Objective To investigate the therapeutic effect and safety of laparoscopic surgery for adrenal tumors. Methods 90 cases of adrenal tumors patients from March 2013 to March 2016 were selected as study subjects and divided into laparoscopic group (48 cases) and open surgery group (42 cases) according to the wishes of the patients. The levels of inflammatory cytokines, gastrointestinal integration, complications and recurrence rate were compared between the two groups. Results The operation time, length of hospital stay, recovery time of bowel function, extubation time and postoperative lead flow rate in laparoscopic group were less than that in the open surgery group (P < 0.05). Before surgery, the level of WBC, NEU%, CPR and IL-6 of the two groups had no significant difference, 1, 3, 5 days after surgery, the level of WBC, NEU and IL-6 groups were all decreased, but the observation group decreased more significantly. The CPR concentrations of the two groups of children in the first day after surgery were experiencing a peak period, after the first 3 days and 5 days which decreased than the first day, but still higher than before the surgery, postoperative group of children CPR concentration of each period were lower than that in control group (P < 0.05). After surgery, patients in the laparoscopic group borborygmus, abdominal pain and gastrointestinal reaction scores were significantly lower than that in laparotomy group (P < 0.05); In the laparoscopic group, the incidence of peritoneal injury and postoperative retroperitoneal hematoma, incision infection, incision hernia and adrenal insufficiency was significantly lower than that in the open group (P < 0.05), there was no significant difference in recurrence rate between the two groups (P > 0.05). Conclusions Laparoscopic adrenal surgery is simple, which can reduce the amount of bleeding and reduce the incidence of postoperative complications, it is worth of promoting clinical application.

BACKGROUND:The animal model of high fat diet-induced obesity is the first choice for the study of human obesity. Leptin and its receptor expression play an important role in the high fat diet-induced obesity and obesity resistant, but the exact mechanism and the role of swimming are not clear.
OBJECTIVE:To explore the effect of 7-week swimming on serum leptin and leptin receptor expression in hypothalamus in rats with high fat diets.
METHODS:A total of 60 Sprague-Dawley rats were fed with high fat diets for 8 weeks. Thediet-induced obeseand obese resistant rats were selected based on the body weight. 14 obese rats were equaly divided into two groups: obese group and obese-exercise group; and 14 obese resistant rats were equaly divided into two groups: obese resistantgroup and obese resistant-exercise group. Al the rats were continualy given high fat diets. Exercise groups accepted free swimming training for 7 weeks at the same time.
RESULTS AND CONCLUSION:Compared with the obese group, obese-exercise group had obviously decreased in body weight, fat pad weight, fat pad weight/body weight and serum leptin concentration. And obese-exercise group had obviously increased receptor mRNA expression in hypothalamus. There was no significant change in above indexes betweenthe obese resistant group and obese resistant-exercise group. Theresults showed that swimming exercise can increase energy consumption and improve metabolism, which decreased the concentration of leptin and effectively improved leptin receptor expressionin the hypothalamus to ease leptin resistance and improve the body’s metabolism.

Objective To investigate the curative effect and the clinical value of double intervention in treating recurrent cancer on the stump of stomach after radical operation of gastric antrum.Methods 11 patients with recurrent cancer and stricture on the stump of stomach were treated with stent implantation and celiac arterial chemotherapy. 2 patients with ascites were treated with intravenous chemotherapy at first ,3 patients with hepatometastatic carcinorma were treated by embolization with lipiodol.All patients were retreated with celiac chemotherapy according to their healthy state after three or four weeks. All patients were fllowed-up.Results After therapy 6 months,12 months and 18 months survival rate were 63 6%,45% and 18% respectively,average survive 12 months.Conclusions Celiac arterial chemotherapy and stent implantation can prolong the survival period of the patients with recurrent cancer on the stump of stomach after radical operation for carcinoma of gastric antrum and improve their living quality.

Objective:To determine the shear bond strength and analyze the bonding mechanism of home-made and imported nickel-based alloys to resin-veneers.Methods: Home-made and imported alloy disks were cast by lost-wax technique and embedded in acrylic resin fabricating cylinders.Sixteen specimens of each alloy were divided into 2 subgroups: thermocycling group and non-thermocycling group.Specimens in thermocycling groups were submitted to thermocycling(300 cycles) and those in non-thermocycling groups were just stored in water at 37?C for 24 h(0 cycles).Then the shear bond strength values were determined by universal testing machine.The highest shear bond strength values were recorded and metallurgical analysis was performed on the interface between alloys and resin-veneers.Results: The shear bond strength values of both alloys to resin-veneers were relatively high either before or after thermocycling.The shear bond strength values of home-made alloy+thermocycling group,imported alloy+thermocycling group,home-made alloy+non-thermocycling group and imported alloy + non-thermocycling group were(10.50?2.72),(13.12?2.82),(15.51?3.04) and(18.44?3.15) MPa,respectively.The bond strength was significantly different before and after thermocycling for both alloys(P

In order to adapting the course construction of anatomy to the needs of medical education in the new situation,we analyzed and summed up the effect of the course construction of anatomy,and put forward some measures such as working out the plan of course construction sci-entifically,perfecting teachers’training,upgrading content of course as well as the teaching methods and means,strengthening the teaching of experiment,reforming the means and contents of evalua-tion and paying attention to the cultivation of students’innovation and manipulative ability.

Objective To explore the early diagnosis value of C‐reactive protein (CRP) and procalcitonin (PCT ) for bacterial in‐fectious pneumonia of children .Methods A total of 101 children with bacterial infectious pneumonia ,64 children with non‐bacterial infectious pneumonia and 73 children with non‐infectious disease were selected in bacterial infectious pneumonia group ,non‐bacterial infectious pneumonia group and non‐infectious disease group respectively .Serum PCT and CRP levels were measured before treat‐ment in the three groups .With sputum culture results as gold standard for the diagnosis of bacterial infectious pneumonia ,the sensi‐tivity ,specificity ,positive predictive value ,negative predictive value ,Youden index and diagnostic accuracy of PCT ,CRP ,PCT /CRP series test and parallel test were calculated for bacterial infectious pneumonia diagnosis .Results The levels of PCT and CRP of children in bacterial infectious pneumonia group were significant higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group(P < 0 .05) .The sensitivity ,specificity ,positive predictive value ,negative predictive value , Youden index and diagnostic accuracy of PCT ( ≥ 0 .5 ng/mL as the best intercept point) for bacterial infectious pneumonia diagno‐sis were 0 .743 ,0 .719 ,0 .806 ,0 .639 ,0 .461 and 0 .733 .And the same values for PCT /CRP series test were 0 .604 ,0 .875 ,0 .884 , 0 .583 ,0 .479 and 0 .709 respectively .All the values were higher than those of children in non‐bacterial infectious pneumonia group and non‐infectious disease group except sensitivity .Conclusion The combination of PCT and PCT /CRP series test is ideal method for early diagnosis of bacterial infectious pneumonia with high sensitivity and specificity .

OBJECTIVETo investigate the treatment for tibial exposure wounds.

METHODS39 patients with tibial exposure wounds were divided into three groups according to the exposure location (upper, medium and below). The local muscular flaps were designed to cover the tibial exposure, followed by skin grafts and VSD. VSD was removed one week later.

RESULTSAll the muscular flap and skin graft survived. Mild epidermis erosion happened in 2 cases, which healed spontaneously after dressing. The patients were followed up for 3-6 months with good healing and no walking malfunction.

CONCLUSIONSThe local muscular flap combined with skin graft and VSD is a simple and effective method for tibial exposure wound with short healing time and high successful rate.

Humans ; Lacerations ; surgery ; Skin ; injuries ; Skin Transplantation ; Surgical Flaps ; Tibia ; Time Factors ; Treatment Outcome ; Wound Healing

Objective To discuss changes of accompanying femoral artery and vein blood gas in patients with burn sep?sis. Methods The retrospective data of twenty-two patients with burn sepsis and forty-three non-sepsis patients (control) was analyzed, and changes of accompanying femoral artery and vein blood gas were compared between two groups. Results Results of femoral artery gas analysis showed that the HCO3-concentration was lower in sepsis group than that of control group. Results of femoral vein blood gas showed that the partial pressure of carbon dioxide [p(CO2)] was higher in sepsis group than that of control group;the oxygen saturation (SvO2) and HCO3-concentration was lower in sepsis group than that of control group (P<0.01). The differences between oxygen partial pressure p(O2), p(CO2), HCO3-concentration, oxygen satura?tion of femoral artery and vein blood gas were significantly higher in sepsis group than those of control group ( P<0.01). Conclusion Results of femoral vein blood gas analysis change obviously in patients with burn sepsis . The detection of accompanying femoral artery and vein blood gas is beneficial to diagnosis of burn sepsis.

Background Oxidative stress is a main cause of age-related macular degeneration (AMD).Lutein has a preventive role for AMD, but its antioxidant mechanism remains unclear.Objective Present study was to investigate the effect of lutein on oxidative stress of Müller cells and its signaling pathway.Methods Human Müller cells (human Müller cell strain) were cultured, and the cells at logarithmimic growth phase were incubated in 96 well plate overnightly.Oxidative stress cell models were established by adding 160 μmol/L H2O2, a median lethal dose for Müller cells.The models were divided into the model control group and 12.5,25.0,50.0 mg/L lutein groups,and the different concentrations of lutein were used to culture the cells for 24 hours, respectively.The routine cultured cells served as the blank control group.Growth of the cells was assayed by MTT method (absorbancy);the reactive oxygen species (ROS) content in the cells was assayed by flow cytometry;the mRNA and protein levels of nuclear factor-E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in the cells were detected by quantitative real-time PCR and Western blot, respectively.Results The inhibitory effects on the cells were gradually enhanced with the increase of H2O2 concentrations,showing a significant difference among the groups (F =43.890,P＜0.01).A significant difference was found in apoptotic rate of the cells among the blank control group,model control group and 12.5,25.0,50.0 mg/L lutein groups (F =346.770, P =0.000) , and the apoptosis rate was significant elevated with the increase of lutein dose (all at P＜0.05).The ROS contents in the cells were 1.92±0.18,64.89±2.86,52.70±2.80,32.61 ±4.20 and 5.68 ± 1.35 in the blank control group, model control group and 12.5,25.0,50.0 mg/L group, respectively, with significant difference among the groups (F =324.900, P =0.000), and the ROS content was gradually reduced as the increase of lutein dose (all at P＜0.05).The relative mRNA and protein expressions of Nrf2 and HO-1 were remarkedly higher in the 12.5,25.0,50.0 mg/L lutein groups than those in the model control group (F =236.960,242.620,186.830,263.120, all at P =0.000) , and no significant difference was seen in the relative expression level of nuclear Nrf2 protein among the groups (F =1.790, P =0.210).Conclusions Lutein can induce the expression of antioxidant enzymes by inducing the expression of nuclear translocation of Nrf2 and consequently inhibit the oxidative stress status.

Objective To know the establishment of the flap pedicle blood supply and the right moment of the cutting off of pedicle by means of laser Doppler blood perfusion imaging instrument on the random flap blood flow changes.Methods 20 adult healthy rabbits were divided in to four groups and each 5 have unilateral flaps.1,3,5,7,9,12,14,18 days after operation,the pedicle blood perfusion values (PU) measurement of the distal pedicle on the flap and midpoint of both ends of the pedicle were performed,and PU values were analyzed.Results Pedicle of the PU values at the different time points changed little (P＞0.05).The PU value in the distal flap reached the minimum 1 day after operation and then increased gradually [3 d (1.24±0.07),5 d (1.57±0.15),7 d (1.79±0.08),9 d(1.89±0.13),12 d(2.01±0.16),14 d(2.18±0.09) and 18 d(2.40±0.18),P＜0.05].When distal PU values/pedicle PU value≥1.2,the flap survival rate reached 99%.Conclusions The establishment of random skin flap blood circulation,as well as the ratio of PU values of distal to the pedicle flap pedicle can be used as the timing of an important indicators.