Under pathologic conditions, nitric oxide causes peripheral insulin resistance by impairing key signal molecules of insulin signaling pathway and mediates dysfunction of islet ? cells caused by lipids, cytokines and hyperglycemia, which plays an important role in the pathogenesis of type 2 diabetes mellitus.

Objective:To explore the changes in somatosensory evoked potential (SEP) in rats with spinal cord injury (SCI) and the effects of relieving spinal cord compression at different times on recovery and the evoked potential.Methods:Seventy Sprague-Dawley rats were randomly divided into a control group of 10 and an experimental group of 60. The experimental group was further divided into a mild injury group of 10, a moderate injury group of 40 and a severe injury group of 10. Spinal cord injuries with different severities were established in the experimental group using a self-made percussion device. The rats′ SEPs were measured before the injury, and 5 minutes, 1 hour, 6 hours, 3 days and 7 days afterward. Some of the rats receiving decompression treatment.Results:The more seriously the spinal cord was injured, the longer was the latency and the smaller was the amplitude. Both differences were statistically significant. Rats with longer compression time had significantly longer incubation periods and greater decreases in the amplitude. After relieving the compression, rats from whom it had been relieved earlier had quicker amplitude recovery. For rats under compression for 30 minutes, their amplitude was the lowest seven days later.Conclusions:For spinal cord injury, longer compression time can lead to more significant changes in the latency and amplitude of SEP, with the change in the amplitude more significant than that in the latency.

Objective To analyze the clinical pathological characteristics of achalasia patients complicated by esophageal cancer.Methods From January 2005 to May 2013,among 658 patients with achalasia,the clinical data,pathological characteristics of tumor and the treatment of those complicated by esophageal cancer were collected and analyzed.At the same time,receiver operating characteristic (ROC) curve analysis was performed to analyze the relationship between the course of achalasia and esophageal cancer.Results Among the 658 patients with achalasia,297(45.1％) cases were male and 361(54.9％) cases were female.A total of 62 cases (9.4％) were lost to follow-up and of 596 cases who completed the follow-up,26 cases (4.4 ％) were complicated with esophageal cancer.Among the 26 patients complicated with esophageal cancer,69.2％ (18/26) were male;the course from achalasia diagnosed to esophageal cancer was (16.5±8.2) years.The patients with a disease duration more than 10 years accounted for 88.5％(23/26),and 80.8％ (21/26) underwent previous balloon dilatation or Heller surgery.The predilection site of esophageal cancer was in the middle esophagus of patients complicated by esophageal cancer (69.2％,18/26),the main type was squamous carcinoma (88.5％,23/26),65.4％(17/26) of the lesions invaded to muscular layer (stage T3 to T4),61.5％(16/26) had the late stage tumor (stage Ⅲ to Ⅳ),and 23.1％(6/26) had distant metastasis.The results of ROC curve analysis showed that when the duration was 10.5 years,the Youden index reached the maximum value (0.71).And 38.5％ (10/26) of patients with esophageal cancer could not be treated with esophageal cancer radical surgery,and their average survival time was (11.4±6.6) months.Conclusion The patients with the duration of achalasia over 10.5 years are required for regular endoscopic examination to improve the prognosis.

Objective To evaluate the diagnostic value of chest X-ray film of pulmonary emphysema (PE)signs for infantile bronchitis.Methods Clinical data of 60 infants with bronchitis (case group)in a hospital between Janu-ary 2010 and December 2014 were analyzed retrospectively,and compared with data of 30 infants with non-respira-tory diseases (control group).Results Of 60 infants with bronchitis in case group,95.00%(57/60)showed mani-festations of PE on X-ray,and 18.33% (11/60)of whom were with mild PE(apical or intercostal pneumocele), 76.67%(46/60)were with typical PE (diaphragm descent);one case (3.33%)in control group showed intercostal pneumocele,the other 29 cases (96.67%)were normal X-ray findings and without signs of PE.The sensitivity, specificity and accuracy of PE signs on chest X-ray film for diagnosing infantile bronchitis were 95.00%,96.67%, and 95.56% respectively.Conclusion Signs of PE on chest X-ray film have important diagnosis value for infantile bronchitis.

ObjectiveTo explore the advantages and disadvantages of different local anesthetic subarachnoid block in patients with cesarean section.Methods120 patients to be in the spinal-epidural cesarean section down,were randomly divided into 3 groups(n =40):lighter than restructuring( Q group),so the proportion of(D),heavy weight ( Z group).Q Group:0.75 ％ bupivacaine 2ml + sterile water for injection 1ml,D group:0.75 ％ bupivacaine 2ml + CSF 1 ml,Z group:0.75％ bupivacaine 2ml + 10％ glucose,1 ml,2ml of each group were given(10mg).Characteristics in each group anesthesia,blood pressure,heart rate,complications and postoperative neurological effects were observed.ResultsThree groups made the same anesthesia,patients satisfaction with anesthesia had no significant difference.Z group was significantly improved compared with block group D and Q group( t =8.3,7.3,all P ＜ 0.05 ),Z group was the highest plane analgesia group than the high D and Q,Z group was significantly longer than the duration of sensory block and Q group(P ＜0.05),Z group and D duration of sensory block had no significant difference.Z group was significantly greater than the impact of the cycle Q and D groups.Anesthesia hypotension,nausea and vomiting,weight was significantly lighter than the restructuring,such as the proportion of high group.ConclusionCesarean section in the three groups in the proportion of different local anesthetic achieved the same anesthesia,and spinal anesthesia and other medication had the proportion of liquid single,and it was relatively simple,safe and more suitable for cesarean section anesthesia.

Objective To evaluate the clinical effect of therapy of the trisacryl gelatin microspheres combinee the gelatin sponge particle on embolize the bronchial artery in acute massive hemoptic patients. Methods One huneree cases with massive hemoptysis were selectee as our subjects ane eivieee into control ane research group(n = 50 for each group). Patients in control group were given only gelatin sponge particle,ane in research group were given the trisacryl gelatin microspheres combinee the gelatin sponge particle to embolize the bronchial artery. All cases were followee up for more than 12 months. Ane the effect of therapy was recoreee. Results In research group,42 cases(84. 0% ,42 / 50)were got the bleeeing stop immeeiately after embolization,7 cases in 72 h(14. 0% ,7 / 50),ane the effective rate of hemostasis was 98. 0%(49 / 50). In the control group,41 case(82. 0% ,41 / 50)were got the stop bleeeing immeeiately,8 cases in 72 h(16. 0% , 8 / 50),ane the effective rate of hemostasis was 98. 0%(49 / 50). There was no statistic eifference between two groups(P > 0. 05). After more than one year follow-up,3 cases(6. 12% )were reoccurree in the therapy group ane 15 cases(30. 61% )was in the control group. The eifference was significant between two groups after surgery for one year( χ2 = 9. 801,P < 0. 01 ). There was no serious complication in patients of two groups. Conclusion The operation of BAE is effective therapy for the massive hemoptoe,ane it is provee to be a safe,effective ane lower rate of recurrence approach of the trisacryl gelatin microspheres combinee the gelatin sponge particle for eouble embolzation the bronchial artery.

Objective:To compare the effect of intracorporeal anastamosis and extracorporeal anastamosis on abdominal infection associated with laparoscopic right hemicolectomy.Methods:The clinical data of 210 patients with colon cancer who underwent laparoscopic right hemicolectomy in Dalian Third Peoples′s Hospital, Liaoning Province from January 2015 to December 2019 were analyzed retrospectively.Among them, 79 patients underwent intracorporeal anastamosis (intracorporeal anastamosis group) and 131 patients underwent extracorporeal anastamosis (extracorporeal anastamosis group). The perioperative indexes and postoperative abdominal infection were compared between the two groups.Results:In intracorporeal anastamosis group, the intraoperative bleeding was (45.2±4.2) mL, the operative time was (161.3±22.4) min, the number of lymph node dissection was (30.8±9.6), the postoperative exhaust time was (3.3±1.2) d, and the postoperative hospital stay was (7.6±0.5) d. In extracorporeal anastamosis group was (42.1±5.0) mL, (167.3±26.7) min, (32.9±8.6), (3.4±1.0) d and (7.5±0.6) d, respectively, there were no significant difference between the two groups (t value were 0.417, 0.207, 0.829, 0.338 and 0.293, respectively; P value were 0.699, 0.845, 0.231, 0.734 and 0.802, respectively). In intracorporeal anastamosis group, the incidence of abdominal infection (with anastomotic fistula)was 13.9%(11/79), the incidence of abdominal infection (without anastomotic fistula)was 10.1%(8/79), and in extracorporeal anastamosis group was 1.5%(2/131)and 0.8%(1/131), the differences were statistically significant (χ 2=12.805, 10.238; P=0.003, 0.008). In intracorporeal anastamosis group, the incidence of respiratory system infection was 1.3%(1/79), the incidence of urinary system infection was 2.5%(2/79), the incidence of surgical incision infection was 1.3%(1/79). In extracorporeal anastamosis group was 3.1%(4/131), 0.8%(1/131) and 3.1%(4/131), respectively.There were no significant difference between the two groups (χ 2 value were 0.662, 0.420 and 0.662, respectively; P value were 0.364, 0.587 and 0.364, respectively). Conclusion:Laparoscopic right hemicolectomy with intracorporeal anastamosis and extracorporeal anastamosis have the same surgical effect, but intracorporeal anastamosis may increase the risk of postoperative abdominal infection.

Objective To observe the clinical effect of Yanshu compound radix sophore injection combined with radiotherapy in treatment of patients with bone metastases from lung cancer. Methods A total of 116 patients with bone metastases from lung cancer admitted to the Department of Radiation Oncology of Gansu Provincial Cancer Hospital from January 2014 to December 2018 were selected. The 58 patients were treated by using three-dimensional conformal radiotherapy (3D-CRT), zoledronic acid and oxycodone sustained-release tablets (control group); the others 58 patients were treated radix sphore injection on basis of control group (integrated Chinese and western medicine). The two groups were treated continuously for 10 days as 1 course of treatment, taking a rest for one week in the middle, then they took the second course of treatment; after the end of 2 courses, the therapeutic effects were evaluated in the two groups. The pain grading, Karnofsky functional status (KPS) score and myelosuppression were observed before and after treatment in two groups, respectively. Results The proportions of patients with painless and mild pain after treatment in the integrated Chinese and western medicine group were significantly lower than those in control group [painless: 22.41% (13/58) vs. 39.66% (23/58), mild pain: 10.35% (6/58) vs. 46.55% (27/58)], while the proportions of patients with moderate pain and severe pain in the integrated Chinese and western medicine group were significantly higher than those of the control group [moderate pain: 53.45(31/58) vs. 12.07% (7/58), severe pain: 13.79% (8/58) vs 1.72% (1/58), both P < 0.05]. After treatment, the proportion of patients with improved KPS score in integrated Chinese and western medicine group was significantly higher than that in control group [55.17% (32/58) vs. 36.21% (21/58), P < 0.05], and the proportion of patients with stable and decreased KPS score were less than that of control group [stable KPS score:18.97%(11/58) vs. 27.59%(16/58), decreased KPS score:25.86% (15/58) vs. 36.21% (21/58)]. The proportions of patients with blood cell count (WBC), hemoglobin (Hb) and platelet count (PLT) showing no myelosuppression (at the zero degree) after treatment in integrated Chinese and western medicine group were obviously higher than those in control group [WBC: 77.59% (45/58) vs. 36.21% (21/58), Hb: 77.59% (45/58) vs. 70.69% (41/58), PLT: 58.62% (34/58) vs. 32.76% (19/58), all P < 0.05]. Conclusion Yanshu compound radix sphore injection combined with radiotherapy can reudce bone metastasis pain, reduce bone marrow suppression and improve quality of life in patients with advanced lung cancer and bone metastasis.

Objective To construct the LyP-1 targeted MR fluorescence dual-modality molecular probe for pancreatic cancer,and to observe its features and MRI charicteristics.Methods The 50 nm MR-fluorescent dual-modality molecular probe with surface modified with cyclic nine-amino acid peptide LyP-1 (Cys-Gly-Asn-Lys-Arg-Thr-Arg-Gly Cys) was rationally designed.Whether the molecular probe could specifically recognize the pancreatic cancer cells were validated by the combination of fluorescent imaging and MR T2WI.Results The new MR-fluorescent dual-modality molecular probe anchored with LyP-1 could be used for the fluorescent imaging and MR T2WI of pancreatic cancer in mouse.And the molecular probe was demonstrated to be effective in conjugating with pancreatic cancer cells on fluorescent images and caused obvious MR signal reduction under T2 relaxometry in vitro.In vivo experiment,the molecular probe could be used for fluorescent labeling tumor tissue and detecting orthotopic pancreatic cancer in C57BL/6 mouse as MR contrast agent.Conclusion The LyP1 immobilized MR-fluorescent dual-modality molecular probe can actively target to mouse orthotopic xenograft of pancreatic cancer,which is hopeful to the application in early probing and diagnosis of pancreatic cancer by multimodal imaging.

Objective:To compare the effect of midcaudal combined approach and the cephalic middle approach in laparoscopic complete mesocolic excision (CME) in the treatment of right colon cancer complicated with incomplete intestinal obstruction.Methods:From January 2014 to January 2019, 90 patients with right colon cancer complicated with incomplete intestinal obstruction admitted to the Third People′s Hospital of Dalian were retrospectively analyzed.All patients underwent laparoscopic right hemicolectomy, CME plus D3 lymph node dissection.According to the choice of different surgical approaches, 44 patients were treated with the midcaudal combined approach (observation group) and the other 46 patients were treated with cephalic middle approach (control group). The intraoperative, postoperative and complications of the two groups were compared statistically.Results:Compared with the control group, the bleeding volume in the observation group was significantly reduced ((105.3±22.6) ml vs.(309.6±28.0) ml, t=13.698), the operation time was significantly shortened ((165.2±17.9) min vs.(219.5±21.5) min, t=8.327), and the differences were statistically significant (all P<0.05). There were no significant differences in the number of lymph nodes dissected ((21.4±7.8)vs.(20.4±6.6), t=0.534), the proportion of lymph nodes dissected≥12(86.4%(38/44)vs.84.8%(39/46), χ 2=0.208), the complications after operation(6.8%(3/44)vs.10.9%(5/46), χ 2=0.318), the length of hospital stay after operation ((11.8±1.6) d vs.(12.5±2.3) d, t=0.986), the difference was statistically significant (all P>0.05). Conclusion:It is safe and feasible to use the middle caudal approach in laparoscopic CME for right colon cancer complicated with incomplete ileus. Compared with the cephalic middle approach, it can reduce thebleeding volume and shorten the operation time.