Bile duct stones are a common disease in clinical practice in China,and due to a high incidence rate of complications and complex causes,its clinical diagnosis and treatment has become a difficult problem which needs to solved urgently.With the development of science and technology and the enhanced knowledge of this disease,many treatment methods for this disease have emerged.This article summarizes the successful experience in the treatment of bile duct stones in the Center for Integrated Traditional Chinese and Western Medicine Therapy for Biliary and Pancreatic Diseases in our hospital.With reference to the type and distribution characteristics of bile duct stones,a combination of various endoscopic techniques,such as laparoscopy,choledochoscopy,and duodenoscopy,can achieve the goal of minimally invasive,diverse,and individualized diagnosis and treatment and provide feasible thoughts and strategies for the treatment of bile duct stones.

Objective To investigate the relationship between plasma glucose transporter (Glut) expression and ERK in diabetic patients with obesity. Methods Subjects in this study included type 2 diabetes (T2DM ) with overweight or obesity(T2DM+ OB/OW group ,n=20) ,T2DM with normal weight (T2DM group ,n=22) ,normal glucose with overweight or obesity(OB/OW group ,n=20) ,normal glucose with normal weight (NC group ,n=21). Automatic biochemical analyzer was used to detect the glucose concentrations ;colorimetry was used to detect blood lipid;ELISA was used to detect the level of insulin;Western blot was used to evaluate the expression of Glut1 Glut2 and Glut4 ;RT‐PCR was used to evaluate the mRNA expression of Glut2 ,Glut4 and ERK. Results Fasting plasma glucose (FPG )and two‐hour postprandial plasma glucose (2 hPG)in group T2DM+ OB/OW[(8.9 ± 3.7) ,(20.1 ± 3.5)mmol/L]and T2DM[(9.3 ± 2.8) ,(18.48 ± 4.59)mmol/L]were higher than in group OB/OW[(4.10 ± 0.90) ,(6.60 ± 0.75)mmol/L ]and NC[(3.9 ± 0.7) ,(6.7 ± 0.8)mmol/L](P<0.01).Hemoglobin A1c(HbA1c) in group T2DM+ OB/OW [9.90 ± 3.19)% ] and T2DM [(8.68 ± 2.75)% ] were higher than in group OB/OW [5.05 ± 0.37)% ] and NC[(5.47 ± 0.59)% ](P<0.01).FIns in group OB/OW [(7.98 ± 2.01)μIU/ml] were higher than in T2DM group[(5.91 ± 3.02)μIU/ml]and NC[(5.49 ± 1.36)μIU/ml](P< 0.05).Total cholesterol and triglyceride in T2DM + OB/OW group[(5.06 ± 0.97) ,(3.52 ± 2.68)mmol/L] , T2DM[(5.13 ± 1.27) ,(3.79 ± 3.56)mmol/L]and OB/OW[(4.67 ± 0.83) ,(1.87 ± 0.95)mmol/L]were higher than in group NC[(3.51 ± 0.89) ,(1.41 ± 1.21)mmol/L](P<0.01). Glut1 Glut2 ,Glut4 expression in T2DM+OB/OW group ,T2DM were lower than those in group OB/OW ,NC.Glut2 expression in T2DM+ OB/OW group was significantly lower than in T2DM group.Glut2 and Glut4 mRNA expression in group T2DM+ OB/OW ,T2DM were significantly lower than in group OB/OW ,NC.ERK mRNA expression in group T2DM + OB/OW ,T2DM were significantly higher than those in group OB/OW and NC.Conclusion Glut1 ,Glut2 and Glut4 expression are lower in diabetic patients with obesity ,and there is a negative correlation between the expression of ERK and Glut2 and Glut4.

Objective To explore the effect of conventional western medicine combined with Qiangxin Tongmai decotion in the treatment of patients with chronic heart failure (CHF).Methods According to the digital table,60 patients with CHF were randomly divided into two groups,30 cases in each group.The control group was treated with conventional western medicine,while the treatment group received combination therapy of conventional western medicine and Qiangxin Tongmai decotion.The heart function and plasma brain natriuretic peptide (BNP) level were observed.Results The total effective rate of the treatment group was 93.3％,which was significantly higher than 70.0％ of the control group (x2 =5.455,P ＜ 0.05).After treatment,the level of BNP in the treatment group was (211.3 ± 87.7) ng/L,which was significantly lower than that of the control group [(410.8 ± 94.3) ng/L] (t =8.485,P ＜ 0.01).Conclusion Qiangxin Tongmai decotion can obviously improve the heart function and reduce the level of BNP in patients with CHF.

Objective To explore characteristics and risk factors for surgical site infection(SSI)in patients in the department of neurosurgery,so as to provide theoretical basis for prevention and control of SSI.Methods Clinical data of patients who were admitted to a department of neurosurgery from January to December 2015 were collected with retrospective survey method,SSI and risk factors in patients were analyzed.Results Among 715 patients un-dergoing neurosurgery,40(5.59% )had SSI. SSI mainly occurred in patients following cerebral vascular surgery, accounting for 7 .69% ,followed by patients following intracranial tumor surgery(5 .94% ). 40 patients were all with organ space/intracranial infection. Difference in SSI in patients with different types of operation,duration of opera-tion,length of hospital stay,and National Nosocomial Infections Surveillance (NNIS)scores were all significant(all P<0.05).Conclusion Incidence of SSI in patients in the department of neurosurgery are related with operation type,duration of operation,length of hospital stay,and operation risk index,preventive measures should be taken to reduce the incidence of SSI.

Objective To investigate the expressions of ?-catenin(?-cat)and ?-catenin(?-cat)and their relation with development and prognosis of non-small cell lung cancer(NSCLC).Methods Expressions of ?-cat and ?-cat were immunohistochemically studied in 43 specimens of NSCLC and 7 cases of normal lung tissues.Results Of the 43 NSCLC cases,the abnormal rate of ?-cat and ?-cat expression was 72.1% and 65.1%,respectively.Differentiation and lymph node involvement had a significantly positive correlation with abnormal expression of ?-cat or ?-cat(P

OBJECTIVE To investigate the infection rate and observe the healing courses of the incision after the open procedures of the suppurative appendicitis,which was managed by positioning drainage tube under the fatty layer of the incision.METHODS The infection rate,manifestation of the incision,and the mean time in hospital were observed after the drainage tube in the incision was employed.RESULTS The infection rate(9.30%) and the mean time in hospital(6.63?1.95days)dropped significantly(P

Objective:To establish nursing quality indicator system for freestanding hemodialysis facilities and identify the weight values of indicators.Methods:With the structure-process-outcome quality model as the framework, the literature analysis method, field survey and semi-structure interview were used to form the indicators item pool. Through Delphi method, experts were consulted for two rounds. The indicator weight was calculated by AHP.Results:The indicator system of this study included 3 primary indicators, 15 secondary indicators and 46 tertiary indicators. Among the primary indicators, the process quality indicator had the largest weight (0.493), followed by the outcome quality indicator (0.310), and the structure quality indicator had the smallest weight (0.196).The process quality were the main evaluation contents. According to the indicator weight, the main manpower allocation (0.131) in secondary indicators had the highest weight, and the proportion of nurses with different hemodialysis work experiences (0.108) in the tertiary indicators had the highest weight.Conclusion:The indicator system of this study is scientific and integrated, which can be used as a nursing quality evaluation tool to verify its practicability in clinical nursing practice.

Objective To compare the treatment responses of the inhaled salmeterol and fluticasone (50/500 μg) for three months in the different clinical phenotypes of chronic obstructive pulmonary diseases (COPD) which were chronic bronchitis phenotype and emphysema phenotype and to explore the difference of the treatment responses.Methods To enroll and follow up the stable COPD patients from outpatient department who received the treatment of inhaled salmeterol and fluticasone (50/500 μg).Patients with low attenuation area (LAA,the density on CT scan ＜-950 HU) ≥15％ of the while lung area％ (LAA％) were defined as emphysema group,while patients with LAA％ ＜ 15％ were defined as chronic bronchitis group.All the subjects received lung function test before and after three-month treatment.Results Totally,84 patients (49 male and 35 female patients) with stable COPD were enrolled with an average age (61.04 ±9.23) years old,30 patients in emphysema group and 54 patients in chronic bronchitis group.Before treatment,forced expiratory volume in one second (FEV1) ％ predicted value and residual volume (RV) ％ predicted value in emphysema group were lower than those of chronic bronchitis group (P =0.04 and P =0.01),while inspiratory capacity (IC)％ predicted value was higher than that of chronic bronchitis group (P =0.02).After three-month salmeterol and fluticasone inhalation treatment,FEV1 and RV were improved in both groups,but FEV1 and RV in chronic bronchitis group were improved more significantly than those of emphysema group (P =0.02 and P =0.03).Conclusions The treatment responses of different clinical phenotypes of COPD to inhalation of combination of salmeterol and fluticasone were different,chronic bronchitis phenotype had better treatment response compared to emphysema phenotype.

Objective To detect and differentiate six major human herpesviruses DNA by PCR, RFLP, DNA clone and sequence analysis. Methods Based on the sequence of well coonserved regions of the DNA polymerse gene in human herpesvimses, we synthesized two pairs of primers, including one pair designed to amplify herpes simplex virus type 1 and 2, Epstein Barr virus and cytomegalovirus, other pair of primer to varicella zoster virus and human herpesvirus 6 by PCR. Identification of the virus species was achieved through restriction enzyme digestion with BamHI and BstUI. Results The products of six human herpesviruses after PCR amplification were from 510bp to 592bp and allowed characterization of herpesvirus type with restriction endonulease analysis. The sensitivity could reach 0.1fg DNA and had no cross reaction to human genomic DNA, bacteria, fungas and virus. 89 cerebrospinal fluids(CSF) and 75 blood specimens were tested for the presence of hepersvirus DNA by this PCR assay, in which 13(14.6%) CSF and 26(34.7%) blood specimens were positive. Comparatively, 10(13.3%) were positive by ELISA for HSVⅠ/Ⅱ,EBV,CMV IgM in blood specimens and significantly lower than that of the PCR rate (P

Both microRNA and DNA methylation are the important contents of epigenetic modification.Lots of studies have confirmed that mutual regulation of microRNA and DNA methylation involve in tumorgenesis and development of cancer.The studies of their mechanisms bring some new ideas for investigating the pathogenesis of tumors,and provide a theoretical basis for the early diagnosis and treatment.