Objective To compare the therapeutic effects of laparoscopic and open surgery treatment for choledocholithiasis.Methods Forty-six cases with choledocholithiasis were randomly divided into laparoscopic surgery group(n = 21)and open surgery group(n = 25).Comparison was conducted between the two groups in terms of operative time,hospitalization day,anorechlnl exhaust time,cases of postoperative pain,the amount of intraoperative bleeding and postoperative complications.Results Hospitalization day(10.5 ±2.4d),anorechlnl exhaust time(27.2 ±9.4h),cases of postoperative pain(28.6%)in the laparoscopic surgery group were significantly better than those in open surgery group(14.3 ±2.5d,54.6 ±12.5h,88.0%)(P ＜0.05).The operative time and the amount of intraoperative bleeding was not significantly different between two groups(P ＞ 0.05).The rate of infection of incisional wound in the laparoscopic surgery group(0%)was lower than that of open surgery group 24.0%(P ＜ 0.05).No residual calculi and bile leakage were found in both groups.The other postoperative complications were not significantly different between the two groups(P ＞ 0.05).Conclusion Laparoscopic choledocholithotomy is safe,effective and feasible.Compare with open surgery,it is a less invasive proceduce for the treatment of choledocholithiasis with the virtue of little trauma,fast recovery,short hospitalization days and few complication.

Objective:To study the effect of electromyographic feedback therapy on hemiplegia of patients with cerebral infarction Method: 120 hemiplegic patients were randomly divided into study group (n=60) and control group (n=60) The former received electromyographic feedback trainings, 6 times a week for four weeks, in addition to regular medication All patients were evaluated with Fugl-Meyer Assesment and Barthel Index Results: The improvement of study group was greater evaluated by both methods Discussion:The eletromyographic feedback can improve motor function of hemiplegic patients and do benefit their activities of daily living

Objective To explore the expression of c-fos gene at early stage and changes of focal cerebral blood flow (CBF) in brain tissue after intracerebral hemorrhage(ICH) in rats.Methods The rat models with ICH were made by Nath improvement method;fos protein in brain tissue and the expression of c-fos mRNA were measured by immunohistochemistry and RT-PCR method;its focal cerebral blood flow (CBF) was measured by hydrogen clearing method.Results The expression of fos protein was found at 1 h after ICH in the ipsilateral basal ganglia after ICH,it peaked at 3 h;c-fos mRNA peaked at 1 h after ICH,and had still expression of higher level after 3 h;cBF was reduced at 1 h after ICH,and returned to the level of the control group by 3 h and maintained to 24 h after ICH,and then appeared the reduction of CBF during 24 h again.Conclusion The increase and long induction expression of c-fos gene were showed in brain tissue of hematoma periperal zone and contralateral cortex one.Although focal CBF reduced after ICH in rats,it wasn't consistent with the expression of c-fos gene.

Objective To assess the efficacy and safety of modified ligation of the intersphincteric fistula tract (LIFT) for low anal fistula.Methods We follow-up visited 20 patients with low anal fistula underwent modified LIFT procedures (Since the outer edge shape of anal fistula incision fistula and the branch into the intersphincteric groove,proximal lateral internal sphincterotomy ligation.The wound was closed to the whole layer of closed suture after removal of the pipe wall).Median follow-up duration was 10(range 3-15) months.To compile statistics on the wound healing time,the clinical healing rate,the recurrence rate and the fecal incontinence score (Wexner score) of those patients.Results The wound healing time was (15.3 ± 4.8) d.The prime success rate of fistula healing was 75 ％ (15/20) after the modified LIFT procedure.2 cases of low complex anal fistula presented with wound infection,and 3 cases (including 1 cases of simple low anal fistula,2 cases of low complex anal fistula)had fistula with infection.They were cured after appropriate treatment.During follow-up of 3 to 15 (median 10)months,1 cases of simple low anal fistula recurred in third months after surgery.To the end of the follow-up,the total clinical healing rate was 95％ (19/20),of which 12 cases of low complex anal fistula total cure rate was 100％ (12/12).Preoperative fecal incontinence scores (Wexner score)were all 0 points.At the final follow-up,18 (90％)cases of fecal incontinence score were 0 points,1 (5 ％) cases were 2 points and 1 (5 ％) cases were 1 points.Conclusion Modified LIFT is better balance the relationship between cure rate and anal function.The sphincter preservation is complete.The fistula is thoroughly cleared.The cure rate is high.The recurrence rate is low.Does not cause anal defects and deformities.It has little influence on the function of anal control,the operation is simple,and it is suitable to be popularized.

Objective To explore the impact of blood-activatingand qi-nourishing therapy on the hypercoagulable state of rats after femur fracture.Methods One hundred and twenty SD rats were randomly divided into 4 groups,namely normal group,model group,low-molecular-weight heparin(LMWH) group,combination group (LMWH + Tongmai Decoction),30 rats in each group.The rat model of femur fracture was established.After successful modeling,LMWH group was given subcutaneous injection of LMWH 600 U/kg,and the combination group was given subcutaneous injection of LMWH 600 U/kg together with gastric gavage of Tongmai Decoction,the model group was given subcutaneous injection of the same volume of normal saline.The treatment lasted for 1-7 days after the surgery.The pathologic features of the left great saphenous vein were observed by HE staining method,and the relative volume,thickness and quantity of the blood vessels were also measured.The plasma D-dimer (D-D) and fibrinogen (FIB) levels were determined by biochemical analyzer,and the plasma levels of whole blood viscosity at low shear rate (WBV-lsr) and whole blood viscosity at high shear rate (WBV-hsr) were measured with hemodynamic detector.Results On day 7 after the modeling,less endothelium cells,agglomerative red cells,and large thrombi were found in the great saphenous vein tissue section of the model group under microscope.Compared with the normal group,the levels of D-D,FIB,WBV-lsr and WBV-hsr in the model group at various time points were increased,the difference being significant (P ＜ 0.05).After 7-day treatment,the levels of D-D,FIB,WBV-lsr and WBV-hsr in LMWH group and combination group were lower than those of the odel group,and the decrease in the combination group was superior to LMWH group(P ＜ 0.05).The blood vessel endothelium cells in the combination group were arranged neatly with same cellular width while without enlargement or swelling,the effect being superior to that of LMWH group.Conclusion Blood-activating and Qi-nourishing therapy can effectively relieve hypercoagulable state of rats after femur fracture.

Objective To analyze the clinical features and gene mutation in mthylmalonic acidemia (MMA) accompanied by homocysteinemia (cblC), and review the relevant literatures. Methods The clinical features of 3 cases of MMA diagnosed by gene detection were retrospectively analyzed, and meanwhile the pertinent literatures of pathogenesis of MMA, especially combined with late-onset cblC and its gene detection, were reviewed. Results Patient 1 (26 days old) suffered from intermittent convulsions for 3 days, with isosuccinic acid 175.8 μmol/L, C3/C2 rate 1.363, homocysteine >?65 μmol/L and abnormal EEG. MMACHC gene detection found an exon deficiency (delEXON1), which has not been reported. Patient 2 ( 12 year old) was hospitalized for limb shaking, hyperspasmia and vomiting. His isosuccinic acid level was 334.3 μmol/L, C3/?C2 rate was 0.37, homocysteine >?65 μmol/L, and had abnormal EEG. MMACHC gene detection found the mutations of c.482G?>?A and c.609G?>?A. Patient 3 was hospitalized for intermittent convulsions for 20 days, whose isosuccinic acid, C3/?C2 rate, and homocysteine were increased. MMACHC gene detection found the mutations of c.394C?>?T and c.540del8 and c.540del8 had not been reported. Review of literatures discovered that MMA was combined with epileptic seizure in some patents, which further validate that the mutation in MMACHC gene c.482G?>?A may be related to the late-onset of cblC. Conclusions Gene detection contributes to the diagnosis of MMA; the mutation of MMACHC gene c.482G>A may be related to the late-onset of cblC; delEXON1 and c.540del8 are new mutations which have not been reported.

Objective To compare the efficiency and safety between Aripiprazole and other traditional drugs for Tourette's syndrome treatment.Methods Databases such as China National Knowledge Infrastructure,Wanfang,VIP,China Biology Medicine Disc,PubMed and Web of Science were electronically searched for studies on Aripiprazole for Tourette's syndrome treatment.According to the inclusion and exclusion criteria,studies,extracted data,and assessed quality were screened.Meta-analysis was performed by using Stata 11.0 software.Results Four studies about Aripiprazole for Tourette's syndrome treatment with 396 patients (Aripiprazole group:201 cases;control group:195 cases) were synthetically and quantitatively analyzed.Meta-analysis results showed that Aripiprazole was better than other traditional agents (placebo,Tiapride,Haloperidol) [standardized mean difference (SMD) =0.21,95％ CI:0.10-0.32].The subgroup by time of treatment analysis results indicated that Aripiprazole was superior to other drugs in 2 weeks (SMD =0.28,95％ CI:0.06-0.50).There was no significant difference in the efficacy between Aripiprazole and other drugs for treatment of Tourette's syndrome in 4 weeks and 8 weeks after treatment (SMD =0.16,0.28;95％ CI:-0.05-0.38、-0.20-0.76).The subgroup by matched drugs results suggested that Aripiprazole was better than Tiapride (SMD =0.29,95 ％ CI:0.15-0.43),but was not significantly different from Haloperidol (SMD =-0.03,95％ CI:-0.28-0.22).There was no significant difference in side effects incidence between Aripiprazole and traditional drugs for treatment of Tourette's syndrome (RR =0.83,95 ％ CI:0.36-1.89).Conclusions Compared with the conventional drugs,Aripiprazole has better therapeutic efficacy in the treatment of Tourette's syndrome in children in 2 weeks.Aripiprazole is better than Tiapride,but equal to Haloperidol in the treatment of Tourette's syndrome.The safety of Aripiprazole needs to be further verified.

Objective To investigate the clinical features of paroxysmal kinesigenic dyskinesia (PKD) and the mutation features of its pathogenic gene proline-rich transmenbrane protein 2 (PRRT2). Method The clinical manifestations and genetic tests of one case of PKD were retrospectively analyzed, and the related literatures were reviewed. Results A 10 year and 9 month male patient was recruited. The age of dyskinesias onset was 7 year and 6 month. The descriptions of the attacks were abnormal involuntary movements which were induced by sudden voluntary movements and presented with dystonia. The frequency of the attacks was three to ifve times per day with the duration lasting ten to twenty seconds, and there is no loss of consciousness. Treatment with oxcarbazepine is effective. A heterozygous mutation in PRRT2 gene, c.649_650insC (p. 217fs224X), was found by genetic testing, and the mutation was inherited from the patient’s mother who showed no symptom of PKD. Conclusion The onset age of PKD could be in the childhood and adolescence. The attack is provoked by sudden movements and the duration time is short. Treatment with antiepileptic drug is effective. The test of PRRT2 gene may help diagnosis. Mutation c.649_650insC is the hotspot mutation of the gene.

BACKGROUND:In consideration of skin as the largest organ al over the body and its abundant vessels and vessel plexuses, there would be sufficient adult stem cels for tissue engineering. OBJECTIVE:To investigate the osteogenic potential of dermis-derived bone morphogenetic protein receptor subtype IB (BMPR-IB) positive cels. METHODS:In current study, histochemical analysis was adopted to study the localization and expression of BMPR-IB+ cels in skin. Fresh skin samples were digested into single cel suspension. Then, the surface marker BMPR-IB was used to isolate cel subpopulation by magnetic activated cel sorting from freshly prepared single cel suspension. After that, the osteogenic potential in vitro andin vivo was tested. Alkaline phosphatase staining and alizarin red staining were performed after osteogenic inductionin vitro. The BMPR-IB+ cels were seeded onto coral scaffolds, and the scaffolds were used to repair critical-sized calvarial defects of mice. Histochemical analysis was performed at 6 weeks postoperatively and micro-CT analysis was carried out at 24 weeks postoperatively to evaluate the ability of bone repairment. RESULTS AND CONCLUSION:We localized BMPR-IB cels in situ by immunohistochemistry that turned out to be expressed in the reticular layer of dermis and by single cels. Cel subpopulation which expressed BMPR-IB could be sorted by magnetic activated cel sorting. Alkaline phosphatase staining was obviously positive and lots of calcium modules were confirmed by alizarin red staining after osteogenic induction, indicating that BMPR-IB+ cels had the osteogenic potentialin vitro. Histochemical analysis demonstrated that plenty of new bone formation was found in BMPR-IB+ cels group after 6 weeks in vivo. Micro-CT analysis revealed that BMPR-IB+ cels-coral scaffold complex could repair calvarial defects successfuly after 24 weeksin vivo. These results indicated that dermis-derived BMPR-IB+ cels possessed adequate osteogenic potential. Moreover, they might be promising seed cels for bone tissue engineering.

Objective To investigate the effects of icarrin on the activity and protein expression of core binding factor otl(Cbfa1) in rat osteoblasts cultured in vitro,and to explore whether mitogen-activated protein kinase (MAPK) pathway is involved in this process.Methods Calvarial osteoblasts were obtained from newborn (<24 h) SD rats by trypsin-coUagenase digestion method.The second generation osteoblasts were cultured in the medium containing icariin (10 ng/ml) or estradiol (10-8 mol/L) with or without extracellular-signal regulated kinase (ERK) inhibitor (UO126) or p38MAPK inhibitor (SB203580).Nuclear protein was extracted from osteoblasts.And then the activity of Cbfa1 was detected by ELISA.The amounts of Cbfa1 protein were detected by Western blot.Results Calvarial osteoblasts were obtained successfully and were used in this study after indentified by alkaline phosphatase and mineralized nodus staining.Cbfa1 expression and the activity in osteoblasts were up-regulated by both icariin and estradiol (P<0.05).The effects were partly inhibited by addition of U0126or SB203580 (P<0.05).Conclusions Either icarrin or estradiol can stimulate the proliferation and maturation of cultured osteoblasts in vitro via up-regulating the activity and expression of Cbfal.The MAPK signal pathway inhibitor seems to partly decrease Cbfa1 activity.It suggests that MAPK pathway may be involved in the transduction of icariin's impact on proliferation and mineralization of osteoblasts.