Objective To evaluate the effect of early endoscopic treatment for patients with severe acute biliary pancreatitis.Methods Ninety patients with severe acute biliary pancreatitis were divided into three groups: Thirty patients underwent early endoscopic treatment(group A),30 patients underwent expectant treatment(group B) and 30 patients receive surgical treatment(group C),respectively.complications and safety were evaluated.Results The symptoms and signs disappeared in all 30 cases after early endoscopic treatment.All the 30 patients(100%) of endoscopic treatment(group A) were cured which significantly better than the other groups(group B 83.3% and group C 93.3%,respectively).Conclusions Early endoscopic treatment relieves the orifice obstruction of biliary and pancreatic ducts,decreases the pressure of biliary and pancreatic ducts,it is safe,mini-invasive and highly effective for the treatment of severe acute biliary pancreatitis.

Objective To investigate the expression of BRMS1 in different metastatic breast cancer cells and its relation to HDAC activity.Methods The gene expression of BRMS1 in 3 types breast cancer cell lines(non-metastasis MCF-7(A cell line),low metastasis MDA-MB-453(B cell line)and high metastasis MDA-MB-231(C cell line)) was determied by RT-PCR technique;the protein expression of BRMS1 was measured with Western blot technique and HDAC activity by enzyme linked immunosorbent assay.Results(1) Gene expressive ratio of BRMS1 was 3.1∶2.0∶1.0 in the A、B、C cell lines,respectively.The gene expression of BRMS1 in the C cell line decreased 210% compared to A cell line,and expression of BRMS1 was markedly reduced as the degree of metastasis increased(P

Objective To study the effect of acute hypervolemic hemodilution on expression of serum chemokine interferon-inducible protein 10 in patients undergoing total hip replacement.Methods Twenty ASA Ⅰ or Ⅱ patients undergoing elective total hip replacement were randomly divided into 2 groups (n=10 each):HES group and LR group.The patients in HES group received 6% HES 20 ml/kg in rate of 30 ml/(kg·h) after anesthesia.The patients in LR group received Ringer's solution 20 ml/kg in rate of 30 ml(kg·h) after anesthesia.The blood loss,blood transfusion and the time of operation were recorded.Venous blood samples were taken before anesthesia (T0),at the begining of operation (T1),30 min after operation (T2),and at the end of operation (T3),in determination of serum chemokine interferon-inducible protein 10.Results The blood loss and the blood transfusion in HES group were (560±90)ml and (200±100) ml,those were significantly lower than that in LR group[(810±110)ml and (600±200)ml].The IP-10 concentrations were significantly increased at T2～T3 as compared to baseline value at T0 in both groups,but were higher in LP group[(77.3±13.8) ng/L and (89.9±15.1) ng/L]than those in HES group [(62.8±13.6) ng/L and (65.4±10.2) ng/L,P＜0.05].Conclusions Acute hypervolemic hemodilution can abate blood loss and blood transfusion during total hip replacement operation.Preoprative infusion with hydroxyethyl starch can attenuate the immunological depression during operation and anesthesia.

BACKGROUND: Previous research has investigated the effect of nano-zirconium dioxide-toughened hydroxyapatite (nano-ZrO2-HA) on the proliferation and differentiation of rabbit bone marrow stromal cells.OBJECTIVE: To evaluate the biocompatibility of nano-ZrO_2-HA compound.METHODS: The experiments of acute toxicity,subacute toxicity,pyrogen,hemolysis,and intramuscular implantation were performed on New Zealand rabbits,healthy adult Kunming mice,and adult rats according to "Technical Evaluation Standards of Biomedical Materials and Medical Instruments",promulgated by Chinese Board of Health.RESULTS AND CONCLUSION: Acute toxicity: All experimental animals survived.There was no significant difference in body mass before and after testing (P> 0.05).Pyrogen: Heating reaction was not tested.Hemolysis: Generally speaking,hemolytic crisis was not observed after 1 hour,and hemolytic rate was less than 5%.Intramuscular implantation: Infection did not occur in any animals,and materials were not discharged at all.Four weeks later,muscles were closely integrated with materials.A certain quantity of tissue grew into material pore,and peripheral muscle still had normal morphology and structure.Subacute toxicity:There was no significant difference in body mass and blood routine before and 2 weeks after testing.HE staining demonstrated that necrotic focus and other lesion were not observed in heart,liver,and kidney tissues under optic microscope.The results suggested that nano-ZrO_2-HA was non-toxicity,and it had no pyrogen and hemolysis effect,as well as it did not stimulate to the muscle of rabbit.Inflammatory rejection did not happen to the animal.The nano-ZrO_2-HA was closely integrated with the muscle,characterizing by great biocompatibility.Therefore,it can be used as substitution materials in clinical experiment.But it still needs to be evaluated completely.

Objective To evaluate the effect of robot-assisted gait training on the walking ability of hemiplegic patients.Methods Sixty hemiplegic patients were randomly divided into a control group and a treatment group,each of 30.Both groups were given traditional rehabilitation and drug therapy.The control group was additionally provided with the traditional gait training,while the treatment group additionally received robot-assisted gait training.The gait training lasted 30 minutes a day,5 days per week.Before and after 8 weeks of training,the time parameters,phase parameters,the joint angles of the lower limbs,and the peak ground reaction forces of both groups were evaluated using a three-dimensional gait analysis system.Results After the intervention,the walking velocity,stride frequency and stride length had increased in the treatment group,while stride width had decreased.Significant improvement was observed in the treatment group in terms of the percentage of swing phase on the paretic side,the percentage of stance phase on the paretic side,the single support time ratio,the percentage of double support phase,the range of motion of the hip and knee joints,and the peak vertical and forward ground reaction force as a percentage of body weight.The improvements were significantly greater than those observed in the control group.Conclusions Compared with traditional walking training,robot-assisted gait training can be more effective in improving the walking ability of hemiplegic patients.

Objective:To evaluate the effect of using a walking support band on the gait of stroke survivors.Methods:Sixty stroke survivors were randomly divided into a walking support band group ( n=20), an ankle foot orthosis (AFO) group ( n=20) and a conventional rehabilitation group ( n=20). All three groups received conventional rehabilitation therapy, while the AFO group members were additionally provided with an ankle-foot orthosis and the walking support band group members received training wearing a walking support band. Before and after 4 weeks of treatment, all three groups were evaluated using three-dimensional gait analysis. Results:A total of 57 patients finished the study. After the interventions, the average step speed, frequency and step length of the three groups had all increased significantly, while the average stride width, the percentage of double stance phase, unaffected and affected side stance phase, and the ratio between unaffected and affected side stance phase had all decreased significantly. After the intervention, the average step speed, frequency and length of the AFO and walking support band groups had increased significantly compared with the conventional rehabilitation group, while the average stride width of the AFO group, and the stride width, the percentage of double stance phase and unaffected side stance phase of the walking support band group had decreased significantly. After the treatment, the average percentages of double stance phase and unaffected side stance phase of the walking support band group had decreased significantly more than in the AFO group.Conclusions:A walking support band can significantly improve the abnormal gait of stroke survivors and is superior to an ankle-foot orthosis when combined with conventional rehabilitation therapy.

Objective:To compare the application effect of domestic and imported intravenous radiofrequency closure system in the treatment of primary varicose veins of lower extremities.Methods:This single-center prospective, non-inferiority randomized controlled trial was performed in the Department of Vascular Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to January 2022. Patients with primary varicose veins of lower extremities who met the ataxation criteria were randomly assigned to the experimental group(domestic novel venous radiofrequency closure system) or the control group(imported venous radiofrequency closure system) in a ratio of 1∶1. The two groups of subjects were compared in terms of target vein closure rate, technical success rate, system operation performance, incidence of adverse events and incidence of serious adverse events(SAE) within 6 months after surgery. Quantitative data were compared by Mann-Whitney U test, and categorical data were compared by χ2 test and non-inferiority test. Results:A total of 80 subjects were included in the trial (41 in the experimental group and 39 in the control group), including 27 males and 53 females, aged ( M(IQR)) 55(23) years (range:40 to 78 years). There were 48 cases of left lower limb and 32 cases of right lower limb. The technical success rate and system control performance between the groups were 100%.The incidence of adverse events (58.5% (24/41) vs. 61.5% (24/39), χ2=0.075, P=0.784), and the incidence of SAE (7.3% (3/41) vs. 5.1% (2/39), χ2=0.163, P=0.686) within 6 months after surgery in experimental group and control group had no statistical significance. There was one device-related adverse event in each of the two groups. In the experimental group, one patient developed endovenous heat-induced thrombosis after surgery and recovered after taking rivaroxaban tablets. One patient in the control group had pain in the upper right thigh for more than 1 day after operation, which was cured after using analgesic cream. No device-related SAE occurred. The venous closure rate of the experimental group was 100% (38/38) at 6 months after surgery, and that of the control group was 97.4% (37/38). The difference between the two groups was 2.63% (95% CI:-3.19 to 8.45, Z=4.865, P<0.01), and the 95% CI lower limit of the difference in target venous closure rate between two groups was greater than the non-inferiority threshold of -10.00%. Conclusion:The early application effect of the new domestic intravenous radiofrequency closure system in patients with primary varicose veins of lower extremities is in line with expectations, it is not inferior to the imported system.

Objective:To compare the application effect of domestic and imported intravenous radiofrequency closure system in the treatment of primary varicose veins of lower extremities.Methods:This single-center prospective, non-inferiority randomized controlled trial was performed in the Department of Vascular Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine from January 2021 to January 2022. Patients with primary varicose veins of lower extremities who met the ataxation criteria were randomly assigned to the experimental group(domestic novel venous radiofrequency closure system) or the control group(imported venous radiofrequency closure system) in a ratio of 1∶1. The two groups of subjects were compared in terms of target vein closure rate, technical success rate, system operation performance, incidence of adverse events and incidence of serious adverse events(SAE) within 6 months after surgery. Quantitative data were compared by Mann-Whitney U test, and categorical data were compared by χ2 test and non-inferiority test. Results:A total of 80 subjects were included in the trial (41 in the experimental group and 39 in the control group), including 27 males and 53 females, aged ( M(IQR)) 55(23) years (range:40 to 78 years). There were 48 cases of left lower limb and 32 cases of right lower limb. The technical success rate and system control performance between the groups were 100%.The incidence of adverse events (58.5% (24/41) vs. 61.5% (24/39), χ2=0.075, P=0.784), and the incidence of SAE (7.3% (3/41) vs. 5.1% (2/39), χ2=0.163, P=0.686) within 6 months after surgery in experimental group and control group had no statistical significance. There was one device-related adverse event in each of the two groups. In the experimental group, one patient developed endovenous heat-induced thrombosis after surgery and recovered after taking rivaroxaban tablets. One patient in the control group had pain in the upper right thigh for more than 1 day after operation, which was cured after using analgesic cream. No device-related SAE occurred. The venous closure rate of the experimental group was 100% (38/38) at 6 months after surgery, and that of the control group was 97.4% (37/38). The difference between the two groups was 2.63% (95% CI:-3.19 to 8.45, Z=4.865, P<0.01), and the 95% CI lower limit of the difference in target venous closure rate between two groups was greater than the non-inferiority threshold of -10.00%. Conclusion:The early application effect of the new domestic intravenous radiofrequency closure system in patients with primary varicose veins of lower extremities is in line with expectations, it is not inferior to the imported system.

Objectives:To observe and analyze the relationship between thoracolumbar vertebral fractures and vertebral bone structure,as well as stress distribution within ligaments,in order to explore the mechanical mechanisms underlying thoracolumbar vertebral fractures.Methods:Eight healthy young male volunteers were recruited for the study.X-ray and CT examinations of the entire spine were conducted to rule out spinal deformity,tumor,and bone disease.Bone mineral density(BMD)measurements were taken for each vertebral body and femur to exclude osteoporosis.CT thin layer scan was performed from the upper endplate of T11 to lower edge of L2 vertebra,and the CT image parameters were imported to ABAQUS 2016 software to standardize and perform finite element mesh construction.The thoracolumbar spine finite element model was developed using MIMICS 17.0,GEOMAGICS 15.0,and PRO/ENGINEER 5.0 softwares to measure relevant parameters,and its efficacy was validated.Seven motion states,including vertical compression,flexion,extension,left and right lateral bending,and left and right rotation,were simulated.ABAQUS software was employed to analyze stress distribution patterns and variations in the seven motion states of the finite element model,allowing for the observation of the relationship between stress distribution and thoracolumbar fracture.Results:The validated three-dimensional finite element model utilized in this study consisted of 309,583 nodes and 428,760 elements,encompassing anatomical structures such as four vertebral bodies,three intervertebral discs,and various ligaments including the anterior longitudinal ligament,posterior longitudinal ligament,intertransverse ligament,and interspinous ligament.Analysis of the data across seven different motion states revealed no significant deviations from the findings reported by other literature,confirming the accuracy and reliability of the model.The cross-sectional areas of T11-L2 pedicle were 135mm2,154mm2,105mm2,and 139.2mm2,respectively.High stress areas presented within the cancellous bone of the vertebral body,the pedicle and surrounding cortex of the vertebral body during various states of motion according to the stress cloud map analysis.Specifically,the T12 vertebral body exhibited the highest stress level(617.4MPa)under vertical compression,while the T11 vertebral body experienced the highest stress level(200.7MPa)during forward flexion.Additionally,the maximum stress levels recorded for the L1 vertebral body were 314.2MPa,574.4MPa,626.2MPa,641.3MPa,and 527.1MPa during extension,left and right lateral bending,and left and right rotation,respectively.The stress experienced by the L1 vertebral body was found to be minimal in the flexion position and maximal in the left rotation position.T12 vertebral fracture was observed under vertical compression,while T11 vertebral fracture occurred during flexion.L1 vertebral fracture,in combination with ligament injury,was observed during extension,left and right lateral bending,and left and right rotation.High stress areas were identified in anterior longitudinal ligament during extension and left and right lateral bending and in posterior longitudinal ligament during flexion.High stress areas were observed in the intertransverse and interspinous ligaments during movements involving forward flexion,left and right lateral bending,and left and right rotation.Conclusions:In the three-dimensional model of thoracolumbar spine,in-corporating key ligaments,intervertebral discs,and other soft tissue structures,notable areas of high stress were identified within the cancellous bone of vertebral body,pedicle and surrounding cortical bone,and liga-ments.Variations in maximum stress levels were observed in vertebral body under different conditions,result-ing in varying degrees of vertebral body fracture and ligament injury;L1 pedicle exhibited the smallest cross-sectional area and was prone to fracture.