0.05).Conclusions This study shows that in severe acute biliary pancreatitis patiens with biliary tract obstruction, emergency endoscopic therapy should be performed within 48 hours from the onset of symptoms; patients with mild acute biliary pancreatitis shoud also undergo prompt endoscopic therapy after ineffective conservative management or appearance of symptoms of acute biliary tract infection.

Pancreatic cancer is regarded as high malignant neoplasm and surgical resection is considered as the only efficient therapeutic method.Radical surgery includes not only removing the whole carcinoma,but also resecting lymph nodes efficiently.There exist controversies whether extended lymphadenectomy can improve the overall survival of patients currently.We have analyzed and reflected on the controversies on the basis of overseas and domestic research status and our experience.

Objective:To observe expressions of vascular endothelial growth factor (VEGF ) and placental growth factor (PLGF) in patients with hypertensive disorder complicating pregnancy (HDCP) during early and mid pregnancy ,and pro‐vide basis for diagnosing HDCP .Methods:A total of 46 normal pregnant women (normal pregnancy group ) and 39 HDCP patients (HDCP group) were enrolled .The HDCP group was further divided into gestational hypertension group (n=26) , mild preeclampsia group (n=8) and severe preeclampsia group (n=5) .Enzyme linked immunosorbent assay (ELISA) was used to measure serum VEGF and PLGF levels during early ,mid and late pregnancy ,and those were compared among a‐bove groups .Results:Compared with normal pregnancy group ,there were significant reductions in serum levels of VEGF [ (187.54 ± 17.36) ng/L vs .(123.35 ± 16.46) ng/L] and PLGF [ (217.49 ± 26.32) ng/L vs .(128.32 ± 21.23) ng/L] in HDCP group during mid period (24th week) , P<0. 01 all ,and serum VEGF and PLGF levels more significantly reduced during late pregnancy (34th week) (P<0.01);in HDCP group ,compared with gestational hypertension group and severe preeclampsia group ,PLGF level [(127.46 ± 16.55) ng/L ,(158.40 ± 26.33) ng/L vs .(99.02 ± 27.26) ng/L] significantly reduced in mild preeclampsia group on 24th week;the serum VEGF and PLGF levels more significantly reduced on 34th week , P<0. 05 or <0. 01 . Conclusion:Reduced serum levels of VEGF and PLGF during mid pregnancy in HDCP patients are help to early diagnosing HDCP .

In the present paper,the authors make a summary about the development of acupuncture needles in Chinese ancient times recorded in the literature,and have a discussion on the effect of the thickness of acupuncture needles on clinical the-rapeutic efficacy in accordance with modern medical theories,the development of its clinical application and by combining their own experience in acupuncture practice. They conclude that the thickness of the abdominal needle is a negligible factor influencing the therapeutic efficacy of the reinforcing-reducing manipulations. In the treatment of deficiency pattern disorders,a thinner acupuncture needle is suitable,while for excess syndrome,a thicker acupuncture needle is recommended. In the light of the patient's constitution and different state of clinical conditions,a flexible application of the acupuncture needle with different diameters is highly recommended in clinical practice. In this way,the clinical therapeutic effect would be improved much.

Objective To investigate the protective effects of green tea polyphenols(GTPs)on dopamine neuron loss in substantia nigra concomitant with a depletion of dopamine in corpus striatum induced by the N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)in mice as a model of Parkinson disease.Methods Male C57BL/6 mice were intraperitoneally injected with saline + saline(group A),saline + GTPs(group B),saline+MPTP(group C)and GTP+MPTP(group D)at 2-hour intervals for a total of 3 doses for MPTP and 5 doses for GTPs(10 or 50 mg/kg delivered).The animals were sacrificed 7 d after the last injection.Levels of dopamine and its metabolites in the corpus striatum were measured with high-performance liquid chromatography with an electrochemical detector(HPLC-ECD).Results Level of dopamine and its metabolites in the corpus striatum in group C decreased significantly compared with group A or B;however,those in group D(both 10 and 50 mg/kg)prevented these effects.Conclusion GTPs can protect the dopamine neurons from loss in MPTP-induced mice.

Nucleic acid aptamers are ligands with high specificity and affinity for their targets, which are screened from large oligonucleotide pools by the SELEX technology. Their characteristics are superior to antibodies in many aspects, which make them important in the research of recognition of molecules. They can be used to determine the levels and inhibit the bioactivity of their targets. There're broad application prospects for aptamers in the diagnosis and treatment of tumor.

Objective:To assess the genetic relationship of clinical isolates of carbapenem-resistant A.baumannii (resistant to both imipenem and meropenem) from January 2007 to March 2008 in Peking University Third Hospital for measures to decrease the isolates; to investigate the characteristics of patients with carbapenem-resistant A. baumannii colonization or infection and to evaluate antibiotic treatment for health care-associated infections caused by carbapenem-resistant A. baumannii. Methods: The medical records of patients with carbapenem-resistant A. baumannii colonization or infection were reviewed. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis. Results: A total of 49 carbapenem-resistant A. baumannii strains were isolated from the 49 patients hospitalized during the study period and pulsed-field gel electrophoresis typing yielded 7 different patterns. A total of 45 (91.8%)genotyped strains showed clonal relationship. The most frequently identified predisposing factors were intensive care unit stay, invasive procedures, and hypoalbuminemia. Chronic obstructive pulmonary disease (12 cases) and cerebrovascular disease (10 cases) were the most common comorbid conditions.The mortality of patients with carbapenem-resistant A. baumannii infection was 38. 1% (8 of 21 patients), and the acute physiology and chronic health evaluation Ⅱ score, initial antibiotic therapy failure rate and the presence of hypoalbuminemia were significantly increased in the death group. Combination therapy regimens had higher success rates than monotherapy regimens (11/13, 84. 6% vs. 3/17,17.6%). Conclusion: There has been clonal spread of carbapenem-resistant A. baumannii strains among patients in our hospital since 2007. Intensive care unit stay, invasive procedures, hypoalbuminemia, chronic obstructive pulmonary disease and cerebrovascular disease were common in patients with carbapenem-resistant A. baumannii colonization or infection. Antibiotic combination therapy may be effective for carbapenem-resistant A. baumannii infection.

Objective To investigate the effects ofviaminate on the proliferation and differentiation of HaCaT cells,a human keratinocyte cell line.Methods Cultured HaCaT cells were treated with various concentrations (2,5,10,15,20,25 and 30?g/mL) of viaminate for various durations.The cell proliferation was assessed by MTT method,the changes of cell cycle and apoptosis rate by flow cytometry,the changes of keratin 10 and involucrin mRNA expressions by semi-quantitative reverse transcription PCR.Results The proliferation of HaCaT cells was inhibited by the treatment with viaminate of≥2?g/mL for 48 h,and the inhibition rate was raised with the increase of treatment time and dosage.The viaminate of 30?g/mL inhibited the proliferation of HaCaT cells by 57.67% and 82.00% at 48 and 72 h after the incubation respectively,and elevated the mRNA expression of involucrin from 40.80% to 156.12%,decreased the mRNA expression of keratin 10 from 96.46% to 14.60%.The mRNA expression of involucrin increased with the elevation of viarninate dosage.Under the treatment with viaminate for 48 h,the cell population at G_1 phase significantly increased,that at S and G_2 phases decreased;the switching of G_1 to G_2 was inhibited;but the cell apoptosis was not affected.Conclusion Viaminate could inhibit the proliferation and induce the differentiation of keratinocytes.

Objective To evaluate the ability of virtual CT colonoscopy to detect colorectal proliferative lesions in endoscopically proven patients and its clinical application prospects. Methods Virtual colonoscopy was performed using thin section helical computed tomography of the abdomen and pelvis in 23 patients with conventional colonoscopic findings suggestive of abnormalities within 1 hour. The data from CT scanning was processed by computer with specific commercial software, two and three dimensional reconstruction was subsequently made. Results The diagnosis of colorectal carcinomas was made on virtual colonoscopy in 21 cases, among which 20 cases were endoscopically diagnosed as cancers and 1 case was found sigmoid stricture of unknown causes, that was finally confirmed surgically and pathologically. All polyps greater than 11 mm were identified both by conventional endoscopy and virtual colonoscopy. 19 polyps with size of 6～10 mm were detected on virtual colonoscopy, the location and size of 13 polyps were in accordance with those of endoscopic findings, 2 false positive polyps were reported in 6 newly detected polyps. Virtual colonoscopy correctly localized all 21 cancers, compared with 18 using conventional colonoscopy. Conclusion Virtual colonoscopy is a valuable clinical method in diagnosis of colorectal cancers and polyps with size larger than 6 mm, and it is a good indication for colonic stricture and colonoscopy intolerable patients.