Objective To investigate the healing mechanism of the rabbit's selerotomy sites undergoing the transconjunctival su- tureless vitrectomy(TSV),and to compare the wound healing effect of the different surgery procedures.Design Experimental study. Participants New Zealand white rabbits.Methods Thirty-two New Zealand white rabbits were divided into four groups:the core vitrec- tomy and fluid-air exchange (Group A),the core vitrectomy (Group B),the non-core vitrectomy and fluid-fir exchange (Group C) and the non-core vitrectomy(Group D).Intraocular pressure(IOP)was measured on the day preoperatively and the day 1,3,5,7,14 postopera- tively with Tonopen tonometers.Sclerotomy sites were investigated with the ultrasound biomicroscope(UBM)on the day 1,5 and 9 postoperatively,and the internal and the external diameter of the wound was estimated on the day 1 postoperatively.The pathological sections of the sclerotomy sites on the day 3,5 and 9 postoperatively were observed under the light microscope.Main Outcome Mea- sures IOP,the internal and external diameter of the wound.Results The IOP of Group A was obviously higher than the other groups on the day 1 postoperatively (P

Objective To evaluate the toxicity of intravitreal injection of triamcinolone acetonide on the cornea,lens,ciliary body and retina in rabbit eyes. Methods Thirty-two gray rabbits were divided into four groups(n=8).The rabbits were intravitreally injected with buffered saline solution(control group),4 mg triamcinolone acetonide(group B),1.3 mg triamcinolone acetonide(group C) and vehicle(group D).Intraocular pressure,scotopic and photopic electroretinogram examinations were performed before injection and at different time points after injection.Histologic and ultrastructural changes were observed 1 week,1 month and 3 months after injection. Results Compared with the other groups,the intraocular pressure of group B was significantly increased on day 1,week 1 and week 2 after injection(P

Objective To research the relationship between the gene polymorphism of serum amyloid A protein(SAA)1 and coronary heart disease(CHD).Methods By using PCR-RFLP and sequencing,the gene polymorphism of SAA1 of 183 patients with coronary heart disease and 152 healthy controls were analyzed.Result In the both groups 3 alleles(1.1,1.3,1.5)and 6 genotypes(1.1/1.1,1.1/1.5,1.1/1.3,1.3/1.3,1.3/1.5 and 1.5/1.5)were found.The frequency of 1.5 allele in healthy controls group was notably higher than that in CHD group(P

BACKGROUND: Nerve growth factor (NGF) and myelin-associated glycoprotein (MAG) can promote the repair of peripheral nerve. However, increasing the expression of NGF and MAG in the injured peripheral nerve by transgene technology has not been reported.OBJECTIVE: To investigate the expression of NGF and MAG after adenovirus (Ad) mediated transfection in the injured sciatic nerve in rats.METHODS: Forty Sprague-Dawley rats were randomly divided into normal, model, Ad, NGF and NGF-MAG groups. Sciatic nerve injury models were established in the latter four groups by cutting and suturing the right sciatic nerve. Afterwards, the rats in each group were subject to the intramuscular injection of normal saline, normal saline, Ad (1×108 PFU), Ad-NGF (1×108 PFU), and Ad-NGF-MAG (1×108 PFU), respectively, once every 2 days, for consecutive three times.RESULTS AND CONCLUSION: The expression level of NGF in the rat sciatic nerve in the Ad and normal groups was significantly higher than that in the NGF and NGF-MAG groups (P < 0.05). Compared with the Ad, NGF and normal groups, the expression level of MAG in the NGF-MAG group was significantly increased (P < 0.05). To conclude, the Ad-mediated NGF and MAG after double gene transfection were expressed effectively in the injured sciatic nerve in rats.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

Objective To investigate and analyze the effect and insulin dosage of insulin pump in type 2 diabetes. Methods 63 hospital patients with type 2 diabetes(FPG≥12mmol/L), who had poorly controlled blood glucose, were treated by insulin pump for 14 days, without hypoglycemic agents. The treatment days when blood glucose was well controlled and the insulin dosage at that time were observed. FPG, CBG, HbA1c, FINS/FPG, ISI, Homa-B and Homa-IR were measured before and after insulin pump. Results When blood glucose were well controlled, the mean time was (5.4+1.6) days, the insulin was (0.6+0.2)U/kg, the basal insulin was 38%. The dosage of insulin was decreased after blood glucose were controlled. Reaction of hypoglycemia was (0.6+0.2). After 2 weeks insulin pump intensive treatment, the result of FPG, CBG, HOMA-IR and HbA1c were significantly decreased (all P<0.01); FINS/FPG, HOMA-B and ISI were incleased (all P<0.01). Conclusion The excellent glycemic control and improvement of beta-cell function can be induced by short-term insulin pump intensive therapy in diagnosed type 2 diabetic patients with severe hypoglycemia.

Objective To summarize clinical experience of emergent surgery for severe liver trauma with rupture of major blood vessels. Methods The clinical data of 12 cases suffering from severe liver trauma with rupture of perihepatic and intrahepatic large blood vessels were retrospectively analyzed. These cases were from Dec 2000 to May 2008. All the cases underwent emergency operation, 6 cases were treated with liver lobectomy: among those 1 case with right posterior lobe liver resection, 1 case with irregular right lobe liver resection, 3 cases with left hemihepatectomy, and 1 case with left lateral lobectomy. Seven cases with rupture of major blood vessels were treated by repair or ligature and/or packing including repair of posthepatic inferior vena though the middle fissure in 2 cases, and through retrahepatic space in one case, interrupted suture of the portal vein in 2 cases, interrupted suture of the right hepatic veins in 2 cases. Mattress suture was applied to the ruptured hepatic veins in 7 cases including mattress suture of the branch of right hepatic vein and middle hepatic vein in 1 case, mattress suture of right hepatic vein in 1 case, suture of middle hepatic vein in 2 cases, and suture of left hepatic vein in 3 cases. One case was treated with ligation of hepatic artery and 3 cases with gauzes packing. Results Among all the 12 cases, 9 cases were cured, 3 cases died: two were caused by severe trauma together with hemorrhagic shock, one by sever brain injury together with hemorrhagic shock. Conclusions Prompt operation, precise stop bleeding and correct operation style are the key for successful rescue of patients suffering from severe liver trauma and massive bleeding.

Objective To analyze characteristics of severe liver trauma and efficacy of different surgical procedures. Methods Clinical data of 109 patients with severe liver trauma treated in the recent 10 years were retrospectively analyzed. Debriding suture was performed in 32 patients, gauze tamponade in 5, debridement hepatectomy in 59 and anatomical hepatectomy in 13 patients. Results In all the 109 patients, 92 were cured and 17 died. The dead patients included 3 with grade Ⅲ trauma,9 with grade Ⅳ trauma, and 5 with grade V trauma. Among the dead patients, there were 3 patients with simple liver injury (17.6%) and 14 with associated injury (82.4%). Conclusion Right hepatic serious damage is the main type of severe liver trauma and is always complicated with associated injury and needs emergency treatment. Application of the most appropriate surgical approach according to the traumatic condition is important to promote the successful rate of treatment.

Objective To investigate the level of uncertainty of illness and social support state in patients with prediabetes,and to discuss the correlation between the two.Methods 243 cases with prediabetes were analyzed by Uncertainty in Illness Scale and Social Support Rating Scale.Results There was a middle uncertainty in the elderly patients with prediabetes.The objective support,sabjective support,social support utilization degree and social support score were negatively related to the complexity of uncertainty(r--0.419,-0.433,-0.390 and-0.421,respectively,all P＜ 0.05).Conclusions Medical staff should evaluate the uncertainty in illness in elderly patients with prediabetes and conduct nursing intervention accordingly,in order to reduce the uncertainty,increase social support,and ultimately improve the quality of life.

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.