Objective To compare the pros and cons of endoscopic papillary balloon dilation (EPBD) with those of endoscopic sphincterotomy (EST) in the treatment of common bile duct stones.Methods We searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared EPBD with EST for the removal of common bile duct stones were included from January 1983 to September 2012 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 software.Results A total of 18 randomized trials with 2385 participants met our inclusion criteria.EPBD compared with EST resulted in similar outcomes with regards to stone removal on 1 st attempt,overall stone removal,perforation,total short-term complication,long-term cholangitis or mortality.EPBD carries a higher risk of pancreatitis (RR =1.99,95％ CI:1.41-2.81) and severe pancreatitis (RR =4.68,95 ％ CI:1.36-16.11),and requires higher rates of mechanical lithotripsy (RR =1.31,95％ CI:1.14-1.50).Conversely,EPBD not only has statistically significant lower rates of bleeding (RR =0.14,95％ CI:0.06-0.34),but also leads to significantly less long-term cholecystitis (RR =0.38,95％ CI:0.19-0.76),long-term stone recurrence (RR =0.67,95％ CI:0.47-0.96) and total longterm complications (RR =0.52,95 ％ CI:0.40-0.67).Conclusion On the basis of lower rates of bleeding or long-term complications,EPBD should be the preferred strategy over EST for endoscopic management of common bile duct stones,however,the rate of pancreatitis,especially the severe pancreatitis is higher with EPBD.

Objective To compare clinical effects of appendicectomy and conservative treatment of uncomplicated acute appendicitis.Methods Searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared conservative treatment with appendicectomy in patients with uncomplicated acute appendicitis were included from January 1983 to May 2013 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 soft-ware.Results Four randomized trials met our inclusion criteria (821partiCI:pants).Antibiotics compared with appendicectomy resulted in similar outcomes with regards to the incidence of complicated appendicitis (RR:0.89,95％ CI:0.29-2.68) and intra-abdominal infection(RR:0.54,95％ CI:0.13-2.35).Antibiotics carries a lower risk of complications (RR 0.46,95％ CI:0.32-0.67),but requires more length of hospital stay (Mean Difference 0.52,95％ CI:0.16-0.88).Conclusions The effect of conservative treatment is safe and effective.But the recurrent uncomplicated appendicitis recommends operation.

ObjectiveTo evaluate the late-phase enhancement of carotid artery in patients with cerebral infarction by contrast-enhanced ultrasonography.MethodsSixty-eight patients whose bilateral carotid artery plaques were both wider than 1.5 mm with treatment in Zhejiang Provincial People?s Hospital from April to July in 2013 were enrolled in this study. Among the enrolled patients, there are 50 patients with cerebral infarction including 30 patients with unilateral cerebral infarction and 20 patients with bilateral cerebral infarction, and 18 patients without cerebral infarction. The enrolled patients underwent conventional and contrast-enhanced ultrasonography. The time-intension curve was obtained till 6 minutes after the injection of contrast agent. The late-phase enhancement intensity and relative intensity of maximal carotid plaque was measured and calculated. The differences of late-phase enhancement intensity and relative intensity between patients with cerebral infarction and patients without cerebral infarction, and between ipsilateral and contralateral side of cerebral infarction in patients with cerebral infarction were compared using two samplet test.ResultsThe late-phase enhancement intensity of carotid plaque in patients with cerebral infarction and in patients without cerebral infarction was (6.0±1.5) and (4.9±1.2) dB, respectively, and the relative late-phase enhancement intensity of carotid plaque was 0.9±0.2 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in patients with cerebral infarction compared with patients without cerebral infarction, and the differences had statistical significance (value oft was 2.132 and 2.258 respectively, value ofP were both less than 0.05). The late-phase enhancement intensity of carotid plaque in ipsilateral and contralateral side of cerebral infarction was (7.1±1.8) and (4.9±1.2) dB, respectively, and the relative late-phase enhancement intensity of carotid plaque was 1.2±0.3 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in ipsilateral side of cerebral infarction compared with contralateral side of cerebral infarction in patients with cerebral infarction, and the differences had statistical signiifcance (value oft was 3.132 and 2.953 respectively, value ofP were both less than 0.01).ConclusionThe late-phase enhancement of carotid plaque in patients with cerebral infarction is significantly different from that in patients without cerebral infarction.

Evidence has indicated that low doses of anti-tumor regimens can induce cell apoptosis in vitro, although different regimens induce apoptosis by different mechanism and pathway. In recent years, new tumor treatment strategy has been mainly focused on inducing tumor cell apoptosis. The present review discusses the advantages and disadvantages of inducing tumor cell apoptosis. The benefit of inducing apoptosis is not to cause inflammatory reaction, but as its disadvantage, it inhibits immune responses, and the phagocytosis of apopotic bodies may result in horizontal transfer of genes (including oncogenes and other oncogenic materials), which can be one of the causes of tumor relapse. This paper proposes that the tumor treatment strategy should be turn into promoting tumor cell necrosis and inducing anti-tumor immune responses.
Antineoplastic Agents ; therapeutic use ; Apoptosis ; drug effects ; Humans ; Necrosis ; chemically induced ; Neoplasms ; drug therapy ; immunology ; pathology

Adult ; Alkanesulfonic Acids ; adverse effects ; Humans ; Male ; Pemphigoid, Bullous ; chemically induced

Background Retinopathy of prematurity is mainly due to retinal neovascularization.Objective This laboratory work was to evaluate the efficacy of different dosage of avastin for inhibiting retinal neovascularization.Methods Ninety 7-day-old clean C57BL/J6 mice were randomized into six groups as follows:air control group,hyperxia control group,hyperxia BSS group and avastin groups.C57BL/J6 mice in air control group were raised in regular air environments.The fifty mice were fed under the environment with 75％ ±2％ oxygen for 5 days to establish the retinal neovascularization models.The 1.25,2.50 and 5.00 g/L avastin (0.5 μl) were injected inteavtreally in forty-five mice models as low,moderate and high dosage avastin groups respectively,and 0.5 μl BSS was used at the same way in fifteen models as hyperxia BSS group.The mice were sacrificed in the 17-day-old age using excessive anesthesia method and the retina sections were prepared for the calculation of the numbers of vascular endothelial cell nuclei broken retinal inner membrane after hemotoxylin and eosin staining.The expression of CD34 in the retina was detected by immunochemistry.The morphology and distribution of retinal neovascular vessel in various groups were observed using retinal flat.The use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The numbers of cell nuclei broken the inner limiting membrane was significant increased in the hyperxia group compared with the air control group( P＜0.01 ),and those in difference doses of avastin were considerably reduced in comparison with hyperxia BSS group (P＜0.01) and hyperxia group (P＜0.01 ).The decrease of numbers of cell nuclei broken the inner limiting membrane was obvious in low dose of high dose of avastin compared with low dose of avastin (P＜0.05 ).CD34 was positively expressed in retina internal membrane of hyperxia group.Retinal flat revealed the regular distribution and normal structure of retinal vessels in air control group and avastin groups.However,retinal and vitreous cavity neovascularization,leakage and enlarged non-perfusion regions in the perimeter of the retina were seen in hyperxia group and hyperxia BSS group. Conclusions Intravitreal injection of avastin can arrest retinal angiogenesis in oxygen-induced retinal neovascularization models in a dose-dependent manner.

The paper is aimed to study the difference in yield and quality at different harvest time and determine the optimum harvest of planting Gentiana in Ludian traditional harvest period. The authors analyzed the variation in fresh weight, dry weight, dry discount rate, length, diameter, volume and the content of gentiopicroside, loganin acid, alcohol-soluble extract and total ash and made a comprehensive appraisal of yield, appearance quality and intrinsic quality by gray relational distance ideal Comprehensive Evaluation method. The results showed that there is a big difference in yield and quality both 2-year-old and 3-year-old Gentiana harvested in traditional harvest period and the comprehensive evaluation more better when harvested more later. It can be seen, Gentiana harvested the later had a better yield and quality in Ludian traditional harvest period. The harvest of Gentiana can be appropriate delayed depending on the particular circumstances of production.
Agriculture ; methods ; China ; Gentiana ; anatomy & histology ; growth & development ; metabolism ; Iridoid Glucosides ; metabolism ; Organ Size ; Quality Control ; Time Factors

Up to date, eight types of human herpes viruses have been identified, all of which are ubiquitous, and usually establish latent infection in the host after primary infection. Since most of the herpes viruses are maintained in an asymptomatic form, they are often neglected. However, under some circumstances, these herpes viruses can cause fatal or severe diseases. Furthermore, the association of herpes viruses with hematopoietic malignancies is attracting researchers' attention. With the extensive development of hematopoietic stem cell and organ transplantation, reports regarding transplantation failure and complication caused by infection of human herpes virus has been increasing. Cytokine storm was firstly suggested as the mechanism of graft-versus-host diseases. In recent years, which has also been applied in the pathogenesis research of inflammation, and is supposed to play an important role in severe virus infection. In this paper, through discussing the possible role of latent infection of human herpes virus in the failure or complication of bone marrow or hematopoietic stem cell transplantation, and in refractory leukemia, the function and significance of latent infection of human herpes virus and the cytokine storm it caused were investigated.
Cytokines ; immunology ; Hematopoietic System ; immunology ; virology ; Herpesviridae Infections ; Humans ; Virus Latency

The article introduces a new method for three-dimensional reproduction of edentulous dental casts, and wax occlusion rims with jaw relation by using a commercial high-speed line laser scanner and reverse engineering software and evaluates the method's accuracy in vitro. The method comprises three main steps: (i) acquisition of the three-dimensional stereolithography data of maxillary and mandibular edentulous dental casts and wax occlusion rims; (ii) acquisition of the three-dimensional stereolithography data of jaw relations; and (iii) registration of these data with the reverse engineering software and completing reconstruction. To evaluate the accuracy of this method, dental casts and wax occlusion rims of 10 edentulous patients were used. The lengths of eight lines between common anatomic landmarks were measured directly on the casts and occlusion rims by using a vernier caliper and on the three-dimensional computerized images by using the software measurement tool. The direct data were considered as the true values. The paired-samples t-test was used for statistical analysis. The mean differences between the direct and the computerized measurements were mostly less than 0.04 mm and were not significant (P>0.05). Statistical significance among 10 patients was assessed using one-way analysis of variance (P<0.05). The result showed that the 10 patients were considered statistically no significant. Therefore, accurate three-dimensional reproduction of the edentulous dental casts, wax occlusion rims, and jaw relations was achieved. The proposed method enables the visualization of occlusion from different views and would help to meet the demand for the computer-aided design of removable complete dentures.
Analysis of Variance ; Computer-Aided Design ; Dental Models ; Denture Design ; Denture, Complete ; Dimensional Measurement Accuracy ; Humans ; Imaging, Three-Dimensional ; methods ; Jaw Relation Record ; Lasers ; Mouth, Edentulous ; rehabilitation ; Waxes

Objective To investigate expression of 4-1BB and lymphocyte subsets in peripheral blood of children with acute infectious lymphocytosis. Methods Flow cytometry (FCM) was applied to detect the expression of 4-1BB and lymphocyte subsets in peripheral blood of 15 cases of acute infectious lymphocytosis and 20 cases of acute upper respiratory infection, and 20 healthy children. Results The expression of 4-1BB and CD3+, CD4+and CD8+lymphocytes were higher in acute infectious lymphocytosis group than those in acute upper respiratory infection group and healthy control group (P<0.05). There was no sig-niifcant difference of CD19+CD23+lymphocytes among three groups (P>0.05). A positive correlation was found between 4-1BB expression and CD3+ lymphocytes expression in acute infectious lymphocytosis group (r=0.73, P<0.05). Conclusions The abnormal expression of 4-1BB may play a pathological role in the development of acute infectious lymphocytosis. T cells in chil-dren with acute infectious lymphocytosis may not function to activate B cells.