Objective [WT5”BZ] To evaluate the surgical treatment of insulinomas in the head and neck of the pancreas. [WT5”HZ]Methods [WT5”BZ] Data of 43 patients with insulinomas located in the head and neck of the pancreas during the past 16 years in PUMC Hospital were analyzed retrospectively.[WT5”HZ] Results [WT5”BZ] The average age of patients was 37 years old with an average preoperative history of 2 7 years. The preoperative accuracy of PTPC, DSA, B ultrasound, CT and MRI were 89 5%,72 5%,22 4%,25 3% and 66 7% respectively. The accuracy of intraoperative palpation was 97 8%. Enucleation of tumors was usually applied, and distal pancreatectomy or Roux en Y pancreaticojejunostomy were performed in 7 cases. The incidence of postoperative pancreatic leakage was 32 6%.[WT5”HZ] Conclusions [WT5”BZ] Selection of operation methods depends on the relationship of tumor with pancreatic duct and bile duct. Intraoperative monitoring of blood glucose is an essential mean to verify the complete resection of tumors. [WT5”HZ]

The big-data era has arrived, which involves all professions and trades. Its impact on the medical field has gradually revealed. With the characteristics of big data "4V" (volume, velocity, variety, value) and its theory generality with TCM (holistic thinking, correlativity) as well as regularity of disease development, combined with present status of acupuncture clinical research, the influences of big-data era on trial design, data collection, analysis and sharing of acupuncture clinical research are discussed in this paper, aiming to provide references for solving the difficulties of study design and determining the future research direction of acupuncture clinical research.
Acupuncture Therapy ; Biomedical Research ; Clinical Trials as Topic ; Database Management Systems ; Humans ; Medicine, Chinese Traditional

BACKGROUND: For its extensive sources and specific biological characteristics, heterogeneous deproteinized bone (DPB) as the tissue-engineered scaffold material gets a good application prospect in repair of large segmental bone defects.OBJECTIVE: To prepare scaffold material by compositing modified heterogeneous DPB with recombinant human bone morphogenetic protein 2 (rhBMP2) and evaluate the osteogenic ability in repairing large segmental long bone defects in large-sized animals.METHODS: Twenty-four goats were randomly and evenly divided into three groups: DPB, autologous bone, and DPB+rhBMP2. Bone defects (20% in length) were made in the middle and lower segments of the right tibia of each goat, and according to group design,different bone grafts were implanted and fixed using semi-ring slot external fixer. At 4-24 weeks after surgery, X-ray examination was performed once every other 4 weeks. At 24 weeks after surgery, newly formed bones were taken out for determining the repair effects of bone defects through duat-energy X-ray analysis, histological observation, and biomechanical analysis.RESULTS AND CONCLUSION: The prepared DPB exhibited a three-dimensional porous structure, with a porosity of (78.5±6.45)% and pore size of (472.5±7.02) μm. Time-dependent bone repair was found in each group. Results regarding anti-compression test, three-point anti-bend test, and anti-torsion test were greatest in the autologous bone group, followed by the DPB+rhBMP2 group, and lastly the DPB group. There were no significant differences in tibial bone density, bone mineral content,anti-compression pressure and ultimate pressure, anti-bending load and ultimate toad, anti-torsion torque and ultimate torque between autologous bone group, DPB+rhBMP2 group and normal bone control group. These findings indicate that modified heterogeneous DPB composited with rhBMP2 has osteogenic ability equivalent to autologous bone in repairing large segmental long bone defects in goat tibias. Therefore, it can be applied as tissue-engineered scaffold material.

Accidents, Occupational ; Chronic Disease ; Hexanes ; poisoning ; Humans ; Shoes

Randomized controlled trials (RCT) is the source of the raw data of evidence-based medicine. Blind method is adopted in most of the high-quality RCT. Sham acupuncture is the main form of blinded in acupuncture clinical trial. In order to improve the quality of acupuncture clinical trail, based on the necessity of sham acupuncture in clinical research, the current situation as well as the existing problems of sham acupuncture, suggestions were put forward from the aspects of new way and new designation method which can be adopted as reference, and factors which have to be considered during the process of implementing. Various subjective and objective factors involving in the process of trial should be considered, and used of the current international standards, try to be quantification, and carry out strict quality monitoring.
Acupuncture Therapy ; standards ; Biomedical Research ; standards ; Evidence-Based Medicine ; Humans ; Randomized Controlled Trials as Topic ; standards

Objective To systematically assess the efficacy of endoscopic operation and open operation for treating carpal tunnel syndrome .Methods The computer retrieval from MEDLINE ,EMBASE ,Cochrane August ,CNKI ,VIP ,Wanfang databases were conducted for collecting all related randomized controlled trials (RCT ) from February 1989 to February 2012 .The included litera-tures were performed the data extraction ,assessment of bias risk and the quality evaluation .Mata analysis was performed by the RevMan 5 .1 .6 software .Results 21 RCTs including 1 863 operations ,982 cases endoscopic carpal tunnel release (ECTR) and 881 cases of open carpal tunnel release(OCTR) ,met the inclusion criteria .Meta analysis showed that the differences in terms of postop-erative grip strength ,two points discrimination ,incidence of complications ,satisfaction rate ,postoperative symptom relief rate and operation time between the ECTR group and the OCTR group had no statistical significance .The ECTR group was better than the OCTR in the aspects of the time returnning to work ,pinch strength ,postoperative pain rate .Conclusion The ECTR group is supe-rior to the OCTR group in terms of the time returnning to work ,pinch strength ,postoperative pain rate .The other related indexes have no obvious differences between the two kinds of operation procedures .Due to the poor quality of some RCTs ,the above conclu-sion needs more high-quality ,large-sample clinical researches to confirm .

Objective Degenerative lumbar scoliosis is frequent clinic spine malformation ,and it is complicated by lumbar inter-vertebral disc ,joint of lumbar vertebra cataplasia and lumbar spinal stenosis .The aim of this paper is to study surgical therapeutic regimen for analyzing clinic feature of degenerative lumbar scoliosis .Methods We comprehended symptom and analyzed imageology feature for lumbar spinal stenosis through reviewing 48 cases of operation from August 2003 to August 2010 ,and then approached its therapeutic principle and regimen .Results There were good therapeutic effect on the basis of comprehending degenerative lum-bar scoliosis and designing different treatment plan by different case feature .Conclusion Ii is need to know degenerative lumbar scoliosis again ,in order to work out individual therapeutic regimen based on clinic feather ,process segment ,state of spinal stenosis , angle of lumbar scoliosis ,degree of vertebra rotation and lumbar destabilizing .

Background Pterygium is a relatively common eye disease,but its aetiology and pathogenesis remain uncertain.At present,the study on pterygia focuses on understanding its underlying mechanism.Objective This study was to detect the expression of 8-hydroxy-2'-deoxyguaine (8-OHdG),a marker of oxidative damage of DNA,and bcl-2,a gene related with apoptosis,on the pterygium tissue.Methods Thirty pterygium tissue specimens were obtained during the surgery with the primary pterygium 24 cases and recurrent pterygium 6 cases.In addition,20 normal conjunctival specimens from retinal detachment surgery and strabismus surgery were collected.The expressions of 8-OHdG and bcl-2 in pterygium tissue were detected using immunochemistry and compared with the normal conjunctival tissue.The difference in the expressions of 8-OHdG and bcl-2 among different specimens was compared by x2test,and the relationship between 8-OHdG expression and bcl-2 expression was evaluated by Kappa test.Results The positive expressing rate of 8-OHdG in the pterygium tissue was 62.5％ and 83.3％ in the primary and recrudescence pterygium tissue,respectively,but the expression of 8-OHdG was absent in the normal conjunctiva tissue.No significant difference was found in the positive expressing rate of 8-OHdG between primary and recrudescence pterygium tissue(x2 =0.938,P＞0.05).The bcl-2 expressing rate was 90.0％ and 87.5％ in the primary and recrudescence pterygium tissue,respectively.However,that in the normal conjunctival tissue was absent.No significant difference was seen in the bcl-2 expression rate between primary and recrudescence pterygium tissue (x2=0.833,P ＞ 0.05).Of the 27 pterygium tissue with bcl-2 positive expression,8-OHdG showed the positive expression in 20 specimens,and 3 specimens with the bcl-2 negative response were absent reactive to 8-OHdG,showing insignificant difference between them (P＞0.05).The relationship between 8-OHdG expression and bcl-2 expression was concord in a certein extent (Kappa =0.464).Conclusions The upregulation of 8-OHdG in the pterygium tissue indicates that oxidative damage of DNA plays a role in the development of pterygium.Oxidative damage of DNA caused by ultraviolet may be an upriver factor,which induces raising up of expression of bcl-2 and inhibits the apoptosis of normal cells and further proliferation of the conjunctiva tissue,resulting in the genesis and development of pterysium.

Nowadays, LAN can't meet the requirements of field communication, and WLAN is playing more and more important role for its strong transmission ability and high mobility. This paper introduces the application of WLAN to filed medicine.

Objective To study the short-term clinical efficacy and its possible mechanism of refractory hypertension(RH) treated by continuous veno-venous hemofiltration (CVVH) in maintenance hemodialysis (MHD) patients. Methods Thirty-four MHD patients with RH treated with CVVH enrolled in the treatment group,all these patients were treatment of 2 -3 times,each time 8 - 10 hours. Thirty MHD patients with wellcontroled blood pressure were recruited as control. Changes of blood pressure, dry weight, plasma levels of parathyroid hormone (PTH), renin ( RA), angiotensin Ⅰ , Ⅱ ( AT Ⅰ , AT Ⅱ ), aldosterone ( Ald ) were observed before and after hemodialysis. Results In the treatment group,compared with pre-treatment, the blood pressure decreased significantly with an effective rate of 64.7% and efficient rate of 100. 0%. Before treatment, plasma RA was ([1.10 ±0.25] μg/(L · h)and [0:78 ±0.26] μg/(L · h),AT Ⅰ was [0.89 ±0.21] μg/L and [ 0. 52 ± 0. 14 ] μg/L, AT Ⅱ was [ 177.68 ± 89.46 ] ng/L and [ 89. 25 ± 12. 84 ] ng/L, Ald was [72. 06 ± 11.47 ]ng/L and [ 48.92 ± 8. 65 ] ng/L, PTH was [ 306. 81 ± 69. 37 ] ng/L and [ 248.76 ± 134. 62 ] ng/L in the treatment and control group respectively. All the measurements in the treatment group were significantly higher than those in the control group (P ＜ 0. 05 ). In the treatment group, compared to pre-treatment, plasma RA significantly decreased ( [ 1.10 ± 0. 25 ]μg/ ( L · h) vs [ 0. 76 ± 0. 17 ] μg/( L · h ), as well as AT Ⅰ ( [ 0. 89 ±0.21]μg/L vs [0.50 ±0.12] μg/L),ATⅡ([177.68±89.46]ng/L vs [ 87.13±14.22] ng/L),Ald ([72.06±11.47]ng/Lvs [ 46. 01± 9. 86 ] ng/L ) and PTH ( [ 306. 81 ±69.37]ng/L vs [ 186.53 ±32.93 ] ng/L) ( P ＜ 0. 05 ). However, there was no significant changes in the above mentioned measurements between before and after hemodialysis in the control group (P ＞ 0. 05). Conclusion CVVH may be an effective methods in the treatment of MHD patients with RH, and its antihypertensive mechanisms may be that CVVH can effectively remove the excess water in the body, and reduce plasma RA, AT Ⅰ , AT Ⅱ ,Ald and PTH levels.