Objective To investigate the causes of intractable abdominalgia after simple choleystectomy and analyse the therapeutic effect of endoscopic sphincterotomy (EST).Methods 84 patients undergoing EST were retrospectively viewed from 1987 to 1998. Results Sixty five out of 84 patients were followed up, in which the clinical signs disappeared completely in 51 cases (78%), and there were 6 cases with relapsing symptom(9%),3 cases with intermittent relapsing symptom (4%). Therapy was ineffective in 5 cases. The intractable abdominalgia is a specific sign of postcholecystectomy syndrome. EST is effective in removing the nervous structure in duodenal papilla submucosa and sphincter muscle layer responsible for abdominal pain, therefore eliminated or relived the pain.Conclusion EST has a significant effect on intractable abdominalgia after simple cholecystectomy in the majority of patients.

Targeted drug delivery can significantly increase the concentration of the drug in treatment site, and decrease the dosage of drugs, cost of treatment and the drug's adverse effects on the body. So targeted drug delivery is the hotspot of recent studies. This paper reviews the development of targeted drug delivery research in recent years, including three areas: passive targeting, active targeting, and physical and chemical targeting.

10.3969/j.issn.1007-3969.2013.05.011

Objective To explore the expression and clinical significance of two oncogenes,CerbB-2 and p53,on cervical squamous carcinoma.Methods The immunohistochemical S-P process was performed on 45 cases of cervical squamous carcinoma.The expressions of CerbB-2 and p53 on 15 cases of CIN(cervical intraepithelial neoplasia)and on 10 cases of normal cervical tissues were chosen and the relationship between the expressions and the related clinicopathological factors were analyzed.Results The positive expression rate of CerbB-2 on normal cervical tissues, CIN and cervical squamous carcinoma was 0,26.7% and 66.7%, respectively; that of p53 was 0,13.3% and 68.9% ,respectively.From the normal cervical epithelium to the CIN and to the cervical squamous carcinoma,the positive rate of CerbB-2 and p53 was increased significantly(P<0.05);the positive rate of CerbB-2 was associated with the pathological grade and the metastasis of lymph node(P <0.05) and that showed no statistic significance with the clinical stage ,the diameter of tumour,the infiltration of vessel and infiltrative depth(P > 0.05) ;the positive rate of p53 is only associated with the pathological grade(P <0.05) ;the difference between the CerbB-2 and p53 expressions on cervical squamous carcinoma were not statistically significant(P> 0.05).Conclusion The expressions of CerbB-2 and p53 have some practical values on the occurrence, the development and the clinical prognostic evaluation for the cervical squamons carcinoma.

Objective　To establish the method of noninvasive measuring the new indexes of cardiac functions by echocardiography and illustrate the diagnostic values of the indexes.Methods　By use of simultaneous screen display of echocardiography, phonocardiography and electrocardiography and synchronously monitoring blood pressure (BP) technique, the values of LV end-systolic and end-diastolic long and short- axis dimensions, wall thickness and area sizes,and synchronous BP were measured in the patients with myocardial infarction (MI) of defferent sites and area sizes before and during BP were altered to defferent degrees. The values of maximum elasticity (Emax) and average maximum myocardial elasticity stiffness (maxEav) and ejection blood fraction (EF) were calculated through computer programmed process.Results　The order of values of Emax,maxEav and EF among MI patients of defferent sites was control group>inferior MI group>anterior MI subgroup>multi-wall MI subgroup. Their order among MI patients of defferent area sizes was control group > small area MI subgroup > larger MI subgroup. Emax was associated with the MI parts and 　maxEav was associated better with the MI area sizes.Conclusions　The study has established a noninvasive method of examining cardiac function by use of echocardiography and reflected the special diagnostic values of Emax,maxEav and EF in MI patients of defferent parts and area sizes.

Objective To observe the therapeutic effect of ultrasonic microbubble combined with bevacizumab (Avastin) on choroidal neovascularization induced by photocoagulation in rabbits.Methods CNV was induced by photocoagulation with argon laser in 30 rabbits (60 eyes).All of the rabbits underwent fundus fluorecein angiography (FFA) 21 days after photocoagulation;6-8 hours later,3 rabbits were randomly chosen to be executed to having the immunohistochemical examination.Twenty-one days after photocoagulation,27 rabbits were divided randomly into 3 groups:bevacizumb,ultrasonic microbubble+bevacizumb,and control group;each group has 9 rabbits (18 eyes).The rabbits in control group had no interference treatment;while the rats in bevacizumb and ultrasonic microbubble+bevacizumb group underwent injection with bevacizumb or ultrasonic microbubble+bevacizumb respectively.FFA was performed on all of the rabbits 7,14,and 28 days after photocoagulation to observe the inhibition of CNV;immunofluorecence and Western blot were used to detect the expression of VEGF in retina and choroid.Twenty-eight days is the time point to determine the therapeutic efficacy.The expression of VEGF and the results of FFA were the sdandards of the judgement of therapeutic efficacy.Results Proliferaion of CNV to the retinal inner layer and the obvious leakage of fluoresein in the photocoagulation area indicated that the model of CNV was set up successfully.Twenty-eight days after injection,obvious fluorescent leakage was found in the control group,and the average fluorescent leakage in bevacizumab group differed much from the control group(t=16.2952,P<0.05);while the difference between ultrasonic microbubble+bevacizumb group and bevacizumab group was also significant (t=4.7955,P<0.05).At the same time point,the expression of VEGF in bevacizumab group detected by immunofluorecent assay and Western blot differed much from the control group (t=7.0327,9.2596;P<0.05),and the difference of VEGF between ultrasonic microbubble+bevacizumb group and bevacizumab group was significant (t=2.9724,17.1937;P<0.05).this experiment show that ultrasound combined bevacizumab intravitreal injection of the therapeutic effect of CNV superior to other groups(P<0.01).Conclusion Ultrasound microbubble combined with bevacizumab injection may improve the therapeutic effect on CNV by inhibiting the expression of VEGF.

Objective Summarized the therapeutic effect of colonic irrigation by mannitol in one-stage resection and primary anastomosis for left hemicolon obstruction. Method For 31 cases of left hemicolon obstruction in our hospital, After process was cut, firstly we had done coloclysis with normal saline, metron-idazole and 20% mannitol,then one-stage anastomosis. Results With the exception of three cases of in-cision infection, the rest who start eating 4～5 days after operation were cured and no anastomotic fistula. Conclusion During the colon resection in left hemicolon obstruction, coloclysis with normal saline, met-ronidazole and 20% mannitol, then one-stage anastomosis, the intestinal function were quick recovery and can prevent colonic anastomotic fistula.

Objective To observe the law of removing dampness, melting phlegm and tonifying spleen on blood lipids in hyperlipidemia rat and its vascular endothelial protective effect. Methods Animals were randomly divided into 6 groups, the high-fat diet of 35 d, 16 d orbital check blood lipids to confirm modeling success and gavage was given by different experimental requirements. NOS and vascular endothelial gene expression were determined at 3rd and 7th day. Results After treatment, NOS expression in experimental rats compared with the normal group, P

AIM:To investigate the inhibition of breviscapine on apoptosis of cultured myocardial cell of neonatal rat induced by hypoxia/reoxygenation. METHODS:Myocardial cell hypoxia/reoxygenation model was established by culturing primary myocardial cells of neonatal rats in vitro. Cultured myocardial cells were divided into 5 groups:control group,hypoxia/reoxygenation group and 3 groups pretreated with breviscapine of final concentration 25,50 and 100 mg/L,respectively. The cell viability was measured with MTT; apoptotic rates were determined by AnnexinV-FITC/PI; the expression of Bcl-2 was detected by immunohistochemical method. Expressions of Cytochrome C (CytC) and Caspase-3 were detected by Western blot. RESULTS:Compared with the control group,the viability of myocardial cell decreased and apoptosis rate elevated after hypoxia/reoxygenation. However after pretreatment with 25,50 and 100 mg/L breviscapine,respectively. Cell viabilities increased and apoptotic rates lowered,and the protective effect on myocardial cell had concentration-dependent. In addition,Expression of Bcl-2 decreased but Caspase-3 activity and CytC release increased in myocardial cells induced hypoxia/reoxygenation. Pretreated with breviscapine,expression of Bcl-2 elevated but Caspase-3 activity and CytC release reduced obviously. CONCLUSION:It is associated with the increase in Bcl-2 expression,inhibition of CytC release and Casepase-3 activity that breviscapine could significantly protect myocardial cell against apoptosis induced by hypoxia/reoxygenation.

Objective To investigate the safety and efficacy of stent insertion combined with high-intensity focused ultrasound(HIFU) ablation for malignant obstructive jaundice caused by pancreatic carcinoma.Methods From January 2013 to February 2017,a total of 80 patients with malignant obstructive jaundice caused by pancreatic carcinoma underwent biliary stent insertion in our center,who were divided into combined treatment(stent insertion with HIFU ablation) group(n=38) and solitary stent insertion group(n=42).The stent patency time and survival time were compared between the two groups.Results Relief of jaundice were archived in all patients in both groups.Cholangitis was observed in 7 cases in both two groups.Reobstruction of stent was observed in 15 patients in both two groups.The median stent patency time was 179 days in combined treatment group and 119 days in solitary stent insertion group(P<0.01);the median survival time was 209 days in combined treatment group and 145 days in solitary stent insertion group,the differences were significant(P<0.01).Based on the univariate and multivariate Cox regression analyses,the predictors of prolonging survival included subsequent HIFU ablation after stent insertion and earlier tumor stage(P<0.05).Conclusion Combined biliary stent insertion and HIFU ablation is a safe and effective method for malignant obstructive jaundice caused by pancreatic carcinoma,and seems to extend stent patency time and survival when compared with biliary stent only.