Objective To investigate what kind of obese patients appropriate to adopt the laparoscopic adjustable gastric banding volume reduction surgery.Methods A retrospective study was performed to review the clinical data of 40 patients who required reoperation to remove the gastric banding after LAGB from November 2003 to March 2013 at the Department of Minimally Invasive Surgery,Changhai Hospital.Selected 40 patients who required LAGB from January 2006 to October 2008 as control group.We conducted a case-control study to analyze.Chi-square test and multivariate and non-conditional Logistie regression analysis were used to identify the risk factors of removing of gastric banding.Results Age and gender were not statistically significant different (P ＞ 0.05).Multiple factors of Logistic regression showed that BMI≥35 kg/m2,postoperative clinic visits per year ＜ 3 and on the basis of gastrointestinal disease were risk factors for the removal of gastric banding (Wald =3.908,7.375,5.209,P ＜ 0.05).Conclusion The risk factors for the removal of gastric banding include BMI,postoperative clinic visits and the basis of gastrointestinal disease.In the treatment of obesity with LAGB should take full account of the above factors.

: Objective To explore the approaches for the pressure sores in patients with paraplegia using drainage tube. Methods 19 cases of pressure sore accepted continuous drainage after thorough debridement were reported. Results 18 cases cured, one infected in wound and dehisced partly, and cured after suture. They were followed up for 1～24 months, and none relapsed. Conclusion Strengthening the nursing of drainage tube can wash out necrotic material intralesion, which would improve the outcome.

Objective To investigated the effects of IL -18 on middle ear allergic inflammation in rat model of OME .Methods Eighteen SD rats were randomly divided into three group :group A(control group ,n=12 ears) , group B (OME model group ,n=12 ears) ,group C (IL -18 injectiion group ,n=12 ears) .The rat model of OME was established by sensitizing with ovalbumin (OVA) and later challenging in tympanic bullae .Recombinant rat IL-18 (1 μg ,+0 .2 ml saline ,) were injected in group C at 1 ,2 ,7 ,8 ,15 ,16 day .At the same time sacle ,0 .2 ml sa-line ,instead of IL -18 ,were intraperitoneal injection in group A and B .The morphologic changes of the middle ear epithelial cells and inflammatory cells infiltration were observed under light microscope .The level of IFN -γand IL-4 in tympanic lavage fluid(TLF) were determined by ELISA .Results Pathological examination showed that middle ear mucosa inflammation and eosinophil infiltration in group C were no less severe than group B .The numbers of neutrophils in group C increased significantly compraring with group B (P<0 .05) .Numbers of eosinophils in group C were slightly increased comparing with group B (P>0 .05) ,while significantly greater than that in group A (P<0 .05) .ELISA showed that the level of IFN -γ in group C was stronger than that in group B and A (both P<0 .05) .As compared to the group A ,the expression of IL -4 in group B and group C were remarkably stronger (both P<0 .05) ,no significant difference was found between group B and group C (P>0 .05) .Addtionally ,there was no significant difference in the ratio of Th1 /Th2(IFN -γ/IL -4)between group B and group C (P>0 .05) . Conclusion IL -18 acts as an immune regulatory factors ,significantly increases Th1 cytokine IFN -γ.Although to some extent alleviate the OME rat middle ear Th1 /Th2 imbalance ,there is still excessive activation of Th cells . Th1 and Th2 cells factor are excessive for the secretion disorder of the immune response status .The OME rat mid-dle ear allergic inflammation has not been fundamentally alleviated ,the underlying mechamism should be further studied .

Objective: To investigate the relationship between chemosensitivity to L-OHP and expressions of multidrug resistance (MDR) associated factors in lymph node metastases (LNMs) of gastric carcinoma. Methods: The chemosensitivity to L-OHP was measured by MIT assay, and the expressions of P-gp, GST-π, P53, Survivin and Bcl-2 were determined by immunohistochemistry in 54 paired primary tumor (PT) and LNMs of gastric carcinoma. Results: The inhibition rates of LNMs cells for L-OHP were lower than those of PT (P<0.05). The expressions of P-gp, GST-π and Bcl-2 were higher in LNMs than in PT (P<0.05), and no signifi-cant difference was found in the expression of P53 and Survivin between LNMs and PT (P>0.05). Positive cor-relations among P-gp, P53 and Bcl-2 were found in PT and LNMs (r=0.3424, 0.7123, 0.4548, P<0.05). There was no significant difference in the expression of GST-π and Survivin between PT and LNMs (P>0.05). There was statistically negative correlation between inhibition rates and expression of P-gp, GST-π, and Survivin in PT (P<0.05). In LNMs, only Survivin was negatively correlated with inhibition rates of L-OHP (P<0.05). Conclu-sion: The LNMs of gastric carcinoma are heterogeneous with PT in respect to chemosensitivity to L-OHP and expression of multidrug resistance associated factors. The main factors that affect chemosensitivity to L-OHP are also significantly different between PT and LNMs. Effective adjuvant chemotherapy after surgery and re-version to multidrug resistance (MDR) of gastric carcinoma depend on targeting the metastatic lesions of gas-tric carcinoma.

This study was aimed to observe the body weight and behavioral changes of heart-spleen deficiency mouseandtoassesstheefficacyofLing-Qi-Jia (LQJ)oralsolutiononqi-supplementingandmind-tranquilizing. The heart-spleen deficiency syndrome mouse model was established by using loading swimming anddrugdaily.Thebodyweight,foodconsumption,intestinepropulsion,tailsuspensiontest (TST),forced swimmingtest (FST),sleepingtimeandtheamountofbrainneurotransmitterweredetected.Theresultsshowed that mouse suffered loading swimming and drug formed heart-spleen deficiency syndrome model, which were indicated by lowering body weight and food consumption, shortened time in FST, prolonged accumulative immobility time in TST, intestine propulsion hyperfunction, shortened sleeping time and lowering brain neurotransmitter amount. LQJ oral solution can obviously improve experiment indexes mentioned above. It was concluded that LQJ oral solution, which can improve insomnia due to heart-spleen deficiency, might had close relation to the efficacy of qi-supplementing and mind-tranquilizing. Meanwhile, changes of brain neurotransmitters might also be the material basis on its efficacy.

[Summary] The activities of 17α-hydroxylase and 17,20 lyase of cytochrome P450c17 were evaluated by ELISA in NCI-H295R cells after treatment with palmitate and oleate. The results showed that 0. 75 mmol/L plamitate did not influence the activity of 17α-hydroxylase, but increased the activity of 17, 20 lyase by 74. 3% ( P<0. 05). Oleate at the same concentration did not change the activity of 17,20 lyase. There were no significant changes in the protein expressions of P450c17, P450 oxidoreductase, and cytochrome b5 after treatment with palmitate and oleate. However,reactive oxygen species in cells were elevated by palmitate. The results suggest that exposure to palmitate may increase androgen production by inducing 17, 20 lyase activity of P450c17 in NCI-H295R cells, which is related with oxidative stress-mediated post-translational regulation of the enzyme.

BACKGROUND:Previous animal experiments have demonstrated that mandibular advancement can cause the remodeling of temporomandibular joint tissue of young SD rats. This is mainly characterized by accelerated growth rate of the condyle tissue and secondary growth of mandible. But the ultrastructural remodeling of condylar chondrocytes remains poorly understood. OBJECTIVE:To observe the histological and ultrastructural variations of reconstructed condylar cartilage of young rats under the effect of continuous mandibular advancement. METHODS:SD rats aged 4 weeks were randomly divided into control and experimental groups. Rats in the experimental group were subjected to mandibular advancement for 24 hours and sacrificed at 3, 7, 14, 21 and 30 days of intervention. Condylar cartilage samples were harvested and their histological and ultrastructural changes were observed under optical microscope and transmission electron microscope. RESULTS AND CONCLUSION:After 14 days of intervention, the thickness of condylar cartilage in the experimental group increased first and then became thin in the period of observation. The cartilage thickness variations in the postmedian condylar were significant (P < 0.01). After 7 days of intervention, the ultrastructure of condylar chondrocytes was reconstructed, including intracelular karyopyknosis, rough endoplasmic reticulum compartment sweling, smaler even absent lipid droplets, less and irregular microfilaments around the nucleus, broadened and increased extracelular matrix and the emergence of large gaps. These results demonstrate that under continuous mandibular advancement, the rat condylar cartilage wil become thick or thin with the endurance time, and chondrocyte matrix synthesis ability wil be significantly enhanced.

Objective:To study the combined use of endoscopic balloon dilation with endoscopic biliary brushings in diagnosis of bile duct strictures.Methods:A prospective single center study was conducted at the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. All patients with suspected malignant bile duct strictures shown on CT or MRI imaging from January 2018 to January 2020 were reviewed. All patients gave informed consent to the endascopic retrograde cholangiopancreatography procedures. Their clinical and follow-up data were analyzed. All patients underwent endoscopic balloon dilation of bile duct strictures. Before and after balloon dilation, biliary brush cytology was performed, and the results were used to classify the patients into the control group and the experimental group. Pathological examination of the brush cytology samples was carried out by a single chief pathologist. Presence of cancer cells or significant heterogeneous cells indicated a positive brush cytology test. Negative patients who still highly consider cholangiocarcinoma and agree to surgery and whose gross specimen is confirmed to be malignant after surgery should be considered as false negative by brush examination; it is difficult to judge that patients with cholangiocarcinoma have progress after 2 months of follow-up should be considered as false negative by brush examination. Any progression of disease indicated that the brush test was wrong and the test was again classified as false negative. Only when there was no progression of strictures was the possibility of a benign biliary stricture being considered. The advantage test (McNemar test) was used to analyze the difference between the two diagnostic methods.Results:Of 39 patients who were included in this study, there were 26 males and 13 females, with an age of (68.0 ± 5.2) years. Cholangiocarcinoma was diagnosed by histopathology, surgery or at 2 months follow-up in 35 patients. In the control group, 17 patients had a positive brush test (sensitivity rate was 48.6%, 17/35). In the experimental group, 26 patients had a positive brush test (sensitivity rate was 74.2%, 26/35). In addition, 2 patients in the control group had a positive brush test, while in the experimental group, a negative brush test. A total of 28 patients were positive in the two groups. The sensitivity rate of the brush test was 80.0% (28/35). There were significant differences between the two groups ( P<0.05). Conclusion:Endoscopic balloon dilation combined with endoscopic biliary brushings improved the sensitivity of pathological diagnosis of cholangiocarcinoma, and endoscopic biliary brushings before and after balloon dilation improved the sensitivity of diagnosis.

Objective To observe Rongxin Pills in the treatment of viral myocarditis in children (deficiency of both qi and yin and heart meridian stasis syndrome) and the effectiveness and clinical application of safety.Methods Viral myocarditis patients (280 cases,deficiency of both qi and yin and heart meridian stasis syndrome),according to 3:1 ratio as the test group (n =21 0) and control group (n =70).The test group took orally Rongxin pills each time 4.5～9 g,3 times daily;the control group oral coenzyme Q10 capsule each time 10 ～ 20 mg,twice daily.The course of treatment was 28 d.The experiment was carried out with the random and double blind method.The symptoms of myocarditis,integrated and electrocardiogram,echocardiography,myocardial enzymes,as well as the efficacy of traditional Chinese medicine and improvement of the effect of the disease were observed.Results The results of FAS (PPS) analysis showed that 28 d after treatment,the symptom score and mean of experimental group and control group were 5.975 (6.000) and 4.721 (4.788).The syndromes of the total effective rates were 91.62％ (90.59％) and 70.59％ (71.21％),curative effect the total effective rates were 90.14％ (92.08％) and 72.06％ (72.73％).The total effective rate of experimental group was higher than that of the control group,the difference was statistically significant.In this experiment,three cases of clinical adverse events were reported,which were not related to the experimental drug.It also not belongs to adverse drug reactions.Conclusion Rongxin Pill in the treatment of viral myocarditis in children (deficiency of both qi and yin and heart meridian stasis syndrome) is more effective than coenzyme Q 10 capsule,and there was no indication of higher risk of clinical application.

Objective To explore the protective effects of proanthocyanidins pretreatment on intestinal function after cerebral ischemia-reperfusion injury. Methods 24 Sprague-Dawley rats were randomly divided into sham group (group A, n=8), ischemia-reperfusion group (group B, n=8) and proanthocyanidins pretreatment group (group C, n=8). The model of cerebral ischemia-reperfusion injury in rats was established according to Longa's method. Group C was intraperitoneally injected with proanthocyanidins 10 mg/(kg ⋅ d), group A and group B were injected with normal saline for 5 consecutive days. 1 and 3 days after cerebral ischemia-reperfusion, ileum myoelectric slow wave and smooth muscle contractility, the activity of superoxide dismutase (SOD) and content of malondialdehyde (MDA) were measured, the content of the serum TNF-α was tested with ELISA kit, ileum tissues were tested with hematoxylin eosin (HE) staining and used for measuring the moisture content. Results Compared with group B 1 and 3 days after cerebral ischemia-reperfusion, the intestinal mucosa injury relieved, the intestinal mucosa score decreased (P<0.05) and the number of infiltrated inflammatory cell decreased in group C; the frequency of slow wave and contraction trended to increase (P>0.05), and the amplitude increased (P<0.05) in group C; the serum SOD activity increased (P<0.05), and the content of MDA and TNF-α decreased (P<0.01) in group C; the intestinal moisture content reduced (P<0.01) in group C. Conclusion Proanthocyanidins pretreatment can protect intestinal function from injury after cerebral ischemia-reperfusion.