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.

OBJECTIVEThis study aims to assess the effects of desensitizing toothpaste containing stannous fluoride on dentine hypersensitivity by performing Meta-analysis of randomized controlled trials (RCT) involving the treatment of dentine hypersensitivity with stannous fluoride-containing toothpaste.

METHODSThe study was developed based on the Cochrane handbook for systematic reviews of interventions (Version 5.1.0) and included the following: search strategy, selection criteria, data extraction, and risk of bias assessment. We searched electronic databases such as CNKI, CBM, PubMed, Embase, and Cochrane Library up to January 2015. RCT of treating dentine hypersensitivity with stannous fluoride-containing toothpaste were included. Data extraction and domain-based risk of bias assessment were independently performed by two reviewers. Meta-analysis was performed with RevMan 5.3 software.

RESULTSSix RCT with 494 patients (247 in the experimental group and 247 in the control group) were included. The results of Meta-analysis showed that the desensitizing effect of stannous fluoride-containing toothpaste was significantly better than that of control in tactile sensitivity test (SMD=1.41, 95% confidence interval 0.74-2.09, P<0.00001) and air blast test (SMD = -1.16, 95% confidence interval -1.84--0.48, P<0.000 01).

CONCLUSIONCurrent evidence shows that stannous fluoride-containing toothpaste is effective in treating dentine hypersensitivity in clinic. However, due to limited sample size and lower quality of the included studies, more high quality and large-sample RCT are needed to further verify the evidence.

Dentin Desensitizing Agents ; therapeutic use ; Dentin Sensitivity ; drug therapy ; Humans ; Randomized Controlled Trials as Topic ; Sodium Fluoride ; Tin Fluorides ; therapeutic use ; Toothpastes ; therapeutic use ; Treatment Outcome

Objective:To retrospectively evaluate the therapeutic efficacy of two different surgical approaches, Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway, in the treatment of middle thoracic esophageal squamous cell carcinoma. Methods:One hundred and two patients from 167 patients with middle thoracic esophageal squamous cell carcinoma received Ivor-Lewis esophagectomy and another 65 patients received 2-incision esophagectomy via left thoracic-cervical pathway. The local recurrence rate of tumor and survival rate were calculated by using Kaplan-Meier method. The difference in the survival rate between the two surgical methods was analyzed by using log-rank test. The prognostic risk factors were assessed by COX regression analysis. Results:Peri-operative complications occurred in 35 patients (21.0%), in which the incidences of recurrent laryngeal nerve (RLN) injury and anastomotic leakage were higher in the left thoracic-cervical group (P<0.05), and the incidence of intrathoracic gastric retention was higher in the Ivor-Lewis group, but the difference was not significant. The 3-year local recurrence rate was 37.3% in the Ivor-Lewis group, and 40.0% in the left thoracic-cervical group. The difference was not significant (P>0.05). The overall 5-year survival rate of the 167 patients was 34.6%. It was 36.0% in the Ivor-Lewis group and 32.3% in the left thoracic-cervical group, respectively (P>0.05). COX regression analysis revealed that pTNM staging was the independent prognostic factor [P=0.000, HR(hazard ratio)=2.69]. Conclusion:Both Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway are feasible alternatives in the treatment of middle thoracic esophageal squmamous cell carcinoma. We should choose the rational operative method based on the patients'individual condition.