10mm, the PLG lie in the neck of gallbladder.(3)PLG complicated with clinical symptoms.(4)The PLG diameter increases or complicated with stones.But surgical treatment should be prudent for non-neoplasm PLG, especially cholesterol polys.

Objective To investigate the value of blood oxygenation level dependent (BOLD) MRI in detecting monkey cerebral ischemic penumbra (IP). Methods Six monkeys were used to make reversible middle cerebral artery occlusion (MCAO) model by an interventional microcatheter method. MR DWI, PWI mean transit time (MTT), T_2WI and quantitative T_2 map, T_2~* map were performed at MCAO (0 h) and 1,3,6,12,24,48 h after reperfusion. Reversible transverse relaxation rate (R_2') BOLD imaging was calculated using quantitative T_2 and T_2~* maps. Lesion volume percentage (lesion volume/bilateral hemispheres volume) were measured on 0 h DWI,48 h T_2WI and TTC staining. Ischemic area was subdivided into infracted core (high signal area on both 0 h DWI and 48 h T_2 WI), IP (high signal on 0 h DWI, iso on 48 h T_2 WI) and oligemia (0 h delayed MTT, iso signal on both 0 h DWI and 48 h T_2 WI). Relative R_2' (rR_2') was calculated to get ratio between the lesion and mirror area in contralateral healthyhemisphere. Paired t test and correlation analysis were used for comparison of lesion volume percentage. rR_2' values at each time point were compared by ANOVA. Results Reversible MCAO models were made successfully in 4 of 6 monkeys. Lesion volume porcentage on 48 h T_2 WI was reduced compared to that on Oh DWI [ (8.16±0.55)% vs (11.37±1.41)% ,t=6.472,P<0.05]. There was no significant difference in lesion volume percentage between TTC staining and 48 h T_2 WI[ (8.15±0.62)% vs (8.16±0.55)%, t= 0.150,P>0.05], which showed significant positive correlation (r=0.98, P<0.05). rR_2' values were significant different at each time point, with highest in ohgemia followed by IP and infarcted core (P< 0.05). rR_2' values in infracted core, IP and oligemia were: 0 h(1.129±0.108,1.329±0.081,1.584± 0.103,F=36.19,P<0.05),1 h(0.668±0.082,1.237±0.072,1.435±0.066,F=134.09,P<0.05), 3 h (0.536±0.075,1.453±0.081,1.770±0.141, F=256.30, P<0.05), 6 h (0.259±0.050,2.435± 0.131,2.957±0.177,F=803.25,P<0.05), 12 h(0.385±0.054,2.447±0.148,3.254±0.184,F= 743.74,P<0.05),24 h(0.083±0.026,1.968±0.127,3.101±0.144,F=1236.26,P<0.05),48 h (0.246±0.058,3.694±0.218,4.297±0.322, F=557.02, P<0.05). After reperfusion, rR_2' values in IP and oligemia showed increased trend with time evolution and reflected positive BOLD effect, while the infracted core showed decreased trend, reflecting negative BOLD effect. Conclusion R_2' BOLD can delineate IP from infracted core according to the difference of oxygen metabolic status in ischemic brain tissue.

Objective To study the influence of defection of Fragile X mental retardation-1 gene (FMR1) on cyclic adenosine monophosphate (cAMP) and to discuss its mechanism. Methods FMR1 gene of peripheral blood mononuclear cell was silenced in vitro by sodium nitrointroprusside. The effect of gene-silencing was detected using reverse transcript polymerase chain reaction (RT-PCR). The specific activity of adenylate cyclase and phosphodiesterase was showed by the activity ratio of yield or consumption of cAMP during a unit time. Spectrophotometry was used to measure the two key enzymes (adenylate cyclase and phosphodiesterase), as to determining the level of intracellular cyclic adenosine monophosphate in the process of cAMP metabolism. Results FMR1 gene was fully silenced by sodium nitrointroprusside at 12th, 24th and 48th hour separately, re-expressed at 72th hour. If the cultivated fluild was replaced with new sodium nitrointroprusside at 48th hour, FMR1 gene would be silenced continuously. The intracellular cAMP level in the gene silenced group was lower, and significant depression of adenylate cyclase specific activity was found in the FMR1 gene silenced group (P=0.000). No significant difference was found on phosphodiesterase specific activity (P=0.983). Conclusions The results suggest that the yield of cAMP could be influenced by defection of FMR1. The depression of adenylate cyclase activity might be one of the causes of the decrease of intracellular cAMP production.

Objective To observe the influences of different analgesic methods on blood sugar, stress hormones and cytokinesMethods According to different postoperative analgesic methods, 30 patients immediately after elective cholecystectomy, were randomly divided into four groups: normal saline was infused epidurally in group C as control; analgesia via epidural infusion of morphine 2 mg in group EM; patient-controlled analgesia via epidural or intravenous fentanyl in group PCEFA or group PCIFABlood sugar, cortisol, insulin, interlukin-2 (IL-2), interlukin-6 (IL-6) and tumor necrosis factor-?(TNF-?) levels were determined during the perioperative periodResults Postoperative visual analog score was higher in group C than that in group EM, group PCEFA or group PCIFA (P005)Conclusions Postoperative application of PCEFA can much more help to maintain the stability of neuroimmunoendocrinal system

Objective To explore the regularity of changes of plasma endothelin (ET), throm-boxame B2(TXB2) and 6-keto-prostaglandin F1α(6-keto-PGF1α) and restenosis after percutaneous transluminal angioplasty (PTCA) in patients with coronary heart disease. Methods Radioimmunoas-say was applied to measuring plasma levels of ET, TXB2and 6-keto-PGF1αat 0,30 min, 1 day and 3 days after PTCA in 41 patients with coronary heart disease. Results The level of ET in the patients with coronary heart disease was significantly decreased in 30 minutes after PTCA (P＜0.05), but no significant difference was observed in 1 day and 3 days after PTCA (P>0.05). The level of plasma TXB2has no statistical difference after PTCA in 30minutes, 1 day and 3 days (P>0.05). The level of 6-keto-prostaglandin F1α(6-keto-PGF1α) of the patients with coronary heart disease was significantly declined in 30 minutes after PTCA (P<0.05) ,but no significant difference was observed in 1 day and 3 days after PTCA (P>0.05). Conclusion PTCA may lead to fluctuation of plasma levels of ET, TXB2and 6-keto-PGF1αThe clarification of changing regularity of these vasoactive substances contrib-utes to prevention of acute artery occlusion or restenosis after PTCA.

In order to understand the representative situation of medical services supply for China's public hospital in the mobile side,the research takes China hospital technology (comprehensive) influence ranked top 100 hospitals as the research object.From service supply channels,service content,providing mode,supply cooperation,comparative analysis of public hospitals from the traditional medical treatment to the mobile health reform is done.The 100 hospitals attaches great importance to the channel construction of mobile terminals,and App and WeChat have been mostly layout;On the basis of the medical process,a variety of service content is derived and innovated;Service providers change gradually to the context of navigation and mobile O2O medicine;The cooperation between hospitals and the technology companies is becoming more and more frequent.At the same time,these changes will also in turn promote the hospital process optimization,interconnection and multi game deepening governance.

Objective To investigate the influence of C arm X- ray perspective computer auxiliary surgery navigation system on lumbar vertebral pedicle screw fixation in the elderly.Methods 286 patients(aged≥65 years) treated by lumbar spine post decompress and pedicle screw fixation for lumbar vertebral degeneration were divided into navigation (n=153) or non-navigation (n=133) groups.The amount of blood loss,surgery duration and time of beginning to walk after surgery were measured and compared, the improvement grading was determined by Oswestry disability index (ODI) before surgery and at the last follow-up. Results The surgery duration [(27.6+6.3)ain vs.(33.8±9.9)min],the volume of blood loss[(135.7±21.1)ml vs.(165.4±32.1)ml] and the time of beginning to walk after surgery[(134.6± 12.3)h vs.(169.0±23.9)h] were obviously reduced in navigation group as compared with non-navigation group (P ＜ 0.05). The grading improvement rate by ODI[(76.6±±3.7)％vs.(69.8+6.6)％] was higher in navigation group than in non navigation group (P＜0.05). Conclusions Using C arm X-ray perspective computer auxiliary surgery navigation system to lumbar pedicle screws fixation is helpful in the elderly for improving clinical efficacy.

Objective:To study influence of renal sympathetic denervation (RDN)on cardiac function of dogs with heart failure (HF).Methods:A total of 40 dogs were randomly and equally divided into RDN group [received bilat- eral renal artery radiofrequency ablation (RFA)]and model group (only received femoral puncture).Pacemaker was implanted in every dog,and dog HF model was established using rapid right ventricular pacing.Cardiac and re-nal function indexes,BNP and sympathetic activity index levels were observed and compared between two groups be- fore RFA/sham operation,instant and four weeks after model establishment.Results:After operation four weeks, compared with model group,there were significant reductions in levels of epinephrine (E)[(362.69±42.54)ng/ml vs.(290.36±42.32)ng/ml],renin (R)[(305.46± 39.68)ng/ml vs.(230.04±32.80)ng/ml],aldosterone (AD)[(408.00±38.56)ng/ml vs.(246.00± 48.37)ng/ml],angiotensin Ⅱ (ATⅡ)[(280.00±48.08)pg/ml vs.(172.00±25.04)pg/ml]and norepinephrine (NE)[(425.65±50.54)ng/ml vs.(316.76±46.29)ng/ml]in RDN group (P<0.05 all);there were significant reductions in HR,respiratory rate (RR)and BNP level in RDN group,P<0.05 all;there were significant rise in SBP,LVEF,CO,CI,left ventricular pressure maximal rising rate (+dp/dtmax),left ventricular pressure maximal dropping rate (-dp/dtmax)and left ventricular end-systolic pressure (LVESP),and significant reductions in left ventricular end-systolic dimension (LVESd),left ventricular end-diastolic dimension (LVEDd)and left ventricular end-diastolic pressure (LVEDP)in RDN group,P<0.05 all.Conclusion:RDN can decrease renal sympathetic activity,improve heart function,inhibit myocardial remode- ling,its therapeutic effect is significant

700 mL/min).Conclusion The CLh-s could be correlated with operation complications,and be considered as an effective supplement to evaluate hepatic functional reserve when combined with ICGR15 and Child-Pugh classification. It could be used to evaluate liver functional reserve more effectively and reliably.

Objective To investigate the effect of preoperative administration of Dextromethorphan (DM) on cough reflex of patients during tracheal extubation under general anesthesia after obstructive sleep apnea syndrome (OSAS) operation. Methods Forty ASA Ⅰ-Ⅱ adult patients scheduled for uvulopalatopharyngoplasty (UPPP) under general anesthesia were randomly divided into control group and DM group (n=20 in each group). Patients in DM group received 0.3 mg/kg DM and control group took 5 ml normal saline preoperatively. Cough reflex of patients and adverse effects were recorded during tracheal extubation. Results Cough reflex during tracheal extubation was remarkably suppressed in DM group as compared with control group (P