It is a consensus to place stent after cutting bile duct in the hepatobiliary surgery in the past.However,as the development of bile physiological research and surgical technique,especially the raise of medical concepts of rapid recovery,the negative effects which are caused by the placement of stent have been taken seriously gradually.Up to now,whether the stent should be placed after the bile duct is cut has no definite answer yet.

With advancements in the field of cancer stem cells,the hypothesis that colon cancer originates from stem cells has not only been introduced but also receives substantial supports by separating a subpopulation of colon cancer cells through primitive cells markers.Unlike most non-tumourigenasis colon cancer cells,these tumor-initiating cells have many specific characters both in vitro and in vivo.An improved understanding of drug resistance based on cancer stem cells and molecular pathways that regulate proliferation and differentiation of gastrointestinal cancer stem cells could doubtless translate into new therapeutic strategies.

Sunitinib malate (SU11248 ,Sutent) is an orally available small-molecule multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities.In 2006 sunitinib was approved by FDA for imatinib intolerant gastrointestinal stromal tumors (GIST) patients or imatinib resistant GIST patients.This article review the molecular-based mechanism,the mechanism of resistance,the biomarker,the clinical trials and the adverse effects of sunitinib in the treatment of imatinib-resistant GIST.

Various hypotheses have been put forward to explain the pathogenesis of hemorrhoidal diseases. However, the etiology and mechanisms of hemorrhoids are far from clear, and as a consequence the present therapeutic objective is just to relieve or abolish the symptoms of hemorrhoids. In this review, the recent research advances on the pathophysiological characteristics that are closely associated with hemorrhoids are analyzed and discussed, which include constipation, high anal resting pressure, anal mucosa damage, aging of the anal cushion supporting tissue, blood and vessel alterations, obstruction of microcirculation and biochemical changes.

Objective; To elucidate the mechanism of the role of ER-a in fat metabolism by regulating the expression of ER-a in SD rats marrow mesenchymal stem cells during differentiating into adipocytes in vitro. Methods ;SD rats marrow mesenchymal stem cells were separated and cultivated. The ER-a was transfected into the rBMSCs in group one. Tamoxifen Citrate was used to restrain the expression of ER-a in group two, the group without any treatment was used as control. Western blot was used to identify the difference of ER-a expression among different groups and Oil-Red-0 staining was employed to identify the adipocytes in vitro. Results; There was significant difference between the number of lipids and different groups (P <0. 01) ,the number of lipid droplet changed concomitantly with ER-a: Low-expression ER-a group > Control group > High-expression ER-a group. Conclusion; ER-a in SD rats marrow mesenchymal stem cells may restrain the adipocyte differentiation.

This artical introduces the cutter develop t for basi hospitals to carry out the vitreous resection.It is characterized by simple structure,easy to use and carry,complete fuctions and it is satified with results.

Objective By measuring the concentrations of serum IL-2,IL-4,IL-8 and TNF-αin chronic bronchitis patients before and after the acupoint sticking therapy which was also called winter disease treated in summer to investigate the effect of therapy on serum concentrations of IL-2,IL-4,IL-8 and TNF-α.Methods 30 cases of patients diagnosed with chronic bronchitis in paracmasia and did not recieve other related treatment were randomly divided into acupoint application therapy group (treatment group)and the control group.The treatment group was giventhree Fuacupoint sticking therapy,the control group was given thecomfortacupoint sticking therapy.Serum IL-2,IL-4,IL-8 and TNF-αconcentrations were compared between the 2 groups before and after treatment.Results In the treatment group,the serum IL-2 concentration of patients after treatment was significantly higher than that before treatment(P <0.05),IL-8 and TNF-αconcentrations were significantly lower than those before therapy(P <0.05).Af-ter treatment,serum IL-2,IL-4 levels were significantly higher than those in the control group(P <0.05 )while IL-8 and TNF-αwere significantly lower than those of the control group(P <0.05 ).Conclusion Acupoint sticking therapy in summer for winter diseases effectively increase the concentration of serum IL-2 in patients with chronic bronchitis,reduced IL-8,TNF-α concentra-tions,and enhance their own immunity ability,reduce the degree of inflammation.

Objective To know about the status quo and influencing factors of undergraduate nurses' psychological empowerment at present,and provide a theoretical basis for nursing administrators so as to take measures to raise the level of psychological empowerment of undergraduate nurses.Methods General information questionnaire for nurses,Psychological Empowerment Scale were used to survey 207 undergraduate nurses in 3 first class teaching hospital of Dalian City.Results Undergraduate nurses' psychological empowerment score was (43.890±6.515) points,four dimensions whose scores from high to low were self-efficacy,job significance,autonomy and job impact.There was statistical difference in terms of ages,working length,working positions,professional titles,working purposes and training opportunities.Among them,working position and working purpose were the most important influencing factors of psychological empowerment.Conclusions Psychological empowerment of undergraduate nurses needs to be improved,managers should pay attention to the role of psychological empowerment,and actively cultivate and correctly guide undergraduate nurses in order to stimulate their potential in work,and finally,promote the sustainable development of a solid nursing career.

Objective To investigate the effects and safety of mechanical continue heart chest compression ventilation (CCV) and interrupt pressure ventilation (30∶2) on cardiopulmonary resuscitation (CPR).Methods According to the mechanical pressure ventilation different way,90 patients with cardiopulmonary resuscitation (CPR) in our hospital emergency center were admitted into control group (30∶2 group) with 48 cases and observation group (CCV group) with 42 cases,with a before and after case-control study to compare the recovery effects [rate of spontaneous circulation restoration (ROCS),successful recovery rate,the ROCS time,withdraw machine time,and Glasgow coma scale(GCS) in successful recovery patients] and recovery of adveme events (fracture,skin lesions,hemopneumothorax,and visceral injury).Results With comparison between two groups,CCV group had shorter ROCS recovery time and withdraw machine time [(9.31±4.32) min vs (12.67±4.86) min,(32.07 t4.84) min vs (36.33 ± 3.37)min,P ＜0.05],higher rate of ROCS and successful recovery rate (42.9％ vs 22.9％,21.4％ vs 6.3％,P ＜ 0.05) than 30∶2 group;while both were no difference in Glasgow coma scale (GCS) in successful recovery patients (P ＞ 0.05).The incidence of adverse events were not different in both (11.9％ vs 8.3％,P ＞0.05).Conclusions Mechanical continue chest compression ventilation (CCV) compared to interrupt pressure ventilation (30∶ 2) can effectively shorten the ROCS recovery time and withdraw machine time,improve the ROSC recovery rate and success rate of recovery,but failed to improve nerve functions.Two groups have a lower incidence of adverse events,which is safe to use.

Objective To compare the influence of cardiopulmonary bypass(CPB) on brain injury in the infants with compli‐cated congenital heart disease(CHD) and simple CHD by analyzing and monitoring the perioperative cerebral electric impedance co‐efficient ,serum S‐100βprotein and neuron specific enolase (NSE) .Methods Forty infants with CHD were randomly selected and divided into two groups:the complicated group(n=20 ,13 cases of tertralogy of fallot ,7 cases of transposition of great arteries) and the simple group(n=20 ,8 cases of atrial septal defect ,12 cases of ventricular septal defect) .Blood samples were taken and the cere‐bral electric impedance coefficients before operation(T1 ) ,at 10 min after CPB(T2 ) ,immediately after aortic clamping(T3 ) ,aortic o‐pening(T4 ) ,end of CPB(T5 ) ,at 5 h(T6 ) and 24 h (T7 ) after CPB were measured by the BORN‐BE noninvasive brain edema moni‐tor .Serum levels of S‐100βprotein and NSE were detected by ELISA .Results There was no statistically significant difference in the cerebral electric impedance coefficient ,S‐100βprotein and NSE before surgery(P>0 .05) .The cerebral electric impedance coef‐ficient ,S‐100βprotein and NSE were significantly increased from the beginning to the end of CPB(P< 0 .05) ,and gradually de‐creased after CPB(P<0 .05) .The cerebral electric impedance coefficient ,S‐100βprotein and NSE were obviously higher in the com‐plicated group than those in the simple group at the same time points(P<0 .05) .The cerebral electric impedance coefficient was re‐spectively correlated with S‐100βprotein and NSE .Conclusion The influence of CPB on brain injury in complicating CHD infants is more serious than that in simple CHD infants .The BORN‐BE noninvasive brain edema monitor can be used during CPB periopera‐tive period in complicating CHD infants for conducting the real time monitoring in order to reduce brain damage .