Objective To study the characteristics,operative timing,repair methods for iatrogenic bile duct injury caused by laparoscopic cholecystectomy.Methods Clinical data of 30 cases of iatrogenic bile duct injury found during or after laparoscopic cholecystectomy were studied retrospectively.Results There were type Ⅱ 1 bile duct injury in 9 patients,type Ⅱ 2 in 4 patients,type Ⅱ 3 in 2 patients,and type Ⅱ 4 in 15 patient.17 cases underwent immediate repair,13 cases did early repair.All cases followed up from 5 months to 10 years,the follow-up rate was 83.3％.1 case with end-to-end anastomosis and biliary stent underwent Roux-en-Y choledochojejunostomy for biliary stenosis 13 months postoperatively,4 cases underwent secondary Roux-en-Y choledochojejunostomy because of obstructive jaundice and the cicatricial anastomotic orifice stenosis one to one and half years after primary repairs.The remaining cases were doing well up to the end of the follow-up.Conclusion Most iatrogenic bile duct injury after laparoscopic cholecystectomy were high in position,while Roux-en-Y choledochojejunostomy is the mainstay of repair.

The prevention of myocardial and brain dysfunction induced by positive acceleration (+Gz) exposure is the focus in the field of aerospace medicine research topic .The characteristics and mechanisms that +Gz exposure caused damages to vital organs such as heart and brain remain to be further elucidated .The research literature about +Gz acceleration exposure-induced heart and brain injuries in experimental animals and its mechanisms at home and abroad was reviewed in this paper .

Objective To analyze the biomechanical changes of lateral atlantoaxial articulation by means of three‐dimensional fnite element models of craniocervical junction malformation(CJVM) .Methods CT scan images of 1 patients with CJVM were ob‐tained .The analytical model was constructed by advanced three‐dimension modeling and finite element softwares .A comparison of range of motion difference between the deformity model and normal model ,referring to the experience of clinical observation ,was used to verify the validity of the model .Applying respectively the same loads and boundary conditions on finite element model .The effectiveness was verified by contrastive analysis of the variation in lateral atlantoaxial joint stresses .Results The finite CJVM ele‐ment model with high geometric accuracyand reliable parameter had built .Compared to the results of cadaver test and finite element model based in normal cranio‐cervical junction ,the segment mobility coincides with the actual clinical performance in patients .The stress distribution the lateral junction between atlas and axis of can be reasonably explained the deformation of lateral atlanto‐axial joint structure and its important role in remaining stable between atlantoaxial vertebraeunder different physiological conditions .Con‐clusion The structure of lateral atlantoaxial joint changes in patients of CJVM ,the biomechanical stability for preoperative diagno‐sis and intraoperative treatment operation has a certain value .

Objective To investigate the significance of calcification in thyroid node for diagnosis of thyroid carcinoma.Method Retrospective analysis of 107 thyroid nodules' pre-operative ultrasonic and postoperative pathologic results.Results Total ultrasonic thyroid calcification ratio was 27.1%(29/107),which in benign samples was lower than Ihat in malignant samples(17.2%vs 70.0%,P＜0.01).Micro-calci-fication ratio in benign samples Was lower than thai:in malignanl samples(8.0%vs 50.0%,P＜0.01).Conclusion The ralio of thyroid carcinoma with calcification is higher,so the detection of thyroid carcinoma,especially micro-single-calcification should be significant.

Objective To study the effect of rhodiola crenulata compound on serum corticosterone and myocardial glucocorticoid receptor ( GR) in rats exposed high sustained +Gz.Methods Seventy-two healthy SD rats were randomly divided into six groups: blank control group, stress control group, +10 Gz stress group and low, medium, high dose drug group, with twelve rats in each.20 mL/kg menstruum was fed to each rat once per day for 14 days.Low, medium and high dose drug group were fed with rhodiola crenulata compound at doses of 0.75 g/kg, 1.5 g/kg and 3.0 g/kg respectively, the other three groups were fed with equal volume saline.Rats were exposed to high +Gz in 15th day.The concentration of corticosterone in the serum of each group rats was detected with ELISA. Western blot was used to detect the expressions of GR in the myocardium of each group rats .Results The content of corticosterone was significantly elevated in +10Gz stress group, while the expression of GR in the myocardium was markedly declined (P <0.01,P <0.05).However, compound preconditioning could decrease concentration of corticosterone in the serum and enhance the expression of GR in the myocardium from rats after +10 Gz exposure. The corticosterone concentration of medium and high dose drug groups was significantly lower and the level of GR expression in the myocardium was significantly higher than that of +10 Gz stress group ( P <0.05 , P <0.01 ) . Conclusion Rhodiola crenulata compound preconditioning could regulate the concentration of corticosterone in the serum and the level of GR expression in the myocardium of the rats exposed +10 Gz, which may be related with its protective effect on high sustained +Gz-induced injury of myocardium.

Objective To explore the clinical features and treatment of upper gastrointestinal bleeding with rare etiologies.Methods A total of 45 cases with rare etiologies was selected from a group of 1200 patients with upper gastrointestinal bleeding admitted from January 2012 to December 2015.Results The incidence of gastric stromal tumor (24.4％) and Dieulafoy's lesion (20.0％) was the highest.Among rare etiologies of upper gastrointestinal bleeding were Mallory-Weiss syndrome (17.8％) and stomal ulcer and hemorrhage of efferent loops after subtotal gastrectomy (17.8％),as well as left-side portal hypertension (6.7％),liver cirrhosis complicated with variceal bleeding in the descending part of the duodenum (2.1％),esophageal hematoma (2.1％),esophageal mucosa avulsion (2.1％),P-J syndrome (2.1％),duodenal adenocarcinoma (2.1％),and cutaneous malignant melanoma with duodenal metastasis (2.1％).Conclusions Gastroscopy in early stages played a role in etiologies identification,while etiological treatments could substantially reduce recurrent bleeding rate,thus enhanced cure rate.Analysis on rare etiologies promoted the medical understanding,with clinical diagnosis and treatment improved.

Objective To investigate the function of CFTR in ApoE-/- mice with HHcy-induced hepato-cellular injury. Methods Thirty six 5-week old ApoE-/- mice were divided into three groups , including the ApoE-/- group, the HHcy group and the intervention group, (n = 12). Twelve normal C57BL/6J mice were fed with regular mouse diet as the normal control (SPF grade). HL-7702 human liver cells were intervened by Hcy (100 μmol/L) and 100 μmol/L Hcy + folic acid (100 μmol/L Hcy + F). The changes of Hcy, ALT and AST in the serum and the expression of CFTR mRNA and protein in liver and liver cells were detected. The concen-trations of ALT and AST in the liver cell intervened by VX-770 agonist and CFTR(inh)-172 inhibitor were mea-sured by ELISA. Results Compared with the control group , the levels of Hcy , ALT and AST were higher and the levels of CFTR mRNA and protein were lower in the Meth group (P < 0. 05 ) , while the reverse result in the Meth + F group (P < 0.05). Compared with the control group, the levels of CFTR mRNA and protein were de-creased and the levels of ALT and AST were increased in the 100 μmol/L Hcy group (P < 0.05). Compared with the 100 μmol/L Hcy group , the levels of CFTR mRNA and protein were increased and the levels of ALT and AST were decreased in the 100 μmol/L Hcy + F group (P < 0.05). Stimulated with VX-770 can reduce the concentrations of ALT and AST and the vice versa in the CFTR (inh)-17 group the concentration was increased in liver cells. Conclusion CFTR plays an important role in the regulation of hepatocellular injury by HHcy.

Objective To study the response characteristics of left and right brain to signals from left(LVF) and right(RVF) visual fields during cognitive activity. Method ERPs at 9 locations to LVF and RVF signals were compared in 23 normal subjects in 3 task conditions:looking forward only (VC); making switch response to target signals(T) only(SR); making switch response to T differentially(DR). Result (1)Significant difference in ERPs was found between that induced by LVF and RVF signals on left brain especially at frontal location(F5), which appeared as slow negative deflection induced by T and NT from RVF in SR and DR;(2) Condition-dependent unsymmetrical features between left and right brain were found: the slow potential at F5 was significantly more negative in T and contralateral spatial relation(i.e., left brain for RVF) but more positive in NT and ipsilateral relation than that at F6.Conclusion Signals with psychological meaning in RVF might cause more psychological load as suggested by the results obtained in this study.

Objective To assess the clinical relevance of polymorphisms at position-251 in the promoter region of IL-8 gene and the incidence of sepsis in patients with severe trauma.Methods A total of 296 patients with severe trauma were included in the prospective cohort study.Incidence of sepsis was decided on the basis of the clinical manifestations and blood culture results.Muhiple organ dysfunction score (MODS) was performed using Marshall' s standard.IL-8/-251 gene polymorphisms were genotyped using restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP).IL-8 plasma level was determined using ELISA method.Results Genotype frequency at IL-8/-251 locus in trauma patients was in accord with Hardy-Weinberg equilibrium (P ＞ 0.05).Sepsis incidence in trauma patients with TT,TA,and AA genotypes at IL-8/-251 locus was 58.1％,49.6％,and 25.0％ respectively.Multiple regression analysis showed inverse correlation between sepsis incidence and quantity of A alleles [OR =0.637,95％ CI (0.421,0.963),P ＜ 0.05].Carriers of AA genotype presented lower MODS score than those of other two genotypes (P ＜ 0.05).IL-8 plasma level presented significant difference among carriers of the three genotypes (P ＜ 0.01) and A alleles were associated with the down-regulation of IL-8 (P ＜ 0.01).Conclusion IL-8/-251T/A polymorphisms are implicated in the development of posttraumatic sepsis and AA genotype is protective against posttraumatic sepsis.

Objective To investigate the intervention of ciliary enurotrophic factors(CNTF)on weightlessness-induced muscle atrophy and its myofiber phenotype transition.Methods Tail-suspended (hindlimb unloading)of adult male Wistar rats were used to create the mode J of weightlessness-induced muscle atrophy.The effect of CNTF treatment on weightlessness-induced muscle atrophy and its myofiber phenotype transition was determined by analyzing the expression changes of MHCI/IIb and p130 or Myf5 with RT-PCR and Western blot.Results CNTF treatment in vivo markedly reversed weightlessness-induced muscle weight IOSS selectively in the slow-twitch muscle soleus.Moreover,during tail suspension,soleus weight loss and myofiber phenotype transition indicated that CNTF treatment could sigificantly attenuate the weight loss and slow to fast myofiber phenotrype transition in soleus compared with control(CNTF untreated and tail suspended).Furthermore,it was showed that the CNTF-induced intervention effect was associated with the protein level upregulation of muscle satellite cell-specific markers,P130 and Myf5.The satellite cell pool in CNTFtreated soleus was increased.Conclusion It iS firstly demonstrated that CNTF can attenuate weightlessness-induced muscle atrophy and its myofiber phenotype transition to be through the increase of satellite cell pool in soleus.