Objective To discuss the application of endoscopic techniques in the treatment of calculus of intrahepatic or extrahepatic duct. Methods Laparoscopy in conjunction with duodenoscopy or cholangioscopy was adopted in 96 cases of calculus of intrahepatic or extrahepatic duct, including 72 cases of cholecystolithiasis complicated by choledocholithiasis, 16 cases of simple choledocholithiasis and 8 cases of left intrahepatic duct calculus complicated by choledocholithiasis. The surgical procedures included laparoscopic cholecystectomy (LC) combined with EST (37 cases), LC combined with cholangioscopic exploration (54 cases), and laparoscopic left hepatic lobectomy combined with cholangioscopic exploration (5 cases). Results Postoperative re-examination revealed no residual calculus in 93 out of 96 patients. Small amounts of biliary leakage occurred in 4 patients and healed spontaneously within a mean time of 10 days. No other severe complications took place. A conversion to open surgery was required in 3 patients, 2 of which were high bile duct stricture and 1 of which were severe portal adhesion. Conclusions Endoscopy in the treatment of calculus of intrahepatic or extrahepatic duct is feasible. Proper application of multiple endoscopic techniques is a safe, effective and minimally invasive means for the treatment of cholelithiasis.

Artesunate ( Art ) is one of the derivatives of Qinghaosu ( Arte-misinin ), an effective and nontoxic new drug from the traditional Chinese medicine Qinghao ( Artemisia annua L. ).We observed a striking protection of Art against acute liver inju-ries induced by Acetaminophen(AAP)and CC14 in mice. The elevated serum transminase levels and liver lesions were reduced by Art given 100mg/kg or 200mg/kg ip to mice. Art also inhibited AAP-induced decrease of liver glycogen and reduced mortality in AAP-treated mice. In addition, Art markedly decreased the duration of the hypnosis of sodium pen tobarbital in mice, suggesting a stimulatory effect of Art on hepatic-metabolizing enzymes.

OBJECTIVE To save the acute radiation sickness patients by preventing nosocomial infection and implementing environment protection of the wards.METHODS The results of air and the object surface in the wards,the workers′ hands detecting and sampling after improving environment protection were compared with those four days before improving it.RESULTS The problems were solved by the improverent of the new systems,rigorous training of the workers,air disinfecting,object surface management and their working process.CONCLUSIONS Discovering problems,seeking causes and solutions and the standardized administration of the environment in the wards are important to save the acute radiation sickness patients by environment protecting and keep safety of patients.

Purpose To investigate the clinical effect of ultrasound guided drainage combined with different hardeners for simple breast cysts,and to further provide reference for individual treatment.Materials and Methods Clinical data of 117 cases breast simple cysts were analyzed retrospectively,of which 42 cases were routine ultrasound-guided puncture combined with fluid injection of hypertonic sugar (group A),40 cases were routine ultrasound guided drainage combined with ethanol injection therapy (group B),and 35 cases were routine ultrasound guided therapy alone (control group).The clinical efficacy and adverse reactions were compared among the three groups after treatment.Results The total effective rate of group A was 95.24％,group B was 97.50％,and control group was 82.86％.Total effective rate of group A and B had no significant difference (P＞0.05),which were both higher than control group (P＜0.05).The adverse reactions rate of group B was higher than group A and control group,which had statistical significance (P＜0.05).Conclusion Ultrasound guided injection of hypertonic sugar or ethanol after drainage treatment for simple breast cysts can both obtain satisfactory clinical results,but adverse reactions of the former one are mild,it should be widely applied.

Objective To evaluate the value of tumor necrosis factor -α( TNF-α) ,leptin ( LEP) ,interleu-kin-6 (IL-6) and carcinoma embryonic antigen (CEA) in both serum and pleural effusion in differential diagnosis of tuberculosis and malignant tumor .Methods Detection were performed on tuberculosis and malignant tumor patients,comparation was conducted on the level and positive ratio of TNF -α,LEP,IL -6 and CEA in different groups.Results The levels of TNF-α,LEP,CEA in serum decreased significantly compared with malignant tumor patients[(34.45 ±17.11)μg/L vs (70.26 ±19.31)μg/L,(490.71 ±197.58)μg/L vs (2 013.62 ±596.22)μg/L, (226.81 ±87.09)μg/L vs (5 329.62 ±1 523.58)μg/L;t=5.221,9.673,12.078;P=0.012,0.031,0.000],but IL-6 was not [(159.73 ±30.33)μg/L vs (22.31 ±3.20)μg/L;t=-16.114;P=0.001];The level of TNF-α, LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients [( 20.31 ± 5.62)μg/L vs (42.06 ±14.07)μg/L,(702.46 ±375.01)μg/L vs (4 532.27 ±2 307.83)μg/L,(112.25 ± 48.72)μg/L vs (4 190.84 ±1 534.29)μg/L;t=5.017,12.096,12.236;P=0.022,0.016,0.033],but IL-6 was not [(92.15 ±32.64)μg/L vs (10.29 ±3.91)μg/L,t=-11.583;P=0.031].The positive ratio of TNF -α, LEP,CEA in serum was decreased significantly compared with malignant tumor patients (17.8% vs 72.2%,20.0%vs 91.7%,0.0% vs 100.0%;χ2 =24.341,41.145,81.000;P =0.000,0.000,0.000),but IL -6 was not (100.0%vs 0.0%,χ2 =81.000;P=0.000);The positive ratio of TNF -α,LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients (28.9% vs 75.0%,4.4% vs 100.0%,0.0% vs 97.2%;χ2 =17.012,73.326,77.038;P=0.000,0.000,0.000),but IL -6 was not(97.8% vs 0.0%,χ2 =77.059;P=0.000).Conclusion The level and positive ratio of malignant tumor patients are higher than tuberculo-sis patients,but IL-6 is not,these indicators are helpful in diagnosing tuberculosis and malignant tumor .

Objective To evaluate the effect of monosialoganglioside (GM-1) on hippocampal protein kinase B (Akt) /glycogen synthase kinase 3β (GSK-3β) signaling pathway in the rats undergoing cardiopulmonary bypass (CPB).Methods Eighteen healthy male Sprague-Dawley rats, aged 6 months, weighing 400-500 g, were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C), CPB group and GM-1 group.GM-1 20 mg/kg was added to the priming solution in group GM-1, while the equal volume of normal saline was given in group CPB.At 3 h after termination of CPB, blood samples were taken from the jugular vein for determination of plasma neuron-specific enolase (NSE) and S-100β protein concentrations using enzyme-linked immunosorbent assay.After blood sampling, the rats were sacrificed, and the hippocampi were isolated for microscopic examination of the ultrastructure of the hippocampal neurons (with electron microscope), and for detection of neuronal apoptosis (with light microscope) and phosphorylation of Akt and GSK-3β (by Western blot).Results Compared with group C, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly increased in CPB and GM-1 groups, the phosphorylation of Akt and GSK-3β was decreased in group CPB, and the phosphorylation of Akt and GSK-3β was increased in group GM-1 (P＜0.05).Compared with group CPB, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly decreased, the phosphorylation of Akt and GSK-3β was increased (P＜0.05), and the pathological changes were reduced in group GM-1.Conclusion GM-1 can reduce apoptosis in hippocampal neurons through activating Akt/GSK-3β signaling pathway, thus mitigating CPB-induced brain injury in rats.

Objective To compare efficacy of pemetrexed (MTA) combined with cisplatin (DDP) and docetaxel (TXT) combined with DDP in treatment of non-small cell lung cancer (NSCLC).Methods 50 patients with NSCLC from May 1, 2013 to May 1, 2015 in the hospital were seleced and randomly divided into two groups:MTA group (n=25) were received MTA combined with DDP, and TXT group(n=25) were received TXT combined with DDP, for a course of twenty-one days.After treatment, the efficacy of two therapy as well as adverse reactions were compared.ResuIts After treatment, the soluble intercellular adhesion molecule 1 (sICAM-1) and soluble vasccular cell adhesion molecule 1 (sVCAM-1) levels in MTA group were significantly lower than those before treatment (P<0.05), but there were no statistical differences in TXT group, and the above two indicators in MTA group were lower than those in TXT group(P<0.05).There were no significant difference of total efficacy between MTA group and TXT group (20.00% vs.16.00%, χ2 =0.136,P>0.05).The adverse reaction of nausea and vomiting, anemia, low platelet count, neutropenia and alopecia in MTA group was lower than that in TXT group (40.00%vs.72.00%,χ2 =5.195,P<0.05).ConcIusion The efficacy of MTA combined with DDP and TXT combined with DDP in treatment of NSCLC is similar, but the adverse reactions of fomer one is lower.

Thirty-three infants with muscular torticollis were treated by Tuina techniques, and the size of the hardened sternocleidomastoid muscle in the affected side was B-ultrasonographically observed before and after treatment. Results: 27 cases were cured, 5 cases got effectiveness, 1 case failed and the total effective rate was 97.0%; B-ultrasonography, in the palpable cord-like or ovary-like lumps,showed low echo in 28 cases, moderate echo in 2 cases and high echo in 3 cases; there were significant differences in the length, thickness and width of the lumps between before and after treatment, P＜0.01. It is indicated that Tuina is quite effective against infantile muscular torticollis; that ultrasonography can be adopted as an objective item for the evaluation of the clinical efficacy of Tuina in the treatment of infantile muscular torticollis, and it is a simple, convenient and inexpensive method and should be extensively popularized in clinical practice.

Objective To reproduce and validate the hexokinase reference method for glucose detection and compare other 5 routine glucose kits with this reference method. Methods The CDC hexokinase reference method for glucose detection was established and the performance was validated through testing a standard reference material (SRM) and participating in the IFCC ring-trial for reference laboratories for glucose evaluation. The CLSI EP 9-A2 protocol was used to compare the 5 routine glucose kits with the hexokinase reference method. Forty serum samples were analyzed by 5 routine kits and the hexokinase reference method. Results When SRM 965a was determined by the reference method,the bias of level 2 and level 3 were 0. 93%, -0. 23% respectively. The results for IFCC ring trial were within the accepted range. For the 5 routine kits, the confidence intervals of the predictive bias at the medical decision point Xc (Xc = 6. 11 mmol/L) were all within the range of defined acceptable error (10%) and the range of biological variation bias (6.9%). Conclusions The hexokinase reference method for serum glucose was reproduced in our lab. The serum glucose results measured with 5 routine kits were different from results detected with the reference method, but the bias was acceptable,and it will not affect the detection results.

Objective To evaluate the feasibility of optimized scan protocol in whole-brain perfusion imaging with 320-MDCT scanner.Methods Twenty healthy volunteers were randomly divided into control group (13 patients) and test group (7 patients).The standard perfusion scan protocol (collecting 19 volumes)was applied in control group.The optimized perfusion CT scan protocol(collecting ll volumes)formulated by reducing scanning phases reasonably and changing the collection intervals was applied in test group.The regions of interest(ROI) with area of(20 ± 2)mm2 were located in the bilateral frontal white matter,parietal white matter,centrum semiovate,basal ganglia,occipital lobe and cerebellum.Bilateral perfusion values from ROI were measured,including cerebral blood volume(CBV),mean transit time (TTP),cerebral blood flow (CBF),mean transit time (MTT) and delay time (DT).Results Dose length product (DLP)and effective dose (ED)in optimized protocol were decreased 42.02％ as compared to control group.Every relative perfusion value of both sides from both groups were not statistically significant (P ＞ 0.05).Every relative perfusion parameters from individual territory in both groups showed no significant differences (P ＞ 0.05).Conclusions Using the optimized scan protocol,we could obtain the same whole-brain perfusion values could be obtained with the default standard protocol and less radiation dose.