Objective To evaluate the value of preoperative color Doppler flow imaging findings for predicting possible difficuulties encountered during laparoscopic cholecystectomy (LC).Methods Eighty-six Datients with acute cholecystitis underwent color Doppler flow imaging examination were divided into operation difficult group(67 cases)and operation easy group(19 cases)according to the diffculty score.The parameters were measured pre-operation including the volume of gallbladder,the thickness of the gallbladder wall,the condition of arterial flow in the gallbladder wall,the conditions of gallbladder cavity and gallbladder fossa and the intra-and extra-hepatic bile duet.The relationships among imaging results,operation difficulties and operation findings were investigated.Results Gallbladder volume,gallbladder wall thickness.the presence rates of plentiful arterial flow in the gallbladder wall,adhesion of gallbladder and stone incarceration In operation difficult group were significantly different from those in operation easy group [(52.6±14.6)mm~3 vs(32.6±10.4)mm~3,(9.7±4.1)mm vs(3.8±0.9)mm,89.5%(17/19)vs 17.9%(12/67),78.9%(15/19)vs 11.9%(8/67),10.5%(2,19)vs 0(0/67)](P<0.05 or<0.01).The accurate rate was 94.2%(81/86)in predicting.Conclusion Preoperative color Doppler flow imaging is helpful in predicting difficulties of LC.

AIM To study the protective effects of vesnarinone on myocardial ischemia. METHODS Rat myocardial oxide nitric (NO) content, protein kinase C (PKC) activities in different groups were determined by kits. RESULTS Vesnarinone 1 mg?kg -1 or 2 mg?kg -1 iv markedly improved the NO content and PKC activity before ischemia for 30 min and reperfusion for 2 h in rats. CONCLUSION Vesnarinone possesses a protective effect against myocardial ischemia via NO induce PKC.

Objective Two Chinese pedigrees with congenital factor Ⅻ(FⅫ)deficiency were enrolled in the present study,and studies on the clinical manifestations,family survey,biochemical examinations and gene diagnosis of these pedigrees were performed.Methods In October 2014-2015 March,two cases of hereditary FⅫ deficiency patients were included in Xinhua hospital.Activated partial thromboplastin time(APTT),FⅫ procoagulant activity(FⅫ:C),FⅫ antigen(FⅫ:Ag)and other parameters of coagulant were detected.The FⅫ deficiency pedigree members,exons 1-14,boundary introns including the splice junctions of the F12 gene were amplified with polymerase chain reaction(PCR).Direct sequencing was exerted to purified PCR product to detect the gene mutation.If the gene mutations were found,polymorphism should be ruled out by directing sequence.One hundred and three healthy persons as normal controls.Results The two probands were manifested prolonged APTT(101 s and 143 s).They showed lower FⅫ activity and FⅫ antigen(2％and 6％,0.4％and 4％,respectively).FⅡ:C,FⅦ:C,FⅧ:C,FⅨ:C,FⅩ:C and Fg are normal in the two probands.LAC is negative.Proband 1 has c.1285C>T(p.Q429 stop)mutation.His parents and son have the heterozygous mutation in the same position.Proband 2 has c.1556T>C(p.L519P)mutation.Her two sons have the heterozygous mutation in the same position.In the promoter regions of F12 gene,there were common 46C/T and 619 G/C polymorphisms in two pedigrees.Conclusion c.1285C>T(p.Q429 stop)and c.1556T>C(p.L519P)are the cause of FⅫ deficiency.

Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods Forty-one patients with Hawkins Ⅲ talus neck fracture were treated.The fractures occurred on the left side in 21 patients and on the right side in 20 patients.All patients were performed internal fixation by internal and lateral approaches.The weight bearing should be adjusted with follow-up.The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS).Results The average duration of follow-up was (37.7 ± 8.2) months.All fractures gained union and the average union time was (4.1 ±0.5) months.The average AOFAS score after treatment was (79.3 ± 2.6) scores which was higher than that before treatment [(35.1 ± 8.0) scores],and there was significant difference (P =0.026).There were 11 cases in excellent,17 cases in good,11 cases in fair and 2 cases in poor.The excellent and good rate was 68.3％ (28/41).Traumatic arthritis occurred in 18 cases (43.9％,18/41),involved tibial astragaloid joint in 4 cases,involved subtalar joint in 6 cases,involved tibial astragaloid joint and subtalar joint in 8 cases.Avascular necrosis occurred in 7 cases (17.1％,7/41).Conclusions The effect of surgical treatment for Hawkins Ⅲ talus neck fracture via a bilateral approaches is satisfactory.Pay more attention to protect blood circulation intraoperative and perform anatomic reduction according to the characteristic of body of talus displacement.After operation,functional rehabilitation should be directed by the principle of early movement,later weighted.

Objective To compare the accuracy of intraocular lens(IOL)power calculations by using 6 formulas(SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ)in different axial lengths of the eye,in order to improve the accuracy of predicating IOL powers for patients after cataract surgery.Design Retrospective comparative clinical analysis.Participants 169 patients(169 eyes)with age-related cataract underwent regular phacoemulsification and posterior chamber IOL implantation.Methods 169 eyes with cataract were divided into five groups according to the axial lengths:AXL≤22mm,22mm28.4mm.The axial lengths and keratometry of the 169 eyes were measured with A-mode ultrasound before operation,and the actual postoperative refraction was measured with the methods of computer and retinoscopy optometry when patients could gain best corrected visual acuity one month after surgery or later.Inputting the axial lengths,keratometry and IOL powers into A-mode ultrasound,the predicted postoperative refraction was calculated with SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ formulas,and the differences of predicted and actual postoperative refractions in different axial lengths were compared.Main Outcome Measures The absolute value with the differences of the predicted and actual postoperative refractions,i.e.absolute predicted errors.Results(1)Comparing the difference of predicted and actual postoperative refraction,there was no statistical significance between the five formulas in the groups of axial length(AXL)≤22mm,22mm28.4mm,but the average absolute predicted error of Haigis and SRK-T formulas is significantly smaller than SRK-Ⅱand Binkhorst-Ⅱ formulas.Conclusions In existing sample size,there was no obvious influence on postoperative refraction when using other five formulas except Binkhorst-Ⅱ.But in the extremely long AXL group,Haigis and SRK-T formulas have some ascendancy over the other formulas.

Objective To evaluate the value of predicting functional improvement of viable myocardium after percutaneous transluminal coronary angioplasty(PTCA) by strain rate imaging(SRI) combining with low-dose dobutamine stress echocardiography(LDDSE).Methods PTCA was performed in 20 patients with old myocardial infarction and 72 segments of resting dyskinetic wall motion at baseline were observed.Peak systolic strain rate(SSR) and systolic peak velocity(Vs) were measured in abnormal walls at baseline and SRI combined with LDDSE one day before PTCA.Increment of SSR and Vs was defined during stress echocardiography(?SSR% and ?V_S%).The follow-up analysis was performed 6 weeks after PTCA.Results The dyskinetic motion of 48/72 segments was improved according to the follow-up echocardiography 6 weeks after PTCA while that of 24/72 segments was not.Considering ?SSR%≥(2.02%),?V_S%≥(8.5%) in 5 ?g?kg~(-1)?min~(-1) stress and ?SSR%≥(24.7%),?V_S%≥(28.5%) in 10 ?g?kg~(-1)?min~(-1)stress as cut-offs for motion improvement of the left ventricular dyskinetic segments,the sensitivities were(93.8%),(89.6%) and(95.8%),(91.7%),respectively.At baseline SSRs of two groups were significantly different while Vs did not have significant difference.Conclusions Combined with LDDSE,SRI can more accuratly predict the motion improvement of viable myocardium than tissue velocity imaging can.

AIM To study the effect of Gardenia jasminoides Ellis on serum IL-1? and TNF-? level of rheumatoid arthritis rats, as well as its mechanism. METHODS An experimental type Ⅱ collagen-induced arthritic rats was established. The inhibitory effects on paw edema were observed, and serum IL-1? and TNF-? levels were determined in experimental rats. RESULTS Compared with models, Gardenia jasminoides Ellis inhibited paw edema on rats significantly, and the levels of serum IL-1? and TNF-? showed markedly decrease by Gardenia jasminoides Ellis at high dose to medium dose( P

Objective: To determine the contents of Paeoniflorin in Jianweiyuyang Granules by reversed phase high performance liquid chromatography. Methods: The method used a C 18 column, acetonitrile -0.05mol/L potassium phosphate solution (16∶84) as the mobile phase, flow rate of 1.0 mL/min. The detection wavelength was set at 230 nm. Results: The method of linear range was 0.0699?g～0.8388?g, The average recovery of the method was 102.14%. Conclusion: The method is simple, reliable, accurate and can be applied to the quality control of the preparation.

Objective To analysis the family management of patients with serious mental illness in Gansu prov-ince, and evaluate its effectiveness to lay the foundation for the better community-based rehabilitation management and treatment for the people with serious mental illness. Method According to Treatment-management specification of severe mental illness (2012) and specification of national basic public health services (2011), the information such as home ther-apy, medicine taken, and dangerous behavior happened were collected from patients who were confirmed as serious men-tal illness in January 2015 to April 2016 in Gansu province. Result Up to April 30th, 2016, totally 70538 serious mental illnesses were identified, and about 81.10%(57195) were under management. The rate of treatment of serious mental ill-ness was 69.9%(48009/68663) in Gansu province, and Bipolar affective disorder (76.0%) was the highest (P<0.001). The rate of taking medication in patients under family-management was 42.16%(24113/57195), and the rate of taking regular medication was 24.74%(14150/57195). The rate of taking medication in Paranoiac psychosis patients (51.98%) was the highest (P<0.001), and the rate of taking regular medication in Mental disorders caused by epilepsy (31.02%) was the highest (P<0.001). Conclusion The rate of family-management, treatment, taking medication and take regular medica-tion of serious mental illness in Gansu province are all below the national average level. A special training should be giv-en to medical professionals to strengthen their capacity to treat serious mental illness.

Objective To analyze the diagnosis and treatment of iliac pseudoaneurysms following renal transplantation.Method The data of two patients with pseudoaneurysm who underwent kidney transplantation were retrospective analysied.Result One case with pseudoaneurysm received transplant nephrectomy,and pathological examination diagnosed mucoraceae infection; the other patient received endovascular treatment and amphotericin B therapy,endly died of hemorrhagic shock.Conclusion The development of pseudoaneurysms at the kidney transplantation recipients with the same donor results in high rates of mucormycosis.They should take anti-fungus therapy and operation as early as possible.