79 patients with an initial onset of ketosis or ketoacidosis were classified into four groups,based on the presence of islet autoantibodies(A+or A-) and-βcell functional reserve(β+or β-).According to their clinical characteristics,biochemical parameters and therapeutic consequences,the four groups can be considered as type 1 DM,idiopathic type 1 DM,latent autoimmune diabetes in adults(LADA) and type 2 DM respectively.

Autoimmune disease is the result of interplay between genetic and environmental factors, Immunoregulatory genes and thyroid specific genes play important roles in the pathogenesis of autoimmune thyroid diseases.

To analyze the effect of the treatment of dual plane breast augmentation ( one part of the implantation was located behind breast parenchyma and the other part was located behind the pectoralis majior muscle) use areo-lar papillaris incision. Using the areolar papillaris incision complete dual plane breast augmentation. For some breast potsis patients the superfluous areolar papillaris skin was removed and suspension fixation was performed at the same time. Some patients were followed up for 3-months to 2-years. All surgical outcomes were satisfactory with natural breast shapes, and there were no complications such as capsular contracture, prosthesis shift or burst. U-sing the areola papillaris incision can complete dual plane breast augmentation surgery without endoscopic guid-ance;surgery is simple under directvision.

Objective:To analyse the dataflow and clinical flow in Suzhou municipal hospital radiology information system and picture archiving system, presents a set of system integration messages, and describes the effect of each message for the communication. Methods: Follow the framework of IHE and HL7 protocol, the paper uses standard messages to integrate two different systems for patient and study status communication. The integration can meet clinical users’ requirements.Results: Based on many years practice, the integration reached designed target.Conclusion: With further research on standard, the seamless system integration between different systems can help customer to make full use of each system and save more cost in system purchase.

OBJECTIVE:To investigate the effects of Periplogenin, a compound extracted and purified from traditional Chinese medicine Cortex Periplocae, on mast cell degranulation and histamine release in mice and rats. METHODS: Sensitization was induced by injecting pertussis vaccine injected in rats' abdominal cavity and ovalbumin injected in mice's hind leg to detect mast cell degranulation reaction and prepare anti-serum; rats were injected intraperitoneally with the diluted serum sample taken form sensitized rats to detect mast cell degranulation reaction; and the concentration of histamine was determined by fluorescence spectrophotometry. RESULTS: Periplogenin showed significant inhibitory effect on histamine release of mast cell cultured in vitro, and at experimental dose it could decrease histamine release by(69.4?8.6)% in an obvious dose-depe-ndent manner. Periplogenin also showed obvious inhibitory effect on histamine release of mast cells in antigen-sensitized rats,and at a concentration of 20 ?g?mL-1,it could decrease histamine release by 73.55%, and at an oral dose of 50 mg?kg-1, it could dose-dependently reduce histamine release by above 80% in sensitized rats. CONCLUSION: Periplogenin showed significant inhibitory effects on histamine release of mast cells either cultured in vitro or in antigen-sensitized rats. Oral administration of Periplogenin can result in the significant reduction of histamine release of mast cells in rats. In view of the role that the mast cell histamine release and degranulation play in inflammation reaction, periplogenin can be regarded as one of the active anti-inflammation components of traditional Chinese medicine Cortex Periplocae.

Objective To identify the risk factors for surgical site infections after operation of laparoscopic cholecystectomy (LC), so as to provide warning signs for preventing such incidents. Methods The data of 4042 LC patients from January 2003 to December 2015 were analyzed retrospectively. The risk factors for surgical site infections were identified among demographic data, preoperative patients′history, and operative data using multivariate Logistic regression analysis. Results Surgical site infections after LC was seen in 7.2% (291/4042) of the patients. Multivariate analysis identified the following parameters as risk factors for surgical site infections: additional surgical procedure ( OR 4.011, 95%CI 2.149-7.486), age over 55 years (OR 2.398, 95%CI 1.777-3.235), conversion to open procedure (OR 2.647, 95%CI 1.935-3.621), postoperative hematoma (OR 1.910, 95%CI 1.192-3.060), duration of operation >60 min (OR 2.493, 95%CI 1.710-3.635), cystic stump insufficiency (OR 12.451, 95%CI 4.169-37.189), gallbladder perforation (OR 6.161, 95%CI 2.365-16.047), gallbladder empyema (OR 1.704, 95%CI 1.080-2.689), and surgical revision (OR 15.725, 95%CI 10.439-23.686). Surgical site infections were associated with a significantly prolonged hospital stay (P<0.01), higher postoperative mortality (P<0.01), and increased rate of surgical revision (P<0.01). Conclusions Additional surgical procedure is identified as a strong risk factor for surgical site infections after LC. Furthermore, operation time >60 min, age >55 years, conversion to open procedure, cystic stump insufficiency, postoperative hematoma, gallbladder perforation, gallbladder empyema, or surgical revision were identified as specific risk factors for surgical site infections after LC.

Objective To observe the treatment and outcomes of gastric stump cancer(GSC) after subtotal gastrectomy,and to analyse the possible related factors for the development of GSC. Methods The clinical data of 693 patients with subtotal gastrectomy were retrospectively analysed.The development,treatment and outcomes of GSC were observed,and the possible factors associated with the development of GSC were analysed. Results Seventy-six cases of GSC emerged in the 693 patients with subtotal gastrectomy.Fifty-one of the 76 cases were perfomed radical operations(n=36) or palliative resection(n=15).No death was found during the perioperative period,and the median survival time was 32.7 and 14.2 months,respectively.Those 25 without surgical management died 3 to 11 months after the development of GSC.Among the 76 cases with GSC,stomach was found as the original site of ulcer in 59(22.3%,59/259),and duodenal bulb in the other 17(3.9%,17/434)(P

Objective To investigate of human esophageal squamous carcinoma cells(Eca-109) in which cyclooxygenase (COX)-2 gene was knocked down by adenovirus delivered siRNA.Methods Based on the plasmid pSUPER cloned with RNA polymerase Ⅲ-dependent promoter HI,the interfering plasmid psiRNA/COX-2 targeting human COX-2 mRNA was constructed,The siRNA/COX-2 fragment was derived from psiRNA/COX-2 digested by Not I and Xho 1.and was cloned into the shuttle plasmid pAdTrack.Then pAdTrack/siRNA/COX-2 was obtained and co transfected into the E.coli strain BJ5183 with the bone plasmid pAdEasy-1,the recombinant adenovirus Ad/siRNA/COX-2 was generated by homologous recombination.Having been packaged and amplified in cells 293,Ad/siRNA/COX-2 was transfected into Eca-109 cells.The PGE2 concentration in the cells culture supernatant was determined by ELISA,and the level of COX-2 mRNA in the cells was tested by real time PCR.Moreover,cell cycle and apoptosis were determined by flow cytometry,and cells growth curve was protracted.Results The recombinant adenovirus Ad/siRNA/COX-2 was successfully constructed.Ninty six hours after Ad/ siRNA/COX 2 transfecting into Eca 109 cells,COX-2 mRNA was reduced by 71.7%,and PGE2 concentration in the cells culture supernatant was decreased by 62.0%.Correspondingly,the growth of cells slowed down.At the same time,the cells in G0-G1 phase was increased by 32.24%,and those in S phase and G2-M phase were reduced by 16.38% and 15.86%.respectively.And cells apoptosis index was increased by 9.19%.Conclusion The adenovirus based-RNAi was capable of knocking down remarkably COX-2 of human esopbageal carcinoma cells,which lead to growth of cells slowing down.

Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.

MicroRNAs(miRNAs)are a class of small(22 nucleotides)non-coding RNAs which play important roles in diverse biological and pathological processes.The dysregulation of miRNA expression is closely related to the development and progression of malignant tumors in humans.DNA methylation is a kind of epigenetic modification in human genome.Both hypermethylation and hypomethylation of DNA are closely related to different kinds of tumors,including gastric cancer.