To investigate the curative effect of electroacupuncture on hip osteoarth-ritis, 120patients with hip osteoarthritis were randomly divided into two groups, 60 cases each group, and treated by electroacupuncture and oral administration of slow released diclofenac tablet,respectively. The degrees of pain, activity and swelling were observed in both groups before and after treatments. A follow-up was performed for more than 2 years. The curative effects were assessed by JOA criteria for evaluating the effect on hip osteoarthritis. After treatment, the average score increased by 18 marks in the electroacupuncture group and by 12.3 marks in the diclofenac group (P<0.05). Electroacupuncture treatment has a significantly better effect on hip osteoarthritis than oral administration of slow released diclofenac tablet.

To discuss the value of the diagnosis and treatment for the submucous myomas by hysteroscope. According to the data of hysteroscopic resection in the treatment of submucous fibroids, the authors suggested that the submucous myomas should be divided into four types and the detailed appearance of each type were discussed. Conclusions: Four types of the submucous myomas were distinguished and the surgical treatment of each type were chosen correspondingly under hysteroscope.

Objective To investigate the correlation between serum uric acid (SUA) level and early-phase insulin secretion in subjects with normal glucose regulation (NGR).Methods Totally 367 community NGR residents confirmed by a 75g oral glucose tolerance test were enrolled.The insulin resistance index (HOMA-IR) and the early-phase insulin secretion index after a glucose load (ΔI30/ΔG30) were used to estimate the insulin sensitivity and the early-phase insulin secretion, respectively.The subjects were divided into 4 groups according to the SUA level quartiles.Differences in early-phase insulin levels, ΔI30/ΔG30, and HOMA-IR were compared among the 4 groups.Results Age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, fasting insulin (FINS), 30 minutes postprandial insulin (30 minINS), 2 hours postprandial insulin(2hlNS), HOMA-IR and TG levels increased across the rising categories of SUA levels, while the HDL-C was decreased across the SUA groups (P ＜ 0.01).The SUA level was positively correlated with age (r =0.157, P ＜ 0.01), BMI (r =0.262, P ＜ 0.01), waist circumference(r =0.372, P ＜ 0.01), systolic blood pressure (r =0.200, P ＜ 0.01), diastolic blood pressure(r =0.254,P ＜ 0.01) , 30 minutes postprandial plasma glucose(r =0.118 ,P =0.023), FINS(r =0.249, P ＜ 0.01), 30minlNS (r =0.189, P ＜ 0.01) ,2hlNS (r =0.206, P ＜ 0.01), glycosylated hemoglobin (HbAlc, r=0.106,P =0.042), HOMA-IR(r =0.244,P ＜0.01), TG(r =0.350,P ＜0.01), ΔI30/ΔG30 (r =0.144, P ＜ 0.01), and negatively correlated with HDL-C level (r =-0.321, P ＜ 0.01).Multiple stepwise regression analysis showed that SUA (β =0.292, P ＜ 0.01) and HOMA-IR (β3 =29.821, P ＜ 0.01)were positively associated with ΔI30/ΔG30.Conclusion SUA level is closely related with the early-phase insulin secretion in NGR subjects.

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a breakthrough in the field of hepatobiliary surgery.The remnant liver regeneration was stimulated during the first stage of the operation,and the radical resection of the tumor could be successfully carried out during the second stage of the operation.ALPPS is a new approach for patients with tumor which is previously considered unresectable during one hospital stay.In April 2014,a patient with hepatocellular carcinoma (HCC) in the right liver and liver cirrhosis was admitted to the Southwest Hospital.Preoperative examination confirmed that the ratio of the remnant liver volume to the standard liver volume was 26.9％,which indicated that the patient was inappropriate to receive radical resection of HCC.Therefore,totally laparoscopic ALPPS was applied.In the first stage of the operation,the portal vein ligation associated with liver hanging tape placement and in situ splitting of liver were carried out after hanging the Glisson's pedicle under the laparoscope.Thirteen days after the first stage of the operation,the ratio of the remnant liver volume to the standard liver volume was 40.6％.The second stage of the operation was carried out 14 days after the first stage of the operation.The right hepatic pedicle and right hepatic vein were transected with a stapler.The tumor was removed after full mobilization of the right liver.The distance between the resection margin to the tumor was 1.5 cm.No complications were detected after the first stage of the operation,while the patient was complicated with pleural effusion after the second stage of the operation and was cured by pleural puncture and drainage.The patient was discharged at postoperative day 9 and followed up at postoperative month 1.The results of follow-up confirmed that the hepatic function was normal,and no mass occupying lesions and pleural effusion were detected.Totally laparoscopic ALPPS is safe and feasible with satisfactory short-term efficacy.

Objective To explore the application value of Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with portal vein (PV) resection and artificial vascular graft and reconstruction.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with cancer of pancreatic head combined with biliary and duodenal obstructions who was admitted to the Southwest Hospital of the Third Military Medical University in November 2015 were collected.Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction were applied to the patient due to intraoperative tumor extensive invasion to the PV and angiogenesis around the tumor.The operation time,volume of intraoperative blood loss and transfusion,time of postoperative drainage-tube removal,postoperative complications,result of postoperative pathological examination,duration of postoperative hospital stay and results of follow-up were observed.The follow-up of outpatient examination and telephone interview was performed to detect the survival of the patient up to February 2016.Results The patient underwent successful Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction.The length of intraoperative excisional PV,operation time,volume of intraoperative blood loss,volume of red blood cell suspension and blood plasma infusions were 3 cm,670 minutes,600 mL,400 mL and 200 mL,respectively.The patient got out-off-bed activity at postoperative day 1 and fluid diet intake after gastric-tube removal at postoperative day 3,and drainage-tube was removed at postoperative day 8.No postoperative complication was detected.The patient had unblocked main PV without obvious stenosis and filling defect by computer tomography rescanning.Adenosquamous carcinoma of the pancreatic head was confirmed by postoperative pathological examination.There were negative resection margins from the proximal and distal duodenum to the pancreas.The patient was discharged from hospital at postoperative day 12 and followed up for 3 months,with a good survival.Conclusions Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction are safe and feasible in the treatment of the cancer of pancreatic head combined with biliary and duodenal obstructions,with a good short-term outcome.

Objective To explore the application of ultrasound- guide modified Seldinger technique for upper arm PICC insertion in infant patients. Methods Use the ultrasound-guide modified Seldinger technique to inserted PICC for 27 infant patients. Results All 27 cases were inserted successfully, success rate of the one puncture reached 92.6%. Conclusions By adequate preparation for infants, effective immobilization and good cooperation of operators, and combined with techniques which prevent PICC misplacement, overcome the shortcoming of bad vessel and non-compliance of infant patients, develop the advantage of ultrasound, could improve the rate of successful catheterization of upper arm PICC insertion in infant patients, and protect the vessels.

Objective To investigate the clinical manifestations,endoscopy and pathological features of Behcet's disease (BD) in gastrointestinal systems in elderly patients.Methods Totally 8 patients aged ≥ 60 years with BD were collected.Clinical characteristics and endoscopic performances of gastrointestinal tracts in patients were summarized.All patients were received gastrointestinal biopsy and the histology change was observed.The vasculitis of gastrointestinal tracts was confirmed by histochemical staining.Results The proportion of patients with BD involving the esophagus was 16.7％ (9/54) and among whom 6 cases (11.1 ％) were elderly,so the proportion of BD patients with esophageal lesions in elderly patients was 66.7 ％ (6/9).The proportion of patients with BD involving the ileocolon was 9.3％ (5/54) and 4 cases (7.4％) were elderly patients,so the proportion of BD patients with ileocolon lesions in elderly patients was 80.0％ (4/5).6 patients had retrosternal chest pain,among whom 2 patients with dysphagia and 4 patients with abdominal pain and hematochezia.In the laboratory tests,the levels of erythrocyte sedimentation rate (ESR) and C reactive protein were elevated in 4 cases,and antinuclear antibodies (ANA) and anti-neutrophil cytoplasm antibody(ANCA)were negative in all patients.In the physical examination,oral and genital ulcers in 6 patients,and a history of recurrent oral and genital ulcers were found in the other 2 patients.6 patients had ophthalmia and 4 patients with skin lesions.6 patients had multiple esophageal ulcers,in which shallow ulcers was more common,and the surface of ulcer was clean and white with congestion and edema at the periphery of ulcers.BD involving the ileocecal and ascending colon were found in 4 cases.Typical small vessel vasculitis was the pathological performance.The retrosternal chest pain disappeared and the esophageal ulcers were healed after the treatment.Conclusions Gastrointestinal involvement in BD patients is associated with the the course of disease.Longer duration can increase the possibility of gastrointestinal involvement in BD.Elderly BD patients are more common with esophageal involvement.Rctrosternal chest pain may be a relatively specific clinical symptom in BD involving esophageal tract.Glucocorticoids and (or) thalidomide are effective for the treatment of BD with esophageal involvement.

Objective To investigate the effects of Qibai Pingfei Capsules(QPC) on the expression of monoamine neurotransmitters of 5-hydroxytryptamine receptor(5-HT) and dopamine(DA) receptors of DA1 and DA5 in the rats with chronic obstructive pulmonary disease (COPD) accompanied with depression, and to explore the possible therapeutic mechanism. Methods Ninety male Wistar rats were randomly divided into 6 groups, namely normal group, COPD depression group, QPC group, Venlafaxine group, and QPC plus Venlafaxine group. The rat model of COPD accompanied with depression was established by compound methods of smoking, food deprivation, water deprivation, forced swimming, shaking, and clipping tail. And then the effects of QPC on the lung function and the general characteristics were observed. Furthermore, the mRNA level of 5-HT1AR was determined by real-time quantitative reverse transcription PCR(RT-qPCR), and protein levels of DA-1 and DA-5 in rat hippocampus were assayed by Western blot analysis. Results Compared with the normal group, forced expiratory volume in 0.3 second(FEV0.3), the forced volume capacity(FVC) and FEV0.3/ FVC in the COPD depression group were significantly reduced (P < 0.01). Compared with the COPD depression group, the values mentioned above were restored to different extents in the groups of QPC, Venlafaxine, and QPC plus Venlafaxine(P<0.01). Compared with the normal group, the expression levels of 5-HT1AR mRNA, and DA-1 and DA-5 protein in the COPD depression group were significantly down-regulated, and their levels were also slightly decreased in the treatment groups(P<0.05). Compared with the COPD depression group, the expression levels were up-regulated to various degrees in all of the treatment groups (P < 0.05). Conclusion QPC can increase the mRNA levels of 5-HT1AR and protein levels of DA-1 and DA-5 in the hippocampus of COPD with depression.

Objective To assess the value of endoscopic ultrasonography (EUS) and abdominal CT scan on preoperative T and N staging of advanced gastric cancer.Methods A total of 188 patients with advanced gastric cancer received EUS and CT scan to evaluate the T and N staging and lymphatic metastasis before surgical operation.The postoperative pathologic results acted as gold standard for comparison of the two methods.The results consistent with pathologic results were considered as correct otherwise were incorrect.The accuracy of EUS and CT and the each consistency of two methods with pathology were analyzed.Results For T staging, the accuracy of EUS and CT was 87.2%(164/188), 76.6%(144/188), respectively, and Kappa value of EUS and CT was 0.726 and 0.509, respectively.There was a statistical difference between the two methods(χ2=7.181,P=0.007).For lymph node metastasis, the accuracy of EUS and CT was 72.9%(137/188) and 79.8%(150/188), respectively, and Kappa value of EUS and CT was 0.397 and 0.487, respectively.No statistical difference was found between them(χ2=0.963,P=0.326).The consistency test between the two methods for T and N staging and lymph node metastasis revealed that the Kappa value was 0.507 and 0.649, respectively.The accuracy of EUS on T staging was 93.0%, 93.3%, 96.8% and 91.5% in cardiac cancer, gastric fundus cancer, gastric corpus cancer, and gastric antrum cancer, respectively.Corresponding Kappa value in the 4 different positions were 0.843,0.881,0.940 and 0.710, respectively according to consistency tests.The accuracy of gastric antrum cancer with pylorus invasion was 63.2% and the consistency test Kappa value was 0.340.Conclusion EUS is an accurate method for T staging and lymphatic metastasis of advanced gastric cancer, but there is a lower accuracy for T staging of gastric antrum cancer with pylorus invasion.

Background When focusing on a target,the accommodative system exhibits small variations in power within a range,termed microfluctuations.Exploring the correlation between the characters of microfluctuations and the aberrations of the eyes through a critical period-teenager can deepen the understanding of the onset and development of myopia.Objective This study was to investigate the correlation between accommodative microfluctuations and wavefront aberrations of human eyes,and to explore the role of accommodative microfiuctuations in the development of myopia.Methods A cross-sectional study was designed and performed.Fifty-four teenagers aged from 12 to 15 years were enrolled in this study in Eye Hospital,Wenzhou Medical University from 2010 to 2011,including 19 emmetropic subjects,18 incipient myopic subjects and 17 progressive myopic subjects,who were chosen based on the refractive changes for the last two years.The accommodative response and microfluctuations were measured by WAM-5500 infrared autorefractor with RSVP at 25,33 and 50 cm respectively,each RSVP distance was tested for 5 minutes.The accommodative values were divided into low frequency component (LFC) (0-0.6 Hz),middle frequency component(MFC) (0.6-0.9 Hz) and high frequency component (HFC) (1.0-1.4 Hz) after Fourier spectrum analysis.The wavefront aberrations of the whole eye and corneal were recorded by i-Trace aberrometer and Humphrey corneal topography.The differences of accommodative response,microfluctuations and aberrations were evaluated and compared among the emmetropic group,incipient myopic group and progressive myopic group.The correlations of accommodation and aberrations were analyzed.This study followed Declaration of Helsinki,and informed consent was obtained from each subject.Results Under the 25 cm and 33 cm reading distance,the accommodative response values were (2.78 ± 0.35) D and (2.19 ± 0.27) D in the emmetropic group,which were significantly higher than (2.44±0.33) D and (1.89±0.35)D in the progressive myopic group (P=0.002,0.003).LFC,MFC and HFC were remarkably increased as the reading distance decreased (Fdistance =8.480,14.270,21.400;all at P ＜0.01).A significant difference was seen in LFC among different reading distances (Fgroup =4.115,P＜0.05),and the LFCs in the progressive myopic group were considerably higher than those in the emmetropic group in the 25,33 and 50 cm reading distances (P=0.044,0.038,0.032).No significant differences were found in MFC and HFC among the three groups (Fgroup =0.859,0.682;both at P＞0.05).Under the 25 cm and 33 cm reading distances,significant positive correlations were found between LFC and corneal coma,intraocular coma,whole ocular aberrations or intraocular higher order aberrations (all at P＜0.05),however,no significant correlations were seen between MFC or HFC and wavefront aberrations (all at P＞0.05).Conclusions In teenagers,the accommodative response of emmetropia is much stronger than that of progressive myopia,and the accommodative microfluctuation in emmetropia and incipient myopia is much less than that in progressive myopia.These shifts are possibly associated with the variability,and microfluctuations of accommodation is greater in progressive myopes than emmetropes.There are certain correlations between wavefront aberrations and accommodative microfluctuations.The refractive group differences in the accommodative microfluctuations may be related to differences in the wavefront between myopes and emmetropes.Under near reading distance,LFC is correlated with higher order aberrations.