Objective To investigate the optimal time for capsule endoscopy in patients with obscure gastrointestinal bleeding (OGIB) .Methods Data of 76 patients with OGIB underwent capsule endoscopy from January 2013 to December 2014 were retro‐spectively analyzed .They were classified into two groups :emergency capsule endoscopy and non‐emergency capsule endoscopy .The demographic and clinical features and outcomes of capsule endoscopy ,complications and the times of hospital stays and hospitaliza‐tion expenses were compared .Results The overall diagnostic yield of capsule endoscopy was 48 lesions(63 .15% ) .The overall di‐agnostic yield of emergency capsule endoscopy group was 73 .68% (28/38) ,which was significantly higher than that in non‐emer‐gency capsule endoscopy group(52 .63% ,20/38) ,with statistical difference (P< 0 .05) .Conclusion Emergency capsule endoscopy have a higher rate of detection ,patients with OGIB should receive capsule endoscopy as soon as possible .

Objective To investigate the clinical significance of B-type natriuretic peptide(BNP) in the process of fluid resuscita-tion with different crystalloid-colloid ratio in the patients with severe acute pancreatitis (SAP) .Methods Clinical data of 85 SAP patients were analyzed retrospectively in the Emergency Center of Chongqing during January of 2010 to December of 2012 .Early goal-directed therapy(EGDT) was confirmed the end criterion of the end point of resuscitation .Low crystalloid-colloid ratio group (n=45) and high crystalloid-colloid ratio group(n=40) were divided according to crystalloid-colloid ratio (3∶1) as the borderline , BNP were observed at the time point of before fluid resuscitation ,and 1 ,2 ,3 days after resuscitation and the day before discharge . Results Different fluid resuscitation of crystalloid-colloid ratio could improve hemodynamics in patients ,BNP increased with the to-tal amount of resuscitation liquid ,were positively correlated with liquid volume .The total amount of fluid of the high crystalloid-colloid ratio group was significantly higher than that of the low crystalloid-colloid ratio group .Conclusion BNP could guide early fluid resuscitation and low crystalloid-colloid ratio should be adopted for SAP patients .

Objective To study the changes of Young's modulus value of the renal cortex,vertebral body and sinus when there was a different degree of acute renal artery stenosis.Methods 10 Japanese white rabbits were used for this study.The left renal artery was dissected.An ultrasound probe was placed on the left kidney,Young's modulus of the renal cortex,vertebral body and sinus were recorded using shear wave ultrasound elastic imaging technique during three stages:when the renal artery was intact (0％ stenosis),tied with a suture (＞ 50％ stenosis),and ligated (100％ stenosis).Renal tissue elasticity with different degrees of renal artery stenosis were compared.Pathological study was carried out in the kidneys,each with either 0％,＞ 50％ or 100％ renal artery stenosis.Results The mean values of Young's modulus from the renal cortex,vertebral body and sinus with different degrees of renal artery stenosis were as follows:0％ stenosis,(16.31 ±1.70) kPa,(13.38± 1.63) kPa,and (12.75±2.26) kPa;＞ 50％ stenosis,(14.16±2.34) kPa,(11.49±2.70) kPa,and (10.72±2.56) kPa;100％ stenosis,(11.35 ± 1.48) kPa,(8.39± 1.29) kPa,and (7.08 ± 1.52) kPa.The mean value of Young's modulus from the renal cortex was significantly higher than those from the renal vertebral body and sinus (P ＜ 0.05).The mean values of Young's modulus from different parts of the kidney decreased progressively with an increase in renal artery stenosis (P ＜ 0.05).The pathological study demonstrated that with the increase in the severity of renal artery stenosis,glomerular volume,renal interstitial capillary diameter and red blood cells decreased.When renal artery stenosis reached 100％,there was patch degeneration and inflammatory cell infiltration within the renal interstitium,and mild degeneration of tubular epithelial cells with obscure cell borders.Conclusions The value of Young's modulus from the renal cortex was higher than those from the renal pyramid and sinus in rabbits.The values of Young's modulus from the renal cortex,pyramid and sinus decreased with an increase in the severity of renal artery stenosis,which suggest that,in the study of the elasticity of the kidney,the renal artery blood flow dynamic state can obviously affect the value of the elasticity of the kidney.

Objective To evaluate the effects of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on weight control in morbidly obese patients.Methods 48 patients with morbidly obesity underwent obese surgery (laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) from Dec.2013 to Dec.2015,and 1-year follow-up study.The general situation of obesity and biochemical indicators were compared and analyzed.Results There were 20 cases in gastric bypass group and 28 cases in sleeve gastrectomy group.The excess weight loss percentage(％EWL)was 73±0.04 in gastric bypass group and 59±0.05 in sleeve gastrectomy group(P=-0.03).There was no statistical difference in weight change between the two groups.Low density lipoprotein cholesterol (LDL) level in gastric bypass group was significantly lower than that in sleeve gastrectomy group at 1 year after surgery (2.42±0.16 vs 3.29±0.20,P=0.006),while folic acid level was significantly higher than that in sleeve gastrectomy group(15.58±1.99 vs 7.59±1.59,P=0.022).Conclusions The one-year follow up shows there is no significant difference in the efficacy of weight control between the two groups.Gastric bypass group may be superior to gastrectomy group in nutrition indexes.However,it is just a short-term postoperative efficacy in morbidly obese patients,long-term weight control effects and obesity related diseases control need to be further explored.

Objective To study the effect of heterogeneity in different parts of acute and chronic deep venous thrombus on the ultrasound shear wave elasticity value.Methods Fifteen Japanese rabbits were used to create an inferior vena cava (IVC) thrombus model via IVC ligation.Young's modulus of the thrombus head,body and tail were measured using ultrasonic shear wave elasticity technique on the fifth day (acute phase) and 14th day (chronic phase) of thrombus formation.Pathological sections were obtained from the IVC thrombus in five rabbits at the two points of time mentioned above.Pair t-test and one-way analysis of variance (ANOVA) were used to compare the data between groups.Results On the fifth day,Young's modulus values of the thrombus head,body and tail were (5.73 ±0.47)kPa,(7.82±0.63)kPa and (4.76±0.45)kPa respectively.ANOVA showed significant difference among three parts (F=134.468,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the head and tail (both P ＜ 0.01),and the value of the head was significantly higher than that of the tail (P ＜ 0.01).On the 14th day,Young's modulus values of the thrombus head,body and tail were (12.46 ± 2.59)kPa,(15.08 ±2.71)kPa and (10.03 ± 2.02)kPa,respectively.ANOVA analysis also showed significant difference among three parts (F=10.539,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the tail (P ＜ 0.01),and also higher than that of the head,although the difference was not significant (P ＞ 0.05).There was no significant difference between the head and tail (P ＞ 0.05).Young's modulus values of the thrombus head,body and tail in the chronic phase were significantly higher than those in the acute phase (t=-7.456,-7.989 and-8.159,respectively,all P ＜ 0.01).Pathological results showed that there was significant difference in thrombus structure and composition among different parts of the thrombus and among the thrombi in different individuals at corresponding points of time following thrombus formation.Conclusion There is significant heterogeneity among different parts of the same thrombus and among different thrombi at corresponding points of time after thrombus formation.Continual monitoring of the thrombus with ultrasound elasticity imaging may help to improve the accuracy of thrombosis staging.

Insulin is produced and secreted by pancreatic β cells in the pancreas, which plays a key role in maintaining euglycemia. Insufficient secretion or deficient usage of insulin is the main cause of diabetes mellitus (DM). Drug therapy and islets transplantation are classical treatments for DM. Pancreatic β cell replacement therapy could help patients to get rid of drugs and alleviate the problem of lacking in transplantable donors. Pancreatic β-like cells can be acquired by cell reprogramming techniques or directed induction of stem cell differentiation. These cells are proved to be functional both in vitro and in vivo. Some hospitals have already performed clinical trials for pancreatic β cell replacement therapy. Functional pancreatic β-like cells, which obtained from in vitro pathway, could be a reliable source of cell therapy for treating DM. In this review, the approaches of obtaining pancreatic β cells are summarized and the remaining problems are discussed. Some thoughts are provided for further acquisition and application of pancreatic β cells.
Cell Differentiation ; Diabetes Mellitus/therapy* ; Humans ; Insulin/metabolism* ; Insulin-Secreting Cells/metabolism* ; Islets of Langerhans Transplantation ; Pancreas/metabolism*