With the improvement of endoscopic retrograde eholangiopancreatography (ERCP) technology, endoscopy is not only applied to diagnosis, but also utilized to therapy for cholangiopancreatic neoplasm. This article is to summarize the application of endoscopic technology on cholangiopancreatic neoplasm.

Objective To compare the feasibility,effectivity and security of modified trabeculectomy in advanced stage angle-close glaucoma with cataract.Methods One hundred and forty-five patients (151 eyes) of advanced stage angle-close glaucoma with cataract were enrolled in this study.Among them,85 patients(91 eyes,observation group) were treated with modified trabeculectomy with the resection of deep scleral resection and 60 patients (60 eyes,control group) were treated with routine trabeculectomy.The visual acuity,intraocular pressure (IOP),type of filtering bleb and postoperative complication were compared.Results There was significant difference in the visual acuity ＜ 0.1,0.4-0.5,＞ 0.5 between after operation for 1 month and before operation in two groups (P ＜ 0.05).but there was no significant difference in the visual acuity 0.1-0.3 (P ＞ 0.05).The IOP before operation in observation group was (29.6 ± 4.1) mmHg (1 mmHg =0.133 kPa),12 months after operation was (13.1 ± 4.9) mmHg,the degree of decrease was (16.6 ± 5.0) mmHg.The IOP before operation in control group was (30.4 ± 6.3) mmHg,12 months after operation was (18.9 ± 3.0) mmHg,the degree of decrease was (10.4 ± 4.0) mmHg.The IOP after operation and the degree of decrease between two groups had significant difference (P ＜ 0.05).The functional filtering bleb(Ⅰ type and Ⅱ type) in observation group was 77 eyes(84.6％,77/91),and 51 eyes(85.0％,51/60) in control group,there was no significant difference (P ＞ 0.05).After operation for 1 month,there was 8 eyes appeared transient hypotony in observation group and 5 eyes in control group,there was no significant difference (P ＞ 0.05).Conclusion The modified trabeculectomy in advanced stage angle-close glaucoma with cataract can reduce IOP more effectively and not increase the intraoperative risk and postoperative complication.

OBJECTIVE:To provide basis and advices for the research of new traditional Chinese medicine (TCM) in Sichuan province.METHODS: The data of the application and registration of TCM treated as new medicine and new TCM in Sichuan province from 2001 to 2006 were analyzed and evaluated statistically.RESULTS: The number of the application was growing but new medicine was countable with low approval rate.The research institutes hadn’t played a prominent role in the research of new drug.CONCLUSION: The innovation and research of original TCM and the transformation of achievement should be enhanced to achieve the goal of a strong province on TCM.

Objective An investigation was conducted to assess the chemopreventive effects of celecoxib, a selective cyclooxygenase(COX)-2 inhibitor, on a rat colon carcinogenesis model induced by dimethylhydrazine (DMH). The results were compared with those of sulindac. Methods Thirty-two 8-week-old female Sprague-Dawley rats were randomly divided into four groups (n=8 each):Group A rats were treated with DMH(120 mg/kg wt, single subcutaneous injection) alone and group B rats were treated with saline alone. Group C rats were pre-treated with sulindac (320 mg/kg feedstuff) and group D rats pre-treated with celecoxib (1500 mg/kg feedstuff) for 7 days before DMH initiation. The animals were killed at the end of the experiment (week 5) and the aberrant crypt foci(ACF) and aberrant crypt(AC) of the colonic mucosa were assessed after being stained with methylene blue. Results In group A(DMH only), the average numbers of ACF and AC were 182.4?93.43 and 262.8?197.8 respectively. In group B (saline group) rats, no ACF was found. In group C (sulindac group) rats, the average numbers of ACF and AC were 91.25?48.98 and 139.60?68.52 respectively, both of them were decreased significantly as compared with those in Group A (P

Objective To evaluate different angiocardiographic techniques of congenital heart disease in children. Methods 11045 pediatric patients with congenital heart disease were performed angiocardiography using cut film, cine film and digital subtraction angiography(DSA) equipments. Different angiocardiographic techniques were used. Results The diagnostic accuracy of cut film with conventional AP and lateral views was 80.5%,the diagnostic accuracy of cine film with angulated views was 90.0% and the diagnostic accuracy of DSA using non-ionic contrast medium with angulated views was 96.5%. Conclusion Dynamic picture angiography with digital subtraction using non-ionic contrast medium under rapid injection is the key for claiming the high quality imaging diaguosis of congenital heart disease in children.

Objective To evaluate the clinical diagnostic value and limitation of MRI and contrast enhancement MRA (CE-MRA) in congenital heart disease of children. Methods Three hundred patients with congenital heart disease underwent CE-MRA. 173 were confirmed by operation. The results of MRA and CE-MRA were compared with operation data. Results 196 (86.0%) intracardiac malformation including septal defect and valve anomaly were diagnosed correctly by MRI within 228 abnormalities which were confirmed by operation. 101 (96.2%) extracardiac malformation including great vessels stenosis and anomalous connection were diagnosed correctly by MRI and MRA within 105 abnormalities which were confirmed by operation. Conclusion MRI and CE-MRA are very accurate diagnostic method for extracardiac malformation. CE-MRA is the best sequence for congenital heart disease.

Objective To report 6 cases of congenital heart disease with high origin of coronary artery and to evaluate the imaging method for diagnosis of congenital high origin of coronary artery. Methods Six patients with congenital high origin of coronary artery underwent angiocardiography ,echocardiography ,and 2 patients also underwent magnetic resonance examination. All 6 cases were confirmed by operation. Results All 6 cases were congenital high origin of right coronary artery. Angiocardiography made correct diagnosis in all 6 cases; MRI made the correct diagnosis in 1 of the 2 cases; echocardiography made 1 correct diagnosis. Conclusion Correct diagnosis of congenital high origin of coronary artery was very important for patients with congenital heart disease. Angiocardiography was a very reliable imaging method and MRI can play an important role in preoperative diagnosis of congenital high origin of coronary artery.

Objective To investigate the clinical features of Mekel diverticulitis,and to improve the cognition rate and diagnosis rate of the disease.Methods The clinical data of 7 patients with Mekel diverticulitis misdiagnosed as acute appendicitis were retrospectively analyzed,and the related literature was reviewed.Results 7 cases of Mekel diverticulitis were misdiagnosed as acute appendicitis before surgery,all corrected diagnosis and operation.One case of mild incision infection after surgery,the remaining 6 cases did not appear complications.After treatment were cured after 7-12d discharged.Conclusion Mekel diverticulitis is lack of specific clinical manifestations and effective auxiliary examination method,easily misdiagnosed as acute appendicitis,when the clinical manifestations of appendicitis is not typical,need to further analysis,identification;when the surgery found appendix lesions are not coincide with clinical practice,the distal ileum should be routinely probed to determine the presence of Meckel diverticulitis.

Objective To explore the effects of granulocyte colony stimulating factor (G-CSF)on chronic cerebral ischemia in rats,and its possible mechanism.Methods Chronic cerebral ischemia (2-VO) model was prepared and bilateral external jugular veins were isolated.A total of 30 rats were divided into 2 groups at random sham group (received no intervention,n=15) and operative group (received G-CSF or PBS through external jugular vein injection,n=15).At 6 weeks after operation,the rats in operative group were divided into G--CSF group (received G-CSF 10 mg/L,1 ml · kg-1 · d-1,1 times every 24 h for,3 times) and PBS control group (received PBS 10 mg/L,1 ml ·kg 1 · d-11,1 times every 24 h for 3 times).At 8 weeks after the operation,morris water maze was carried out to evaluate the learning and memory ability of the rats.The cell proliferation,threedimensional vascular distribution,ischemic neuronal apoptosis,cell morphological changes in ischemic area and the plasma VEGF levels were detected to explore the possible mechanisms.Results In morris water maze,escape latency at the 2rd to 5th day were significantly lower in G-CSF group than the PBS group (all P＜0.05).The swimming time spent in the first quadrant in G-CSF group was significantly longer than the PBS group (P＜0.05).There was a significant difference in the number of BrdU positive cells in the ischemical area between the G-CSF group and the control group [(27.7±4.76) vs.(10.4 ± 3.7),P =0.030).Three-dimensional quantitative measurements of vascular structure showed that the capillary diameters was smaller in the G-CSF group than in the PBS group [(2.90±0.20) μm vs.(3.45±0.26) μm,P=0.020] and the number of branch points in the boundary regions of ischemia had a significant difference in the G-CSF group compared with the control group [(207.82±10.73) /0.002 mm3 vs.(162.10±9.31) /0.002mm3,P=0.005].Threedimensional cerebral vessel surface area in the ipsilateral hemisphere was increased in the G-CSF group compared with the PBS group [(86498±2896) μm2/0.002 mm3vs.(73976±3826) μm2/0.002 mm3,P=0.003].The number of apoptotic cells in G-CSF group was decreased compared with the PBS group [(32.10±6.70) vs.(56.30±11.20),F=11.89,P=0.043].The electron microscope morphological observations showed inflammatory edema in intercellular gap was significantly reduced in the G-CSF group compared with the PBS group.The level of plasma VEGF was significantly increased in the G-CSF group compared with the PBS group [(58.81±6.61) ng/L vs.(20.81±4.35)ng/L,P=0.025].Conclusions G--CSF can improve the learning and memory ability in the chronic cerebral ischemic rats,and its possible mechanism might involve the nerve protection and the vascular regeneration associated with the VEGF.There is a great prospect for G-CSF in the therapy of chronic cerebral ischemic disease.

Objective To investigate the effect of autologous bone marrow-derived endothelial progenitor cell (EPC) transplantation on neurological outcomes in cerebral ischernia in rats and its poss le mechanisms.Methods Autologous bone marrow-derived EPC was cultured in vitro and it was labeled with 5-bromodeoxyuridine (BrdU).A middle cerebral artery occlusion (MCAO) model was induced by the intraluminal suture method.The rats in a EPC group transplanted autologous EPC (106/ml/kg) via external jugular veins,those in a control group were injected with phosphate buffered saline (1 ml/kg),and those in a sham operation group (n =15)were not treated.The modified neurological severity score (mNSS) was used to observe the neurological changes of the rats.BrdU immunohistochemical staining was used to evaluate EPC proliferation and differentiation.Three-dimensional confocal image analysis was used to detect the vascular structure and density in cerebral ischemic areas.TUNEL staining was used to detect the apoptotio cells in ischernic brain tissue.Enzyme-linked immunosorbent assay was used to detect the concentration of plasma vascular endothelial growth factor VEGF).Results The mNSS in the EPC group was siginficantly lower than that in the control group (at day 8:6.43 ±0.69 vs.8.86 ±0.95,q =2.673,P=0.035; at day 14:4.55 ±0.89 vs.6.73 ± 1.06,q =5.360,P =0.035).The number of BrdU positive cells in the EPC group was significantly higher than that in the control group (42.2±5.76 vs.25.67±5.49,q=4.020,P=0.030).The capiilary diameter in the EPCgroup was significantly smaller than that in the control group (4.51 ± 0.21 μm vs.6.34 ± 0.24 μm,q =3.980,P =0.003); the density of blood vessels (212.64 ± 8.02/0.002 mm3 vs.153.60 ± 7.21/0.002 mm3; q =9.670,P =0.001 ) and the total surface area of microvessel (92 013 ± 5 132 μm2/0.002 mm3 vs. 71 366 ±4 538 μm2/0.002 mm3; q=4.180,P=0.014) were significantly higher or more than those in the control group.The number of apoptotic cells in the EPC group was significantly less than that in the control group (36.26 ± 6.91 vs.78.34 ± 7.21; t =-4.834,P =0.003).The plasma VEGF concentration in the EPC group was significantly higher than that in the control group (54.91 ± 5.71 pg/ml vs.13.81 ± 4.25 pg/ml,q =12.300,P=0.002).Conclusions Autologous EPC transplantation has a protective effect on ischemic brain tissue in rats.It may be associated with VEGF related angiogenesis and neuroprotection.It has an important application prospect in the treatment of ischemic cerebrovascular disease.