Objective To explore the effect of the combination of benazepril and beraprost sodium on urinary microalbumin (UMA), serum high sensitivity C-reactive protein (hs-CRP) and TNF-α in patients with diabetic nephropathy(DN) in early stage. Methods From Mar. 2010 to Mar. 2013, 120 patients with early-stage DN were randomly divided into Benazepril Group, Beraprost Sodium Group and Combination Group. Each group consisted of 40 patients with medical therapy in 20-week duration. The levels of 24 h-UMA, serum hs-CRP and TNF-α were detected and compared before and after therapy. Results After treatment, the levels of 24 h-UMA, serum hs-CRP and TNF-αall decreased significantly in three groups (P<0.05) and there were lower 24 h-UMA, serum hs-CRP and TNF-αin Combination Group than those in Benazepril Group and Berapros sodium Group (P <0.05). Conclusion There is coordinating protection of combination of benazepril and beraprost sodium on diabetic nephropathy in early stage, possibly being related with the inhibiting of micro-inflammation.

BACKGROUND:Studies have shown that low-intensity and short-time vibration with a certain frequency can reduce the absorption of bone tissue and increase the quantity and quality of bone through promoting the proliferation and differentiation of osteoblasts.
OBJECTIVE:To investigate the effects of different frequencies of vibration strains on cycle, proliferation and differentiation potency of RAW264.7 cel s cultured in vitro.
METHODS:Passage 6 RAW264.7 cel s in good conditions were randomly divided into six groups, and each group was induced cultured with Dulbecco’s modified Eagle’s medium containing receptor activator of nuclear factor kappa B ligand. The final concentration of receptor activator of nuclear factor kappa B ligand was adjusted to 50μg/L, and then kept without changes. The non-loading group did not loaded with vibration strain, and the other five groups were loaded with 3-10 Hz, 15-35 Hz, 35-45 Hz, 50-70 Hz and 70-90 Hz vibration strains on the RAW264.7 cel s respectively. The other vibration parameters were consistent;the vibration time was 15 min/time with the vibration intensity of 0.3 g, twice per day. The cel cycle and cel proliferation were detected at 3 and 6 days after loading of vibration strains.
RESULTS AND CONCLUSION:After composite vibration loading for 6 days, the cel cycle phase in the vibration groups was changed to some extent when compared with the non-loading group. Compared with non-loading group, the cel number in the G 1 phase of the vibration group was significantly increased (P<0.01);the cel number in the S phase and G 2+M phase of the vibration group was significantly decreased (P<0.01);the vibration parameters in the vibration group were significantly decreased (P<0.01). The results indicate that different frequencies of vibration strains can affect the cel cycle and proliferation, and can inhibit the proliferation and differentiation of osteoblasts.

Objective:To study the technical and essential steps in laparoscopic selective devascularization with paraesophageal veins-preservation.Methods:To retrospectively analyze the clinical data of 13 cirrhotic patients who underwent laparoscopic selective pericardial devascularization for portal hypertension at the Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital from January 2019 to March 2020. There were 9 males and 4 females with age ranging from 41 to 83 years (median 51 years). The operative time, intraoperative blood loss, postoperative complications and follow-up data were analyzed.Results:All the 13 patients completed theoperation, no patient stopped the operation or transferred to laparotomy. The operation time was (170±32) min.The intraoperative bleeding was (160±30) ml. The postoperative hospital stay was (6.1±1.1) days. There were no complications, including pancreatic leakage and intra-abdominal infection. On follow-up which ranged from 1 to 15 months, one patient developed portal vein thrombosis, no upper gastrointestinal rebleeding.Conclusions:Preservation of esophageal veins in laparoscopic selective devascularization is an accurate surgery which requires close teamwork and rich experience in laparoscopic surgery. The preservation of the main trunk of the gastric coronary vein and integrity of the esophageal veins are the keys to the surgery which is safe and feasible.

The consecutive data of 822 senior public officials in Chengdu undergoing health checkup from 2011 to 2016 were retrospectively reviewed.Among them,56 new cases of diabetes was diagnosed with a cumulative incidence of 6.81％.Fifty six age-and sex-matched healthy subjects served as controls,the risk factors of new-onset diabetes were analyzed with multivariate logistic regression.The results showed that BMI (OR =1.82,95％ CI:1.27-2.59,P =0.00) and fasting plasma glucose (OR =13.63,95％ CI:2.71-68.43,P =0.00) were independent risk factors of new-onset diabetes in senior public officials.

BACKGROUND:Among the pathogenic factors of cervical spondylosis,herniation of the intervertebral disc,dislocation of the facet joint and the stenosis of the intervertebral foramen are important factors leading to symptoms in patients.Moreover,inappropriate manipulation may aggravate the possibility of cervical disc rupture,leading to exacerbation of symptoms in patients. OBJECTIVE:To compare the effect between sagittal cervical manipulation and traditional cervical rotation manipulation on the area of the intervertebral disc,facet joint and intervertebral foramen at the operative segment by the finite element analysis. METHODS:The neck CT data of a male volunteer with a normal neck were selected and imported into Mimics 17.0 three-dimensional reconstruction software.Geo-magic Studio 12.0,Solidworks 2017 and Ansys Workbench 17.0 software were used for the construction of the finite element model of cervical vertebrae(C3-6)including intervertebral disc and articular cartilage.The lower end plate of the C5 vertebral body was fixed.A uniformly distributed vertical downward 50 N load was applied on the upper surface of the upper vertebral body(C3).The stress,deformation and deformation direction of the C4-5 intervertebral disc,joint capsule stress,the displacement of facet joints and the area of bilateral intervertebral foramen were compared between sagittal cervical manipulation and traditional rotation reduction. RESULTS AND CONCLUSION:(1)When using the rotation technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 8.06 MPa;the total deformation was 1.05 mm,and the fiber ring expanded to the left and outside.When using the sagittal tip lifting technique,the maximum normal equivalent stress(von Mises stress)of the C4-5 disc was 2.60 MPa;the total deformation was 0.90 mm,and the fiber ring expanded to the left and back.Compared with the rotation technique,the pressure of the cervical manipulation technique on the disc was less(about 32.3%of the rotation technique),and the deformation degree of the disc was also light(about 85.7%of the rotation technique).(2)When the rotation technique was used,the maximum stresses of the left and right articular capsule ligaments were 0.37 MPa and 1.69 MPa,respectively.The overall displacement of the facet joint was 2.21 mm.The area of the right intervertebral foramen decreased by about 3.8%and the area of the left intervertebral foramen increased by about 0.9%.When the sagittal end lifting manipulation was performed,the maximum stresses of the left and right articular capsule ligaments were 0.27 MPa and 1.70 MPa,respectively;the overall displacement of the facet joint was 1.63 mm;the area of the right intervertebral foramen increased by about 2.6%,and the area of the left intervertebral foramen decreased by about 0.9%.Compared with rotation manipulation,sagittal end lifting manipulation had fewer changes in the displacement of facet joint,joint capsule stress and intervertebral foramen area,so it was safer to operate.(3)In conclusion,compared with cervical rotation manipulation,sagittal end lifting manipulation has fewer changes in facet joint displacement,intervertebral disc stress/deformation degree,joint capsule stress,and foraminal area.In clinical practice,more appropriate manipulation should be selected based on biomechanical results after an accurate assessment of patients'conditions.

【Objective】 To compare the degree, efficacy and safety of testicular catch-up growth after inguinal and subinguinal surgery for adolescent varicocele. 【Methods】 Clinical data of 121 adolescent varicocele patients with secondary testicular atrophy treated during Sep.2014 and Jun.2021 at Huili People’s Hospital were retrospectively analyzed, including 40 cases treated with the inguinal incision approach, and 81 with the subinguinal approach. The characteristics of intraoperative, efficacy, surgical complications and prognosis were compared between the two groups. 【Results】 The inguinal group had significantly shorter microscope usage time (P=0.006), fewer number of preserved internal spermatic arteries (P<0.001), and significantly larger diameter of preserved internal spermatic arteries than the subinguinal group (P=0.005). The subinguinal group required ligation of more internal spermatic veins, and there were significantly more internal spermatic veins with a diameter of 4 mm or more (P<0.001). No recurrence occurred, and the incidences of scrotal edema and hydrocele were very low (P>0.05). Two years after surgery, the bilateral testicular volume of both groups was significantly larger than that before surgery (P<0.05), and there was no significant difference in the testicles (P>0.05). 【Conclusion】 In the treatment of adolescent varicocele patients with secondary testicular atrophy, the subinguinal approach significantly reduces the difficulty of microsurgical varicocele ligation, and has good efficacy and safety, which is worthy of clinical promotion and application.