Objective To investigate the therapeutic effects of varied operative for the treatment of intrahepatic bile duct stones.Methods The clinical data of 176 consecutive cases of hepatolithiasis surgically treated in the past 3 years in our hospital were retrospectively analyzed.There were 45 type Ⅰ patients,25 type Ⅱ a patients,25 type Ⅱ b patients,3 type Ⅱ c patients,52 type Ea patients,19 type Eb patients,and 7 type Ec patients.These 176 patients were divided into 4 groups according to modus operandi:choledocholithotomy and T-tube drainage in 71 patients (type Ea 31 patients,type Ⅰ 15 patients,type Ⅱ a 25 patients) ; choledocholithotomy and choledochojejunostomy in 25 patients (type Ea 14 patients,type Eb 7 patients,type Ec 4 patients) ; choledocholithotomy and hepaticojejunostomy in 10 patients (type Ⅱb 5 patients,type Ⅱ c 3 patients,type Ea 2 patients) ; hepatectomy plus T-tube drainage or choledochojejunostomy in 70 patients (type Ⅰ 30 patients,type Ⅱ b 20 patients,type Ea 5 patients,type Eb 12 patients,type Ec 3 patients).The postoperative residual stone rate,perioperative complications and long term results were compared between groups.Results Patients undergoing hepatectomy have less postoperative residual stone rate,higher rate of good long term efficacy as compared with those who did not undergo hepatectomy (17.1％ (12/70) vs 43.4％ (46/106),91.4％ (53/58) vs 77.0％ (67/87)).Though patients undergoing hepatectomy had higher rate of perioperative complications (37.1％ (26/70) vs 14.2％ (15/106)).Conclusions Hepatectomy is the most effective procedure for the treatment of type Ⅰ and type Ⅱ b hepatolithiasis.Hepaticojejunostomy is the main procedure for the treatment of type Ⅱ c hepatolithiasis.

ObjectiveTo investigate the knowledge of stroke in patients with first stroke. Methods259 patients with first stroke were investigated with questionnaire. ResultsMost patients knew that hypertension was a risk factor of stroke, early treatment of stroke was important and hemiplegia was the frequent early symptom of stroke. They lacked other knowledge of stroke such as other risk factors, standards of hypertension, and so on. ConclusionIt is important to improve the knowledge of stroke in patients.

The authors hold that factors affecting the quality of hospital network data include ideologies of relevant personnel, state of the administrative organization, quality of the staff, standardization level of data, level of the software used, interdepartmental cooperation, feedback of test data, and mechanism of supervisory control. Only by taking corresponding measures can the quality of network data be constantly improved.

Objective To investigate the effect of high-mobility group box protein1 (HMGB1) on the expression of TNF-αand its mechanism in 16HBE in vitro. Methods groups with different HMGB1 (0, 100, 500, 2 000 ng/mL) concentration was set; RAGE antagonizing groups were as control, HMGB1-2000ng, anti-RAGE and anti-RAGE+HMGB1. The changes of TNF-αmRNA and secretion were determined by quantitative PCR and ELISA. RAGE protein level was measured by western blotting. Results HMGB1 intervention and TNF-α expression of 16HBE presented a positive dose-dependent relationship. Thechanges of RAGE was HMGB1positively concentration dependent. In comparison with HMGB1 2 000 ng/mL group, anti-RAGE+HMGB1showed a remarkable reduction of TNF-α secretion. Conclusion In vitro, HMGB1 increases TNF-α expression in 16HBE with a dose-dependent manner through RAGE.

AIM:To investigate the kinetics of tumor necrosis factor alpha(TNF-?)in an animal model of chronic P.aeruginosa biomembrane associated with lung infection.METHODS:Rats were challenged with 0.1 mL of PAO579(1012 CFU/L)in alginate beads or 0.1 mL of planktonic PAO579(1012 CFU/L).After challenging for 3,7 and 14 d,bacteriological and pathological features,and TNF-? expression in lung tissue were observed.RESULTS:(1)CFU/lung in alginate beads group was significantly higher than that in planktonic bacteria group(P

Objective To evaluate the effects of surgical treatment of acute deep vein thrombosis (DV T) of lower extremity. Methods Thirty-six patients with a cute DVT of lower extremity were treated by thrombectomy with thrombolytic,a nticoagulant and compression on the affected lower extremity during and after op eration. Results No death and serious complications happened i n this series. Thirty-one patients were followed-up for 2 to 20 months with a n average of 9 months. Symptoms disappeared totally in 23 patients , 8 patien ts had slight edema in the lower extremities. Conclusions Com bination of thrombectomy the thrombolytic and anticoagulant agent,and comp ression of the affected lower extremity is a safe and effective method in the t reatment of acute DVT of lower extremity.

Objective To observe the destructive and scavenging effect of ambroxol (AMB) on the biofilm (BF) of Pseudomonas aeruginosa (P.a).To evaluate the synergistically bactericidal effect of AMB along with levofloxacin (LFX) on BF of P.a.Methods The early model (cultured for 3 d) and mature model (cultured for 7 d) of P.a wild strain (PAO1) BF were established,in vitro,respectively.The models were randomly (random number) divided into control group,AMB group and AMB + LFX group.The concentrations of AMB were 256 μg/ml and 512 μg/ml,respectively.When the early BF model and mature BF model were made,different concentrations of AMB were added in AMB group and AMB + LFX (1μg/ml) was added in AMB + LFX group.The number of viable P.a on the BF carrier was counted with the continuous dilution method 24 h after AMB or/and LFX added.Then,the BF morphological changes on the carrier surface were observed by using scanning electron microscopy (SEM).Measured data were analyzed with single factor analysis of variance (One-Way ANOVA).Results Both in the early BF model and in the mature BF model,the SEM examination showed that the BF in AMB group was significantly reduced compared to the control group,and this reduction of BF was in dose-dependent manner.LFX 1 μg/ml could reduce the number of viable bacterial in BF in both early model and mature model (P ＜ 0.05).LFX with addition of different concentrations of AMB showed stronger bactericidal effect than LFX used alone identified by more significant reduction in the number of colonv within the BF (P ＜ 0.05).Furthermore,the LFX combined with 512 μg/ml AMB reduced more significant number of colony apparently than the LFX combined with 256 μg/ml AMB (P ＜ 0.05).Conclusions AMB can destroy the early BF or mature BF partly,and LFX alone can partly reduce the number of viable P.a within BF.When LFX combined with AMB,they exert a synergistically bactericidal effect.

Objective To explore pathological characterization of the enlarged contrast enhanced area of hepatocellular carcinoma ( HCC) on contrast enhanced ultrasonography ( CEUS). Methods Thirty-five HCC patients underwent conventional ultrasonography and CEUS before hepatectomy. The tumor sizes were measured on conventional ultrasonography,CEUS and postoperative resected specimen at the largest section. The infiltration depth of the HCC was observed under microscope in the peripheral area of the tumors. HCC with the size of contrast enhancement area on CEUS 0. 3 cm larger than that on conventional ultrasonography was defined as group A, and the others as group B. The pathological character of the tumor and tissues surrounding the tumor were analyzed and compared between the two groups. Results Among 35 HCC, 40% (14/35) HCC increased in size on CEUS compared with ultrasonography. Of them,9 tumors with increased area on CEUS were confirmed to be invasive HCC on pathology. Using the enlarged contrast enhanced area on CEUS as the diagnostic criteria of invasive HCC, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 90%, 80%, 82.9%, 64.3%, 95. 2%, respectively. Conclusions The contrast enhanced area on CEUS can reflect the infiltrative tumor size more accurately compared with conventional ultrasonography.

OBJECTIVE To understand the effects of lasR/rhlR mutations on the biofilm formation of Pseudomonas aeruginosa in vitro.METHODS The biofilms of PAEO1 and lasR,rhlR,and lasR rhlR mutants were incubated in a polyvinyl chloride tube in 0.9% saline and studied by means of scanning electronic microscopy(SEM) after three days′ incubation.RESULTS After 3 day′s incubation,PAEO1 biofilm showed a well-developed structure,whereas thin and poor developed biofilms were seen in lasR/rhlR mutant groups.CONCLUSIONS lasR/rhlR Genes play probably an important role in the formation of P.aeruginosa biofilm in vitro.

Objective To investigate the in vitro destructive effect of chlorogenic acid (CRA)/isochlorogenic acid (IRC)on Aspergillus fumigatus biofilm in a model of biofilm formation.Methods The in vitro biofilm model was established using clinical isolates of A.fumigatus.The minimum inhibitory concentrations (MIC)of antimicrobial agents against A.fumigatus were determined by microdilution method.Scanning electron microscope (SEM)and laser confocal scanning microscope (CLSM)were used to characterize the biofilm.Crystal violet staining method was used for biofilm quantitation.Results After reaction with CRA/IRC for 24 h or 48 h,observation of biofilm showed that A.fumigatus extracellular matrix was thinner than the control group.Biofilm quantitation showed that the optical densities were 1.05±0.19,1.14±0.26,0.99±0.14 for CRA group (1 024 mg/L,512 mg/L,256 mg/L);1.39±0.06,1.41±0.06,1.60±0.04 for IRC group (1 000 mg/L,500 mg/L,250 mg/L)at 24 h,and 1.91±0.17 for control group (P<0.05).The quantitation of biofilm showed that the optical densities were 2.25±0.05,2.27±0.05,2.31±0.03 for CRA group,2.26 ± 0.02,2.27±0.02,2.29±0.04 for IRC group at 48 h,and 2.36±0.01 for control group (P<0.05).Conclusions CRA/IRC has some inhibitory effect on the formation of A.fumigatus biofilm.