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 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: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 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.

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: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.

ObjectiveTo evaluate whether AN69 ST membrane would prolong filter lifetime in continuous renal replacement therapy (CRRT) without anticoagulation in patients with high risk of bleeding.Methods A single-center, prospective, randomized, double-blind control trial with crossover design was conducted. From March 1st to December 31st in 2013, patients who were admitted to Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University meeting CRRT treatment indications, but could not receive systemic anticoagulation because of high risk of bleeding were studied. The selected patients were randomly divided into two groups according to a random number table, and four filters consisting of two AN69 ST100 membrane filters (A) and two traditional AN69 M100 membrane filters (B) were used for them. GroupⅠ with the filter order of A-B-A-B, and groupⅡ with the order of B-A-B-A. The clinical data of patients was recorded in detail, and conventional AN69 ST and AN69 membrane filter lifetime, their influence on coagulability, and the incidence of bleeding complications were compared.Results Seventeen patients were enrolled, with 10 in groupⅠ, and 7 in groupⅡ. The basic medical characteristics including gender, age, acute physiology and chronic health evaluationⅡ (APAECHⅡ) score, sequential organ failure score (SOFA), Acute Renal Injury Network (AKIN) stage, activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), platelet count (PLT), and use of mechanical ventilation were not significantly different between two groups. But the use of vasoactive drug was more frequent in groupⅡcompared with that of groupⅠ[100.0% (7/7) vs. 30.0% (3/10),χ2 = 8.330,P = 0.010]. AN69 ST filter lifetime (n =34) was (15.92±2.10) hours, there was no statistically significant difference compared with that of AN69 membrane (t = 0.088,P = 0.942), filter lifetime of which (n = 34) was (16.12±1.38) hours. It was also found by Kaplan-Meier survival analysis that there was no significant difference between the two membrane filter lifetime (χ2=1.589,P =0.208). Logistic regression analysis showed that the life of the first filter was not correlated with coagulation indicators, including APTT, PT, INR, and PLT [APTT: odds ratio (OR) = 0.977, 95% confidence interval (95%CI) = 0.892-1.071, P = 0.623; PT:OR = 1.001, 95%CI = 0.901-1.109,P = 0.988; INR:OR = 1.078, 95%CI = 0.348-3.340,P = 0.896;PLT:OR = 0.996, 95%CI = 0.974-1.019,P = 0.735]. The application rate of vasoactive drugs, which was different between two groups for basic medical indications showed no effect on filter life time (OR = 2.541, 95%CI = 0.239-26.955,P = 0.439). Reasons of clotting in filters were also analyzed, and it was found that blood coagulation in the filter ranked the top (88.2%), and the other reasons were catheter-related problems, death, and unscheduled transport. No difference in blood coagulation function was found in both groups after treatment for 12 hours, and there was no bleeding complication.ConclusionDuring the CRRT without systemic anticoagulant, both surface-treatment with polyethyleneimine AN69 and AN69 ST membrane cannot prolong filter lifetime.

A novel method for quantification of astragaloside IV in Radix Astragli was developed by using online SPE liquid chromatography coupled with corona charged aerosol detection( CAD) . The sample solution
was loaded into Acclaim Polar AdvantageⅡC18(50 mm×4. 6 mm, 3 μm) which was selected as online SPE column. Then the cleaning process was done by using the Right one of dual gradient pumps with Methanol-water as mobile phase. Acclaim C18(150 mm×4. 6 mm, 5 μm) was selected as analytical column with acetonitrile-water as mobile phase at a flow rate of 1. 0 mL/min. The eluate containing the target from SPE column was transferred into the analytical column by heart-cutting mode. The temperature of nebulizer of corona CAD was set at 30 ℃ and the nitrogen pressure was 241. 3 kPa. The baseline separation of astragaloside IV from matrix components has been achieved. There was a good linear correlation in the range of 4 . 0-80 mg/L for astragaloside IV and the correlation coefficient was 0 . 9998 . The standard addition average recovery of astragaloside IV in Radix Astragli was 97 . 6%. It has been validated that astragaloside IV in Radix Astragli and its preparations can be quantified rapidly and accurately with this method.