Objective To study the early diagnostic value of olfactory function measurement to Alzheimer disease (AD). Method Detected the thresholds of detectability, identification threshold with pictu.re-based odor identification test in 21 AD patients (AD group) and 21 healthy elderly people (control group), and evaluated the relationship with mini-mental state examination (MMSE). Results AD group was impaired on threshglds of detectability [(1.81±0.75) scores], identification threshold [(2.48±0.68) scores]compared with control group [(1.24±0.89) scores and (2.00±0.71) scores, P< 0.05]. The thres holds of detectability and identification threshold were related to MMSE in AD group (r =-0.50,-0.54, P< 0.01). Conclusion The early diagnostic value of olfactory function measurement to AD is very great.

OBJECTIVE: To explore the immunological mechanism of exfoliative tongue fur in children with asthma. METHODS: Thirty-nine children with asthma, twenty-eight children with repetitive respiratory tract infection (non-asthma) and eleven healthy children were divided into five groups, which were asthma with exfoliative fur or with non-exfoliative fur groups, non-asthma with exfoliative fur or with non-exfoliative fur groups and normal control group. The concentrations of keratin 13 and bcl-2 in cells exfoliated from tongue fur were detected by immunohistochemical method. The expression levels of blood cell chemokine receptor-3 (CCR-3) and CD4(+) were examined by flow cytometry, and the levels of serum cortisol and IgE were detected by radioimmunoassay. RESULTS: The levels of blood CD4(+) and CCR-3 of children with asthma and exfoliative fur were higher than those in the asthma with non-exfoliative fur group and the normal control group (P<0.05). The serum level of cortisol in the groups of asthma with exfoliative fur and non-asthma with exfoliative fur were lower than that in the other groups (P<0.05). The serum levels of IgE in asthma with exfoliative fur or with non-exfoliative fur groups were higher than that in the other groups (P<0.05). Concentrations of keratin 13 in the cells exfoliated from tongue fur in the groups of asthma or non-asthma with exfoliative fur were lower than that of the other groups (P<0.05). There was no significant difference of expression level of bcl-2 in the cells exfoliated from tongue fur among these five groups. CONCLUSION: There is a reasonably close relationship between the formation of exfoliative tongue fur and the immune system such as low level of serum cortisol and high levels of blood CD4(+) and CCR-3, which may all promote the formation of exfoliative fur. The disability of keratinization and apoptosis of epithelial cells of tongue may also be one cause for its formation.

Objective To explore the feasibility and validity of laparoscopic choledochotomy and choledochoscopy for treament of patients with acute pancreatitis accompanying commom bile duct stones. Methods A total of 102 patients acute pancreatitis accompanying common bile duct gall stones were treated in our institution between January 2007 and November 2009. Among them, 43 patients underwent laparoscopic choledochotomy and choledochoscopy within 72h after admission entered our study group. They all had a laparscopic cholecystectomy and choleldochotomy and choledochoscopy to retrieve common bile duct stones. Of these, 13 patients undergoing pancreatic capsule incision and peritoneal lavage. Fifty-nine patients undergoing traditional conservative treatment firstly were used as a control group. Of these, 46 were performed laparscopic surgery and choledochotomy after smoothly recovery from pancreatitis. 13 underwent emergency open operation due to complications of pancreatitis. Results In the gastrointestinal function recovery time, amylase recovery time, length of stay and hospitalization cost, there was a significant difference between study group and the control group (P<0.05). Conclusions Our study provides evidence for the good clinical efficacy of early implementation of laparoscopic choledochotomy and choledochoscope for treatment of choledocholithiasis and acute pancreatitis.

Objective To study the relationship of early postoperative CRP and PCT with pancreatic fistula after pancreaticoduodenectomy (PD);to study whether the combination of CRP and PCT can be used as an early predictor of pancreatic fistula;and to determine the optimal cut-off values of CRP and PCT for early diagnosis of pancreatic fistula after PD.Methods Postoperative pancreatic fistula and other complications were recorded in 82 patients after PD carried out at the Anshan Iron and Steel Group General Hospital from January 2013 to May 2017.PCT and CRP were measured on the 1st to the 5th postoperative day (POD).CRP and PCT were compared between the pancreatic fistula group and the non-complication group on pancreatic fistula prediction.The sensitivity,specificity,and combined sensitivity,combined specificity,negative predictive value,positive predictive value and optimal cut-off value were calculated.Results 56 patients developed postoperative complications,including 17 patients with pancreatic fistula,and 39 patients with non-pancreatic fistula.The postoperative CRP and PCT were correlated with postoperative pancreatic fistula and with other complications.The higher the CRP and PCT,the higher the risk of postoperative pancreatic fistula.The ROC curves suggested that CRP and PCT had a high predictive value for pancreatic fistula,especially on POD 2.The optimal cut-off value of CRP was 189.05 mg/L,the sensitivity was 94.1％,the specificity was 81.5％,the positive predictive value was 94.7％,and the negative predictive value was 24.4％.The optimal cut-off value of PCT was 0.89 mg/dl,the sensitivity was 88.2％,the specificity was 84.6％,the positive predictive value was 91.3％,and the negative predictive value was 20.5％.The sensitivity and specificity of combined CRP with PCT on POD 2 in predicting pancreatic fistula after operations were 100％ and 69.1％,respectively.Conclusion Combined CRP and PCT had a high early predictive rate in the identification of pancreatic fistula after PD.

Objective To study the impact of weight loss surgery after 3 months of stable condition through intervention on patients with obese hyperlipidemic acute pancreatitis (HLAP).Methods Ten patients with obese HLAP who underwent laparoscopic sleeve gastrectomy (LSG) at the General Surgery Department of our hospital were followed-up at 1,3,6,12,24 months after surgery.Their weight,BMI,EWL,and blood parameters (TG,LDL-C,HDL-C,TC,FPG,HbA1c,UA,hs-CRP,ESR,and hemorheology indexes) were compared.The impact on postoperative obese HLAP was assessed.Results The weight,BMI,EWL and blood index (TG,LDL-C,HDL-C,TC,FPG,HbA1c,UA,hs-CRP,ESR,and hemorheology indexes) of the patients gradually decreased.The decrease was significantly different from that before surgery (P＜0.05),which became stable at 12 months and with no recurrence at 24 months after surgery.Conclusions LSG reduced body weight and improved metabolic status of the patients.It stopped the occurrence of obese HLAP.LSG can be used as an effective intervention for patients with obese HLAP.

The advent of catheter ablation technology has changed the treatment strategy for atrial fibrillation, and the efficacy of catheter ablation is accurate with small surgical trauma. Catheter ablation treatment of atrial fibrillation is significantly better than pharmacologic therapy of anti-arrhythmia and rate control. However, the clinic data of catheter ablation of atrial fibrillation show that the recurrence rate is high. The risk factors for recurrence after catheter ablation include age, sex, body mass index, related primary disease, left atrial volume, pulmonary vein volume, gene, atrial fibrillation types, surgery and so on. Regulation of the above factors is crucial in improving the clinical efficacy and prognosis of catheter ablation of atrial fibrillation.
Anti-Arrhythmia Agents ; Atrial Fibrillation ; Catheter Ablation ; Humans ; Pulmonary Veins ; Recurrence ; Risk Factors ; Treatment Outcome

OBJECTIVETo explore the relationship between the distributions of posterior ramus of spinal nerve (PRSN) and locations of acupoint in low back through anatomical observation.

METHODSThe regional anatomy was performed at five corpses to observe the distribution of erector spinae muscle and PRSN in areas ofpoints and back-points in low back.

RESULTSThe T, L, L, Land LPRSN distributed on both sides of the spine; the medial branches of PRSN travelled between spinalis thoracis muscle and longissimus thoracis muscle, while the lateral branches of PRSN travelled between longissimus thoracis muscle and iliocostalis lumborum muscle.

CONCLUSIONS points and back-points in low back are closely associated with PRSN, particularly T, L, L, Land L.

To explore the clinical effect, safety and effectiveness of ultrasound-guided rhomboid intercostal and subserratus plane (RISS) block for postoperative analgesia after minimally invasive McKeown esophagectomy (MIE-McKeown), and provide new ideas for the selection of postoperative analgesia programs for minimally invasive esophageal cancer surgery patients.