Objective To discuss the manifestations, diagnosis and management of acute superior mesenteric artery occlusion (ASMAO). Methods The clinical data of 15 cases of ASMAO admitted in our hospital between 2000 and 2007 were analyzed retrospectively. Results The causes of ASMAO were mesenteric artery embolism in 11 patients and mesenteric artery thrombosis in 4 patients. All cases underwent emergency laparotomy, in which 2 cases underwent removal of the embolus, 11 cases were subjected to resection of necrotic bowel after removal of the embolus, and 2 cases gave up definite surgery. Postoperative heparin anticoagutherapy was used in all patients. The overall mortality rate was 27% (4 cases). Conclusions Acute superior mesenterie artery occlusion should be suspected in a patient with sudden abdominal pain, especially in those who have organic cardiac disease. Early diagnosis and prompt embolectomy are the key to save the patients.

Electrical stimulation is well used in medical therapeutics,but the mechanism still needs to be studied further. This paper applies an electrical stimulator to generate low frequency pulse,which is used to stimulate at the root of the thumb,right on the median nerve. EEGs were recorded before and after the stimulation. Comparing the EEGs changes between the former and latter using power spectral analysis,the effect of low frequency electrical stimulation on human nerve excitability is discussed.

Objective The patients with non-small cell lung cancer ( NSCLC) are still at risk of brain metastasis after surgi-cal treatment.The study was to investigate the clinical characteristics and the risk factors for postoperative brain metastasis in patients with NSCLC in order to provide references for prophylactic cranial irradiation ( PCI) . Methods The clinical and prognostic data of 213 patients with NSCLC in our department of oncology from February 2008 to February 2012 were retrospectively analyzed.The occur-rences of postoperative brain metastasis in NSCLC patients with different characteristics were observed.Cox model was used to investi-gate the risk factors for postoperative brain metastasis in patients with NSCLC. Results The overall cumulative rate of brain metasta-sis was 23.9%(51/213) and the rates of brain metastasis at 1-year, 2-year, 3-year after surgery were 6.1%, 14.1%, 22.5% re-spectively.Univariate analysis showed that the rates of postoperative brain metastasis in NSCLC patients with different ages, histological types, tumor stages and CEA levels were statistically significant (P<0.05).Cox regression showed that adenocarcinoma (HR=2.00, 95%CI:1.11~3.64), lung cancer stageⅢ(HR=3.70, 95%CI:1.67~8.25) and high CEA (≥5.0μg/L)(HR=3.16, 95%CI:1.60~6.25) were risk factors for postoperative brain metastasis in patients with NSCLC.The survival time in NSCLC patients with brain metastasis was remarkably lower than that in patients without brain metastasis (P<0.05). Conclusion The NSCLC pa-tients with adenocarcinoma, III stage disease, or high CEA are more likely to develop brain metastasis after surgery, which should be the focus of PCI.

This study was aimed to establish a HPCE method for the content determination of hesperidin and phillyrin in Bao-He-W an (BHW). Fused silica capillary (75 cm í 50 μm) was employed and 30 mmol·L-1 borax so-lution (8% acetonitrile, pH9.64) was served as the running buffer. Other conditions were as follows: electrokinetic injection was 50 kPa í 20 s; analytical voltage was 20 kV; temperature was 20℃; and detection wavelength was 254 nm. The silica capillary was flushed with 0.1 mol·L-1 sodium hydrate and the running buffer for 10 min before each injection, respectively. The results showed that the linearity of hesperidin was in the range of 0.10~2.40 mg·mL-1 (r=0.999 4), the average recovery was 99.85% and RSD=2.34%. The phillyrin was in the range of 0.07~0.84 mg·mL-1 (r=0.999 2), the average recovery was 99.16% and RSD=2.78%. It was concluded that the method was rapid and sensitive. It can be used for the quality control of content determination of hesperidin and phillyrin in BHW.

Objective: To observe the role of parenteral nutrition and laparoscopic therapy in chylous ascites.Methods: A patient with chylous ascites was therapied with parenteral nutrition(4 weeks) and laparoscopic therapy and parenteral nutrition(1 week) subsequently.Output of ascites was daily measured from the drainage catheter of abdominal cavity.The body weight and other nutritional indexes were determined.Results: During the course of parenteral nutrition,the production and output of ascites gradually decreased,the body weight increased,and the serum album in level kept unchanged.After laparoscopic therapy and parenteral nutrition(1 week),ascites decreased significantly and did not rebound after diet,the body weight and the serum album in level also obviously increased.Conclusion: Laparoscopic therapy and parenteral nutrition are very useful in the treatment of patients with chylous ascites.

Objective To investigate the effects of short-term continuous subcutaneous insulin infusion (CSII) in newly diag-nosed type 2 diabetes mellitus(T2DM ) and to evaluate the treatment regimen conversion after CSII therapy .Methods 72 patients with newly diagnosed T2DM were treated with CSII for 2 weeks .Then they were randomly divided into two groups :the basal insu-lin group(glargine) and the oral anti-diabetic drug(OAD) group .Both groups were followed up for 2 years .Blood glucose ,insulin and HbA1c were measured before and after CSII and during the 2-year follow-up .Results CSII significantly controlled the glucose levels ,reduced the TG ,TC ,LDL levels and the homeostasis model assessment of insulin resistance ( HOMA-IR) and increased the homeostasis model assessment of insulin secretion (HOMA-IS)(all P< 0 .05) .During 1-year follow-up ,HbA1c in the glargine group and the OAD group was (6 .13 ± 0 .47)% and(6 .21 ± 0 .38)% respectively .During 2-year follow-up ,the HbA1c values in the two groups were (6 .91 ± 0 .57)% and(6 .43 ± 0 .62)% respectively .T HOMA-IR and HOAM-IS obtained the long tern improve-ment without significant body weight increase .Conclusion Short-term intensive insulin therapy can effectively control the blood glucose ,improve the sensitivity of insulin and the β-cell function ;after CSII ,adopting basic insulin and oral antidiabetic drugs can a-chieve the ideal glycemic control .

Objective To evaluate operative efficacy in regional pancreaticoduodenectomy with mesenteric-portal vein resection and graft reconstruction using iuternal jugular vein for pancreatic head carcinoma.Methods From Jan 2000 to Jan 2003,6 patients with pancreatic head tumors and mesenteric- portal vein involvement underwent regional pancreatieoduodenectomy with mesenteric-portal vein reseetion and vascular reconstruction using internal jugular vein.Results Surgery was successful in all 6 patients. Postoperative pathology revealed that mesenteric vein or portal vein were invaded by tumor in all cases. Survival time ranged from 17 to 49 mouths.The median survival was 23.4 months.Two cases have survived over 3 years and one of them was alive 49 months postoperatively without recurrence.Conclusion The regional pancreaticoduodenectomy with tumor invaded mesenteric-portal vein resection and graft reconstruction by using internal jugular vein renders a longer survival in metastasis-negative patients of pancreatic head adenocarcinoma.

OBJECTIVE:To provide reference for the further implementation of national essential medicine system of township hospitals. METHODS:5% township hospitals in a province were collected as sample by using random cluster sampling method, and statistics,comparison and evaluation was made by issuing questionnaires to get health resources distribution status,health ser-vice status and income and expenditure status before(in 2009 and 2010)and after(from 2011 to 2013)the implementation of na-tional essential medicine system of township hospitals. RESULTS:Totally 46 township hospitals were surveyed and totally 46 ques-tionnaires of township hospitals were recycled. Average number of beds in township hospitals increased from 15.1 beds in 2009 to 19.4 beds in 2013. Average annual outpatients increased from 11 200 in 2009 to 16 100 in 2013,and average number of hospital discharge increased from 644 in 2009 to 924 in 2013. The proportion of government financing to total income increased from 25.9% in 2009 to 47.1% in 2013,proportion of drug income to the total income decreased from 54.9% to 29.7%,drug profit rate decreased from 25.5% to 3.7%,and proportion of township hospital under deficit decreased from 17.4% to 4.3%. Average time that residents see a doctor in township health center increased from 0.47 in 2009 to 0.74 in 2013,and cost of average hospitaliza-tion and outpatient drugs decreased from 805 to 718 and 28.1 to 24.1,respectively. CONCLUSIONS:The implementation of nation-al essential medicine system has no negative effect on outpatient service,but first inhibits then promotes the inpatient services. Na-tional essential medicine system has effectively cut down the financial burden of drugs,but it has no effect on total health burden. It is difficult to realize the excessive rapid rise of health ex-pense by the single implementation of essential medicine sys-tem,and it needs comprehensive reform,collaboration and in-teraction of medicine and health to effectively relieve the prob-lem of“expensive ill”.

Objective To study the protection of mouse bone marrow-derived mesenchymal stem cells ( MSCs) for allogenic islets. Method MSCs from C57BL/6 mice were preceded to a 24-well culture plate with the density of 3 × 104/well. On the second day, islets were isolated, purified and divided to undergo streptozotocin (STZ) induced chemical injury and mixed lymphocyte reaction ( MLR) respectively. Then, treated and control islets were respectively divided into the following groups: islets + MSCs, STZ-islets + MSCs, and MLR-islets + MSCs. As control groups for their counterparts, treated or non-treated islets were also cultured without MSCs. On the 5th day incubation, glucose-stimulated insulin secretion test was performed to assess the function of islets in different groups, comparing their insulin-secretion amount stimulated by low or high glucose and the stimulation index determined by the ratio of (insulin amount secreted under high-glucose stimulation)/(insulin amount secreted under low-glucose stimulation ). Islet viability was evaluated by acridine orange (AO)/propidium iodide (PI) fluorescence staining. Result As shown by AO/PI staining, large numbers of dead cell with red fluorescence could be observed in STZ- or MLR- treated islets without MSCs, while the number of dead cells obviously reduced in MSC-cocultured islets with increased viable cells of green fluorescence. STZ- or MLR- treated islets exhibited apparently decreased insulin-secretion amount either under low- or high-glucose stimulation, as well as the stimulation index. The insulin-secretion function was significantly improved in islets cocultured with allogenic MSCs (P ＜ 0. 05 ). Conclusions Bone marrow-derived MSCs can protect isolated allogenic islets against chemical and immunological injury.

Objective To investigate the clinical effects of gastric bypass( GBP) on type 2 diabetes mel-litus(type 2 diabetes mellitus, T2DM)patients with different body mass index(BMI).Methods T2DM patients undergoing GBP from Sep.2012 to Jul.2013 were divided into 2 groups:obese group( BMI≥28 kg/m2 , 16 ca-ses)and overweight group(BMI<28 kg/m2,21 cases).Changes of fasting plasma glucose(FPG), insulin resist-ance index(HOMA-IR)and insulin stimulation release(INS), C peptide release, BMI, glycosylated hemoglobin ( HbA1c) at 3 and 6 months after surgery were observed.Results INS and C peptide improved 3 months after surgery(P<0.05),and they were close to normal at 6 months after surgery.HbA1c significantly decreased 3 months after surgery compared with that before surgery( P<0.05) and it was close to normal at 6 months after sur-gery.Patients in obese group had significantly declined weight 3 months after surgery compared with that before surgery, and reached the steady state 6 months after surgery.15 cases(93.7%) in the obese group had BMI<25 kg/m2 , and the difference had statistical significance ( P<0.05 ) .Patients in the overweight group had their weight declined but no statistical difference was found(P>0.05).Blood sugar in the obese group decreased with different degrees at 3 and 6 months after surgery.The effective rate was 92%for the obese group and 78%for the overweight group.The overall effective rate was 90%.Conclusion GBP has significant therapeutic value for T2DM patients with different BMI, especially for patients in obese group, which is worth of clinical promotion.