Objective To determine the methods and effects of common bile duct(CBD) exploration and primary suture by laparoscopic procedure after laparoscopic cholecystectomy (LC) . Methods After LC, 35 patients' CBD were explored.After hte CBD stone was removed by choledochofiberscopy completely and CBD stenosis was excluded, the CBD was sutured primarily. Results 32 cases of CBD gallstone were removed ,and 3 exploration were negative.All the 35 CBD were sutured primarily . Two patients occurred bile leakage 1～3 day after the operation ,which were cured by conservative therapy.29 patients were followed-up for 3～24 months,no residual stone or bile duct stricture was found. Conclusions Primary suture CBD is safe and effective in laparoscopic CBD exploration,if the patient selected correctly.

Objective:To study assessment value of brachial‐ankle pulse wave velocity (baPWV) for severity of coro‐nary disease in patients with coronary heart disease (CHD) .Methods :According to SYNTAX score of coronary an‐giography ,a total of 206 CHD patients from our hospital were divided into mild group (n=74 ,SYNTAX score <23 scores) ,medium group (n= 72 ,SYNTAX score 23~32 scores) and severe group (n= 60 ,SYNTAX score > 32 scores) .Another 80 healthy subjects undergoing physical examinations were selected as healthy control group during the same period .BaPWV ,ankle brachial index (ABI) and carotid -femoral pulse wave velocity (cfPWV) were measured and compared among all groups .Pearson correlation analysis was used to analyze the correlation among baPWV ,cfPWV ,ABI and SYNTAX score in CHD patients ;multi -factor Logistic regression model was used to analyze whether baPWV ,cfPWV and ABI were risk factors for SYNTAX scores .Results:Compared with healthy control group ,there were significant rise in baPWV [ (1.2 ± 0.3) m/s vs .(1.5 ± 0.4) m/s vs .(1.8 ± 0.6) m/s vs . (2.0±0.7)m/s]andcfPWV [ (1.3±0.5)m/svs.(2.5±0.7)m/svs.(2.9±0.8)m/svs.(3.4±0.7)m/s]in mild group ,medium group and severe group (P<0.05 or <0.01) ,and that of severe group was more than that of medium group ,and>mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all);significant reduction in ABI [ (1.02 ± 0.32) vs .(0.82 ± 0.24) vs .(0.73 ± 0.16) vs .(0.56 ± 0.09)] in mild group , medium group and severe group ,and that of severe group was < medium group ,and < mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all) .Pearson correlation analysis indicated that baPWV and cfPWV were positively correlated with SYNTAX score ( r= 0.613 , P= 0.007;r=0.528 , P=0.023) ,while ABI had no correlation with SYNTAX score .Multi-factor Logistic regression analysis indicated that diabetes melli‐tus ,hypertension ,baPWV and cfPWV were risk factors for SYNTAX score (OR=4.016~5.809 , P<0.05 or <0.01) .Conclusion:The baPWV can effectively assess severity of coronary disease in CHD patients .

Objective To find out the mechanism of strephenopodia and strephexopodia of children with spastic cerebral palsy by analyzing their gait character.MethodsForty children with spastic cerebral palsy and forty healthy children with normal walking ability were involved in this research.Footscan 7 gait analysis system was used to measure foot initial touchdown part,the ratio of different part touchdown phase to single supporting phase,the degree of strephenopodia and strephexopodia in different part.Two groups' characteristic parameters were analyzed by statistics method.ResultsSignificant differences were found in foot first touchdown part between two groups(P<0.05).The phenomenon that toes or metatarsus or whole foot first touch the earth was found in children with spastic cerebral palsy.The ratio of anterior foot and middle foot touchdown phase to single supporting phase were higher than normal children(P<0.05).In spastic cerebral palsy group the phenomenon of strephexopodia was more serious than strephenopodia during anterior foot touchdown phase.ConclusionLots of children with spastic cerebral palsy are suffering long-time compression pain and strephexopodia with anterior foot,active rectification must be performed during rehabilitation care.

Objective To investigate the effect of thyroid stimulating hormone (TSH) on the expression of endothelial nitric oxide synthase (eNOS) and its mechanism in human microvascular endothelial cells (HMEC-1) in vitro culture.Methods Different concentrations of TSH (0,10,50 mIU/ml) were used to intervene HMEC-1.The expression of eNOS mRNA was detected with quantitative polymerase chain reaction (qPCR) method.The protein expressions of eNOS,phosphorylated protein kinase B (p-AKT),protein kinase B (AKT),phosphorylated extracellular signal-regulated kinase (P-ERK),and extracellular signal-regulated kinase (ERK) were determined with Western Blot.Results (1) The expression level of eNOS was significantly decreased by TSH in dose-dependent manner (P ＜ 0.05).(2) TSH could promote the phosphorylation of AKT and ERK (P ＜ 0.05).Conclusions Thyroid-stimulating hormone may inhibit the expression of nitric oxide synthase in human microvascular endothelial cells by activating AKT and ERK signaling pathways.

Escherichia coli was metabolically engineered to produce poly(glycolate-co-lactate-co-3-hydroxybutyrate) using glucose and xylose as carbon sources. The combinatorial biosynthetic route was constructed by the overexpression of a series of enzymes including D-tagatose 3-epimerase, L-fuculokinase, L-fuculose-phosphate aldolase, aldehyde dehydrogenase, propionyl-CoA transferase, β-ketothiolase, acetoacetyl-CoA reductase, and polyhydroxyalkanoate synthase. Overexpression of polyhydroxyalkanoate granule associated protein significantly improved biopolymer synthesis, and the recombinant strain reached 3.73 g/L cell dry weight with 38.72% (W/W) biopolymer content. A co-culture engineering strategy was developed to produce biopolymer from a mixture of glucose and xylose, achieving 4.01 g/L cell dry weight containing 21.54% (W/W) biopolymer. The results of this work offer an approach for simultaneously utilizing glucose and xylose and indicate the potential for future biopolymer production from lignocellulosic biomass.
3-Hydroxybutyric Acid ; Escherichia coli ; Glucose ; Glycolates ; Lactates ; Metabolic Engineering ; Polyesters ; Xylose

ObjectiveTo establish an ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry（UHPLC-QqQ-MS） for determination of the active ingredients in Erdongtang， and to predict the targets and pathways of anti-insulin resistance action of this formula. MethodThe analysis was performed on an ACQUITY UPLC BEH C₁₈ column（2.1 mm×100 mm， 1.7 μm） with the mobile phase of 0.1% formic acid aqueous solution（A）-acetonitrile（B） for gradient elution（0-3 min， 90%-87%A； 3-6 min， 87%-86%A； 6-9 min， 86%-83%A； 9-11 min， 83%-75%A； 11-18 min， 75%-70%A； 18-19 min， 70%-52%A； 19-22 min， 52%A； 22-25 min， 52%-5%A； 25-27 min， 5%-90%A； 27-30 min， 90%A）. The contents of active ingredients in Erdongtang was detected by electrospray ionization（ESI） and multiple reaction monitoring（MRM） mode under positive and negative ion modes. On this basis， network pharmacology was applied to predict the targets and pathways of Erdongtang exerting anti-insulin resistance effect. ResultThe 20 active ingredients in Erdongtang showed good linear relationships within a certain mass concentration range， and the precision， stability， repeatability and recovery rate were good. The results of determination showed that the ingredients with high content in 15 batches of samples were baicalein（1 259.39-1 635.78 mg·L^-1）， baicalin（1 078.37-1 411.52 mg·L^-1）， the ingredients with medium content were mangiferin（148.59-217.04 mg·L^-1）， timosaponin BⅡ（245.10-604.89 mg·L^-1）， quercetin-3-O-glucuronide（89.30-423.26 mg·L^-1）， rutin（46.91-1 553.61 mg·L^-1）， glycyrrhizic acid（55.97-391.47 mg·L^-1）， neomangiferin（37.45-127.03 mg·L^-1）， nuciferine（0.89-63.48 mg·L^-1）， hyperoside（6.96-136.78 mg·L^-1）， liquiritin（30.89-122.78 mg·L^-1）， liquiritigenin（26.64-110.67 mg·L^-1）， protodioscin（58.57-284.26 mg·L^-1）， the ingredients with low content were wogonin（7.16-20.74 mg·L^-1）， pseudoprotodioscin（5.49-22.96 mg·L^-1）， ginsenoside Rb₁（7.31-23.87 mg·L^-1）， ginsenoside Rg₁（10.78-28.33 mg·L^-1）， ginsenoside Re（7.78-24.76 mg·L^-1）， ophiopogonin D（2.08-4.29 mg·L^-1）， methylophiopogonanone A（0.74-1.67 mg·L^-1）. The results of network pharmacology indicated that the mechanism of anti-insulin resistance exerted by Erdongtang might be related to the phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt） signaling pathway. ConclusionThe established UHPLC-QqQ-MS has the advantages of simple sample processing， strong exclusivity and high sensitivity， and can simultaneously determine the contents of the main ingredients from seven herbs in Erdongtang， which can lay the foundation for the development of Erdongtang compound preparations. The results of the network pharmacology can provide a reference for the mechanism study of Erdongtang in the treatment of type 2 diabetes mellitus.