Objective To study the effect of the MafA therapy for blood slucose control in diabetic rats.Methods Rats were divided into 3 groups:treatment group,DM group and control group.In DM group,Wistar rats were rendered diabetic by intrvenous injection of streptozotocin(STZ).In treatment group,mixture of MafA and liposomes at the volume ratio of 1:1 was injected to the portal vein of the diabetic rats.Blood glucose change in the diabetic rats Was measured.Results ① For treatment group,blood slucose decreased from 20.6 mmol/L-22.8 mmol／L to 13.6 mmol／L-14.8 mmol／L and plasma insulin level was significantly elevated for a duration about 2 weeks.②After treatment,blood slucose level significantly decreased compared to DM group (P<0.05).③ Plasma insulin level Was significantly higher than that in DM group(P<0.05).④ Expression of MafA mRNA can be detected in the liver oftreatment group while it Was not found in DM group.Immunohistochemical analysis revealed that insulin expression Was found in the liver of treatment group while it Was not found in the liver of DM group.Conclusion Injection of MafA and liposomes at the volume ratio of 1:1 via the portal vein can effectively decrease blood glucose in diabetic rats.

ObjectiveTo analyze the reasons of complications after laparoscopic gastrectomy with D2.MethodsThe clinical courses of 150 cases who suffered from gastric cancer treated by laparoscopy in the First Affiliated Hospital of Yangzhou University from March 2007 to December 2010 were retrospectively analyzed.ResultsFourteen cases showed complications after operation,the rate being 9.33％ (14/150).The remaining patients with postoperative complications were discharged after treatment,no death occurred during the perioperation.ConclusionEnhancing the refinement of surgical operations,the postoperative observation and the management of drainage tube are the key to the prevention and treatment of complications after laparoscopic gastrectomy.

0.05). Conclusions LS,whereas of less traumatic and low morbidity, results in comparable effects as OS for the treatment of ITP.

Objective To investigate the diagnostic significance of endoscopic ultrasonography (EUS) for suspected choledocholithiasis in non-cholangiectasis. Methods EUS was performed on 33 patients with cholecystolithiasis, whose common bile duct diameters were less than 8 mm, with one of the histories of acute pancreatitis, obstructive jaundice or recurrent biliary colic, but without common bile duct stone (CBDS). The results were compared with surgical or ERCP findings. Results Twenty cases in 33 were diagnosed ascholedocholithiasis by EUS. Sixteen of the 20 cases were confirmed as CBDS with further operation or ERCP. Compared with the results of surgery or ERCP, the sensitivity, specificity, positive prediction value and negative prediction value of EUS for choledocholithiasis were 100% , 76. 5% , 80% and 100% respectively. Conclusion EUS is of high diagnostic significance for suspected choledocholithiasis in non-cholangiectasis.

ObjectiveTo evaluate the feasibility,safety and therapeutic efficiency of laparoscopic total mesorectal excision (TME) with anal sphincter preservation in the treatment of the middle-lower rectal cancer.MethodsFrom February 2008 to June 2010,37 patients with middle-lower rectal cancer received laparoscopic TME with anal sphincter preservation,while 45 patients underwent conventional open TME with anal sphincter preservation according to their wills.The operative procedures,postoperative recovery,postoperative complication and short-term outcome were collected and compared between the two groups.ResultsBlood loss was (60.6 ± 20.9) mL in laparoscope group which was significantly less than that in laparotomy group (P＜0.01),time for bowel movement retrieval and hospital stay were (3.3 ±0.6) and (9.2 ±2.8) days respectively,which were significantly shorter than those in laparotomy group (P ＜ 0.01 ).The incidence of postoperative complications was 8.1％ in laparoscope group,which was significantly lower than those in laparotomy group (P ＜ 0.05 ).The mean distance between resected margin and the tumor,the mean number of disected lymph nodes were not different between the two groups.The rate of sphincter preservation was 91.9％ in laparoscope group,which was higher than those in laparotomy group (73.3％) ( P ＜ 0.05 ).All patients were followed-up from 6 to 36 months,the recurrent rate and overall survival rate were 10.8％ and 94.6％ in laparoscope group,with no significant difference compared to those in laparotomy group (11.1％ and 91.1％,P ＞ 0.05).ConclusionsLaparoscopic TME with anal sphincter preservation which achieved the same effect of oncological clearance is a safe and feasible procedure for middle-lower rectal cancer,with less postoperative complications and better recovery after treatment,and enhances the rate of sphincter preservation,which is worthy of clinical application.

Objective To compare the early outcomes of laparoscopic and open resection and evaluate the safety and feasibility of laparoscopic surgery in patients with colorectal cancer aged ≥ 70 years.Methods A total of 91 consecutive patients with colorectal adenocarcinoma underwent surgery in Yizheng City People's Hospital between Jan.2009 and Dec.2015.In 91 patients included in this study,38 received laparoscopic surgery and 53 underwent open surgery.Main outcome measures were clinical data,postoperative recovery status and short-term outcomes.Results There were no significant differences between two groups with respect to demographic indicators,clinicopathological results and chronic comorbidities had no significant difference between two groups.No death cases occured in both groups.One patient in the laparoscopic group required conversion to open surgery due to ureteral injury.Laparoscopic surgery was associated with significantly longer operating time [(238 ± 71.3) minutes vs (175 ± 60.8) minutes,P ＜ 0.001],less estimated blood loss [(145 ± 58 ml) vs (186 ± 45) ml,P ＜ 0.001)],a shorter postoperative hospital stay [(11.9 ± 3.9) days vs (14.5 ± 3.7) days],lower overall postoperative complication rate (23.7％ vs 45.3％,P =0.035),wound-related complication rate (2.6％ vs 22.6％,P =0.017) when compared with open surgery.Quality of surgical specimen,lymph nodes harvested were not significantly different between two groups.Conclusion Laparoscopic colorectal cancer surgery is safe and feasible in elderly patients,associated with better short-term outcomes when compared with open surgery.

Objective: To investigate the application of low molecular weight heparin modified injection in the nursing of patients with acute myocardial infarction. Methods: A total of 90 patients with myocardial infarction who underwent subcutaneous injection of low molecular weight heparin from May 2017 to May 2018 were enrolled in the study. The patients were divided into the control group and the observation group according to the different injection and treatment methods. The control group used the traditional injection method of low molecular weight heparin, and the observation group used the low molecular weight heparin modified injection method. Forty-five patients were observed and compared for the degree of subcutaneous hemorrhage, incidence of induration and pain. Results: The incidence of subcutaneous induration and subcutaneous hemorrhage in the observation group were 10.16% (64/630) and 19.84% (125/630), respectively. The control group was 16.19% (102/630) and 31.11% (196/630), respectively. The difference between the groups was statistically significant (χ²=10.019, 21.073, both P<0.05). The pain score of the observation group was 1.29±0.21, and the control group was 1.86±0.28. The difference between the two groups was statistically significant (t=40.877, P<0.05); the subcutaneous mild, moderate, and severe bleeding in the observation group were 17.30% (109/630), 2.54% (16/630), and 0, respectively, and the control group was 21.90% (138/). 630), 8.41% (53/630), 0.79% (5/630), the difference between the two groups was statistically significant (χ²=4.235, 20.990, 4.019, all P < 0.05). Conclusions Low molecular weight heparin modified injection method for myocardial infarction patients can effectively reduce the incidence of subcutaneous hemorrhage and induration, reduce the degree of subcutaneous hemorrhage and pain, suitable for clinical promotion.

Objective To prospectively survey the well-known experts of critical care and endocrine secretion to summarize their experience in treating diabetes mellitus complicated by sepsis for the purpose of providing guidance of theory and practice in making treatment schemes of traditional Chinese medicine for such disease.Methods The questionnaires were designed and submitted to the experts.The statistic analysis was undertook to investigate the rules.Results A total of 30 questionnaires were released and 28 were retrieved.The experts generally believed that eight-principle syndrome differentiation was the most useful method in the syndrome differentiation and treatment of this disease.The heat,stasis and toxin were usually acted as the main pathogenic factors while damp and phlegm commonly act as secondary pathogenic factors.They thought that weak body resistance under the invading of evil was the key mechanisms in the deterioration of the disease and they chose clearing heat,activating blood and detoxication as 3 core treatment principles.Conclusions The summarized opinions from the experts should be act as important reference in treating this disease,but its effectiveness and possibility for further generalization need to be validated in the clinical practice.