI showed no influence on the mortality rate (OR = 1.70, 95%CI = 0.88-3.56,P = 0.227).Conclusions The use of contrast medium is not a risk factor of CI-AKI in critically ill patients. CI-AKI will not raise mortality rate in ICU patients.

In terms of the characteristic of exonuclease I that can selectively catalyze the degradation of single-stranded DNA, we report a new sensitive electrochemical biosensor for the detection of breast cancer cells by using the aptamers of MUC1 that is overexpressed on the surface of MCF-7 cells. Because the binding of aptamer and MUC1 that is over-expressed on the surface of breast cancer cell MCF-7 can prevent its hybridization with the complementary probe DNA, the unhybridized single-stranded probe DNA that is immobilized on the electrode surface will be selectively digested by Exonuclease I and result in the removal of the signal molecule methylene blue. Therefore, by tracing the changes in electrochemical responses, the biosensor can be used to sensitively detect MCF-7 cells in a linear range from 103 to 106 cell/mL with a detection limit of 330 cell/mL, and easily distinguish the control islet β cells with high specificity.

BACKGROUND:Interleukin-8 is an important inflammatory chemokine that plays an important role in the regulation of tumor cel proliferation and angiogenesis.
OBJECTIVE:To investigate the effect of interleukin-8 on the invasion and metastasis of CD133+hepatocel ular carcinoma stem cel s.
METHODS:After isolation and culture of MHCC97-H cel lines, CD133+/CD133-MHCC97-H cel s were sorted using immunomagnetic beads. CD133 expression was detected using flow cytometry, and interleukin-8 level in supernatant was measured using ELISA method. Cloning efficiency, tumorigenic capacity, cel migration and invasion ability were detected through colony formation assay, tumorigenesis experiment in nude mice, and Transwel detection. Additional y, other cel s were neutralized using interleukin-8 neutralizing antibody. Measurement results were compared between cel s undergoing different treatments.
RESULTS AND CONCLUSION:The CD133 level, interleukin-8 level, cloning efficiency and cel membrane permeability of CD133+MHCC97-H cel s were significantly higher than those of CD133-MHCC97-H cel s (P<0.05). Transplantation of CD133+MHCC97-H cel s at 1×106/L and 1×107/L resulted in subcutaneous tumors in some mice, whereas no subcutaneous tumors appeared in mice undergoing transplantation of CD133-MHCC97-H cel s at the same concentrations. After interleukin-8 neutralizing antibody treatment, the CD133 level, interleukin-8 level, and cloning efficiency of CD133+/CD133-MHCC97-H cel s were significantly decreased (P<0.05), especial y in the CD133+MHCC97-H cel s (P<0.01);the migration and invasion ability and cel membrane permeability of CD133+MHCC97-H cel s were significantly reduced (P<0.05), but these changes were not obvious in CD133-MHCC97-H cel s (P>0.05). These results show that interleukin-8 could be specifical y involved in the invasion and metastasis of CD133+MHCC97-H cel s.

AIM: The purpose of this study was to investigate the effects of rhBMP-2/collagen composite on bone regeneration during expansion of the interparietal suture in the rats. METHODS: 32 10-week old SD rats were divided into groups consisting of 8 rats each. They were comprised of normal control group, expansion control group and the treatment group, the two treatment groups were covered with atelo-typeⅠcollagen and rhBMP-2/collagen composite on the suture before subjected to the expansion force. The bone regeneration in the interparietal suture was estimated by histological method, the osteocalcin content was measured by radioimmonoassay and the calcium content was determined by atomic absorption spectrophotometer. RESULTS: The bone regeneration was more active in the suture after giving an expanding force than in the suture without any intervention. Even bone bridge was formed in the rhBMP-2/collagen composite group. Both the osteocalcin content and calcium content were much higher in the rhBMP-2/collagen composite group than in other three groups (P