Objective To evaluate the feasibility and safety of peroral direct cholangioscopy (PDCS) by freehand intubation using routine straight-view endoscope for diagnosis and therapy of biliary diseases.Methods Patients with bile duct dilation underwent standard ERCP and native papilla was dilated using EST and/or endoscopic papillary large balloon dilation,according to the size of the papilla.Then peroral direct cholangioscopy was performed by freehand intubation using routine straight-view endoscope.General data of patients,procedure of ERCP,diagnosis of PDCS and complications were recorded.Results A total of 5 patients underwent PDCS.Indications included common bile duct stones (n =2),intraductal papillary neoplasm of bile buct (n =2) and benign biliary stricture after removable metal stent placement (n =1).The diameter of common bile duct ranges from 1.2 cm to 2.4 cm.EST or/and EPLBD was required in 3/5 patients to facilitate PDCS.Freehand PDCS intubation of the bile duct was successful in all procedures (1 case into distal common bile duct,4 cases into proximal common bile duct).Complications were cholangitis managed with intavenous antibiotics (n =1).No procedure related death occurred.Conclusion Freehand PDCS is technically feasible and safe,and may be clinically useful for diagnostic and therapeutic purposes in managing select biliary tract diseases.

Athletes ; Humans ; Microcirculation ; Muscles ; physiology ; Sports

Objective To assess the outcome of internal urethrotomy for the treatment of urethral stricture. Metho ds In the past 10 years, a total of 203 patients with proved urethra l strictures were treated by optical internal urethrotomy.Follow-up studies wer e carried out for 157 patients. Results Of the 203 patie nts 194(96%) have undergone successful internal urethrotomy, 9 patients(4%) with long stricture more than 3 cm failed on repeated internal urethr otomy and required open surgery. Internal urethrotomy was carried out twice for 9 patients and thrice for 5 with successful outcome. Of the 194 patients 157 wer e followed up for 6 months to 8 years, in whom 143 have had satisfactory voiding and 14 needed intermittent dilation. Conclusions Endosc opic treatment shoud be considered as the procedure of first choice for the tr eatment of urethral strictuer, however repeated urethrotomy should be avoided.

Objective To observe the efficacy of radical nephrectomy plus embolectomy for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement. Methods Clinical and pathologic data of 8 patients with renal cell carcinoma extending into renal vein or inferior vena cava were summarized.The operative essentials were introduced,and survival periods were followed up. Results A total of 8 patients underwent radical nephrectomy plus embolectomy.One patient died during the operation after embolectomy with exhausted respiration and cardiovascular function.Three patients survived for 2,4 and 22 months respectively,but all died of distal metastasis later.Four patients were alive for 2,14,25 and 47 months respectively after operations till writing of this article. Conclusions Radical nephrectomy plus embolectomy is a valuable method for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement.

Objective To evaluate the efficacy of repeated internal urethrotomy as the treatment for male urethral stricture. Methods A total of 296 patients with proved urethral stricture was treated with optical internal urethrotomy and the value of repeated internal urethrotomy has been analysed. Results Of the 296 patients internal urethrotomy has been successful in 261 (88.2%),217 patients with single operation,twice or three times with successful outcome in 32 and 12 patients respectively.35 patients (11.8%) failed with more than three times internal urethrotomy,of which 26 patients was then treated with stents and 9 required open surgery. Conclusions Internal urethrotomy is an efficacious treatment for male urethral stricture,but repeated operation is of limited value especially when the course of the disease is longer than 1 year.

Objective To study the tactics, methods and relevant factors of transcatheter embolization for acute gastrointestinal hemorrhage.Methods Fifteen patients with acute gastrointestinal hemorrhage were embolized by one of the methods of Polyvinyl Alcohol (PVA), gelfoam or metal coils. Four of the fifteen patients were upper gastrointestinal hemorrhage, the other cases were lower gastrointestinal hemorrhage which were embolized using coaxial microcatheter. Results Fourteen of the fifteen patients were treated successfully by these methods. There were total 17 times of embolization for 16 parts, the success rate reached 94.1%. The other one reveaded an infarction of intestine after the embolization and was cured by resection. One of the fifteen patients appeared a recurrent hemorrhage 3 months later, and confirmed to be a hemangiolymphangioma. Two patients with malignant tumor were operated upon selectively. The other patient of intestinal hemorrhage was embolized successfully by using a metal coil after shock. Leiomyoma complicated with large area of bleeding was finally proven by operation.Conclusions Transcatheter embolization for acute massive gastrointestinal hemorrhage is safe and efficient under different choice of methods. The key of success is the right selection of embolized target artery and dosage of emboli.

Objective To explore the inductive effect of striatal tissue on mouse embryonic stem cells and further analyse the cell source and inductive pattern of this inductive effect. Methods We employed striatal extracts、conditioned medium of striatal astrocytes and conditioned medium of striatal neurons to induce embryonic stem cell to differentiate directly. The differentiated cells were evaluated by morphological observation and TH immunocytochemical staining method. We also performed a quantitative analysis of the results. Results Striatal extracts and conditioned medium of striatal astrocytes had obvious inductive effect on embryonic stem cell.Percentages of three groups were 15%,15.2% and 3% respectively. Conclusions The astrocytes in striatum might have an inductive effect on dopaminergic neuronal differentiation of embryonic stem cells.The determination of inductive factor will be our next research aim.;

Objective To explore the optimal condition of direct differentiation into dopaminergic neurons of embryonic stem cells in serum-free and feeder layer cell free medium. Methods We used the method of phase induction to culture embryonic stem cells. At first, embryonic stem cells were cultured in the serum-free medium with bFGF and LIF so as to realize the direct differentiation from embryonic stem cells to neural precursors. Differentiated cells were determined by nestin immunocytochemical staining. On this basis, we transferred embryonic stem cells to the B27 serum-free medium with IL-1 so as to realize the direct differentiation from neural precursors to dopaminergic neurons. Differentiated cells were determined by TH immunocytochemical staining. Results Approximately 85 percent of cell masses were nestin immuno-positive. The differentiation ratio of dopaminergic neurons was 13%, which increased significantly in comparison with natural differentiation ratio of dopaminergic neurons.Conclusion Without serum and feeder layer cell, we can induce embryonic stem cells to differentiate into dopaminergic neurons effectively by adding different growth factors at different phases, which makes the inductive processes more easily.

Objective:To search for carrier of short active peptide with binding to human CD59 of the surface of HeLa cell.Methods:Ph. D. 12 display peptide library was biopanning with HeLa cell high-expressing CD59. After competitive test, positive phage clones were identified by sandwich ELISA and sequenced.Results:10 phage clones were identified to have higher combination with CD59.Conclusion:The sequence of peptide with binding to CD59 has been obtained.That might lay a basis for design of short peptide of CD59 on tumor sneaking through.

Calcification is a major cause of clinical failure of bioprosthetic and other tissue cardiac valve substitutes.The mechanism of calcification of cardiac valve substitutes is quite complex and has a variety of determinants,involving reaction of calcium-containing extracellular fluid with membrane-associated phosphorus to yield calcium phosphate mineral deposits.The most promising anticalcification strategies have included binding of calcification inhibitors to glutaraldehyde fixed tissue,removal or modification of calcifiable components,modification of glutaraldehyde fixation and use of tissue cross linking agents other than glutaraldehyde.This article reviews current progress toward the research of calcification and anticalcification strategies that are under investigation either in advanced animal models or in clinical trials.