ObjectiveTo evaluate the result of direct parathyroid adenomectomy for the treatment of hyperparathyroidism caused by single parathyroid adenoma. MethodsClinical data of 13 cases were retrospectively analyzed from 1993 to 2000. Preoperative Bus, CT, 99mTc-MIBI localization was suggestive of a single adenoma and direct parathyroid adenomectomy through minimal incision was performed.ResultsHyperparathyroidism was cured in all cases. One case underwent second operation in which the pathology found malignancy, making the success rate of simple adenomectomy of 92.3%.Conclusions Simple parathyroid adenomectomy for primary hyper parathyroidism caused by single adenoma is effective?safe alternative to conventional neck exploration should preoperative diagnostic measures verify a single adenoma as the etiology of hyperparathyroidism.

OBJECTIVE: To investigate the changes of ultrastructure of biliary epithelia with ischemic-type biliary lesion (ITBL) and the protection effect of exogenous growth hormone (GH) in order to provide experimental information for prevention of biliary complication after liver transplantation. METHODS: Rats underwent liver transplantation were randomized into control group, ITBL group and recombinant human growth hormone (rhGH) group (n=6, respectively). Each group was given drugs at the same day postoperation. 7 days later, the specimen of bile ducts was collected. The epithelial changes of biliary tract were observed with TEM, and the injury degree of the epithelia was analyzed quantitatively in a specialized image analysis system. The epithelial plane measurement parameters of each group were measured, including the density of area and quantity of epithelia, and the density of area of epithelial microvilli. RESULTS: As compared with control group, in ITBL group the integrity of bile ducts was destroyed, epithelial microvilli became sparse, the epithelial plane measurement parameters were significantly decreased (P

Objective To study the current management strategy for colorectal injuries. Methods The clinical data of 86 consecutively admitted patients with penetrating colorectal injuries were retrospectively reviewed. Results Most injuries were of closed type. Iatrogenic colon injury accounted for 14%. There were 61 patients (71%) associated with other abdominal organ injuries. Operations were performed in all patients. Seventy six patients were treated with primary repair or resection and anastomosis, and 10 with diverting colostomy. In recent 10 years mortality rate dwindled from 10% to 4%(2/46). Mortality was most often caused by hemorrhagic shock, associated organ injuries or severe secondary infection. Conclusions Most colorectal traumas are blunt closed type in China. Primary repair or resection and anastomosis at the time of initial exploration is most often used for colorectal injuries. Indications for diverting colostomy are severe shock, heavy intra abdominal contamination, poor condition, and rectal injury. Fecal peritonitis should be effectively prevented and treated.

Objective:To investigate the association of the rsl801133 polymorphisms of the methylenetetrahydrofolate reductase (MTHFR)gene and rs2236225 polymorphisms of the methylenetetrahydrofolate dehydrogenase(MTHFD1)gene with non-syndromic cleft lip with or without cleft palate (NSCL/P)in Chinese population of Shanxi Province.Methods:The rsl801133 polymorphism of MTHFR gene and rs2236225 polymorphism of MTHFD1 gene were examined by PCR-RFLP in 265 patients with NSCL/P and 276 healthy controls.Data were statistically analysed.Results:The genotypic distribution of rsl801133 and rs2236225 was not deviated from the Hardy-Weinberg equilibrium.There was no significant difference in allele frequencies of rsl801133 and rs2236225 variants between patients with NSCL/P and healthy individuals(P <0.05).Conclusion:The polymorphism of MTHFR gene and MTHFD1 gene was not associated with NSCL/P in Chinese population of Shanxi Province.

Objective To compare the anesthetic effect of ropivacaine and bupivacaine in combined spinal-epidural anesthesia(CSEA)for cesarean section,and their influence on the incidence rate of supine hypotension syndrome(SHS).Methods 200 patients with cesarean section surgery in our hospital from February 2016 to July 2016 were randomly divided into observation group and control group,all of cases were given CSEA.100 patients in the observation group(the group L)were given ropivacaine in spinal anesthesia,the other 100 patients in the control group(the group B)were given bupivacane in spinal anesthesia.Recorded the relevant indicators,compared the incidence rate of SHS,the effect of anesthesia and neonatal score.Results The incidence rate of SHS of the group L was lower than the group B(χ2 =9.261,P<0.01).The effect of anesthesia and Apgar score of two groups had no statistically significant differences(all P>0.05).Conclusion The application of ropivacaine in CSEA for cesarean section not only has exact anesthesia effect,but also can effectively prevent SHS without any side effects.

A 18-year-old male patient's case was diagnosed as Degos'disease with pathognomonic skin lesions,accompanied by small bowel perforation,and reported here. Skin histopothological test show that the typical wedge-shaped necrobiosis and lymphocyte inflammatory infiltration. Vessels showed narrowing and thrombosis,with lymphocyte infiltration. Degos'disease is a systemic necrotizing vasculitis. Skin biopsy can confirm its diagnosis. Severe systemic complication should be prevented. Degos'disease should be considered in the differential diagnosis of skin lesions associated with systemic involvement.

Objective To investigate the pathogenic bacterial distribution and drug resistance situation of multi‐drug resistant bacterial strain mixed infection among postoperative traumatic patients in Zaoyang area to provide a reference for clinical treatment . Methods A total of 71 traumatic cases of multi‐drug resistant bacterial strain mixed nosocomial infection were selected and per‐formed the bacterial culture and drug resistance analysis according to the samples taking from different infection sites .The the re‐sults were statistically analyzed .Results Among 71 cases of multi‐drug resistant strains mixed infection ,205 multi‐drug resistant strains of bacteria were isolated .Among them ,119 (58 .05% ) strains were Gram‐negative bacteria ,Gram‐positive bacteria was in 83 strians(40 .49% ) and fungus was in 3 strains(1 .46% ) .The resistance of Escherichia coli ,Klebsiella pneumoniae ,Enterobacter and Serratia to more than 10 kinds of antibacterial drugs was more than 50% ,which to ampicillin ,cephalothin ,cefuroxime ,azlocillin ,ce‐fotaxime cefuroxime ,azlocillin ,cefotaxime and cefoperazone was more than 80% ,while which to imipenem and amikacin was only 5 .88% and 28 .57% respectively .The resistance rates of Gram‐positive bacteria represented by Staphylococcus aureus ,Staphylococ‐cus epidermidis ,Staphylococcus haemolyticus and Streptococcus pneumoniae to penicillin G ,oxacillin and ampicillin generally reached 98 .80% ,97 .59% ,and 95 .18% respectively .No Gram‐positive bacteria was resistant to vancomycin ,in addition the resist‐ance to rifampin and chloramphenicol also was only 32 .53% and 34 .94% respectively .Conclusion In early stage of infection ,it is unable to determine the types of pathogenic bacteria and difficult to select sensitive antibacterial drugs ,under this occasion ,the com‐bination of imipenem and vancomycin is a good choice .

Objective To investigate the clinical features and influencing factors of somatic symptoms in patients with acute stroke.Methods Patients with acute stroke were enrolled in the study.Using the scores of symptom checklist 90 (SCL-90)-somatization factor part,the patients were divided into either a somatic symptom group (≥24) or a control group (＜24).Their age,gender,economic level,education level,underlying diseases,Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),NEO Five-Factor Inventory scores,Social Support Rating Scale scores-simplified Chinese version,Mini-Mental StateExamination (MMSE) scores,National Institute of Health Stroke Scale (NIHSS) scores were documented and analyzed.Results A total of 70 patients with acute stroke were enrolled,and 33 (47.1％) of them had somatic symptoms.There were no significant differences in demographic characteristics,education level,family income,occupation,marital status,living alone,residence,medical expenses payment methods and social support scores between the somatic symptom group and the control group.There were also no significant differences in the types of stroke,lesion side,baseline NIHSS score,MMSE score,and NEO Five-Factor Inventory score between the 2 groups.There was significant difference in lesion side between the somatic symptom group and the control group (x2 =0.161,P=0.006).The comparison of neuropsychological test results showed that the proportion of patients with an anxiety state of the somatic symptom group was significantly higher than that of the control group (24.2％ vs.5.4％;x2 =5.055,P =0.025),but there was no significant difference in the proportion of patients with depression status;after excluding the cases who met the anxiety and depression criteria,HAMA (8.08 ± 3.12 vs.5.58 ± 3.06;t =-3.059,P =0.003) and HAMD (10.80 ± 4.81 vs.7.73 ± 3.88;t =-2.694,P =0.009) scores of the somatic symptom group (n =25) were significantly higher than those of the control group (n =33).The number of somatic symptoms of the somatic symptom group was significantly more than that of the control group (Z =-5.817,P ＜ 0.001),and was more likely to have pain symptoms (97.0％ vs.73.0％;x2 =7.584,P =0.006).The correlation analysis showed that there was a significant positive correlation in the 12-item scores of the SCL-90 somatic factors and HAMA (r =0.494,P ＜0.001) and HAMD (r=0.369,P=0.002) scores in patients.Multivariate logistic regression analysis showed that HAMA score was an independent risk factor for somatic symptoms after stroke.(odds ratio 1.286,95％ confidence interval 1.060-1.560;P=0.011).Conclusions The incidence of somatic symptoms is high after acute stroke,especially in patients with cortical stroke.The somatic patients after stroke are prone to have pain-related symptoms.The patients with anxiety and depression status after stroke are prone to have somatic symptoms after stroke;HAMA score is an independent risk factor for having somatic symptoms after stroke.

Objective:To study the expression of B-1a cells in mice with obesity and periodontal infection.Methods:Mouse models of diet induced obesity combined with experimental periodontitis were established,the expression of CD5 protein,anti-collagenⅠ antibody(anti-Col-Ⅰantibody) and IL-10 protein was examined in mouse jaw bone and spleen by immunohistochemistry and Western blot;The mRNA expression of CD5,anti-Col-Ⅰantibody and IL-10 in mouse jaw bone was detected by real time quantitative PCR.Results:The mRNA and protein expressions of CD5 and IL-10 and anti-Col-Ⅰantibody in jaw bone in periodontitis group were significantly higher than those in control group(P<0.001).The protein expressions of CD5 and IL-10 and anti-Col-Ⅰantibody in spleen in obesity group were significantly higher than those in standard group(P<0.05).The protein expression of anti-Col-Ⅰantibody in spleen in standard accompanying periodontal ligature group was significantly higher than that in standard without periodontal ligature group(P<0.05).Conclusion:B-1a cells are activated in the early stage of obesity and periodontal inflammation with a certain pathological significance and without interation between the two inflammatory states in the pathological mechanism.

Objective:To explore whether spontaneous sene-scence widely existed in malignant tumor cells. Methods:Sene-scence-associated beta-galactosidase (SA-β-Gal) staining kit was used to detect the activity of SA-β-Gal in ten different malignant tumor cell lines before and after serum deprivation. Results:SA-β-Gal was expressed in some cells of 10 malignant tumor cell lines during exponential growth phase without any treatment. However, the percentage of senescent cells was significantly different among them, the lowest expression was observed in HeLa cell line (0.65%), and the highest expression was seen in HepG2 cell line (3.69 %, F=13.006, P= 0.000). Furthermore, not all the SA-β-Gal positive aging cells were polyploid cells. After 24-h serum deprivation, the number of SA-β-Gal positive cells was significantly increased (P=0.001). Conclusion:These findings indicate that immortal malignant tumor cell lines could undergo spontaneous senescence but the level was different between various cell lines. Short-term serum de-privation significantly increased the percentage of aging cells indicating that serum deprivation-induced cell senescence may be a rapid, easy, and effective way for anti-tumor therapy.