Objective To explore clinical effect of choledocholithotomy by laparoscopy-assisted choledochoelectroscopy and endoscopic retrograde cholangiopancreatography.Methods The clinical data of 126 gallstone and choledocholithiasis patients treated by laparoscopy-assisted choledochoelectroscopy(L group)and endoscopic retrograde cholangiopancreatography(E group)were analyzed retrospectively.In L group,the patients were performed LC and choledocholithotomy by laparoscopy-assisted choledochoelectroscopy directly,but in E group,the treatment procedures were finished by two steps.Firstly,the bile duct stones were carried out by ERCP,days later LC operations were performed.Between the two groups,the hospital days,costs,the rate of residual stone,the rate of bihary infection or panereatitis and the rate of stone recur were compared.Results In the two groups,hospital days were(6.5±0.3)d and(12.5±0.5)d,costs were(1.22±0.17)and(1.98±0.24)ten thousand yuan,the rate of residual stone was 0 and 5.3%,the rate of biliary infection or pancreatitis was 1.4%and 15.8%,and the rate of stone recur was 1.4%and 10.5%respectively.When compared each other the difference was statistically significant(t=2.48,1.96,χ2=4.32,4.90,8.79,all P＜0.05).Conclusion In patients with gallstone and bile duct stones,laparoscopy-assisted choledochoelectroseopy presented more predominances when compared with two steps methods.

A quantitative nuclear magnetic resonance spectroscopic ( qNMR) method was established for the simultaneous determination of resveratrol and polydatin in Polygonum Cuspidatum traditional Chinese herb cuts and granule. The 2_step ultrasonic extraction method using 80% alcohol and acetone was used for fully extracting these two components in samples before qNMR determination. The qNMR experimental conditions were investigated and deuterated dimethyl sulphoxide_deuterium oxide (10∶1, V/V) was selected as solvent, the pulse delay time was 5 s, the scan number was 32, 2,3,5_triiodobenzoate was used as internal standard which was calibrated with primary standard substance of potassium hydrogen phthalate. The 1 H_NMR peaks atδ6. 388-6. 391 ( d, 2H) of resveratrol and δ 6. 322-6. 330 ( t, 1H) of polydatin were chosen as the quantitative peaks. Method validation was performed in terms of precision ( RSD<0. 6%), linearity (correlative constants R2>0. 999), limit of detection (0. 23 g/L for resveratrol and 0. 24 g/L for polydatin) and limit of quantitation ( resveratrol 0. 69 g/L, polydatin 1. 57 g/L), recovery ( resveratrol 97. 7% -103 . 5%, RSD=2 . 4%, polydatin 94 . 5%-99 . 2%, RSD=1 . 6%, including the sample extraction and preparaton process) . The results showed the reliability of qNMR for traditional Chinese medicine assay. The resveratrol and polydatin in Polygonum Cuspidatum real cuts and granule samples were experimental determined as 3. 57-5. 69 mg/g and 12. 73-24. 07 mg/g, respectively.

Objective:To investigate extraocular muscles(EOM) susceptibility to myasthenia gravis(MG).Methods:Acetylcholine receptor(AChR) ?, ?, ?, ? and ? subunits from human EOM and other different muscle groups from 8 health controls and intercostal muscles from 10 MG patients were studied by RT-PCR System. Serum AChR antibodies from 83 patients with MG were assayed by ELISA.Results:①AChR?, ?, ?, ? and ? subunit mRNA could be amplified from normal human EOM and all muscle groups studied. ②AChR? P3A+/?-actin mRNA was expressed at higher level in general MG than in health controls(P=0.028). ③Ocular and general MG patients had higher AChR antibodies against AChR from adult gastrocnemius muscle than that from fetus(P=0.001,0.016).Conclusion:Susceptibility of EOM to MG is likely associated with muscle AChR subunit mRNA expression and intrinsic susceptivity of EOM.

Objective:Study the effect of Acanthopanax gracilistylus extract(Age) on monocyte,and reveal the anti trmor mechanism.Methods:The content of TNF ?,IL 12 were examined by using biological method and ELISA,respectively.The expression of monocytic cytokine mRNA are investigated by RT PCR.The effect of Age on the phagocytosis of monocytes is studied using TdR incorporation method.Results:After cultured with Age,the production of cytokines by monocytes such as TNF ?,IL 12 are markedly increased with good dose dependent manner.After monocytes cultured with LPS in the presence or absence of Age,Age markedly enhances LPS induced TNF ? production.Treatment with Age,the production of cytokines and the expression of their mRNA are increased simultaneously.The results in vivo also show:Age can enhance the productions and the expressions of TNF ? and IL 12.Conclusion:The anti tumor active component of Age has obvious stimulative activity on monocytes, increasing the production of cytokines, enhancing the phagocytosis.These results product the scientific evidence for the study of anti tumor mechanism and clinical ultilization.

Objective To quantitatively evaluate the metabolic changes of prostate adenocarcinoma using magnetic resonance spectroscopy (MRS).Methods Eighteen patients of prostate cancer proved by ultrasound guided systemic biopsy were enrolled in this study.All the puncture locations were marked and the corresponding (Choline+Creatine)/Citrate ratios were calculated on the basis of the MRS metabolic map.Results 204 samples were obtained and 106 of them were diagnosed as cancer.The average (Cho+Cre)/Cit ratio in the 106 positions was 2.53?1.02.The (Cho+Cre)/Cit ratio of cancer area was statistically higher than that of noncancerous area (F=8.64, P

Objective: To analyze the current condition and inlfuencing factors for clinical compliance in patients with permanent pacemaker implantation and to improve the follow-up condition in relevant patients. Methods: A total of 817 patients with permanent pacemaker implantation in our hospital from 2006-01 to 2013-01 were retrospectively studied. The clinical compliance condition and inlfuencing factors were accessed for 1 year period. Results: There were 26/817 (3.18%) patients lost contact and 1 patient died. A total of 790 (96.7%) patients finished the followed-up study by 2 groups: Clinical visit group,n=440 (55.70%) and Telephone visit group,n=350 (44.30%). The education level, medical cost, residency, comprehension of arrhythmia and accompany personnel were different between 2 groups,P<0.05. The patients were with high school education or above, reimbursed medical cost, local residency, comprehension of arrhythmia and accompany personnel had the higher clinical visit rate. The overall 1 year occurrence rate of complication was 1.8% without severe event. There were 59.5% of patients optimized the pacemaker parameters during clinical visit. Conclusion: The patients with permanent pacemaker implantation had the lower rate of clinical follow-up visit which should be improved in several issues.

Objective:To investigate the relationship of urinary 8-oxoguanosine(8-oxoGsn)with muscle mass, muscle strength, advanced glycation end products(AGEs), trace elements, heavy metals and other health-related indictors in different age groups of the Beijing area.Methods:A cross-sectional research was conducted.Healthy adults aged 25 to 93 years who sought health examination in the Health Examination Center of Beijing Hospital were recruited.Participants were divided into the young and middle-aged group and the elderly group with age 60 as the cutoff.Urinary 8-oxoGsn levels were detected by mass spectrometry and adjusted using urine creatinine values.Body composition was measured by multifrequency bioelectrical impedance analysis(BIA). Grip strength, 6-meter walking speed and 5-times sit to stand test were conducted by experienced team members.Skin autofluorescence was used to detect skin AGEs.A portable optical scanner was used to detect heavy metals and trace elements using reference points of the palm.Levels of fasting blood glucose, glycosylated hemoglobin, high-density lipoprotein and other common blood biochemical indicators were measured.Results:A total of 106 subjects were enrolled, including 68 in the young and middle-aged group and 38 in the elderly group.The proportion of patients with hypertension(14 ases or 36.8% vs.7 ases or 10.3%), systolic blood pressure[130(120, 140) vs.120(110, 126)mmHg], fasting blood glucose[5.7(5.2, 5.9)mmol/L vs.5.2(4.9, 5.5)mmol/L], glycosylated hemoglobin[6.0(5.7, 6.2)% vs.5.7(5.4, 5.9)%], 8-oxoGsn/Cre[1.9(1.4, 2.6) vs.1.3(1.0, 1.6)], AGEs(2.44±0.46 vs.2.01±0.29), 5-times sit to stand test scores[7.8(6.9, 9.8)s vs.6.0(5.0, 6.8)s], magnesium(31.4±7.2 vs.27.7±6.4), mercury(0.013±0.003 vs.0.008±0.003)and silver[0.011(0.010, 0.012) vs.0.010(0.009, 0.011)]were higher in the elderly group than in the young and middle-aged group, while grip strength[28.0(22.0, 35.1)kg vs.36.6(28.5, 49.1)kg], fat-free mass[44.9(37.5, 51.1)kg vs.53.3(42.4, 58.5)kg], trunk muscle mass[21.0(17.5, 23.9)kg vs.25(19.8, 27.4)kg], appendicular skeletal muscle mass[20.9(17.6, 23.9)kg vs.24.9(19.8, 27.3)kg], calcium[273.3(219.1, 480.0) vs.457.8(428.5, 489.1)], cobalt[0.029(0.027, 0.031) vs.0.031(0.028, 0.034)], selenium[1.44(0.93, 1.71) vs.1.61(1.53, 1.68)]and nickel[3.5(3.3, 4.0)*10 -3vs.3.8(3.6, 4.1)*10 -3]were lower in the elderly group than in the young and middle-aged group( P<0.05). Urinary 8-oxoGsn/Cre levels were positively correlated with age, time of 5-times sit to stand test, AGEs, fasting blood glucose, mercury and aluminum( rs=0.443, 0.292, 0.357, 0.205, 0.316 and 0.214, P<0.05), and negatively correlated with trunk muscle mass, appendicular skeletal muscle mass, fat-free mass, grip strength, silicon and manganese( rs=-0.334, -0.333, -0.332, -0.366, -0.246 and -0.234, P<0.05), with statistical significance. Conclusions:Increased urinary 8-oxoGsn/Cre levels are correlated with decreased muscle mass, poor physical function, accumulation of AGEs, decreased trace element levels and increased heavy metal levels.Therefore, 8-oxoGsn has the potential to be a broadly representative and sensitive indicator for health assessment.

BackgroundPocket hematoma is one of the major complications associated with cardiovascular implantable electronic devices (CIEDs) implantation. The aim of this study is to evaluate the impact of body mass index (BMI) on the occurrence of pocket hematoma after CIEDs implantation.MethodsThe study is a retrospective review of 972 patients receiving CIEDs implantation between 2008 and 2012 in a tertiary hospital.ResultsTwenty two patients (2.2%) developed severe pocket hematoma requiring re-intervention. The hematoma rate (4.6%,n = 15) of patients with a BMI of < 23 kg/m2 was significantly higher compared with that of patients with a BMI of≥23 kg/m2 (1.1%, n = 7,P< 0.001). In multivariate regression analysis, a BMI < 23.0 kg/m2 may be associated with the development of severe pocket hema-toma. An increase of 1.0 kg/m2 in BMI was associated with lower incidence of hematoma formation (OR: 0.84; 95% CI: 0.74-0.95;P = 0.006).ConclusionBMI < 23 kg/m2 was associated with a higher incidence of pocket hematoma, requiring re-intervention. The data sup-port that great care must be taken when patients were with a lower BMI received CIEDs implantation.

Objective:To investigate the effect of Tongrnai Yangxin Pill on the serum hepcidin level of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.Methods:Seventy patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease whose age were above 40 years old were enrolled as the research group and divided into the medication group (group Ⅱ) (n=35) and the nonmedication group (group Ⅲ)(n=35),while 40 CAD patients were enrolled as the normal control group (group Ⅰ).Before and after medication,the Hepc,Hb,etc levels were compared between two groups.Results:Before medication,the levels of Hepc in the two research subgroup were significantly higher than that of the control group (P＜0.05).At 8 weeks after treatment,the Hepc level of group Ⅱ was significantly declined,and the level of Hb was increased than those before treatment (P ＜0.05);the Hepc levels of group Ⅰ and group Ⅲ showed no significant difference (P＞0.05),the Hepc levels of group Ⅱ and group Ⅲ were obviously higher than that of the control group (P ＜0.05),the Hepc levels of group Ⅲ was obviously higher than that of the group Ⅱ(P＜0.05),the Hb level of group Ⅲ was obviously lower than those of group Ⅰ and group Ⅱ (P＜0.05).Conclusion:Tongmai Yangxin Pill could reduce the level of Hepc and enhance the Hb levels of patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease.It was useful to the patients with Coronary Atherosclerotic Heart Disease and Anemia of Chronic Disease,especially patients with mild anemia.

Objective To investigate whether the combination of maintenance hemodialysis (MHD) with hemoperfusion(HP) can improve the clearance rate of middle- and largemolecule uremic toxins so as to improve the quality of life and reduce the mortality in MHD patients. Methods A prospective, randomized and controlled clinical trial was carried out. One hundred MHD patients were selected and then randomly divided into two groups after four weeks of run-in period. HD+HP group received MHD alone 2 times a week and the combined treatment of HD with HP (HD+HP) once a week, whereas HD group received MHD alone 3 times a week. The follow up lasted for mean 2 years. The primary outcome was the death of patients. Secondary end points included clinical data, leptin, high sensitive C-reactive protein (hsCRP), interleukin 6 (IL-6),β2 microglobulin (β2-MG), parathyroid hormone (PTH), tumor necrosis factor α (TNF-α) and the indexes of dimensions of Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36Chinese Edition ). Results At the end of the two-year observation, the serum concentration of leptin, hsCRP, PTH, IL-6, β2-MG and TNF-α, systolic blood pressure (SBP), diastolic blood pressure(DBP), heart rate(HR), cardiothoracie ratio, left ventricular mass index (LVMI), EPO dose and the types of antihypertensive drugs used were lower in HD +HP group as compared to HD group (all P＜0.05). HD+HP group had higher hemoglobin (Hb), ejection fraction (EF) and body mass index (BMI) (all P＜0.05). No significant differences between two groups were found in terms of serum albumin (Alb), serum iron (SI), total iron binding capacity (TIBC), cardiac output (CO),Kt/V, early/atrial mitral inflow velocities (E/A) (all P＞0.05). Besides, the SF-36 indicated that the total score of overall dimensions in HD+HP group was higher (P＜0.05) and the quality of life of HD+HP group was evidently better as compared to HD group. The Kaplan-Meier survival curves for the 2-year observation period showed that patients in HD +HP group had obvious survival advantage, while Log-rank test results showed P＜0.05. No serious adverse incidents occurred during the HD+HP treatment. Conclusion HD+HP is superior to HD in eliminating regularly middleand large-molecules uremic toxins and has a potential role in improving the quality of life and survival rate of MHD patients.