Objective To explore an easy,safe and effective method for correction of the hypertrophy of mandibulae angle and inferior facial enlargement.Methods Based on the complexion of mandibulae angle hypertrophy,32 patients were treated through an intraoral incision with complete separation of masseter,polish of the diagonal site,camber gonion osteotomy and mandibular marginal plasty under local anaesthesia.Meanwhile,19 patients with masseter hypertrophy were injected with botulinal toxin A three months after the operation,and 2 patients with facio-buccal fullness were treated with removal of the buddal fat pad.Results 12 patients were satisfied with the results after following-up for one to six months.Conclusion This method is easy-doing,safe,reliable and accords with the principle of aesthetics.Osteotomy and grinding of the bone are convenient,which have little damage to patients with less complications and quick recovery.

Objective To study enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy.Methods A case-control study was conducted on 56 patients who underwent pancreaticoduodenectomy in our hospital from May 2012 to December 2016.These patients were divided into two groups:25 patients received ERAS management (the ERAS group) and 31 patients traditional perioperative management (the control group).The data on postoperative pancreatic leakage,bile leakage,postoperative bleeding,delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay,medical cost and readmission rate within 90 days between the two groups were compared.Results The rate of delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay and medical cost were significantly better in the ERAS group than the control group (all P ＜ 0.05).There were no significant differences in the rates of pancreatic leakage,bile leakage,postoperative bleeding,and readmission within 90 days between the two groups (all P ＞ 0.05).Conclusions Perioperative ERAS in pancreaticoduodenectomy was safe and efficacious.It improved recovery of patients and reduced hospital stay and expenses.

OBJECTIVE: To observe the effect of perioperative administration of rhubarb on the acute inflammatory response in patients with gastric cancer. METHODS: In this prospective, single-blinded, controlled clinical trial, thirty-one patients with gastric cancer operatively treated were randomly divided into two groups, with 14 patients in control group and 17 in study group. Patients in both groups were given an isocaloric and isonitrogenous enteral diet. The enteral diet was started 36 hours after operation, and continued for 6 days. Patients in the study group were fed with rhubarb before operation, and at 1 day and 2 days after operation. Indexes of acute inflammatory response such as serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha), and indexes of nutritional status such as serum albumin (ALB), prealbumin (PA) and transferrin (TRF) were measured before operation, and at 1 day, 3 and 7 days after operation. RESULTS: Patients in both groups had acute inflammatory response, and the indexes of nutritional status decreased after operation.IL-6, CRP and TNF-alpha tested at 3 and 7 days after operation were lower in the study group as compared with those in the control group, and the recovery time of gastrointestinal motility such as borborygmus, gas elimination and defecation was shorter in the study group as compared with that in the control group. The indexes of nutritional status showed no significant differences between two groups after operation. CONCLUSION: Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.

This study was aimed to reveal the material basis on different diseases of the same syndrome damp-heat syndrome from the level of metabonomics.The typical damp-heat syndrome patients diagnosed as chronic viral hepatitis B,non-alcoholic fatty liver disease,or chronic glomerulonephritis were included,with 30 cases in each disease.There were 30 healthy volunteers in the control group.The serum samples were detected by UPLC-QTOFMS and GC-TOFMS.And then,the results were analyzed by variance analysis in order to find out the generality and specificity of metabolic material in three different diseases with damp-heat syndrome.The results showed that through comparisons of different diseases with damp-heat syndrome,as well as the healthy group as control,it was revealed that inosine,uridine,aspartic acid,oleic acid glyceride and lactate were the same substances of three diseases of damp-heat syndrome.It was concluded that based on metabonomics,as for three different diseases with damp-heat syndrome,there were different substances among different diseases,but common substances related to damp-heat syndrome.Thus,it provided objective evidences for the theory of different diseases of the same syndrome in traditional Chinese medicine (TCM) from the level of metabonomics.

Objective This study was to compare surgical safety and oncologic adequacy of laparoscopy-assisted gastrectomy (LAG) versus open gastrectomy (OG) for advanced gastric cancer.Methods 120 consecutive AGC patients undergoing LAG with D2 lymph node dissection between September 2005 to December 2009 were compared with 120 AGC patients undergoing OG during the same period.In each group,50 underwent distal gastrectomy,70 for total gastrectomy.Results There was no conversion to open surgery in LAG.The operative time was significantly longer in LAG than OG [(307 ± 84) min vs.(203 ± 52) min,t'=11.556,P ＜ 0.01].The estimated blood loss was significantly less in LAG group than OG group [(258 ± 78) ml vs.(318 ± 89) ml,t =5.550,P ＜ 0.01].The number of lymph nodes retrieved was(17 ±11) in LAG,(16 ±10)in OG (t =0.723,P＞0.05).All margins were tumor free in both groups.9 patients had the postoperative complication in LAG,8 patients in OG (P ＞ 0.05).Length of postoperative stay was significantly shorter in LAG than OG [(10.6 + 4.7) vs.(14.3 ± 2.9) days,t' =7.339,P ＜0.01].There was no mortality in both groups.The 5-year recurrence-free survival rate were comparable (47.6％ in LAG vs.42.8％ in OG,x2 =0.577,P ＞ 0.05) between the two groups.Conclusions This study suggested that laparoscopy-assisted gastrectomy is safe and feasible in terms of surgical outcome and oncologic adequacy for advanced gastric cancer.

Objective To investigate the effects of total anthraquinone in rheum on aquaporin 2 and aquaporin 4 expression in rat kidney and explore its diuresis mechanism.Methods Thirty-two SD rats were randomly divided into control group,low dose group,medium dose group and high dose group.Total anthraquinone in rheum was administered to rats at different doses.Urinary volume of 24 h,Na+ concentration and osmolality were detected.Rats were sacrificed 5 days later.Blood samples were taken from the abdominal aorta to detect blood biochemical indicators. Kidneys of rats were removed to detect AQP2, AQP4 expression through immunohistochemistry,Western blot,and RT-PCR. Results Compared with control group,there were significantly increased 24 h urine output of rats in medium and high dose group[(16.21±1.96),(18.16±1.8) ml vs(13.85±1.25)ml,P＜0.05].24 h urine output in low-dose group did not change significantly.AQP2 protein and mRNA expression were significantly decreased in rats'kidneys of medium and high dose group (P＜0.01),The AQP4 protein and mRNA expression was significantly down-regulated in high dose group (P＜0.01).In medium does group,the AQP4 protein expression was down-regulated (P＜0.01),without significant decrease in the mRNA expression.Protein and mRNA expression of AQP2 and AQP4 did not significantly change in low dose group.Conclusion Total anthraquinone in rheum can reduce the expression level of AQP2 and AQP4 in rat kidney,which is probably one mechanism of diuresis caused by rheum.

Aim To construct a eukaryotic expression vector of human MCHR2 and to analyze the stable expression and signal transduction pathways of MCHR2 in CHO cells. Methods The full-length MCHR2 cDNA fragment was amplified by PCR from the human fetal brain cDNA library and inserted into eukaryotic expres-sion vector pcDNA3.1(+), resulted in the recombinant expression vector pcDNA3.1-MCHR2. The recombinant plasmid was confirmed by the restriction enzymatic digestion and DNA sequencing analysis, and then transfected into CHO cells by lipofectamine. A stably-transfected cell line was obtained by the dominant G418 selection, and the expression of the MCHR2 gene on transcription and translation levels were identified by RT-PCR and Western blot. Signal transduction pathways mediated by MCHR2 were analyzed by measurement of intracellular cAMP and calcium. Results The eukaryotic expression vector pcDNA3.1-MCHR2 was successfully constructed and the MCHR2 gene was stably transfected into CHO cells. A stably-transfected cell line was established and the MCHR2 gene was efficiently transcribed and translated. MCH stimulation had no effect on the production of cAMP, however, it could induce a clear and transient increase of intracellular calcium, suggesting that MCHR2 was only coupled to Gq protein. Conclusion The stable expression of MCHR2 and analysis of its signal transduction pathways in CHO cell line provided a solid experimental foundation for further studies on the function of the MCHR2 gene in vitro.

Objective:To study the drug resistance patterns of Bordetella pertussis in vitro, and to know the clinical characteristics of pediatric pertussis and evaluation the treatment outcomes, which may provide references for experiential diagnosis and treatment of this disease. Methods:Nasopharyngeal swabs of the hospitalized children with suspected pertussis in Children′s Hospital, Zhejiang University School of Medicine in 2017 were collected for culture. And the clinical data of the children were collected. The strains were identified by pertussis-specific antiserum agglutination and finally confirmed by mass spectrometry. The drug sensitivity test was performed using the E-test method. The efficacy of therapy with antibiotic was evaluated after two weeks of treatment. Statistical analysis was performed with Mann-Whitney U test and chi-square test. Results:Of 1 029 children, 211 (20.5%) nasopharyngeal swabs were positive for Bordetella pertussis culture, and the isolation rate of the specimens was highest (31.2%, 45/144) in July. Of the 211 pertussis patients, 105 (49.8%) were male and the age were 3.8 (2.2, 6.9) months, 114 (54.0%) were not vaccinated with pertussis diphtheria tetanus mixed vaccine and 192 (91.0%) were prescribed with previous antibiotics. There were 142 (67.3%) children from families with two or more than two children, and 136 (95.8%) of which were the youngest siblings. One hundred and fifty-nine (75.4%) patients had paroxysmal cough and 61 (28.9%) had whooping. The white blood cell counts were higher than 20×10 9/L in 94 (44.5%) patients, and the lymphocyte counts were higher than 10×10 9/L in 97 (46.0%) of patients. The drug susceptibility results showed that 138 (65.4%) strains were against erythromycin, azithromycin and clindamycin with minimum inhibitory concentration (MIC)>256.000 mg/L. The MIC 90 of the isolates to ampicillin, ceftriaxone, cefoperazone/sulbactam, meropenem and trimethoprim/sulfamethoxazole were 0.190 mg/L, 0.190 mg/L, 0.094 mg/L, 0.094 mg/L and 0.750 mg/L, respectively. All strains had a MIC of <0.016 mg/L for piperacillin/tazobactam. After treatment, symptoms were improved in 195(92.4%) patients when they were discharged from hospital. Seventy-six (57.1%) children whose symptoms did not improve after seven-day treatment with macrolides, were prescribed with other antibiotics or other antibiotic with macrolides in combination. Compared with the patients treated with macrolides, more patients treated with cefoperazone/sulbactam or piperacillin/tazobactam had negative nasopharyngeal culture results after two weeks of therapy (46/48(95.8%) vs 46/57(80.7%)), or on day seven (45/46(97.8%) vs 39/47(83.0%)) and on day 14 (45/45(100.0%) vs 41/47(87.2%)) since discharged. The differences were all statistically significant ( χ2=5.50, 5.86 and 6.15, respectively, P=0.019, 0.015 and 0.013, respectively). Conclusions:The majority of children with pertussis do not have whooping, and the resistant rate of Bordetella pertussis to macrolides is high. Further study is needed to evaluate the feasibility and reasonability of cefoperazone/sulbactam and piperacillin/tazobactam in treating pediatric pertussis caused by macrolides-resistant Bordetella pertussis.