Objective To evaluate the feasibility and safety of peroral direct cholangioscopy (PDCS) by freehand intubation using routine straight-view endoscope for diagnosis and therapy of biliary diseases.Methods Patients with bile duct dilation underwent standard ERCP and native papilla was dilated using EST and/or endoscopic papillary large balloon dilation,according to the size of the papilla.Then peroral direct cholangioscopy was performed by freehand intubation using routine straight-view endoscope.General data of patients,procedure of ERCP,diagnosis of PDCS and complications were recorded.Results A total of 5 patients underwent PDCS.Indications included common bile duct stones (n =2),intraductal papillary neoplasm of bile buct (n =2) and benign biliary stricture after removable metal stent placement (n =1).The diameter of common bile duct ranges from 1.2 cm to 2.4 cm.EST or/and EPLBD was required in 3/5 patients to facilitate PDCS.Freehand PDCS intubation of the bile duct was successful in all procedures (1 case into distal common bile duct,4 cases into proximal common bile duct).Complications were cholangitis managed with intavenous antibiotics (n =1).No procedure related death occurred.Conclusion Freehand PDCS is technically feasible and safe,and may be clinically useful for diagnostic and therapeutic purposes in managing select biliary tract diseases.

Athletes ; Humans ; Microcirculation ; Muscles ; physiology ; Sports

Animals ; Antioxidants ; therapeutic use ; Coronary Disease ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Free Radical Scavengers ; therapeutic use ; Humans ; Pancreatitis ; drug therapy ; Phytotherapy ; Salvia miltiorrhiza ; chemistry

Objective To explore the inductive effect of striatal tissue on mouse embryonic stem cells and further analyse the cell source and inductive pattern of this inductive effect. Methods We employed striatal extracts、conditioned medium of striatal astrocytes and conditioned medium of striatal neurons to induce embryonic stem cell to differentiate directly. The differentiated cells were evaluated by morphological observation and TH immunocytochemical staining method. We also performed a quantitative analysis of the results. Results Striatal extracts and conditioned medium of striatal astrocytes had obvious inductive effect on embryonic stem cell.Percentages of three groups were 15%,15.2% and 3% respectively. Conclusions The astrocytes in striatum might have an inductive effect on dopaminergic neuronal differentiation of embryonic stem cells.The determination of inductive factor will be our next research aim.;

Objective To explore the optimal condition of direct differentiation into dopaminergic neurons of embryonic stem cells in serum-free and feeder layer cell free medium. Methods We used the method of phase induction to culture embryonic stem cells. At first, embryonic stem cells were cultured in the serum-free medium with bFGF and LIF so as to realize the direct differentiation from embryonic stem cells to neural precursors. Differentiated cells were determined by nestin immunocytochemical staining. On this basis, we transferred embryonic stem cells to the B27 serum-free medium with IL-1 so as to realize the direct differentiation from neural precursors to dopaminergic neurons. Differentiated cells were determined by TH immunocytochemical staining. Results Approximately 85 percent of cell masses were nestin immuno-positive. The differentiation ratio of dopaminergic neurons was 13%, which increased significantly in comparison with natural differentiation ratio of dopaminergic neurons.Conclusion Without serum and feeder layer cell, we can induce embryonic stem cells to differentiate into dopaminergic neurons effectively by adding different growth factors at different phases, which makes the inductive processes more easily.

Objective To observe the efficacy of radical nephrectomy plus embolectomy for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement. Methods Clinical and pathologic data of 8 patients with renal cell carcinoma extending into renal vein or inferior vena cava were summarized.The operative essentials were introduced,and survival periods were followed up. Results A total of 8 patients underwent radical nephrectomy plus embolectomy.One patient died during the operation after embolectomy with exhausted respiration and cardiovascular function.Three patients survived for 2,4 and 22 months respectively,but all died of distal metastasis later.Four patients were alive for 2,14,25 and 47 months respectively after operations till writing of this article. Conclusions Radical nephrectomy plus embolectomy is a valuable method for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement.

Objective To study the tactics, methods and relevant factors of transcatheter embolization for acute gastrointestinal hemorrhage.Methods Fifteen patients with acute gastrointestinal hemorrhage were embolized by one of the methods of Polyvinyl Alcohol (PVA), gelfoam or metal coils. Four of the fifteen patients were upper gastrointestinal hemorrhage, the other cases were lower gastrointestinal hemorrhage which were embolized using coaxial microcatheter. Results Fourteen of the fifteen patients were treated successfully by these methods. There were total 17 times of embolization for 16 parts, the success rate reached 94.1%. The other one reveaded an infarction of intestine after the embolization and was cured by resection. One of the fifteen patients appeared a recurrent hemorrhage 3 months later, and confirmed to be a hemangiolymphangioma. Two patients with malignant tumor were operated upon selectively. The other patient of intestinal hemorrhage was embolized successfully by using a metal coil after shock. Leiomyoma complicated with large area of bleeding was finally proven by operation.Conclusions Transcatheter embolization for acute massive gastrointestinal hemorrhage is safe and efficient under different choice of methods. The key of success is the right selection of embolized target artery and dosage of emboli.

Objective To analyze the CT features of renal carcinoma associated with Xp11.2 translocations/TFE3 gene fusions (Xp11.2 RCC),and to improve the diagnostic accuracy.Methods Clinical data,CT imaging and pathological features of 12 cases with pathology proved Xp11.2 RCC were analyzed retrospectively.Results All the 12 cases were solid masses.11 cases were oval or quasi-circular,1 case was irregular.Tumors were iso-density or hyperdensity on CT plain scan images.The density was heterogene-ous,combined with necrosis in 11 cases and spotty or patchy calcification in 7 cases.After injection of contrast,moderate or obvious enhancement of tumors was found,1 case had retroperitoneal lymph node metastasis,1 case was found with mass formation in the re-nal hilus,1 case had adrenal metastasis.Another one was found with psoas major muscle and lumbar 5 invaded.Conclusion The Xp11 .2 RCC has certain CT characteristics.This disease should be considered when a renal tumor is iso-density or hyperdensity on the CT plain scan images and has moderate or obvious enhancement,combined with necrosis or calcification.

Objective: By analyzing the relationship between the meteorological factors and the outbreak of emergencies, an artificial neutral network model was established in order to make the medical-meteorological forecast and to reduce and prevent the emergencies. Methods: The data of emergency cases and meteorological factors within the same time in 2007 and 2008 in Ji'nan, China were collected and analyzed by using SAS9.0. The back-propagation (BP) artificial neutral network model was built by using Matlab7.0. Results: A close relationship exists between the meteorological factors as well as their changes and emergencies. The results of forecast show high accuracy rate of each emergency (76% ～ 89%) except CO poisoning (46%). Conclusions: This emergencies medical-meteorological forecasting model based on BP neutral network has good prediction effect and the value of further research.

Objective:To establish a human monocyte cell line U937 stably expressing CD200.Methods:The eukaryotic expression vector pcDNA3-CD200 containing human CD200 cDNA and vector pcDNA3 were transferred into human monocyte U937 cell line by electrotransfer.These two cell lines were selected by G418, and the selected cell lines were subcultured. U937 cell line was enclosed as control group.The expression of CD200 mRNA and protein was detected by RT-PCR and flow cytometry.Results:After G418 selection,U937 cell line in control group was died, and the cell lines transferring pcDNA3 and recombined pcDNA3-CD200 were subcultured over 30 generations.The CD200 mRNA expression in pcDNA3-CD200 group was confirmed with RT-PCR.The CD200 expression in U937-pcDNA3-CD200,U937-pcDNA3 and U937 were 77.20%,3.20% and 2.10%,compared with other two groups (F=133 996.40,P0.05).Conclusion:Our study provides foundation for mechanism of action for CD200 in future.The human monocyte series U937 cell line that expresses CD200 protein stably is established successfully by gene transfection method.