ObjectiveTo explore the clinical effects of laparoscopic common bile duct exploration and primary suture combined with choledochoscopy (LBEPS) and laparoscopic common bile and duct exploration T-tube drainage(LCHTD) on cholelithiasis.Methods101 cholelithiasis patients were selected and,grouped by the operation methods.56 cases were treated with LCHTD,while 45 cases were treated with LBEPS.The operation time,blood lose,and postoperative digest function recovery time were ampared betreen two groups.ResultsThe operation time betreen the two groups has no significant difference(P ＞ 0.05 ),while the blood lose,postoperative digest function recovery time in LBEPS group were better than the LCHTD group( all P ＜ 0.05 ),the differences were statistically significant.Meanwhile the LBEPS group had a less complication and re-treatment rate than those of the LCHTD group ( P＜0.05).ConclusionCompared with LCHTD,LBEPS had smaller trauma,less operation complications and faster postoperative digest recovery time,worthy of clinical promotion.

Cyclooxygenase-2 (COX-2) plays an important role in the development of leukemia.COX-2 inhibitor plays a certain anti-leukemia role in the process.Many studies show that COX-2 inhibitor plays antileukemia role by inhibiting the proliferation of leukemia cell,promoting apoptosis,affecting cell cycle,inhibiting cell metastasis and reversing cell drug resistance and so on.Therefore,the researches about the anti-leukemia mechanisms of COX-2 inhibitor will provide a new target in clinical prevention and treatment of leukemia.

Objective: To optimize the extraction process for polysaccharides from the stems of Acanthopanax gracilistylus by smashing tissue extraction (STE) and to further investigate their cytotoxicity and immunological activities. Methods: Extraction process for the polysaccharides from the stems of A. gracilistylus was optimized by using the spherical symmetrical design test, and three factors were considered (material-liquid ratio, extraction temperature, and extraction time). The test compared STE with two traditional extraction methods, reflux extraction and ultrasonic extraction. The bioassay tests of cytotoxicity and immunological activities on polysaccharides extracted were studied in vitro. Results: The optimal extraction conditions for polysaccharides from the stems of A. gracilistylus were as follows: material-liquid ratio was 1:13.2, the extraction temperature was 80°C, and the extraction time was 420 s. With the best extraction conditions, the yield of polysaccharides from the stems of A. gracilistylus was 0.78%. The yield by STE was higher than those by reflux extraction and ultrasonic extraction in this research. In addition, the bioassay results showed the polysaccharides had no significant toxicity on RAW 264.7 cells at the dose of 10-20 μg/mL and facilitated the secretion of nitric oxide (NO) in the cells supernatant at the dose of 10-40 μg/mL in vitro. Conclusion: These results establish a steady and convenient extraction technology for polysaccharides from the stems of A. gracilistylus using STE method, indicating the polysaccharides have immunological activity to some extent, which provides a theoretical basis for the reasonable development of A. gracilistylus resources.

Objective:Bone marrow-derived dendritic cells ( DCs) were extracted and gave tanshinone ⅡA to intervene ,and we observed the change of DCs function ,which investigate the effects of tanshinone ⅡA in immune system.Methods:Extract bone mar-row-derived DCs,and cells were cultured in complete medium with 10 ng/ml GM-CSF and IL-4.On day 5,magnetic cell sorting was used to purify DCs,and the purify must be up to 90%.Then,a certain concentration of tanshinone ⅡA or LPS was gave to the cell cul-ture,and cells and supernatant were collected for following experiments .We used flow cytometry to detect phenotype , and enzyme-linked immunosorbent assay(ELISA) was used to detect cytokine production of TNF-αand IL-12.Also,allogeneic mixed lymphocyte reaction was used to detect the ability of DCs to induce T cell proliferation and polarization .Results:When the concentration of tanshi-none ⅡA was 500 ng/ml,the inhibition of secretion of TNF-αwas maximal.So we chose that concentration .Compared with the control group,DCs in experimental group had reduced expression of CD 80,CD86 and MHCⅡ(P<0.05).Compared with the control group ,DCs in experimental group displayed the reduced level of IL-12 and TNF-α(P<0.05).Compared with the control group,DCs in experimen-tal group had reduced ability to induce T cell proliferation (P<0.05).Compared with the control group ,DCs in experimental group in-duced T cell to secret increased level of IL-4,and reduced level of IFN-γ(P<0.05).Conclusion:TanshinoneⅡA can inhibit the den-dritic cells maturation induced by LPS ,which takes part in immune system and autoimmune diseases .

Objective To investigate the changes of cardiac structure and function in type 2 diabetes mellitus (T2DM), analyze the related risk factors of heart failure, and improve the awareness of the effect of diabetes on the heart. Methods Randomly selected 170 cases of T2DM patients As the object of study, 170 cases of non diabetic patients as con-trol group, according to whether complicated with heart failure were divided into heart failure patients and non heart failure patients.Comparison of each group left ventricular posterior wall thickness, left ventricular end diastolic diameter, left ven-tricular end systolic diameter, left ventricular ejection fraction, E/A ratio Differences, analysis of the related risk factors of heart failure by logistic regressive.Results T2DM group left ventricular posterior wall thickness, left ventricular end diastolic diameter and left ventricular end systolic diameter increased , Left ventricular ejection fraction decreased, E/A ratio de-creased, were statistically significant difference compared with the control group (p <0.05).These differences are mainly come from non heart failure patients.Logistic regression showed that factors in patients with diabetes duration, HbA1c, com-pliance and complications of hypertension, coronary heart disease, is a risk factor for heart failure complicated with T2DM (all p<0.01).These may be the risk factor for diabetic patients with heart failure.Conclusion Diabetes can cause cardiac remodeling, systolic and diastolic dysfunction maybe some T2DM patients.They did not show symptoms of heart failure in the clinical, but their Cardiac structure and function are abnormal.We should pay attention to the cardiac function examination and early evaluation, prevention of risk factors, to avoid the occurrence of heart failure.

Objective To assess the benefit of intraoperatively placed nasointestinal feeding tubes for early postoperative enteral nutrition.Methods The retrospective study was carried out on 19 cases of in-fants with long gap esophageal atresia who underwent one-stage operation in Xinhua Hospital from January 2006 to December 2013.Patients were divided into two groups according to whether the transanastomotic na-sointestinal feeding tubes(TNFT)were placed.Demographics,associated anomalies,operative findings,com-plications,duration of enteral nutrition(EN),length of stay were analyzed.Results Thirty-seven patients had long gap esophageal atresia and nineteen underwent one-stage operation.Eight patients were identified as TNFT group while eleven patients were identified as nonfeeding tube(NFT)group.There was no significant differences between the two groups in gestational age,birth weight,associated anomalies,anastomotic leak, weight gain,ICU-free days and length of stay(P>0.05).But the ventilator-free days(23.5 d vs.19.3 d), first EN time(0.8 d vs.9.1 d)and total EN feeding time(15.9 d vs.21.4 d)between the two groups were significantly different(P<0.05 ).Conclusion Intraoperatively placed TNFT may lead to earlier EN feeding and shorter parenteral nutrition duration,but a larger prospective study would be required to prove the benefits and ensure the safety.

Objective To investigate application value of two vacuum assisted biopsy systems in benign breast lesions and compare the advantages and disadvantages of EnCor and Mammotome system.Methods Vacuum assisted excision was performed on 346 benign breast lesions in 227 patients (EnCor with 103 cases, Mammotome with 124 cases) from November 2012 to May 2013, including 162 cases using EnCor system and 184 cases using Mammotome system.Results Duration of operation in EnCor group was (14.18± 4.21) minutes,in Mammotome group was (18.77 ± 7.06) minutes, and the difference was significant (P ＜ 0.001) .Weight of tissues in Mammotome group was (6.87± 3.43) g, in EnCor group was (8.32± 1.18) g, and the difference was significant (P ＜ 0.001).No significant differences were found in postoperative hematoma (P =0.58), postoperative pain (P =0.35), incidence of residual tumor (P =0.15).Conclusion Compared Mammotome group, EnCor group had significantly shorter duration.But using Mammotome system, the specimens can be observed directly.Mammotome is more suitable for women of childbearing age, it can preserve lactation function.There is no significant difference in complication and residual tumor of two vacuum assisted biopsy system in benign breast lesions.

Objective To investigate the effect of nuclear factor ?B(NF-?B)decoy on the chemokine expression in bladder cancer cell line. Methods Human bladder cancer cell line EJ,NF-?B decoy ODN were used as a NF-?B inhibitor(scrambled NF-?B decoy was used as control).NF-?B DNA binding activity was detected by electrophoretic mobility shift assay (EMSA);and p65 subunit of NF-?B was detected by RT-PCR and Western blot.Chemokines including IL-8,MCP-1,RANTES were detected by RT-PCR. Results EMSA showed that NF-?B decoy inhibited NF-?B activation induced by TNF-?.RT-PCR or Western blot test suggested that p65,IL-8,MCP-1 and RANTES were upregulated by TNF-? and downregulated by NF-?B decoy.However,mutated decoy ODN had no effect on them. Conclusions Chemokines can be detected in bladder cancer.They are activated by TNF-? and inhibited by NF-?B decoy.

Objective To study the effects and clinical significance of tea pigment on 24 hour urinary endothelin(UET) excretion in patients with early stage diabetic nephropathy.Methods 65 cases of early stage diabetic nephropathy were randomly divided into expermental group and control group.Control group was treated by routine treatment and the expermental group was treated by tea pigment,in addition to routine treatment,and was orally given tea pigment capsule 0 24g three time daily,for 8 weeks.The amounts of 24 hours UET and urinary albumin excretion rate(UAER)in the two groups patients before and after treatment were measured using radioimmunoassay method.Results The amounts of 24 hour UET in patients with diabetic nephropathy were elevated significantly as compared with those in normal control group(P0 05).After 8 week's treatment,the amounts of 24 hour UET and UAER in expermental group were significantly lower than those of control group(P

Objective To investigate the clinicopathologic features and the expression of p53,PCNA and Bcl-2in tricholemmal carcinoma.Methods Skin lesions were studied with HE staining and immunohis-tochemical markers for p53,PCNA and Bcl-2(S-P method)in22cases of skin tricholemmal carcinoma.Both morphological manifestations and immunohistochemical expression were observed.Results There were15fe-male and7male cases of tricholemmal carcinoma with the ages of40-79y,including16cases whose scalp were involved.Positive staining of p53,PCNA and Bcl-2was found in72%,100%and63%of patients,re-spectively.The positive cells of p53were diffusely distributed.PCNA-positive cells were increased along with the degree of differentiation.Significant differences of Bcl-2expression were found among the various degrees of differentiation(P