In clinical practice,regional portal hypertension is infrequent,but it is the only type which could be cured of portal hypertension.Pancreatic diseases are the chief pathogeny of regional portal hypertension,and the obstruction of spleen vein is the basic reason.The common clinical manifestation is isolatism varicose veins of pylorus.The golden standard of its iconography diagnosis is DSA,and the treatment should follow the individual principle.The splenectomy is the basic measure for them who have UGIB or hypersplenism.This is a review about recent advance in regional portal hypertension of etiology and classification,pathology and physiology,clinical manifestation,diagnosis,radiographic examination,cure,and so on.

Objective To assess the interobserver reliability and intraobserver reproducibility of Neer classification system and its influencing factors.Methods The present study reviewed the series preoperative radiographs (including those of scapular anteroposterior view,scapular lateral view and modified Velpeau axillary view and an axial CT scan) of 40 patients who had been treated in our department from January 2010 to December 2010 for proximal humeral fractures.The radiographs were assessed by 12 individual observers on 2 separate occasions with an interval of 3 months at least Half of the observers (the professional group; n =6) had received a shoulder fellowship training and the other half (the control group; n =6) had not All the observers were asked to categorize the radiographs according to the Neer classification system of 16 types of fractures in a same process.The reliability and reproducibility of the system were assessed with the Kappa statistics.Comparisons of classification agreement were made between the professional group and the control group.We also evaluated the simplified Neer system of only 6 types of fractures with recombinant data.Results The interobserver reliability coefficients were 0.534 and 0.473 for the first and second assessments,with an intraobserver reproducibility coefficient of 0.669.The agreement level in the professional group was significantly higher than in the control group ( P ＜ 0.05).The interobserver reliability coefficients of the simplified Neer system were 0.581 and 0.502,with an intraobserver reproducibility coefficient of 0.680.Use of the modified Neer system did not elevate the agreement level beyond the moderate range.The classification was agreed on by all the observers in 17.5％ of the fractures during the first assessment and in 15.0％ during the second assessment.Conclusions Neer classification may have fair interobserver reliability and moderate intraobserver reproducibility.Experience of shoulder fellowship training is an important factor influencing the reliability of the Neer system.Simplification of the system may not help increase its reliability.

Objective:To investigate and explore the science management mode for high- value medical consumables in order to solve the problem of management deficiency in purchase and using of high-value medical consumables.Methods: To strengthen the management for high value consumables on 5 aspects: systematized institution, normalized processes, standardized operation, scientific evaluation and informationalized management.Results:The normalized, standardized and programmed management mode for high-value medical consumables has been established and improved throughout the whole process monitoring and management of total life cycle for the consumables. This research normalized the management for these consumables and formed a new science management mode.Conclusion: The exploration and implementation of new management method and path for medical high-value consumables can effectively improve the level of hospital material management, reduce management loopholes, decrease the cost of high-value consumables and increase work efficiency.

OBJECTIVE:To observe the clinical efficacy of insulin glargine versus intermediate-acting insulins(NPH)injected subcutancously at bedtime in initial diabetes mellitus cases.METHODS:64 initial type 2 diabetes mellitus cases were assigned to insulin glargine group(A)or NPH insulin group(B).Both groups were subcutancously injected with short-action insulin on the basis of alimentary control and a certain amount of activity.Comparison was made between the two in respect of fasting blood glucose(FBG),duration of glycemic control,glycemic excursion,hypoglycemic incidence and total daily insulin dose.RESULTS:FBG,duration of glycemic controlling,glycemic excursion and hypoglycemic incidenc were lower in glargine insulin group than in NPH group(P

Femtosecond laser is mainly used in corneal refractive surgery.In recent years,the progress of the entire process of femtosecond laser makes a dramatic change and development of corneal refractive surgery.Photoinduced decomposition of femtosecond laser can ionize human tissue and accurately carry out intratissue cutting with less influence for the outside area of target site.So it is proved to have a high safety in clinical application.Femtosecond laser-assisted cataract surgery and lens refractive surgery is going to be a new stage in ophthalmology,and its application in cataract extraction includes the cutting of clear corneal incision and anterior capsula of lens as well as cutting up of lens nuclei.The advancement of femtosecond laser in lens refractive surgery mainly is the correction of presbyopia.The progress of femtosecond laser in lens surgery was summarized.

BACKGROUND: To review progressions in the pharmacological study of natural plant Ficus carica L. (fig), summarize its main pharmacological effects so as to manifest values in clinical practice.DATA SOURCES: .By computer retrieval system, the relevant papers on the researches on Ficus carica were retrieved on Medline from January 1950 to September 2004 and limited at the referred word "Ficus carica" in English. Simultaneously, the relevant papers were searched by the computer on China National Knowledge Infrastructure (CNKI) database from January 1999 to September 2004, focusing on the referred word "Fieus carica" in Chinese.STUDY SELECTION: Of all the relevant papers, ones focusing on the pharmacological study of Ficus carica were selected and the whole text were checked, meanwhile those had no relation with the pharmacological latex as well as various constituents and preparations. Exclusion criterion:repeated studies.DATA EXTRACTION: A total of 226 papers were checked on the study of Ficus carica, 30 papers were consistent with the standards. Among the 196 excluded papers, 189 were excluded because they were clinical experience report or repeated studies, 7 were reviews.DATA SYNTHESIS: Investigations of the fig, its leaves and latex as well as various constituents and preparations, have revealed many pharmacological effects such as: anti-tumor effects, the ability to mediate body metabolism, mediating hyperglycemia, hyperlipidemia and cholesterol levels, enhancing oxidation resistance, antibiotic effects, antivirus effects, the ability to mediate immunity, activating blood coagulation etc. It also may play an important role in supportive therapy in tumor treatment by reducing toxicity and side effects in actinotheraphy and chemotherapy. Several reports of anaphylaxis after fig intake have reported both in China and abroad.CONCLUSION: As an herb, fig has wide pharmacological effects and clinical practise values. The main pharmacological studies of it were focused on its anti-tumor effects and the ability to mediate body metabolism.Separation and purification of its active components and determining the interactions between them as well as the pharmacological and toxicological effects need further study. New pharmacological effect s will be found by studying various fig extracts.

Objective:To study the histogenesis and cell differentiation of desmoplastic ameloblastoma.Methods:The expression of various protein filaments was detected by immunohistochemical stainning in 20 cases of desmoplastic ameloblastoma and the ultrastructure of the tumor was observed in 4 cases.Results:CKH,CK8 and CK19 were positive in spindle-shaped and polygonal epithlium tumor cells.Vimentin was positive in mesenchymal fibrocytes and smooth muscle actin in some mesenchymal cells.Ultrastructural observation found that tonifilaments were in epithelial cells and there were desmosomes between these cells.In stroma myofibroblasts were presented.Loose connective tissue could be seen around some epithelial cell nests.Conclusion:Desmoplastic ameloblastoma may be arise from the early stage of the dental germ formation, epithelial cells of the tumor had the tendency to differentiate to the keratinized cells.

Objective To study the effect of Xuebijing, a Chinese traditional medicine injection, on the THP-1 cells challenged by endotoxin, and to explore whether it induces endotoxin tolerance. Methods The THP-1 cells were pretreated with Xuebijing in different concentrations (10, 25, 50 mg/mL) and times (4, 12, 24 hours), and then challenged by endotoxin. The level of TNF-α in culture supernatant was detected by ELISA assay, and the expression of TLR4 and IRAK-M mRNA were detected by Real time-PCR technique. Results There was no significant difference in TNF-α level among all the groups (pretreated with different concentrations of Xuebijing for different time) (P>0.05). Only in 50 mg/mL Xuebijing group, TLR4 mRNA was 1.547-fold increase in 24 h than in 4 h group (P<0.05). Only when pretreated for 24 h, IRAK-M mRNA was 1.349-fold increase in 50 mg/mL Xuebijing group than in control group (P<0.05). However,there was no significant difference among other groups (P>0.05). Conclusions Xuebijing can not block the release of TNF-α from the THP-1 cells challenged by endotoxin;and it does not induce endotoxin tolerance. When pretreated with high concentration of Xuebijing for long time, the expression of both TLR4 and IRAK-M mRNA is up-regulated, but its significance is not yet clear.

BACKGROUND: A variety of cages for lumbar interbody fusion have been used, which have good mechanics and clinical effects. Conventional posterior fusion requires parallel implantation of two cages, but some researchers believe that single lumbar fusion cage in oblique way is also possible.OBJECTIVE: Through in vitro biomechanical tests, to find a method with favorable effect and little trauma by combination of percutaneous lateral oblique way into the single expansive lumbar fusion cage between the fixed-line operations.DESIGN, TIME AND SETTING: A randomized, controlled experiment was performed at the Shanghai Institute of Biomechanical Engineering between May 2005 and May 2008.MATERIALS: Expansile lumbar interbody fusion cage was simulated from B-Twin Cage (Disc-O-Tech, Israel). Fresh calf lumbar specimens were used.METHODS: Biomechanical tests were performed in 18 specimens of calf lumbar function spinal units (FSU), which were divided into 3 groups: 6 in control group, 6 in single cage groups and 6 in two-cage groups. The biomechanical tests of two experimental groups were performed following tests of intact specimens. Stiffness tests were conducted in the WE-10A MTS,including axial compression, flexion, extension, lateral bending, and torsion.MAIN OUTCOME MEASURES: Axial and torsion stiffness results of each group.RESULTS: The stiffness was greater in two-cage groups compared with single cage group in axial compression and extension, but significant differences were only found in axial compression and extension tests (P < 0.05). The torsion stiffness of single cage group was significantly greater than two-cage groups (P < 0.05).CONCLUSION: Percutanous lumbar interbody fusion by single expansile lumbar interbody fusion cage from lateral approach is feasible theoretically. Biomechanical properties of FSU with B-Twin cage are improved, which contributes a lot to lumbar stability. Compared with posterior approach of single cage, two-cage can provide better stiffness and stability but its torsion stability is lower.