Objective To evaluate the efficacy of laparoscopic management for bile duct and gastrointestinal injuries during laparoscopic cholecystectomy. Methods Laparoscopic cholecystectomy with or without laparoscopic bile duct exploration was attempted in 9 016 consecutive patients between October 1991 and December 2002. We experienced 14 cases of bile duct injuries (0.15%) and 3 cases of gastrointestinal injuries (0.03%). One patient with circumferential injury and 10 patients with partial laceration injuries of the bile duct underwent a laparoscopic simple closure. One gastric and two duodenal injuries were successfully repaired under laparoscope. Results Expect 1 patient suffered postoperative biliary leakage and bile duct stricture 1 year after the surgery, all the patients were cured and discharged from the hospital. Conclusions Partial laceration injuries of the bile duct or gastrointestinal injuries could be treated with a laparoscopic technique. Concerning laparoscopic management of circumferential bile duct injuries, further study should be taken.

Anxiety disorders are the commonest emotional disorders in children, who may be at increased risk of the later develop-ment of other types of mental disorder. Early diagnosis and intervention should be applied. In this article, epidemiology, major factors rele-vant and effective therapy of anxiety disorders in preschool children are summarized.

Objective To investigate the association between the MTHFR gene C677T mutation and CAD in patients with hypertension. Methods Of the 103 cases of patients with hypertension who underwent coronary angiography, 58 were CAD and 45 were not. MTHFR genotypes were identified by PCR and restriction fragment length polymorphism analysis with Hinf I digestion. Plasma folate was determined by radioimmunoassay. Plasma HCY was determined by HPLC. Results The frequencies of T677 allele (0.45) in the CAD group were markedly higher than those in the control group (0.33, P=0.03), plasma homocysteine level in the CAD group (17.73?2.22 ?mol/L) was also significantly higher than that in the control group (12.18?1.23 ?mol/L, P=0.037). There was no significant difference in the concentrations of folate for the two studied groups. Conclusion The MTHFR gene T677 variant is the genetic high risk factor for CAD in patients with hypertension. It can induce the hyperhomocysteinemia, potentially contributing to the pathogeny of CAD.

Purpose: To observe the clinical therapeutic effect of acupuncture plus Chinese herbs in treatment of poststroke depression. Methods: Forty-two cases of poststroke depression were treated by acupuncture plus Chinese herbs, and 30 cases of poststroke depression were treated by Western drug as control. Results: After 6 weeks of treatment, the scores of Hamilton Depressive Scale in two groups were all reduced statistically and remarkably when compared with before treatment; when the acupuncture plus Chinese herbs group were compared with Western drugs group, no significant difference was found in total effective rate. Conclusion: Acupuncture plus Chinese herbs had marked therapeutic effect in the treatment of poststroke depression, and had the advantages of safety and no side effect.

Objective To compare common bile duct pressure changes after laparoscopic common bile duct exploration between primary closure of the bile duct and T-tube drainage.Methods Postoperative common bile duct pressure changes were analyzed in 30 cases of laparoscopic common bile duct exploration,including 15 cases of primary suture of the bile duct and 15 cases of T-tube biliary drainage respectively,from August 2003 to January 2004 in this hospital.Results ①The hydrostatic pressure in common bile duct was 6.0~18.5 cm H_2O(0.54~1.66 kPa).②As compared with preoperative levels,the common bile duct pressure increased slightly on the first postoperative day and decreased significantly on the fifth postoperative day in primary suture cases(q=4.531,P

The efficiency of Siemens E.CAM is evaluated by analyzing and practicing the technology of Siemens U-fly.Basic testing procedure is run.Standard source 99mTc and 57Co is used respectively and the operation is performed according to the instruction.The detecting head's uniformity can be corrected in this way with satisfactory results.It is suggested uniformity should be tested every day before study because it is the most important factor for the quality of clinical images.

Objective To compare serum potassium concentrations in type 2 diabetic and nondiabetic patients in the early phase of acute coronary syndromes (ACS). Methods Seven hundred and forty-five consecutive patients with ACS underwent cardiac catheterization from January, 1999 to March, 2003. Patients were stratified by duration of symptoms,type2diabetes,and?-receptor blocker therapy before admission. Results Serum potassium concentration was significantly higher in type 2 diabetic patients with ACS than that in nondiabetic patients with ACS 〔(4.34?0.48)mmol/L vs (4.00?0.52)mmol/L,P

Objective To analyze the susceptibilities of Escherichia coli isolates collected from blood and the prevalence of ESBLs encoding genes.Methods A total of 121 Escherichia coli isolates collected from blood during 2012 were analyzed for antimicrobial susceptibilities by software of WHONET 5.6,the production of ESBLs was confirmed by confirmatory pheno-typic testing,PCR and DNA sequence were further implemented to analyze the ESBLs-encoding genes.Results 121 E.coli isolates displayed high resistance towards broad spectrum penicillin and 2nd or 3rd generation cephalosporins,levofloxacin and cotrimoxazole,with the resistance rates being more than 40%,susceptibilities to imipenem,piperacillin/tazobactam,ami-kacin were observed,with the resistance rates to be less than 12%,86(88.7%)out of 121 isolates were found to produce ESBLs.Among them,59.5% (72),38.8% (47)and 4.1% (5)were confirmed to carry blaCTX-M,blaTEM and blaSHV genes.Additionally,2(1.7%)isolates carried all the genes detected,30(24.8%)isolates carried both of blaCTX and bla-TEM,1(0.8%)isolate carried both of blaSHV andblaTEM.Conclusion Most of the E.coli isolates from the blood culture in Nanjing Gulou Hospital produce ESBLs,and displayed resistance towards most of the penicillins,cephalosporins and sin-gle amide antimicrobial agents should be chosen according to susceptibility results.

BACKGROUND: CpG oligonucleotide has been shown to strengthen the function of peripheral blood mononuclear cells (PBMCs), but its effects on type 1 diabetes mellitus has been rarely reported. OBJECTIVE: To investigate the effects of CpG oligonucleotide on the expression of interferon γ (IFN-γ), interleukin (IL) -12 and IL-10 in PBMCs in patients with type 1 diabetes mellitus versus healthy controls. METHODS: PBMCs were isolated from patients with type 1 diabetes mellitus and healthy controls and then cultured in RPMI-1640 with non-stimulator (control group) and CpG oligonucleotide (CpG oligonucleotide group), respectively. The mRNA expression of IFN-γ, IL-10, and IL-12 in PBMCs was detected by reverse transcription-polymerase chain reaction. RESULTS AND CONCLUSION: mRNA expression of IFN-γ and IL-10 was significantly lower in patients with type 1 diametes mellitus than in healthy controls (P < 0.01). In the CpG oligonucleotide group, the mRNA expression of IFN-γand IL-12 was significantly higher than in the healthy control group (P < 0.01), but the mRNA expression of IL-10 was similar to that in the healthy control group (P > 0.05). These findings demonstrated that CpG oligonucleotide can promote the production of IFN-γ and IL-12 in PBMCs of type 1 diametes mellitus.

Objective:To investigate the expression and clinical relevance of micro RNA (miR)-324-5p in pancreatic cancer tissues, and to explore the effects and potential mechanisms of miR-324-5p on the proliferation and migration of pancreatic cancer cells.Methods:Real-time quantitative PCR was used to detect the expression of miR-324-5p in 34 pairs of pancreatic cancer and adjacent normal tissues resected at Peking University First Hospital from October 2018 to September 2019. The correlations between miR-324-5p expression and clinicopathological characteristics and prognosis of pancreatic cancer were analyzed using data from the Cancer Genome Atlas (TCGA) database. Real-time PCR was used to detect the expression of miR-324-5p in pancreatic cancer cell lines, and PANC-1 cell was used for functional study by overexpressing miR-324-5p via mimic transfection. CCK8 assay was used to evaluate cell proliferation. Both transwell and scratch wound healing assay were used to assess the cancer cell migration ability. Related proteins were detected by Western blot. The potential downstream target genes of miR-324-5p were selected using data from miRNA target genes predicted webs, in combination with functional analysis and their expressional correlation with miR-324-5p.Results:Data from TCGA database showed that the expression of miR-324-5p in tumor tissues was significantly lower than that in normal pancreatic tissues. And low level of miR-324-5p in pancreatic cancer was correlated with poor prognosis. Analysis of 34 pairs pancreatic cancer and adjacent normal tissues showed that miR-324-5p expression in tumor tissues (11.7±2.0) was significantly lower than that in adjacent normal tissues (70.9±14.4), and the pancreatic cancer patients who had the nerve invasion cancer showed low level of miR-324-5p (82.1%, 23/28) was significantly higher than that patients with high level of miR-324-5p (33.3%, 2/6). The expression of miR-324-5p in human pancreatic cancer cell line was also significantly lower than that in normal pancreatic ductal cells. CCK-8 assay showed that the proliferation ability of PANC-1 cell was significantly decreased when miR-324-5p was overexpressed. Transwell and wound healing assays showed that the capabilities of vertical migration and the horizontal movement were significantly inhibited in PANC-1 cell with miR-324-5p overexpressed [(30.11±5.2) and (174.6±27.0) μm, respectively] than those in control groups [(63.6±4.2) and (458.3±22.3) μm, respectively]. Moreover, Western blots showed a significant overexpression of miR-324-5p inhibited epithelial-mesenchymal transition (EMT). According to the data from miRNA target genes prediction and the functional analysis we found KLF3, MGAT3, PBX1 and ZNRF2 were considered as the potential downstream target genes of miR-324-5p.Conclusions:Our results indicated that miR-324-5p is lowly expressed and acts as the tumor suppressor gene in pancreatic cancer, and low level of miR-324-5p is correlated to a higher rate of nerve invasion and poor prognosis. In human pancreatic cancer cell, miR-324-5p may regulate EMT by directly inhibiting target genes such as KLF3, MGAT3, PBX1, ZNRF2, which in turn suppresses cancer cell proliferation and migration.