Objective To explore the effectiveness and safety of endoscopic sphincterotomy(EST)plus endoscopic pap-illary balloon dilation (EPBD) for the removal of common bile duct stones. Methods One hundred patients who re-ceived endoscopic retrograde pancreatic angiography(ERCP)in the first hospital of shanxi medical university from June 2012 to March 2014 were randomly divided into EST group and ESBD group. ESBD group in advance nipples small in-cision after balloon expansion; EST group used normal operation. The successful rate of stone clear-ance,operation time,the rate of mechanical lithotripsy and related complications were observed.Results After one time,all stones were removed one time from 46 cases(92%) assigned EST and 48 cases(96%) assigned EPBD(P>0.05); Mechanical lithotripsy was used to fragment stones 8 cases(16%) in EST group and 2 cases(4%) in ESBD group(P<0.05); EST group had 4 cases of high amylase levels,2 cases of acute pancreatitis,hemorrhage in 1 case; ESBD group had 2 cases with high blood amylase occurred,1 case of acute pancreatitis, early complications of total incidence were 14% and 6% respectively(P>0.05); Average operation time,respectively (45.3±13.0) min and (30.5±9.2) min(P<0.05). Con-clusion Endoscopic papillary sphincter small incision combined with balloon dilatation lithotomy success rate and post-operative complication rates comparable to conventional sphincterotomy is similary,but the average operation time and the use of mechanical lithotripsy probability compared with EST were low,so EST combined with EPBD to treat com-mon bile stone is a safe and effective method.

Objective To study the effects of butylphthalide on cognitive function,apoptosis and pp38MAPK in hippocampus of rat model of vascular dementia.Methods The vascular dementia (VD) model was established by two vascular (2VO) method,and then sixty male Wistar rats were randomly divided into VD group,sham operation group and NBP (butylphthalide) group.Rats in NBP group were given 120 mg · kg-1 · day-1 dose butylphthalide by gavage,and rats in VD group and sham operation group were given the same dose vegetable oil.The cognitive function of each rat was tested by Morris water maze.The expression of p-p38MAPK in the hippocampus was observed by Western blot;and the apoptosis was observed in hippocampal CAl region by TUNEL staining.Results The hidden platform escape latency of NBP group ((48.72 ± 7.01) s,(42.41 ± 4.06) s,(40.34 ± 2.46) s)was significantly shortened compared with those of VD group((82.71±8.27) s,(80.36±9.65) s,(77.74±6.33) s)(P＜ 0.01) ; and the former platform quadrant time and the number of passing through the platform of NBP group ((26.45±4.66)s,(1.84±0.82) times) were significantly prolonged (P＜0.01) compared with those of VD group ((18.67±5.39) s,(1.32±0.61) times);the apoptosis and the expression of p38MAPK phosphorylation in hippocampus in NBP group ((153.65±9.85),(0.42±0.04)) significantly reduced (P＜0.01) compared with those of VD group ((209.46±11.49),(0.88±0.10)).Conclusion Butylphthalide can improve the learning and memory ability of VD rats,the reduce apoptosis in the hippocampus by the inhibition of the P38MAPK pathway.This may be one of the ways by which butylphthalide can treat vascular dementia.

Objective Brain metastasis of non-small cell lung cancer (NSCLC) significantly reduces the survival time of the patients, and no effective tool is yet available for the prediction of the risk.This study aimed to develop an effective and feasible nomogram for predicting brain metastasis of NSCLC after radical surgery.Methods This retrospective study included 636 cases of NSCLC treated by radical resection of the tumor in our hospitals between January 2010 and January 2014.Based on the analysis of the risk factors for brain metastasis, we developed a nomogram using logistic regression with the R-language, calculated the confidence interval (CI) of the C-index using the bootstrap, and then internally verified the overfitting degree of the model to evaluate its stability.Results Brain metastasis developed in 94 of the 636 patients.According to the results logistic regression analysis, the risk factors for brain metastasis included history of cigarette smoking (OR=1.783, 95% CI: 1.037-3.066), pathological types (OR=0.453, 95% CI: 0.275-0.744), the T stage (OR=2.047, 95% CI: 1.511-2.774), and the N stage (OR=1.588, 95% CI: 1.154-2.184).The nomogram showed a coefficient of coincidence of 0.73 (0.71-0.82) and a mean absolute error rate of 0.012, which indicated an excellent stability.Conclusion The nomogram we developed can be used to predict the risk of brain metastasis in individual NSCLC patients after surgery, contributing to follow-up programs and preventive strategies for brain metastasis.

Objective:To evaluate the efficacy and safety of drospirenone and ethinylestradiol tablets (Ⅱ) in Chinese women with dysmenorrhea.Methods:This was a single-arm, open-label, interventional, multicenter, post-authorization safety/effectiveness study of drospirenone and ethinylestradiol tablets (Ⅱ) across 6 treatment cycles, a total of 526 patients were included in the dysmenorrhea subgroup. Visual analog scale (VAS) was used to assess the severity of menstrual pain. Secondary outcomes included unintended pregnancies, bleeding pattern, cycle control and safety.Results:After treated with drospirenone and ethinylestradiol tablets (Ⅱ), VAS of pain had decreased significantly compared with baselines [(49.5±23.7) vs (32.3±24.9) vs (20.7±19.4) vs (18.4±18.7) mm, P<0.01]. From the second cycle to the fifth cycle, the incidence of scheduled bleeding increased from 93.9% (450/479) to 96.4% (431/447). The duration of scheduled bleeding decreased from (5.7±2.7) to (5.4±1.8) days. The incidence of intermenstrual bleeding decreased from 9.0% (43/479) to 5.6% (25/447). 17.5% (92/526) patients reported adverse drug reactions, most frequently reported adverse events were breast pain, nausea, breast swelling, headache, and uterine bleeding. No death occurred during the study. Conclusion:Drospirenone and ethinylestradiol tablets (Ⅱ) is effective for the treatment of dysmenorrhea and has good safety.

Tyrosine-decahydrofluorene derivatives feature a fused [6.5.6] tricarbocyclic core and a 13-membered