Bile duct injury is the most common complications of biliary surgery.With the development of tissue engineering,using artificial bile duct to treat the biliary tract disease has become the focus for the treatment of bile duct injury.This article summarizes the applications in clinical work and animal experiment of artificial bile ducts made of biological material,autologous tissue,non-absorbable polymer materials,as well as absorbable polymer materials in the clinical application and animal experiments.The advantageof each material is also discussed here.

OBJECTIVE To investigate the epidemiology of Norwalk virus enteritis in Hospital,and find the proper program to control it.METHODS Epidemiology and clinical data research was given to the 13 patients who were suspected to infected with Norwalk virus in our department of cardiac medicine.RESULTS The aggregation of enteritis was found in our department from Feb 14,2008 to Feb 20,2008.The bacterial culture of stool of the patients was negative,so we supposed to detect the Norwalk virus in the patients stools and find 4 positive specimens.We gave the patients with symptomatic treatment and all the patients were cured.Then,strict isolation for the patients with Norwalk virus infection and disinfection to of environment of our department was given.No more patients were infected with Norwalk virus.CONCLUSIONS It′s possible to control the Norwalk virus infection,and strict isolation and disinfection of the environment as early as possible are crucial to control the Norwalk virus infection.

Objective:To establish a method for the determination of tanshinoneⅡA and salvianolic acid B in Zhiyou capsules by HPLC. Methods:The chromatographic column was Waters Atlantis@T3(150 mm × 4. 6 mm,3 μm)using acetonitrile and aqueous ammonium acetate solution(adjusting pH to 2. 4 with formic acid)as the mobile phase with gradient elution,the flow rate was 1. 0 ml ·min-1 and the detection wavelength was 260 nm. Results:The contents of salvianolic acid B and tanshinoneⅡA showed good linear relationship within the range of 1. 20-60. 00μg·ml-1(r=0. 999 7)and 0. 40-20. 00 μg·ml-1(r=0. 999 8),respectively. The av-erage recovery was 101. 53%(RSD=1. 14%)and 95. 17%(RSD=4. 33%),respectively. Conclusion:The method is efficient,con-venient and accurate,which can be used in the quality control of Zhiyou capsules.

Objective To study the molecular mechanism of glutamate receptor-6 (GluR6) in the pathogenesis of epilepsy. Methods Seizure model of SD rats was induced by intraperitoneal injection of kainate (KA). Immunoprecipitation and immunoblotting were performed to examine the interactions of GluR6 and MLK3 with PSD95 at various time points after KA injection. The effect of Tat-GluR6-9c on the MLK3 phospharylation induced by kainate was observed with immunoblotting and immunohistochemistry. Results The assembly of GluR6 and MLK3 with PSD95 was induced after KA hippocampal CA3 region, and bagan to decrease one day later. Pretreatment after KA injection in CA3 region (P<0.05). Conclusion KA induces the assembly of the GluR6-PSD95-MLK3 signaling module and subsequently activates MLK3, which ultimately results in brain injury.

Objective To investigate the indications and clinical efficacy of combined application of laparoscope,choledochoscope and duodenoscope in the treatment of extrahepatic cholangiolithiasis.Methods The retrospective cohort study was adopted.The chnical data of 2 364 patients with extrahepatic cholangiolithiasis who were admitted to the First Hospital of Jilin University from January 2008 to December 2015 were collected.Of the 2 364 patients,861 patients had cholecystolithiasis combined with extrahepatic cholangiolithiasis and the diameter of common bile duct ≥ 8 mm,720 patients had cholecystolithiasis combine with extrahepatic cholangiolithiasis and the diameter of common bile duct ＜ 8 mm,783 patients had only extarhepatic cholangiolithiasis.In the patients diagnosed as cholecystolithiasis combined with extrahepatic changiolithiasis,laparoscopic cholecystectomy (LC) + laparoscopic common bile duct exploration (LCBDE) were applied to patients with the diameter of common bile duct≥8 mm,and the T-tube placement or primary suture was used intraoperatively according to the status of individualized patients;endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation (EPBD) + LC were applied to patients with the diameter of common bile duct ＜ 8 mm.For patients with only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy,EST or EPBD was applied,and LCBDE was applied to patients with multiple stones and maximum diameter ＞ 2 cm and unsuitable for EST or EPBD.If residual stones were found after operation in patients with T-tube placement,choledochoscope was used to extract stone;otherwise,EST or EPBD was used.Treatment outcomes including treatment method,success rate of minimally invasive lithotomy,operation time,incidence of complication,duration of postoperative hospital stay and treatment expenses,and the results of follow-up including 1-,3-year recurrence rate of stones were recorded.The follow-up was done by outpatient examination and telephone interview till January 2016.All the patients were reexamined blood routine,liver function and color doppler ultrasonography of the abdomen at 1 month,3 months,6 months,1 year and 3 years after operation.Suspected residual cholangiolithiasis found by ultrasound was varified by computer tomography (CT) or magnetic resonanced cholangiopancreatography (MRCP) imaging examination.For patients with T-tube placement,CT scan and biliary photography were performed at 2-3 months postoperatively to determine whether residual stones existed and T tube could be pulled out.Measurement data were presented as mean (range).Results Of 2 364 patients,2 271 patients received minimally invasive lithotomy successfully.Of 861 patients of cholecystolithiasis combined with extrahepatic cholangiolithiasis and the diameter of common bile duct≥8 mm,836 succeeded in minimally invasive lithotomy,with a success rate of 97.10％ (836/861),the other 25 patients were converted to open surgery.Seven hundred and three patients of 836 patients received T-tube placement in LCBDE,and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 97 minutes (range,41-167 minutes),3.70％ (26/703),6.7 days (range,3.0-32.0 days) and 3.4 × 104 yuan (range,1.5 × 104-6.7 × 104 yuan),respectively.One hundred and thirtythree patients of 836 patients received primary suture,and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 89 minutes (range,39-123 minutes),3.01％ (4/133),4.1 days (range,2.0-17.0 days),2.1 × 104 yuan (range,1.6 × 104-3.4 × 104 yuan),respectively.Of 720 patients with the diameter of common bile duct ＜ 8 mm who underwent EST or EPBD + LC,687 succeeded in minimally invasive lithotomy,with a success rate of 95.42％ (687/720),the other 33 patients were converted to open surgery.The mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses of 687 patients were 101 minutes (range,69-163 minutes),2.91％ (20/687),5.6 days (range,2.0-15.0 days) and 2.8 × 104 yuan (range,2.0 × 104-6.4 × 104 yuan),respectively.In 783 patients with only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy,701 of 725 patients who were treated with EST or EPBD succeeded in minimally invasive lithotomy,with a success rate of 96.69％ (701/ 725),and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses of 701 patients were 47 minutes (range,11-79 minutes),2.28％ (16/701),3.7 days (range,2.0-19.0 days),1.7 × 104 yuan (range,1.3 × 104-5.5 × 104 yuan),respectively;47 of 58 patients who were treated with LCBDE succeeded in lithotomy,with a success rate of 81.03％ (47/58),and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 124 minutes (range,94-170 minutes),8.51％ (4/47),7.9 days (range,5.0-21.0 days) and 3.8 × 104 yuan (range,2.3 × 104-7.9 × 104 yuan),respectively.Of 2 364 patients,2 207 were followed up for a mean time of 38 months (range,1-72 months).The 1-,3-year recurrence rates were 2.74％ (19/693) and 5.08％ (24/472) in patients receiving LC + LCBDE,3.10％ (21/677) and 5.69％ (30/527)in patients receiving EST or EPBD +LC for cholecystolithiasis combined with extrahepatic cholangiolithiasis.The 1-,3-year recurrence rates were 3.22％ (20/621) and 6.11％ (25/409) in patients receiving EST or EPBD + LC,7.32％ (3/41) and 11.11％(2/18) in patients receiving LCBDE for only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy.Conclusions It is safe and effective to treat extrahepatic cholangiolithiasis based on combined application of laparoscope,choledochoscope and duodenoscope,with choosing appropriate indications as the key to improve the therapeutic effect.Primary suture in the LCBDE is recommended because it can protect patients from T-tube placement.

Objective To study the dynamic change of polysaccharides from Bupleurum marginatum in Northwest of Hubei province,and to explore the optimal harvest period for Bupleurum marginatum. Methods The contents of soluble and crude Bupleurum polysaccharides were determined by anthrone-sulphuric acid colorimetric method and detected at 620 nm,and total polysaccharide content was calculated. Results The content of polysaccharides at various collecting periods was very different from 9. 642% to 15. 479%,and reached the highest level in November when the seed comes to mature. ConclusionThe optimal harvest period for Bupleurum marginatum in Northwest of Hubei is at the end of November.

Objective To compare anti-inflammatory and hepatoprotective effects of Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. Methods The anti-inflammatory effect of two kinds of radix bupleuri decoction were compared using the xylene-induced ear edema mice model and the egg white-induced foot swelling rats model. Acute liver injury in mice was induced through intraperitoneal injection of peanut oil with 0. 1%carbon tetrachloride. Alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) , and alkaline phosphatase ( ALP ) in serum, superoxide dismutase ( SOD ) , malondialdehyde ( MDA ) , and glutathione ( GSH ) in liver tissue homogenate were detected. Histopathological changes, transforming growth factor-β ( TGF-β) and nuclear factor-κB ( NF-κB) in hepatic tissues were also observed. Results Ear swelling experiment showed that the decoction of both Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. had equal anti-inflammatory effects (P>0. 05). Similarly,the decoction of Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. improved levels of ALT,AST,SOD,GSH,and MDA to the same extent compared with the model control group ( P<0. 05 or P<0. 01 ). There was no significant difference among all groups in ALP levels ( P > 0. 05 ). Histopathological and immunohistochemical experiments showed that expressions of TGF-β and NF- κB were similar between the two kinds of radix bupleuri. Conclusion Bupleurum marginatum Wall. ex DC. and Bupleurum chinense DC. have similar anti-inflammatory and hepatoprotective effects.

Pancreatic leakage is most common among numerous complications after pancreaticoduodenectomy surgery.Predicting at early stage and taking preventive measures in time are of great importance to reducing the incidence of pancreatic leakage as well as its related complications.The article reviewed pancreatic leakage monitoring related reports worldwide in recent 10 years.It was found that some factors were useful for the prediction of pancreatic leakage including the drainage fluid amylase and leukocyte count on postoperative day 1 and 3,C-reactive protein on postoperative day 3,the combined detection of white blood cells and albumin on postoperative day 4,the serum urea nitrogen and the serum albumin on postoperative day 1 and 5-8 days,as well as the ratio of amylase level in abdominal drainage to abdominal drainage volume.

Objective To compare the effect of naive porto-azygous devascularization and that as a remedy therapy after a failed endoscopy for the treatment of bleeding portal hypertension.Method From June 2005 to June 2010,230 portal hypertension patients were treated with porto-azygous devascularization,among them,202 cases were of portal hypertensive cirrhotics,28 cases of alcoholic cirrhosis.Group A (16 patients)received remedial porto-azygous devascularization after endoscopic treatment failed (esophageal variceal ligation,esophageal variceal selerotherapy).Group B(214 patients)received naive porto-azygous devascularization.Results The average operation time in group A was 198 min(115-335)min,mean bleeding amount was 750 ml(300-2000)ml,average post-operative hospital stay was 11 days (8-15)days.The average operation time in group B was 120 min(90-190)min,mean blood loss was 250 ml(150-500)ml,average post-operative hospital stay was 7 days(6-9)days.The average operation time,bleeding amount and post-operative hospital stay was significantly different between the two groups (P＜ 0.05).212(92.2％)patients were followed up,and the mean follow-up time was 2.5 years (1-6)years,mortality rate was 4.2％,rebleeding rate was 5.7％.Conclusions Surrounding the perioesophageal and gastric tissues were fibrotic and hard after the endoscopic treatment,this significantly increased the difficulty of surgery,therefore,porto-azygous devascularization is the choice of therapy for portal hypertension patients.

Objective To summarize the clinical applications and surgical technique of laparoscopic distal pancreatectomy (LDP). Method The clinical data of 10 cases of pancreatic body and tail tumors undergoing laparoscopic distal pancreatectomy were retrospectively analyzed.Results Laparoscopic distal pancreatectomy (LDP) was successfully undertaken in 8 cases (including spleen preserving distal pancreatectomy in one case ). Intraoperatively two cases were converted to open surgery because of peripancreatic organs involvement by cancer in one case and massive bleeding in another case during laparoscopic procedures. The average operation time of LDP was 141 ± 35 min (95 -195 min),mean blood loss was 263 ± 151 ml( 100 -600 ml), average postoperative hospital stay was 7 ± 1 days (5 -9 days ). There was no major postoperative complications and no mortality. Final pathology was solid psedopapillary tumor in 4 cases, mucinous cystadenoma in 3 cases and islet cell tumor in 1 case, pancreatic ductal adenocarcinoma in 2 cases, hence 80% of tumors were benign. Conclusions LDP is indicated for benign body and tail pancreatic tumors and early malignant tumor of pancreatic body and tail. Being less traumatic, and fewer complications, LDP is a safe, effective and minimally invasive therapy.