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 provide anatomic evidence for the application of the lateral thigh perforator flap.Methods Dissected five fresh Chinese adult lower limbs specimens which were injected with red latex via arterial cannula.On the lateral area of middle and distal thigh,obseved the number,distribution,course,category,length of pedicle and external diameter of the flaps' perforators on specimens.Results On the lateral area of middle and distal thigh 19 perforator arteris were observed in these specimens,averagely there were (3.8 ± 1.3) cutaneous perforators in each flap.Perforators mainly origined from the third perforator artery of profunda femoris,secondly from the second,fourth perforator artery and superior lateral genicular artery.Cutaneous perforators of the third perforator artery of profunda femoris pierced the flap on (13.8 ± 1.5) cm proximal of the fibulae capitulum,while the cutaneous perforators of superior lateral genicular artery on (8.6 ± 1.3) cm proximal of the fibulae capitulum.Averagely internal diameter of cutaneous perforators was (0.7 ± 0.2) mm at the point where the perforators pierced deep fascia.The diameter of the profunda femoris was (1.9 ± 0.2) mm,and the pedicle length was (12.2 ± 0.6)cm.The diameter of superior lateral genicular artery was (1.5 ± 0.2)mm,and the pedicle length was (6.8 ± 1.1) cm.There were inosculated branch in these perforators which came from profunda femoris and superior lateral genicular artery.Conclusion The anatomic characteristic allowed this flap would likely be clinically useful in repairing soft tissue defects in extremity limbs as a free or pedicled flap,which the cutaneous perforators invariably appeared on the skin of lateral areat of middle and distal thigh ; the flap could obtain enough length of the pedicle from its origination ; the vessel has large caliber supporting a substantial cutaneous territory.

Objective To investigate the effects and clinical value of neoadjuvant chemotherapy in patients with locally advanced cervical cancer.Methods 102 cases with locally advanced cervical cancer treated were randomly divided into observation group and control group,the observation group received the surgery after the neoadjuvant chemotherapy,and the control group was given a direct surgical treatment.Operative time,blood loss and postoperative pathologic results were observed,and chemotherapy and toxicity evaluation were made for the observation group.Results The chemotherapy effective rate of the observation group was 74.51％,and the toxicity could be tolerated;the operation time and blood loss of the observation group were significantly lower than those of the control group(all P ＜ 0.05) ;surgical trauma and postoperative complications' occurrence rate of the observation group were significantly lower than those of the control group (all P ＜ 0.05) ; pelvic lymph node metastasis and vaginal cutting edge of the residues of the observation group were significantly lower than those of the control group (all P ＜ 0.05).Conclusion For locally advanced cervical cancer,NACT has a positive significance in reducing the tumor volume,low-er tumor stage,and at the same time reducing the difficulty of operation,surgical trauma,postoperative complications,and preventing recurrence and metastasis,which can be used as a better adjuvant treatment program for locally advanced cervical cancer.

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.

To investigate the inhibitory effects of siRNA expression vector on proto-oncogene Pokemon expression in SW480 cells and to provide experimental basis for further research about the biological function of Pokemon.siRNA expression vectors were constructed to express a short hairpin RNA against Pokemon.The recombinants were transfected into SW480 cells with liposome.Cellular morphology and transfection efficiency were observed.The expression of Pokemon were checked by real-time fluorescence quantitative PCR and Western blot.MTT assay was used to detect the effect of siRNA on the growth of SW480 cells and Fluorescence Activated Cell Sorter was applied to study cell apoptosis of SW480 cells.The transfection efficiency was about 36% and the cellular morphology changed greatly at 48h after transfection.siRNA expression vectors could specifically reduce the expression of Pokemon mRNA and protein in SW480 cells.Compared with negative control,the inhibition ratio of Pokemon mRNA expression was 34.2% and 67.7%,in 24th hour and 48th hour,the inhibition ratio of Pokemon protein was 48.3% and 73.6%,in 48th and 72th hour,respectively.Transfection with Pokemon siRNA expression vectors could inhibit cell growth and induce cell apoptosis of SW480 cells.siRNA expression vectors were successfully established that could effectively inhibit the expression of Pokemon in SW480 cells.Pokemon gene silencing could decrease growth and increase apoptosis of SW480 cells.

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.