Objective To compare the effect of endoscopic retrograde cholangiopancreatography sphincterot-omy plus laparoscopic cholecystectomy(ERCP/S +LC)and laparoscopic common bile duct exploration(LCBDE)in the treatment of cholecystolithiasis patients with concurrent choledocholith.Methods Retrospective analysis was made of information of 280 cholecystolithiasis patients with concurrent choledocholith,who were randomly divided into group A (n =60)and group B (n =220).group A was arranged with LCBDE and group B was treated ERCP/S +LC. The operation time,hospital stay after operation,hospitalization fee,size of common bile duct calculi,stone clearance rate and the incidence of postoperative complications were compared.Results The operation time,hospital stay after operation,hospitalization fee,size of the common bile duct calculi,stone clearance rate and the incidence of postopera-tive complications of group A &B were (95.58 ±22.66)m vs.(87.46 ±40.25)m,(15.18 ±5.46)d vs.(14.32 ± 4.21)d,(2.45 ±0.32)ten thousand yuan vs.(2.89 ±0.64)ten thousand yuan,(1.12 ±0.34)cm vs.(1.39 ± 0.38)cm,96.6% vs.91% and 1.6% vs.3.2%.There was no significant difference in calculus clearance rate between the two treatments(χ2 =1.44,P >0.05 ).Patients in LCBDE group spent slightly less on hospitalization expenses than patients in ERCP/S +LC group,but there was no significant difference shown(t =0.923,P >0.05). Patients in ERCP/S +LC group had suffered a relatively high incidence of complications than patients in LCBDE group,and significant difference was found(χ2 =4.17,P <0.05).Conclusion Both LCBDE and ERCP/S +LC are effective minimally invasive therapies for concurrent cholecystolithiasis and choledocholith,and should be clinically applied in accordance with their specific characteristics.

BACKGROUND: Endothelium damage is the promoter of atherosclerosis, and endothelial progenitor cells as vascular endothelium precursor cells play an important role in endothelium repair and angiogenesis. The influence of statins on atherosclerosis through endothelial progenitor cells is the new research hot spot. OBJECTIVE: To summarize the research progress of statins through endothelial progenitor cells on atherosclerosis. RETRIEVAL STRATEGY: A computer-based search of Pubmed and Ovid database from January 2000 to December 2006, with the retrieval word of "endothelial progenitor cells, statins, atherosclerosis", and language was limited in English. Meanwhile CNKI and VIP database were retrieved from January 2000 to December 2006, the retrieval words were "endothelial progenitor cells, atherosclerosis, statins" in Chinese. Totally 62 articles were retrieved and checked primarily. Inclusive criteria: ①articles closely related to the influence of statins through endothelial progenitor cells on atherosclerosis;②articles published recently or in authorities journal were preferred in the same field. Exclusive criteria: repetitive research. LITERATURE EVALUATION: The mainly resource of documents is the influence of statins on atherosclerosis through endothelial progenitor cells. All 28 included documents were clinical or basic empirical studies, and 2 were reviews. DATA SYNTHESIS: Under physiological conditions, the integrity of the endothelial monolayer can be maintained by reproduction of adjacent cells. However, in conditions of oxidative stress damage, the integrity of the endothelium is prevented by progenitor cell homing.Statins mobilize endothelial progenitor cells to repair impaired endothelium and then postpone atherosclerotic progress. Statins mobilize endothelial progenitor cells through PI3K/Akt pathway and suppress endothelial progenitor cell apoptosis, leading to increase the number of endothelial progenitor cells in blood circulation, precipitate endothelial progenitor cells homing to myocardial ischemia site, promote new vascular generation, ameliorate blood supply of ischemia myocardium, and ameliorate the function of ventricular contraction. CONCLUSION: Through mobilizing endothelial progenitor cells, statins can increase the number of endothelial progenitor cells in blood circulation and suppress endothelial cells apoptosis, so as to postpone the progress of atherosclerosis, decrease the mortality rate of atherosclerosis patients, and improve their prognosis, which all indicate a wide research prospect.

Phase separation immunoassay (PSI) combines some advantages of both homogeneous and heterogeneous immunoassays by carrying out a fast homogeneous immune reaction and a simple heterogeneous separation process. The method is readily amenable to automation. The principle of PSI is introduced. The carriers, the immobilization modes, the labels, the applications and the development of PSI are comprehensively reviewed with 60 References.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Foot Diseases ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Pain Management ; Spinal Stenosis ; complications

Objective To explore the clinical efficacy and safety of intraoperative radiotherapy (IORT) for the patients with unresectable locally advanced pancreatic cancer. Methods Cochrane library, PubMed, EMbase, CBM, CNKI, VIP database and WANFANG database were used to retrieve, in addition to manual retrieval important literature references and conference papers. The randomised controlled trials, cohort study, controlled clinical trials of the IORT in unresectable locally advanced pancreatic cancer were searched. According to the inclusion criteria and exclusion criteria, after the extraction of literature and data, RevMan 5.3 software was used for meta-analysis. Results The total of 1 401 articles were retrieved, 7 met the inclusion criteria, including 1 for randomized controlled trials, 4 for cohort study, 2 for case-control study. 313 cases in the IORT group, 362 cases in the control group, and meta-analysis showed that IORT group was better than control group in overall survival (OS) (Z=4.15, P<0.000 1, RR=2, 95%CI 1.05-2.94). Because lack of complete data in local control rate, pain remission rate, complications, descriptive analysis was done, rather than meta-analysis. Conclusions IORT may improve the OS of patients with unresectable locally advanced pancreatic cancer and the local control rate, and effectively alleviate pain with favorale safety but it still needs high quality randomized controlled trials to confirm.

Objective To investigate the optimal operative time interval from the combined application of endoscopic sphincteropapillotomy ( EST) and endoscopic nasobiliary drainage ( ENBD) to laparoscopic cholecystecto-my ( LC) in the treatment of concurrent cholecystolithiasis and choledocholith.Methods Retrospective analysis was made in the 180 patients who had received sequential treatment of concurrent cholecystolithiasis and choledocholith with the combined application of EFS+ENBD+LC.Patients in group A received LC 3 days after EST +ENBD;patients in group B received LC 7 days after EST +ENBD;patients in group C received LC 30 days after EST +ENBD.Comparative analysis was made in the duration of LC,the intraoperative blood loss,the number of conversion to laparotomy and the total hospital expenses among patients in the three groups.Results Operation time in group A,B and C was separately (34.70 ±2.24)min,(51.00 ±2.31)min and (34.43 ±2.51)min.Patients in group B suffered significantly-extended surgical duration ( F=6.15,P<0.01);Intraoperative blood loss in the three groups was separately (28.86 ±3.35)mL,(50.43 ±3.90)mL,(28.57 ±3.40)mL.Significant increase was observed in group B(F=7.23,P<0.01).There were 1,6 and 1 patients who underwent conversion to laparotomy in the three groups. Slight increase was found in group B(χ2 =6.54,P<0.05).Total hospitalization expenses was separately (10 093.29 ± 496.05)yuan,(10 845.86 ±744.27)yuan and (15 250.57 ±1 006.67)yuan.Patients in group C had incurred a significant increase(F=6.62,P<0.01).Statistical difference was equally found.Conclusion 3 days after EST+ENBD is the optimal operative time for LC.

OBJECTIVE:To compare the efficacy and safety of alfacalcidol and strontium ranelate in the treatment of senile menopausal osteoporosis. METHODS:158 elderly menopausal patients with osteoporosis were randomly divided into control group (79 cases)and observation group(79 cases). All patients were orally given 1 Calcium carbonate D3 tablet,once a day. Based on it, control group was given 2 Alfacalcidol soft capsules,once a day. Observation group was additionally given 1 bag of Strontium ranelate dry suspension,orally before bedtime,once a day. The treatment course for both groups was 12 months. L2-4 and BMD of femoral neck,osteocalcin,TPINP and VAS and ADR before and after 6 and 12 months in 2 groups were observed. RESULTS:Before treatment,there were significant differences in the BMD of L2-4 and femoral neck,osteocalcin,TPINP and VAS scores be-tween 2 groups(P>0.05). BMD of L2-4 and femoral neck in control group after 12 months and in observation group after 6 and 12 months were significantly higher than before,and it gradually increased be time in observation,observation group was higher than control group;TPINP and VAS scores in control group after 12 months and in observation group after 6 and 12 months were significantly lower than before,and it gradually decreased be time,observation group was lower than control group,the differenc-es were statistically significant(P<0.05);osteocalcin levels in 2 groups were significantly higher than before,and it gradually in-creased be time,the difference was statistically significant (P<0.05),but there was no significant difference between 2 groups (P>0.05). There were no ADR during treatment. CONCLUSIONS:Based on the conventional treatment,the efficacy of alfacal-cidol and strontium ranelate is superior to alfacalcidol alone in the treatment of senile menopausal osteoporosis,with similar safety.

Objective To evaluate the importance of serum thyroid hormonens level of patients with stable coronary heart disease(CAD)in different glucose metablic statuses.Methods 173 cases of CAD patients in different glucose metablic statuses and 58 cases of healthy people were enrolled in the study.The levels of thyroid hormonens and serum insulin was measured by electro-chemiluminescence,and the evaluation of glucose metablic statuses and insulin resistance index was by means of 75 g oral glucose tolerance test.Results There was no significant difference in the levels of systolic pressure(SBP),diastolic pressure(DBP),insulin resistence index and serum thyroid hormonens among CAD patients with different glucose metablic statuses(P >0.05).The levels of fasting plasma glucose,2 hour postprandial plasma glucose(PG2h)and glycosylated hemoglobin(HbA1c)in CAD complicated with type 2 diabetes group were significantly higher than those in CAD complicated with impaired glucose tolerance group and CAD complicated with normal glucose tolerance group (P < 0.05 ).And the PG2h level of CAD complicated with impaired glucose tolerance group was significantly higher than both of CAD complicated with normal glucose tolerance group and normal control group s(P <0.05).Conclusion It indicates that serum thyroid hormonens level may not affect glycometabolism in CAD patients.

The experimental teaching is one of the important parts of psychology teaching.How to make the best of the lab resource to efficient experiment teaching is an important topic on psychological specialty construction.We have explored the construction of psychological lab and experiment teaching,and provided some helpful guidance for others.

The authors observed the development of the organ of Corti in the temporal bones of 64 human fetuses of various fetal ages by means of comparing celloid sections with surface preparations. The organ of Corti just begins to appear in the second month. Most rapid development occurs in the period from the third to the fifth month. Afterwards, the principal structure of the organ of Corti tends to be stable with no further major changes, except for the differentiation and maturation of the intracellular components. In the fifth month, the major part of the higher columnar epithelial cells on the inner Side of the tunnel begins to degenerate and disintegrate before the formation of the inner spiral sulcus. But a few epithelial cells turn into large wandering cells. The authors discussed the characteristics, function and possible transformation of the wandering cells and compared them with essentially similar cells that appear in the developing central nervous system.