Objective To evaluate the effect of endoprostheses for short and long term management of common bile duct stones in elderly patients(70 89 years). Methods Fifty two patients over 70 years with common bile duct stones undergone endoscopic biliary stenting(Group S, 28 cases) or common bile duct exploration (Group D, 24 cases) were followed up for 14 85 months. The two groups were similar to each other in clinical manifestations. Results One patient (4 2%) died because of breath and circulation exhausting on the 3rd day postoperation in Group D. Early complications were 14 4% and 33 3% respectively ( P

BACKGROUND:Acelular matrix which is decelularized but retains the matrix components in the nature materials can reduce the immunogenicity of natural materials effectively and keep the material mechanical strength. OBJECTIVE:To prepare the natural biological scaffold material by using elution method to remove the cels in the rabbit costicartilage matrix. METHODS:After removal of the surrounding tissues, the costicartilage samples from New Zealand white rabbits were randomly divided them into three groups: costicartilages untreated as normal control group, detergent-enzyme digestion for 48 hours as 48-hour treatment group, detergent-enzyme digestion for 96 hours as 96-hour treatment group. Hematoxylin-eosin staining and electron microscope were used to observe decelularized effects. At 7 days of induction, bone marrow mesenchymal stem cels, 3×109/L, were colected and co-cultured with alogeneic acelular costicartilage matrixin vitro. At 3 and 7 days of co-culture, the composite was taken for observation of cel growth on the cel-free substrate surface under electron microscope. RESULTS AND CONCLUSION:Two or three cartilage cels were closely packed in each cartilage pit, began to depigment using the detergent-nuclease digestion method, and then completely depigmented at 96 hours after treatment. At 3 days of co-culture, there were a large amount of polygon-shaped adherent cels with pseudopodiasobserved on the acelular matrix surfacein vitro, and cels could proliferate and divide in partial regions. At 7 days of co-culture, adherent cels spread mostly throughout the acelular matrix surface, these cels were flat-shaped and extended with multiple interconnected processes. Mass of secreted excelular matrixes were deposited on the matrix surface and showed frost-like changes, indicating the prepared acelular matrix has favorable cytocompatibility.

Objective To explore the diagnosis and treatment of cystic pancreatic tumors. Methods The clinical data of 21 cases with cystic pancreatic tumors were retrospectively analyzed. Results This group enrolled 21 cases including serous cystic neoplasm of the pancreas (SCN, 11 cases), mucinous cystic neoplasm of the pancreas (MCN, 6 cases), intraductal papillary mucinous neoplasms (IPMN,2 cases), solid posudopapillary tumor of the pancreas (SPTP,2 cases). Seven cases had certain symptoms or typical signs, while others were asymptomatic and tumors were found by regular physical examinations. All of the cases were diagnosed by CT scans, and the value of serum tumor markers was within normal range. Twenty patients underwent pancreatic tumor resections and there was no perioperative death. Pancreaticoduodenectomy was performed in 8 cases, and distal pancreatectomy was performed in 6 cases including 1 patient undergoing laparoscopic distal pancreatectomy. Middle segment resection was performed in 4 cases, and tumor enucleation was performed in 2 cases. These 20 patients were followed up for 11 to 96 months, and there was no tumor recurrence or metastasis. One patient with mucinous cystic carcinoma underwent palliative operation and survived 4 months after surgery. Conclusions Preoperative imaging was not able to confirm the definite tumor pathological category. Laparotomy should be performed in a patient with cystic pancreatic tumor. The selection of surgical approach should be individualized, and the laparoscopic operation is an alternative.

OBJECTIVE To investigate the distribution and drug-resistance of extended-spectrum ?-lactamases((ESBLs)) producing Gram-negative bacteria in the hospital,in order to control and treat them.METHODS The bacteria were detected and isolated with VITEK TWO system,the suspected ESBLs producing bacteria were(detected) with K-B method.RESULTS There were 1 889 isolated strains of Enterobacteriaceae and the ESBLs(producing) bacteria were 302 strains including E.coli(551),K.pneumoniae(583),and others bacteria(755).Their(positive) rates bacteria were 18.5%,24.7%,and 7.4%,respectively;the wards isolated rate was in the following order: 38.2% were in surgical ICU,29.9% in medical ICU,20.5% in surgery wards,20.6% in oncology wards,12.7% in respiratory wards.12.4% in hematology wards,10.3% in cadre wards,6.4% in endocrinology wards,and 1.6% were in(others) wards.ESBLs producing bacteria were better sensitive to imipenem and meropenem,then to piperacillin(/tazobactam) and cefoperazone/sulbactam.CONCLUSIONS(Enterobacteriaceae) could be(detected) accurately with VITEK TWO system.The main sources of ESBLs producing bacteria are patients in ICU and chronic(patients).To kill these bacteria,imipenem and meropenem can be used first,then(piperacillin)/tazobactam and(cefoperazone)/sulbactain.

Objective: To explore the relationship between post-stroke depression and coping style and social sustian for guiding psychological intervention.Methods: A control study was done in 78 patients with post-stroke depression and 65 patients with non-post-stroke depression by using Medical Coping Modes Questionnaire and Social Sustian Scale.Results: The score of confrontation was lower and that of resignation was significantly higher in depression group than in non-depression group(P

BACKGROUND: A few mesenchymal stem cells (MSCs) can be found in peripheral blood.OBJECTIVE: To isolate rabbit peripheral blood MSCs and induce its differentiation into osteoblasts.DESIGN, TIME AND SE'I-I'ING: The cytological in vitro study was performed at the Central Laboratory of Shangdong Provincial Hospital from June to December 2008.MATERIALS: A total of 6 New Zealand rabbits were purchased from Shandong Academy of Agricultural Sciences. α-MEM and L-DiEM were bought from Hyclone.METHODS: Full-thickness skin (3 cm×3 cm) (dorsal muscular layer was left) was incised at various sites of rabbit back, every 3days. Incised skin was dressed following orthotopic transplantation. Each rabbit received four consecutive wounds. Peripheral blood was collected from femoral vein before injury and 1 week after injury. MSCs were harvested from peripheral blood by density gradient cantrifugation. MSCs were divided into 2 groups, which were respectively incubated in α-MEM supplemented with 10% fetal bovine serum and L-DiEM. Cells at passage 2 and 1 ×105/cm2 were incubated in a 12-well plate and induced with H-DiEM containing osteogenic inductor.MAIN OUTCOME MEASURES: The following parameters were measured: cell morphology before and after injury; colony forming efficiency of MSCs; outcome of osteogenic induction.RESULTS: Following primary medium change and before injury, obtained cells were normal. Twenty-four hours following incubation and after injury, MSCs were spindle or polygonal, and adhered to the wall. 5-6 days later, cell colonies appeared.Compared with the L-DiEM group, the number of primary culture colony formation in α-MEM group was significantly greater (P < 0.05). Peripheral blood MSCs were spindle, tdangle or polygonal, with the presence of processes, 2-3 nuclei and cell division phase, and slowly proliferated following osteogenic induction. At day 7 after differentiation of MSCs into osteoblasts, positive rate of alkaline phosphates was above 80%. At day 21, calcium deposition was detected by Alizarin Red S (positive staining).CONCLUSION: MSCs could be harvested from peripheral blood of wounded rabbits, with characteristics of osteogenic differentiation, α -MEM was more suitable than L-DiEM for peripheral blood MSCs to growin vitro.

Optical coherency tomography (OCT) is one of the powerful optical imaging tools that allows cross-sectional tomography of the microstructure in living subjects with high resolution. With the rapid development of OCT and a wide range of preclinical and clinical tumor imaging, it provides profound insights into the complex physiological, cellular and molecular behaviors of tumors. Preclinical OCT has elucidated many inscrutable aspects of tumor biology, while clinical applications of OCT are revolutionizing diagnosis and therapies. As a new noninvasive optical imaging technique, OCT can realize the intraoperative imaging of tumor and provide meaningful image data, which will provide great help for the diagnosis, classification and boundary determination of tumor diseases in the future.

Objective To study the epidemiological status of reproductive health related behaviors of out of school adolescents in Kunming and Shenzhen City,and to explore the social-psychological influencing factors of the behaviors.Methods A cross-sectional study was conducted in 410 out of school adolescents aged 15-24 years who were recruited with accidental sampling.All the subjects were required to complete a self-administrated questionnaire.Single factor Chi-square analysis and multi-factor Logistic method were used for data analysis.Results The correct respondent rate of the questions on reproductive health knowledge among the adolescents was low.The sexual intercourse rate was 42.9％ (176/410).Nearly 44.9％ (79/176) of the adolescents who had sexual experience did not use condom in the latest sexual intercourse,and those who had no less than one sexual partner accounted for 48.9％ (86/176).The prevalence of genital discomfort and sexual transmitted disease was 48.8％ (200/410) and 2.9％ (12/ 410),respectively.Chi-square test showed that marriage,living statue,behaviors of holding hands,kiss,caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort(x2 values were 4.667,10.862,10.032,15.619,17.423,28.239,17.817 and 21.369,respectively ; all P ＜ 0.05).In binary Logistic analysis,living in a dormitory or with other people,behaviors of caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort (odds ratio (OR) was 0.449 (95％ CI:0.216-0.933),0.377 (95％ CI:0.147-0.967),4.364 (95％ CI:1.594-11.949),0.312 (95％ CI:0.111-0.877) and2.646 (95％ CI:1.417-4.941),respectively ; all P ＜ 0.05).Conclusions The status of reproductive health was poor among out of school girls in kunming and Shenzhen,and living status,behaviors of caress the body,sexual intercourse and having no less than one sexual partner could influence the prevalence of genital discomfort.Comprehensive measures should be taken to strengthen the reproductive health management in this population.

Objective To investigate the effects of rapamycin on the expression of glioma patients tumor helicase RECQ1.Methods 50 glioma patients admitted to the department of neurosurgery in second hospital of hebei medical university were selected and randomly divided into 2 groups,25 patients in control group,were treated with routine admission surgical treatment;25 cases in the experimental group,firstly were given rapamycin capsule 1 mg,1 times/day orally,took 14 days in a row,and had surgical treatment after stopping drug a week.Glioma tissue samples were taken during the operation,mRNA and protein expression of tumor helicase RECQ1 were detected by reverse transcriptase polymerase chain reaction(RT-PCR)and Western blot.Results Glioma tumor helicase RECQ1 mRNA expression in the control group increased more significantly than experimental group,the optical density value in control group was(1.657 ±0.748),while the experimental group optical density value was(1.059 ±0.894),and the difference was statistically significant(P<0.05 );all organizations had the expression of tumor helicase RECQ1 protein,but gliomas tumor helicase RECQ1 protein expression in the experimental group patients(0.952 ±0.021)was significantly lower than that in the control group(1.211 ±0.024),and the difference was statistically significant(P<0.05).Conclusion Rapamycin capsule could reduce the expression of mRNA helicase RECQ1,inhibit DNA glial tumor cells of brain replication,effectively kill cancer cells,control the the progress of brain glioma,and improve prognosis,worth clinical promotion.

Objective A suspected strain of Brucella canis isolated in Hebei Province in 2015 was identified and its genetic characteristics were analyzed.Methods After conventional identification of the bacteria strain,multiplex polymerase chain reaction (M-PCR) and multiple-locus variable-number tandem-repeat analysis (MLVA) were conducted to determine its species and genetic characteristics.Results The strain was identified as Brucella canis by conventional subtyping and M-PCR.Using Panel 1,the strain was genotype 3,using Panel 2A,the strain was genotype 28.It was closely clustered with Brucella canis,and differences of repeated numbers at variablenumber tandem-repeat (VNTR) loci Bruce04,Bruce07,Bruce09 and Bruce16 were also displayed.Conclusions The conventional subtyping and molecular methods can improve the stability and accuracy of the identification.Genetic characteristics of the strain is closely related to that of Brucella canis.