Objective To study treatment of massive variceal bleeding secondary to localized pancreatitis-associated portal hypertension (MVBPAPH).Methods A retrospective study on the clinical data of patients with MVBPAPH was carried out.Of 24 patients with MVBPAPH,20 had pancreatic pseudocysts.12 were operated after failure of treatment with endovascular intervention for variceal bleeding (including 10 patients with splenectomy and gastric fundus-body peripheral vessels amputation and 2 patients with pancreatic pseudocystogastrostomy).8 patients underwent partial splenic embolization and left gastroepiploic artery embolization.4 patients directly underwent splenectomy and gastric fundus-body peripheral vessels amputation for variceal bleeding.Results Left pleural effusion developed in 5 patients who underwent arterial embolization.Left pleural effusion and lung infection occurred in 2 patients who underwent operation.All patients recovered well and were discharged home.During the follow-up period of 2 to 72 months,no rebleeding occurred in these patients (including 2 patients had passed little interval melena).Gastroscopy re-examination showed that variceal veins were not found in 18 patients.Variceal veins which were detected in the remaining 6 patients were obviously less severe.Conclusion Individualized treatment should be given to patients with MVBPAPH and according to the specific type of pancreatitis and the onset time of any accompanying pseudocyst.

Objective To investigate the technical feasibility and clinical significance of non-vascular contrast-enhanced ultrasound(NVCEUS) in screening pyelogenie cyst out of simple renal cysts so as to avoid damage to the urinary tract from absolute ethanol while undergoing percutaneous aspiration and ethanol sclerotherapy(PAEST). Methods Following an inclusion criteria 23 patients with renal cysts were selected to receive NVCEUS scanning by means of administrating SonoVue contrast agents through puncture needle into their renal cyst lumen prior to the injection of absolute ethanol for sclerosing treatment. By the demonstration of hyperechoic contrast agents leaving from intra cyst into renal collecting system,a pyelogenic cyst was defined. The patients with this kind of cyst was not allowed for further ethanol sclerotherapy. Results NVCEUS made 3 patients with pyelogenic cyst resembling simple ones free from ethanol selerotherapy,and 4 patients suspicious of pyelogenic cyst due to weird cyst configuration remain in the list of simple cyst for further selerotherapy. Conclusions NVCEUS of renal cyst is highly capable of differentiating pyelogenie cyst from simple cyst and highly valuable in increasing the safety for the procedure of PAEST.

Objective:To assess the implementation of injection-related risk management based on WeChat platform for type 2 diabetic patients with the insulin self-injection.Methods:A total of 124 diabetic patients, who would receive insulin therapy by self-injection at home after discharge from the PLA 903 hospital during April 2017 to July 2018, were divided into the control group( n=62)and the study group( n=62). All patients were given routine education on insulin injection during the hospitalization,while the study group( n=62)received additional video and text education based on WeChat platform after discharge. The skill of self-injection and the status of blood glucose control were evaluated in both groups 4 weeks and 8 weeks after discharge, respectively. Results:The insulin injection skill, including skin disinfection [36(58%) vs. 11(18%),χ 2=21.42, P<0.01], exhaust before injection [62(100%) vs. 51(82%),χ 2=12.07, P<0.01], stay 10s after injection [60 (97%) vs. 47(76%),χ 2=11.52, P<0.01], disposal of used needle[49(79%) vs. 18(29%),χ 2=31.20, P<0.01], rotation of injection site [48(77%) vs. 35(56%),χ 2=6.16, P=0.01], insulin storage [62(100%) vs. 57(92%),χ 2=5.21, P=0.02], and the ability of correctly dealing with hypoglycemia [52(84%) vs. 38(61%),χ 2=7.94, P=0.01] in the study group were significantly better than those in the control group after 4 weeks of injection-related risk management. The fasting plasma glucose [(6.41±0.76) vs.(7.19±0.81)mmol/L, t=5.61, P<0.01], glycosylated hemoglobin A1c [(6.71±0.64)% vs. (7.37±0.78)%, t=5.18, P<0.01], incidence of hypoglycemia [6(10%) vs. 15(24%),χ 2=4.64, P=0.03] in the study group were significantly lower than those in the control group after 12 weeks of the management. Conclusion:The risk management based on WeChat platform can improve insulin self-injection skill and the ability of dealing with hypoglycemia,also promote effective blood glucose control for diabetes patients.

A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations.And 40 women with normal ovulation served as the controls.Ovarian volume (OV),ovarian stroma area (SA),ovarian total area (TA) and SA/TA ratio were measured by transvaginal uhrasonography.Their endocrine hormone levels were determined.Patients with PCOS showed significantly higher OV,SA,TA and SA/TA than those of PCO and control groups.SA/TA was positively correlated with testosterone.The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups.AMH and inhibin B of PCOS were higher than the PCO and control groups.It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO.SA/TA is associated with the elevated serum testosterone of PCO.And SA/TA is an important ultrasonic parameter for diagnosing PCOS.

Objective To evaluate the immunogenicity of an immune complexed hepatitis B vac-cine ( HBsAg-HBIG immune complexes , IC) in mouse and cynomolgus monkeys by using recombinant hepa-titis B vaccine ( Saccharomyces cerevisiae, HBsAg) as the control .Methods BALB/c mice were vaccinated with single dose of IC and single dose of HBsAg respectively and then serum samples were collected at differ -ent time points for the detection of dynamic anti-HBs by using ELISA .The serum anti-HBs titers in BALB/c mice vaccinated with different immunization strategies were also analyzed .ELISPOT assay was performed to detect the numbers of IFN-γSFC and IFN-γpositive rate in splenocytes of BALB/c mice intramuscularly im-munized with IC, HBsAg or standard hepatitis B vaccine at 5μg/mouse.ED50 was measured to evaluate the stability of IC.Twelve cynomolgus monkeys were equally divided into two groups and immunized with high dose (100 μg) and low dose (20 μg) of IC respectively and then , serum anti-HBs levels at different time points were detected .Results The serum anti-HBs titers in IC immunized group at different time points were higher than those immunized with HBsAg .Moreover, the anti-HBs titer induced by two doses of IC reached a level comparable to that elicited by three doses of HBsAg .ELISPOT assay showed that both the numbers of IFN-γSFC and IFN-γpositive rate were the highest in IC immunized group as compared with those immunized with HBsAg and standard hepatitis B vaccine .IC had a lower ED50 than HBsAg, indicating a good long term stability .Cynomolgus monkeys immunized with high or low dose of IC produced high levels of anti-HBs titer during a long time period .Conclusion IC has a higher immunogenicity inducing both hu-moral immunity and cellular immunity as compared with HBsAg or standard hepatitis B vaccine .

Objective To investigate abdominal visceral fat area and its relationship with insulin resistance in male patients with type 2 diabetes and normal body mass index (BMI).Methods Seven male patients with type 2 diabetes and normal BMI were divided into two groups according to the abdominal visceral fat area (VFA) measured by CT:visceral obesity group (VFA ≥ 100 cm2) and non-visceral obesity group.Indicators of glucose and lipids metabolism were measured in two groups.Results Among 70 patients 50 (71％) had visceral obesity.In 59 patients who had normal BMI and normal waist circumference (≤90 cm),41 presented visceral obesity (69％).Compared with non-visceral obesity group,the waist circumference,homeostasis model assessment of insulin resistance (HOMA-IR),triglyceride,and VFA were significantly higher in visceral obesity group [(86.4 ± 5.6) vs.(81.2 ± 4.8) cm,t =-2.980,P ＜ 0.01;2.83±2.31 vs.2.01±1.30,t=-2.025,P＜0.05;1.93(1.26-2.79) vs.1.11(0.75-1.46) mmol/L,Z=-3.777,P＜0.01;(143.6 ±31.8)vs.(73.7 ±17.3)cm2,t =-11.456,P＜0.01].Fasting insulin,fasting plasma glucose and glycosylated hemoglobin tended higher in visceral obesity group but not significantly (P ＞ 0.05).Multiple linear regression analysis showed that after adjustment for age and body mass index,abdominal VFA was positively correlated with HOMA-IR (r =0.240,P ＜ 0.05).Conclusion Male type 2 diabetic patients have a high rate of visceral obesity even when their body mass index and waist circumference are normal.Abdominal visceral fat area is closely associated with insulin resistance.

OBJECTIVE:To observe the efficacy and safety of metformin in the treatment of type 2 diabetes(T2DM) with non-alcoholic fatty liver disease(NAFLD). METHODS:106 patients with T2DM with NAFLD were randomly divided into control group and observation group. Control group was received health education about T2DM with NAFLD and living intervention(diabe-tes diet and physical therapy);observation group was additionally given Metformin tablet 0.5 g,orally,3 times a day. The treat-ment course for both groups was 12 weeks. Clinical efficacy,and liver fat content,BMI,FPG,IR,TG,TC,LDL-C,HDL-C,HbA1c before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,liver fat con-tent and related index in 2 groups were significantly better than before(except HOMA-IR in control group),and observaton group was better than control group,the differences were statistically significant(P<0.05). The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on the conventional treatment,metformin has good efficacy and safety in the treatment of T2DM with NAFLD.

Objective To investigate the role of ATP￣binding cassette ( ABC ) family on the resistance of nasopharyngeal carcinoma (NPC) stem cells (CSCs) to cisplatin. Methods We compared the differences between the drug extravasation capability of CNE￣2 and CNE￣2S by using Rhodamine￣123 efflux assay. We determined the mRNA and protein expression levels of ABC transport family members, including ABCA3,ABCB1,ABCB5,ABCC1,ABCC2 and ABCG2,after 48 h being treated with 1 μmol.L-1 cisplatin by RT￣PC and Western blotting.Rhoamine￣123 efflux and apoptosis by cisplatin in two kinds of cells was examined by ABCA3 gene silencing with specific small￣interfering RNA. Results The IC50 of cisplatin on CNE￣2S was 4.1 fold to that on CNE￣2(P<0.05).For the relative drug effluent activity and Na+K+ ATPase activity,CNE￣2S was 4.8 fold to CNE￣2(P<0.05),suggested that CNE￣2S expressed more ABCA3,ABCB1,ABCC1 and ABCG2 in comparison to CNE￣2(P<0.05).After 48 h treatment with 1 μmol.L-1 cisplatin,ABCA3 specifically highly expressed in CNE￣2S (P<0.05), and knocking down of ABCA3 resulted in reduction of rhodamine￣123 efflux and increase of apoptosis. Conclusion The cisplatin resistance of NPC CSCs is associated with enhanced expression of ABCA3,ABCC1 and ABCG2, suppression of ABCA3 could reverse the resistance of NPC CSCs to cisplatin.

Objective To investigate the prevalence of overweight,obesity and related metabolic diseases among male public institution office workers in health check-up.Methods Total 1 018 male public institution office workers aged 23-60 underwent annual health check-up at our hospital in 2012.The data including blood pressure,waist circumference,height,body weight,serum glucose,plasma lipids and serum uric acid were analyzed.According to body mass index (BMI),the subjects were classified as:underweight(BMI ＜ 18.5 kg/m2),normal weight (18.5 kg/m2 ≤ BMI ＜ 24 kg/m2),overweight (24 kg/m2 ≤ BMI ＜ 28 kg/m2) and obesity(BMI≥28 kg/m2).Results The prevalence of overweight,obesity,central obesity and metabolic syndrome (MS) were 40.9％ (416/1 018),7.9％ (80/1 018),53.0％ (540/1 018),and 11.2％ (114/1 018),respectively.There were significant differences in fasting blood glucose (FPG),TC,TG,uric acid(UA),systolic blood pressure(SBP) and diastolic blood pressure(DBP) levels among different groups (F =4.82,12.09,40.55,6.19,28.97 and 49.29,respectively,all P ＜0.01).The prevalence rate of hypertension in underweight,normal,overweight and obesity groups was 0,11.8％,27.4％ and 37.5％,respectively; that of diabetes was 0,1.6％,5.5％ and 10.0％,respectively; that of hyperlipidemia was 40.0％,47.2％,66.3％ and 71.2％,respectively; that of hyperuricemia was 0,5.0％,13.5％ and 13.8％,respectively,which showed that with the increasing of BMI,the prevalence rates of related metabolic diseases were increased(x2 =55.97,9.65,43.32 and 24.08,all P ＜0.01).And the co-morbidity rate with ≥3 diseases in 4 BMI groups were 0(0/20),1.4％ (7/502),5.8％ (24/416) and 13.8％ (11/80),respectively (x2 =31.90,P ＜ 0.01).Conclusion Obesity and overweight are correlated with metabolic disorders and the obese subjects are at high risk for cardiovascular diseases.

To explore the diagnostic values of real-time elastosonography quantitative parameters in uterine fibroids and adenomyoma.The clinical data of 175 cases were analyzed retrospectively.Strain ratios (B/A) of lesion and normal adjacent myometrium were measured and mean B/A was calculated.The average B/A of uterine fibroids and adenomyoma was 3.81 ±0.52 and 1.39 ±0.46 respectively.And there was significant statistic difference (t =2.563,P ＜ 0.05).the accuracy rates of real-time elastosonography in the diagnosis of uterine fibroids and adenomyoma were high at 97.4％ (148/152) and 95.3％ (122/128) respectively.Real-time elastosonography has high diagnostic values for uterine fibroids and adenomyoma.