[Objective]To investigate the influence of the two different methods on the runtime of capsule endoscope in the small bowel.[Method]There were 31 patients who accepted the examination of capsule endoscope.Among these patients,we used pro- kinetic agents or gastroscope for 12 cases with capsule endoscope staying in the stomach for more than 60 minutes.We analyzed the influence on runtime of capsule endoscope in the small bowel with the two methods above and that of the 19 untreated cases. [Result]In the control group,15 cases completed the examination on the whole small bowel,with the average runtime 234.4?70.3min,and 4 of them failed.In medicine group,5 cases completed the examination with the average runtime 121.8?103.7min. 7 cases with the help of gastroscope all completed the examination on small bowel and its average runtime was 275.3?81.8min. [Conclusion]Taking prokinetic agents tends to have more influence on the runtime of capsule endoscope in the small bowel,but it has disadvantages over the observation of small bowel diseases;Help of gastroscope takes less effect on the runtime of capsule en- doscope in the small bowel,while it loses the advantage of no traumas and sufferings.

Objective To evalute the efficacy and safety of primary percutaneous coronary intervention (PCI) therapy and facilitated PCI therapy (thrombolysis plus PCI) for acute myocardial infarction (AMI). Methods Sixty four patients with ST elevation myocardial infarction (STEMI) were divided randomly into two groups including the facilitated PCI group and the primary PCI group. The patency rate of infarct-related artery (IRA) before intervention, the incidence of bleeding complications and acute ischemic events during hospitalization as well as the left ventricular ejection fraction (LVEF) measured by echocardiography before discharge were compared. The thrombolysis in myocardial infarction (TIMI) flow grade (TFG), TIMI myocardial perfusion grade (TMPG) and angiographic perfusion score (APS) in all patients were measured before and after PCI and the extent of ST segment elevation resolution was analyzed 90 minutes after reperfusion therapy. The relationship between APS and percentage of complete ST resolution was analysed by linear regression. Results The IRA patency rate and TMPG in the faciliated PCI group were significantly higher than that in the primary PCI group before PCI (P

Objective To detect steroidogenic acute regulatory protein (StAR) expression in apolipoprotein E-deficient mice at different ages and serum lipid levels. Methods Nighty-six C57BL/6J and apoE-/- mice were enrolled, which were divided into 16 groups with 6 mice per group according to age (1 day, 1, 3, 5 months), sex and genotype (C57BL/6J and apoE-/-). The serum lipid levels in C57BL/6J and apoE-/- mice were detected by commercial kits. StAR mRNA and protein expressions in liver were detected by Real-time PCR and Western blot respectively. Results ApoE-/- mice had higher LDL-cholesterol and lower HDL-cholesterol compared with C57BL/6J mice of the same age and sex. StAR mRNA and protein expressions were decreased following with aging in C57BL/6J mice. However, in apoE-/- mice with higher lipid levels, StAR mRNA and protein expressions were changed with the lipid levels other than ages. StAR mRNA and protein increased in the early stage, and then decreased with the increasement of lipids levels. Conclusions StAR could affect lipids levels and may be an effective regulator for atherosclerosis and other cardiovascular diseases.

SIMCA(self independent modeling of class analogy) is a classical class modeling method for chemical) pattern recognition. Although widely used, SIMCA suffers difficulties in selecting a proper number of principal components and determining the decision region. A new class modeling technique based on partial least squares regression, partial least squares class model(PLSCM) is proposed, where the number of latent variables) and decision region can be readily estimated by the routine methods in multivariate calibration, e.g. Monte Carlo cross validation. PLSCM is successfully applied to identify trueborn bezoar samples from artificial and adulterated bezoar samples based on infrared spectra measured in the range of 4000-9000 cm~(-1). It is demonstrated that PLSCM outperforms SIMCA in terms of both maneuverability and identification accuracy. For the raw spectra, both the training and prediction accuracy of PLSCM are 100%. For the standard normal variate-processed data, the training and prediction accuracy of PLSCM is 99% and 100%, respectively.

Objective To investigate the feasibility of percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. Methods One patient with thoracic disc herniation involved the level of vertebral segment in T11/12 was treated with percutaneous transforaminal endoscopic spine system and followed up for 1 month. The targeted puncture was performed under local anesthesia and fluoroscopic guidance with patient in prone position. The foramen of T 11/12 was enlarged gradually with four trephinations, and the working cannula was inserted transforaminal into the canal. Then the herniation was exposed and removed with full endoscopic technique, including the loosen nucleus pulposus. The dural sac was exposed and released adequately. Drainage was placed during operation. Results The procedure was successfully carried out and the dural sac was completely released. The drainage was removed in the second day of operation. The patient could walk in the third day after operation with obvious relief of back and leg pain. At the follow-up of one month postoperation, the visual analogue scale of leg pain decreased from 8 to 1, and the Oswestry disability index (ODI) decreased from 64 to 4. According to MacNab scale, excellent result was acquired. Conclusion There is the feasibility of the percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. It is a good minimal invasive technique with good results and high technical requirements for surgeons.

Objective To analyze the clinical characteristics and treatment Methods of severe com?plications after percutaneous tracheotomy( PDT) in neurosurgery patients,and to provide reference for the treat?ment and rescue of these patients. Methods A retrospective analysis of 578 cases after PDT was performed in Neurosurgery Intensive Care Unit ( NSICU ) of Xuanwu Hospital of Capital Medical University from 2005 to 2015. The types of complications,treatment method and prognosis were analyzed. Follow?up was 3 months to 1 year. Results Eighteen cases with severe complications,including bleeding,wound infection,asphyxia caused by tracheal mucosa suffocation,airway stenosis caused by granulation tissue,subcutaneous emphysema and neu?momediastinum,etc. After treatment and active rescue,most patients recovered,no patients die directly associated with surgery. Conclusion PDT plays an important role in the treatment of patients in NSICU,but it is still pos?sible to have serious complications,so physicians must understand and be prepared for complications,and pay more attention to prevent poor prognosis.

Objective To investigate the accelerating role of recombinant human parathyroid hormone (PTH) in bone fracture repair.Methods 2-month old male Sprague-Dawley rats underwent closed unilateral femoral fracture and intramedullary nail fixation.The rats were divided into 2 equal groups randomly: the treatment group receiving subcutaneous injection of rhPTH(1-34) 10 μg/(kg·d) immediately after operation and for 2,7,14,21 and 42 d,respectively, and the control group receiving subcutaneous injection of normal saline in the same volume.X-ray and micro-CT were conducted at 2, 7, 14, 21 and 42 days after surgery.Results The continuity of porosis between fracture sides was better and fracture line has been blurred in the PTH-treated group at 21 days after fracture compared with the control group, the bone volume (BV),BV/TV, bone mineral density(BMD)and trabecular pattern factor (Tb.Pf) were significantly higher, and trabecular separation (Tb.Sp) and degree of anisotropy (DA) were significantly lower in the PTH-treated group at 42 days after fracture.Conclusions Our findings suggest that a low dose recombinant human parathyroid hormone can accelerate the bone fracture healing, probably through improving the BV, BV/TV, Tb.P and BMD, and decreasing the Tb.Sp and DA.

Objective To investigate the effect of anterior percutaneous endoscopic discectomy (APECD) and open-door laminoplasty (ODLP) through hybrid surgery in the treatment of multisegmental cervical stenosis and giant disc herniation. Methods This study involved 3 patients with multisegmental cervical stenosis and giant disc herniation confirmed by MRI. Among them, there were 2 males and 1 female, with ages from 56-61. All patients showed significant paresthesia or weakness, and were treated between September and November 2016. The surgery was performed by first the ODLP that made spinal cord back shift, and then APECD for the second step. The visual analog scale (VAS) and neck disability index (NDI) were assessed before and after operation. Results The VAS and NDI scores were improved two weeks after operation. No adverse events like spinal cord injury and vascular injury were found during the operation. After operation, no patients were found incision infection, hematoma formation, cerebrospinal fluid leakage, dysphagia, trachyphonia and so on. Conclusion The hybrid surgery of APECD and ODLP for the treatment of the multisegmental cervical stenosis and giant disc herniation can not only decompress the nerve safely and improve the function, but also preserve cervical intervertebral disc and motion segments, therefore delaying the degeneration of adjacent segments with clinical significance.

Objective:To evaluate the value and efficacy of self-anchored anterior lumbar discectomy and fusion (SA-ALDF) for L 5 isthmic spondylolisthesis. Methods:From June 2018 to December 2019, a total of 11 cases of L 5 isthmic spondylolisthesis were treated with SA-ALDF, including 4 men and 7 women, aged 43.2±12.6 (range 29-63) years. All patients had intractable low back pain aggravating during standing activities and alleviating during rest, without lower extremity radicular symptoms. Imaging examination showed bilateral isthmus cleft of L 5 with spondylolisthesis of 1 degree in 10 cases and 2 degree in 1 case according to Meyerding grading system. Under general anesthesia and supine French position, transverse 6 cm incision was made. Then, the L 5S 1 intervertebral disc was exposed via extraperitoneal approach between the bifurcation of abdominal aorta and vena cava. The intervertebral disc was sufficiently removed. The intervertebral space was released and distracted followed by canal ventral decompression and sequential mold testing. Suitable self-anchoring cage filled with auto iliac cancellous bone was implanted to restore intervertebral height and lordosis as well as reduction of spondylolisthesis. Under fluoroscopic guidance, the distal anchoring plate was knocked into the sacrum followed by direct reduction and proximal anchoring plate locking in the L 5 vertebral body. The patients were followed up for 12.1±4.7 (range 6-18) months. The visual analogue score (VAS) and Oswestry dysfunction index (ODI) were evaluated. The reduction and fusion were evaluated on the X-ray films. Furthermore, the rate of spondylolisthesis, the height and the lordosis of intervertebral space were measured. Results:The operation was performed successfully in all the patients with operation duration 90±18 (range 70-120) min, intraoperative blood loss 30±16 (range 10-60) ml. No severe complication such as nerve and blood vessel injury occurred. All patients experienced alleviation of symptom during follow-up. X-rays confirmed that the spondylolisthesis and alignment were recovered obviously without obvious cage displacement. However, the loss of reduction was 63.2% for the grade 2 spondylolisthesis. At the final follow-up, VAS decreased from 6.1±2.1 to 0.9±0.5, ODI decreased from 43.6%±14.2% to 6.0%±3.4%. The spondylolisthesis recovered from 17.7%±10.3% to 8.0%±7.2% with reduction rate of 54.8%±21.6%. The interverbral height recovered from 6.4±2.1 mm to 9.8±3.9 mm and intervertebral lordosis recovered from 4.8°±2.9° to 9.6°±4.7°.Conclusion:SA-ALDF can provide satisfactory outcomes for selected L 5 isthmic spondylolisthesis of degree 1 without neurological compromise. However, its mechanical stability may be insufficient for isthmic spondylolisthesis of degree 2.

Objective To investigate the changes of serum apolipoprotein M (ApoM) level in cord blood and pregnant women during different gestational periods and to explore the relationship with the occurance and development of gestational diabetes mellitus (GDM).Methods Three hundred and eight pregnant women performing regular prenatal examination were registered in Changzhou Women and Children Health Hospital from June,2011 to April,2013,including 99 normal pregnant women during the second trimester,122 during the third trimester,and 87 pregnant women with GDM.At the same time,100 samples of cord blood of normal neonates were collected.The levels of serum ApoM and other lipids were measured.Results (1) Serum ApoM levels in pregnant women during the second trimester,during the third trimester,and in the cord blood of normal neonate were (0.036-± 0.013) g/L,(0.023 ± 0.008) g/L,and (0.010 ± 0.004) g/L,respectively.(2) The serum ApoM level of GDM group was lower than that of control [(0.029 ± 0.010 vs 0.036 ± 0.013) g/L,P＜0.05].Multivariate non-conditional logistic regression analysis showed that there was statistically significant difference in ApoM levels between GDM and control groups after adjusting for potential confounders (Z =-3.62,P＜0.05).Conclusions The level of serum ApoM in pregnant women was increased at first and then decreased.The serum ApoM level in the neonatal cord blood was significantly lower than that in pregnant women.The level of serum ApoM was lowered with raised blood glucose level in women with GDM,suggesting that ApoM might play a role in the pathological processes of GDM.