Objective To explore the correlation between carotid atherosclerosis and cerebral infarction through checking carotid atherosclerosis.Methods Intima-media thickness of carotid arterial,carotid atherosclerosis plaque score and degree of stenosis are measured in both infarction groups(200 cases)and control group(200 cases).Patients with carotid atherosclerosis plaque were treated with aspirin and siavaastatin and then the plaque after theray was compared with itself before theray in size of plaque and degree of sclerosis.Resluts The incidence rate of carotid atherosclerosis plaque is 70% in infarction group and 28% in control group;The incidence rate of moderate-severe carotid stenosis is 22% in infarction group and 6% in control group.The difference between infarction and control group is significant in intima-media thickness of carotid arterial,size of carotid atherosclerosis plaque and level of stenosis(P

Objective To observe the effect of laparoscopy combined with choledochoscopy in treatment of cholelithiasis clinical effect .Methods 80 cases diagnosed as cholelithiasis cases were divided into control group and observation group with 40 cases in each group .The control group used the traditional laparotomy incision gallbladder stone ;observation group were treated by laparos-copy combined with choledochoscopy .Results In the observation group ,the operation and the hospital stay were significantly shor-ter than the control group ,operation curative effect was obviously superior to the control group ,the incidence of postoperative com-plications was significantly lower than the control group .Conclusion The use of laparoscopy combined with choledochoscopy tech-nology in treatment of gallstones have good clinical effect .

OBJECTIVE:To establish a method for simultaneous determination of pulchinenoside B4,caffeic acid,baicalin, palmatine hydrochloride and berberine hydrochloride in Baipuhuang tablets. METHODS:HPLC method was adopted. The determi-nation of Agela Technologies Venusil XBP C18(L)with mobile phase consisted of acetonitrile-0.05 mol/L monopotassium phosphate (gradient elution)at the flow rate of 0.8 mL/min. The detection wavelengths were set at 203 nm(pulchinenoside B4)and 323 nm (caffeic acid,baicalin,palmatine hydrochloride,berberine hydrochloride). The column temperature was set at 30 ℃,and the sam-ple size was 10 μL. RESULTS:The linear ranges were 0.08141-8.141μg for pulchinenoside B4(r=0.9998),0.01871-1.871 μg for caffeic acid (r=0.9994),0.03733-3.733 μg for baicalin (r=0.9992),0.02885-2.885 μg for palmatine hydrochloride (r=0.9996) and 0.02758-2.758 μg for berberine hydrochloride (r=0.9997). The limits of quantitation were 0.009,0.006,0.008, 0.011,0.013 ng,respectively. The limits of detection were 0.030,0.020,0.025,0.034,0.036 ng,respectively. RSDs of preci-sion,stability and reproducibility tests were all lower than 2.0%. The average recoveries were 97.39%-102.34%(RSD=1.81%,n=6),96.77%-98.92%(RSD=0.85%,n=6),97.38%-103.72%(RSD=2.46%,n=6),96.73%-102.01%(RSD=2.22%,n=6)and 96.47%-101.07%(RSD=1.61%,n=6),respectively. CONCLUSIONS:The method is simple,accurate and reproducibility,and can be used for simultaneous determination of pulchinenoside B4,caffeic acid,baicalin,palmatine hydrochloride and berberine hy-drochloride in Baipuhuang tablet.

Objective To observe the change of brain iron content in deep gray nucleus using susceptibility weighted imaging (SWI) in patients with Parkinson's diseases (PD). Methods The SWI examination was performed in 40 PD patients (10 patients with Hoehn-Yahr stage Ⅰ , 9 patients with Hoehn-Yahr stage Ⅱ , 9 patients with Hoehn Yahr stage Ⅲ , 6 patients with Hoehn-Yahr stage Ⅳ, 6 ptients with Hoehn Yahr stage Ⅴ ) and 33 gender- and age- matched controls, after conventional brain magnetic resonance imaging examination on a 3.0T magnetic resonance imaging.The signal values of substantia nigra zona compacta (SNc), substantia nigra zona reticulate (SNr),red nucleus (RN), putamen (Pu), globus pallidus (GP) and caudate nucleus (CN) were assessed.Results Compared with the controls, the PD patients had statistically significance of signal value differences of SNc (P=0.002), SNr (P=0.043). RN (P= 0.003), Pu (P=0.023). GP (P=0.001) andCN (P=0.033). The more significant differences of SNc(P=0.001), SNr (P=0.010),RN (P＜0. 001 ), Pu (P=0. 008), GP (P＜0. 001) and CN (P=0. 011) were observed between more severe PD lesion and control. The signal values of SNc and GP showed obviously negative correlations with Hoehn-Yahr grading (SNcr=-0.943. P＜0.001; GPr=-0.923, P＜0.001). But there was weakly correlation of the signal values of SNr, RN, Pu, CN with Hoehn Yahr grading (SNr r=0. 496. P=0.001; RN r=-0. 480. P=0.002; Pu r=-0. 494, P=0.001; CN r=-0.471, P=0.002) Conclusions Measurement of the brain iron content of SNc and GP using SWI on MRI is a reliable means of diagnosing PD, and it has significant correlation with Hoehn-Yahr grading, It could evaluate the severity of PD.

Objective To investigate the application value of perioperative enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) in the treatment of choledocholithiasis.Methods The clinical data of 84 patients with choledocholithiasis who were admitted to the Yijishan Hospital from January 2011 to December 2013 were prospectively analyzed.A single-blind,randomized,controlled study was performed in the 75 patients who were allocated into the control group and the enhanced recovery after surgery group (ERAS group) based on a random number table.All the patients underwent LCBDE,the patients in the control group received conventional perioperative management and the patients in the ERAS group received perioperative management according to enhanced recovery rehabilitation program.All the patients were followed up by outpatient interview till postoperative month 6.The clinical features,liver function and residual stones in the patients were observed.The operation time,postoperative complications,postoperative intestinal function recovery,duration of hospital stay and hospital expenses in the two groups were compared.Measurement data with normal distribution were presented as x ± s.Comparison between groups were evaluated with an independant sample t test.Count data were analyzed using the chi-square test.Results All the 75 eligible patients undergoing successful operation were randomly divided into the control group (35 patients) and the ERAS group (40 patients).The operation time and volume of intraoperative blood loss in the control group and the ERAS group were (185 ±46)minutes and (124 ±28)mL,(178 ±37) minutes and (114 ±32)mL,respectively,with no significant difference (t =0.729,1.431,P ＞ 0.05).There were 12,14 and 10 patients in the control group and 5,6 and 4 patients in the ERAS group with postoperative incision pain,vomit and infection,showing a significant difference (x2=5.054,5.966,4.241,P ＜ 0.05).The level of white blood cell,alanine aminotrausferase and direct bilirubin in the control group and in the ERAS group were (11.4 ± 3.5) × 109/L,(128 ± 33)U/L,(38 ±14) μmol/L and (10.6 ± 3.0) × 109/L,(135 ± 35) U/L,(44 ± 16) μmol/L at postoperative day 1,compared with (7.8 ±2.9) × 109/L,(48 ± 14) U/L,(21 ± 8) μmol/L and (6.9 ±2.1) × 109/L,(43 ± 13) U/L,(20 ±7) μmol/L in the 2 groups at postoperative day 4,respectively,showing no significant difference between the 2 groups (t =1.018,-0.872,-1.767,1.553,1.836,1.044,P ＞ 0.05).The postoperative first flatus day,time of food intake,time of postoperative infusion and duration of hospital stay were (42 ± 13)hour,(45 ±14) hours,(6.8 ±2.3)days and (11.3 ±4.5)days in the control group,and (35± 11)hours,(19 ±7)hours,(4.2 ± 1.8) days and (9.6 ± 2.4) days in the ERAS group,with a significant difference between the 2 groups (t =2.741,10.524,5.485,2.077,P ＜ 0.05).The total hospital expenses was (18 729 ± 3 127) yuan in the control group,which was significantly greater than (16 981 ±2 756) yuan in the ERAS group (t =2.574,P ＜ 0.05).The liver function of all the patients was recovered at the postoperative month 1.Four patients with residual stones in the 2 groups were detected by T-tube cholangiography,and were cured by removal of gallstones by choledochoscopy.There were no complications of the abdominal pain,jaundice and fever in all the patients till the end of follow-up.Conclusion ERAS combined with LCBDE for the treatment of choledocholithiasis is safe and feasible,with the advantages of low morbidity,quick recovery,short duration of hospital stay and less hospital expenses.

Objective To explore the use of the right hepatic pedicle to guide classification of liver neoplasms on medical imaging and the type of liver resection.Methods From January 2009 to December 2012,32 patients with a single liver neoplasm surrounding the right hepatic pedicle,including 17 patients with primary liver cancer and 15 patients with cavernous hemangioma of liver,were recruited into this study in our hospital.Using the position of the neoplasm in relation to the right hepatic pedicle on CT or MRI,these liver neoplasms were divided into 4 types:type A neoplasms which infiltrated or surrounded the right hepatic pedicle; type B neoplasms which were in the front of the right hepatic pedicle; type C neoplasms which were at the back of the right hepatic pedicle,and type D neoplasms which were between the two branches of the right hepatic pedicle.Before surgery,a simulated plan was designed on the different hepatic vascular inflow obstruction and types of hepatectomy based on the classification in medical imaging.Results The locations of the liver neoplasm were completely in line with the preoperative imaging classification.Boththe vascular flow obstruction and the types of hepatectomy correlated with the preoperative surgery simulation planning.Five patients with type A neoplasms underwent right hemihepatectomy or extended right hepatectomy; 8 with type B tumors underwent right anterior sectionectomy or mesohepatectomy; 9 with type C neoplasms underwent segment Ⅴ,Ⅵ resection; 10 with type D tumors underwent right anterior or right posterior sectionectomy.Pringle maneuver,total hepatic blood inflow obstruction and selective right hepatic blood inflow obstruction were applied according to the operation and the regional anatomical structures.All operations were smoothly carried out with an average operation time of 145 min.The average blood loss was 320 ml and 18 patients required intraoperative blood transfusion with an average blood transfusion amount of 460 ml.Postoperative complications included bile leakage (n =3),right pleural effusion (n =2) and hemorrhage (n =1).They all responded to conservative treatment.Conclusion This classification using preoperative medical imaging of the right hepatic pedical could provide important information for liver resection,and it is helpful for formulating more refined operation scheme.

102 cases of Tourette's syndrome were divided into three types of the liver and kidney yin deficiency, phlegm and damp blockage and spleen and stomach deficiency.Acupuncture, auricular-plaster therapy, cupping therapy and herbal medicine were combined to treat this syndrome. As a result, 30 cases were satisfactorily effective, 61 cases were improved and 11 cases were ineffective with a total effective rate of 98.2% and no side effects were noticed during treatment.

Objective To investigate the relationship between growth inhibiting effect of arsenic trioxide(As_2O_3) and phosphorylation of P27kip threonine residue 187(P27T187) in human hepatocellular carcinoma(HCC) cell line SMMC-7721.Methods SMMC-7721 were treated for 72 h with 2 ?mol/L As_2O_3.The cell growth inhibition was detected by cell counting and the cell cycle was detected by flow cytometry(FCM).The expression and localization of P27,T187 phosphorylated P27(p-P27T187) were detected by Subcellular Fractionation,Western blot and immunoflurescence.Results As_2O_3 significantly inhibited the proliferation of SMMC-7721 cell and cell cycle was arrested in G2/M.A significant decrease in p-P27T187 expression and a reciprocal increase in P27 expression were found in 2 ?mol/L As_2O_3-treated SMMC-7721 cell.Meanwhile,As_2O_3 decreased the protein levels of Cdk2 and cyclinE.The location of P27 was transferred from cytoplasm to nuclei and the expression of p-P27T187 was decreased in nuclei.Conclusion As_2O_3 inhibits the phosphorylation of P27T187,thereby promoting P27 accumu-lation in SMMC-7721 cell nuclei,inducing cel1 cycle arrest and growth inhibition.

Objective To investigate the expression of C-JUN activation domain binding protein 1(JAB1)and its relationship with expression of P27 protein in human hepatocellular carcinoma(HCC),and to determine whether JAB1 is associated with clinicopathological parameters and prognosis of HCC.Methods Immunohistochemical analysis was performed to investigate the expression of JAB1 and P27 in 76 cases of HCC and adjacent nontumorous tissues.Fresh tumor tissues and their adjacent nontumorous tissues from 8 cases of HCC were collected for Western blot and immunoprecipitation assays.Results The expression of JAB1 in HCC was significantly higher than that in adjacent nontumorous tissues.In contrast,P27 level was higher in nontumorous liver tissues than that in HCC.JAB1 overexpression was correlated with histological differentiation,serum alpha-fetoprotein(AFP)level and metastasis(P

Objective To detect the differences of triggering receptor expressed on myeloid cells-1 (TREM-1) and cyclo-oxygenase-2 (COX-2) expressions in rectal cancer tissues and carcinoma adjacent tissues so as to explore the relationship between the two factors and clinical pathological characteristics and their effects on the patients` survival.Methods The expressions of TREM-1 and COX-2 were analyzed in 68 cases of rectal cancer tissues and 58 cases of carcinoma adjacent tissues with the method of immunohistochemical staining.We made a regular follow-up of the patients, analyzed the relationship between the two factors and prognosis of rectal cancer.Results The positive expression rates of TREM-1 and COX-2 in rectal cancer tissues were higher than those in carcinoma adjacent tissues (P<0.05).The expression of TREM-1 was related to lymph node metastasis, while COX-2 was related to pathological stage and lymph node metastasis (P<0.05).However, the two factors were not related to age, sex, histological differentiation or tumor size.The expressions of the two factors were positively correlated (r=0.550, P<0.001).The overall survival (OS) of TREM-1 and COX-2 positive expression groups was shorter than that of the negative groups (P<0.05).Cox multiple regression analysis showed that the expression of TREM-1, pathological stage, lymph node metastasis and tumor size affected the prognosis.Conclusion The expressions of COX-2 and TREM-1 in rectal cancer increase, suggesting that the two factors may promote the development and lymph node metastasis of rectal cancer, and the expressions of the two factors are related to the patients` poor prognosis.