Spontaneous choledochocyst perforation in adults is a rare disease with more acute onset and rapid progression of the disease.Most cases of spontaneous choledochocyst perforation are misdiagnosed due to the lack of typical symptoms,meanwhile,treatment remains controversial,and accordingly it is hard for doctors to make a decision on treatment.Nevertheless,the individualized treatment can be performed on patients according to the clinical symptoms and conditions of patients combined with the medical history,laboratory and imaging examinations or other special procedures.In this article,the diagnosis and treatment of spontaneous choledohocyst perforation were summarized on the basis of global literatures and analyses of the pathogeny and clinical presentation of this disease.

Laparoscopic hepatectomy has been utilized in clinic,however to some extent there are some limitations for various equipments being used in laparoscopic hepatectomy, as a result, the laparoscopic bepa-tectomy is being constrainted on its development. Therefore, with the research and development of the ideal tool for laparoscopic hepatectomy,laparoscopic liver surgery is bound to be booming.

Circulating tumor cells (CTCs)are special kind of tumor cells in the peripheral blood of patient with tumor.Now CTCs detection has been used in the survival time prediction,post-operational recu-rrence detection,individualized treatment and other aspects in the patients with gastric cancer.As the research going,CTCs will provide new help for the comprehensive treatment of gastric cancer.

Objective:To compare etomidate in propylene glycol(Eto-PG) with a new galenic preparation of etomidate solved in a lipid emulsion of soya-bean oil(Eto-Lip).Method:Sixty patients were randomly divided into 2 groups:Eto-PG group and Eto-Lip group.The dosage of etomidate was 0.3mg/kg.Hemodynamic change and side effects(pain on iv-injection,involuntary movement, phlebitis, thrombophlebitis etc.) were observed.Result:There were no difference between the two groups in the incidence of involuntary movement.Side effects at the site of injection,both immediate and after operation,were encountered with Eto-PG but were not encountered in the lipid emulsion. Conclusion:Eto-Lip can reduce some undesired side effects without changing its pharmacodynamics.

Reducing blood loss during hepateetomy is important.Intraoperative blood loss and liver damage of hepatectomy under the total hemihepatic vascular exclusion could be less than that under the other methods of vascular occlusion.It could be worth improving and applying further.This article review the latest studies to introduce the latest advancement in this area.

Secondary lymphoid tissue chemokine (CCL21) is a double-edged sword, which exerts antitumor, anti-infection immune response by binding to the receptor CCR7 on the surface of the multiple immune cells. However, a variety of tumor cells also express the receptor CCR7, the combination of CCL21 with CCR7promotes the invasion and metastasis of tumor cells, leading to the facilitation of tumor development. Therefore,exploring the mechanism(s) of tumor invasion and metastasis might be helpful for use of CCL21 as tumor gene therapy through blocking of CCL21's promotion of tumor invasion and metastasis.

Electromyography ; Electrophysiology ; Genetic Testing ; Humans ; Neuromuscular Diseases ; diagnosis ; genetics

Recently,the incidence of Alzheimer's disease has been significantly increasing.However,the pathogenesis of Alzheimer's disease remains unknown.It is presumed that insulin and insulin receptor may be involved in the pathogenesis of Alzheimer's disease.The relationship between insulin and cerebral glucose metabolism,the relationship between insulin,insulin receptor,insulin resistance and pathogenesis of Alzheimer's disease as well as the possible mechanism are reviewed in this paper,and the progress of treatment of AD is also described.

Background C57BL/6andB10R Ⅲareroutinemurinespeciesusedinexperimental autoimmune uveitis (EAU).The inflammation is light for mouse after immunization whereas it is prominent for B10R Ⅲ.ObjectiveThis study was to observe the killing effect of interphotoreceptor retinoid binding protein (IRBP) 1-20-specific T cells on mouse retinal astrocyte.Th1 and Th17 cells effect in the EAU mechanism was discussed.MethodsB10RllⅢ mice and C57BL/6 mice were immunized with IRBP 161-180 and IRBP 1-20 in complete Freund adjuvant (CFA).The infiltrating cells of diseased B10R Ⅲ eyes were analyzed by flow cytometry.IRBP 1-20-specific T cells were isolated from the drainage lymph node and spleen and cultured in IL-2 or IL-23 for Th1 and Th17 cells polarization,respectively.Th1 and Th17 cells cultured for 5 days were seeded on the mouse retinal astrocyte monolayer pretreated with gamma interferon.Cell interaction was observed and the quantity of TNF-α was tested by ELISA.Every test was repeated 6 times and the mean was calculated.The maintenance of experimental animals complied with the Statement of ARVO.ResultsThere were lots of infiltrating cells in the eyes of B10Rm mice after immunization,including 9.5％ IFNγ+ cells,5.1％ IL-17+cells and 41.4％ CD45+ cells.Six days after IRBP1-20 stimulation and cultured by IL-2 and IL-23,44.0％ and 8.0％ cells were IFNγ+,and 1.0％ and 26.0％ cells were IL17+.Twentyfour hours after the interaction between Th1 or Th17 and retinal astrocyte,retinal astrocyte died and detached.The killing effect of Th17 was stronger than Th1.48 hours after co-culture of Th1 or Th17T cells with astrocytes,the concentrations of TNF-α were ( 500± 10 ) and ( 801 ±24 μg/L) μg/L,respectively,with a significant statistical difference (t =-20.36,P =0.00).ConclusionsBoth Th1 and Th17 can kill retinal astrocyte,but Th17 plays a key role in the EAU pathogenesis process.The killing effect is caused by intercellular contact and interaction under the induction of cytokines.

OBJECTIVE: To investigate the intestinal absorption behaviors of Diospyros kaki L.f. extract (PLE) in self-microemulsifying drug delivery system (SMEDDS). METHODS: The concentration of quercetin, kaempferol and phenol red in rat intestinal perfusion solution was determined by HPLC. Rat single-pass intestinal perfusion technique was employed to assay the effects of concentrations of PLE in perfusion solution, intestinal segments and different formulations on the drug percentage absorbed (P) and the absorption rate constant (Ka). RESULTS: No significant changes of Ka and P were observed in different PLE concentrations. The main absorption segments of SMEDDS in rat intestines were the duodenum and ileum. The values of Ka and P of SMEDDS were significantly higher than the PLE solution (P<0.05). CONCLUSION: The absorption mechanism of PLE conforms to passive diffusion. The PLE SMEDDS presented the high absorption rate than conventional solution in rat intestine, which illustrates the potential use of SMEDDS for the delivery o f PLE by the oral route.