Bariatric surgery began in 1950s.The rapid increase of obese patients and development of laparoseopic techniques lead to popularity of bariatric surgery all over the world in 1990s.Current mainstream of bariatric surgeries include laparoscopic adjustable gastric banding,sleeve gastrectomy,Roux-en-Y gastric bypass and biliopancreatic diversion.In this review,the efficacy of different surgical procedures was compared in the aspects of metabolic disorder remission and incidence of operation complications and mortality.Efficacy of bariatric surgery on the alleviation of metabolic disorders (including hypergycemia,hyperlipidemia,hypercholesterolemia),individual treatment and interdisciplinary cooperation should be emphasized.

Through the simulation based on a two-dimensional whole-heart electrophysiological model, the effect of ventricular electrical activity on the precordial cardioelectrical field as well as the ECG manifestation have been discussed. Such effect can vary with the changed excitation sequence of ventricles and the changed active and passive electrical properties of cardiac tissues. As the result, many abnormal ECG waves can form. By carefully analyzing such effect, the correlation among ECG waveforms recorded at different lead locations can be revealed and the significance of ECG manifestation can be fully explored.As a case of analyzing, some ECG waves at certain right chest lead locations can get a proper explanation.

Objective]To summarize and promote Professor Zhou Enchao’s experience in the treatment of chronic renal failure especially the usage of herbal pairs.[Methods] Illustrate Professor’s medication experience in the treatment of chronic renal failure and summarize the herbal pairs that he commonly used by the methods of learning from his daily treatment in inpatient and outpatient department, arranging medical cases records of chronic renal failure, reading relative books and articles, recognition from the study of ancient classics, modern phamocological research and Professor’s own academic opinion etc. [Results]In Professor’s treatment of chronic renal failure, besides protecting the Zheng Qi(anti-pathogenic Qi), he emphasizes the methods of detoxification and promotion of the discharging of toxin which is in feature of the treatment by herbal pairs. In his experience, there are coincidence, supplement and prevention in the function between the pairs of herbs when using them together. The commonly used herbal pairs include the pair of Su Ye and Huang Lian with the function of resolving dampness and detoxificaion, the pair of Ban Zhilian and BaiHua She She Cao with the function of clearing away heat and detoxification, the pair of Tu Fu Ling and Liu YueXue with the function of reducing and discharging the turbid fluid and toxin, the pair of TuBie Chong and Tao Ren with the function of breaking the hard blood stasis and detoxification, the pair of Mu Li and Da Huang with the function of resolving the phlegm and activating and discharging blood stasis, the pair of Hei Da Dou and Wan Can Sha with the function of detoxifying the wind-toxin, the pair of Yin Chen and Shi Xiao San with the function of resolving damping, clearing away heat. [Conclusion] Pro. Zhou Enchao's clinical experience of chronic renal failure from toxin and using drug pairs is effective and worth promotion of application.

Background Optic nerve crush (ONC) model is an available tool in the basic research on the mechanism and treatment of optic nerve injury.The opening optic nerves sheath crushing and via bulbar conjunctiva lateral canthus optic nerves crushing are frequently used ONC modeling methods.However,the comparison between these models is not elaborated.Objective This study was to compare the outcomes between opening sheath ONC model and via bulbar conjunctiva lateral canthus ONC model.Methods Twenty-four male SD rats were randomized into four groups.ONC models were established via superorbital rim opening sheath to crushing optic nerve for 20 seconds in the opening sheath ONC group,or via bulbar conjunctiva lateral canthus cutting to crush optic nerve for different time in the via bulbar conjunctiva ONC 20-second,40-second and 60-second groups,respectively.All models were monocular created in the rats,and the fellow eyes served as controls.In 14 days after modeling,flash visual evoked potential (F-VEP) were recorded,optic nerve and retinal sections were prepared in the rats.The histopathology of the samples was examined by hematoxylin and eosin staining.The expression of Brn-3α in the retinal ganglion cells (RGCs) was detected by immunofluorescence technique and the number of Brn-3α+ RGCs was counted.The modeling procedure and outcomes were compared between the two approaches.Results The latencies of P1 waves were significantly extended in the opening sheath ONC group,via bulbar conjunctiva ONC 20-second,40-second and 60-second groups in comparison with the corresponding control eyes (t =-11.64,-8.04,-6.50,-10.84,all at P＜0.01).The P1 latencies were longer in the opening sheath ONC group than those in the via bulbar conjunctiva ONC 20-second,40-second and 60-second groups (P =0.01,0.02,0.05),but no significant differences were found in the amplitudes of P1 waves between model eyes and corresponding control eyes (all at P＞0.05).The Brn-3α+ RGCs numbers were evidently decreased in the model eyes in comparison with the fellow control eyes.The Brn-3 α + RGCs numbers were (13.60 ± 2.14),(18.74 ± 3.61),(15.84 ± 2.31) and (14.58 ± 3.23)/field in the opening sheath ONC group,via bulbar conjunctiva ONC 20-second,40-second and 60-second groups,which reduced to 47.49％,67.70％,56.69％ and 50.17％ of the fellow eyes,respectively.No significant differences were seen in the Brn-3α+ RGC numbers between the opening sheath ONC group and via bulbar conjunctiva ONC 40-second or 60-second groups (both at P＞0.05).The disorder of glial cell arrangement,vacuolization of the cell matrix and infiltration of inflammatory cells were displayed in various model groups,with the prominent findings in the opening sheath ONC group.Conclusions Compared with the via bulbar conjunctiva ONC models,the morphological and functional damage of optic nerve is more obvious,and the survival rate of RGCs is lower in the opening sheath ONC models.

OBJECTIVE: To explore the expression and significance of programmed cell death 5 (PDCD5) and Bcelllymphoma/lewkmia-2(Bcl-2) in sinonasal squamous cell carcinoma (SNSCC). METHOD: Immunohistochemical method and Western Blot method was used to determine the expression of PDCD5 and Bcl-2 in specimen of SNSCC in thirty cases, sinonasal inverted papillomas (SNIP) in thirty-eight cases, and normal nasal mucosa in twenty cases. RESULT: (1) The expression of PDCD5 protein in SNSCC significantly decreased compared with SNIP and normal nasal mucosa. (2) The expression of Bcl-2 protein in SNSCC up-regulated obviously compared with SNIP and normal nasal mucosa. (3) Positive rate of PDCD5 protein and Bcl-2 protein in well, moderate and low differentiatied group is respectively 100.00%, 83.33%, 38.89% and 50.00%, 70.83% and 100.00%, the difference was statistically significant (P < 0.05). (4) In the follow-up cases, the survival rate of the patients with higher expression of PDCD5 protein was higher, but that with lower expression of Bcl-2 protein was higher. CONCLUSION The inactivation of PDCD5 protein and the activation of Bcl-2 protein may play an important role in the development of SNSCC, and there are a positive correlation between PDCD5 and Bcl-2 protein in SNSCC, which may be identified as a new therapeutic target.
Apoptosis Regulatory Proteins ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; mortality ; Head and Neck Neoplasms ; metabolism ; mortality ; Humans ; Neoplasm Proteins ; metabolism ; Papilloma, Inverted ; metabolism ; Paranasal Sinus Neoplasms ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate

This study was aimed to carry out pharmacological research on the hemostatic activity and mechanism of Yi medicine Ma-Bu (Paris polyphylla Smith var stenophylla Franch.). One kind of C27 steroidal saponin from P. polyphylla Smith var stenophylla Franch. was isolated and identified as Paris saponin H (PSH). The effect of PSH on the index of bleeding time (BT), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) of mice were measured. The results showed that PSH have significant hemostatic activity by shortening BT. The effect of PSH on shortening PT and APTT of mouse was not significant. However, the FIB was enhanced significantly after treatment with PSH. It was concluded that PSH had no significant promoting effect on the extrinsic coagulation pathway (ECP) or the intrinsic coagulation pathway (ICP). The enhancement of FIB may be a pathway for the effect of hemostatic activity by PSH.

Objective To evaluate the outcomes of meniscal injures treated by Ho∶YAG laser using arthroscopy.MethodsA total of 31 patients with meniscal injury were treated with holmium∶YAG laser by arthroscopy from January 2006 to March 2008 in our hospital.Among the cases,11 had flap tear,8 had horizontal tear,6 showed bucket-handle tear,and 6 were found with longitudinal tear.The pre-and post-operative Lysholm score,and compilations in the patients were recorded.Results The operation was completed successfully in all the cases with a mean operation time of 44 min(rang,22-55 min).No injuries to the vessels and nerves occurred in the surgery.The patients got out of bed in 1 to 4 days after the surgery(mean,2.1 days).All the surgical wounds achieved primary healing.Follow-up was carried out in the patients for 9 to 28 months(mean,14.5 months).The patients showed significantly lower Lysholm score at 6 months during the follow-up than that determined before the operation(92?6 vs 57?13,t=13.61,P=0.00).Among the cases,21 showed excellent outcomes,7 were good,and 3 were improved.The rate of excellent and good results was 90.3%(28/31).Conclusion Ho∶YAG laser is a safe,simple,and effective tool in cutting menisci under a arthroscope.

[Objective]To investigate the manner and the key of reoperation for failed back surgery syndrome(FBSS).[Method]Twenty reoperated FBSS cases were investigated retrospectively.The data about the history,physical sign,image and exploration were analyzed.The treatment protocols were made correspondingly.Twenty cases were all operated with decompression of nerve root and dura assisted with fusion of auto-bone kraft between posterior arches of vertebra.In them,12 cases who were suffered from spinal instability were treated with pedicle screw fixation supplementarily.All patients were rehabilitated after operation.[Result]The complications included neural root injury in 1 case and tear of dural cyst in 3 cases.The outcome was evaluated according to the standard of Ragab's,10 cases were excellent,5 cases good,2 cases fair and 1 case poor.The rate of excellent and good was 85%.[Conclusion]FBSS is a complication of back surgery manifesting as a syndrome with multi-factor and multi-present.We should analyze the clinical present of patient integratively to find out the cause before operation,and map out appropriate operational protocol.

[Objective]To improve the diagnosis and treatment of acute fatal pulmonary thromboembolism(PTE)in orthopedic perioperation.[Method]Clinical manifestations,radiological features,laboratory examination data,treatment and prognosis of 12 patients diagnosed as acute fatal PTE in orthopedic perioperation from February,2002 to July,2005 were retrospectively analyzed.[Result]Nine patients received emergent thrombolytic and anticoagulant therapy,7 were alleviated and 2 died;3 patients with sudden cardiac arrest died after failed cardiopulmonary resuscitation.[Conclusion]Acute fatal PTE is a severe disease of orthopaedics.The realization and alert of the existence of acute fatal PTE must be increased.Early diagnosis and efficient treatment is the key to preventing from death.

[Objective]To retrospectively analyze efficacy and complications of lumbar transpedicular osteotomy combination pedicle screw system for correction of kyphosis in ankylosing spondylitis. [Method]From Jan 1998 to Dec 2007,54 patients of ankylosing spondylitis with kyphotic deformity were treated with surgery.Forty eight patients were followed up,and time was 6 to 36 months.Preoperative and postoperative Chin-brow vertical angle and Cobb's angle were measured.The outcome was evaluated according to pose correction,visual field improvement and back pain relief in follow-up.The results were divided into being excellent,good,fair and poor.[Result]The mean Chin-brow vertical angle was corrected from preoperative 59? to postoperative 16?,and the Cobb's angle from 43? to 11?.All patients could walk with forward vision and sagittal balance and gait were improved significantly.The symptom of dyspepsia and respiratory limitation relieved.The excellent outcome was attained in 45 cases(93.75%),the good in 3 cases(6.25%).[Conclusion]Lumbar transpedicular osteotomy combined with fixation of pedicle screw system was a safe and effective method for treatment of kyphosis in ankylosing spondylitis.