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

Objective To explore the effect of laparoscopic bile duct exploration,balloon dilation,and catheter drainage in the treatment of postoperative recurrent choledocholithiasis.Method The data of 61 patients with postoperative recurrent bile duct stones from August 1999 to August 2009 were retrospectively analyzed.The patients received laparoscopic bile duct exploration (LCDE),laparoscopic papillary balloon dilation (LPBD),and laparoscopic papillary balloon dilation endoprosthesis (LPBDE).ResultSatisfactory outcome was achieved in all the 61 patients.Among the 61 patients,20 patients received LPBD and primary suturing,36 patients received LPBDE and primary suturing,and 5 patients received LPBDE and T-tube drainage.There was no residual stone.There was no perioperative mortality or serious complications including biliary leak and hemobilia.On follow up for 1 to 9.5 years in 56 patients,there was no recurrent choledocholithiasis.ConclusionThe procedures were feasible and safe,and they prevent recurrence of choledocholithiasis.

Purpose To analyze the hemodynamic characteristics of brain stem in patients with basilar artery hypoplasia (BAH) by magnetic resonance perfusion-weighted imaging (PWI).Materials and Methods According to the inclusion and exclusion criteria,51 patients with BAH were selected as the BAH group,and 79 patients without BAH were selected as the non BAH group.All patients were examined by MRI,3D-TOF and PWI,and magnetic resonance angiography was acquired after the three examinations.The regional cerebral blood flow (rCBF),regional cerebral blood volume (rCBV),regional mean transit time (rMTT) and time to peak (TTP) values of pontine area were measured.Results The rCBF value of the BAH group [(17.10±6.52) ml/(100 g · min)] was significantly lower than that of the non BAH group [(29.06± 13.32) ml/(100 g · min)] (P＜0.05);the rCBV value of the BAH group [(1.41 ±0.26) ml] was significantly lower than that of the non BAH group [(2.62± 0.82) ml] (P＜0.05);the TTP value of the BAH group [(6.14± 1.31) s] was significantly higher than that of the non BAH group [(5.39 ± 1.08) s] (P＜0.05);the rMTT value of the BAH group [(20.78±3.48) s] was significantly higher than that of the non BAH group [(19.01 ±2.39) s] (P＜0.05).TTP was the most sensitive index of cerebral perfusion injury,and the incidence of TTP extension was 41.18％ in the BAH group.Conclusion PWI can detect the abnormal cerebral hemodynamics in patients with BAH,which provides the basis for the timely treatment and prevention of irreversible injury in the ischemic area of the brain.

Objective To investigate whether arsenic trioxide(As2O3)with different density is capable of affecting the invasiveness of neuroblastoma(NB)cells,and to give grounds for NB therapy with As2O3.Methods 1.Well-developed NB cells were selected and exposed to 0.75 ?mol/L,1.50 ?mol/L,3.0 ?mol/L As2O3 for 24 h;2.Collect the adherence cells,count the number and float them in nutrient medium again,add them into the transwell polycarbonate membrane plate that was covered by matrigel,there were 2?104 NB cells in each well;3.After 24 h,take off the membrane,fix the cells which cross the membrane with mehanol and dye them with hematoxylin;4.Observe the NB cells and count them,so the capability of invasion of LA-N-5 was evaluated by transwell chamber assay.Results After 24 h with the different density As2O3,the number of invading LA-N-5 cells was significantly lower in As2O3 group than that in control group(the number of invading cells of the As2O3 group was 28.0?4.0,19.33?4.16,6.33?1.53,respectively,the cell number of the control group was 46.33?6.11)(P=0.013,0.003,0);among the experiment groups,there was no difference between 0.75 ?mol/L and 1.50 ?mol/L(P=0.06),and it was significantly different between 0.75 ?mol/L and 3.0 ?mol/L,1.50 ?mol/L and 3.0 ?mol/L(P=0,0.007),the number of invading LA-N-5 cells of 3.0 ?mol/L As2O3 was the least.Conclusions As2O3 could inhibit the invasive potential of NB cells;the inhibitory action of 3.0 ?mol/L As2O3 is the most.

Objective: To investigate the incidence and influencing factors of abnormal body posture among urban primary school students in Yinchuan City, and to provide evidence for the prevention and treatment of abnormal body posture. Methods: A multi stage stratified cluster random sampling method was adopted to select 1 947 urban primary school students aged 7-12 years from 9 schools in Yinchuan City. Body Style(Model.S-8.0) instrument was used to screen abnormal body posture and questionnaire was designed to investigate related factors. Results: The comprehensive body posture score of urban primary school students in Yinchuan City was(22.07±2.87), and the detection rate of abnormal posturing was 71.29%；which varied significantly by gender, age, body mass index (BMI)( χ 2=9.84, 13.47, 6.46, P <0.05). Specially, the rate of girls (73.54%) was higher than that of boys( 69.07 %); the abnormal rate of children aged 7-8(68.24%) was lower than that of 9-10(72.17%) and 11-12(73.54%); obese children (74.91%) was higher than that of overweight (72.64%) and normal weight children(70.28%). The high and low shoulders (40.73%), pelvis forward (39.39%) and X/O legs (38.57%) were the most common indicators of abnormal posture; the composition of the overall body posture abnormalities was higher in mild (54.32%) than moderate (37.82%) and severe (7.85%).Multivariate Logistic regression analysis showed that girls( OR =1.23), being older(9-10 years old OR =1.89, 11-12 years old OR = 2.48 ), overweight ( OR =1.39) and obesity( OR =2.34), occasionally participate in physical exercise ( OR =2.96), exercise duration <30 minutes daily ( OR =2.77), video duration ≥2 h daily ( OR =2.84), almost no dairy products ( OR =1.79), almost no food Fish consumption ( OR =1.77), almost no vegetables ( OR =2.14), drinking carbonated beverages daily ( OR =2.97), and sleeping time <6 h daily ( OR =2.56) were the related factors of body posture development of urban primary school students( P <0.05). Conclusion The abnormal body posture of urban primary school students in Yinchuan City is prevalent, which is related to the timely length of physical exercise, nutrition, video screen and sleep duration, and should be paid enough attention.

Objective To study the clinical characteristics and to summarize our experience in the diagnosis and treatment of ectopic splenic autotransplantation (ESAP) many years after splenic rupture and splenectomy.Methods The clinical data of 15 patients with ESAP who were treated in the People's Hospital of Zhengzhou from January 1998 to January 2013 were retrospectively analyzed.Results Of the 15 patients,2 patients presented with intestinal obstruction due to the ectopic splenic tissues and required partial resection of small intestine.In 5 patients,the ectopic splenic tissues were in the greater omentum which required resection of part or the whole of the greater omentum.In 4 patients,the ectopic splenic tissues were in the mesentery which required partial or total resection of the tissues.The ectopic tissues were in the pelvis in 3 patients and resection of the left fallopian tube was carried out in 2 patients and resection of the pelvic tissues in 1 patient.In 1 patient the diagnosis was made under laparoscopic biopsy,thus avoiding open surgery.Three patients had multiple implanted sites for these ectopic splenic tissues.Conclusions ESAP is an uncommon disease and it has no clinical characteristics.It is easy to confuse the condition with metastatic deposits.A diagnosis could be made only by combining the history with magnetic resonance imaging,or 99mTc study of red blood cells,or laparoscopic exploration and biopsy.

Objective To explore the pathological process of MR imaging and clinical characteristics of bilateral Wallerian degeneration (WD) in the middle cerebellar peduncles after pontine infarction.Methods The present article reported one patient with paramedian pontine infarction who complicated bilateral WD in the middle cerebellar peduncles after 6 months;the major data included multimode MR imaging,brainstem auditory evoked potential and blink reflex.And then,these English and Chinese literature which reported 16 patients were reviewed together.The clinical,pathology and imaging characteristics of the 17 patients were summarized.Results Seventeen patients were all paramedian pontine infarction before finding WD:5 were on the right side and 11 were on the left side and one was bilateral side.When WD was found,original symptoms of pontine infarction were aggravated in 4 patients,one appeared dizziness and 12 were without symptoms.Thirteen patients had good prognosis,and the other 4 patients involved a poor prognosis because of severe primary lesions.Wallerian degeneration were found fiom 3 weeks to 33 weeks:2 were found DWI high signal in the bilateral middle cerebellar peduncles within four weeks after pontine infarction which attributed to first stage ofWD;4 had high MRI T2 signal close to 14 weeks which were in the second stage of WD;there were 11 with high T2 and FLAIR signal,low or equal apparent diffusion coefficient signal within 16 weeks after pontine infarction which were in the third stage of WD.No cases were in the fourth stage of WD.Conclusions Bilateral symmetry WD in the middle cerebellar peduncles is easily consolidated unilateral paramedian pontine infarction.The majority of these patients can be free for clinical symptoms and MR imaging features are usually in stage 2 and stage 3 of WD.These conditions have good clinical outcomes and should be paid more attention and avoided inappropriate treatments.

Objective To explore the role of tissue inhibitor of metalloproteinase-1(TIMP-1) during renal senescence by using human TIMP-1 transgenic mice.Methods Renal histological changes of wild type mice and transgenic mice at the age of 3,12,24 months were observed by periodic acid-schiff(PAS)staining of paraffin sections.The numbers of F4/80 positive cells were detected by immunofluoreseence.The protein expressions of TIMP-1,TIMP-2,matrix metalloproteinase(MMP)-9,MMP-2,intercellular adhesion molecule-1(ICAM-1),transforming growth factor?1(TGF-?1),collagenⅢand collagenⅣwere detected by Western blot.The activities of gelatinases and TIMP-1 were examined by gelatin zymography and reverse zymography respectively.Results Focal renal fibrosis was found in two genotypes with aging.At the age of 24 months,compared with wild type,in kidneys of transgenic type,the expressions and activities of gelatinases were dowregulated (MMP-2:2.08?0.20 vs.3.39?0.43;MMP-9:4.02?0.82 vs.6.72?1.40,all P＜0.05);the expressions of collagenⅢ,collagenⅣ,ICAM-1,and TGF-?1 were upragulated(0.72+0.11 vs.0.57?0.09;0.84?0.13 vs.0.6?0.11,0.72?0.12 vs.0.53?0.07; 0.69?0.12 vs.0.45?0.09,all P＜0.05),and the numbers of F4/80 positive cells were increased (18.8?4.4 vs.12.7?3.6,P＜0.05)with the upregulated expression and activity of TIMP-1(1.10?0.18 vs.0.62?0.09;50.75?7.25 vs.20.64?3.50,P＜0.05).Conclusions TIMP-1 could promote age-related renal fibrosis through enhancing inflammation reaction by ICAM-1 upregulation.

Abstract Upper cross syndrome (UCS) is an abnormal body posture phenomenon. The detection rate of UCS in adolescents is high in China, which has become a serious public health problem threatening the health of adolescents. Exercise therapy has a positive effect on the prevention and treatment of UCS.The article reviews the pathological mechanisms of muscle imbalance, muscle interaction inhibition, and neural control related to the occurrence and development of UCS both domestically and internationally in recent years.And it elucidates the effects and corresponding mechanisms of exercise interventions such as gentle exercise, stretching exercise and physical function training on UCS, so as to provide help for the correction of UCS.

Intracranial arterial dolichoectasia (IADE), also known as dilatative arteriopathy of the brain vessels, refers to an increase in the length and diameter of at least one intracranial artery, and accounts for approximately 12% of all patients with stroke. However, the association of IADE with stroke is usually unclear. Cerebral small vessel disease (CSVD) is characterized by pathological changes in the small vessels. Clinically, patients with CSVD can be asymptomatic or present with stroke or cognitive decline. In the past 20 years, a series of studies have strongly promoted an understanding of the association between IADE and CSVD from clinical and pathological perspectives. It has been proposed that IADE and CSVD may be attributed to abnormal vascular remodeling driven by an abnormal matrix metalloproteinase/tissue inhibitor of metalloproteinase pathway. Also, IADErelated hemodynamic changes may result in initiation or progression of CSVD. Additionally, genetic factors are implicated in the pathogenesis of IADE and CSVD. Patients with Fabry’s disease and late-onset Pompe’s disease are prone to developing concomitant IADE and CSVD, and patients with collagen IV alpha 1 or 2 gene (COL4A1/COL4A2) and forkhead box C1 (FOXC1) variants present with IADE and CSVD. Race, strain, familial status, and vascular risk factors may be involved in the pathogenesis of IADE and CSVD. As well, experiments in mice have pointed to genetic strain as a predisposing factor for IADE and CSVD. However, there have been few direct genetic studies aimed towards determining the association between IADE and CSVD. In the future, more clinical and basic research studies are needed to elucidate the causal relationship between IADE and CSVD and the related molecular and genetic mechanisms.