Objective To investigate the efficacy of laparoscopic transcystic duct exploration for cholecystolithiasis complicated with stones in the non-dilated common bile duct.Methods Before the resection of the cyst,the cystic duct was cut under a laparoscope,and then a C tube was inserted for cholangiography.Stones in the common bile duct were removed under the guidance of C-arm X-ray.Then,C-tube drainage was carried out after removal of the calculi.Results The stones were completely removed in all of the 36 cases with a mean operation time of 125.4 minutes(90-150 minutes).The C-tube was withdrawn in 3 or 4 days after the operation.The mean postoperative time of this series was 4 to 7 days.The patients were followed up for 3 months,during which no patients had biliary leakage,residual stones,or stenosis or dilation of the common bile duct.Conclusions Laparoscopic transcystic duct exploration is minimally invasive,safe,and effective for cholecystolithiasis complicated with stones in the non-dilated common bile duct.

Objective For drinking water deep treatment,this study compared the abilities of several common domestic products of activated carbon in virus removal from water through adsorption. Methods This study compared the abilities in virus removal of two types of granular activated carbon (GAC) materials (domestic product made of coconut shell) and one type of activated carbon fiber (ACF) material (domestic product made of mucilage glue-based ACF felt) under a fixed condition (phosphate buffered saline-PBS solution,pH =7.3,25 ℃) and the abilities of one of the above two GAC types under various conditions (before and after pretreatment,15-35 ℃,pH= 6.0-8.4,concentration of Ca2+ 0-500 mg/L,ionic strength 0-0.1 mol/L). The tested virus was the indicator phages obtained from sewage with an enterobacterium (Escherichia coli 285). Results The removal process with the GACs followed the first order kinetic model (R2: 0.83-0.99),whereas that of the ACF did not (R2: 0.44-0.64),with the rate constants of 0.505 3-2.606 8 (GACs) and 0.219 2-0.413 8 (ACF). Pretreatment (boiling for 2 h and then washing in deionized water) could both increase and decrease the removal effects,depending on the GAC sources. Different abilities in virus removal were found between the two GACs with their comparative outcomes depending on if they were subject to the pretreatment; higher levels of temperature,Ca2+ concentration,and ionic strength,and slight acidic and alkaline conditions favored virus removal. Calculation from the first order kinetic simulation showed that: the removal percentage within 15 min was around 30% with the highest 40% and the lowest 5%; and the maximum removal during the experimental period of 5 h reached 5-log. Although the amount (1 g) of the GACs used was ten times of that of the ACF (0.1 g),the measured values showed that the latter had faster initial removal rates than the former. Conclusion The three domestic products of activated carbon showed a large difference in their abilities to remove the viruses from water through adsorption with their comparative outcomes depending on the experimental conditions. If the short duration (about 15 min) currently employed in activated carbon treatment process is considered,it will be necessary to study the ways in promoting virus removal through adsorption onto the activated carbon materials of domestic products used in this experiment.

AlM:To investigate the opportunity of the concomitant strabismus operation and the function in the treatment of strabismic amblyopia through analyzing the changes of binocular summation of pattern visual evoked potential ( P-VEP ) before and after the surgery of concomitant strabismus.
METHODS: ln this retrospective study we investigated 67 cases admitted in our hospital. All patients were less than 18a and the postoperation squint angle was less than ± 10△. Patients were divided into three groups according to the strabismus type, age, and amblyopia degree. P-VEP binocular summation response was recorded in all cases, to observe the changes of the binocular summation response of P-VEP before strabismus surgery and 1mo, 3mo after surgery. The P-VEP response of binocular /monocular ( B/M ) ratio was taken as an evaluation index.
RESULTS: B/M value of three groups all improved obviously 1mo after surgery, which the difference showed statistical significant (P<0. 01). 1) After 3mo surgery, B/M value in esotropia group was higher than that in exotropia group (P<0. 05). 2) After 3mo surgery, B/M value in≤6a group was higher than that in >12a group (P<0. 05). 3) After 1mo surgery, B/M value in severe amblyopia group was higher than that in mild group (P<0. 05). After 3mo surgery, B/M value in severe amblyopia group was higher than that in mild group significantly (P<0. 01).
CONCLUSlON: Concomitant strabismus surgery is suggested to be performed before 6 years old when the patients are difficult to improve the vision after amblyopia treatment, especially with the severe amblyopia and esotropia (accommodative esotropia must be excluded). The early operation is better to amblyopia treatment and binocular vision recovery.

OBJECTIVETo explore effective approaches of treating elderly patients with distal tibiofibular fractures.

METHODSFrom August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate (LCP) through anterior tibial. There were 112 males and 63 females with an average of 71.3 (ranged 60 to 83) years old. Of them,89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of (71.8 +/- 6.4) years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of (70.3 +/- 6.7) years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation.

RESULTSSwelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was (5.6 +/- 1.3) and (9.7 +/- 2.1) days, healing time was (4.2 +/- 1.4) and (5.4 +/- 1.9) months,and complications were found 3 in tension reduced incision and 10 in distak tibial incision respectively;and all data shown statistically significant differences between two groups (P < 0.05). At 12 months after operation,AOFAS score was 89.0 +/- 9.7, 87.9 +/- 9.4; and there was no statistically significant difference between two groups (P > 0.05).

CONCLUSIONTension reduced incision through anterior tibial combined with locking compression plate fixation in treating elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

Objective To evaluate the efficacy of naloxone used in the postoperation of cerebral tumor.Methods Eighty patients were randomly assigned to receive (treated group:40 patients) or not re- ceive (control group:40 patients) naloxone.Both the two groups accepted the conventional therapy.Re- sults After operation,the content of?-EP,ET decreased continuously but the one of the treated groups was more obviously than that of the control groups (P

Objective To explore the relationship between IL-1?-511C/T and IL-1?+3953C/T site polymorphisms and the susceptibility of pediatric epilepsy.Methods Under the case-control study,IL-1?-511C/T and IL-1?+3953C/T site polymorphisms in 117 patients with pediatric epilepsy and 95 healthy individuals controls(healthy control group) were analyzed with polymerase chain reaction restriction and fragment length polymorphism(PCR-RFLP),the relationship between IL-1?-511C/T,IL-1?+3953 C/T site polymorphisms and the risk of pediatric epilepsy were analyzed.SAS 8.0 software was used to analyze the data.Results Multiple variate logistic regression analysis revealed that compared with healthy control group,there was no relationship between the IL-1?-511C/T site polymorphisms and the susceptibility of pediatric epilepsy individuals,carrying at least one +3953T variant allele(CT and TT genotypes) had a significantly increased risk for pediatric epilepsy(adjusted OR=2.46,95%CI 1.03-5.87),compared with the wild-type genotype(+3953CC).Furthermore,individuals with epilepsy or febrile seizures family history had a significantly higher risk(adjusted OR=4.12,95%CI 1.28-29.34),compared with those with both CC genotypes.Conclusions These findings support the hypothesis that IL-1?-511C/T site polymorphisms have no relationship with epilepsy,but the IL-1?+3953C/T polymorphism may contribute to the risk of developing pediatric epilepsy.

OBJECTIVEThe study aimed to test if Paridis Rhizoma total saponins (PRTS) could induce apoptosis of human gastric cancer cell MKN-45.

METHODBased on the previous researches, PRTS was set by different concentrations to treat human gastric cancer cell for 12 h (5, 10, 20 mg x L(-1)). Fluorescent staining methods were adopted to observe apoptotic morphological changes of MKN-45. The apoptosis rates were analyzed by flow cytometry with Annexin V-FITC/PI staining. The enzymatic activities of caspase-3 and caspase-8 were measured by ELISA. The protein levels of Fas and FasL were detected by Western blotting.

RESULTUnder a fluorescence microscope, MKN-45 treated by PRTS was seen typical apoptotic morphological features. PRTS significantly increased the rate of apoptosis. Compared with the control group, there exsited significant differences in apoptosis rate of PRTS concentration of 20 mg x L(-1) (P < 0.01); besides, the enzymatic activities of caspase-3 and caspase-8 were promoted obviously after the effect of PRTS on MKN-45 cells for 12 h (P < 0.01). The protein levels of Fas and FasL in the MKN-45 were upgraded significantly.

CONCLUSIONPRTS can induce apoptosis of human gastric cancer cell MKN-45 , which is concerned with caspase-3 and caspase-8 and upgraded Fas and FasL.

Apoptosis ; drug effects ; Caspase 3 ; genetics ; metabolism ; Caspase 8 ; genetics ; metabolism ; Cell Line, Tumor ; Drugs, Chinese Herbal ; pharmacology ; Fas Ligand Protein ; metabolism ; Humans ; Magnoliopsida ; chemistry ; Rhizome ; chemistry ; Saponins ; pharmacology ; Signal Transduction ; drug effects ; Stomach Neoplasms ; drug therapy ; genetics ; metabolism ; physiopathology ; fas Receptor ; metabolism

Objective To investigate the expression and significance of Smad 7,Smurf 1 and Smurf 2 in basal cell carcinoma and squamous cell carcinoma.Methods Biopsy specimens were resected from 14 patients with basal cell carcinoma,19 patients with squamous cell carcinoma and 30 normal controls.Quanti- tative real-time PCR and immunohistochemical techniques were utilized to assess the expression of Smad 7, Smurf 1 and Smurf 2 in these specimens.Results The gray scale for staining of Smad 7,Smurf 1 and Smurf 2 was 166.61?7.11,166.08?8.71,and 166.25?8.15 respectively in basal cell carcinoma,161.66?5.52,166.84?9.27,and 169.98?9.48 respectively in squamous cell carcinoma.The expression levels of Smad 7,Smurf 1 and Smurf 2 were all significantly increased in basal cell carcinoma and squamous cell car- cinoma in comparison with normal controls.Conclusions The over-expression of Smad 7,Smurf 1 and Smurf 2 may interfere with transforming growth factor?signaling transduction pathway through several links,therefore prevent the inhibitory effect of transforming growth factor?on epidermal proliferation,and accelerate the abnormal proliferation in above epidermal tumors.

Background Corneal parameters (such as curvature,thickness,etc) are essential to the diagnosis of corneal related diseases,contact lenses fitting and corneal refractive surgery.Objective The aim of this study was to assess the repeatability and accuracy of corneal parameters obtained by RTVue Fourier-domain optical coherence topography (FD-OCT).Methods In this prospective study,77 eyes of 43 subjects with the refraction from-1.25 D to-10.00 D and astigmatism ＜2 D were enrolled in keratorefractive surgery center,Eye Hospital of Wenzhou Medical College.The anterior and posterior corneal curvature in 3 mm central zone (Ranterior and Rposterior),the ratio of posterior and anterior curvature (Rposterior/Ranterior),corneal central thickness (CCT),total corneal power(Knet),the simulated corneal power (Sim K),the anterior and posterior corneal power (Kanterior,Kposterior)were measured by FD-OCT.Corneal power (Km) was obtained by Topolyzer topography based on Placido ring.Three consecutive scans were acquired in every tested eye.Repeatability of FD-OCT measurement was assessed using the coefficient of variation CV),Cronbach Alpha and intra-class correlation coefficient (ICC).Repeated measure ANOVA was used to analyze the differences among SimK,Knet and Km.Pearson correlation analysis was used to analysis the correlation between SimK and K Knet and Km,SimK and Km.The agreement between Sim K and K Knet and Km,SimK and Km was assessed by Bland-Altman plots analysis.All the subjects understood the purpose of this investigation and written informed consent was obtained prior to the medical examination.Results The Ranterior,Rposterior,Rposterior/Ranterior,Kanterior,Kposterior,Sim K,Knet and CCT were (7.691 ±0.302) mm,(6.532±0.276) mm,0.849±0.014,(48.97±1.92)D,(-6.13±0.26)D,(43.95±1.72) D,(42.95±1.68) D and (545.20± 35.04) μm,respectively.The CV of all parameters was less than 1％.The Cronbach Alpha and ICC were both more than 0.9 except 0.802(ICC)of the Rposterior/Ranterior.SimK was (0.27±0.34) D higher than Km,and Knet was (0.73±0.37) D lower than Km.SimK was (1.01 ±0.11) D higher than K and all the differences showed a statistical significance (P＜0.001).There were close positive correlations between SimK and Km,Knet and Km,SimK and Knet(all r ≥ 0.976,P＜0.001).The Bland-Altman analysis showed a poor agreement between SimK and Km,Knet and Km,SimK and Knet.Conclusions The RTVue FD-OCT measuring corneal curvature and CCT performes good repeatability.The Sim K obtained by RTVue FD-OCT is slightly greater than that obtained by corneal topography,and the Rposterior/Ranterior obtained by RTVue FD-OCT is slightly lower than that from Gullstrand model eye.These results offer a basis for establishing a more accurate standardized model eye.

Liquid chip technology have been licensed to be used in clinic because of its advantage of high-throughput, high-sensitivity, good signal to noise ratio, reaction in liquid phase, convenient operation and short time consuming, etc. The optimization of a liquid chip system for the detection of serum biomarkers of colorectal tumour and initial application in the detection of CEA were studied. The optimized reaction conditions of liquid chip were determined through orthogonal design after it was prepared. The results showed that the consuming reaction time of the coated antibody and the antigen was 1hour. The microspheres, biotinylated detecion antibody and the consuming complexes and avidin-PE time of the microspheres and the biotinylated tested antibody was 1hour, 1hour and 15minutes respectively.the consuming time of the complexes and avidin-PE was fifteen minutes, The optimized dilution of the biotinylated tested detection antibody was 1∶300 and the optimized concentration of avidin-PE was 12?g/ml. Totally 55 clinical samples were detected by the liquid chip and by Enzyme-Linked Immunosorbent Assay (ELISA) simultaneously and the results of the two methods were compared. The results of the two methods showed good correlation between positive and negative samples but the detection limits and the dynamic ranges of the liquid chip method were more sensitive and wider than those of the ELISA. The multiple tumour biomarkers may be detected simultaneously and the time of clinical test and manpower requirements were reduced by the liquid chip method.