Objective To evaluate the significance of percutaneous transhepatic cholecystoscopy ( PTCCS) in managing cholecystolitheasis. Methods From September 1999 to November 2001, eighty - six patients with symptomatic gallstones were allocated into this study. At first percutaneous transhepatic gallbladder drainage ( PTGBD) was carried out, one week later the formed fistula was dilated by bouginage to 16-22Fr in diameter, thereafter cholecystoscope was inserted into gallbladder through the dilated fistula to extract the stones using basket or electrohydraulic lithotripsy (EHL). Results PTGBD was attempted successfully in 82 out of 86 cases, PTCCS was performed in 80 of them. The amount of stones ranged from 1 to 76, single stone in 28 patients, stones more than two in 52 , with stone size ranged from 5 to 32 mm, and stones greater than 15mm in 45 cases. The stones were removed only using basket in 28, and by EHL in 54 cases due to their large size. The overall stone removal rate was 97. 5 % (78/80) . Complication of peritonitis appeared in 4 cases (4. 7% ) requiring emergent surgical intervention. The follow - up period with an average of 16. 4 months, gallstones recurred in 2 cases (2.5%). Stones were assayed by intra - red spectrom-etry in 30 of 54 patients with EHL, cholesterol stone existed in 24 of them. Conclusion PTCCS is relatively a safe and effective procedure for those patients with high risk on surgical cholecystectomy, or unsuitable to receive laparoscopic cholecystectomy. If the patients were selected strictly along the rules of indication, the complication and stone recurrence can be avoided.

Objective To observe the real-time and short-term therapeutic efficacies of fire-needle acupuncture and warm needling in treating cervical vertigo due to upward disturbance of phlegm-turbidity, and compare the two treatment methods. Method Eighty-four patients with cervical vertigo due to upward disturbance of phlegm-turbidity were randomized into a fire-needle acupuncture group and a warm needling group, 42 cases in each group. The two groups received treatment once a day, respectively for 10 sessions. The symptoms, functions and total score were evaluated by adopting the modified Cervical Vertigo Symptoms and Functions Assessment Scale before the second treatment session and after 10 treatment sessions; the therapeutic efficacy was evaluated based on the traditional Chinese medicine symptoms scale. Result The scores after 10 treatment sessions were significantly different from that before treatment in the two groups (P<0.05);before the 2nd treatment session, the improvements of the symptoms and total scores in the fire-needle acupuncture group were more significant than that in the warm needling group (P<0.05);after 10 sessions, there were significant differences in comparing the symptoms, functions and total scores between the two groups (P<0.05);the clinical control rate was 26.2%and total effective rate was 95.2%in the fire-needle acupuncture group, versus 9.5%and 90.5%in the warm needling group, and there was a significant difference in comparing the therapeutic efficacy between the two groups. Conclusion Fire-needle acupuncture and warm needling both are effective in treating cervical vertigo due to upward disturbance of phlegm-turbidity, while fire-needle acupuncture can improve the vertigo symptoms in a real-time manner, and its short-term therapeutic efficacy is also superior to that of warm needling.

Objective To investigate the effect of music electroacupuncture on perifocal ferric ions and neuronal apoptosis and the brain water content in rats with acute cerebral hemorrhage and explore the mechanism of its action on acute cerebral hemorrhage.Methods One hundred and twenty-eight healthy adult male Wister rats were randomized to normal, model, electroacupuncture and music electroacupuncture groups. In each group, four time points of 6 hrs, 24 hrs, 3 days and 7 days were set up, eight rats each time point. A rat model of acute cerebral hemorrhage was made using collagenase. In the electroacupuncture and music electroacupuncture groups, point Baihui was connected to the anode and point Taiyang to the cathode, 2 voltage was used as a selection parameter and electroacupuncture lasted 30 min. Intracerebral perifocal ferric ions and neuronal apoptosis and the brain water content were measured at four time points of 6 hrs, 24 hrs, 3 days and 7 days after model making.Results Intracerebral ferric ion content was higher in the model, electroacupuncture and music electroacupuncture groups of rats than in the normal group at 6 hrsafter model making (P<0.05), lower in the electroacupuncture and music electroacupuncture groups than in the model group at 24 hrs, 3 and 7 days after model making (P<0.05) and lower in the music electroacupuncture group than in the electroacupuncture group at 3 and 7 days after model making (P<0.05). Intracerebral neuronal apoptosis was higher in the model, electroacupuncture and music electroacupuncture groups of rats than in the normal group at 6 hrs after model making (P<0.05) and lower in the music electroacupuncture group than in the electro- acupuncture group at 7 days after model making (P<0.05). The brain water content was higher in the model, electro- cupuncture and music electroacupuncture groups of rats than in the normal group at 6 and 24 hrs after model making (P<0.05), lower in the electroacupuncture and music electroacupuncture groups than in the model group at 3 days after model making (P<0.05) and lower in the music electroacupuncture group than in the electroacupuncture group at 7 days after model making (P<0.05).Conclusions Music electroacupuncture has a benign regulating effect on intracerebral perifocal ferric ions, inhibits neuronal apoptosis around hematoma in the early stage and reduces cerebral edema in rats with acute cerebral hemorrhage. Its therapeutic effect is superior to that of electroacupuncture.

Objective To investigate the risk factors of recurrent common bile duct (CBD) stones after treatment with endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 802 patients with CBD stone and with complete follow-up data were recruited to the study, among which 297 patients were accompanied with gallstone, 222 patients having undergone cholecystectomy before ERCP and 283 having no gallstones. The CBD stone recurrent frequency and the possible risk factors were calculated with uni- and multi-variate logistic regression analysis. Results The patients were followed up at a mean duration of 84. 8 months, and CBD stone re-occurred in 92 (11.5%). Both uni- and multivariate analysis showed gallstones, CBD larger than 1.5 cm, endoscopic mechanical lithotrity (EML) and angle of bile duct less than 120° were risk factors of recurrence. Multivariate analysis showed cholesterol stones, cholangeal stricture or sphincter of Oddis dysfunction (SOD) were all risk factors for reccurrence. Univariate analysis revealed that history of cholecystectomy or Billroth Ⅱ gastrectomy, stones larger than 1.5 cm and multiple stones were risk factors of recurrence. Conclusion For those with CBD stones undergoing ERCP, gallstone,common bile larger than 1. 5cm, EML and the angle of CBD less than 120° are major risk factors of recurrence. History of cholecystectomy and Billroth Ⅱ gastrectomy, SOD, large CBD stone ( ≥1.5 cm), cholesterol stone and multiple stones are also associating risk factors.

Objective To study the effect of Sandra Fucile oral stimulation on oral feeding readiness and ability of preterm infants.Methods Sixty-five premature infants were selected in the study.All of the premature infants were recruited randomly in convenience between Jul.and Dec.2012.For a randomized control principle,SPSS 13.0 was performed to achieve complete random design.Objects were divided into control group(receiving routine nursing) and intervention group(on the basis of routine nursing,receiving 15 minutes oral stimulation,1 time/day,for 10 days).Chinese version of Preterm Infant Oral Feeding Readiness Assessment scale(PIOFRA scale-CV) was used when intervention began,and 7 days,10 days,14 days after the start of the intervention.Results PIOFRA-CV scale score was statistically different at different time in both groups(F =169.062,P ＜0.001).The first day ratings were minimum in the 2 groups,after which with an upward trend over time.The control group and intervention group rated a statistically significant difference(F =5.538,P =0.022).Except for no difference on the first day and seventh day (t =1.650,P =0.204 ;t =0.817,P =0.369) between the 2 groups,the intervention group had a higher score than the control group (t =17.339,24.141,all P ＜0.001).Group and time had an interaction effect(F =1 1.561,P ＜0.001).The incidence of vomiting[42.4％ (14/33 cases) vs 34.4％ (11/32 cases)],infection [27.3％ (9/33 cases) vs 9.4％ (3/32 cases)],and gastro-oesophageal reflux[30.3％ (10/33 cases) vs 25.0％ (8/32 cases)] were not significantly different between the 2 groups(x2 =0.445,3.457,0.288,all P ＞ 0.05).Conclusions Saudra Fucile oral stimulation method can significantly promote the development of premature oral feeding ability on the 10 day after the intervention,and will not increase vomiting,gastroesophageal reflux,and infection.It is suitable for clinical application.

OBJECTIVETo summarize and analyze rules for acupoint selection and prescription composition in clinical literature regarding acupuncture for polycystic ovary syndrome (PCOS).

METHODSCHKD, VIP and Wan-fang databases were retrieved. The clinical literature data included in the study was collected. The descriptive statistical analysis was conducted on the main acupoints, main meridians of main acupoints, distribution of main acupoints, application of special points and rules for acupoint composition.

RESULTSFifty-two articles were included, involving 55 main acupoints with a total frequency of 375. The most frequent acupoints of acupuncture for PCOS were Sanyinjiao (SP 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zhongji (CV 3) and Qihai (CV 6). The meridians of main acupoitns were conception vessel, spleen meridian of foot-taiyin and stomach meridian of foot-yangming. The main acupoints were distributed in the lower abdomen, lower limbs and back. In the special points, the use of front-mu points, five-shu points and back-shu points was more frequent. The prescription was usually consisted of 5 to 7 acupoints, (6. 9 ± 3. 6) acupoints in average.

CONCLUSIONIn the modern treatment of acupuncture for PCOS, Sanyinjiao (SP 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zhongii (CV 3) and Qihai (CV 6) are most used. With the theories of meridian and zang-fu as essential references, the acupoint selection is based on disease differentiation and meridian circulation. Additionally, the methods for selecting the adjacent points and the distant points are adopted.

Objective To investigate the relationship between bile amylase (BA) elevation and biliary tract disease in patients with normal pancreaticobiliary junction (NPBJ). Methods The bile juice was collected from bile duct in 202 consecutive cases who underwent therapeutic endoscopic retragrade cholangiopancreatography (ERCP) for biliary diseases ( biliary bile group), and from gallbladder (GB) in 73 consecutive cases who underwent percutaneous transbepatic cholecystoscopy for extraction of GB stone ( GB bile group). In biliary bile group, in addition to the measurement of BA, the level of lipnse (n =68), bacteria culture ( n = 149 ), manometry of Oddi's sphincter ( n = 27 ) and bile duct ( n = 38) were also performed. In GB bile group, additional GB biopsy was taken in 31 cases. No patient with pancreaticobiliary maljunction, history of cholangiojejunostomy or post-endoscopic sphincterotomy was included in the study. Results In biliary bile group, BA level was elevated in 95 patients (47. 0% ), in which there was no significant difference between neoplastic and non-neoplastic cases ( 56. 9% vs. 43.7%, P > 0. 05 ), although BA was elevated in most patients with hiler cholangiocarcinoma (7/9). The level of BA was correlated with bile lipase (r =0. 561 ), but not with pressure of Oddi's sphincter or bile duct. No significant difference in positive rate of bile bacteria culture was detected between patients with normal BA level and those with elevated level. In GB bile group, BA level was elevated in 25 patients (34. 3% ), in which the frequency of GB epithelium dysplasia is 87.5%, which was significantly higher than that from patients with normal BA level ( P < 0. 001 ). Conclusion The patients with biliary tract disease and NPBJ have high incidence of reflux of pancreatic juice into bile duct. In patients with elevated BA level, there was no significant difference between incidences of neoplastic or non-neoplastic disease, while the frequency of GB epithelium dysplasia and hilar cholangiocarcinoma were higher than those from patients with normal BA level.

Biomacromolecules play an important role in the treatment of many diseases, but as a result of cell membrane serving as the natural barriers, only the small molecular compounds whose molecular weights are smaller than 600 Da can get through cell membrane and enter the cell. In recent years, some short peptides (the length less than 30 amino acids) are found to have the cell-penetrating function, called cell-penetrating peptides (CPPs). They are able to effectively translocate segments of protein, polypeptides, nucleic acid into the cells of many mammal animals with many methods. They have high transduction efficiency and will not lead to cell damage. So, the discovery of CPPs has a very good applicable prospect in such research fields as cell-biology, gene-therapy, drug transduction in vivo, evaluation of clinical medicine and medical immunology. This paper reviews the types and characteristics of CPPs, internalization mechanisms, applications, and their existing problems.

Objective To evaluate clinical application of VCS technology in diagnosis for acute leukemia and its subtypes by LH750 automated hematology analyzer. Methods A total of 178 leukemia patients (105 acute granilocytic leukemia, 42 acute lymphocytic leukemia, 31 acute monecytic leukemia)and 151 non-leukemia patients (86 granulocytic abnormal cases, 35 lymphocytic abnormal cases,30 monocytic abnormal cases) were enrolled into this study. Peripheral blood samples were analyzed by both Coulter LH750 automated hematology analyzer and manual microscopic examination. Microscopic examination was used as reference to evaluate the diagnosis value of VCS technology in blast detecting. VCS parameters were compared for AGL subsets. The clinical value of VCS technology in diagnosis for different acute leukemia was also evaluated by combining VCS scattergram and suspect flags provided by LH750. Results Compared with manual examination, a sensitivity of 95.5% (170/178) and specificity of 95.4% (144/151) were achieved by VCS technology in detecting blasts in acute leukemia and nonleukemia patients. In patients with AGL, the MNV, MNV-SD, MNC and MNC-SD (224.40 ± 23.37,37.40 ±12. 31,145. 80 ±7. 93,24. 79 ±5. 18) were higher than granulocytic abnormal patients( 169.96 ±11.50,29.21 ± 5.27,133.30 ± 5.50, 10.62 ± 4.09) and the differences were statistically significant ( t values were 16. 832, 5. 148, 5. 735, 19. 953 respectively, P < 0. 01 ). On the contrary, MNS ( 122. 90 ±6. 35) in AGL patients was significantly lower than granulocytic abnormal patients( 131.00 ± 5. 69, t =-7.64, P<0.01). In patients with ALL, the MLV, MLV-SD, MLC, MLS, MLS-SD (97.60 ± 13.40,22. 35 ± 7.94,110. 00 ± 4. 60,77. 60 ± 19.00,20. 61 ± 3.30 ) were higher than lymphocytic abnormal patients(82. 10 ± 3.00, 14.41 ±2.35, 100.60 ±2.70, 48. 10 ±3.50, 17.60 ± 1.60). The data also showed a statistical significance (t values were 7.576, 6. 118, 4. 041, 9. 353, 2. 988 respectively, P <0.05). In patients with AMOL, the MMV, MMV-SD, MMC, MMC-SD, MMS(197. 30 ±20.50,30.47 ±6.58,123.20 ± 10. 10,6.57 ± 1.57,98.00 ± 5.60) were significantly higher than monocytic abnormal patients( 167.80 ± 15.77,21.90 ± 9. 64,113.60 ± 6. 73,5.20 ± 3. 21,84. 20 ± 14. 35 ) and the differences were statistically significant (t values were 6. 332, 4. 033, 4. 650, 2. 993, 6. 273 respectively , P <0. 01 ).The differences of MNV, MNV-SD, MNC, MNC-SD, MNS-SD for different AGL subtypes were statistically significant ( F values were 21.2, 169. 5, 13.6, 3. 6 and 98.6 respectively, P <0. 01 ). For AGL, ALL and AMOL, the ratios of normal blast distribution in scattergram were 81% (85/105), 74% (31/42) ,and 74% (23/31). Conclusions The VCS parameters can reflect the changes of peripheral white blood cell morphology sensitively. VCS technology can diagnose acute leukemia and its subtypes efficieutly.

Objective To observe the clinical efficacy of pricking anti-Ashi points with fire needles in treating acute lumbar sprain.Method Seventy-six patients with acute lumbar sprain were randomized into a treatment group and a control group, 38 cases in each group. The treatment group was intervened by pricking anti-Ashi points with fire needles, while the control group was by warm needling. The Visual Analogue Scale (VAS) and Roland-Morris Dysfunction Questionnaire (RMDQ) were adopted to evaluate lumbar pain and dysfunction after 1-day and 5-day treatment, and the clinical efficacies were compared between the two groups.Result Respectively after the first treatment session and 5 treatment sessions, the VAS and RMDQ scores were significantly changed in both groups (P<0.01). Respectively after the first treatment session and 5 treatment sessions, the VAS and RMDQ scores in the treatment group were significantly different from that in the control group (P<0.05). The total effective rate and recovery rate were respectively 94.7% and 63.2% in the treatment group, versus 86.8% and 42.1% in the control group, and the differences were statistically significant (P<0.01).Conclusion Pricking anti-Ashi points with fire needles is an effective method in treating acute lumbar sprain, and it can produce a significant real-time analgesic effect.