Objective To investigate the relationship between occult pancreaticobiliary reflux (OPR) and biliary diseases.Methods Forty-four patients with primary biliary diseases was enrolled,and serum amylase level was determined,and the bile in common bile duct (CBD) was collected to measure the amylase level,then the △ amylase was calculated,which equals bile amylase level minus serum amylase level.OPR was confirmed if bile amylase level was higher than serum amylase level,otherwise it would be defined as the control group.Results Among the 44 patients with primary biliary diseases,the incidence of OPR was 72.7％ (n =32).The bile and serum amylase activity of patients with OPR were (1 513 ± 2 725),(44 ± 21)U/L;and they were (18 ± 14) and (38 ± 17) U/L in the control group.The bile amylase level in OPR group was significantly higher than that in the control group,and the difference was statistically significant (P ＜ 0.05),while there was no significant difference in serum amylase activity between the two groups.The incidence of OPR in patients with CBD stones was 100％,and the bile amylase activity was (1 048 ± 1 317) IU/L,and the △ bile amylase activity was (996 ± 1 322) U/L;the incidence of OPR in patients with choledocholithiasis and cholecystolithiasis was 75％,and the bile amylase activity was (2 457 ± 3 312),the △ amylase activity was (2 412 ± 3 320)IU/L;and the corresponding values in patients with gallbladder stones were 80％,(95 ± 82),(57 ± 76)IU/L;and the corresponding values in patients with bile duct cancer were 50％,(73 ± 51),(40 ± 37)U/L.Conclusions The occurrence of OPR is closely related to CBD stones only,CBD stones and gallbladder stones,and it may be one of the main pathogenic factors of bile duct stones.

Objective To observe the effects of Qutantongluo decoction on the expression of TGF-β1 in renal tissue of diabetic nephropathy(DN) rats,which can help to understand the mechanism of action.Methods The rats models of diabetic nephropathy were established by injecting with streptozotocin intraperi-toneally.All Wistar rats were randomly divided into 6 groups:the normal control group,the model control group,Benazepril Hydrochloridec group ( 1 mg/kg ·d-1 ),Qutantongluo decoction low dose group (3 g/kg ·d-1 ),Qutantongluo decoction median dose group (4.5 g/kg · d-1 ),and Qutantongluo decoction high dose group (6 g/kg · d-1 ).Rats in the normal control group and the model control group were given celiac perfusion of distilled water once at the same time and dose.All the rats were gavaged once daily for 8 weeks.The expression of TGF-β1 at the level of gene and protein in renal tissue were tested by immunohistochemistry and RT-PCR methods.Results Compared with the model control group(2.79±0.22),the expression of TGF-β1 at the level of protein in renal tissue of Benazepril Hydrochloridec group (1.55 ±0.12)and the Qutantongluo decoction low dose group ( 1.54± 0.16),Qutantongluo decoction median dose group (1.49 ± 0.17),Qutantongluo decoction high dose group(l.39±0.25) decreased significantly (P＜0.05).Compared with the model control group (0.35±0.07),the expression of TGF-β1 mRNA in renal tissue of Benazepril Hydrochloridec group(0.35± 0.07)and the Qutantongluo decoction low dose group(0.39±0.03),Qutantongluo decoction median dose group (0.35± 0.06),Qutantongluo decoction high dose group (0.32± 0.07) decreased significantly (P＜0.05).Conclusion Qutantongluo decoction can down regulate the expression of TGF-β1 in kidney,which may be one of the mechanisms of Qutantongluo decoction effectiveness in clinical treatment of diabetic nephropathies.

Objective To investigate multifunctional direct digital radiography system (DDR) in clinical practice, in order to improve the applied value of it.Methods EPEX DDR was performed in 1000 cases,these images were analysedby 3 senior radiologists and tried to find the best method of usually positions. Results The quality of DDR was assessed as grade A in73.00%, grade B in 22.70%, grade C in 4.30%, and no waste film.Conclusion DDR is easy to operate, fast in capturing image and can provide post-processing techniques, which will facilitate the accurate diagnosis of radiography.

Objective To investigate the relationship of fetal total bile acid (TBA) concentration with the change of fetal pancreas endocrine secretion and its impact on fetal growth and development in intrahepatic cholestasis of pregnancy(ICP). Methods The concentrations of TBA, insulin, glucagon and glucose in the cord blood were measured in 30 fetuses with maternal ICP (case group) and 30 fetuses of normogravidas(control group) after elective cesarean section during the same period in the Department of Obstetrics of Xiangya Second Hospital of Central South University from March 2007 to February 2008. The cord blood TBA concentration was investigated by enzyme method and the concentrations of insulin and glucagon were investigated by radioimmunoassay. The glucose was measured by oxidase-superoxide method. The neonatal weight, length and the ponderal index (PI) were measured after parturition. Results (1) The cord blood insulin concentration (9.0±3.3) mU/L and the ratio of insulin over glucagon 0. 048±0. 028 in the case group was significantly lower than that of controls(10.1±3.7) mU/L,0.050±0. 020 (P<0.05). The concentrations of TBA(10.3±3. 8)μmol/L and glucagon(235±57) ng/L in case group were obviously higher than that in controls (4.1±1.3)μol/L, (205±34) ng/L(P<0.05). But no difference was shown in the glucose concentration in cord blood between the ease and control groups [(3.4±1.1) mmol/L vs (3.6± 1.2 )mmol/L, P > 0.05]. (2)The neonatal weight and length in case group were significantly lower than that of control [(3163±478) g vs (3498±393)g, (46.5±2.3) cm vs (49.3±1.9)cm, P<0.01]; while the Ponderal index in ease group was significantly higher than that of control group (3.13±0. 23 vs 2. 92±0. 29,P <0.01). (3) The cord blood TBA concentration respectively showed a linear relationship with the cord blood insulin concentration, the cord blood glucagon concentration and the ratio of insulin over glucagon in the case group. With the increase in cord blood TBA concentration, the cord insulin concentration and the ratio of insulin over glucagon decreased; meanwhile the cord blood glucagon concentration rose(P<0.01). The cord blood insulin concentration and the ratio of insulin over glucagon in case group were respectively positively correlated with the neonatal weight and length, and were negatively correlated with the PI (P<0.01); while the cord glucagon concentration was respectively negatively correlated with the neonatal weight and length, and positively correlated with the P1 (P < 0.01 ).Conclusions In 1CP fetus pancreas, there are hypoinsulinism, glucagon oversecretion, and decrease of the ratio of insulin over glucagon, which is closely correlated with fetal TBA concentration. The endocrine function of fetal pancreas affects the fetal growth and development.

OBJECTIVETo develop and evaluate the application of the facial minimally invasive fat granules injection device with controlled pressure and quantity.

METHODSDue to the requirement of facial fat grafting (small volume, precision, high pressure), we developed the integrated device with handheld controller and motor. From Nov. 2013 to Mar. 2015, 50 cases who underwent facial fat transplantation were selected to receive facial fat grafting with the device on the right side and with conventional syringe on the left side as control. The clinical effect was assessed by patients, surgeon and one from the third party. The intraoperative pain, injection difficulty, postoperative swelling and hruising, complications and overall satisfactory were recorded. Pain intensity was assessed using digital classification method ( NRS). Therapeutic effect was evaluated using Likert 5 points scoring method. Chi-square test, Wilcoxon test and one-way ANOVA were used for statistical analysis.

RESULTSThe device has the advantages of minimal designed and easily handling. The injection speed is 7.2 mm/s with the fat injection volume as precise as 0.04 ml/s (0.0056 m/mm). Among the 50 cases, the excellent and good effect were achieved in 90% (45/50) on the right face, and 78% (39/50) on the left face (Z = -4.285, P < 0.01). Local nodes happened in 7 cases on left face, while none on the right face (χ² = 6.57, P < 0.05). Petechiae occurred in 21 cases on right face and 45 cases on left face (χ² = 5.37, P < 0.05). Pain was assessed as 3.7 ± 1.1 points on the right sides, and 5.2 ± 0.7 points on the left sides (F = 17.405, P < 0.01).

CONCLUSIONSThe facial minimally invasive fat granules injection device with controlled pressure and quantity has the advantages of easily handling, precisely controlled quantity with hotter effect, less pain and complication.

Adipose Tissue ; transplantation ; Analysis of Variance ; Chi-Square Distribution ; Face ; surgery ; Humans ; Injections ; instrumentation ; Pain Measurement ; Statistics, Nonparametric

Objective To assess the mental health status of the pregnant women with missed abor-tion, as well as related influencing factors, and to provide the basis for mental nursing. Methods 100 pregnant women with missed abortion were chosen as the observation group by convenience sampling, while other 100 normal pregnant women as the control group. The mental state of the pregnant women in both groups was evaluated by using symptom checklist-90 (SCL-90), the results of which were then studied in contrast using t test and variance analysis. Results The total scores and the average scores of pregnant women in the observation group were significantly higher than those in the control group. The mental health status of pregnant women with missed abortion was influenced by age, education degree, and the times of pregnancy. Conclusions There are significant mental health problems in pregnant women with missed abortion, to which should be paid much attention. And the psychological counseling should be carried out in time in case of detrimental influences in treatment, rehabilitation, and next pregnancy.

Objective To probe the definition of cicateicial cryptotia and its plastic and reconstructive surgery.Methods Local skin flaps combined with full-thickness skin graft by zonation grafting technique were used to treat twenty-six patients with thirty-three cicateicial cryptotia.A cicateicial adhesion between auricle and cranial wall and mastoidea was removed,cranioaural angle was reformed,and helix and auricular lobule were reconstructed.Results All skin flaps survived,and the survival rate of skin grafts reached over 95 ％.The appearance of auricle was very good,its major constructions might be noted,and cranioaural angle nearly returned to normal.The follow-up results from three months to one year post-operation showed that the appearance of auricle kept well,and the patients felt satisfactory.Conclusions In view of deformity characteristics of cicateicial cryptotia,it might be an effective approach to treat cicateicial cryptotia to take a seris of appropriate surgical procedures.

Objective To summarize the experience of emergency treatment and cosmetic repair of facial trauma.Methods The clinical materials of 584 wounds from 291 cases of facial trauma,recruited in hospital from January 2010 to August 2012,were summed up retrospectively.The principles of medical aesthetics and plastic and cosmetic surgery were followed.A high pressure douching technique was employed to carry out thorough debridement,but occasion of the debridement did not emphasize with intensive attention.A wound without skin and soft tissue defect was sutured accurately according to tissue zonation with a new suture technique,and the needle distance or side distance was limited in 0.2 cm to 0.3 cm.Otherwise,the wound was repaired by full-thickness skin graft or various flaps according to the repair principle ofrather near than further,rather simple than complicated.Attention was paid to rehabilitation care.Results After debridement,328 wounds were sutured directly,147 wounds were repaired by full-thickness skin grafting and 109 wounds by various flaps.A total of 571 wounds healed on the first stage,and the healing rate reached 97.8％.The wounds were in satisfactory apposition and without obvious cicatrix.Five senses did not appear in malposition and deformity.The other 13 wounds did not heal because of bad taking of skin grafts and flaps or wound splitting.Among them,4 wounds were repaired by second operation,and 9 wounds healed by changing dressings.By means of rehabilitation care,scar hyperplasia and pigmentation appeared slightly in those 13 wounds.A total of 454 wounds from 217 cases were followed up.The results showed good appearance and slight cicatrix hyperplasia,a pigmentation in different degree appeared in 11 wounds covered by skin grafting.In addition,eyebrow excalation,auricle excalation or total lose appeared in 12 cases.Conclusion During treating emergency cases of facial injuries,if an idea cosmetic repair of traumais followed,the theory of aesthetics and the techniques of plastic and cosmetic surgery are fully used,a multiple-discipline cooperation is brought into full play,and a prompt and accurate treatment is put into practice,the aim of cosmetic repair would come true.

Objective To investigate the inhibition rate of cell proliferation, cell apoptosis rate and their effects on the cell cycle proceeding of the SSMC7721 cell line when 5-FU combined with thermotherapy is induced into the cells, and then provide theoretical bases to the combined therapy of hepatocellular carcinoma. Methods The inhibition rate of cell proliferation was detected by the MTT under different conditions, the cell cycle proceeding and the cell apoptosis rate was detected by flow cytometry and the subcellular structure was detected by the electronmicroscope. Results The cell inhibition rate of the thermotherapy group, 5-FU group and the combinedgroup were 18.4% ,28. 3% and 52. 7% ,respectively. The inhibition rates in the latter two groups were significantly different to the thermotherapy group. The results of flow cytometry showed that the cell numbers increased in G1 stage decreased in S stage,and increased in G2/M stage;the cell apoptosis rate increased. There was significant difference between different groups(P ＜ 0.01 or P ＜0.05). The results of the electronmicroscop showed that the nuclear chromatins agglutinated in the borderline and the mitochondriums became swelled. Conclusions The 5-FU combined with thermotherapy could significantly improve the inhibition rate of cell proliferation, inhibit the cell cycle proceeding from G1 stage to S stage, and induce cells apoptosis and change the subcellular structures in the SSMC7721 cell line.

Objective: To observe influence of enalapril maleate and folic acid tablet (EFA) on blood pressure and blood glucose levels in patients with H-type hypertension (HTH) complicated diabetes mellitus (DM).Methods: According to random number table, a total of 300 HTH + DM patients were equally divided into enalapril group, amlodipine group and EFA group.Levels of blood pressure, plasma homocysteine (Hcy), carotid intima-media thickness (CIMT), fasting plasma glucose (FPG), 2h postprandial glucose (2hPG), fasting insulin (FINS), 2h postprandial insulin (2hPINS) were measured and compared among three groups before, and one, 12 and 24 months after treatment.All patients were followed up for two years, incidence rates of cardiovascular and cerebrovascular events were compared among three groups.Results: Compared with enalapril group and amlodipine group on 24 months after treatment, there were significant reductions in levels of SBP[(134.65±7.25) mmHg, (136.00±8.62) mmHg vs.(128.62±5.00) mmHg], DBP[(84.79±4.26) mmHg, (88.47±7.25) mmHg vs.(74.29±5.06) mmHg], plasma Hcy[(11.18±5.21)μmol/L , (30.29±5.62)μmol/L vs.(9.72±2.47)μmol/L], CIMT[(1.30±0.19) mm, (1.46±0.37) mm vs.(0.95±0.38) mm], 2hPG[(12.50±1.70)mmol/L, (12.90±1.90)mmol/L vs.(9.50±1.00)mmol/L]and 2hPINS[(71.38±17.63)μU/ml, (78.42±21.49)μU/ml vs.(61.28±18.14)μU/ml], P<0.05 or <0.01.After two-year follow-up, compared with enalapril group and amlodipine group on 24 months after treatment, there was significant reductions in incidence rates of cerebrovascular events (11%, 23% vs.0) and cardiovascular events (2%, 11% vs.0) in EFA group, P<0.01 all.Conclusion: EFA tablets can significantly reduce blood pressure, blood glucose and Hcy level and effectively delay atherosclerosis progression in HTH+DM patients,its safety is good, which is worth extending.