Objective　To study the value of intraoperative cholangiography(IOCG) in cholecystectomy for gallbladder stone. Methods　The IOCG data of 694 cases in the Affiliated Hospital, Yanan University Medical School were retrospectively analysed. Results　Among 694 cases with IOCG, 65 had positve findings. Bile duct stone occurred in 44 patients, residnal stone in cyst duct in 7, bile duct injury in 2, and Mirizzi syndrom in 3. Among the 44 cases with bile duct stone, the age of 4.3% cases was 22～50 years old, 10.3% older than 50 years. The incidence of bile duct stone occurring after 50 years old increased with age. The accurate rate of IOCG was 98% in this series. Conclusions　IOCG can not only find residual stone, but also find bile duct abnormality and bile duct injury in time, if correct imagic technique is applied.

nclude positive vascular remodeling,low plaque density,spotty calcification,and eccentric stenosis.

Objective To investigate utilization of antenatal health care service,analyze its influential factors and intervention methods.Methtods 1685 pregnant women who were in hospitalization from January 2011 to July 2012 were selected.A self-designed questionnaire was conducted and case history information were collected,including general information,medical costs means,awareness of prenatal care knowledge,whether convenient to see doctor,the degree of attention paid to pregnant women,the utilization of antenatal health care.Results 81.19％(1368/1685)of the pregnant women used antenatal health care service.Multiple Logistic regression analysis showed that the difference between diverse age,medical costs means,the number of pregnancies,level of awareness of prenatal care knowledge,the degree of attention paid to pregnant women was significant.Conclusions The utilization of antenatal health care service in this area is on the low side.The critical of improving the utilization of prenatal care services is improving prenatal care service mode,increasing the quantity of health education,perfecting the medical security system,strengthening community health service consciousness and the improvement of technology.

Objective To evaluate images quality and diagnostic feasibility of low-dose CT in patients with traumatic rib fractures.Methods Twenty-five patients presented with thoracic iniury were underwent 64-slice spiral CT scanning in inspiration breath-hold technique.Two scan protocols were performed.In one scan protocol noise index(NI)is 11,and in another NI is 21,but the other scan parameters were no difference.The mean value of tube current,the volume CT dose index(CTDIvol),and effective dose(ED)were recorded.Image quality was scored by 2 experienced radiologists using the 5-points scale.The numbers and degrees of rib fractures were recorded.The data were tested by using the Wilcoxon signed rank sum test.The differences of the inter-observer were determined by Kappa statistics.Results The mean CTDIvol and ED in scan protocol with NI of 11 were(13.88±5.17)mGy and(8.14±3.21)mSv,and that with NI of 21 were(3.91±1.57)mGy and(2.31±0.97)mSv.Compared the scan with NI of 11.there was 72%intrinsie dose reduction in the scan with NI of 21.The mean value of tube current in scan with NI of 11 and 21 were(195.88±69.33)mAs and(54.56±21.54)mAs.AIl patients with 11 and Ⅲ degree and most patients with I degree rib fractures that identified by the scan with NT of 11 were detected by the scan with NI of 21.There were no statistical difference between two scaus with the Wilcoxon signed rank sum test.The diagnostic acceptability and image noise score in the scan with NI of 11 were 4.9±0.2 and 4.6±0.5.and that with NI=21 were 3.5±0.5 and 3.3±0.5.There was prefect concordante in the inter-observers in diagnostic acceptability on finding of rib fractures.diagnostic acceptability and image noise(Kappa=0.876,0.820,0.792,P<0.01)between two scan protocols.Conclusion Rib fractures can be diagnosed by the low-dose CT using the scan protocol with NI of 21.

BACKGROUND: There are numerous inducers used in inducing bone marrow mesenchymal stem cells (BMMSCs) differentiate into neuron-like cells, however, due to poisonous, most chemical inducers can not be used in human.OBJECTIVE: To investigate the effect of ligustrazine on differentiation of rat BMMSCs into neuron-like cells in vitro, and to search for the optimal inductive concentration.METHODS: After SD rats were anesthetized, bone marrow was obtained from the femoral and tibial bones, centrifuged, and the supernatant was discarded. The extracted cells were cultured in L-DMEM supplemented with 15% fetal bovine serum. The expression of CD44 and CD45 of the 5~(th) passage of BMMSCs were identified by immunocytochemical technique. Serum-free L-DMEM medium contains 1.00, 1.25 and 1.50 g/L ligustrazine concentrations were used to induce the 5~(th) passage of BMMSCs in vitro. Morphology changes of BMMSCs were observed under an inverted phase microscope. Expression of nestin, neuron-specific enolase and glial fibrillary acidic protein were identified by immunocytochemical technique, and the expression ratio of neuron-like cells' surface antigens induced by different concentrations of ligustrazine were compared.RESULTS AND CONCLUSION: ①Most primarily cultured BMMSCs adhered to the wall at 3 days after culture, which proliferated faster after passaged, and the 5~(th) passage of cells were mostly purified into BMMSCs, spread radially or vortex-likely. ②The 5~(th) passage of BMMSCs was positive expressed (98.02±0.81)% CD44, but negative for CD45. ③Neuron-like cells with prominence and bifurcation could be seen after induction. The immunocytochemical method showed that nestin and neuron-specific enolase in most induced cells were positive expressed, especially received a highest ration of neuron-specific enolase expressing in the induced group with 1.25 g/L concentration of ligustrazine. It revealed that ligustrazine can induce BMMSCs differentiated into neuron-like cells, and 1.25 g/L is the optimal inductive concentration.

Objective To explore the value of endoscopic ultrasound (EUS) in differential diagnosis of ectopic pancreas and stromal tumor in stomach.Methods The clinical data and endoscopic ultrasound findings of 40 patients with ectopic pancrea and 141 patients with stromal tumor were retrospectively analyzed,including the location,size,growth pattern,layer of origin,internal echo pattern and so on.All patients were diagnosed pathologically.Results Ectopic pancreas were predominantly located in the antrum (92.5％) and stromal tumor were mainly located in the gastric body (45.4％),the antrum (23.4％) and the fundus (22.0％),there was a significant difference in lesion' s location between two diseases (P ＜0.001).There was no statistical difference in the ratio of longest/shortest diameter of the lesion size(P =0.057).But there was statistical difference in lesion size between ectopic pancrease and stromal tumor [(19.98 ± 12.80)mm vs (11.25 ± 3.61)mm].Mural growth pattern was most common in ectopic pancrease (82.5％) and mural growth pattern (37.6％),extraluminal growth pattern (24.8％) and intraluminal growth pattern (22.7％) in stromal tumor (P ＜0.001).The third layer (75.0％) was predominant in ectopic pancrease while the fourth (54.6％) and the second layers (34.0％) in stromal tumor (P ＜0.001).With regard to internal echo pattern,hypoechoic (32.5％),intermediate (27.5％) and heterogeneous (27.5％) was predominant in ectopic pancrease and homogeneous hypoechoic lesion (72.3％) in the stromal tumor (P ＜ 0.001).Conclusions There were statistical differences between ectopic pancrease and stromal tumor in the location,size,layer of origin,growth pattern and internal echo pattern under EUS.EUS plays an important role in identification of ectopic pancrease and stromal tumor.

Objective To evaluate the efficacy and safety of prucalopride two mg once daily in the treatment of chronic constipation (CC) in China.Methods In this multicentre,randomised,placebo controlled,parallel-group,phase Ⅲ study,patients with CC received either two mg prucalopride or placebo,once daily,for 12 weeks.The primary efficacy endpoint was the proportion of patients reaching an average of three or more spontaneous complete bowel movements (SCBM) per week during the 12 week treatment.The key secondary efficacy endpoint was the percentage of patients reaching three or more SCBM/week during the first four weeks of treatment.Other efficacy assessments included the average number of SCBM/week; the median time to onset of first SCBM after intake of the first dose of trial medication and the average number of bisacodyl tablets or enemas used per week.Furthermore,the symptoms of constipation were assessed by patient assessment of constipation symptom (PAC-SYM) questionnaire.The quality of life was evaluated by patient assessment of constipation-quality of life (PAC-QOL) questionnaire.Safety assessments included adverse events,laboratory values and cardiovascular events.Results Four hundred and forty-six patients from China were screened,313 were treated and 295 completed 12-week study treatment.Averaged over 12 weeks,significantly higher proportion of patients on prucalopride two mg (39.4％,P＜0.01) had three or more SCBM/week compared with placebo (12.7％,x2 =29.50,P＜0.01).Over four weeks,significantly higher proportion of responders was also found in patients on prucalopride (40.0 ％vs 13.3 ％,x2 =28.58,P＜0.01).Prucalopride also significantly improved associated symptoms and quality of life (QOL).The most frequent treatment emergent adverse events were diarrhoea,nausea,abdominal pain,and headache,which were mild to moderate and transient,spontaneously resolved in a few days.Conclusion Prucalopride two mg once daily significantly improved bowel function,associated symptoms and satisfaction in CC over a 12-week treatment period,and was safe and well tolerated in Chinese patients.

Objective To investigate effects of xeroderma pigmentosum B(XPB) gene on IL-6 induced proliferation and apoptosis in human vascular smooth muscle cells (VSMC).Methods Recombinant plasmid pcDNA3.1-XPB and vacant vector plasmid pcDNA3.1 were transfected stably into VSMC by liposome,and these cells were incubated with IL-6 at a 100 U/ml for 48 hours.The experiments were divided into six groups:blank control group; pcDNA3.1 group; pcDNA3.1-XPB group;IL-6 group; IL-6 + pcDNA3.1 group; IL-6 + pcDNA3.1-XPB group.The expression levels of XPB,Bcl-2,Bax and wild type p53 (wt-p53) were detected through reverse transcription polymerase chain reaction (RT-PCR) and Western blotting.The cell survival,cell cycle and apoptosis were examined with 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and flow cytometry,respectively.Results The transfection of pcDNA3.1-XPB increased the expression of XPB,Bax and wt-p53 (P＜0.05 or P＜0.01),decreased the expression of Bcl-2 (P＜0.05 or P＜0.01),and reduced the IL-6 induced effects on decreasing the expression of Bax and wt-p53 and increasing the expression of Bcl-2(P＜0.05 or P＜0.01).The over expression of XPB inhibited the cell growth(q=2.95,P＜ 0.05),and reduced the positive effects of IL-6 on VSMC growth ( 102.6 +6.2) ％ vs.(124.5 + 7.9) ％,q=3.49,P＜0.05.The over expression of XPB increased the apoptosis rate of VSMC(P＜0.01 ) and the cell amounts of G0/G1 phase (q=2.99,P＜ 0.05),decreased the cell amounts of S phase(q=3.05,P＜0.05),and reduced the IL-6 induced effects on decreasing the apoptosis rate of VSMC(5.9±2.1)％ vs.(0.3±0.1)％,q=7.53,P＜0.01; the cell amounts of G0/G1 phase(70.9±6.7) ％ vs.(54.8±2.9) ％,q=6.91,P＜0.01 ;and on increasing the cell amounts of Sphase(20.2+3.6)％ vs.(36.4+7.2)％,q=8.54,P＜0.01.Conclusions XPB gene could inhibit VSMC proliferation,promote VSMC apoptosis,and reduce the effects that IL-6 promotes VSMC proliferation and inhibits VSMC apoptosis.Therefore,XPB gene is likely to be potential molecular target for treatment of atherosclerosis.

OBJECTIVE: To assess the expression of NGF, BDNF, NT-3 mRNA in the peripheral blood of patients with allergic rhinitis (AR). Meanwhile, to analysis whether the expression of NGF, BDNF, NT-3 mRNA correlate with the severity of rhinitis. METHOD: This study is a group controlled trial, which takes the healthy adults as control group. The total RNA have been extracted from the peripheral blood of AR patients. The expression of NGF, BDNF and NT-3 mRNA have been tested by real-time quantitative RT-PCR. RESULT: Comparing with the healthy adults, the expression of NGF, BDNF and NT-3 mRNA as 2(-deltadeltaCt) are 2.436 8, 4.4588 and 1.781 8 respectively. The increasing expression of NT-3 correlated positively with the scores of visual analog scale. CONCLUSION The expression of NGF, BDNF and NT-3 mRNA are as high as 2.4368, 4.4588 and 1.7818 times to healthy adults. We propose NGF, BDNF and NT-3 may contribute to the pathogenesis of AR. NT-3 could reflect the severity of rhinitis as a molecular biological index.
Adolescent ; Adult ; Brain-Derived Neurotrophic Factor ; blood ; genetics ; Child ; Female ; Humans ; Male ; Nerve Growth Factor ; blood ; genetics ; Neurotrophin 3 ; blood ; genetics ; RNA, Messenger ; genetics ; Rhinitis, Allergic ; blood ; Young Adult

OBJECTIVE: To detect the expression of NGF, BDNF, NT-3 mRNA in the peripheral blood of patients with allergic rhinitis (AR). And to analyze the correlation between NGF, BDNF, NT-3 mRNA expression and the epidsode of rhinitis through Th-2 Hypothesis. METHOD: This study was a group controlled trial. The expression of NGF, BDNF and NT-3 mRNA were tested by real-time quantitative RT-PCR and the concentrations of IL-4, IL-6, IL-10 and INF-alpha were tested by ELISA. RESULT: The expression of NGF, BDNF and NT-3 mRNA in AR patients were 2.44, 4.46 and 1.78 times the amount of those in the healthy adults, respectively. The increased expression of NT-3 correlated positively with the scores of visual analog scale of AR. The concentrations of IL-4, IL-6 and IL-10, which were 2198 +/- 472 pg/mL, 9407 +/- 703 pg/mL and 3917 +/- 323 pg/mL respectively, were higher than those in the healthy adults. The concentration of INF-alpha was 2198 +/- 472 pg/mL and less than the healthy adults. The increased expressions of NGF, NT-3 were positively related to the increase of IL-4, IL-6 and IL-10. CONCLUSION The expressions of NGF, BDNF and NT-3 mRNA in AR patients are higher than those in the healthy adults. NGF, BDNF and NT-3 may contribute to the pathogenesis of AR. Moreover, NGF and NT-3 may induce the episode of rhinitis through Th-2 Hypothesis.
Adolescent ; Adult ; Brain-Derived Neurotrophic Factor ; blood ; Case-Control Studies ; Child ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-4 ; blood ; Interleukin-6 ; blood ; Male ; Nerve Growth Factor ; blood ; Nerve Growth Factors ; blood ; genetics ; Neurotrophin 3 ; blood ; RNA, Messenger ; genetics ; Rhinitis, Allergic ; blood ; immunology ; Th1-Th2 Balance ; Young Adult