Objective To study the role of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosing and treating iatrogenic bile duct injury after laparoscopic cholecystectomy (LC).Methods A retrospective study was conducted on 45 patients with iatrogenic bile duct injury after LC who were investigated and treated by ERCP from December 2002 to August 2015.Results Using the StrasbergBismuth classification,there were 14 patients with type A and 4 with type C who were managed successfully using endoscopic nasobiliary drainage (ENBD) and interventional ultrasound abdominal localized puncture and drainage ; 7 patients with type D were managed successfully using endoscopic sphincterotomy (EST) and endoscopic retrograde biliary drainage (ERBD).For the 5 patients with type E Ⅰ and 3 patients with type E Ⅱ who were treated by EST and ERBD,one patient who had common bile duct transection required cholangioenteric Roux-en-Y anastomosis.For the 6 patients with type E Ⅲ and 6 patients with type EⅣ who were treated by EST and ERBD,a patient required a cholangioenteric Roux-en-Y anastomosis to achieve good results.Conclusions When iatrogenic bile duct injury is suspected after LC,correct assessment with ERCP should be taken immediately.ERCP when combined with ENBD and (or) ERBD could reduce bile duct pressure and dilate stenotic bile ducts to avoid further operation.

[ ABSTRACT] AIM:To investigate the effect of microwave radiation at different intensities on the rat myocardium and its possible mechanism.METHODS:The rats were radiated by the intensity of 500, 1 000, 1 500 and 2 000 W/m2 with 2 450 MHz microwave for 6 min.The heart tissue was collected 6 h after microwave radiation.ATP and mitochondria complexⅣandⅤwere measured.The changes of the tissue structures were observed under transmission electron micro-scope.The apoptosis of the myocardial cells was detected by a cell analyzer.The protein level of cleaved caspase-3 was de-termined by Western blotting.RESULTS:The concentration of ATP and activity of mitochondria complexⅣandⅤsigni-ficantly decreased compared with control group in the cardiac tissues.The decreased number, morphological abnormalities such as dissolved cavitation, matrix and obvious tumefaction of mitochondria were observed under transmission electron mi-croscope.The microwave radiation induced the apoptosis of myocardial cells in the rats.The cell apoptotic rate and the pro-tein level of cleaved caspase-3 increased with increasing intensity of microwave radiation ( P<0.05 ) .CONCLUSION:Microwave radiation has obvious injury effect on the rat heart, which can cause cardiac energy metabolism dysregulation and cardiac myocyte apoptosis.

OBJECTIVE: To analyze the results of hearing screening and the related factors in 3200 newborn infants, in order to know the incidence of neonatal hearing disorders. METHOD: Three thousand two hundred cases of newborn infants born during 2014-01 and 2015-03 were tested for hearing screening. According to risk factors, newborns were divided into the normal newborn group (2945 cases) and the high-risk neonatal group (255 cases). Using fast brainstem auditory evoked potential (AABR) to screen the hearing screening of newborn infants with 3~5 d; those who did not pass the screening, after the birth of 30~42 d re-screening; re-screening still not pass, within 3 months line diagnostic auditory brainstem evoked potential (diagnostic ABR) confirmed. Comparative analysis of newborn hearing screening by screening through rate, re-screening through rate and hearing impairment rate proportional relationship with the relevant factors, and the differences of hearing screening results in the normal newborn group and the high-risk neonatal group. RESULT: (1)The rate of neonatal hearing screening did not pass was 7.50% (240/3,200); 30 cases was not involved in re-screening, the rate of re-screening did not pass was 15.24% (32/210); hearing impairment rate is about 0.38%(12/3200), and the bearing impairment positive rate was 1.31% (42/3200). (2) There was no significant difference of different delivery mode, neonatal sex in newborn hearing screening through rate, re-screening through rate and hearing impairment rate (P > 0.05). Different gestational age, maternal age in newborn hearing screening through rate, re-screening through rate and hearing impairment rate, the difference was statistically significant (P < 0.05). (3) Screening through rate and re-screening through rate of the high-risk neonatal screening group were significantly lower than the normal newborn group (P < 0.05), and hearing impairment rate was higher than normal newborn group (P < 0.05). CONCLUSION Strengthen prenatal health care, to reduce abnormal childbirth conditions (preterm birth, neonatal asphyxia), universal newborn hearing screening and improve screening accuracy, and to strengthen newborns with risk factors for early diagnosis and intervention, to reduce the incidence of neonatal hearing impairment has important significance.
Evoked Potentials, Auditory, Brain Stem ; Gestational Age ; Hearing Disorders ; epidemiology ; Hearing Tests ; Humans ; Incidence ; Infant ; Infant, Newborn ; Neonatal Screening ; Risk Factors

Objective To observe the clinical efficacy of cerebral palsy children with liver strong spleen weak syndrome treated with integrated traditional Chinese medicine therapy. Methods Eighty cerebral palsy children with liver strong spleen weak syndrome were divided into treatment group (40 cases) and control group (40 cases). Patients in control group were treated with conventional therapy (including exercise therapy, occupational therapy, guidance education, physical factors, and psychological therapy), and patients in treatment group were treated with integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) additionally. Three months were set for a course of treatment, and the whole treatment lasted for a total of four courses. TCM clinical symptoms were scored every six months, muscle tone (MAS), gross motor function (GMFM), and daily life activity ability (MBI) were evaluated every three months for both groups. Results There were significant differences in the total scores of TCM clinical symptom, MAS, GMFM, and MBI at different treatment time points in the two groups, compared with that before treatment (P<0.01). There were significant differences in the total scores of clinical symptom for Chinese medicine, MAS, GMFM, and MBI at different treatment time points for treatment group, compared with that of control group (P<0.05). Conclusion Integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) for cerebral palsy children on the basis of western medicine therapy can more effectively improve function and life quality of children patients.

Objective:To prepare the velvet antler polypeptide-collagen/chitosan composite materials,and to investigate its promotive effect on cicatrization of mandibular defect and possible mechanism.Methods:The collagen and chitosan solution were mixed.The composite material was prepared by glutaraldehyde crosslinking method.The microstructure of the composite material was observed by transmission electron microscope (SEM).The unilateral mandibular defect models of 36 rabbits were established.The rabbits were divided into experiment and control groups,and each group was divided into 4-,8-and 12-week subgroups,and there were 6 rabbits in each sub group.The rabbits in experiment group were implanted with velvet antler polypeptide-collagen /chitosan composite materials and the rabbits in control group were treated.4,8 and 12 weeks after operation,the histology of bone defect and peripheral nerve reconstruction of the rabbit models were detected by CT;the expression of vascular endothelial growth factor (VEGF) in bone tissue of the rabbits was detected by immunohistochemistry;the ultrastructure of bone defect was observed by SEM.Results:The structure of composite materials had layered folds and the inner diameter of the stent became larger and mainly dominated by sheet structure,which was the ideal structure of biological materials.4 weeks after operation,the new bone was formatted in experiment group,most of the new bone like-tissue materials were degraded,and the VEGF expression showed an increasing trend;8 weeks after operation,the trabecular bone in the bone defect of the rabbits in experiment group was increased obviously and the expression of VEGF was decreased.12 weeks after operation,the new bone formation and the density in experiment group was consistent with the normal tissue,and the expression level of VEGF returned to normal.At each the point after operation,the degree of bone defect healing and bone formation rate in experiment group were obviously prior to control group.Conclusion:Velvet antler polypeptide-collagen /chitosan composite material has the promotive effect on the fracture healing of mandibular defect of the rabbits and its possible mechanism may be related to promoting the expression of VEGF.

Objective To observe the effect of spleen-warming and kidney-tonifying therapy on Toll-like receptor 4 (TLR4) signaling pathway of cerebral infarction sequelae patients. Methods A total of 60 cerebral infarction sequelae patients with spleen and kidney(yang) deficiency were divided into control group and treatment group, 30 cases in each group. The two groups were given function rehabilitation training following by the theory of modern rehabilitation medicine, and additionally the treatment group was treated with spleen-warming and kidney-tonifying herbs orally. The treatment period for the two groups averaged 3 months. Before and after treatment, the scores of traditional Chinese medicine (TCM) symptoms and signs, peripheral blood TLR4 mRNA expression level, and the inflammation-related factors in the two groups were observed, and the observation parameters were compared with 30 healthy volunteers. Meanwhile, the changes of modern rehabilitation evaluation indexes were also evaluated before and after treatment. Results (1) After treatment, the Fugl-Meyer scores for motor function and Modified Barthel Index(MBI) scores for activities of daily living in the treatment group were obviously increased(P < 0.05 or P < 0.01 compared with those before treatment); the MBI scores in the control group was much increased(P < 0.05 compared with those before treatment), but the Fugl -Meyer scores only showed an increasing trend(P > 0.05). (2) After treatment, the predominant symptoms and signs of hemiplegia, facial distortion and dysphasia in the two groups were much improved(P < 0.01 compared with those before treatment), and the improvement in the treatment group was superior to that in the control group(P < 0.05). The control group had no significant effect on relieving the symptoms and signs of dizziness and blurred vision, numbness of limbs, spontaneous sweating, shortness of breath and weakness, and darkish tongue(P > 0.05 compared with those before treatment); the treatment group had obvious effect on the above symptoms and signs, and the effect was superior to that in the control group(P < 0.05 or P < 0.01).(3) For the inflammation-related factors, tumor necrosis factor alpha(TNF-α) level in the treatment group was much decreased and even arrived to the normal level(P > 0.05), and TNF-α level in the control group was decreased but did not arrive to the normal level(P < 0.05); levels of interleukin(IL)-1β, IL-6 and TLR4 mRNA in the two groups were decreased but did not arrive to the normal(P < 0.01), and the decrease in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01). (4) During the treatment period, no obvious adverse effect was found in the two groups. Conclusion Oral use of spleen -warming and kidney –tonifying Chinese medicine combined with modern rehabilitation therapy is effective for the treatment of the sequelae of cerebral infarction patients by relieving the clinical TCM symptoms, and one of the therapeutic mechanisms is probably related with the TLR4 signaling pathway through regulating the expression of inflammatory factors.

Abdomen, Acute ; etiology ; Child ; Family Health ; Female ; Gastrointestinal Diseases ; etiology ; Genes, Dominant ; genetics ; Humans ; Male ; Nausea ; etiology ; Pedigree ; Telangiectasia, Hereditary Hemorrhagic ; complications ; genetics ; pathology ; Time Factors ; Vomiting ; etiology

Objective To investigate hemodynamic changes of deep vein in lower limb during the perioperative period of total hip arthroplasty (THA) and early diagnosis of deep vein thrombosis (DVT). Methods Doppler ultrasound, hemorheology detection and plasma D-dimer testing were done on 62 patients treated with THA. Statistical analysis was carried out on the data of patients with or without DVT to study the early diagnosis of DVT. Results The results of Doppler ultrasound showed DVT in 8 patients. Compared with postoperative concentration of plasma D-dimer, the preoperative con-centration of plasma D-dimer was significandy higher in patients with or without DVT (P < 0.05). The levels of hemorheological indices were significantly increased at postoperative day 7 (P < 0.05). Con-clusions Doppler ultrasound combined with plasma D-dimer testing and hemorheology detection are helpful in early diagnosis of DVT.

Objective To identify molecular typing of Brucella abortus isolates in Xinjiang,and determine the identification ability of multiple locus variable-number tandem repeat analysis (MLVA).Methods The optimized Brucella AMOS-PCR was used for identification of Brucella (n =7) genus and species in Xinjiang from 2010-2015,and MLVA-16 was used to further identify the isolates.Results were compared with the data of the Brucella standard strain provided by the http://mlva.u-psud.fr database.Cluster analysis was carried out with Bionumerics 6.6.Results The results of AMOS-PCR and MLVA-16 were identical,all were Brucella abortus.Further classification results of the MLVA-16 showed that the strain in Xinjiang was type 3 of Brucella abortus,which was basically the same as that of the domestic Brucella.Conclusions The molecular typing of isolates separated in Xinjiang is type 3 of Brucella abortus.MLVA can identify Brucella at the level of species,and highly sensitive to Brucella biotype and isolates differences,which provides a basis for the traceability and evolution of brucellosis epidemic strains.

Objective To evaluate the effects of 0.0％ and 0.02％ atropine on pupil diameter (PD) and accommodation amplitude (AMP) in myopic children and analyze its relation factors.Methods A prospective randomized controlled trial design was adopted.One hundred and ninety-three myopia children were included from June to October,2016 in the First Affiliated Hospital of Zhengzhou University,all the children completed one-year follow-up.All the children were divided into three groups randomly,with 72,74 and 80 myopic children in 0.01％ atropine group,0.02％ atropine group and control group,respectively.The myopic children in 0.01％ atropine group and 0.02％ atropine group wore single-vision spectacle lenses and were treated with 0.01％ and 0.02％ atropine eye drops nightly,respectively.The myopic children in the control group wore spectacle lenses only.The PD and AMP were measured at baseline,and 4,8 and 12 months after treatment.Results There were no significant difference of baselinePD and AMP among the three groups (F=9.321,P=0.820;F=13.209,P=0.220).Compared with basline,after 12 months,the PD increased by 0.75,0.84 and 0.02 mm in 0.01％ atropine group,0.02％ atropine group and control group,respectively.There were statistically significant differences of PD among three groups at different time points (Fgroup =2.168,P=0.013;Ftime =2.139,P=0.015;Finteraction =2.148,P=0.001).Compared with baseline,the PD of 0.01％ atropine group and 0.02％ atropine group were increased 4,8 and 12 months after treatment,and the difference was statistically significant (all at P＜0.001).The PD was stable in control group.After 12 months,the AMP were reduced by 1.25,1.12 and 0.28 D in 0.01％ atropine group,0.02％ atropine group and control group,respectively.There were statistically significant differences of AMP among the three groups at the different time points (Fgroup =18.346,P =0.034;Ftime =1.823,P =0.002;Fintercation =3.239,P =0.023).Compared with baseline,the AMP of 0.01％ atropine group and 0.02％ atropine group were increased 4,8 and 12 months after treatment,and the differences were statistically significant (all at P＜0.05).The AMP remained stable in control group.The change of PD in 0.01％ atropine group and 0.02％ atropine group was correlated with age,baseline PD and baseline eye axis length,respectively (β =0.060,P =0.019;β =-0.440,P＜0.001;β =-0.37,P =0.045).The change in AMP of the atropine group was significantly correlated with the baseline adjustment range (β =-0.71,P＜0.001).Conclusions 0.01％ and 0.02％ atropine show similar effects on pupil diameter and accommodation amplitude after 12 months of treatment in myopic children.