Objective To evaluate gastric bypass on relieving type 2 diabetes mellitus. Methods From September 2009 to September 2010,Thirty two cases of type 2 diabetes mellitus patients underwent gastric bypass operation in Xijing Hospital.Preoperative FBG,2hPG,HbAlc,weight,blood pressure and fatty liver were compared with that on 1 month,6 months,12 months after operation. Result There was no significant postoperative complications.FBG on 1 month,6 months,12 months postop and preoperative level was respectively 7.8 ± 2.2,7.7 ± 2.2,7.2 ± 1.8 and 11.1 ± 2.7 ( mmol/L),P ＜ 0.05.2hPG was 10.2 ± 2.6,10.5±2.8,10.5 ±3.1 and 14.0 ±3.5 (mmoL/L),P＜0.05.HbAlc was 7.6％ ±1.4％,7.5％ ± 1.7％,7.1％ ±1.9％ and9.0％±2.3％,P＜0.05.FBG[(6.9±1.5) mmol/L],2hPG[(10.0±3.2) mmol/L] and HbAlc[ (6.9％ ± 1.9％ ) ] on 12 months after operation were lower than preoperative[ FBG ( 10.7 ± 2.9 ) mmol/L,2hPG ( 14.3 ± 4.1 ) mmol/L,HbAlc ( 8.8％ ± 2.0％ ) ] in patients with BMI ＜25 kg/m2 (P ＜ 0.05 ).In patients with preoperative BMI ≥ 25 kg/m2,FBG ( 7.5 ± 2.3 ) mmol/L,2hPG ( 11.3 ±2.9) mmol/L HbAlc (7.3％ ± 1.9％ ),12 mos pest were lower than that of preoperative levels of [FBG(11.7 ±2.3) mmol/L,2hPG(13.5 ±2.4) mmol/L,HbAlc(9.2％ ±2.7％)] (P ＜0.05).Postoperative blood pressure became normal in 5 out of 6 patients complicating preoperative high blood pressure as evaluated on 12 months after operation. Fatty liver ameliorated in 8 out of 17 patients.Conclusions Gastric bypass significantly improves glycometabolism and comorbidity in type 2 diabetes patients.

Obesity and related comorbidities have become serious health threats all over the world. Bariatric surgery has been shown to be an effective method for severe obesity in both the short and long term. Patients experience significant and sustained weight loss after bariatric surgery. Moreover, the preexist obesity associated comorbidities have been improved or resolved in most patients. A series of clinical researches have demonstrated the safety and validity of bariatric surgery. The clinical applications of surgery therapy provide an alternative for obesity and related comorbidities.

Objective To summarize the strategies for perioperative nursing of the patients with radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy.Method Eighteen patients with radical resection of esophageal carcinoma were treated with a combination of thoracoscopy and laparoscopy and their histories were retrospectively reviewed.Results Before the operation,nursing care focused on psychological nursing and preparations of operating room and various operating instruments.During the operation,the key nursing points included position care,proper cooperation with doctors,strict aseptic procedures and non-tumor techniques to reduce postoperative infections and dissemination of tumor cells.All the patients lived through the successful operations,their recovery satisfactory.The blood loss ranged from 100 mL to 300 mL,averaged(225.00±24.30)mL. Conclusions Radical resection of esophageal carcinoma under the combination of thoracoscopy and laparoscopy is technically feasible and safe.The perioperative nursing care is important for the improvement of operative success.

Objective:To review clinical experience of PICC parenteral nutritoin in the acute and severe patients.Methods:Basilic vein,median vein and brachiocephalic vein were selected for PICC.Results:Insertion and use of PICC were successful in 56 cases with success rate of 93.33%.The parenteral nutrition was carriedout in 32 cases.There was no infection and phlebitis.2 cases failed in puncture. Conclusion:There was important clinical significance with the use of PICC in acute and severe patients.

Objective To investigate the relationship between plasminogen activator inhibitor(PAI) activity and coronary artery disease(CAD) in elderly patients. Methods Plasma samples from 93 patients with CAD were analyzed for the PAI activity, plasminogen activator(t-PA) activity, serum levels of cholesterol and triglyceride. The values of these parameters were compared between the CAD and the control groups. Results Higher plasma PAI activity 〔(810?360) AU/L vs. (640?300) AU/L,P

Objective:Evaluate the role of reactive oxygen species production and the differential expression of Rac2 and RhoGDI of neutrophils in pathogenesis of coronary heart disease.Methods:Reactive oxygen species production was measured by chemiluminescence method,the mRNA expression of Rac2 and RhoGDI was detected by quantitative RT-PCR.Results:The reactive oxygen species production by neutrophil is significantly increased in the coronary heart disease group,and the increase is related to the inflammatory cytokines in plasma.There is a significant increase of Rac2mRNA expression in coronary heart disease group than that of the control,while the expression of RhoGDImRNA in two groups are not significantly different.The ratio of Rac2mRNA to RhoGDImRNA is correlated to the production of reactive oxygen species of neutrophils.Conclusion:Netrophils are involved in the pathogenesis of coronary heart disease through their reactive oxygen species production,and the abnormal expression of Rac2 and RhoGDI is an important cause leading to the increased reactive oxygen species production.

Objective To investigate ASPS induced G_2/M arrest in lung cancer cell line H446 and its effect on ERK MAP kinase signal transduction pathways. Methods Cell cycle phases were inspected by flow cytometery (FCM) ; Western blot analysis was used to inspect the proteins of ERK, p-ERK. Results Compared with control group, G_2/M phase cells increased with concentration significantly, G_0/G_1 phase cells were not different, G_2/M phase cells and G_0/G_1 phase cells were not different when pre-incubated with PD98059 prior to exposure to ASPS of different concentrations, protein of p-ERK was significantly increased, expression of ERK was no different. Conclusion ASPS may induce G_2/M arrest of H446 cells possibly by activation ERK MAP kinase pathways.

Objective:To investigate the curative effect of hysterectomy and lymph node dissection with laparoscope or laparotomy on elderly patients with cervical cancer.Methods:60 elderly patients with cervical cancer were enrolled in our hospital from January 2014 to January 2016 and randomly divided into two groups.Group A (n=30) accepted hysterectomy and lymph node dissection with laparotomy,and Group B (n=30) adopted same surgery with laparoscope,the operation condition and postoperative recovery were compared between two groups.The intraoperative and postoperative complications of all patients were recorded and analyzed,and the quality of life of patients was evaluated in the following-up period.Results:The number of lymph node dissection in Group B was significantly more than that of Group A (P＜0.05);the intraoperitive blood loss and the times of using postoperative analgesia pump in Group B were significantly fewer than those in Group A (P＜0.05).The time of postoperative exhaust,bladder function recovery,drainage tube retention and hospital stay in Group B were all shorter than those in Group A(P＜0.05).The incidence of massive hemorrhage during operation and postoperative urinary retention and lymphatic cyst in Group B were significantly lower than those patients in Group A (P＜0.05).After operation 3 and 6 month,the I-QOL and FACT-G scores of patients in Group B were significantly higher than those in Group A (P＜0.05).Conclusions:Hysterectomy and lymph node dissection under laparoscope had remarkable curative effect on the elderly patients with cervical cancer,which improved the postoperative recovery and the quality of life of patients.

Objective To monitor the distribution of pathogenic bacteria causing wound infection in trauma patients and their susceptibility to antibiotics in an effort to offer evidence for the rational clinical use of antibiotics.Methods Pathogens were identified by expressive type,but a very few was determined by the molecular methods.Micro-dilution or Kirby-Bauer method for minimum inhibitory concentration (MIC) was adopted for drug susceptibility test.Results A total of 121 species of pathogens numbering 1,257 bacterial strains were isolated from 1,066 patients.Strain number of the top 10 species accounted for 70.09％.Gram-positive cocci accounted for 48.93％ and Gram-negative bacilli for 49.72％.Among Staphylococcus aureus and epidermidis,methicillin-resistant bacterial strains accounted for 34.76％ and 71.08％ respectively,but none were resistant to vancomycin or linezolid.Enterococcus faecalis contained 6.06％ vancomycin-resistant enterococcal (VRE) and remained ＞ 90％ sensitive to teicoplanin,ampicilin and vancomycin.Enterococcus faecium contained 10.53％ VRE and remained ＞90％ sensitive to teicoplanin and ＞ 80％ sensitive to vancomycin.Baumanii contained 12.77％ multidrug resistant strains and remained ＞ 70％ sensitive to imipenem and meropenem.Baumanii/calcoaceticus complex contained 29.72％ multi-drug resistant strains and remained ＞ 50％ sensitive to imipenem and meropenem.Pseudomonas aeruginosa contained 3.73％ multi-drug resistant strains and remained ＞90％ sensitive to amikacin,meropenem,imipenem and piperacillin/tazobactam.No E.coli,klebsiella pneumoniae and enterobacter cloacae resistant to imipenem or meropenem were found.E.coli contained 69.51％ extended-spectrum β-lactamases (ESBLs)-producing strains and remained ＞ 90％ sensitive to piperacillin/tazobactam and ＞ 80％ sensitive to amikacin.Klebsiella pneumoniae contained 53.13％ ESBLs-producing strains and remained ＞ 80％ sensitive to amikacin.Conclusions Common bacteria are the leading cause of posttraumatic infection.Enterococcus faecalis and enterococcus faecium demonstrate higher susceptibility to teicoplanin; two kinds of acinetobacter demonstrate higher susceptibility to imipenem.

Objective To observe the effects of oldhamianoside Ⅱ on the invasive 'ability of prostatic carcinoma DU-145 cells,and to investigate the potential mechanism.Methods After treatment of DU-145 cells with oldhamianoside Ⅱ,MTT assay was used to test the effect of oldhamianoside Ⅱ on the cell proliferation.The invasive ability was assessed with a transwell cell culture chamber.Immunocytochemistry stain was used to investigate the expression of matrix metalloproteinase(MMP-2)and CXC-chemokine receptor 4 (CXCR4).Results The proliferation of DU-145 cells was inhibited after treatment with oldhamianoside Ⅱ.In vitro invasion assay indicated that the cells moved through the membrane were(180.3 ± 14.6)/field in the control group,while decreased to(100.4 ±1.5),(80.2±2.7)and(60.1 ±5.3)/field in 0.25,0.5 and 1μg/mL oldhamianoside Ⅱ treated DU-145 cells respectively.Comparing to control group,the cells of oldhamianoside Ⅱ groups moved through the membrane were decreased remarkably(P ＜0.05).Immunocytochemistry showed that the expression of MMP-2 and CXCR4 were decreased of oldhamianoside Ⅱ groups.Conclusions Oldhamianoside Ⅱ can inhibit the invasiveness of DU-145 cells,which is related to the down regulation the expression of MMP-2 in DU-t45 cells.Oldhamianoside Ⅱ can inhibit the prostate cancer cells metastasis to the bone,which is related to the down regulation the expression of CXCR4 in DU-145 cells.