Objective To investigate the prevention and treatment strategy of bile duct injury (BDI) in laparoscopic cholecystectomy (LC). Methods Latest progress was reviewed based on recent documents and the experience on BDI in LC in our department. Results With the popularity of LC, BDI in LC is increasing. The reasons include illegibility and variability of local anatomy in gallbladder trigone,injury caused by galvanothermy, as well as operator’s over confidence. In order to prevent BDI, we should apply more blunt dissection, not to use electrocogulation if possible and to study local anatomy and its variance clearly. The common bile duct and common hepatic duct should be clearly identified. Intraoperative cholangiography, laparoscopic ultrasonography and hepatobiliary scintigraphy are selections as necessary.The treatment of BDI depends on the type of BDI and its site and local condition.The treatment includes end to end anastomosis, repairing the defect, choledochoduodenostomy, Roux en Y choledochojejunostomy and so on. T tube should be maintained in place for more than half a year after operation.Conclusion The key to improve the prognosis of BDI is prevention and treatment in proper time and in correct way.

Objective To investigate the correlation of intima-media thickness (IMT) of the lower peripheral arteries and maximal shear rate (SR) in diabetic (DM) patients and to analyze the related risk factors.Methods A total of 84 diabetic patients and 46 controls were recruited in the study.Color Doppler ultrasonography technique was applied to observe the IMT,diameter(D) and hemodynamics of the lower peripheral arteries and the comparison with biochemical parameters was carried out in order to reveal their correlation to the pathological changes of vascular in DM patients.ResultsIn DM group,the SR was lower than that in control group (P＜0.05).The risk factors related to the lower peripheral arteries of DM patients also were significant difference to that of control group (P＜0.05).Conclusion The decrease of SR in diabetes patients can cause the thicker IMT,which is one of the important factors leading to atherosclerosis and is correlated to various risk factors for metabolic syndrome.

The vast majority of traumatic cranial nerve injuries are associated with compression of fragment fracture, and microsurgery outside the epidural can be used for most of the cases. Therefore, early and accurate diagnosis of cranial nerve injury is especially important. As the cranial nerves go out of the cranial cavity through the holes and cracks of the skull base, and there are a number of special structures through which cranial nerve goes into the human skull, and they include the optic canal, superior orbital fissure, facial nerve canal, jugular foramen and so on. Most traumatic cranial nerve injuries are associated with these structures; however, the common imaging examination is very difficult for these structures due to their deep location. To further study the imaging diagnosis of cranial nerve injury associated with traumatic brain injury, this paper reviews the radiological technology for examination of the special positions in the skull.

Objective To study the clinical effect of triethanolamine cream in treatment of traumatic wounds and its effect on level of interleukin-2 (IL-2), interleukin-8 (IL-8) and tumor necrosis factor-α(TNF-α).Methods 88 patients with traumatic wounds were selected in our hospital from February 2015 to January 2016, those patients were divided into observation group and control group according to coin method.The control group was treated with alginate dressing, observation group were given triethanolamine cream for treatment.The levels of IL-2, IL-8, TNF-αand visual analogue scale(VAS) between the two groups were compared.The clinical curative effect of the two groups was evaluated.Results After treatment, the total effective rate of the observation group(90.91%) was significantly higher than the control group (68.18%).There were no significant differences in VAS scores between the two groups before treatment, 5, 10,20 days after treatment, the VAS scores of the two groups were significantly lower than before treatment (P<0.05), at 5,10,20 days after treatment, the VAS scores in the observation group were significantly lower than the control group (P<0.05).The level of IL-2 in the observation group were significantly higher than the control group, the levels of IL-8,TNF-αwere significantly lower than the control group (P<0.05).Conclusion Triethanolamine cream can increase the level of IL-2 and decrease the levels of IL-8 and TNF-αin patients with traumatic wounds, it can relieve the pain of patients and has good clinical curative effect.

Objective To observe the effects of DanShen on the growth of hepatocellular carcinoma in malignant obstructive jaundice in the SD rat model. Methods The model was established by vaccination of transplanting tumour in the porta hepatis with the walker-256 hepatocarcine line, and then obstruction was caused by the infiltration and metastasis of hepatocellular carcinoma. ② The SD rats were divided into four groups: the rats treated by 0.9% NS (n=12), the rats treated by Inosine + Vitamin C (n=20), the rats treated by DanShen (n=20) and the rats treated by 5-FU(n=20). ③ The liver function, morphological changes and the expression of PCNA VEGF and ICAM-1 in carcinoma and peri-carcinoma tissues, adjacent lobe (left-internal lobe) as well as lung tissues were observed after four experimental groups were successively treated by four medicines. ④ Statistical analysis was done to the experimental results. Results ① The growth of rats treated by DanShen injection showed that liver injury caused by malignant obstructive jaundice was significantly relieved compared with liver function and pathological morphological changes in other groups(P0.05); ③ The expression of PCNA VEGF and ICAM-1 in carcinoma, peri-carcinoma adjacent lobe (left-internal lobe) tissues as well as lung tissues were significantly downgraded in groups treated by DanShen injection compared with those in groups treated with 0.9%NS and Inosine combined with Vitamine C (P0.05). Conclusion DanShen injection not only has protective effects on liver injury caused by obstructive jaundice, but the medicine can inhibit the proliferation and growth of hepatocarcinoma, interfere with the vascularization of tumors, and prevent recurrence and metastasis of hepatocarcinoma.

Objective To study the induction of IL-6 on expression and activity of tissue factor (TF)in peripheral blood monocytes(PBMCs).Methods rhIL-6 100 ng/L and rhIL-6 100 ng/L+ rhIL-6 MoAb 10?g/L were used respectively to stimulate the PBMCs for 24 h,PBMCs without any stimulation as control group,to study the changes of antigen content,mRNA expression and the ac- tivity of the TF.Results The antigen content,mRNA expression and activity of TF were increased significantly in 100 ng/L rhIL-6 group as compared with rhIL-6 100 ng/L+rhIL-6 MoAb 10?g/L and control groups(P＜0.01).Conclusions rhIL-6 can induce the increase of antigen expression,activity and mRNA expression in PBMCs,and these effects can be suppressed successfully by rhIL-6 MoAb. This study demonstrated that there was potential relations between cytokines and thrombogenesis, which may play an important role the pathogenesis of chronic rejection.

The histological and ultrastructural changes in cerebellum of mice exposed whole-body irradiation with high doses of 60Coy-ray were studied in this paper. The animals suffered from acute radiation sickness of CNS form, intermediate form and intestinal form after 16000, 8000 and 4000 rads irradiation respectively. The nuclear shrinkage of the cerebellar granular cells was the most prominent change after irradiation. The cellular necrosis was found only in individural cells. The shrinkage of nucleus, different from necrosis, with characteristic ultrastructural features, tended to recover as manifested by the appearance of nucleolus, increase of free polysomes and well development of Golgi apparatus. It was considered that the cerebellar granular cells were rather resistent to, the radiation. Some pathological changes of small blood vessels in cerebellum were also observed, but was not responsible for the degeneration of the neurons.

High mobility group A1 belongs to the family of high mobility group. It is widespread in human,and involved in the physiological and pathological situations. It is overexpressed in many human cancers including haematological malignancies as the oncogene.

Objective To illustrate a method of lifting the upper-lip to alleviate the aging face,and to evaluate its effects and risks.Methods In the past two years,53 cases of overlong upper-lip were performed with this procedure.The recovery periods,lifted effects,side effects and the total satisfactions were evaluated.Results As for recovery periods,edema roughly reduced in 6-20 months,reddish scar faded in 1-11 months,expression restored in 2-8 months,and numbness disap peared from 4 to over 18 months.The lifted effects showed that 37 cases (78.7％) were satisfactory,7 cases (14.9％) of the lifting was not enough and still complained a long upper-lip,2 cases (4.2％) was ineffective,and 1 case (2.1 ％) considered an excessive lifting.The long term follow-up showed that 3 cases (6.4％) had obvious scar (visible at a distance of more than 1 m),14 cases (29.8％) had depression of columella/base of nostril alar or with increased exposure of nostril,3 cases (6.4 ％) had expansion or morphological changes of alar,6 cases (12.8％) had increased thickness of the upper lip and prominent vermilion tubercle,1 case (2.1％) had changes of expression,1 case (2.1％) had asymmetry,1 case (2.1％) had arching sagging,and 35 cases (74.5％) had numbness or insensitivity of upper-lip.Overall results showed very satisfied in 29 cases (61.7％),satisfied in 15 cases (31.9 ％) and dissatisfied in 3 cases (6.4 ％).Conclusions The technique for upper-lip lifting displays a significant effect with few complication.It is recommended for further clinical application.

One hundred kinds of excellent books on basic medicine were selected from Wanfang Data Knowledge Platform to develop a books-papers citation database.Their academic levels of the selected books were evaluated by PageRank algorithm.The chapters and sections of the books were divided into 4 parts according to their PageRank value and the distribution characteristics of their citation frequencies to study the PageRank and the top 20 cited chapters and sections of the books.The advantages and disadvantages of PageRank algorithm in book evaluation were described.