[Summary] Obesity has been a great threat to people ’ s health.It is a kind of disease which lead to various metabolic diseases.Besides, there are significant difference in psychological status between obese people and normal population .Obese people have more psychological disorders , such as depression and anxiety .Some studies have suggested that psychological disorders can influence the result of bariatric surgery .In addition, bariatric surgery may relieve patients ’ psychological disorders .In this review, we focused on the mental aspect of bariatric surgery .

Objective To compare the effects of semi conductor laser nasal cavity irradiation with He Ne laser intravenous irradiation therapy on patients with brain lesion. Methods Ninety six cases of cerebral infarction(CI), traumatic brain injury(TBI) were randomly divided into semi conductor laser group (group A, n =50, ?=650nm , 2.4mW, 30mins/nasal cavity), He Ne laser group (group B, n =46, ?=632.8nm, 2.5mW, 40mins/ intermedia cubiti vein or basilic vein). The changes of the blood lipids, hemorheology parameters, scores with Fugl Meyer movement scale and Barthel index assessment were compared after the semi conductor laser and He Ne laser irradiation. Results After laser irradiation,The CHOL, TG, LDL, ESR and HCT were significantly reduced in both groups( P 0.05). The brain damage area was reduced in all the patients as revealed by CT examination. Conclusion The influence of the two kinds of laser irradiation therapies is similar when applied in patients with brain injury. But semi conductor laser nasal cavity irradiation is a simple, safe, inexpensive therapy for the patients.

Objective To explore the technique of implantation of double-J stent via the guide-wire track, which was established through percutaneous renal puncturing, for the treatment of ureteral stricture and obstruction, and to evaluate its therapeutic effect. Methods A total of 75 patients with ureteral stricture or obstruction, who failed to respond to cystoscopic catheterization, were enrolled in this study. The lesions included benign stricture(n=60) and malignant stricture(n=15). Ureteral guide-wire track was established through percutaneous renal puncturing, which was followed by the dilatation of the stricture with balloon catheter and subsequent implantation of double-J stent via the guide-wire track. After the double-J stent was removed, the patients were followed up for 3 months to five years. Results The success rate of the procedure was 98.7%(74/75). Technical failure occurred in one patient with benign ureteral stricture. The cure rate was 70.7%(53/75), the improvement rate was 26.7%(20/75), and no improvement was seen in one case (1.35%). The total effective rate was 97.3%(73/75). Conclusion For the treatment of ureteral stricture and obstruction, the implantation of double-J stent via the guide-wire track, which is established through percutaneous renal puncturing, is a safe and effective method.

Objective To evaluate the clinical effect and feasibility in treating urethral stricture caused by benign prostatic hyperplasia in elder with transurethral implanted stent(Memotherm) under X-ray guided.Methods 47 patients included in this study,they ranged in age from 72 to 93 years,with an average age of 78.3 years,the symptom of dysuria ranged from 7 to 21 years.After 1% Lidocaine urethra mucous membrane anaesthesia,the processes of transurethral implanted stents at the most narrowing area of the urethra under X-ray guided were performed.Results The treating processes were successful in all cases(100%) one time,of them,the micturition in 43 cases was free and could act on one's own immediately after stent implantation.None having urethral restricture and lithiasis occured.Conclusion The clinical therapeutic effect was obvious using the memory alloy net-like stent for the treatment of urethral stricture caused by benign prostatic hyperplasia,it is worth promoting application in clinic.

Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

Objective To investigate the effects and mechanisms of a disintegrin and metalloproteinase 17 (ADAM17) on high-glucose mediated permeability,proliferation and migration in human retinal microvascular endothelial cells (HRMECs).Methods HRMECs were divided into 4 groups:normal group (5 mmol · L-1 glucose),high glucose group (25 mmol · L-1 glucose),NC (Negative control for siRNA) + high glucose group and siADAM17 (ADAM17 siRNA) + high glucose group.The expression of ADAM17 was detected using real time PCR and Western blot.Horseradish Peroxidase (HRP) was used to detect the permeability of HRMECs.Cell Counting Kit-8 (CCK-8)and BrdU were used to evaluate cell proliferation.Cell migration was determined using Transwell assay.In addition,the expression of p-EGFR,p-ERK and MMP9 was assayed using Western blot.Results Compared with normal group,the mRNA and protein levels of ADAM17 were increased in high glucose group (P ＜ 0.01).ADAM17 expression of siADAM17 + high glucose group was markedly reduced compared with NC + high glucose group.High glucose increased the permeability of HRP comparison to normal group,whereas in siADAM17 + high glucose group the permeability of HRP was reduced compared with NC + high glucose group.The optical density of HRMECs was decreased in siADAM17 + high glucose group 1.53 ± 0.29 in comparison with NC + high glucose group 2.43 ± 0.25,as well as the content of BrdU-incorporation(P ＜ 0.05).The number of migrated cells in high glucose group,NC + high glucose group,siADAM17 + high glucose group and normal group were 157.00 ± 7.93,169.00 ± 10.12,121.00 ± 9.28,110.00 ±8.25,respectively.Moreover,the expression of p-EGFR,p-ERK and MMP9 in siADAM17 +high glucose group was decreased compared with NC + high glucose group (all P ＜0.01).Conclusion SiADAM17 can reduce the cell permeability,suppressed and migration induced by high glucose via EGFR/ERK/MMP9 signaling pathway.

Objective To compare the clinical effect of manual aspiration thrombectomy versus systemic thrombolysis for acute lower extremity deep venous thrombosis of mixed type.Methods The clinical data of 380 patients with acute lower extremity deep venous thrombosis of nixed type was analyzed retrospectively,who were classified into two groups according to treatment methods.Group A (229 cases):the ipsilateral femoral vein was accessed under local anesthesia,a 12-14 F sheath was introduced via a guide wire to aspirate iliofenoral thrombus.As for the femoropopliteal thrombus,a Fogarty balloon catheter was introduced to pull thrombus to iliac vein,then mechanical aspiration thrombectomy was performed.One hundred and thirteen patients with stenosis or occlusion of comnon iliac vein were treated with adjunctive PTA and stenting.As for the residual thrombus bclow popliteal vein,a small dose urokinase vas given to thrombolysis and heparin anticoagulation after procedure.Group B(151 cases) were treated by systemic thrombolysis and anticoagulation with heparin.Results The swelling and pain of affected limbs of group A began to relief after operation immediately,but these times of group B was 3-7 days after operation.The thrombus was eliminated completely(Grade Ⅰ):goup A was better than group B (63.32％ vs 37.09％) (x2 =20.53,P =0.002).Conclusions The manual aspiration thrombectomy was superior to simple systemic thrombolysis in treating acute lower extremity deep venous thrombosis of mixed type,especially in protecting the normal valve function that was better than thrombolysis,aspiration thrombectomy with adjunctive iliac vein angioplasty was a more reasonable method to treat acute LEDVT.

Objective To estimate the clinical effect and application value of percutaneous transluminal angioplasty and stenting (PTAS) on patients with lower extremity atherosclerotic occlusive disease (LEAOD). Methods Percutaneous transluminal angioplasty (PAT) and PATS were performed on 127 patients with diabetic lower limb arteriosclerosis. Results Total achievement ratio was 97.64% (124/127). PTAS was failed in 3 patients, clinical symptoms disappeared or improved in 124 patients. The average ankle brachial index (ABI) before and after operation was 0.35 (0.11-0.58) and 0.87 (0.67-1.06), respectively. The difference in ABI before and after operation was significant (P<0.05). During 3-60 months following-up, arteria iliaca remained open in 53 patients, and no recurrence of clinical symptom was found. At 6, 12, 36 and 60 months after operation, the encumbered superficial femoral artery kept smooth bloodstream with a proportion of 97.78%, 91.11%, 84.44%, 75.56% in 45 patients in upper 2/3 segment and 89.66%, 79.31%, 72.41%, 65.52% in 29 patients in infer 1/3 segment, respectively. Conclusion Long-term vessel recanalization can be obtained effectively and haemodynamics index be remarkably improved with PTA and PTAS in LEAOD patients.

Objective To evaluate the mid-term and long-term result of mechanical aspiration thrombectomy or combined with balloon thrombectomy,venoplasty and catheter-directed thrombolysis therapy for lower extremity deep venous thrombosis.Methods Clinical data of 1 068 admitted patients were analysed retrospectively from January 2000 to June 2010.Among these patients,271 cases were treated by thrombectomy only,537 cases received thrombectomy with arterial catheter-directed thrombolysis,260 cases were treated by thrombectomy with dorsalis pedis vein thrombolysis,492 patients with stenosis or obstruction of iliac vein underwent venoplasty treatment.Results After 36 month follow-up edema,pigmentation and chronic ulcers were 10.26％,7.28％,1.55％ respectively.The patency without reflux,patency with reflux,residual thrombus,occlusion rate of the iliofemoral vein were 84.25％,8.95％,4.3％,2.5％ respectively; The patency,residual thrombus and occlusion rate of popliteal vein were 93.32％,5.49％,1.19％.Iliac vein stent patency rate was 92.28％.Conclusions Endovascular treatment for lower extremity deep venous thrombosis was a reasonable therapy with a satisfactory mid-term and long-term result,protecting venous valve function and reducing the morbidity of post-thrombotic syndrome.

Objective To explore the influence factors of hyperarousal,personality characteristics and coping strategies on the vulnerability to stress-related sleep disturbance.Methods A total of 345 sleep good healthy volunteers were recruited bypurposive sampling technique.Every participant completed an extensive survey that included the general condition questionnaire,Ford Insomnia Response to Stress Test (FIRST),PreSleep Arousal Scale (PSAS),NEO Personality Inventory-Revised (NEOPI-R),Coping Inventory for Stressful Situations (CISS) and Heart Rate Variability(HRV).All participants were classified as High risk group andLow risk group by using the FIRST criterion.Results The high risk group was younger than the low risk group (27.91±8.22 vs 24.82±7.73,P＜0.01),and had a higher percentage of females (34.7％ vs 53.4％,P＜0.05).The high risk group showed significantly higher scores in PSAS total (30.11±6.22),pesleep cognitive arousal (17.73± 4.51),presleep somatic arousal (12.78 ± 3.23),neuroticism (3.13 ± 0.51),emotion oriented (48.98 ± 10.54),but lower score in extraversion (2.96±0.54),then those indicators of the low risk group (28.52±5.82,16.32±4.32,11.41±2.75; 3.11±0.56,2.87±0.47,46.23±11.21,3.11±0.56,P＜0.01 or 0.05).There were significant difference between the two group in LF/HF (1.51 ±0.19 vs 1.17±0.11,P＜0.01),HF((311.21 ±72.32) ms2/Hz vs (490.43 ± 91.74)ms2/Hz,P＜0.01),LF((469.49±85.67)ms2/Hzvs (573.21±98.75) ms2/Hz,P＜0.01) in HRV.Results of linear regression analysis showed that gender,and scores of PSAS total,cognitive arousal,presleep cognitive arousal,presleep somatic arousal,neuroticism,emotion oriented and LF/HF were significant correlation with FIRST score (P＜0.01 or 0.05).Conclusion Presleep cognitive and somatic arousal,neurotic character may be the premorbid characteristics of stress-related sleep disturbance,and bad stress coping strategies are easy to promote the development of insomnia.