Objective To observe the effect of gastrectomy for gastric cancer on blood glucose in patients complicated with type 2 diabetes mellitus by using different operation strategies.Methods The retrospective analysis was carried out of 68 cases who undergone radical surgery for gastric cancer and complicated with type 2 diabetes mellitus.These patients were divided into 3 groups by different kinds of digestive tract reconstruction,Billroth Ⅰ (n =26),Billroth Ⅱ (n =22) and Roux-en-Y (n =20).The levels of fasting blood glucose (FBG) were detected before and after operation one week,one month and six months in three groups.Results Comparing to the level before operation,the level of FBG after operation showed a descent in group B and group C((10.03 ±5.12) vs.(13.56 ±3.36) mmol/L; (8.44 ±5.21) vs.(13.56 ±3.36) mmol/L;(10.61 ±3.16) vs.(12.84 ±3.36) and(7.68 ±4.88) vs.(12.84 ±3.36) mmol/L) which was better than group A((10.03 ±5.12)vs.(11.12 ±6.32),(8.44 ±5.21) vs.(11.12 ±6.32) mmol/L;(10.61 ±3.16) vs.(11.12 ±6.32) mmol/L),(7.68 ±4.88) vs.(11.12 ±6.32) mmol/L;P＜0.05,but there was no significantly difference between B and group C (P ＞ 0.05).The 3 groups of patients,with B,C groups of patients with diabetes improved obviously,of which nearly 50％ of patients cured,normal blood sugar control,the other part with the exception of a few effective,degradation of diabetes drug treatment,and operation effect was significant.Conclusion It is effective to control the blood glucose of gastric cancer patients complicated with type 2 diabetes with Billroth II or Roux-en-Y gastrectomy.There is a correlation between postoperative blood glucose change and different gastrojejunal anastomosis.

Objective To explore the effect of probucol on the inflammatory response in rabbits with arteriosclerosis obliterans.Methods SPF male new zealand white rabbits were subjected to incomplete right femoral artery ligation model of arteriosclerosis obliterans.The model rabbits were divided into experimental group and control group.The rabbits in experimental group were treated by probucol.After treatment for 4 weeks,HE staining was used to evaluate the injury severity of right femoral artery in rabbits;ELISA was used to measure the levels of IL-1,IL-6,TNF-α and CRP;Realtime PCR was used to detect the expressions of IL-1,TNF-α in right femoral artery;Western blot was used to measured the nucleus accumulations of NF-κB,and the phosphorylation of IκB.Results Compared with control group,the degree of pathological injury of right femoral artery was significantly atteunated,the levels of IL-1 、IL-6 、TNF-α and CRP in plasma,the mRNA expressions of IL-1 、TNF-α and the nucleus accumulations of NF-κB,and the phosphorylation of IκB in right femoral artery decreased significantly.Conclusion Probucol attenuates the inflammatory response in rabbits with arteriosclerosis obliterans significantly.

BACKGROUND: Intraocular contract lens (ICL) implantation emerges as a crystal refrangibilit operation to rectify and cure high myopia in recent years. Collagen, a new material, is consisted of collagen Ⅳ and aquagel in Starr Company. It is an ideal material for ICL; however, high price is restricted to its development at a certain degree.OBJECTIVE: To find out ideal method of collagen ICL implantation through animal experiment in rabbit eyes and evaluate intraocular biocompatibility by observing inflammatory reaction and variation of inflammatory mediators.DESIGN: Single exponent and opening study.SETTING: Department of Ophthalmology, Xinhua Hospital affiliated to Medical College of Shanghai Jiaotong University.MATERIALS: The experiment was carried out in Xinhua Hospital affiliated to Medical College of Shanghai Jiaotong University and Shanghai Nanyang Radio-immunity Testing Center from August 1999 to March 2000.Twenty New Zealand rabbits were divided into three groups according to randomly digital table: ICL implantation group (n=8), operative control group (n=6) and blank control group (n=6).METHODS: ① Right eyes of rabbits in ICL implantation group were suffered from ICL implantation and peripheral operation of iris [1]; however,right eyes of rabbits in operative control group were only suffered from peripheral operation of iris. After operation, hormone-antibioltic eyedrops were dribbled into eyes four times a day for total 10 days. At 1, 4 and 7days after operation, 2.5 mg dexasone + 40 000 U cidomycin were subconjunctivally injected into eyes. Rabbits in black control group did not receive any operation. ② At 1, 4, 7, 14 days and 1 month after operation,indexes of operative eyes in ICL implantation group and operative control group were measured including luctuation of intraocular pressure, damage of corneal endothelium, protein leakage in anterior chamber, depth of anterior chamber, hyphema, posterior synechiae of iris, ICL decentration and lens opacity. ③ At 1, 4, 7, 14 days and 1 month, samples of aqueous humor were aspirated from operative eyes of rabbits in ICL implantation group, operative control group and blank control group. Radioimmunoassay (RIA) was used to examine the concentration of prostaglandin-E2 (PGE2)in aqueous.MAIN OUTCOME MEASURES: ① Results of reaction in anterior chamber at each time point before and after operation; ② results of PGE2 concentration of inflammatory mediators in aqueous humor after operation.RESULTS: All 20 rabbits were involved in the final analysis. ① Changes of intraocular pressure at each time point before and after operation: As compared with that before operation, intraocular pressure was not changed in ICL implantation group and operative control group at each time point after operation (P ＞ 0.05). ② Damage of corneal endothelium and leakage in anterior chamber after operation: ICL implantation group: Five eyes were shown as shallow anterior chamber at various degrees on the first day after operation, and recovered normally within 1 week; hemorrhage was observed in anterior ch amber of two eyes and absorbed after 2 weeks; two eyes had anterior and posterior synechiae of iris, respectively, and pupil was deformed slightly; ICL decentration at various degrees was observed in two eyes; point-like opacity was observed in anterior bursal membrane of crystal in one eye after 1 month. Operative control group: Leakage of grade 1-2 was observed in 6 eyes on the first day after operation and was absorbed within 1 week. Cornea was clearing, and hyphema, shallow anterior chamber, posterior synechiae of iris and lens opacity were not changed. ③ PGE2 concentration of inflammatory mediators in aqueous humor after operation:PGE2 oncentration was the highest in ICL implantation group at 1-4 days after operation, and then it was decreased gradually; however, PGE2 concentration was similar at 14 days and 1 month after operation (P＞0.05).CONCLUSION: There is no obvious occurrence of chronic uveitis in anterior chamber after ICL implantation. PGE2 concentration in anterior chamber is decreased gradually, and this suggests that a classic foreignbody granulomatous inflammation emerges after ICL implantation, which reflects a good tolerance of ICL for ocular tissue.

Objective To determine and compare the levels of serum matrix metalloproteinase (MMP)-2 and MMP-9 in acute stage of cerebral infarction and the relationship and prognosis between them and the classification of TOAST. Methods The levels of MMP-2 and MMP-9 were detected by ELISA in 60 cerebral infarction patients(CI group)while 30 healthy donors were served as control group (NC group).Results The level of MMP-2 in CI group was significantly lower than that in NC group (P＜0.01) and the level of MMP-9 was significantly higher than that in NC group (P＜0.01).Compared with lacunar infarction (LI) group,the level of MMP-9 was significantly higher in cardiogenic cerebral embolism group(CCE group) and large artery arteriosclerosis cerebral infarction group (LAA group);The serum level of MMP-9 was related to NIHSS.The serum level of MMP-9 in good prognosis patients was significantly lower than that in poor prognosis patients (P＜0.01).Conclusions The serum level of MMP-9 is increased after cerebral infarction.The serum level of MMP-9 in the CCE group and LAA group is significantly higher than that in LI group.The level of MMP-9 is a reliable parameter in evaluating the disabilities in cerebral infarction.The level of serum MMP-9 within 24 hours of onset can predict the prognosis of cerebral infarction independently.

BACKGROUND: A new type of materials, Collamer, is polymerized with type V collagen and HEMA by Staar company, which is a good material for the establishment of intraocular contact lens(ICL). There is no similar material in our country.OBJECTIVE: To evaluate the biocompatibility of ICL made mainly by collagen-polymer in animals.DESIGN: A randomized controlled trial.SETTING: Testing Center of Shanghai Institute of Biomaterial.MATERIALS: Our study was conducted in the Testing Center of Shanghai Institute of Biomaterial from January 2000 to April 2000. Cell strain: hearty L-929 cells(fibroblast of mouse) after 48-72 hours of passage; Twenty white guinea pig of either gender aged between 1 month and 3 months with a body mass between 300 g and 500 g; Seven healthy adult New Zealand rabbit of either gender(female rabbits were not required pregnant for pyrogenic reaction test) with a body mass between 1.7 kg and 3.0 kg or between 2.5 kg and 3.5 kg(experimental animals were obtained from Shanghai experimental animal center, ordinary grade).INTERVENTIONS: Collagen was used to perform the following biological tests: ① cytotoxicity test (cell growth rate); ② anaphylaxis test; ③ pyrogenic reactions test; ④ subcutaneous implant test. The data were analyzed and evaluated according to criteria.MAIN OUTCOME MEASURES: ① Growth and proliferation of fibroblast in mice; ② Reactions of erythema and edema of every provocation site and every observatory time after the induction of intradermal injection and local patch test; ③ Increase of body temperature of the rabbit after the injection of the extraction of the material into auricle marginal vein; ④ Reactions around the materials after 4 weeks of collagen implantation in rabbits subcutaneously.RESULTS: ① Cytotoxicity test: relative growth rate of collagen group was 99％ to 106%, and the toxicity grade was level 0 - 1. ② Anaphylaxis test:there was no erythema or edema reaction at every provocation site at each time point of collagen group. The skin reaction to collagen-polymer was level 0. ③ Pyrogenic reactions test: the temperature increased in rabbit was below 0.6 ℃ and the total increase of the temperature was below 1.4 ℃ in rabbits. ④ Subcutaneous implant test: there was very little lymphocyte infiltration around the sample in both collagen group and control group with Level I inflammatory reaction. And the evaluation of the formation of fiber cyst was level I.CONCLUSION: Results of material biological evaluation tests demonstrate that this collagen-polymer has high biocompatibility, and can become an ideal material for ICL.

AIM: To investigate the effects of external counterpulsation (ECP) on nitric oxide (NO) and nitric oxide synthase (NOS) and the expression of NOS gene in myocardial infarction canines. METHODS: Nineteen healthy dogs were randomly divided into three groups ie. controls, ischemia group, ischemia and ECP group. Serum NO concentrations and myocardium NO levels and NOS specific activity were determined by modified nitrate reductase method. The protein synthesis of sub-type NOS including inducible NOS (iNOS) and endothelial NOS (eNOS) of myocardial tissue were also determined by immunohistochemical method. The constitutive NOS (cNOS) mRNA was measured via in situ hybridization. RESULTS: 120 and 180 minutes after the ligating of LAD, serum NO concentration in ECP groups were higher than those in ischemic groups (P

Objective To summarize the surgical experience and primary follow-up results for robotic assisted radical cystectomy ( RARC ) , as well as to evaluate the safety and feasibility of this procedure.Methods From Jan 2013 to Oct 2015, we retrospectively analysis the perioperative data and primary follow-up data from 35 patients who underwent radical cystectomy with Da VinCi robotic laparoscopic in urological institution of Changhai Hospital.The median age was 65 (ranging from 46 to 78) years.The amount of male cases were 34, the female case were 1.There were three kinds of urinary diversion, ureterocutaneostomy, Bricker operation and orthotopic neobladder, were 2, 26 and 7 respectively.We collected the parameters including operating time, estimated blood loss, blood transfusion volume, time to flatus,length of hospital stay,perioperative complication,time of recurrence,time of death and the reason of death.Results All of the related operations had been accomplished successfully, none of which had been converted to the open procedure.The estimated operating time of ureterostomy was (315.0 ±106.1) min, Ideal conduit was ( 443.2 ±93.2 ) min, Orthotopic bladder was ( 488.3 ±80.6 ) min.The estimated intraoperative blood loss was 260.0 ±108.6(100 to 500 )ml.5 cases of all patients were transfused 400ml red cell suspension, the transfusion rate was 14.2%.The mean time to flatus was 3.1 ±1.6(1 to 7) d.The estimated time to remove the gastric tube and the drainage tube was 4.2 ±2.2d(2-10d),10.8 ±5.1d(4-25d),respectively.The length of hospital stay after surgery was 12.4 ±5.17(6 to 25) d.Overall,17,8, 10,31 and 4 of these patients had

Objective To investigate feasibility and early stage postoperative complications of lapa-roscopic radical cystectomy ( LRC) . Methods We retrospectively analyzed the data of 63 consecutive pa-tents (58 males and 5 females) who underwent LRC from Oct .2011 to Oct.2013 in our institute.Of these patients, 46 patients underwent ileal conduit , 9 patients underwent ureterocutaneostomy , and 8 patients un-derwent orthotopic ileal neobladder urinary diversion .The average age and body mass index of patients were 67.7±11.1 (33-84) years and 23.3±2.1 (18.8-28.7) kg/m2, respectively.The mean hemoglobin and al-bumin of patients were (130.7±20.3) g/L and (38.9±4.1) g/L, respectively.Comorbidities of hyperten-sion, diabetes, coronary heart disease and decompensated liver cirrhosis were found in 10, 6, 2 and 1 pa-tient, respectively.10 of 61 patients had a history of abdominal surgery .The indications for cystectomy were classified as muscle invasive bladder cancer for 30 patients, unresectable superficial bladder cancer for 19 patients and recurrent bladder cancer for 14 patients.Postoperative data and early stage postoperative compli-cations within 3 months after surgery were collected . Results The median operative time for LRC and uri-nary diversion was 390 (260-480) min, with a median estimated blood loss of 400 (100-1 500) ml.This was one patient converted to open surgery .The mean postoperative hemoglobin and albumin of patients was 108.5±14.7 g/L and 29.5±3.7 g/L, respectively, both of which significantly reduced compared with pre-operative data (P<0.01).The median duration of hospital stay was 15 days.The median time for liquid in-take, abdominal drainage removal and ureteral stent removal was 4 days, 9 days and 2 months after surgery , respectively.Catheter was removed 2 weeks after laparoscopic orthotopic cystectomy .21 (33.3%) of 63 pa-tients suffered from perioperative complications .15 of 46 patients (32.6%) in ileal conduit group had com-plications including ileus ( 5, 1 of 5 need re-operation ) , lymphatic fistulas ( 5) , pulmonary infection ( 1) , pyelonephritis (1), delirium (1), anastomotic leak (1, re-operation was needed) and pneumothorax (1). 2 of 9 patients (22.2%) in ureterocutaneostomy group had complications such as ileus (1) and lymphatic fistulas (1).4 of 8 patients (50.0%) in orthotopic ileal neobladder group suffered from complications like ileus (2, 1 of 2 required re-operation), lymphatic fistulas (1) and arrhythmia (1). Conclusions LRC is technically feasible and safe .It reduces the estimated blood loss and postoperative complications .It is noteworthy to surgeons that serum albumin significantly reduced after LRC , nutrition should be kept balanced after surgery.

Objective To explore the clinical effect of tension-free repair in the treatment of inguinal hernia in elderly patient.Methods A total of 124 elderly patients with inguinal hernia admitted in our hospital in 2016 were randomly divided into a study group(n=62)and a control group (n=62).The control group was treated with open tension-free inguinal hernia repair,whereas with laparoscopic tension-free inguinal hernia repair in the study group.The operation time,intraoperative blood loss,the postoperative pain relief-time,mean days of hospitalization,postoperative recurrence rate,and complications rates were compared between the two groups.Results The more significant improvements were found in study group versus control group in the intraoperative bleeding volume [(19.9±2.0)ml vs.(36.8±-2.5)ml,t=41.564,P=0.000],in the mean hours of postoperative pain [(22.1 ± 4.2) h vs.(35.3 ± 7.0) h,t =12.732,P =0.000],in mean days of hospitalization [(5.5 ± 1.0)d vs.(9.2±1.9)d,t=13.569,P=0.000],in incidence rate of postoperative recurrence(0.0％ vs.6.5％,x2 =4.133,P=0.042),and in postoperative complications rate(3.2％ vs.12.9％,x2 =3.916,P=0.048).Nevertheless,the operation time was longer in the study group than in the control group[(87.0±5.0)min vs.(55.5±4.2)min,t=-37.984,=0.000],Conclusions As compared with open tension-free repair,the clinical efficacy of laparoscopic tension-free hernia repair is exactly sure in the treatment of inguinal hernia,with shorter postoperative hospitalization time and lower incidence of complications.

Objective To investigate the relationship between intelligence impairment and interictal epileptiform discharges spreading in mesial temporal lobe epilepsy(mTLE)patients. Method We assessed 145 patients diagnosed as mTLE and their general materials, analyzed the relationship between intelligence impairment and interictal epileptiform discharges spreading. Results ①Patients with mTLE with longer disease course and higher frequencies of epilepsy tended to have a severe impairment in the total intelligence quotient (IQ), verbal intelligence quotient (vIQ) and performance intelligence quotient (pIQ). ② IQ of was negatively correlated with the condition that interictal epileptiform discharges spreading to the ipsilateral central and parietal region in patients with left lesion; pIQ was negatively correlated with the condition that interictal epileptiform discharges spreading to the ipsilateral frontal region, while positively correlated with the condition that interictal epileptiform discharges spreading to the ipsilateral occipital region in patients with right lesion. Conclusion ①Intelligence impairment of mTLE patients is related with courses and frequencies.②Total IQ is more severely impaired by interictal epileptiform discharges spreading to the ipsilateral central and parietal region in left mTLE patients, and the pIQ is more severely impaired by interictal epileptiform discharges spreading to the ipsilateral frontal region in right mTLE patients.