Objective To analyze the superiority of implanting operation with autoskull stored at ultrahypothermia over low temperature's and frozen skull bone of oneself.Methods 42 case were observed and followed up after operation.Results Incision is healing by firct intention.there were many advantages,such as good biological activity,beautiful appearance,no repellent response,no immunoreaction and hard to infection,etc. After storing 1,3,6 and 12 months,the histological structure of frozen skull observed by electronscope was similar to those of fresh skull.Pestroyed skull bone cells were not found.All cases had no complication during the period of 3 to 12 months(mean 6.5 months) follow-up after operation.After 12 months,X ray and CT scan showed that skulls were healed.Conclusions Implanting operation with autoskull stored at ultra-hypothermia is one of the most effective technique for repairing skull defects.

Objective To assess the usefulness of spiral CT examination in detecting the local recurrence and the metastatic lymph nodes of chest in the patients with post-pulmonectomy for central lung cancer.Methods The data of 110 contrast spiral CT of chest in 55 patientswith central bronchial carcinoma post-operation were retrospectively analysed.Results 12 person-time in 9 cases recurred in thebronchial stump or anastomose.The short diameter of lymph nodes in the thorax ≥1 cm was showed in 33 person-time of 26 cases,of them,14 cases was considered as metastasis in combination with the clinical data.Conclusion Spiral CT is the one of the best examination indetecting the post-operation recurrence in the patients with central bronchial carcinoma,but it is still of limitation in evaluating the nature of lymph nodes.

Objective To analyse the normal helical CT appearances of the bronchial stump or anastomosis after pulmonectomy for central bronchial carcinoma.Methods The available 110 contrast-enhanced spiral CT images in 55 patients undergone different surgical procedures for central bronchial carcinoma were evaluated retrospectively.Results The CT findings of bronchial anastomosis in shape appeared as smooth,concave and convex,sharp angle,obtuse angle,spininess,irregulated or short tube.The thickness of anastomosis was (3.26?1.46) mm.Conclusion Spiral CT can display the bronchial anastomosis clearly after pulmonectomy for central bronchial carcinoma.

Objective To explore the mediating role of self-confidence in the parental rearing style and facing-audience com munication apprehension(FACA).Methods The Chinese College Students' Facing-audience Communication Apprehension Scale (revised version of 2011),the Short-form Egna Minnen av Barndoms Uppfostran for Chinese(s-EMBU-C) and the Overall Self-confidence Questionnaire Version of College Students were adopted to survey on 1 072 college freshmen from Guizhou Province.Results FACA in the freshmen of non-one-child was significantly higher than that in the freshmen of one-child,FACA in the freshmen of good performance was significantly lower than that in the freshmen of middle and poor performance;FACA of college freshmen,parental rearing style and self-confidence were significantly correlated with each other;self-confidence played a complete mediated role between the parental care and FACA,and a partial mediated role between the parental control and FACA.Conclusion Self-confidence has significant mediate effect between the parental rearing style and FACA of college freshmen.

Objective To investigate the correlation between helicobacter pylori infection and pathological characteristics of gastric mucosal in the elderly.Methods Retrospective analysis was conducted in 278 patients with benign upper gastrointestinal disease from January 2014 to June 2014.The patients were examined by endoscopy and 13C-UBT,and divided into elderly group (aged 60 years and over,n=111) and non-elderly group (aged＜60 years,n=167).The relationships between Hp infection and pathological changes in gastric mucosal tissue (severe chronic inflammation,neutrophil infiltration,lymph follicles,gastric gland atrophy,intestinal metaplasia) were analyzed.Results There was no significant difference in helicobacter pylori infection rate between the elderly group and non-elderly group [27.0％ (30/111) vs.36.5％ (61/167),P＞0.05].The rate of gastric gland atrophy was higher in elderly group than in non-elderly group [13.5％ (15/111) vs.6.0％ (10/167),P=0.028].The rates of severe chronic inflammation,neutrophil infiltration,lymph follicles,gland atrophy and intestinal metaplasia were 73.6％,70.3％,14.3％,18.7％,29.7％ in patients with helicobacter pylori infection,which were higher than those in patients without helicobacter pylori infection (19.8％,3.2％,0.5％,4.3％,8.6％,respectively,all P=0.000).Removing the factor of Hp infection,the rates of glands atrophy and intestinal metaplasia were higher in elderly group than in non-elderly group (8.6％ vs.0.9％,43.3％ vs.23.0％,P=0.013 and 0.045).Conclusions Helicobacter pylori infection correlates with severe chronic gastric mucosal inflammation,neutrophil infiltration,lymph follicles formation.Gland atrophy and intestinal metaplasia are related to the Hp infection,and age is also their influencing factor.

ObjectiveTo observe the effects of salmeterol fluticasone on the glucose metabolism and bone density of the elderly patients with chronic obstructive pulmonary disease (COPD) combined with type 2 diabetes mellitus (T2DM).MethodsThirty-one patients with COPD combined with T2DM were divided into 2 groups by random digits table,14 cases in control group were given conventional therapy,17 cases in experimental group were given conventional therapy and fluticasone propionate 50/500 μg,twice a day,for 3 months.The fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin,plasma cortisol and bone density respectively before and after treatment were detected.ResultsIn experimental group,the fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin and bone density before treatment was (5.25 ± 0.21 ) mmol/L,(7.14 ± 0.33 ) mmol/L,(5.58 ± 0.26 )％,( 1.96 ± 0.11 ) g/cm2,and after treatment was(5.31 ± 0.27 ) mmol/L,(7.22 ± 0.29 ) mmol/L,(5.67 ± 0.23 )％,(2.03 ± 0.15 ) g/cm2,there was no significant difference (P ＞ 0.05).In control groups,the fasting blood glucose,postprandial 2 hours glucose,glycosylated hemoglobin and bone density before treatment was (5.33 ± 0.35) mmol/L,( 7.26 ± 0.29 ) mmol/L,( 5.62 ± 0.19 )％,( 1.88 ± 0.20 ) g/cm2,and after treatment was ( 5.36 ± 0.31 ) mmol/L,(7.30 ± 0.35 ) mmol/L,( 5.69 ± 0.26 )％,( 1.98 ± 0.17 ) g/cm2,there was no significant difference (P ＞ 0.05 ).There was no significant difference in plasma cortisol before and after treatment in two groups (P ＞0.05).ConclusionInhaling salmeterol fluticasone for elderly patients with COPD combined with T2DM is safe.

Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.

OBJECTIVE: To establish an HPLC method for the determination of the contents of the related substances in metoclopramide.METHODS: The sample was separated on C18 column with the mobile phase consisted of acetonitrile-0.02 mol?L-1 phosphonic acid solution(19∶81) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 275 nm;the column temperature was kept under room temperature and the injected volume was 20 ?L.The contents of the related substances in metoclopramide were computed by self-control method of main constituent.RESULTS: Under the above described chromatographic conditions,metoclopramide was completely separated from its impurities.A good linearity between impurities' peak area and metoclopramide(contrast solution) concentration was achieved when the concentrations of impurities were over the range of 0.05%～4.0%.The lowest detectable limit of metoclopramide was 0.3 ng,and the contents of the related substances were all less than 0.26%.CONCLUSION: The method is convenient,accurate,sensitive and,specific,and it can be used for the determination of the related substances in metoclopramide.

Objective:To investigate the influence of chemotherapy on the phenotype of secreted protein, acidic and rich in cysteine (SPARC) in gastric cancer (GC). Methods:Immunohistochemistry was used to analyze SPARC expression in 132 GC patients. Among these patients, 54 with preoperative chemotherapy and 78 without preoperative chemotherapy were selected to analyze the effect of chemotherapy on SPARC phenotype by comparing the postoperative specimens of the two cohorts. Results:SPARC expression was higher in GC lesions than in the desmoplastic stroma surrounding the tumor cells and noncancerous tissues. High SPARC expression was related to invasion depth, lymph node metastasis, and TNM staging. SPARC expression was lower in patients with preoperative chemotherapy than in controls ( P<0.05). Gross type, histology, depth of invasion, lymph node metastasis, TNM staging, and SPARC phenotype correlated with the overall survival of the patients with preoperative chemotherapy. Further multivariate analysis suggested that lymph node metastasis, histology, and SPARC phenotype after chemotherapy were independent prognostic indicators of GC. Conclusion:SPARC expression was associated with invasion depth, lymph node metastasis, TNM staging and GC prognosis. Preoperative chemotherapy may change the phenotype of SPARC in GC patients.

Objective To investigate whether gut microbiome dysbiosis and translocation occurred in experimental uremia,and whether they consequently contribute to microinflammation.Methods Health male SD rats were randomly divided into uremic group and sham group.Uremic group were operated for 5/6 nephrectomy to establish uremic models,while sham group were only operated for nephrocapsulotomy.Postoperative blood,livers,spleens,and mesenteric lymph nodes (MLNs) were subjected to bacterial 16S ribosomal DNA amplification to determine if bacteria were present.Bacterial genomic DNA samples from the MLNs and colon were amplified with specific primers designed by the 16SrRNA sequence of the species obtained from blood,livers and spleens.Pyrosequencing was used to analyze the ileum and colonic microbio.me of each subject.Intestinal permeability to 99mTc-DTPA,plasma hs-CRP,and IL-6 were measured.Results Bacterial DNA in extraiutestinal sites and altered colonic microbiomes at the phylum,family,and genus levels were detected in some rats in the uremic group.Bacterial genomic DNA in MLNs and colon were obtained by primers specific for bacterial species observed from blood,livers,and spleens of identical individuals.Intestinal permeability,plasma hs-CRP,and IL-6 levels were statistically higher in the uremic group compared with that in sham group(all P ＜ 0.05).Conclusion Gut microbiome dysbiosis occurs and presumably bacteria translocate to the systemic and lymph circulation,thereby contributing to microinflammation in experimental uremia.