Objective To investigate the effect of hyperphosphatemia on type Ⅱa sodium dependent phosphate cotransporter (NaPi-2)mRNA expression in the kidneys of 5/6 nephrectomized (STNx)rats and evaluate the interference of Renagel. Methods Forty-two male Sprague-Dawley rats underwent 5/6 nephrectomy or sham operation. The animals were then divided into seven groups: (1)STNx+high-Pi diet(HP) group (1.2%P); (2)STNx+low-Pi diet(LP) group(0.2%P); (3)STNx+ normal-Pi diet (NP) group; (4)STNx+HP+Renagel-treated (Ren)group; (5)sham+HP group; (6) sham+LP group; (7)sham+NP group. Serum ionized calcium (iCa) , phosphorus, and iPTH levels were detected at day 2,7,14.The kidneys were removed after the rats were sacrificed on day 14 and serum 1,25-(OH)2D3 and FEp were measured. RT-PCR was applied to examine NaPi-2 mRNA. Results Serum P and iPTH levels in STNx+HP group were significantly higher than those in STNx+ LP and 3 sham groups (P0.05)among these five groups mentioned above. Serum P and iPTH levels in Renagel-treated group were much lower than those in STNx+HP group (P

0.05).In the group with primary common bile duct suture,the occurrence of bile leakage was relative with hyperglycemia(P0.05).Conclusion It is the key factors,including chosing appropriate patients, intraoperative special examination, careful manipulation and effective medical treatment that can reduce the morbidity of bile leakage.

Objective To improve the preoperative diagnosis accuracy of cerebellopontine angle tumors through analyzing MRI findings. Methods Ninety-six cases with cerebellopontine angle tumors, confirmed by pathology and surgery, were collected and underwent MRI scan plus enhanced MRI. Among the 96 capes, we observed acoustic neurinoma in 55 cases, meningioma in 20 cases, cholesteatoma in 9 cases, trigeminal neuroma in 7 cases,cavernous hemangioma in 3 cases,arachnoid cyst in 2 cases. The MRI characteristics of all cases were analyzed retrospectively. Results The chief type of tumor happened in the cerebellopontine angle zone was acoustic neurinoma,followed in order by meningioma,cholesteatoma,trigeminal neuroma,cavernous hemangioma and arachnoid cyst. The accuracy of preoperative localization and qualitative diagnosis were 100% and 94.7%respectively.Conclusion MRI has a high value in the diagnosis and differential diagnosis of cerebellopontine angle tumors,which can be used as a preferred preoperative examination method in cerebellopontine angle tumors.

Objective To investigate psychological health status and its change in short term among persons bit by dogs.Methods Psychological health status was evaluated with patient health questionnaire (PHQ-15) Chinese version for the 613 wounded persons bit by dogs,including 368 males and 245 females with average age of 36 years plus or minus 14 years (standard deviation),meanwhile their wounds were handled routinely at clinics,as well as health education and cognitive psychological intervention were provided for them.Results All of the 613 persons with dog bites had mild or moderate somatic syndrome in their initial visits and 478 of them (78.0%) still presented mild somatic syndrome and only 23 (3.7%)with moderate symptoms four week after dog bites by PHQ-15 scores.One hundred and fifty-two of 613 (24.8%) followed-up at their initial visits had depressive symptoms,which could remain in 61 of them (10.0%) four weeks after bites.Two hundred and eighty-four of them (46.3%) had anxiety symptoms at initial visits,and 258 (42.1%) still had mild and nine (1.5%) had moderate symptoms four weeks after bites.Conclusions Psychological symptoms were popular in wounded persons by dog bites,which can persist for a certain time.PHQ-15 can be used for evaluating their psychological status.

Objective To investigate the effects and significance of neuronavigation and electrocorticography monitoring in resection of eloquent brain glioma. Methods Thirty-six cases with intracranial tumors accepted microneurosurgery resection under neuronavigation and electrocorticography monitoring. The clinical data and postoperative outcome were analyzed. Results The mean registration error was (2.0 ±0. 5)mm in all operations and all skin flaps and bone windows designed by neuronavigation could fit the operation demands. Total resectin of the tumor was achieved in 31 cases and subtotal resection in 5 cases. Neurological symptoms improved and no severe complications or death happened in all patients. Conclusion Neuronavigation combined with electrocorticography monitoring can accurately locate the eloquent glioma and retrieve the brain shift. This method is a real-time technique and has functional test ability. It can improve the total removal rate and decrease the mortality and disabled rate.

Objective To evaluate the effect of simvastatin and atorvastatin on clinical progression of benign prostatic hyperplasia (BPH) in elderly patients with metabolic syndrome (MS).Methods A total of 135 patients with BPH and MS aged 60 years and over were divided into three groups:simvastatin group (n=45,40 mg/d),atorvastatin group (n=45,20 mg/d) and control group (n=45).BMI,waist circumference,blood pressure,levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL C),high sensitivity C-reactive protein (hs-CRP),interleukin 6 (IL-6),testosterone,estradiol,prostate specific antigen (PSA) and international prognostic scoring system (IPSS) and prostate volume were detected before and 12 months after treatment.Results Compared with control group,patients receiving simvastatin or atorvastatin for 12 months showed that the levels of serum TC,TG,LDL-C,hs-CRP,IL-6,IPSS were decreased(all P＜0.05),the level of serum HDL-C level were increased (all P＜0.05),and prostate volume was reduced(P＜0.05).The decrease in prostate volume was more in patients receiving simvastatin than receiving atorvastatin [(10.86±5.65) ml vs.(5.91 ± 3.03)ml,P＜0.05].Multiple stepwise regression analysis showed that the reduction of prostate volume was positively related to the decreases of serum TC and IL-6 levels,and to the increase of serum HDL-C level.Conclusions Simvastatin and atorvastatin have the efficacy reducing prostate volume and improving obstruction symptoms of lower urinary tract,and slowing the clinical progression of BPH and simvastatin is more effective than atorvastatin on reducing prostate volume.The efficacies of statins might be through lowering cholesterol level and antiinflammatory effect.

Objective To summarize the diagnosis and surgical treatment of mesenteric cyst in children.Methods The clinical records of mesenteric cyst cases from January 2011 to December 2015 were reviewed retrospectively.The diagnosis and treatment options were analyzed, and the prognosis of laparoscopic surgery and laparotomy was compared.Results The main clinical symptoms included abdominal mass, abdominal pain, and abdominal distension.Abdominal ultrasound and/or CT scan were the diagnostic tools in all cases.Traditional laparotomy was performed in 14 cases, while laparoscopy in 7 cases (1 case switched to laparotomy).2 cases had emergency surgery due to acute abdomen, laparotomy and laparoscopy in each case.Simple cyst resections were completed in 14 cases, of which 2 cases with a small amount of residual in the mesenteric root.Intestinal resection and anastomosis were required in other 7 cases.The average time of hospital stay for laparotomy group was 12 days, and 10.14 days for laparoscopy group.There was no significant difference.All patients were discharged without postoperative complications.With 1-4 years follow-up, there was no recurrence.Conclusion The operation for mesenteric cysts depends on the relationship between the cyst and the adjacent bowel or organs, and the overall outcome is favorable.The selective use of laparoscopy will benefit more children.

Objective To investigate the clinical significance of soluble intercellular adhesion molecule‐1 and inflammatory factors (CRP ,IL‐17) in elderly patients with colorectal carcinoma .Methods The expression of sICAM‐1 ,CRP and IL‐17 in 76 ca‐ses of elderly patients and 32 cases of youg patients with colorectal cancer were detected by enzyme linked immunosorbent assay be‐fore and after surgery ,and to analyze its clinical significance correlated with pathological parameters .Meanwhile ,60 cases of healthy were controls .Results The serum levels of IL‐17 and sICAM‐1 were higher in patients with different ages of colorectal cancer than those of the normal control group (P<0 .05) ,and the concentrations of the two group after operation were significantly lower than those of the normal control group (P<0 .05) .The CRP levels of the young group and old group were similar to that of the normal control group (P>0 .05) .The level of CRP before operation in the young group was higher than that in the normal control group (P<0 .05) .The levels of serum IL‐17 and sICAM‐1 were significantly different between the young and the old group(P<0 .05) , while the CRP level was similar in the two groups (P>0 .05) .The serum levels of sICAM‐1 and IL‐17 in colorectal cancer patients were associated with the degree of differentiation ,depth of invasion ,lymph node metastasis and TNM staging (P<0 .05) .The level of CRP was significantly correlated with the depth of invasion ,lymph node metastasis and TNM staging (P<0 .05) .Conclusion The serum levels of sICAM‐1 ,CRP and IL‐17 reflect the invasion and metastasis of colorectal cancer in a certain extent ,which play important roles in predicting the development and prognosis of colorectal cancer .

Objective To evaluate the functional features of motor function area in patients with meningioma by blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI).Methods fMRI were obtained from 10 patients who suffered from meningioma which was adjacent to the motor function cortex.Probabilistic independent component analysis method was used for data analysis.Preoperative and postoperative line Karnofsky Performance Scale (KPS)score was used to assess the patient’s condition.Re-sults Contralateral primary motor cortex and the supplementary motor cortex motor functions were observed in all the activation clusters,in which one side activation area compared with the contralateral activation zone was symmetrical in 6 cases,and significant shift in 4 cases.In 4 patients with the movement function activated,tumor extrusion function shift forward or backwardwith tensile deforma-tion were found.Conclusion BOLD-fMRI imaging technology can effectively locate motor functional area for patients with meningi-oma,which can provide preoperative surgical planning.

BACKGROUND:Screw fixation of the fractured vertebral body can share the stress of implant, increase fixing strength, and help to maintain the stability of late fracture. However, whether it can assist reduction using fracture vertebral screw, but no relevant clinical reports were found at present. OBJECTIVE:To explore the effectiveness of self-designed screw-assisted reduction of fractured vertebrae. METHODS:161 cases of thoracolumbar fracture who had been hospitalized between June 2001 and June 2009 were enrol ed in this study, including 101 males and 60 females, at the age of 22-67 years, averagely 36 years. By Denis classification, 64 cases affected burst fractures and 97 flexion-compression fractures. Fracture levels involved T11 (9 cases), T12 (63 cases), L1 (74 cases) and L2 (15 cases). The self-designed method of reduction assisted with screw insertion was used. The efficacy of this reduction method was evaluated by operation time, intraoperative bleeding, fracture union time, height ratio of anterior borders of injured and normal vertebrae, sagittal Cobb’s angle, and reduction of fragments.
RESULTS AND CONCLUSION:The operation time ranged from 60 to 150 minutes, averaging 80 minutes. The intraoperative bleeding ranged from 67 to 750 mL, averaging 98 mL. The fol ow-up time ranged from 16 to 42 months in 161 patients. Fracture union time ranged from 10 to 18 weeks, averaging 12.6 weeks. The ratio of anterior heights and sagittal Cobb’s angle of fractured vertebrae were significantly improved from (54.39±9.60)%and (22.55±7.90)° respectively preoperati on to (82.80±6.63)%and (8.91°±5.85)° 12 months postoperation (P<0.05). The size of spinal canal was increased by (46.5±2.6)%postoperatively. CT scan revealed satisfactory fragment reduction and no deep infection appeared. These findings suggest that our self-designed screw-assisted reduction of the fractured vertebrae can improve the reduction quality in the treatment of thoracolumbar fractures.