Biliary stricture after cholecystectomy poses difficult management problems to surgeons because of high and stable incidence.In contrast to malignant stricture,benign stricture requires durable repair.Repeated operations may not only increase the suffering of the patient,but also reduce the likelihood of a better outcome. A 56-year-old woman with biliary stricture after cholecystectomy who had undergone several operations in other hospitals was admitted to Chinese PLA General Hospital.Computed tomography (CT) scan showed a dilated biliary tree and localized the level of ductal obstruction in the hepatic hilar stricture.In addition,CT identified fluid collections in the left upper quadrant and no artery injury was detected. Ultrasound-guided percutaneous abdominal drainage was performed to control the abdominal infection. Magnetic resonance cholangiopancreatography classified the injury as Bismuth Ⅲ.The patient with bile leakage and severe abdominal infection was treated with antibiotics before the final operation.On June 1,2012,the patient received Roux-en-Y hepaticojejunostomy.After operation,the patient recovered smoothly without severe complications,such as bile leakage,cholangitis and recurrent stricture.Liver function of the patient was back to normal and T tube drainage was pulled out at the end of 3 months of follow up.

Objective To establish a method for the determination of paraquat in vegetables by high performance liquid chromatography(HPLC). Methods The HPLC separation was conducted by using an Agilent TC-C18 column (4.6 mm?250 mm,5?m). The detection wavelength was 257 nm. The eluent is the mixture of 10 mmol/L sodium heptanesulfonate and methanol (50+50) with the flow rate of 1.0 ml/min. Results The linearity of the method ranged 0.00-10.0 ?g/ml. The concentration of paraquat showed a good linear relationship (R2=0.999 4), the RSDs were 0.75%-3.65%, the rates of recovery were 96.1%-104.0%, and the limit of detection was 0.03 ?g/ml. Conclusion This simple and accurate method is applicable to the determination of paraquat in vegetables.

Total 215 patients with simple varicosis of great saphenous vein underweni surgical treatment in our hospital from February 2007 to January 2012,including 75 cases receiving traditional high ligation segmentation stripping operation (group A),69 cases receiving endovenous laser light therapy (group B),and 71 receiving minimally invasive translucent atherectomy (group C).The efficacy and postoperative complications were compared among 3 groups.The operation time,intraoperational bleeding and length of hospitalization in groups B and C were significantly less than those in group A (P ＜ 0.05).The hospitalization cost of groups A and B was significantly lower than that of group C (P ＜ 0.05).The incidence of subcutaneous induration in groups A and B was significantly higher than that of group C (P ＜ 0.05).The incidence of subcutaneous congestion in group A was significantly higher than that in groups B and C (P ＜0.05).The recurrence rate during 2-years of follow-up in groups A and B was higher than that in group C (x2 =8.592,5.672,P =0.003,0.016).Three surgical modalities in treatment of great saphenons varicose veins have advantage and disadvantages,the appropriate methods should be chosen based on the characteristics of procedures and the condition and intention of patients.

Objective To analyze the molecular epidemiological characteristics of norovirus (NoV) outbreaks in Qingdao between 2014 and 2016.Methods Stool samples were collected from NoV outbreaks between January 2014 and December 2016 and detected by real-time RT-PCR.NoV open reading frame 1 (ORF1) and ORF2 were partially amplified by RT-PCR.The amplified products were further analyzed by gene sequencing and genotyping.Phylogenetic analysis was conducted by using MEGA 6.0 software package.Results A total of 23 NoV outbreaks, involving 260 cases, were reported during 2014 to 2016.Of all collected stool samples, 128 were positive for NoV including 6 of genogroupⅠ (GⅠ) and 122 of genogroupⅡ (GⅡ).All positive samples were genotyped into 6 genotypes, which were GⅡ.P17-GⅡ.17, GⅡ.P12-GⅡ.3, GⅡ.P7-GⅡ.6、GⅡ.P2-GⅡ.2, GⅠ.Pb-GⅠ.6 and GⅡ.Pg-GⅡ.12.The 23 outbreaks included both single infections and mixed genotype infections, which were 11 of GⅡ.17 single infection, 4 of GⅡ.3 single infection, 3 of GⅡ.17 and GⅡ.3 mixed infection, 2 of GⅡ.17 and GⅡ.6 mixed infection, 1 of GⅠ.6 single infection, 1 of GⅡ.17 and GⅡ.2 mixed infection and 1 of GⅡ.17 and GⅡ.12 mixed infection.Conclusion NoV was an important pathogen responsible for viral diarrhea outbreaks in Qingdao.Several different genotypes were detected.The newly variant GⅡ.P17-GⅡ.17 was the predominant epidemic strain causing norovirus outbreaks in Qingdao during 2014 to 2016.

In teaching the course of Environmental Hygiene to the senior major of the four-year undergraduates of the Department of Public Administration,we have tried to reform the teaching program for the course of Public Place Hygiene.The related theories are taught right on the spot of public places instead of in classrooms.Students are organized to carry out such activities on their own as studying subject matters,consulting related documents and data,working out and implementing programs for on-the-spot monitoring and inspection,and then exchanging and discussing the results of monitoring and inspection,so that their interest in the courses is increased and their understanding of what they have learned is deepened.In this way they are able to apply their knowledge to practice,improve their practical capabilities,and enhance their overall capacity for analyzing and finding solutions to problems they are faced with.

To study the regulating effect of Astragalus Polysaccharides ( APS) to the mice infected by Brucella suis S2.Methods:120 BALB/c mice were randomly divided into 4 groups:experimental mice were injected APS 1 ml ( 0.4,1.2,3 mg/ml) via peritoneal cavity respectively once a day and the control group was injected with the same volume of saline for 3 days,then infected with Brucella suis S2 1 ml (1×107 L-1 ) by ip.Five mice of each group were killed through eye bloodletting at 1,6,12,24,48, 72 h respectively post-infection with Brucella suis S 2 and the peritoneal macrophage were obtained respectively to make smear.Phagocytic rate and phagocytic index were calculated by the Wright Giemsa staining after infected 1 h.TNF-α,IL-12 and IFN-γlevels of serum at different time points were measured by ELISA.The bacterial load of MΦand spleen were measured by coating method.Results:The phagocytic rate and phagocytic index of MΦin APS 3 dose groups were higher than those of the control group ( P<0.05 ).The microbial load of MΦin APS 3 dose groups at 1 h infected by Brucella suis S 2 were significantly higher than those of control,but significantly lower than those of control at 6,12,24,48,72 h after infected by Brucella suis S2.The microbial load of spleen in APS 3 dose groups at 6 h infected by Brucella suis S 2 were significantly higher than those of control ,but significantly lower than those of control at 12,24,48,72h after infected by Brucella suis S2.The concentrations of TNF-α,IL-12 and IFN-γin the serum of APS groups had significantly been improved ( P<0.05 ).Conclusion: APS can promote the activation of MΦin vivo and strengthen the activity of phagocytosis and killing to Brucella suis S 2.APS can promote the secretion of TNF-α,IL-12 and IFN-γof mice,strengthen the cellular immune response of mice to Brucella suis S 2.

Objective:To investigate the whole genome characteristics of coxsackievirus A4 (CVA4) circulating in Qingdao city.Methods:Four CVA4 isolates circulating in Qingdao city during 2013 to 2015 were selected. Whole genome sequences of these strains were amplified by one-step reverse transcription-polymerase chain reaction (RT-PCR). Sequence alignment and phylogenetic analysis were performed using MEGA7.0 software package. Genetic recombination analysis was performed using similarity plots 3.5.1 software package.Results:Phylogenetic analysis showed that based on the sequences of the whole genome and P1, P2 and P3 regions, HS312/QD/CHN/2013 and HS605/QD/CHN/2014 strains together with the early domestic isolates belonged to the same clade, while FY218/QD/CHN/2015 strain and CV-A4/P1033/2013/China strain collected in Wenzhou in 2013 formed another clade in each phylogenetic tree. HS144/QD/CHN/2014 strain belonged to the same clade as HS312/QD/CHN/2014, HS605/QD/CHN/2014 and the early domestic CVA4 isolates in the phylogenetic tree based on the P1 region, but formed a separate clade in the phylogenetic trees based on the whole genome, P2 region and P3 region. Genetic recombination analysis revealed that there was genetic recombination between HS144/QD/CHN/2014 strain and the CVA2 strain of CV-A2/P373/2013/China isolated in mainland China in 2013 in the region of 2C-3D (5 081-7 301); FY218/QD/CHN/2015 and CV-A4/P1033/2013/China strains were highly homologous and recombination signal sequences were detected in the region of 2A-2B (3 821-4 161) between the two strains and the CVA2 strain of CV-A2/P373/2013/China.Conclusions:The CVA4 isolates circulating in Qingdao city presented obvious genetic diversity at the genome-wide level.

Gluconobacter oxydans is known to oxidize glucose to gluconic acid (GA), and subsequently, to 2-keto-gluconic acid (2KGA) and 5-keto-gluconic acid (5KGA), while 5KGA can be converted to L-(+)-tartaric acid. In order to increase the production of 5KGA, Gluconobacter oxydans HGI-1 that converts GA to 5KGA exclusively was chosen in this study, and effects of carbon sources (lactose, maltose, sucrose, amylum and glucose) and nitrogen sources (yeast extract, fish meal, corn steep liquor, soybean meal and cotton-seed meal) on 5KGA production were investigated. Results of experiment in 500 mL shake-flask show that the highest yield of 5KGA (98.20 g/L) was obtained using 100 g/L glucose as carbon source. 5KGA reached 100.20 g/L, 109.10 g/L, 99.83 g/L with yeast extract, fish meal and corn steep liquor as nitrogen source respectively, among which the optimal nitrogen source was fish meal. The yield of 5KGA by corn steep liquor is slightly lower than that by yeast extract. For the economic reason, corn steep liquor was selected as nitrogen source and scaled up to 5 L stirred-tank fermentor, and the final concentration of 5KGA reached 93.80 g/L, with its maximum volumetric productivity of 3.48 g/(L x h) and average volumetric productivity of 1.56 g/(L x h). The result obtained in this study showed that carbon and nitrogen sourses for large-scale production of 5KGA by Gluconobacter oxydans HGI-1 were glucose and corn steep liquor, respectively, and the available glucose almost completely (85.93%) into 5KGA.
Bioreactors ; Carbon ; chemistry ; Culture Media ; chemistry ; Fermentation ; Gluconates ; metabolism ; Gluconobacter oxydans ; metabolism ; Industrial Microbiology ; Nitrogen ; chemistry

Objective To investigate the effective route and proper method in transfecting gene into liver graft mediated by adeno-associated virus vector.Methods Three routes including hepatic artery,portal vein and hepatic artery+portal vein,and 3 methods,i.e.routine,circulation and clamping were employed for infusion.The best infusion route and method of gene transfection into liver graft were determined by observing the color change of liver and detecting liver function and transfoetion rate of liver cells.The safety of these methods was evaluated.Results In all the infusion procedures,the color of the liver grafts turned from red to white,no apparent color differenee of the livers and no enlargement nor mottling were observed under surgical microscope.The liver color was back to normal immediately after blood flow was restored.No significantly statistical differences of the ALT values were observed among all the groups(F=0.343,1.265,0.055,P＞0.05).Adeno-associated virus vectors coding for the enhanced green fluorescence protein(AAV2-EGFP)were successfully transfected into liver cells by the 3 infusion routes 1 week later,and the difierences of transfection rates via the 3 routes had no statistical significance(F=0.080,0.091,0.045,P＞0.05).The transfoction rate of AAV2-EGFP was the highest at any time points when using the clamping method,and then followed by circulation method and routine method,with statistical differenee(F=3.880,2.976,5.129,P＜0.05).The transfection rates of AAV2-EGFP were increased progressively and peaked at the 6th week,and then they were decreased gradually.Conclusions Infusion via hepatic artery is the effective route for gene transfection and clamping the vessels can elevate the transfection rate of AAV2-EGFP.All procedures were performed without detectable liver injury.The transfection of gene into liver graft mediated by adeno-associated virus vector is a slow and persistent process.

Objective To investigate influence of mirtazapine on polysomnograpy (PSG) of depression dysphylaxia patient and treatment effect.Methods 22 dysphylaxia patients and 22 healthy contrast persons were detected by PSG.The group of dysphylaxia patients were re-detected PSG 6 weeks later after treatment by Mirtazapine.In order to evaluate the patient' symptoms of depression and early awakening,the scale of HAMD was utilized at the time before and after 2 weeks,6 weeks treatment by mirtazapine.To compare changes of PSG index,HAMD scores and dysphylaxia scores before and after treatment.Results Compared with healthy controls,there existed much deviation with dysphylaxia patients on PSG index.6 weeks after mirtazapine treatment,the PSG showed the sleeping latency had shortened to ( 16.9 ± 6.6) min,sleep efficiency had improved ( 85.4 ± 6.7 ) ％,awake time had shortened (27.7 ± 10.4)min,sleep maintenance rate had risen (87.9 ±5.3)％,decrease (9.7±4.1 )％ of the S1 sleeping stage percentage,S2 had increased ( 148.0 ±30.7)％,REM density had decreased (56.1 ±3.8)％.the difference was significant (P＜0.05).The scores of HAMD and early awakening after treatment were significantly lower than before treatment,the difference was significant (P＜0.01 ).Correlation analysis showed there was no significant correlation between the HAMD,dysphylaxia reduced rate and changes of PSG all indicators(P ＞ 0.05 ).Conclusion It may be one of the biological markers for dysphylaxi in shortened of REM sleep latency,prolonged of REM sleep time and increased of REM activity and density.There is no correlation between post-treatment changes of PSG.