Objective To investigate the feasibility and safety of transumbilical laparoscopic single-port choledocholithotomy in the treatment of common bile duct stones. Methods The clinical data of four patients who underwent transumbilical laparoscopic single-port choledocholithotomy at Shengjing Hospital of China Medical University from January to June, 2010 were retrospectively analyzed. The operation method and postoperative effects were reviewed. Results All the operations were successfully carried out. The mean operation time was 100 minutes and the mean blood loss was 62. 5 ml. All patients were cured without the occurrence ofcomplications except for one patient who had a peritoneal infection and was cured after surgical drainage. Conclusion Transumbilical laparoscopic single-port choledocholithotomy is safe and feasible, but indications should be strictly followed.

Objective To discuss how to use the core elements of international classification of functioning,disability and health(ICF) as a guide in stroke operation treatment to develop targeted,effective therapy plan and rehabilitation goals,establish individualized treatment of rehabilitation,and to observe the effect of limb movement function in stroke patients. Methods Sixty cases patients with stroke and aged from 40 to 65 years old were selected. The body function and structure of all stroke patients were marked by comprehensive evaluation scores of The National Institutes of Health Stroke Scale ( NIHSS ) and Fugl?Meyer assessment. And then they were randomly divided into two groups,30 cases in each group. The observation group used the Chinese version of brief ICF Core Sets for evaluation, and set individualized treatment according to the results of the assessment;The control group, according to the conventional rehabilitation process, involved in training routine physical therapy. Again 8 weeks after treatment for patients with evaluation,the assessment results was compared with the results of the first assessment. Results Before treatment, the NIHSS, Fugl?Meyer assessment and Chinese version of brief ICF core elements scale scores for the observation group were 7. 95±2. 37,34. 5±4. 0 and 82. 15±17. 96,for the control group were 7. 58±2. 25,34. 8±4. 0 and 81. 55±18. 78. After treatment,the above three rating scale scores, for the observation group were improved to 4. 78 ± 1. 63, 56. 3 ± 4. 2, 60. 45 ±11. 04,for the control group were improved to 5. 13±1. 75,48. 1±3. 8,73. 56±16. 89. The two groups were significantly improved ( observation group:t=4. 94, 15. 51, 18. 59, P<0. 05;control group:t=3. 17, 14. 66, 12. 33,P<0. 05). After treatment,compared with the control group of three rating scale scores(5. 13±1. 75,48. 1
±3. 8 and 73. 56±16. 89),the observation group(4. 78±1. 63,56. 3±4. 2 and 60. 45±11. 04) improved more apparently(t=3. 15,14. 54,15. 45,P<0. 05) . Conclusion Guided by the idea of ICF and scale,with the demand of the patients as the center,to develop personalized physical therapy,can achieve more productive and more targeted rehabilitation goals.

Mitochondria play a central role in the regulation of cellular energy metabolism, bio-synthesis and cell death. Dysfunction of mitochondria can lead to many diseases. Mitochondrial proteomics provides important theoretical foundation for a systematic understanding of the biological functions of mitochondria, studying the mechanisms of mitochondria-related diseases, and promoting the research and development of mitochondria-targeting drugs. The methodologies, recent technology development, and characteristics and applications of mitochondrial proteomics were reviewed and the challenges and prospects were also discussed.

The animal models for pharmacologic assessment of drugs against premature delivery arereviewed, which include the measure of spontaneous delivery time between the first and the second pups in term pregnancy rats, the delay in the onset of labor in rats and premature delivery artificially induced by lipopolysaccharide, interleukin 1 ? and prostaglandin F 2? in mice.

Objective To detect γ-secretase gene mutations in a large Chinese pedigree with acne inversa (AI).Methods Clinical evaluation was carried out in a large pedigree with AI through field investigation.Peripheral blood samples were obtained from 17 family members (11 affected and 6 unaffected) and 100 unrelated healthy human controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN 1,PSENEN and NCSTN genes followed by DNA sequencing analysis.Results There were 67 members over 5 generations in this family,of whom,25 (13 males and 12 females) were affected by AI.AI was inherited in an autosomal dominant manner in this family.Skin lesions were mainly distributed on the neck,back,chest and buttocks,and occasionally in subaxillary regions.DNA sequencing revealed a novel missense mutation,c.1258C＞ T (p.Q420XP),in the exon 11 of the NCSTN gene in 11 affected family members,which leads to a substitution of glutamine by a premature termination codon at amino acid 420 (p.Q420X).The mutation was undetected in either the unaffected members or the unrelated healthy controls,and had not been registered in the single nucleotide polymorphism (SNP) database in National Center for Biotechnology Information.Conclusions There is a novel heterozygous missense mutation,c.1258C ＞ T in the exon 11 of the NCSTN gene,which may be the molecular basis of pathogenesis of AI in this family.

Objective To investigate the effects of ulinastatin on the number of peripheral blood lymphocyte and the percentage of its subsets in patients with severe sepsis. Methods The scores of APECHE II and SOFA, the number of lymphocyte and the percentage of different subsets in these sepsis patients at different treatment time were measured. Results After treatment, the scores of APECHE II and SOFA of severe sepsis patients were decreased, the number of lymphocyte elevated and the percentages of different subset were corrected. Sepsis caused by Gram- positive pathogens had stronger suppression of peripheral blood lymphocyte and subsets compared with Gram - negative pathogens. Conclusion Patients with severe sepsis had less peripheral blood lymphocyte and abnormal subsets. Ulinastatin could help to correct such abnormality.

Objective To investigate the clinical efficacy of transumbilical single-incision retrograde laparoscopic cholecystectomy.Me,otis The clinical data of 979 patients with gallbladder diseases who were admitted to the Shengjing Hospital of China Medical University from May 2009 to December 2012 were retrospectively analyzed.The numbers of patients who were admitted in the year of 2009,2010,2011 and 2012 were 51,265,374,289,respectively.The preoperative preparation of transumbilical single-incision retrograde laparoscopic cholecystectomy was similar to that of traditional multi-portal laparoscopic surgery.During the operation,the umbilical incision was selected.After the body and bottom of the gallbladder was dissociated,the cystic duct of gallbladder was dissociated and straightened,which was vertical to the common bile duct.After clipping the proximal part of the cystic duct of gallbladder with 2 hem-o-lock clips,the cystic duct was cut off with the ultrasonic knife,and then the gallbladder was removed.Postoperative nursing was also similar to that of traditional laparoscopic cholecystectomy.Patients were followed up via phone call or out-patient examination till March 2013.The wound infection,incisional hernia,incisional pain,cosmetic benefits were observed.Results No patient was converted to open surgery.Twenty patients were converted to multi-portal laparoscopic cholecystectomy because of severe inflammation (3 patients in 2009,5 in 2010,5 in 2011 and 7 in 2012).The mean operation time and volume of blood loss of the 959 patients were 48.5 minutes and (27 ± 25) mL.The operation time in 2009,2010,2011 and 2012 were 51.8 minutes,49.2 minutes,48.9 minutes and 46.7 minutes.The volumes of blood loss in 2009,2010,2011 and 2012 were 35.0 mL,32.1 mL,33.8 mL and 22.9 mL,respectively.The postoperative pain was slight.Forty-seven patients were administered antalgesics (5 in 2009,12 in 2010,18 in 2011 and 12 in 2012).In the 959 patients,umbilical swelling occurred in 4 patients,and was cured by disinfection treatment.Bile duct injury occurred in 3 patients from 2010 to 2011,timely repair wad done in 2 patients,and 1 was cured by drainage.The mean time of postoperative exhuast time and duration of hospital stay were 2.2 days and 4.2 days.A total of 924 patients were followed up for 1-3 months.The scar was hidden in the navel,and no incisional hernia occurred.Conclusion Transumbilical single-incision retrograde laparoscopic cholecystectomy is safe and effective with cosmetic benefits.

Mitochondria play a central role in the regulation of energy metabolism and signal transduction in eukaryotic cells. Although many fluorescent labeling strategies have been developed for mitochondrial studies, the methods that enable labeling efficiency assessment at the single-mitochondrion level are still lacking. By employing the unique advantages of high sensitivity flow cytometry ( HSFCM ) in the sensitive, rapid, and quantitative multiparameter analysis of individual mitochondria, here we examined the performance of several different mitochondrial labeling strategies from the perspectives of brightness, labeling ratio, and stability. Mitochondria isolated from HeLa cells transfected with pAcGFP1-Mito plasmid upon transient or stable transfections, and mitochondria directly labeled with MitoTracker Green or SYTO 62 were analyzed by a laboratory-built three-channel HSFCM. Upon the quantitative measurement of fluorescence brightness, it was found that the fluorescence intensity of green fluorescent protein ( GFP ) in mitochondria isolated from cells with stable transfection was about 17. 7-fold higher than the transient transfection ones, and was approximately two orders of magnitude brighter than mitochondria labeled with MitoTracker Green. On the other hand, the fluorescence signal of SYTO 62 labeling decreased upon washing, indicating its rapid dissociation rate. The strong fluorescence intensity and good labeling stability make stable transfection an efficient method to label mitochondria. The experimental results demonstrates that HSFCM provides a powerful analytical tool to assess the performance of mitochondrial fluorescence labeling via high throughput single mitochondria analysis.

Objective To evaluate the application of clinical cases related problem-based-learning (PBL) method in critical care medical standardized resident training program. Methods 84 residents were randomly divided into experimental group (n=42) and control group (n=42) by lottery way. The experimental group received PBL process during clinical case analysis while the control group learned completely through traditional teaching method . The residents' clinical competence were assessed by multiple scale mixed method including question bank examination (QBE), case-based discussion (CBD), direct observation of procedural skills (DOPS), simulation etc, and Likert-type scale questionnaire was used to evaluate the feedback of training residents. SPSS 17.0 was used to do line t test to the data of both groups. Results Finally 84 residents finished the study. There were no difference in the general conditions in two groups. The PBL group achieved higher examination score during QBE [(80.26 ±8.89) vs. (86.10 ±9.32)], CBD [(84.83±5.43) vs. (75.36±6.06)], DOPS [(88.81±6.68) vs. (82.70±6.98)], simulation [(79.86±10.09) vs.(72.71±9.30)]. Except two groups residents all gave high scores in enhancing cross connection in clinical knowledge [(4.786±0.470) vs. (4.571±0.859), P=0.16], and the questionnaire results showed that the resi-dents of PBL group gave higher points in exciting autonomous learning, improving clin-ical analysis ability, accelerating clinical thinking establish, developing independent thinking habits, improving the clinical communication skills and teamwork ability (P<0.05). Conclusion The clinical cases related PBL method can improve the training effects during critical care medical standardized resident training program. It can be used broadly after adapting modification in critical care medical education.

Objective:To study the changing characteristics and impact factors of helical tomotherapy (HT)for longitudinal dose fall-off outside the target, in order to guide the plan junction or pretreatment target and implementation efficiency in clinical.Methods:Eight patients with head and neck tumors admitted to the Department of Oncology Radiotherapy of the First Affiliated Hospital of Zhengzhou University in December 2019 were retrospectively selected as the research objects. The planning target area and dose drop structure were outlined in the head and neck images with a thickness of 1 mm obtained by Siemens SOMATOM Definition AS positioning computerized tomography (CT). Different field widths (FW, 5.0 cm/2.5 cm/1.0 cm) and pitches (0.430/0.287/0.215) were assembled for planning with the same modulation factor (1.8), finest does calculation grid (0.195 cm ×0.195 cm) and other planning parameters were consistent. The plans were designed by different parameters, and the result was analyzed by univariate analysis.Results:The that different pitch curves coincided under the same field width by comparative analyzing, so pitchs had no effect on dose drop. The different field width curves were independent of each other, indicating that the field width had an effect on dose drop in the head and foot direction. The relationship between the longitudinal dose drop speed outside the target and the change of the field width was inversely correlated: the larger field widths meant the slower dose fall-off and the larger penumbra, while the smaller field widths meant the faster fall-off and the smaller penumbra. When the dose fall-off to 50% of the prescribed dose, the distance from the target was approximately equal to half the field widths, and the pitchs had not affect the rate of dose-drop, while the dose at different distances from the target boundary could be calculated by the fitting formulas. The field widths and pitchs had little effect on the CI and HI index of the target, relatively, the target area was best when the field width was 2.5 cm. The total beam-on time gradually decreased with the increase of the field widths and pitches.Conclusions:When segment target therapy needs to consider planning junction, execution efficiency, and controlling longitudinal dose fall-off and considered the execution, the optimal planned parameters such as field widths and pitches could be selected or the target at the junction regions could be adducted according to the longitudinal dose drop formula, so as to achieve the ideal dose distribution.