Objective This paper preliminarily research the clinical effect of 3D laparoscopy in the biliary tract surgery.Methods Thirty-eight patients clinical data of cholelithiasis who accepted laparoscopic cholecystectomy and laparoscopic choledocholithotomy T-tube drainage from January 2015 to June 2016 were retrospectively analyzed,which sixteen patients underwent three-dimensional laparoscopic surgery while twenty-two patients underwent two-dimensional laparoscopic surgery. The operation time, intraoperative blood loss, postoperative drainage,time of drainage, postoperative hospital stay, hospital costs and the incidence of complications were observed in two groups.Results There was a statistical significant (P < 0.05) in operation time and intraoperative blood loss between the two groups, 3D group was better than 2D group. There was no statistical significant (P > 0.05) in postoperative drainage, time of drainage, postoperative hospital stay, hospital costs and the incidence of complications between the two groups. One patient of 2D group suffered residual stones and recovered by choledochoscopy through T tube sinus after two months, while no one suffered residual stones in 3D group. There was no recurrence of stones in both groups during the follow-up period which varied from two months to eighteen months.Conclusions 3D laparoscopy enables biliary tract surgery was more accurate and minimally invasive, it has a widely applicable prospect.

Objective: To analyze the influence of different inclination of cusp on the stress of an implant supported denture. Methods: A spiral CT was used to scan a corpus' head.The model of mandible,teeth and implant was established by ANSYS 6.1 software. The superstructure of the denture had three different inclination of cusp.The stress distribution of the models under loading was analyzed. Results: When bearing non central loading, the maximum equivalent stress (max EQV) of the abutment was situated at the first screw of the abutment.When bearing central loading, the maximum equivalent stress(max EQV) of the abutment was situated at the cervix. Under all loading, the max EQV of the implant was situated at the cervix, the max EQV of mandible was situated at the upper cortical layer around the cervix of the implant. Higher inclination of cusp and non central loading lead to higher stress. Conclusion: The location of the max EQV of the abutment is consistent with the location of the abutment fracture; lower inclination of cusp and flatsurface teeth are benefit to the stress distribution of the implantation.

Through referring to relevant works and the latest literature, the application and research progress of the traditional Chinese medicine inducing mesenchymal stem cells were summarized. The researching results focusing on induction and proliferation of mesenchymal stem cell by salvia, notoginseng, tortoise plastron, pilose antler, ginseng, astragalus were introduced.

CLN3 gene product is an antiapoptotic membrane protein, the expressions of CLN3 in normal tissues and cells are at very low level. Juvenile-Batten disease is a neurodegenerative disease caused by accelerated apoptosis of photoreceptors and neurons resulting from deletion of 1.02 kb in the CLN3 gene. A number of observations showed that CLN3 mRNA and protein are overexpressed in a variety of human cancer cell lines. Blocking of CLN3 expression using an adenovirus-expressing antisense CLN3 inhibited growth and viability of cancer cells. CLN3 may regulate apoptosis through modulating ceramide synthesis or the expression of some down stream genes. More importantly, these results suggested that CLN3 is a novel molecular target for the etiology, progression and theraputics of cancer.

Objective To investigate the effect of integrated traditional Chinese and western medicine in the treatment of postoperative pain in patients with anorectal diseases. Methods From November 2015 to October 2017, 70 patients with anorectal diseases underwent surgical treatment in the First People 's Hospital of Yongkang were selected. The simple western medicine treatment was performed in 35 patients with anorectal diseases in the control group,and 35 patients in the observation group were given combined Chinese and western medicine. The total effective rate of the two groups was observed and calculated. The pain score at 2 h,6 h,12 h and 24 h after operation,the incidence rate of postoperative complications were observed. Results The total effective rate of the control group (80. 00％ ) was lower than that of the observation group (97. 14％ ),the difference was statistically significant(χ2 =5. 080,P < 0. 05). The pain scores at postoperative 2h,6h,12h,24h in the control group were (2. 0 ± 0. 5) points, (3. 6 ± 1. 0)points,(4. 5 ± 1. 0)points,(5. 0 ± 1. 2)points,respectively,which in the observation group were (1. 4 ± 0. 2)points,(2. 0 ± 0. 6)points,(2. 4 ± 0. 5)points,(2. 3 ± 0. 4)points,respectively,the differences were statistically significant(t = 6. 591,8. 116,11. 112,8. 116,all P < 0. 05). The incidence rate of postoperative complications in the control group (17. 14％ ) was higher than that in the observation group (2. 86％ ),the difference was statistically significant(χ2 = 3. 968,P < 0. 05). The total satisfaction rate of the control group (74. 29％ ) was lower than that of the observation group (94. 29％ ),the difference was statistically significant(χ2 = 5. 285,P < 0. 05). Conclusion The combination of traditional Chinese and western medicine is effective in the treatment of postoperative pain in patients with anorectal diseases,which can increase the effective rate and improve the quality of life of the patients, and it is worthy of clinical application.

Objective To study the efficacy and safety of low-dose azithromycin with tiotropium bromide in the treatment of stable chronic obstructive pulmonary disease.Methods A hundred and ten patients were randomized into three groups:tiotropium bromide group (36 cases,group A),azithromycin with tiotropium bromide group(38 cases,group B)and control group(36 cases,group C).Patients in group A were given tiotropium bromide (18 μg,q,d )in addition to conventional treatment.The patients in group B were given lowdose azithromycin (250 mg,twice a week) in combined with tiotropium bromide.The patients in control group were given the conventional treatment only.The courses of treatment lasted for six months.Results Compared with the control group,the frequency of acute exacerbation in patients treated with azithromycin and tiotropium bromide was reduced remarkably ( 2.1 ± 0.6 and 4.9 ± 0.7,t =18.5061,P ＜ 0.05 ).The severity of clinic symptoms ( Cough 1.3 ± 0.5 vs.2.2 ± 0.6,P ＜ 0.05 ),expectoration ( 1.0 ± 0.2 vs.1.7 ± 0.3,P ＜ 0.05 ),anhelation ( 1.5 ± 0.8 vs.2.1 ± 0.6,t =3.6342,P ＜ 0.001 ) ],life quality ( 29 ± 8 vs.42 ± 11,P ＜ 0.05 ) and six-minutes walking distance( [ 370.00 ± 14.26 ] m vs.[ 290.00 ± 12.85 ] m,P ＜ 0.05 ) of the azithromycin with tiotropium bromide group were improved significantly when compared with control.Compared with the tiotropium bromide group,the frequency of acute exacerbation ( 2.1 ± 0.6 vs.3.2 ± 0.8,P ＜ 0.05 ),the severity of clinic symptoms (Cough 1.3 ±0.5 vs.1.8 ±0.4,P＜0.05),expectoration( 1.0 ±0.2 vs.1.3 ±0.3,P ＜0.05) and anhelation( 1.5 ±0.8 vs.1.9 ± 0.6,P ＜ 0.05 ) ],life quality ( 29 ± 8 vs.36 ± 10,P ＜ 0.05 ) and six-minutes walking distance ( [ 370.00 ± 14.26 ] m vs.[ 330.00 ± 13.76 ] m,P ＜ 0.05 ) were improved over those of tiotropium bromide group.Conclusion The long-term low-dose azithromycin in combinned with tiotropium bromide is good and safe in treating stable COPD.Therefore,it is worth of further clinical evaluation.

AIM: To investigate the effect of heme oxygenase on vascular remodeling in renal hypertension. METHODS: Male Wistar rats were randomly divided into sham-operated, 2K1C (two-kidney one-clip) and hemin-induced groups. Four weeks after the treatments, the thickness of aortic media and HO enzymatic activity of the aorta were determined. Immunohistochemical staining was carried out to detect protein of HO-1 in the aorta. RESULTS: The blood pressure in 2K1C renal hypertension rats started to increase two weeks after the surgery and stabled at a high level at the 4th week. Hemin, an inducer of HO-1, markedly inhibited the increase in blood pressure. Aortic medium thickness of the 2K1C rats at 4th week was 27 5% thicker than that in the sham-operated rats. The thickness of aortic medium of the hemin-induced rats was 16 1% less than that in 2K1C group. At the 4th week after operation, protein level and enzymatic activity of HO-1 in aorta were higher than that in 2K1C group compared to those in the sham-operated group. CONCLUSION: Renal hypertension caused vascular remodeling and the activation of HO-1. HO-1 induction decreased the blood pressure of renal hypertension and reduced vascular remodeling.

Objective To evaluate the diagnostic accuracy of ultrasound bladder detrusor wall thickness (DWT) measurement for female bladder outlet obstruction (FBOO) and investigate the application of this non-invasive method for diagnosis of FBOO.Methods DWT was measured by linear ultrasound (7.5 MHz) either at a filling volume of 50％ of cystometric capacity or at 250 ml filling in 93 women undergoing pressure flow study (PFS) for lower urinary tract symptoms (LUTS).FBOO was defined as maximal flow rate (Qmax) of less than 12 ml/s combined with a detrusor pressure at maximal flow rate (Pdet Qmax)greater than 25 cm H2O.All the patients were divided into 2 groups according to FBOO and non-FBOO.The age,urodynamic parameters and DWT of the 2 groups were compared.Meanwhile DWT was evaluated for diagnosing BOO through receiver operating characteristic (ROC) curve.ResultsThe age (61.2 ± 8.3 vs 59.9 ± 7.7 years,P =0.44) and maximal cystometric capacity (292.2 ± 82.3 vs 308.1 ± 87.5 ml,P =0.37 ) between the 2 groups had no significant difference.DWT was significantly higher ( P =0.00 ) in FBOO group (42 cases,DWT 1.8 ±0.3 mm) compared to non-FBOO group (51 cases,1.4 ±0.2 mm).Furthermore maximal detrusor pressure (43.1 ± 11.2 vs 16.2 ± 7.1 cm H2O,P =0.00),Pdet Qmax (34.3 ±8.2 vs 13.1 ±7.8 cm n2O,P =0.00),Qmax(7.4 ±3.2 vs 17.4 ±4.1 ml/s,P =0.00),voided volume (157.1 ±63.7 vs 251.2 ±77.4 ml,P=0.00) and post-void residual volume (117.5 ±71.3 vs 37.7 ± 18.1 ml,P =0.00) had significant differences between the 2 groups.For a diagnosis of FBOO,DWT of 1.9 mm or greater had a positive predictive value of 100％,a negative predictive value of 62％,specificity of 100％ and sensitivity of 38％.ROC analysis revealed that DWT had a high predictive value for FBOO with an area under the curve of 0.88 ± 0.06.Conclusions Ultrasound DWT measurement for FBOO is non-invasive,convenient and reliable.DWT 1.9 mm or greater assessed by ultrasound has a high predictive value and specificity for FBOO and can replace PFS in some extent.However,this cutoff value needs to be validated in multiple center and larger population study.

Objective To evaluate the value of the tests of mean corpuscular volume (MCV ) ,mean corpuscular hemoglobin (MCH) in the screening of thalassemia .Methods 603 cases were performed MCV and MCH tests and gene detection of thalasse-mia .The results of gene detection were used as reference standard .The sensitivity ,specificity ,accuracy ,positive predictive value and negative predictive value of single or combined results of MCV ,MCH tests were calculated .Results The sensitivity and specificity of single MCV test were 91 .2% and 76 .1% ,single MCH test were 91 .2% and 70 .7% .The sensitivity and specificity of parallel combined tests of MCV and MCH were 94 .8% and 61 .4% ,serial combined tests of MCV and MCH were 88 .4% and 75 .6% .Con-clusion The sensitivity of single MCV or MCH test in the screening of thalassemia is high .Parallel combined tests of MCV and MCH can improve the sensitivity ,and will be widely used in the in the screening of thalassemia .

BACKGROUND:The immune cells of renal al ograft recipients have always been the hot spot of research. However, there are few studies addressing the immune cellsubsets in renal al ograft recipients before operation. OBJECTIVE:To investigate the proportional distribution of immune cellsubsets in renal al ograft recipients before operation. METHODS:Fifteen de novo living-related renal transplant recipients were enrol ed in this study with 15 healthy volunteers, aged 18-40 years, as healthy controls. Flow cytometry was employed to observe the proportion of the immune cellsubsets by extracting peripheral venous blood of al participants. RESULTS AND CONCLUSION:In the renal al ograft recipients, the proportions of CD4+CD25+T cells, the proportion of CD4+CD25+/CD4+T cells, CD19+B cells, CD19+CD5+B cells, CD19+CD27+B cells, NKG2A/NK cells, and NKG2A/NKG2 cells were al lower than those in the healthy controls;however, the proportion of CD38+IgD-/CD19+B cells and NKG2D cells were higher than those in the healthy controls. The difference of the proportion of immune cellsubsets aforementioned between the two groups was statistical y significant (P<0.05), while no difference was observed in other subsets. Immune cellsubsets in renal al ograft recipients before operation could be used to assess the immune status of the recipients, and also could be seen as the basal control for postoperative immunological monitoring.