Objective To explore the method of three-dimensional reconstruction of fetal bilateral renal artery and its application value of three-dimensional visualization model.Methods One case of 31 weeks fresh fetal bilateral kidney specimens was infused with epoxy resin-titanium dioxide and then casted.Obtained the original two-dimensional CT image data sets through CT thin layer scanning of the casting mold.Reconstructed the three-dimensional model of fetal bilateral renal artery with the Mimics 17.0 software, and the model was compared with the casting mold specimen.Results The casting mold specimen of fetal bilateral renal artery clearly showed the shallow blood vessels, but it was difficult to observe the deep renal arteries.On the contrary,the three-dimensional model of fetal bilateral renal artery could help to observe and measure the deep renal arteries accurately,but it failed to show the shallow blood vessels clearly.Conclusion Based on the advantage of the three-dimensional model fetal bilateral renal artery and casting mold specimens,the direction and distribution of fetal bilateral renal arteries could be displayed with stereoscopic multi-level through the combination of virtual and reality,which may provide a reliable morphological data for anatomy teaching and fetal basic medical research information.

Objective To observe the effect of berberine to islet ?-cell function in type 2 diabetes mellitus (damp-heat type). Methods 60 patients with type 2 diabetes mellitus (damp-heat type) were randomly divided into 2 groups, under basic treatment of 2 weeks with metformin, the treatment group was given berberine. After 8 weeks, the changes in the levels of blood glucose, insulin, HbA1c, CRP and the grade of traditional Chinese medicine individual event symptom and general integral symptom were observed. Apply the formular to evaluate the pancreas's function. Results Each group had notable difference before and after the experiment in many aspects, especially in treatment group. There was a notable difference in 2 groups. Conclusion Berberine has obvious effect on increasing insulin releasing level, improving insulin sensibility, lightening insulin resistance and improving islet ?-cell function.

OBJECTIVE:To determine plasma concentration of irbesartan by HPLC with fluorescence detection.METHO-DS:Samples were separated on Diamonsil C18 with mobile phase consisted of 0.02mol?L-1 KH2PO4-acetonitrile(50∶50) at a flow rate of 1.0mL?min-1.The fluorescence detector was set at an excitation wavelength of 250nm and an emission waveleng-th of 375nm.The column temperature was 40℃.RESULTS:The linear range for irbesartan was from 1.0 to 1000ng?mL-1 (r=0.999 8).The mean relative recoveries of irbesartan at low,middle and high concentrations(2.0,50.0,and 500.00ng? mL-1) were 97.4%,106.1% and 101.6%,respectively.Both intra-day and inter-day RSD were below 10%.CONCLUSION:The method is simple,rapid,accurate and specific,and it can be used for the plasma concentration determination and pharmacokinetic study of irbesartan.

Objective To investigate the incidence of fetal malnutrition( FM), its affected factors and their relationship with small - for gestational - age (SGA) fetus. Methods The intrauterinal growth of fetus was evaluated by the body weight of neonates and FM was detected by clinical assessment of nutritional status ( CANS ). Results ①33 out of 204 cases were found to be FM (16% ). FM in SGA group was significantly higher than that in AGA group ( 5.9% ) (x2 = 69.9, P ＜ 0. 01 ).② When ot = 0. 05, the body weight and head circumference of neonates, the education level of mothers were included into logistic regression model, and their regression coefficient were negative. Conclusion SGA was supposed to be two of the risk factors in developing FM. Fetus with low body weight, small head circumference and not - so - well educated mother were prone to suffer from FM.

[Objective]To report the mid-term results and main points of modular femoral prosthesis in total hip revision surgery for Paprosky type Ⅲ bone defect of the proximal femur.[Method]Nine cases of Paprosky type Ⅲ bone defect of the proximal femur were treated with modular femoral prosthesis MP and ZMR from May 2003 to October 2006.There were 5 males and 4 females with the age range of 39-65 years(mean age 57 years).All the patients were followed up for 8-34 months(mean 19 months).Causes for revision included loosening and osteolysis of primary cemented prosthesis in 7,and coral face prosthesis sterile loosening in 2.The shortest time from the last operation to the revision was 4 years,and the longest was 12 years.There were 5 of type ⅢA and 4 of type ⅢB according to the Paprosky bone defect classification.[Result]The Harris score was 35 points(28-54) before operation and 85(70-90) after operation.Seven patients walked without the help of crutches,one had a mild pain in the thigh and a leg crispation of 2.5 centimeter,and the other having a medium pain in the thigh limping with a crutch.No significant loosening,infection or osteolysis of distal femur was found.One prosthesis sinking 12 mm in 1 case.[Conclusion]Total hip revision surgery for Paprosky type Ⅲ femoral bone defect using modular femoral prosthesis has optimal mid-term results.It offers stabilization both in the initial and late stages.Due to the separation of prosthetic stem from the proximal prosthesis,the implantation is easy to fix.Modular femoral prosthesis,which is benificial to control offset,anteversion angle,and limb length makes the total hip revision surgery simpler and safer.

Objective　To evaluate the treatment of in-stent restenosis with rotational atherectomy and balloon angioplasty. Methods　The rotational atherectomy and 4～6 atm low pressure balloon angioplasty was performed in 3 patients with in-stent restenosis and follow up after treatment. Results　All cases were succeeded. The bradycardia occurred in one patient was quickly disappeared without treatment, two other patients were found no effect on heart rate, hemodynamic performance, global LV function, or regional wall motion. No complications, angina, death or other coronary event occurred during the follow up for 6～12 months. Two of them was performed coronary angiography after 6 months and showed the diameter of target vessel was less than 30% as compared with that on coronary angiography which performed immedately after operation. Conclusion　The management of in-stent restenosis in target vessels using a combination of rotational atherectomy and balloon angioplasty is safe and efficient.

Objective To develop an evaluation index system of health management services for the elderly with the perspective of combining medical service and long term care, and laying the foundation for the field assessment. Methods Using Delphy expert consultation method to improve Andersen health service utilization model. Excel was used for data input, SPSS 22.0 statistical software was used for analyzing the data from the expert consultation questionnaire to determine the importance and feasibility of the scores including mean, standard deviation and coefficient of variation. Constituent ratio analysis was done for expert positive coefficient, and the expert authority coefficient and coordination coefficient were analyzed by chi square test. The indicator's weight was calculated by using average method and multiplicative cumulative combination weighting. Results We constructed the framework for evaluating the effectiveness of health management service for the elderly in the community, the evaluation index system of the community health service was established. The system included 4 first level indicators, 12 second level indicators, 35 third level indicators, each index had a corresponding weight. Conclusions The evaluation index system is an effective way to assess health management service, selection of the indexes should be consistent with the connotation and characteristics of elderly health management under new aging care policy. Further empirical investigation is needed to modify the index system in order to provide decision-making basis for improving and regulating health management services for the elderly.

To investigate the relationship between partial esophagectomy with staple anastomosis for carcinoma and gastroesophageal reflux (GER). The pressure in the esophagus and intrathoracic stomach was measured with SG-Ⅱ computer manometer in 45 patients. Twenty-four-hour esophageal pH monitoring, endoscopy and pathological examination were performed in 20 patients. Resting pressure above the esophago-gastric anastomosis was higher than that under the esophago-gastric anastomosis. Twenty-four-hour pH monitoring revealed that GER occurred. Abnormal findings were observed in 80% of patients by endoscopic and pathological examinations. The results showed that GER existed in the patients after esophagectomy and esophagogastrostomy for esophageal cancer. The occurrence of GER with stapling anastomosis were similar to that with manual anastomosis. The occurrence of GER was not related with the length of postoperative period. Sleeping in semirecumbent position was an effective method to prevent GER for postoperative patients. Twenty-four-hour pH monitoring was a reliable method for detecting GER.

OBJECTIVE:To study the association between the reticulated platelets(RP) percentage and aspirin resistance(AR) with the percentage of reticulated platelets in whole blood representing the platelets turnover rate to illuminate the influence of platelets turnover rate on AR.METHODS:The RP percentage and arachidonic acid(AA) and adenosine diphosphate(ADP)-induced platelet aggregation in 80 patients after receiving aspirin(100 mg?day) for no less than 7 days were determined.The patients were divided into AR group,aspirin semi-resistance(ASR) group,and aspirin sensitive(AS) group,and the RP percentage in the three groups were compared.RESULTS:RP percentages in AR,ASR,and AS groups were(4.11?2.62)%,(2.23?1.79)%,and(2.18?1.24)%,respectively,showing signficant differneces between AR group and AS group(P0.05).CONCLUSION:Increased platelets turnover may induce AR,therefore,the patients with coronary artery disease should receive aspirn for multiple daily(antiplatelet therapy) or to take controlled release or sustained release aspirin.The safety and efficacy of these therapies should be confirmed in clinical trials.

Objective To investigate mechanism and clinical effect of implantation of pacemaker with artial fibrillation(Af) preventive pacing algorithms (Vitatron 900E).Method 24 cases of patients with paroxysmal Af were observed in three phases (each phase two weeks):⑴Monitoring phase,in which onset mechanism of atrial arrtythmias was recorded, the device was programmed into DDD mode with 60 bpm;⑵Lower rate limit phase (LRL),DDDR mode with 85bpm LRL, and evaluating anti-Af effect by elevated rate;⑶Preventive pacing therapy phase,all preventive pacing therapies with programming to on or off, and this phase determined whether combined pacing therapies impacted on incidence of Af. Results 24 cases of patients were free of Af, in which 17 cases were done by using post-PAC-response or/and post-exercise-rate-control therapy only, and 7 cases of 17 casees were done by combining it with cordarone 0 1～0 2g/d also. The other 7 cases were done by DDDR 85 bpm only.Conclusions Af prevention pacing may be benefit for patients with paroxysmal Af,especially with complicated symptomatic bradycardia.