Objective To compare the safety between laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) for benign gallbladder diseases in elderly patients. Methods A total of 120 patients above the age of 60 with indications for cholecystectomy and tolerance to general anesthesia were divided into two groups (LC Group and OC Group), in admission order of odd or even, with 60 patients in each group. Peri-operative parameters including operation time, analgetic consumption, postoperative gastrointestinal recovery time, length of duration with fluid infusion, length of bed rest, postoperative complications, and hospital stay were compared between the two groups. Serum total triiodothyronine (TT3) and thyroid stimulating hormone (TSH) levels, as well as the functional recovery of the abdominal muscles, were also recorded and compared. Results Peri-operative parameters were better in the LC Group than in the OC Group. Serum TT3 levels decreased significantly after surgery in both the LC Group (F=8.26,P=0.000) and the OC Group (F=124.70,P=0.000), with a more significant difference in the OC Group.Postoperatively,serum TSH levels decreased insignificantly in the LC Group (F=1.87,P=0.157) and significantly in the OC Group (F=27.24,P=0.000). Lasegue’s test at 7 days after surgery showed significantly higher leg-raising times in the LC Group than in the OC Group (t=3.640,P=0.000). Conclusions Laparoscopic cholecystectomy is superior to open cholecystectomy in the treatment of benign gallbladder diseases in elderly patients.

The serum level of 25-dihydroxyvitamin D3 was determined in patients with type 2 diabetes,diabetic nephropathy,and healthy objects..The results demonstrated that the serum 25-dihydroxyvitamin D3 level in type 2 diabetic patients with nephropathy was lower than that in the healthy objects or type 2 diabetes objects.Blood β2-M,total cholesterol,creatinine,24 h urinary albumin,and course of illness in type 2 diabetic patients with nephropathy have relationship with serum 25-dihydroxyvitamin D3.

Objective To evaluate the prognosis value of the expression of galectin 3 in patients with acute ischemic stroke. Methods 165 Patients with acute ischemic stroke had been observated for 12 months and their occurrence of recurrent stroke e-vents were recorded.The concentration of galectin-3 was detected.Results 65 patients had recurrence stroke events with a rate of 39.39% within 12 months.It was also found that the serum concentration of galectin-3 in acute ischemic stroke recurrence patients were significantly higher than those of patients without recurrence,the difference was statistically significant(P <0.05).The rate of acute ischemic stroke recurrence in patients with high concentrations of galectin-3 was higher than that in patients with low concen-trations of galectin-3,the difference was statistically significant(P <0.05).Conclusion Galectin-3 is a good indicator to predict the prognosis of patients with acute ischemic stroke,and it could be used to evaluate the risk of recurrence in patients.

BACKGROUND: Islet transplantation is an effective method for the treatment of type 1 diabetes mellitus and parts of type 2 diabetes mellitus. However, its application is hindered by insufficient sources and immunologic rejection. Though transdifferentiation of pancreatic stem cells is at the starting step, it is thought to be the hopeful source for islet cell transplantation.OBJECTIVE: To look for a suitable cells-transplantation source for the treatment of diabetes mellitus. METHODS: The pancreatic ductal epithelial cells were separated from Kunming mice and cultured in DMEM/F12 medium supplemented with keratinocyte growth factor, hepatocyte growth factor and nicotinamide, etc. Samples were taken at different time points for light microscopy and electron microscope. The changes of CK-19 and PDX-1 were detected by immunocytochemistry at 1 and 16 days. The expressions of insulin and glucagon gene were detected by RT-PCR at 1 and 16 days. The physiologic function of these islet-like clusters was determined by dithizone staining and glucose stimulation at 21 days. RESULTS AND CONCLUSION: A large number of epitheliod cells were CK-19 immunoreactive positive and few of them were PDX-1 positive at 1 day after isolation, then CK-19 positive cells proliferated quickly and formed substantial plaques of epithelial cells in cobblestone pattern. At 16 days later, these cells begin to form islet-like clusters gradually, while most of them were PDX-1 immunoreactive positive. The analysis of mRNA by RT-PCR showed very low levels of insulin and glucagon mRNA in the starting materials but increase was found as the process of transdifferentiation. At 21 day differentiated islet-like clusters were stained red by dithizone. In those samples exposed to a stimulatory 15 mmol/L glucose, there was a 1.6-fold increase in insulin compared with to 5.6 mmol/L glucose (P < 0.05). Pancreatic ductal cells of adult Kunming mice could proliferate quickly and have the potency of transdifferentiation into islet-like clusters when cultured in vitro under appropriate conditions.

Objective To investigate the value of serum α1 acid glycoprotein(AAG) and Homocysteine(Hcy) in different stage of renal damage in type 2 diabetes(T2DM ) .Methods a total of 128 patients with T2DM were recruited from January 2013 to Octo‐ber 2013 ,According to 24 h urinary albumin excretion rate (UAER) were divided into the first group ,the second and third groups , and choose 80 healthy cases over the same period as the normal control group .Serum AAG ,Hcy ,creatinine (Cr) and blood urea ni‐trogen (BUN) were detected ,the test results were analyzed statistically .Results There were significant differences in type 2 diabe‐tes mellitus group ,early diabetic nephropathy group ,clinical diabetic nephropathy group of the serum AAG ,Hcy levels(P<0 .05) , there were positively correlated (r=0 .673 ,P<0 .05) between UAER and serum AAG levels ,and were positively correlated (r=0 .35 ,P<0 .05) between UAER and Hcy levels .Conclusion Combined detection of serum AAG ,Hcy have a significant for early diagnosis of diabetic nephropathy and assessing the degree of renal injury in diabetes .

Objective To investigate the serum cystatin C (CysC) and urinary albumin excretion (mALB) joint detection in di‐agnosis of early diabetic nephropathy injury .Methods 120 cases of determination of CysC and microalbuminuria in type 2 diabetic patients and 40 healthy people and related clinical and biochemical parameters were measured ,and the various factors by correlation analysis ,the determination of differences in early renal damage in diabetes and healthy people .Results the early diabetic nephropa‐thy group ,diabetic nephropathy group serum cystatin C and urinary microalbumin is higher than the normal control group ,CysC and mALB level had significant difference ,the difference was statistically significant (P<0 .05) ,the mALB was positively correla‐ted with serum CysC levels (r=0 .662 ,P<0 .05) ,and no obvious correlation of serum Cr ,BUN levels and mALB .Conclusion trace albumin serum cystatin C and urine is reflecting early renal function injury sensitive and reliable index ,serum cystatin C com‐bined detection of urine micro albumin contributes to kidney disease early diagnosis ,treatment and prognosis judgement .

Objective To investigate the role of nuclear factor-kappa B(NF-?B)in the modulation of diallyl trisulfide(DATS)on interleukin-1?(IL-1?)expression induced by lipopolysaccharide(LPS)in mice with acute lung injury(ALI).Methods Mice were randomly divided into Control group,ALI group,DATS group,DATS prevention group and DATS treatment group.The expression of IL-1? mRNA in the lung tissue was detected by reverse transcription PCR(RT-PCR).NF-?B activity in the lung tissue was detected by electrophoresis mobility shift assay(EMSA).The expression of phospho-I?B and I?B were assayed by Western blot.Results The expression of IL-1? mRNA,NF-?B activity and the phospho-I?B expression in lung tissues increased significantly at ALI group(P

Objective To assess the efficacy of methylprednisolone (MP)pulse therapy in treatment of Hashimoto thyroiditis(HT) complicated with goiter.Methods 30 patients with HT complicated with goiter participated in the study and received MP pulse therapy.The patients had to be euthyroid for at least 3 months before the date of inclusion with plasma concentrations of thyroid hormones within their reference range.The goiter was still obvious and had no improvement.A dose of 250 mg MP was administered intravenously for seven consecutive days,and then treated with oral prednisone 10 mg,three times per day for 6 weeks with the dosage in each week gradually reduced at 5 mg to none.Ultrasonic was used to measure thyroid size before and after MP treatment.Results The treatment was successful at the end of the trial in all of the 30 patients receiving MP.The thyroid size from length,breadth,thickness to isthmus obviously decreased (P ＜ 0.05).The length of the left lobe was (57.42 ± 12.87) mm and (46.37 ± 7.67) mm (t =4.58) before and after treatment; The breadth of the left lobe was(26.68 ±7.71) mm and(22.21 ±6.09) mm(t =4.56) before and after treatment; The thickness of the left lobe was (27.18 ± 6.60) mm and (21.14 ± 5.67) mm(t =7.28) before and after treatment.The length of the right lobe was(58.17 ± 12.32)mm and(49.73 ±9.35) mm(t =3.84) before and after treatment; The breadth of the right lobe was (26.14 ± 7.37)mm and (23.00 ± 6.68) mm(t =3.29) before and after treatment ; The thickness of the right lobe was(27.57 ± 6.42)mm and(22.00 ±5.55)(t =5.88)before and after treatment.The isthmus before and after treatment was(9.94 ±4.15)mm and(6.19 ±2.57)mm(t =6.09).The recurrence rate was 17％ (5/30) after one year.Conclusions MP pulse therapy is an effective treatment for HT complicated with goiter.The recurrence rate is low.

ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) after liver resection for hepatocellular carcinoma (HCC) with tumor thrombus in the main trunk and/or first branch of portal vein,and to clarify prognostic factors affecting survival.Methods From 2005 to 2009,there were 358 consecutive patients with HCC who underwent surgical resection in our Department.In 55 patients (15 ％),portal vein tumor thrombus (PVTT) was found intraoperatively or postoperatively during histopathological examinations to involve the first portal branch,main portal trunk,or contralateral portal branch.In this retrospective study,these 55 patients were divided into two groups:Group A,29 patients received postoperative TACE,and Group B,26 patients who did not receive TACE.The clinical data and survivals were compared between the two groups.Prognostic factors were indentified using univariate analysis,followed by multivariate regression analysis using the Cox proportional hazards model.ResultsThere were no significant differences in the demographic clinical data between Group A and Group B.The overall 1-,2- and 3-year survivals for the 55 patients were 63.3 ％,51.4 ％ and 43.5 ％,respectively.The accumulative 1-,2- and 3-year survivals for group A were 71.4 ％,60.1 ％ and 50.1 ％,respectively.The corresponding figures for group B were 56.7％,21.7％ and 10.4％,respectively.Multiple tumors,intrahepatic metastases,hepatic vein thrombus,and invasive type of tumor thrombus were found to be risk factors for short-term survival on univariate analysis,while the latter 3 factors were further found to be significant prognostic factors in the Cox proportional hazards model.Postoperative TACE was shown to be a significant factor in both univariate and multivariate analyses.ConclusionLiver resection was beneficial for some patients with portal vein tumor thrombus.Postoperative TACE further improved the prognosis and prolonged survivals in these patients.

Objective To investigate the MRI findings of perihip heterotopic ossification (HO) in the early, mid and late stages. Meth-ods The MRI of 44 inpatients with HO from February, 2011 to September, 2013 were reviewed, in which 20 cases (28 joints) were in early stage, 18 cases (24 joints) in mid stage and 6 cases (8 joints) in late stage. For the enhanced T1WI, 9 cases (11 joints) were in early stage, 6 cases (7 joints) in mid stage, and 3 cases (4 joints) in late stage. Theχ2 trend test was used to evaluate the MRI signal change with the HO maturity. Results With the maturity of hip HO, the signal intensity of T2WI reduced (χ2=16.773, P<0.001), fat signal on T1WI increased, the enhancement reduced (χ2=16.048, P=0.007). Conclusion The MRI findings of perihip HO are characteristic in MRI in all the stages. MRI is useful for the diagnosis of perihip HO, especially for the early HO.