Objective To study a safe and effective method for the dissection of the cystic duct under laparoscope.Methods Laparoscopic cholecystectomy was performed in 1 460 cases,by using the retrograde dissection of the cystic duct,from December 2002 to December 2005 in this hospital. Results The laparoscopic cholecystectomy was successfully completed in 1 442 cases,with an operation time of 15~100 min(mean, 42 min).A conversion to open surgery was required in 18 cases(1.23%).Complications included 5 cases of bile duct injury(0.34%),3 cases of intraabdominal hemorrhage(0.21%),and 3 cases of biliary leakage(0.21%).Follow-up for 2~24 months(mean,11.8 months) found 2 cases of residual calculi in the common bile duct.Conclusions The retrograde dissection of the cystic duct during laparoscopic cholecystectomy is a safe method and simple to perform.

OBJECTIVE:To evaluate the economics of somatostatin,ulinastatin,octreotide and gabexate preventing hyperamy-lasemia and pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). METHODS:Medical records of 316 cho-ledocholithiasis patients underwent ERCP were selected from our hospital during Jul. 2008-Apr. 2016,and then divided into blank control group(58 cases),somatostatin group(64 cases),ulinastatin group(65 cases),octreotide group(68 cases)and gabexate group (61 cases) according to the use of protease inhibitor. Before ERCP,blank control group received routine treatment as fast-ing,parenteral nutrition support,acid suppression,etc. Based on it,other 4 drug groups received prophylactic drug use according to package inserts 6 h before ERCP. The incidence of hyperamylasemia and pancreatitis after ERCP,VAS scores 3,24,48 h after surgery and the occurrence of ADR were compared among 5 groups. The cost-effectiveness analysis was used to evaluate the eco-nomics of therapy plans in each group. RESULTS:Compared with blank control group,hospitalization time of somatostatin group, ulinastatin group,octreotide group and gabexate group were shortened significantly;the incidence of hyperamylasemia and pancre-atitis were significantly decreased;VAS score 3,24,48 h after surgery were significantly decreased,with statistical significance (P<0.05). Compared among 4 groups,above indexes had no significant difference,and the incidence of ADR was in low level and had no statistical significance(P>0.05). The cost-effectiveness ratio of somatostatin group was the lowest and has cost-effec-tiveness advantage. The results were supported by incremental cost-effectiveness and sensitivity analysis. CONCLUSIONS:Soma-tostatin,ulinastatin,octreotide and gabexate can significantly prevent the occurrence of hyperamylasemia and pancreatitis after ER-CP,and relieve pain with good safety. Somatostatin can achieve the best therapeutic efficacy at the lowest cost,so it is the best plan for hyperamylasemia and pancreatitis after ERCP.

We presented a new method for vessel segmentation and vascular structure recognition for coronary angiographic images. During vessel segmentation, a new vessel function was proposed to attain vessel feature map. Then the region growing algorithm was implemented with an automatic selection of seed point, extraction of main vessel branch, and vessel detail repairing. In the algorithm of vascular structure recognition, a fuzzy operator was used, which can detect the structures of vascular segments, bifurcations, crosses, and tips. The experimental results indicated that there was about 5 percent larger vessel region which was extracted by the proposed segmentation method than that by the simple region growing algorithm, and several thinner vessels were resumed from the lower gray region. The results also indicated that the fuzzy operator could correctly infer the simulative and real vessel structure with 100% and 90.59% correctness rate on the average, respectively.
Algorithms ; Coronary Angiography ; Humans ; Radiographic Image Enhancement ; methods ; X-Rays

ObjectiveTo investigate theeffectof expression of excision repair cross complementing 1(ERCC1) on adjuvant chemotherapy and prognnsis in advanced gastric cancer.MethodsIn this study 88 advanced gastric cancer cases were divided into initial neoadjuvant chemotherapy group (45 patients) and upfront surgical group (43 cases).In neoadjuvant chemotherapy group two courses neoadjuvant chemotherapy with XELOX were given before an interval standard radical gastrectomy.Postoperatively another four cycles of chemotherapy with XELOX were given; In upfront surgical group standard radical gastrectomy was done followed by 6 cycles of postoperative chemotherapy with XELOX;Patients in the two groups were followed up for 3 years.ResultsERCC1positive expression were 49％ and 44％ in neoadjuvant group and surgical patients; Response rate in neoadjuvant chemotherapy group was 49％.Patients with ERCClnegative expression were more sensitive to chemotherapy (P ＜0.05 ); 3-year recurrence-free survival rate in patients with ERCC1negative expression was 64％,which was significantly higher than 30％ in patients with positive expression,the difference was statistically significant (P ＜ 0.05 ) ;3-year recurrence-free survival rate in initial surgical group patients with ERCCl-negative expression was 79％,significantly higher than in patients with positive expression (38％),the difference was statistically significant (P ＜0.05) ; Cox regression analysis revealed that ERCC1expression is closely related to 3-year disease-free survival ( P ＜ 0.05 ). ConclusionsERCC1expression in patients with advanced gastric cancer is related to chemosensitivity and prognosis,it can forecast the prognosis and chemotherapy sensitivity.

Objective To discuss the high-risk human papillomavirus (HPV )infection in the Guangxi .Methods A total of 26 796 copies of the test results for female cervical secretions specimens were analyzed retrospectively from what the second-genera-tion hybrid capture technology mixed detect 13 kinds of high-risk HPV viral DNA .Results Infection rate was 17 .94% in Guangxi , and the infection of HPV in north was higher than other regions ,and the differences of regions had statistically significant (P<0 .05) .The peak age of infection in the Guangxi region was less than 20 years old ,50- <60 years old ,and equal or more than 60 years old .The differences among age groups was statistically significant(P<0 .05) .Patients constitute HPV infection Guangxi re-gion had high viral load for 40 .93% ,and high viral load constituent ratio rise with age .Conclusion The existence of high-risk HPV infection is regional different and age different in the Guangxi region ,to high-prone areas ,infection high age should focus on monito-ring ,high viral load in patients with complete cervical cytology and histology examination if necessary .

BACKGROUND: Appropriate seed cell is important for transplantation in the treatment of cerebrovascular disease and other central nervous system disease.OBJECTIVE: To investigate the capacity of human adipose tissue-derived stromal cells (ADSCs) to differentiate into neurons.METHODS: The fatty tissue was harvested from removed abdominal unnecessary fat of healthy adult with no communicable disease or endocrine disease. Human ADSCs were isolated from human liposuction tissues and cultured in neural induction medium with GM1. Invert phase-contrast microscopy was used to observe morphology changes of ADSCs. The expression of nestin, neuron specific enolase (NSE) and microtubule-associated protein 2 (MAP2) were identified by immunocytochemistry.RESULTS AND CONCLUSION: The majority of cells displayed typical appearance of neuronal-like cells following induction. Following 1 hours of induction, some cells began to express nestin, and NSE and MAP2-positive cells were observed at 5 hours. ADSCs can differentiate into neurons, and the differentiated neurons have the capacity of expressing nestin, NSE and MAP2.

Objective:To compare the post-operative outcomes between extended lateral approach and L-shaped lateral approach in surgical treatment of Sanders type III intra-articular calcaneal fractures.Methods:A retrospective case-control study was made on clinical data of 34 patients with fresh Sanders type III intra-articular calcaneal fractures hospitalized in Langfang Hospital of Traditional Chinese Medicine from October 2014 to October 2017. There were 33 males and 1 female, with the age of 18-56 years [(42.5±9.4)years]. All fractures were fresh. Seventeen patients were fixed by the extended lateral approach (extended approach group) and seventeen patients by L-shaped lateral approach (L-shaped approach group). Operation duration, intraoperative bleeding volume, length of hospital stay, one-stage wound healing rate and complication rate were observed. B?hler and Gissane angle were measured before operation, one week after operation and 12 months after operation. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was applied to evaluate function recovery.Results:There were no significant differences between groups in operative time and intraoperative bleeding volume ( P>0.05). There were significant differences between extended approach group and L-shaped approach group in length of hospital stay [(15.7±4.0)days vs.(22.4±9.6)days], one-stage wound healing rate [88%(15/17) vs. 47%(8/12)] and postoperative complication rate [12%(2/17) vs. 47%(8/17)] ( P<0.05). The B?hler and Gissane angles did not differ significantly between groups before operation and one week and 12 months after operation ( P>0.05). At postoperative 12 months, the B?hler and Gissane angles were improved from preoperative (8.2±6.0)°, (85.3±10.5)° to (23.9±6.1)° and (119.3±6.2)° respectively in extended approach group, and those from preoperative (9.4±3.9)°, (85.5±7.1)° to (25.8±3.7)° and (122.2±5.6)° respectively in L-shaped approach group (all P>0.05). At 12 months after operation, the AOFAS score was (86.9±7.5)points in extended approach group, with the excellent and good rate of 88%; and was (83.3±12.5)points in L-shaped approach group, with the excellent and good rate of 76% ( P>0.05). While the score of hindfoot joint activity in extended approach group was (5.8±0.7)points, significantly higher than (3.4±1.0)points in L-shaped approach group ( P<0.05). Conclusion:For Sanders III intraarticular calcaneal fractures, compared with L-shaped approach group, plate fixation via extended approach can promote fracture healing, shorten hospital stay, reduce incidence of complications and facilitate function recovery of subtalar joint.

Objective:To investigate the optimal cut-off values for the prediction of lumbar spinal stenosis using lumbar pedicle thickness.Methods:The clinical data of 64 patients with lumbar spinal stenosis (patient group) admitted to Binzhou Center Hospital from November 2019 to April 2021 and 48 healthy volunteers (healthy control group) who concurrently received routine physical examination involving lumbar spine MRI examination in the same hospital were retrospectively analyzed. Lumbar pedicle thickness was measured on T 2 weighted images of the L 5 vertebral body in the axial projection. Lumbar pedicle thickness was compared between groups using the independent sample t-test. The relationship between lumbar pedicle thickness and age change was analyzed using a one-way analysis of variance. The efficacy of lumbar pedicle thickness in the diagnosis of lumbar spinal stenosis was evaluated using the receiver operating characteristic (ROC) curve, optimal cut-off values, sensitivity, specificity, and the area under the ROC curve. Results:There was no significant correlation between lumbar pedicle thickness and age change ( P > 0.05). Lumbar pedicle thickness of patients with lumbar spinal stenosis was significantly higher than that of healthy controls [(13.25 ± 1.73) mm vs. (8.54 ± 1.88) mm, t = 13.75, P < 0.05]. ROC curve results showed that the optimal cut-off value was 10.50 mm, with a sensitivity of 95.3% and a specificity of 85.4. The area under the ROC curve was 0.963 (95% CI 0.928-0.998). Conclusion:The increase in lumbar pedicle thickness is related to the increase in the incidence of lumbar spinal stenosis. Lumbar pedicle thickness is an accurate, objective, and clear morphological parameter for the prediction of lumbar spinal stenosis. Application of lumbar pedicle thickness to predict lumbar spinal stenosis is innovative and scientific.

Drug-drug interactions (DDI) change dose-response relationships, and may result in low efficacy or high toxicity, which are important considerations especially in medical practice with multiple-drug therapies. Predicting clinically significant drug interactions during new drug development is an important part of benefit and risk assessment in drug development and review. This article summarizes the purpose and significance of drug interactions in new drug development, the main content and precautions of DDI studies in vivo and in vitro. Drug interaction studies on novel drug approvals for 2020 in the National Medical Products Administration (NMPA) and US Food and Drug Administration (USFDA) are examined, respectively. It aims to provide reference for DDI studies and regulatory reviews in new drug development in our country.

OBJECTIVETo investigate the changes in serum protease and cytokine in patients with silicosis, tuberculosis, and lung cancer.

METHODSSerum samples of patients with silicosis, tuberculosis, and lung cancer were collected. The variation trends of the expression of granzyme A, cathepsin G, apolipoprotein A, and interferon-β (IFN-β) were analyzed using enzyme-linked immunosorbent assay.

RESULTSThe concentration of apolipoprotein A of the silicosis group was 200 µg/ml, significantly higher than those of the tuberculosis and lung cancer groups (P < 0.05), and the lung cancer group had a significantly higher concentration of apolipoprotein A compared with the tuberculosis group (P < 0.05). The silicosis group had significantly higher expression of cathepsin G compared with the tuberculosis and lung cancer groups (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in the concentration of cathepsin G (P > 0.05). The tuberculosis group had a significantly higher concentration of granzyme A than the silicosis and lung cancer groups (P < 0.05), and the silicosis group and lung cancer group had similar protein concentration trends (P > 0.05). The tuberculosis group and lung cancer group had significantly higher concentration of IFN-β compared with the silicosis group (P < 0.05), and the tuberculosis group and lung cancer group showed no significant difference in IFN-β concentration (P > 0.05).

CONCLUSIONThis study may offer diagnostic markers for the clinical diagnosis of silicosis, tuberculosis, and lung cancer, and could provide a basis for the research, as well as potential molecular targets for the diagnosis and treatment of these diseases.

Biomarkers ; Cathepsin G ; metabolism ; Cytokines ; blood ; Endopeptidases ; blood ; Enzyme-Linked Immunosorbent Assay ; Granzymes ; metabolism ; Humans ; Interferon-beta ; metabolism ; Lung Neoplasms ; enzymology ; Silicosis ; enzymology ; Tuberculosis ; enzymology