Objective To discuss the pathogenesis and clinical characteristics of acute relapsing pancreatitis .Methods The clini-cal data and relevant data of 274 acute pancreatitis cases from January 2010 to and December 2012 were analyzed ,of which one group of 231 cases were first onset and the other group of 43 cases were relapsing .Results The probability of relapse of acute pan-creatitis were highest from 1 month to half a year after first onset (20 cases ,accounting for 46 .51% );biliary factors were the major causes of first onset and relapse cases ,where the relapsing group was higher than first onset group ,with statistical significance (P<0 .05);the relapsing group had more severe symptoms of hyperlipidemia than the first onset group ,with significant difference (P<0 .05) ,The relative risk (OR value) of relevant factors were higher than biliary factors ;improper diet ,alcohol and other factors of the relapsing group were lower than the first onset group ,without statistical significance (P> 0 .05);there was no significant difference between the occurrence rate of severe pancreatitis and the occurrence rate of surgeries and deaths .Conclusion Biliary diseases and hyperlipidemia are closely related with the relapse of acute pancreatitis .

Objective To explore sympathetic skin response (SSR) in the region innervated only by the median or ulnar nerve. Methods Thirty healthy volunteers, ten patients with median nerve injury, ten patients with ulnar nerve injury and three patients with both median and ulnar nerve injury were involved in the study. SSR was elicited by electrical stimulation and the latency and amplitude of the SSR were recorded in the center of the palm and on the hypothenar, and the pulps of the index and little fingers. Results After median nerve injury the SSR of the index finger pulp disappeared, the SSR amplitude of the palmar center was reduced, while the SSR amplitude of the little finger pulp was normal. In contrast, after ulnar nerve injury the SSR of the little finger pulp disappeared,the SSR amplitude of the hypothenar was reduced, while the SSR of the index finger pulp was normal. When both nerves were injured, no SSR could be elicited anywhere on the palm. Conclusions The SSR of the palmar center and hypothenar are affected by both the median and ulnar nerves. The index and little finger pulps are sites for recording SSR which represent the SSR of the median and ulnar nerve distribution, respectively. Index and little finger pulps are ideal sites for detec t ing efferent functioning of sympathetic nerves from the median and ulnar nerve paths,respectively.

Objective To evaluate the feasibility of transperitoneal laparoscopic adrenalectomy for 3 patients with primary aldosteronism who previously underwent ipsilateral adrenal surgery or nephrectomy. Methods From October 2003 to March 2004,transperitoneal laparoscopic adrenalectomy was performed on 3 male patients with primary aldosteronism,including 2 patients (39 and 72 years,respectively) who had previously undergone ipsilateral retroperitoneal laparoscopic partial adrenalectomy for Conn’s adenoma and 1 patient (42 years) who had previously undergone ipsilateral open nephrectomy for renal tuberculosis. Results Transperitoneal laparoscopic adrenalectomy was successfully performed on all the 3 patients; no complication occurred.The mean tumor size was average 1.7 cm in greatest dimension;the mean operative time was average 93 min;the mean estimated blood loss was average 18 ml,and no one needed blood transfusion.The postoperative food intake time was average 17 h,and postoperative hospital stay was average 5.0 d. Conclusions Although scar and adhesion of previous operation may present more difficulties in the subsequent operation,it is feasible to perform transperitoneal laparoscopic adrenalectomy through different surgical access on the patients who have previously underwent ipsilateral retroperitoneal adrenal or nephric surgery.

Objective To evaluate retroperitoneal laparoscopic adrenalectomy. Methods From June of 1999 to January of 2001, retroperitoneal laparoscopic adrenalectomy was performed on 52 patients with adrenal diseases, including 34 cases of aldosterone-preducing adenoma,3 nodular hyperplasia bilateral in 1, 5 Cushing's syndrom,1 Cushing's disease, 3 adrenal pheochromacytoma (bila- teral in 1), 4 nonfunctional adrenal adenoma, 1 myelolipoma and 1 metastasis carcinoma. Results 54 sessions of retroperitoneal adrenalectomy have been carried out for 52 patients (2 on both sides) with success in 51 procedures. The procedure was converted to open operation in 3 occasions because of bleeding or adhesion. The mean operation time was 135 minutes (40～270 min), and the estimated blood loss 45 ml (5～150 ml) with no need of transfusion. The postoperative hospital stay was 6 d (3～14 d) and the mean analgesia consumed 8.5 mg (0～50 mg) of morphine equivalents with no need of any analgesic at all in 17 patients. Conclusions Retroperitoneal laparoscopic adrenalectomy was less traumatic to the patients, with less postoperative discomfort and quicker recovery. The procedure should be considered as the first choice of therapy for benign adrenal diseases.

Objective To study the relationship between vascular endothelial growth factor (VEGF) and occurrence and invasiveness of bladder cancer. Methods The concentration of VEGF in urine was examined by ELISA in 36 cases of transitional cell carcinoma of bladder. Results The concentration of VEGF was low (3.73?2.63 pg/ml) in controls whereas it has been high in bladder carcinoma (210.97?154.68 pg/ml ), P

Objective To evaluate retroperitoneal laparoscopic surgery in the treatment of primary aldosteronism. Methods Retroperitoneal laparoscopic surgery was performed in 90 patients with primary aldosteronism (92 sites on either or both sides).Their clinical indicators were compared with those of 30 cases undergoing open surgery. Results Retroperitoneal laparoscopic procedures were successfully performed in 91 of the 92 sides.In these successful cases,mean operative time was 93 minutes (compared with 114 minutes in open surgery cases),mean volume of blood loss was 36 ml (compare with 87 ml),mean postoperative hospital stay was 6.8 d(compared with 11.0 d),mean time to flatus was 1.6 d (compared with 3.1 d),and mean time to walk around was 2.1 d(compared with 3.3 d), P

0.05).In the 16 cases,17 retroperitoneal laparoscopic excisions of pheochromocytoma were successful,only 1 was converted to open surgery due to intraoperative bleeding. The mean operative time was 85?31 (range,45 to 150) min in laparoscopic surgery group vs 155?39 (90 to 240) in open surgery group (P

Objective To compare the reproducibility and reliability of facial soft tissue landmarks using a direct and an indirect placement methods in facial three-dimensional (3D) soft tissue assessment.Methods 3D coordinates of 37 soft tissue landmarks were obtained respectively in 35 normal healthy volunteers from 3D optical capture system and Materialise's interactive medical image control system (Mimics).Landmarks were affixed on the cutaneous surface (direct method) and marked on the 3D reconstructed craniofacial model (indirect method).Intra-class correlation coefficients (ICCs) and paired t-tests were used to compare the reliability and reproducibility of facial landmarks between two placement methods.Results For the direct placement method,86.5 ％ landmarks had an ICC higher than 0.75.For the indirect placement method,75.7％ landmarks had an ICC higher than 0.75.The inter-observer variability using the direct placement method was (1.259±0.566) mm,which was significantly smaller (P＜0.05) than (1.420±0.638) mm obtained by the indirect placement method.Conclusions Compared with indirect method,direct method has higher reliability and reproducibility in evaluating facial soft tissue.

OBJECTIVETo observe the impact of acupuncture on the subjective symptom, sleep quality and sleep efficiency in the patients of insomnia differentiated as spleen deficiency or non-spleen deficiency in terms of the spleen and stomach theory.

METHODSSixty patients with insomnia were divided into a spleen deficiency group and a non-spleen deficiency group, 30 cases in each one. In the two groups, acupuncture was applied at Sishencong (EX-HN1), Shenmen (HT 7), Sanyinjiao (SP 6), Zusanli (ST 36) and Tianshu (ST 25). The treatment was given once every other day, five times as one course, and two courses were required. The Athens Insomnia Scale (AIS) was used to observe the changes in the patients' subjective symptoms. The Pittsburgh sleep quality index (PSQI) was adopted to observe the changes of patients' sleep quality. The sleep efficiency was applied to observe the changes in sleep time. The clinical efficacy was determined.

RESULTSThe total effective rate was both 80. 0% (24/30) after 5 and 10 treatments in the spleen deficiency group and was 76. 7% (23/30) and 80. 0% (24/30) respectively in the non-spleen deficiency group. The differences were not significant between the two groups (both P >0. 05). The AIS total scores and PSQI total scores were reduced apparently after 5 and 10 treatments as compared with those before treatment (all P<0. 01). The difference at each time point was not significant between the two groups (all P>0. 05). The sleep efficiency after 5 and 10 treatments was all improved as compared with that before the treatment in the two groups (all P<0. 01).

CONCLUSIONAcupuncture based on the spleen and stomach theory achieves possibly the same clinical efficacy in the patients of insomnia differentiated as those with spleen deficiency and non-spleen deficiency. It relieves the subjective symptoms and improves the sleep quality and sleep efficiency in the patients.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy ; Spleen ; physiopathology ; Stomach ; physiopathology ; Treatment Outcome

Objective:To evaluate the feasibility of integrating 3D photos and cone-beam computed tomography (CBCT)images and to assess the degree of error that may occur during the above process,and to analyze soft and hard tissue changes after orthognathic surgery using this new method.Methods:Ten patients with maxillofacial deformities were chosen.For each patient,CBCT scans and stereophotographic images were taken before and 3 months after surgery.3D photos were superimposed onto the CBCT skin im-ages using relatively immobile areas of the face as a reference.3D color maps and mean distances were used to evaluate the errors that might occur during the process.Two reference planes were set up using cer-tain points.The distances between Prn (pronasale),Sn (subnasale),Ls (labrale superior),ANS (anterior nasal spine),A (subspinale),UIE (upper incisor edge)to the coronal plane were calculated before and af-ter surgery.In order to verify the repeatability of this method,we examined the distances twice at two-week intervals.Paired t test was used to evaluate the reproducibility.Results:CBCT and 3D photos could be successfully fused with clinically acceptable errors.This new method could be used to evaluate soft and hard tissue changes after orthognathic surgery.The 3D color maps showed that the two images could be fused with minimal errors.The mean distances were within 0.3 mm,and the locations of landmarks on maxilla and mandible such as Ls,ANS,A,UIE changed significantly after orthognathic surgery (P <0.05). Landmarks on the nose such as Prn,Sn had little changes after surgery (P >0.1 ).The paired t test showed that the mean value and standard deviation were (0.08 ±0.98)mm.Conclusion:Fusing of CBCT and 3D stereophotographic images used as a new method in evaluating soft and hard tissue changes after orthognathic surgery was feasible and accurate.The virtual 3D composite craniofacial models permitted concurrent assess-ment of hard and soft tissues during diagnosis and treatment planning.Maxillary and mandibular locations had significant association with orthoganthic surgery while the nasal tissue was not simp affected by surgery.