OBJECTIVE: To discuss advances in intrahepatic and intrabiliary stent application and evaluate their biocompatibility.METHODS: A computer-based online search of CNKI between 1989 and 2009 was performed to search related articles with the keywords of "bile duct, hepatic duct, stent, treatment". A total of 51 articles were searched and 20 were included according to inclusion and exclusion criteria. The articles were summarized from aspects of treatment advances in intrahepatic and intrabiliary stent application and prevention of obstruction following intrahepatic and intrabiliary stenting; the clinical application of intrahepatic and intrabiliary stent, biocompatibility and prevention of stent obstruction were discussed.RESULTS: Intrabiliary stent mainly includes metal stent and plastic stent. The metal stent is superior over plastic stent in preventing bacteria and keeping stent patency, but its cost is large. The plastic stent is easy for bacteria attachment and stent obstruction, but it is simple to change the stent and the cost is low. Intrabiliary stent implantation is the best method to treat malignant obstruction of bile duct with few complications. Intrahepatic stent in combination with various radiotherapies can prolong effective patent time of the stent and effectively prevent stent obstruction. CONCLUSION: Intrabiliary stent implantation is the most effective clinical method to treat malignant obstruction of bile duct.However, the biocompatibility of various intrabiliary stents should be improved. Intrahepatic stent in combination with radiotherapies can prevent stent obstruction.

Child ; Contraindications ; Humans ; Kidney Diseases ; immunology ; Risk Factors ; Vaccination

Neovascular glaucoma ( NVG ) is a series of blinding and intractable eye diseases, which caused by various intraocular or extraocular diseases. The iris and angle neovascularization and vascular membrane fiber contraction may eventually lead to progressive elevation of intraocular pressure and angle closure. Because of complex etiology, the treatment of NVG is intractable and inefficient. Based on the articles published in recent years, we reviewed the progressions of the relevant cytokines and animal models.

Objective To study the serum levels of homocysteine(Hcy) and the polymorphism of C677T mutation of methylenetetrahydrofolate reductase (MTHFR) gene in pregnant women to explore their role in the pathogenesis of pre-clampsia. Methods Fifty pregnant women with preclampsia (study group) including 14 mild pre-eclampsia and 36 severe pre-eclampsia and 40 healthy ones (control group) were selected. Hey concentration was determined by fluorescence polarization immunoassay. The mutations of the 677C→T and 1298A→C of MTHFR were investigated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The mean level of plasma Hey in the study group was higher than that of control 1(12. 00±4. 59) μmol/L vs (7. 85:1:1.51) μmol/L, P<0.05], and that of the severe pre-eclampsia group was higher E(13. 30±2. 06) μmol/L, P<0. 01]. However, no significant difference was found between the control and the mild pre-clampsia group[(8. 63±3. 94) μmol/L, P>0.05]. There was significant difference in the genotype frequencies of MTHFR 677CT, TT genotype(C/T:42.0% ;T/T:14. 0%)and the total frequency of mutant T (T: 35.0%) allele between the study and control groups (P < 0. 05). Conclusions Hyperhomocysteinemia plays an important role in the pathogenesis of pre-clampsia. The polymorphism of MTHFR C677T might be associated with the development of pre-clampsia as it affects the metabolism of Hey.

ObjectiveTo investigate the influence of the midazolam sedation based on remifentanil analgesia on the occurrence of delirium in critically ill patients in intensive care unit (ICU).Methods A single-center prospective randomized controlled trial was conducted. 140 consecutive critically ill patients admitted to ICU of Peking University People's Hospital, undergoing mechanical ventilation longer than 24 hours, with the need of sedation, from February 2014 to January 2015 were enrolled. They were randomly divided into two groups by computer generated random numbers table, eachn = 70. The patients in observation group received midazolam 1μg·kg-1·min-1 for sedation, and 1 mg/mL remifentanil for analgesia with 0.05 mg/kg intravenous bolus, then continuous infusion of 0.02-0.10 mg·kg-1·h-1. The patients in control group received midazolam for sedation only. The data were recorded as follows: the main indices for observation included the occurrence of delirium and its duration; the second item for observation was consumption of drug for sedation, followed by the mean arterial pressure (MAP) before and after sedation, the time of wake-up, duration of mechanical ventilation, the length of ICU stay, and 28-day fatality rate. The 28-day survival was analyzed by Kaplan-Meier survival curve.Results The dosage of remifentanil used in observation group was (98.6±24.9) mg/d, the dosage of midazolam was significantly lower than that of the control group (mg/d: 160.6±33.3 vs. 178.9±43.4, t = 2.829,P = 0.005), the incidence of delirium was obviously lower than that of the control group [22.9% (16/70) vs. 57.1% (40/70),χ2 = 15.700,P< 0.001], and the time of delirium was slightly shorter than that of the control group (hours: 162.9±78.0 vs. 194.8±117.3,t = 0.947,P = 0.348). Among the patients with delirium, the dosage of dexmedetomidine used in observation group was significantly less than that of the control group (mg/d: 0.54±0.11 vs. 0.64±0.14,t = 2.112,P = 0.041). The MAP before sedation was similar as the MAP after sedation in both groups, and there was no significant difference between observation group and control group [mmHg (1 mmHg = 0.133 kPa), before treatment: 84.7±16.2 vs. 89.5±37.7, after treatment: 82.3±10.7 vs. 80.8±13.9, bothP> 0.05]. There was no significant difference in the time of waking-up between observation group and control group (hours: 2.3±0.9 vs. 2.4±0.8,t = 0.487,P = 0.627). The duration of mechanical ventilation (hours: 143.4±138.3 vs. 163.9±158.9, t = 0.812,P = 0.418), the length of ICU stay (days: 8.8±7.7 vs. 10.0±7.8,t = 0.917,P = 0.361) and 28-day fatality rate [11.4% (8/70) vs. 20.0% (14/70),χ2 = 1.941,P = 0.245] in observation group were slightly lower than those of the control group without significant difference. Kaplan-Meier survival curve showed that the cumulative 28-day survival rate in observation group was slightly higher than that of control group (χ2 = 1.647,P = 0.199). ConclusionAnalgesia based on sedation may reduce the occurrence of delirium and its severity, furthermore, even if delirium occurs, it may be less severe.

Objective To investigate the accumulation of liver bile acids and bile acid regulated nuclear receptor farnesoid X (FXR) and its target gene cholesterol 7α hydroxylase (Cyp7α1) and small different dimer partner (SHP) in normal rats during pregnancy and lactation .Methods SD rats were maintained in the SPF‐grade facilities for time‐controlled mate .Livers were collect‐ed at Gestation Day (GD) 10 ,14 ,and 19 and Postnatal Day (PND) 1 ,7 ,14 and 21 d .Hepatic bile acids were quantified with a total bile acid assay kit ,and mRNA expression of FXR ,Cyp7α1 and SHP was determined by RT‐PCR .Western blot was used for Cyp7α1 protein quantification .Results In livers of normal rats ,bile acids was not elevated during pregnancy but was increased during lacta‐tion .The bile acid synthesis rate limiting enzyme Cyp7α1 increased during lactation but were normal during pregnancy .SHP was 6 fold higher at the late pregnancy ,and slightly higher during lactation .FXR was increased at postpartum .Conclusion Under normal circumstances ,hepatic bile acid synthesis during pregnancy was controlled by SHP feedback ,while during lactation ,hepatic bile acids increased ,along with increased Cyp7α1 and FXR .

Objective To evaluate the effects of aerobic combined strength and balance exercise on cognitive function and satisfaction in patients with cognitive impairment no dementia. Methods Four hundred and twenty patients with cognitive impairment no dementia were divided into control group (200 cases) and experimental group (220 cases) by random digits table method. The control group received general health education and rehabilitation training. The experimental group received aerobic combined strength and balance exercise. The patients were assessed with Montreal Cognitive Assessment (MoCA) to evaluate their cognition before training, as well as after training. And the patients′satisfaction with the questionnaire was evaluated. Results The total scores of MoCA, scores of name, attention, language, memory and directionafter training were (23.47 ±2.38), (2.77 ±0.42), (5.09 ±0.86), (2.50 ±0.65), (3.42 ±0.68), (5.03 ± 0.10) points in the experimental group, and (21.20±2.55), (2.31±0.76), (4.71±1.10), (2.35±0.70), (2.23±0.81), (4.48±0.96) points in the control group, and there were significant differences, P<0.05. There were no significant differences in the space and abstract thinking between experimental group and control group:(3.61±0.91) points vs. (3.45±1.09) points, (1.83±0.76 ) points vs. (1.72±0.52) points, P>0.05. The scores of satisfaction in the experimental group was significantly higher than that in the control group:(49.33 ±1.57) points vs. ( 48.20 ±2.14) points, P<0.01. Conclusion The application of aerobic combined strength and balance exercise could improve the cognitive function and patients′satisfaction.

Objective To investigate the effect and perioperative nursing experience of surgical operation on patients with incomplete cervical spinal cord injury caused by traumatic cervical spine fracture. Method Fifty-nine patients with traumatic cervical spine fracture in our hospital from January 2011 to 2014 were nursed perioperatively, including before operation , training accttenty with swallowing and blowing balloons besides basic nursing care , and after operation , mental care , close observation and functional exercises postoperatively. Results The operation time was (110.5+13.0) min, the amount of bleeding was (155.6+7.5)mL. Three patients developed hematoma compression, 13 patients developed high fever. All patients were cured after treatment and nursing. Conclusion Preoperative training of swallowing and blowing balloon is fundamental for ensured surgical effect and intraoperative surgical cooperation and close observation together with postoperative mental care, close obsersation and functional exercise are the guarantee for surgical effect.

Objective To assess volume state precisely and rapidly by ultrasonography of internal jugular vein (IJV) in healthy blood donor.Methods The values of the sonographic IJV collapse index and corrected IJV longitudinal length (cIJVLL) of 46 healthy blood donors were compared before and after blood donation.The correlations between IJV collapse index and cIJV LL were analyzed.Results The value of cIJV LLs before and after blood donation were significantly difference (6.56 ± 0.32 vs.6.11 ± 0.41,P ＜ 0.01).IJV collapse index before blood donation was not differently significant after blood donation (33.12 ± 2.21 vs.39.01 ± 3.83,P＞ 0.05).There was correlation between the value of cIJV LLs before and after blood donation (r =0.81).The value of IJV collapse index before and after blood donation,as well as cIJVLL was not well correlated (r =0.24,r =0.13,respectively).Conclusion The IJV collapse index is not a useful parameter for evaluation of hypovolemia,cIJV LL is more valuable marker for the detection of blood loss in emergency.

0.05).The third day after SE,the expressions of MVP in CA1 and CA3 in adult rats experiment group increased,and in CA3,the value reached up to(4.0?1.41)in adult experiment group,which had significant differences compared with control groups(P