Objective To analyze and investigate the diagnosis method and treatment measures of insulinoma.Methods The clinical data in 16 cases of insulinoma in the hepatobiliary surgery of our institute from Dec.2008 to Dec.2015 were retrospectively analyzed.Results All cases had typical Whipple′s triad,the biochemical examination suggested that all cases had plasma glucose decrease and plasma insulin increase during the onset period.The imaging examinations included preoperative ultrasonography,enhanced CT,MRI,EUS and intraoperative ultrasound (IOUS).Their diagnosis positive rates were 56.3% (9/16),77.8% (7/9),80.0% (8/10),100.0%(2/2) and 100.0%(5/5) respectively.Sixteen cases all received surgical treatment,including local tumor excision in 6 cases,simple distal pancreatectomy in 3 cases,distal pancreatectomy plus splenectomy in 5 cases and pancreaticoduodenectomy(PD) in 2 cases.Plasma glucose level in all cases was significantly increased after tumor removal.Postoperative follow-up lasted for 1-5 years without recurrence and metastasis.Conclusion The first choice of insulinoma localization diagnosis is CT and MRI,intraoperative palpation combined with IOUS is the main method of intraoperative localization,and the surgical resection is the only effective method for treating this disease.

Objective To explore the expression of aquaporin (AQP)-4 in white matter of spinal cord after spinal cord contusion (SCC). Methods 88 adult Sprague-Dawley rats were assigned randomly to sham operation group and SCC group. The model was established by Al-len's method. BBB sore was used to assess the motor function of rats. The relative expression of AQP-4 mRNA was determined by Q-PCR technique. The localization of AQP-4 was observed by immunohistochemistry. Results BBB score showed motor dysfunction in SCC group, and it increased 7 and 14 days after SCC (t>5.061, P<0.001). The level of AQP-4 mRNA decreased on the 1st and 3rd days (t>50.44, P<0.001), and increased on the 5th day (t=-3.968, P=0.001), and lasted until the 28th day (t=-4.227, P=0.001) compared with that on the 3rd day. The immunohistochemistry showed AQP-4 was located on the process of glial cell and vascular endothelial cells in white matter of spi-nal cord. Conclusion AQP-4 may play various roles at different stages in SCC.

Objective To compare the efficacy and safety of lidocaine and ropivacaine for scalp block in providing adequate analgesia with minimum side effects during awake craniotomy.Methods60 patients, ASA 1～2, were randomized into either lidocaine (L) group (n=30) or ropivacaine (R) group (n=30). 1% lidocaine or 0.5% ropivacaine were taken for scalp nerve block 15 min before incision. Supplemental oxygen was given using nasal prongs that were adapted for the monitoring of end tidal CO2 and respiratory rate. Serial parameters about circulation and respiratory were measured and drug consumption were recorded.ResultsThe hemodynamic parameters of L group were higher than R group in the latter stage(P<0.05). L group was associated with significantly more consumption of sufentanil and more respiratory depression than R group(P<0.05).ConclusionRopivacaine, taking for scalp block undergoing awake craniotomy, is associated with less consumption of analgesic and less respiratory depression than lidocaine.

Aged ; Denture, Complete ; Female ; Follow-Up Studies ; Humans ; Hypercementosis ; therapy ; Mandibular Condyle

Objective To explore the effect of heme oxygenase-1 (HO-1) on expressions of hypoxia inducing factor 1 alpha (HIF-1α) and vascular endothelial growth factor (VEGF)and regeneration of hepatic vascular plexus after orthotopic liver transplantation ischemia-reperfusion injury in rats.Methods Theexperimental study was conducted.According to the random number table,240 SD rats were divided into the 3 groups,80 rats in each group.Empty virus group:rats were transfected with the empty virus.Induced group:rats were transfected with HO-1 overexpression adenovirus.Inhibited group:rats were transfected with HO-1 RNAi adenovirus.Rats were made pairs (1 ∶ 1) and established rat liver transplantation model according to two cuffs method.Rats with less weight and with heavier weight were respectively chosen as donor rats and recipient rats,and then recieved tail intravenous injection of adenovirus at 24 hours before operation.(1) Detection of transfection efficiency of adenovirus before operation:HO-1 expression of liver tissue of rats in each group was detected by Western blot at 12 and 24 hours after injection of adenovirus.(2) Liver function test of recipient rats after liver transplantation:liver functions of recipient rats [alanine transaminase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),gamma-glutamyl transferase (GGT)] were detected at l,3,7 and 14 days postoperatively.(3) Pathological histology of liver tissue and injury scores of recipient rats in the 3 groups after liver transplantation:paraffin sections of recipient rats in the 3 groups at postoperative 1 and 14 days were stained by HE staining and observed by light microscope,and were evaluated by Suzuki damage score standard.(4) Relative expressions of HIF-1α,VEGF and HO-1 in liver tissue of recipient rats were detected by Western blot.(5) Von Willebrand factor (vWF) in liver tissue of recipient rats at 14 days postoperatively was detected by immunofluorescence staining and small vessels were counted.Measurement data with normal distribution were represented as x ±s.Comparison between groups was analyzed by the independent-sample t test,comparison among groups was done using one-way ANOVA,and pairwise comparison was analyzed by the LSD test.Results (1) Detection of transfection efficiency of adenovirus before operation:the relative expression of HO-1 of liver tissue of rats at 12 and 24 hours preoperatively after injection of adenovirus was 1.08±0.16 and 1.08±0.26 in the empty virus group,1.18±0.21 and 1.39±0.19 in the induced group,0.87±0.26 and 0.57±0.12 in the inhibited group,respectively,with statistically significant differences in different time points (F =4.232,36.513,P＜ 0.05).(2) Liver function test of recipient rats after liver transplantation:level of ALT at 3 days postoperatively in the empty virus group,induced group and inhibited group was (504±67)U/L,(438±47)U/L and (490±39)U/L,with a statistically significant difference (F=3.517,P＜0.05).Levels of ALT,AST and ALP at 7 days posto-peratively were (443±49) U/L,(430± 34) U/L,(455± 38) U/L in the empty virus group and (382± 49) U/L,(372±50) U/L,(394±25) U/L in the induced group and (493±44) U/L,(455±62) U/L,(470±72) U/L in the inhibited group,respectively,with statistically significant differences (F =10.950,5.667,5.398,P＜0.05).Levels of ALT,AST,ALP and GGT at 14 days postoperatively were (394±46)U/L,(361 ±68)U/L,(417 ±17)U/L,(4.5±1.1)U/L in the empty virus group and (283±47) U/L,(288±60) U/L,(332±46) U/L,(2.5±0.5) U/L in the induced group and (446± 43) U/L,(422± 51) U/L,(423± 63) U/L,(4.3 ± 1.3) U/L in the inhibited group,respectively,with statistically significant differences (F=26.906,9.924,8.013,9.279,P＜ 0.05).(3) Pathological histology of liver tissue and injury scores of recipient rats in the 3 groups after liver transplantation:liver cell swelling,loose cytoplasm and a varying quantity of inflammatory cell infiltration in the portal regions in the liver tissue of 3 groups were observed at 1 day postoperatively.A few inflammatory cell infiltrations in the portal regions,basically normal liver cell arrangement and a slightly swelling of liver cell were found in the empty virus group at 14 days postoperatively.Reduced liver cell swelling and basically normal structure of liver lobule were observed in the induced group.There were small patchy or focal necrosis of liver cell,masses of inflammatory cell infiltration in the portal regions and damage of bile duct in the inhibited group.Suzuki score at 1 day postoperatively in the empty virus group,induced group and inhibited group were respectively 6.7± 1.7,6.1 ± 1.2 and 7.6± 1.3,with no statistically significant difference (F=2.257,P＞0.05).Suzuki score at 14day postoperatively in the empty virus group,induced group and inhibited group were respectively 4.0±0.8,2.9± 0.8 and 5.1± 1.4,with a statistically significant difference (F=9.776,P＜0.05).(4) Western blot results:the relative expressions of HIF-1α and VEGF (43 KD) in liver tissue of recipient rats at 1 day postoperatively were 0.21±0.10,0.30±0.12 in the empty virus group and 0.23±0.09,0.34±0.14 in the induced group and 0.17± 0.06,0.29±0.11 in the inhibited group,respectively,with no statistically significant difference (F =0.902,0.410,P＞0.05).The relative expressions of VEGF (24 KD) and HO-1 in liver tissue of recipient rats at 1 day postoperatively were 1.21 ±0.25,0.55±0.12 in the empty virus group and 2.13±0.40,0.72±0.12 in the induced group and 0.91±0.22,0.26±0.07 in the inhibited group,respectively,with statistically significant differences (F=35.158,39.082,P ＜ 0.05).The relative expressions of HIF-1α,VEGF (43 KD),VEGF (24 KD) and HO-1 in liver tissue of recipient rats at 7 days postoperatively were 0.49±0.22,0.46±0.13,0.98± 0.37,0.98±0.37 in the empty virus group and 0.83±0.26,0.63±0.19,1.60±0.33,1.49±0.46 in the induced group and 0.24±0.09,0.30±0.12,0.64±0.18,0.75±0.26 in the inhibited group,respectively,with statistically significant differences (F=16.853,10.021,20.756,8.156,P＜0.05).(5) Immunofluorescence staining results:number of small vessels at 14 days postoperatively in the empty virus group,induced group and inhibited group was respectively 7.9±2.0,10.6± 1.9 and 7.6 ± 1.9,with a statistically significant difference (F=5.921,P＜0.05).Conclusion HO-1 could promote expressions of HIF-1α and VEGF in liver tissue after liver transplantation ischemia-reperfusion injury and regeneration of intrahepatic vascular plexus,and it also alleviate bile duct ischemia-reperfusion injury after liver transplantation.

Objective To screen serum markers in patients with PBC by high-throughput protein chips encoded by the human genome. Methods High-throughput protein chips (contains a total of 38 400protein spots, including 17 718 human genes encoding proteins) were used to screen sera from 21 PBC patients, 20 disease control patients and 10 normal controls. Bioinformatics software was used to analyze information and statistical software was used to analyze the data to confirm the serum markers of PBC. Results The detection rate of protein spots using anti-GST antibody on the chip was 97. 6%, and the signal intensity correlation coefficient of double protein spots was 0. 98. Four serum markers( PDHA1, DBT,DLAT and HK1 )were screened by high-throughput protein chips between PBC group and the control group with a statistically significant. The positive rate of the four markers in the three groups was 66. 67% ( 14/21), 5.00% (1/20) and 0(0/10); 57. 14% ( 12/21 ), 5.00% (1/20) and 0(0/10); 52. 38% ( 11/21 ),0(0/20) and 0(0/10); 52. 38% ( 11/21 ), 0(0/20) and 0(0/10) respectively. All the four markers were different in the three groups with statistically significant (PDHA1 :x2 = 16. 79, P ＜0. 01 ;Fisher exact test,P=0. 000; DBT:x2 =12.86, P＜0. 01;Fisher exact test, P=0. 004; DLAT and HK1:Fisher exact test,P ＜0. 01 or 0. 05). Of those markers, antibodies to PDHA1, DBT and DLAT were the component of AMAM2 which had been used as the marker of PBC. Antibody to HK1 was identified as new marker of PBC,whose sensitivity to PBC was 52. 38% and specificity was 100. 00%. There were no serum marker were screened between the AMA-M2 positive and negative PBC patients. Only antibody to CENPB was identified to be significantly expressed between the ACA positive and negative PBC patients ( Fisher exact test, P =0. 000). Conclusions High-throughput protein chip encoded by the human gene is a technology for quick and comprehensive screening of new markers of PBC. Antibodies to HK1 could be used as new marker for PBC with highly sensitivity and specificity. No serum marker is found between the AMA-M2 positive and negative PBC patients whereas only antibody to CENPB is identified as marker between the ACA positive and negative PBC patients.

This paper introduces remote Computed Tomography van, telemedicine and telecommunication vehicle.
Computer Communication Networks ; Humans ; Image Processing, Computer-Assisted ; methods ; Lung Neoplasms ; diagnosis ; Mass Screening ; Telemedicine ; instrumentation ; methods ; Telemetry ; instrumentation ; methods ; Tomography, X-Ray Computed ; instrumentation ; methods

Objective To observe the stellate ganglion block (SGB) on obstructive sleep apnea syndrome (OSAS) combined the curative effect of sleep respiration and blood pressure control in patients with hypertension.Methods Incorporating meets the criteria for the OSAS patients with high blood pressure in hospital order randomly assigned into normal group and experimental group and routine group was given antihypertension drugs,adjustment in lifestyle,continuous positive airway pressure (CPAP) treatment,the experimental group on the basis of conventional treatment at the same time give SGB to intervene.Using t test on admission and intervention were compared after a period of treatment in patients with sleep apnea and blood pressure control,using 2 test comparison blood pressure control rates of two groups patients.Results Compared with normal group,the experimental group after intervention in a course of apnea hypoventilation index (AHI),SaO2 and 24 h mean arterial pressure were obviously improved,the difference was statistically significant (P＜0.05).Conclusion SGB as a new treatment method,not only can improve clinical symptoms in patients with OSAS,but also make the patients get better control of blood pressure.

Objective:To evaluate the benefit of autologous stem cell transplantation (ASCT) as a consolidation therapy in the survival of multiple myeloma (MM) patients at different risks. Methods:A total of 67 MM patients who received ASCT as consolida-tion therapy between August 2006 and July 2011 were enrolled in the retrospective study. The cases were divided into three risk groups on the basis of the International Staging System and fluorescence in situ hybridization. Another 67 patients who accepted consolidation chemotherapy at the same period were selected as case-paired controls matched in terms of age, sex, optimal response after induction, and risk stratifications. All the patients received bortezomib-and/or thalidomide-based induction therapies. Results:No statistical differ-ences in non-complete remission (nCR)/complete remission (CR) rate were observed between the ASCT and chemotherapy groups (44.8%vs. 37.3%, P=0.380) after the induction therapy. The progression-free survival (PFS) was longer in the ASCT group than in the chemotherapy group (32.4 months vs. 15.1 months, P<0.001). The overall survival (OS) was longer in the ASCT group than in the che-motherapy group (58.8 months vs. 42.1 months, P=0.009). both the PFS (median:30.5 months vs. 11.2 months, P<0.001) and the OS (median:85.5 months vs. 34 months, P=0.015) rates were significantly prolonged in the high-risk subgroup after ASCT. In the interme-diate-risk subgroup, neither PFS nor OS showed any significance after ASCT (P>0.05). In the low-risk subgroup, only PFS was extend-ed (median: 34.8 months vs. 17.6 months, P=0.012) after ASCT, without significant improvements in the OS (P>0.05). Conclusion:The MM patients obtained cytogenetic high-risk benefits mostly from ASCT consolidation after inductions based on novel agents.

To improve the effect of pediatrics clinical probation teaching for eight-year program medical students,the exploration and practice of case-based instruction teaching with symptoms as main line,reading reports,and application of high quality counterfeit baby simulator-assisted instruction were carried out,which could inspire students' learning interest,and contribute to the training of students'clinical and scientific thought,their self-education and clinical skills.