AIM:To observe the effects of Tianma Gouteng Decoction on mRNA expression of L-Type Calcium Channel ?1 C subunit (CaL-?1C) and plasma membrane calcium-ATPase (PMCA1) in vascular smooth muscle cells of spontaneously hypertensive rat (SHR). METHODS:Twelve-week-old SHRs were assigned randomly to 5 groups:group A (treated with Tianma Gouteng Decoction),group B (treated with Tianma Gouteng Decoction excluded concha haliotidis),group C (treated with Nifedipine),group D (treated with concha haliotidis),group E (treated with normal sodium,NS),each group consisted of 9 rats was adminstrated,once a day for 4 weeks and mRNA expression of CaL-?1C and PMCA1 was measured with RT-PCR half-fix-quantify method. RESULTS:After 4-week-treatment,both Tianma Gouteng Decoction,Tianma Gouteng Decoction excluded concha haliotidis and Nifedipine could regulate downward mRNA expression of CaL-?1C in vascular smooth muscle cells and regulate upward mRNA expression of PMCA1 in vascular smooth muscle cells,concha haliotidis has no effect on mRNA expression of CaL-?1C and PMCA1. CONCLUSION:Tianma Gouteng Decoction can regulate downward expression of CaL-?1C,and regulate upward expression of PMCA1 at the same time,and meliorate the Ca 2+ overload in vascular smooth muscle cells with hypertension.

Objective To evaluate the effect of mini-abdominal incision for choledochoscopy via cystic duct in exploration of the common bile duct(CBD).Methods The right subcostal incision was 4-6 cm in length.Choledochoscopy via cystic duct stump for exploration and extraction of CBD stones was done in 135 cases.Results The CBD stone was removed in 109 of 135 patients(80.7%).The CBD exploration was negative in 26 cases(19.3%)and retained CBD stones occurred in 4 cases(3.0%).One case(0.7%)had intraoperative injury of common bile duct,2 cases(1.5%)had tear of cystic duct stump,and 2 cases(1.5%)had biliary leakage,all the 5 cases were recovered after treatment.Conclusions The mini-abdominal incision with choledochoscopy via cystic duct for exploration of the CBD is safe and feasible.

Objective To explore early endoscopic diagnosis and treatment of the clinical value of biliarypancreatitis. Methods From January 2007 to December 2009 completed 93 cases acute pancreatitis of endoscopic treatment,routining for endoscopic incision nipple,observed remission of symptoms and recurrence after treatment. Results In these cases acute biliarypancreatitis was 62.4% (58/93),occult biliarypancreatitis diagnosed by endoscopy was 27.6% (16/58),remission rate was 93.8% (15/16),no surgical operation and recurrence. Conclusion Occult biliarypancreatitis occupies a certain proportion of acute pancreatitis,also easily missed diagnosis and recurred,endoscopy is currently the most effective method.

Objective To determine the value of ERCP and EST after Billroth gastroenterostomy. Methods ERCP was used in 31 patients after Billroth- Ⅰ gastroenterostomy, 12 of whom received EST. It was in 137 patients after Billroth-Ⅱ gastroenterostomy, of the 34 received EST and 4 EPBD.Results Billroth- Ⅰ gastroenterostomy ERCP was successfully performed in 28 out of the 31 patients and EST in 11 out of the 12 patients. Billroth- Ⅱ gastroenterostomy ERCP was successfully performed in 109 out of the 137 patients and EST in 31 out of the 38 patients. There were no serious complications in patients receiving endoscopic treatments. Concluasion The success rates of ERCP and EST are high in patients with bile duct lithiasis after Billroth-gastroenterostomy. Endoscopic treatment or cholangioduodenostomy has good therapeutic effects.

Objective To investigate the effectiveness and safety of applying midzolam combined with propofol in conscious sedative and analgesic colonoscopy.Methods 145 cases of ASA I-II were included in this study.The patients were randomly divided into two Groups:Group A(painless colonoscopy),Group B(conventional colonoscopy).Group A was given midazolam 0.05mg/kg、fentanyl 1?g/kg intravenously before operation.Group B was underwent conventional colonoscopy.Results The MAP,SpO2 at 1min after injection is lower significantly than that before injection in Group A(P0.05).The incidence of respiratory inhibition(SPO2

Objective:To investigate the correlation of the blood concentration of tacrolimus ( Tac) and serum cystatin C ( SCysC) and serum creatinine (Scr) in the patients with renal transplantation. Methods:Totally 84 cases of renal transplantation patients (67 male/17 female) treated with Tac were involved. The blood concentration of Tac, SCysC and Scr were monitored after the operation. Data results were categorized according to the postoperative time and the blood concentration. The correlations of Tac blood concentra-tion,SCysC and Scr were analyzed and compared by using Pearson correlation analysis. Results: The blood concentration of Tac was not significantly associated with SCysC and Scr in different postoperative time groups and different drug concentration groups ( P >0. 05). As the extension of time,the blood concentration of Tac showed a gradual declining trend, while SCysC and Scr levels de-creased first, and then increased gradually after two years of the operation. Conclusion:The blood concentration of Tac has no effect on the function evaluation of transplanted kidney by the biochemical indicators such as SCysC and Scr.

Objective To investigate the causes of and prophylactic measure for complications of minilaparotomy cholecystectomy (MC).Methods The clinical data of 10 200 patients receiving MC from Apri1 1991 to March 2006 were analyzed.Results MC was successful in 9 835 cases(96.4%), and in 365 cases(3.6%) the incision was lengthened. Serious complications were 12 cases(0.12%)of bi1e duct injury, 4 cases(0.04%)of colon injury, 8 cases(0.08%)of massive haemorrhage, and 25 cases (0.25%)of bile leakage. Four 4 cases(0.04%) died. Conclusions The key to prevention of complications is a strict selection of MC indications,careful identification of the anatomical structures of Calot's triangle,use of suture ligation of the mesentery of gallbladder triangle and the technique of deep knot-tying and the timely use of extension of the incision.

Objective To detect the infection and subtype distribution of human papillomavirus (HPV) in cervical epithelial cell line in the People's Hospital of Jinhua.Methods 26 kinds of HPV genotypes were detected by gene chip,and the infection states among all subtypes were analyzed.Results A total of 25 genotypes of HPV were identified in 984 female patients,with the positive rate of 36.89％.The top three common high-risk HPV,ranging from high to low according to positive rate were HPV-16,58 and 52.The positive rates of high-risk HPV,low-risk HPV and multiple infection rate were 25.91％,5.69％ and 5.28％,respectively.The positive rates of the age groups of 21-30 years,＞ 30-40 years and ＞ 40 years were 42.33 ％,35.23％ and 35.94％,respectively.There were significant differences among the three age groups in the detection rate of high-risk HPV,low-risk type and multiple infection rate(x2 =71.58,P ＜ 0.05).Conclusion HPV 16,58 and 52 are the main high-risk genotypes of the 984 women in our hospital.The genotyping of HPV has important significance in the prevention,treatment and etiology of cervical cancer,as well as in the study of HPV vaccine.

Objective To observe the effects of perfusion of rosiglitazone (RSG) in lesion areas on the expression levels of the perihematomal tight junction-associated proteins occludin and zonula occluden-1 (ZO-1) mRNA,the permeability of blood-brain-barrier (BBB),and neurological function score in a rabbit model of cerebral hemorrhage (ICH).Methods A total of 45 healthy male rabbits were selected (a body mass of 2.0 to 2.5 kg).They were divided into 3 groups,a control group,a ICH model group,and a RSG treatment group (n =15,5 of them for BBB determination) according to the random number table.The control group was use to simulate the process of making intracranial hematoma.After successful puncture,the target was iujected with isotonic saline 0.3 ml and isotonic saline 0.1 ml was injected again after 6 h;after successful puncture,the ICH model group was injected with 0.3 ml of autologous non-anticoagulant arterial blood,and the target was injected into isotonic saline 0.1 ml after 6 h;RSG 0.5 mg was infused into the hematoma area (dissolved in 0.1 ml isotonic saline) in the RSG treatment group at 6 h after the ICH model was successfully induced.All rabbits in each group were sacrificed on day 7 after the neurological deficit scale score (Purdy score).Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression levels of perihematomal oecludin and ZO-1 mRNA.The formamide method was used to measure the Evans blue (EB) content in the perihematomal tissue in order to evaluate the permeability of BBB.Results (1) Neurological function scores:Purdy scores of the control group,ICH model group,and RSG treatment group were 2.53 ± 0.05,8.13 ± 0.06),and 6.67 ± 0.08,respectively.There were significant differences among the groups (F =459.116,P ＜ 0.01).Compared with the control group,Purdy scores of the ICH model group and RSG treatment group were increased significantly (all P ＜ 0.01).Compared with the ICH model group,Purdy scores of the RSG treatment group were decreased (P ＜ 0.05).(2) The expression levels of occludin and ZO-1 mRNA:The differences were statistically significant in occludin and ZO-1 mRNA in the control group,ICH model group,and RSG treatment group (1.013 ±0.051,1.001 ± 0.045;0.221 ± 0.017,0.247 ± 0.019;0.498 ± 0.041,and 0.613 ± 0.045,respectively in each group;F =443.924 and 381.929 respectively,all P ＜ 0.01).Compared with the control group,the expression levels of occludin and ZO-1 mRNA were significantly decreased in the ICH model group and RSG treatment group (all P ＜ 0.01).Compared with the ICH model group,the expression levels of occludin and ZO-1 mRNA were increased in the RSG treatment group (all P ＜ 0.05).(3) The permeability of BBB:The EB content in the control group,ICH model group,and RSG treatment group were 12.0 ± 1.0,51.6 ± 0.9,and 36.4 ± 1.0 μg/g,respectively.The differences were statistically significant among the groups (F =223.516,P ＜ 0.01).Compared with the control group,the EB content was significantly increased in the ICH model group and RSG treatment group (all P ＜ 0.01).Compared with the model group,the EB content was significantly decreased in the RSG treatment group (P ＜ 0.01).Conclusion The perfusion of RSG in the lesion area can significantly improve the neurological function of rabbits after ICH,increase the expression levels of occludin and ZO-1 mRNA in the perihematomal tissue,and decrease the permeability of BBB.

OBJECTIVETo evaluate the effect and safety of enucleation of insulinoma under the Da Vinci robotic surgical system combination with intraoperative ultrasonography(IOUS) for the localization.

METHODSThe clinical materials of 50 insulinoma cases which underwent IOUS and assisted by the robotic surgical system from September 2012 to September 2014 in Peking Union Medical College Hospital were reviewed retrospectively. The patients were followed up by outpatient review and telephone until October 2014. The diagnostic accuracy rate, operation time, blood loss, complications and cure rate were analyzed by t-test.

RESULTSThe locations of tumors were 13 in the head, 21 in the body and 13 in the tail of pancreas, 2 were multiple insulinoma, 1 was ectopic to mesenterium.The average operation time was 142 minutes; the average blood loss was 165 ml.Three(6.0%) patients were transformed to open.One patient experienced postoperative bleeding about 300 ml on the 7(th) day after operation and no infection and perioperative death.Thirty-five cases were of class A and 14 of class B according to the clinical grading of postoperative pancreatic fistula.The blood glucose 60 minutes after tumor dissection was significantly elevated than that before operation ((6.2±1.8)mmol/L vs.(3.7±1.2)mmol/L)(t=-6.89, P<0.01). The cure rate was 100% as all the patients' symptoms were disappeared during follow-up time.

CONCLUSIONSCombination IOUS is a highly sensitive method for the localization of insulinoma, which is helpful in localizing tumors precisely in insulinoma cases assisted by robotic surgical system and shortening operation time.It is safe and effective for insulinoma enucleation.

Blood Glucose ; analysis ; Humans ; Insulinoma ; diagnostic imaging ; surgery ; Operative Time ; Pancreas ; diagnostic imaging ; surgery ; Pancreatic Neoplasms ; diagnostic imaging ; surgery ; Postoperative Complications ; Retrospective Studies ; Robotic Surgical Procedures ; Ultrasonography