Objective To evaluate the short-term effect of open and laparoscopic cholecystectomy surgery on body.Methods Forty patients with cholecystectomy were divided into open surgery group and laparoscopic surgery group by random digits table method with 20 cases each.The clinical index was compared between two groups.The immunoglobulin G(IgG) and procalcitonin (PCT) before surgery and 4 d after surgery were determined.Results The operative blood loss,anal exhaust time,length of stay was (135.80 ±26.74) ml,(1.6 ±0.9) h,(6.7 ±3.2) d in open surgery group,which was better than that in laparoscopic surgery group [(63.41 ± 15.06) ml,(0.4 ± 0.3) h,(2.8 ± 1.9) d],and there was significant difference (P ＜ 0.05).The incidence of heat was 15％(3/20) in open surgery group,which was higher than that in laparoscopic surgery group (0),and there was significant difference (P ＜0.05).There was no significant difference in the IgG and PCT between two groups before surgery (P ＞ 0.05).The IgG and PCT at 4 d after surgery was (13.93 ± 1.98) g/L,(2 153.2 ± 1 452.1) mg/L in open surgery group,which was higher than that in laparoscopic surgery group[(9.23 ± 2.87) g/L,(768.0 ± 237.0) mg/L],and there was significant difference (P ＜ 0.05).Condmion Laparoscopic cholecystectomy has smaller short-term effects on body,while the body of the humoral and cellular immune function in mild,conducive to the body's recovery.

[Summary] This paper was to investigate whether serum angiopoietin-like protein 2 (Angptl 2) is associated with macrovascular complications in type 2 diabetes mellitus.The results showed that there were statistically significant differences in serum Angptl 2 levels among control group and groups of type 2 diabetic patients with or without carotid atherosclerosis [0.98 (0.82-1.22),3.70 (2.69-4.85),1.17 (0.76-2.47) ng/ml].Logistic regression showed that Angptl 2 was an independent risk factor of macrovascular complications in the patients with type 2 diabetes.

Objective To investigate the expression of engulfment and cell motility protein 1 (ELMO1) in hepatocellular carcinoma(HCC) and its effects on cell migration.Methods The expression of ELMO1 in HCC cell lines and HCC tissues was assessed by Western blot.We used transient transfection with an ELMO1 expressing vector to over-express ELMO1 protein in SK-HEP-1 cells.Over-expression of ELMO1 was confirmed by Western blot.siRNAs specific to ELMO1 (ELMO1 siRNA) were used to knockdown ELMO1 expression.Rho Family Small GTPase Activation Assay, Western blots, transwell assay were used to determine the migration potential of cells.Student's test was employed for statistical analysis.Results The expression of ELMO1 protein was obviously up-regulated in HCC tissues and cell lines (P<0.05).Over-expression of ELMO1 promoted cell migration in SK-HEP-1 cells, while knock-down of ELMO1 showed the opposite effect.Conclusion ELMO1 up-regulation significantly correlates with cell migration in hepatocellular carcinoma.

Objective To explore the dynamic changes of von willebrand factor(VWF)and Pseleetin in the finger-replanted patients,and the relationship between the prognosis of the surgery and hypercoagulability.Methods From December 2004 to December 2006,eishty finger-replanted patients were recruited to our study.with 40 healthy volunteers as controls.Plasma VWF and P-selectin were detected by enzyme-linked immunosorbent assay(EUSA)in both controls and patients before or after replantation.Results The VWF and P-selectin levels had significant differences between the replantations and controls(F=14.76,11.76,P＜0.01).The VWF levels in the patients of 1,4,8,16 hours after replantation were(1 715±493),(1 396±549),(1 266±504),(1 163±436)U/L respectively,all markedly higher than the controls(P＜0.01).The P-selectin levels in patients of 1,4,8,16,24 hours after operation were(14.7±2.6),(12.5±3.0),(11.8±3.2),(11.1±3.0)、(10.5±2.6)μg/L,significanfly higher than the controls(P＜0.01).The VWF levels in patients of pre-replantion and the 1,4,8,16,24,48,72 hours after replantation were(854±209),(1 535±389),(1 177±407),(1 040±283),(958±216),(829±193),(777±151),(713±137)U/L in successful group,and were(1 202±164),(2 333±243),(2 146±161),(2 039±244),(1 865±170),(1 645±283),(1 427±331),(1 188±262)U/L in unsuccessful groups.They were all significantly different at the same test-time points between two groups(t=4.44,5.12,6.10,8.43,10.17,8.85,5.10.4.61,P＜0.05).The P-selectin levels in patients of 1,4,8,16,24,48,72 hours after replantation were(13.9±2.5),(11.2±2.0),(10.2±1.6),(9.6±1.2),(9.2±0.9),(9.5±0.6),(9.3±0.4)μg/L in successful group,and(17.2±1.0),(16.9±1.0),(17.0±1.3),(16.1±1.1),(14.9±1.5),(13.8±1.4),(12.8±1.2)μg/L in unsuccessful group.Significant difference existed at the same testtime points between two groups again(t=5.22.9.91,10.35,12.79,9.46.9.45,9.33,P＜0.01).After replantation,both VWF and P-selectin were rapidly elevated and went to the summit 4 hours later,then declined to pre-replantation level about 24 to 48 hours later after replantation.Conclusions VWF and P-selectin were associated with the hypercoagulability.Dynamic monitoring VWF and p-selectin may be useful in determining the existence of hypercoagulability and the therapy of anti-coagulability.

Objective To explore the medial open wedge high tibial osteotomy (OWHTO) combined with arthroscopic condyle plasty with clinical flexion deformity in patients with osteoarthritis of knee varus.Methods From January 2014 to July 2015,11 cases (11 knees) of varus knee joint flexion deformity were applied the procedure of OWHTO combined with arthroscopic condyle plasty,including 4 male and 7 female;the average age was 52.1 years old (ranged from 48 to 58 years).OWHTO could adjust the line of force of the lower limbs in coronal plane (the connection line between femoral head center point and the center point of ankle joint) through lateral tibial plateau 62.5％ position,and implant allogeneic bone to support posterior inclination angle,underwent arthroscopic condyle plasty to improve flexion deformity at the same time.Results 11 patients in this group were all followed up,and the follow-up time was 1-2.5 years,average 1.5 years.No case of fracture nonunion or delayed healing was found.Imaging data was measured to evaluate the mechanical axis of lower extremity by the relative position of tibial plateau,femoral tibial angle,femoral notch width index,tibial plateau posterior angle before operation and one year after the operation.The relative position of the mechanical axis of the lower limb through the tibial plateau was 17.4％ ± 4.9％ preoperatively,and 58.9％ ± 3.1％ after operation,femoral tibial angle changed from 181.6°± 1.2° to 170.3°± 1.3°,tibial plateau posterior inclination angle:preoperative 7.7°±2.2°,postoperative 7.9°±1.9°,femoral notch width index was increased from 0.221±0.007 to 0.272±0.009 after operation,flexion deformity angle of preoperative was 11.1 °± 3.1 °,and 1.4°± 1.5° one years after operation,VAS score was (6.5 ± 1.1)points before surgery,and (2.5±0.8) points of postoperative,Lysh(o)lm score was (50.72±6.57) points before operation,and (75.72±7.41) points one year after operation,and the differences were all statistically significant.Conclusion 0WHT0 combined with arthroscopic condyle plasty can significantly improve the lower limb line and flexion deformity,and also maintain the posterior inclination angle of tibial plateau,and can get a good short-term efficacy.

Objective To investigate the impact factors of real-time shear wave elastography ( SWE) by using the ultrasound phantoms . Methods The noduled phantoms with different densities and viscosities and background phantoms with three textures ( soft ,medium ,and hard) were prepared by using gelatin as the main ingredient . Nodule phantoms were embedded in background phantom in different depths . The elasticity ( Emax ) was measured by SWE . Factorial designed was used to evaluate the effects of various factors ,including density ,viscosity and depth of nodule phantom and texture of background phantom on Emax of nodule phantom . Binary Logistic regression was used to analysis the effects of various factors , including density ,viscosity ,diameter ,depth of nodule phantom and texture of background phantom on the window phenomenon . Results The density ,viscosity and the Emax of nodule phantoms increased as the gelatin ratio increased . The Emax of nodule phantoms in shallow position ( depth < 3 .0 cm ) were higher than those in deep position ( depth ≥ 3 .0 cm) . In hard-background phantoms ,the Emax of nodule phantoms was maximal ,soft-background phantoms was minimal . Main effects of the density ,viscosity ,depth of nodule phantoms and texture of background phantoms on Emax of nodule phantoms were different ,and all of the factors had interactive effects ( P < 0 .05 ) . The density ,viscosity ,diameter and depth of nodule phantoms were independent risk factors of the windowphenomenon ( P < 0 .05 ) . According to OR ( 23 .846 ,0 .093 ,and 0 .003 ,respectively) ,reduced density and viscosity ,or increased diameter and depth of nodule phantoms ,could increase the incidence of the window phenomenon . Conclusions The density and viscosity of self-making ultrasound phantoms can be easily and flexibly controlled .Density ,viscosity , diameter ,depth of nodule and texture of background are the impact factors of shear wave elastography .

Objective To analyze the changes of benign and malignant thyroid nodules during followup and to increase the diagnostic accuracy.Methods The ultrasonographic changes of 161 thyroid nodules confirmed by pathology were retrospectively analyzed,including size,internal components,echogenicity,margin,microcalcification,anteroposterior to transverse dimension ratio(A/T) and the relationships with thyroid capsule,and the change of cervical lymph nodes.Results Ninety-three benign thyroid nodules and 68 malignant thyroid nodules were enrolled in this study,the changes in size,internal components,microcalcification,the relationships with glandular capsule,and cervical lymph nodes were significantly different (P ＜ 0.05),while the echogenicity,margin,and A/T were not significantly different,benign nodules changed more easily in size and internal components,while malignant nodules changed more easily in microcalcification.Both the nodules broken the thyroid capsule or cervical lymph nodes exhibited malignant signs suggest probable malignancy.Conclusions Analyzing the ultrasonographic changes during follow-up contributes to identify benign and malignant thyroid nodules.

Objective:To analyze the feature of cranial nerve involvement in nasopharyngeal carcinoma (NPC) and its relationship with the prognosis.Method:A total of 1892 patients who were diagnosed as NPC in our hospital from January 2002 to December 2003,of which the cranial nerve involvement was 183 (9.6%) patients, were analyzed the effect of cranial nerve involvement on the prognosis.Result:The percentage of cranial nerve involvement was 9.4%. The 5 year overall survival rate was 61.0%,disease free survival rate was 55.3%,local relapse free survival rate was 75.2% and distant metastasis free survival rate was73.4%.Periods of cranial nerve involvement,clinical stage,the diameter of the lymph nodes,involvement of cavernous sinus, and the level of the recovery of cranial nerve involvement were significantly associated with prognosis in univariate analysis(P<0.05).With multivariate analysis,the recovery level of cranial nerve involvement was the independent factor that affected the 5-year overall survival (RR=2.087). The diameter of the lymph nodes and involvement of cavernous sinus were the independent factors that affected the 5-year distant metastasis-free survival(RR=1.954 and 2.136,respectively).Conclusion:Periods of cranial nerve involvement and the level of the recovery of cranial nerve involvement were significantly correlated with prognosis. Involvement of cavernous sinus could increase the rate of distant metastasis.

Objective To explore the way of contrast-enhanced ultrasound(CEUS)and quantitative analysis technology to assess testicular microvascular ischemia-reperfusion inj ury.Methods Twenty-four healthy adult rabbits were randomly divided into the control group and the microvascular mild,moderate, serve ischemic inj ury group (group Ⅰ,including group Ⅰ1 ,Ⅰ2 ,Ⅰ3 ).The spermatic cord of the control group were threaded but not ligated.The group Ⅰ1 ,Ⅰ2 ,Ⅰ3 were reperfused 2 h after 2 h,4 h,6 h complete testicular ischemia respectively.The ultrasound contrast angiographic parameters of each group were analyzed by the quantitative analysis techniques,including peak intensity(PI),time to peak(TP),slope,mean transmit time(MTT),DT/2 and area.The levels of plasma vWF,NO and ET-1 were tested after the CEUS. The pathological changes of the ipsilateral testicular were observed by the HE and immunohistochemical staining.Statistical analysis was performed by SPSS 13.0 software.Results Preoperativeiy,each parameter of the experimental group and the control group showed no statistical significance (P > 0.05 ). Postoperatively,the PI,slope,area of the group Ⅰ1 increased significantly,while the TP,MTT were prolonged(P <0.05).Contrast time-intensity curve was significantly higher peak and retrusion.The groupⅠ2's PI,slope,area increased further,DT/2 was significantly prolonged,but TP significantly reduced (P <0.05).The contrast curve significantly increased,forward and decreased slowly.The contrast curves of the group Ⅰ3 was approximate a straight line.The vWF,NO,ET-1 levels of each experimental group were significantly higher than those in control group (P <0.05),among them,the levels of group Ⅰ2 were the highest (P <0.05 ).With the aggravation of ischemia,the testicular capillaries expansion,erythrocyte sedimentation,leakage,infiltration of inflammatory cells,MMP-9 expression in vascular basement membrane gradually increased.Conclusions The CEUS and quantitative analysis techniques can effectively evaluate testicular microvascular inj ury.

Objective To study the effect of interleukin (IL)-10 knockout (IL-10-/-) on renal repair after renal ischemia-reperfusion injury in mice.Methods Eighteen IL-10-/-mice (KO) aged 8-10 weeks and 18 C57BL/6 wild type mice (WT) aged 8-10 weeks were divided into control group (Sham) and renal ischemia-reperfusion injury (IRI) group.The renal tissue morphology change was observed by Hematoxylin and eosin (HE) staining and Masson staining.The expressions of IL-18, Ki67 and TGF-β1 were detected by immunohistochemistry.The expression of TGF-beta1 and IL-18 were detected by Western blotting.Results Compared with that in WT-IRI group, in KO-IRI group renal pathological damage was more severe, renal interstitial fibrosis was visible, Ki67 expression of renal tubular epithelial cells decreased distinctly (P＜0.01), the expression of TGF-betal increased significantly (P＜0.01).Conclusion Repair slows down significantly after kidney ischemia-reperfusion injury and fibrosis occurs gradually in IL-10-/-mice, eventually progressing to chronic kidney disease.