Objective Insulin resistance is implicated in the pathogenesis of nonalcoholic fatty liver disease(NAFLD).This study was to investigate the effect of metformin on liver enzyme abnormalities in patients with NAFLD.Methods One-hundred and thirty cases of NAFLD were divided into 2 groups,control(n=43)and metformin treatment group(n=98).The former group(TLC)was offered therapeutic life style change advice,and the later group(Met)was given metformin 1.5 g/day on the basis of TLC for 6 months.The changes of liver enzyme tests,waist circumference,blood pressure,lipid profiles,plasma glucose,insulin and the HOMA insulin resistance index were analyzed in 2 groups.Results ALT and AST declined in 2 groups after 3,6 months' treatment;enzyme abnormalities were normalized among 65% and 35% patients in Met and TLC group(P

Objective To explore the clinical manifestations, pathogenic mechanisms and treatment of Mirizzi syndrome.Method 65 patients with Mirizzi syndrome were analysed retrospectively.Results According to Csendes typing, patients with Mirizzi syndrome included type Ⅰ in 18 patients(27 6%), type Ⅱ in 25 patients (38 4%), type Ⅲ in 13 patients(20 0%), type Ⅳin 9 patients(13 8%), all patients were healed by corresponding operation and perioperative management.Conclusions Good outcome of Mirizzi syndrome patients can be achieved by accurate diagnosis,exact operation and active perioperative management.

Objective To study the effect of substance P (SP), calcitonin gene-related peptide (CGRP) on the blood flow and the function of endolymphatic sac (ES) in guinea pigs to clarify the pathogenesis of some inner ear diseases further.Methods The guinea pig model of superior cervical ganglion (SCG) resection was set up. The ESs of the model animals were stained by SP and CGRP immunocytochemically. The staining images were analysed by the computer. The ESBF was measured with the biologic microphere method.Results Compared with the control group, the staining of SP decreased sharply in the model group, however, the staining of CGRP remained unchanged. In the model animals, the ESBF was decreased either.Conclusion SP and CGRP could take part in the regulation of ESBF to affect the function of ES further.

Objective To assess the ability of interleukin-1 beta (IL-1?) antibody and tumor necrosis factor alpha (TNF?) antibody to prevent postoperative abdominal adhesion formation in mice.Methods 60 BALB/c mice were randomly divided into four groups: normal saline group(n=15), anti-IL-1? group(n=15), anti-TNF? group(n=15),and anti-IL-1? combined with anti-TNF? group(n=15). After an identical peritoneal injury operation, mice were treated using intraperitoneally with either normal saline or corresponding antibody at the time of abdominal closure. The mice were killed 20 days after operation, the abdominal incisions and the development of intra-abdominal adhesions were observed. Adhesion scoring was based on an overall assessment of the extent,location, and type of adhesion.Results Anti-IL-1? combined with anti-TNF? group had significantly lower adhesion scores (0 84?0 19) than that in other groups(P

Objective To improve the pancreaticoenterostomy technique and drainage in panereatieoduodenectomy, so as to prevent postoperative pancreatic leakage. Methods One hundred and thirty-eight panereaticoduodenectomy cases underwent parachute continuous running suture of pancreaticojejunostomy and extra drainage of the anastomotic stoma. Results The average time of the double-deck continuous invaginated pancreaticoenterostomy was 11 minutes, and there was no pancreaticoenterostomy leakage in all cases, lntraoperative blood loss was 353±61 ml, the average hospital stay was 19.2 days. Pulmonary infection developed in 6 cases, three cases suffered from postoperative upper gastrointestinal bleeding due to stress ulcer, two cases from functional delayed gastric emptying. All these complications were cured by conservative treatment, and there was no mortality in these series. Conclusions The parachute continuous running suture of pancreaticojejunostomy and extra drainage has the advantages of easy performance, saving time and less complications, and is an effective way in the prevention of panereatieojejunostomy leakage.

OBJECTIVE:To observe the effects of Breviscapine injection on serum copeptin,NT-proBNP and ischemia modi-fied albumin (IMA) level and hemorheology indexes in patients with acute cerebral infarction. METHODS:Data of 132 patients with acute cerebral infarction were selected and randomly divided into observation group(66 cases)and control group(66 cases). Control group received 1 Aspirin enteric-coated tablet,qd + 20 ml Muscular amino acids and nucleosides injection adding into 500 ml 0.9% Sodium chloride solution,intravenous infusion,qd + 4 ml Ozagrel injection adding into 250 ml Sodium chloride solution, intravenous infusion,qd. Observation group was additionally given 5 ml Breviscapine injection adding into 250 ml 0.9% Sodium chloride solution,intravenous infusion,qd. 7 d ag was regarded as 1 treatment course,it lasted for 2 courses. Copeptin,NT-proB-NP,IMA levels (showed by serum ACB value) and changes of related hemorheology indexes before and after treatment in 2 groups were observed. RESULTS:Before treatment,there was no significant difference in Copeptin,NT-proBNP,serum ACB val-ue,whole blood viscosity,plasma viscosity,hematocrit,ESR and fibrinogen levels in 2 groups(P>0.05);after treatment,Co-peptin,NT-proBNP,whole blood viscosity,plasma viscosity,hematocrit,ESR and fibrinogen levels in 2 groups were significant-ly lower than before,and observation group was lower than control group,while serum ACB value was significantly higher than be-fore,and observation group was significantly higher than control group,the differences were statistically significant(P<0.05). CONCLUSIONS:Based on conventional treatment,Breviscapine injection can significantly improve the copeptin,NT-proBNp and IMA levels,and improve hemorrheology.

Aim To investigate the effect of intrauterine injection of rat fetal hepatocytes on homograft rejection reaction. Methods The skin graft from a male LOU/CN rat was transplanted to a female recipient CHN rat of 7 to 9 weeks after parturition, and then survival time of the graft was observed. Simultaneously, homograft rejection reaction was examined by mixture lymphocyte culture. Results As compared with control group, survival time of transplanted skin graft was obviously prolonged. Mixure lymphocyte culture demonstrated that homograft rejection reaction was inhibited markedly. Conclusion Intrauterine injection of rat fetal hepatocytes wuld obviously inhibite homograft rejection reaction, thus prolonging survival time of the graft.

Objective To investigate the clinical effects of laparoscopic sleeve gastrectomy with duodenaljejunal bypass (LSG + DJB) for the treatment of type 2 diabetes mellitus.Methods The clinical data of 17 patients with type 2 diabetes mellitus who underwent LSG + DJB at the Xijing Hospital of the Fourth Military Medical University from March 2013 to February 2014 were retrospectively analyzed.The fasting blood glucose,postprandial 2-hour blood glucose,glycosylated hemoglobin (HbA1c) and body mass index (BMI) in 17 patients before operation were (9.2 ± 0.6) mmol/L,(14.4 ± 2.2) mmol/L,8.3％ ± 1.2％ and (29.4 ± 2.2) kg/m2,respectively.All the patients received LSG + DJB and were followed up by outpatient examination up to March 2015.The pre-and post-operative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1 c and BMI in 17 patients were compared.Measurement data with normal distribution were presented as-x ± s and analyzed by the t test.Results All the 17 patients received successful laparoscopic LSG + DJB without conversion to open surgery.The operation time,volume of intraoperative blood loss and recovery time of postoperative gastrointestinal function were (141 ±53)minutes,40 mL and 2.5 days.Of 3 patients with postoperative complications,1 patient with anastomotic leakage at postoperative day 5 received reoperation by laparoscopic Roux-en-Y gastric bypass,1 patient with digestive tract obstruction at postoperative day 10 released obstruction by reoperation and 1 patient with left subphrenic abscess and leakage at the upper of the stomach at postoperative week 2 was cured by the symptomatic treatment.The duration of hospital stay was 5.2 days.All the patients were followed up for a median time of 16 months (range,13-24 months).The postoperative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1c and BMI in 17 patients were (5.5 ± 0.7)mmol/L,(8.8 ± 1.7)mmol/L,5.1％ ± 0.7％ and (24.7 ± 2.3)kg/m2,which were significantly different from preoperative indicators (t =19.96,10.52,12.06,31.99,P ＜ 0.05).During the follow-up,no anastomotic ulcer and stenosis,dumping syndrome and severe malnutrition were occurred.Conclusion LSG + DJB is safe and feasible for the treatment of type 2 diabetes mellitus,with a good short-term hypoglycemic effect.

Objective To study the iodine nutritional status and thyroid function of adults in urban and rural areas of Wuwei City Gansu Province.Methods A cross-sectional survey was performed in 200 adults aged 18-45 who had lived more than six months in Wuwei City from April 2009 to January 2010.A random urine and fasting blood samples were collected.Urinary iodine content was measured with arsenic cerium catalytic spectrophotometry.The thyroid-stimulating hormone (TSH),free thyroid hormone (FT4) and three free triiodothyronine (FT3) were quantified by direct chemiluminescence immunoassay.Thyroglobulin antibodies (TGAb) and thyroid microsomal antibodies (TMAb) were detected by radioimmunoassay.Results A total of 99 and 98 copies of urine samples of urban and rural groups were tested,respectively.The median of urinary iodine of urban and rural groups was 189.0 and 258.2 μg/L,respectively,and rural group was higher than urban group (Z =-4.020,P ＜ 0.01).A total of 104 and 95 copies of blood samples of urban and rural groups were detected; mean value of FT4 in urban group [(16.8 ± 3.0)pmol/L] was higher than that of rural group [(15.4 ± 2.4)pmol/L,t =3.539,P ＜ 0.01].The positive rates of TGAb of urban and rural groups were 11.5％ (12/104) and 15.8％ (15/95),respectively; the positive rates of TMAb of urban and rural groups were 13.5％ (14/104) and 14.7％ (14/95),respectively; the positive rates of TGAb of male and female were 5.5％ (6/109) and 23.3％ (21/90),respectively; the positive rates of TMAb of male and female were 6.4％ (7/109) and 23.3％ (21/90),respectively.The positive rates of TGAb and TMAb were lower in male than in female (x2 =13.362,11.661,all P ＜ 0.01).The rates of thyroid function disorders of urban and rural groups were 16.3％ (17/104) and 8.4％ (8/95),of male and female 11.9％ (13/109) and 13.3％ (12/90),respectively.Subclinical hypothyroidism in all thyroid function disorders was the most common,which was 14.4％ (15/104) and 7.4％ (7/95) in urban and rural groups,11.0％ (12/109) and 11.1％ (10/90) in male and female,respectively.Conclusions Iodine nutrition level is appropriate for adults in urban areas,but in rural areas iodine nutrition is high or excessive; subclinical hypothyroidism in all thyroid function disorders is the most common; we should be concerned about the risk of iodine overdose,especially the risk of illness in women.

Objective:To evaluate the iodine level of drinking water in different ecological regions in Gansu Province, and to provide a basis for preventing iodine deficiency disorders in accordance with local conditions.Methods:In May to July 2017, according to different topography, landforms and climatic conditions, Gansu Province was divided into six ecological regions: desert area, Hexi Corridor gobi area, Loess Plateau hilly area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area, and Loess Plateau gully area. One county was selected from each of the five districts in the east, west, south, north, and central areas in each ecological regions. Drinking water samples were collected in each county based on the township, and the water iodine content was determined by arsenic-cerium catalytic spectrophotometry.Results:A total of 4 037 water samples were collected in 527 townships of six ecological regions, the water iodine range was 0.10 - 97.60 μg/L, with a median of 2.10 μg/L. Among them, the medians water iodine of the six ecological regions were less than 40 μg/L, the difference between different ecological regions was statistically significant ( H = 1 007.440, P < 0.01); the unified centralized, partially centralized and dispersed water supply water samples were 157, 2 263 and 1 617, and the medians water iodine were 1.61, 2.42, and 1.83 μg/L, respectively, and there was statistically significant difference among different water supply methods ( H = 37.164, P < 0.01). Stratified by water supply method, the differences in water iodine between different ecological regions of the same water supply method were statistically significant ( H = 32.628, 580.630, 391.070, P < 0.01); stratified by ecological region type, the differences of different water supply methods in desert area, Hexi Corridor gobi area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area were statistically significant ( Z = - 2.770, H = 6.369, 9.936, 12.666, P < 0.05). Conclusions:The six ecological regions in Gansu Province are all iodine-deficient areas. The water iodine content varies among different ecological region types and different water supply methods. Surveys on water iodine content and the operating status of water supply facilities should be carried out regularly, and measures should be adjusted in time to prevent and control iodine deficiency disorders in accordance with local conditions.