The CT findings and diagnosis of 39 operatively verified cases of bile duct stone are analysed. All the cases are studied with CT,part of the cases are studied with ultrasonography, ERCP and PTC. The direct CT findings, the intrahepatic biliary duct stones display high attenuation shadow or soft tissue density (20/23); the extrahepatic biliary duct stones display target sign or high attenuation shadow in the pancreatic head (14/24). The indirect findings show the dilatation of the intrahepatic biliary system.The extrahepatic biliary duct stone also shows dilatation of the distal common bile duct (CBD) with gradually fining away. CT diagnosis of the bile duct stone is considered to base on the direct findings with reference of the indirect findings and synthesized diagnosis.The thin slice scanning technology can press the visible rate of the CBD stone (it should be a routine studying method of the CBD stone). The method of imaging diagnosis of the biliary duct stone is also discussed.

Objective To study the expression of small breast epithelial mucin(SBEM) in the peripheral blood of the patients with breast cancer,and explore the correlation between micrometastasis and SBEM.Methods Peripheral blood samples were obtained from 92 patients with breast carcinoma,20 patients with benign breast diseases,10 patients with malignant tumor not originating from breast,and 10 normal healthy volunteers.SBEM-mRNA expression was detected by nested reverse transcription-polymerase chain reaction(Nested-RT PCR).Results Among 92 breast carcinoma patients,43(46.7%) were Nested-RT-PCR positive for SBEM-mRNA,but it was negative in all the other groups.The expression of SBEM-mRNA in peripheral blood did not correlate with ER or PR status,menstruation state or primary tumour size.but correlated with patient′s age,the state of Her-2,CEA,CA15-3 and axillary lymph node metastasis of breast cancer.Conclusions The expression of SBEM-mRNA in peripheral blood of breast cancer can be of potential use to monitor the micrometastasis of breast cancer.

The effect of Lycii Cortex on the PCOS rat model and the mechanism of action were investigated in the present study. The PCOS rat model was induced with Poretsky methods. Then the rats were randomly divided into four groups: the model group, melbine group (0.45 g x kg(-1)), low (2.5 g x kg(-1) and high (10 g x kg(-1)) dosage group of Lycii Cortex. The animals were orally administrated with the drugs for 14 days. In addition, another control group was added in this study. The rats were weighted before and after drug treatment. After 14 days treatment, oestrous cycle of rats were detected; blood serum was separated to determine T and FINS and rat's uteri were isolated. The mRNA and protein (total and phosphorylated) expressions of PI3K and PKB in uteri were measured with Real-time RT-PCR and Western blot, respectively. Compared with the control rats, the body weight gain and serum level of T and FINS were significantly increased. While, the mRNA and protein (phosphorylated) levels of PI3K and PKB were markedly decreased in PCOS group. Lycii Cortex treatment significantly decreased the body weight gain and serum level of T and FINS in a dose-dependant manner. It also markedly increased the mRNA and protein (phosphorylated) expressions of PI3K and PKB. Meanwhile, the melbine treatment also showed the curative effect. Lycii Cortex can relieve the symptoms of PCOS and the mechanism might be related to PI3K/PKB pathway.
Animals ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Lycium ; chemistry ; Phosphatidylinositol 3-Kinases ; genetics ; metabolism ; Phosphorylation ; drug effects ; Polycystic Ovary Syndrome ; drug therapy ; enzymology ; genetics ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects

Acupuncture Points ; Aged ; Aged, 80 and over ; Bloodletting ; Female ; Humans ; Middle Aged ; Pruritus ; therapy

Objective To observe the concentration of the inflammatory cytokines in vitreous of severe proliferative diabetic retinopathy (PDR) after intravitreal ranibizumab injection (IVR).Methods A total of 80 PDR patients (80 eyes) were enrolled in this study.The patients were randomly divided into vitrectomy group (group A) and IVR combined with vitrectomy group (group B),40 eyes in each group.The differences of sex(x2=0.05),age (t=0.59),duration of diabetes (t=0.36),HbA1c (t=0.13) and intraocular pressure (F=0.81) between two groups were not significant (P＞0.05).The eyes in group B received 0.5 mg (0.05 ml) ranibizumab injection at 7 days before operation.The vitreous samples (0.4 ml)were obtained before operation.The concentration of vascular endothelial growth factor (VEGF),interleukin (IL)-6,IL-8,intercellular adhesion molecule-1 (ICAM-1) and connective tissue growth factor (CTGF) were measured by enzyme-linked immunosorbent assays.Results The concentration of VEGF and ICAM-1 were (10.70±3.60),(224.64±90.32) pg/L in group B and (72.38±23.59),(665.61±203.34)pg/L in group A.The differences of VEGF and ICAM-1 concentration between two groups was significant (t=16.34,12.53 ; P＜ 0.001).The concentration of IL-6 and IL-8 were (210.64 ± 80.27),(156.00±57.74) pg/L in group B and (45.78±33.82),(41.07±13.82) pg/L in group A.The differences of IL-6 and IL-8 concentration between two groups was significant (t=11.97,12.24; P＜0.001).There was no difference of CTGF concentration between two groups (t=1.39,P=0.17).The CTGF/VEGF in group B was higher than that in group A (t=14.75,P＜0.001).Conclusions One week after IVR,the concentration of VEGF and ICAM-1 are decreased,while IL-6 and IL-8 increased.There is no obvious change in CTGF,but CTGF/VEGF is increased.

Objective To explore the effect and experience of problem-based (PBL) teaching in neurosurgical clinical training and improve the quality of the neurosurgical clinical training. Methods 600 clinical medical students of Grade 2011 in their probation in our department of neurosurgery were chosen as the subjects of study and were randomly divided into the experimental (PBL, 15 groups, 20 people/group, over 300 people) and control groups (CBL+ LBL, 15 groups, 20 people/group, over 300 people). In experimental group, PBL which is a problem-based, student-centered and teacher-directed pedagogy was adopted. In control group, CBL (case-based learning) + LBL (lecture-based learning) were adopted. After probation, two groups of students had the unified test and assessed their teaching methods by questionnaire survey and at the same time, the questionnaire survey about PBL' impact on the various aspects was done only to experimental group students. SPSS 15.0 software was used to do statistical analysis and data were processed by description analysis, t test, Mann-Whitney U test and correlation analysis. Results The scores of theoretical knowledge and general ability in PBL group [(40.57 ±3.24), (41.23 ±4.56) individually] were higher than these in control group [(37.21 ±4.05), (36.51±4.11) individually]. The differences demonstrated statistically meanings. Through the surveys, the students in experimental group showed the high satisfaction (97.0%, n=291) in PBL teaching. Most of the students considered that their abilities of team cooperation (96.7%, n=290), and self-directed learning (92.7%, n=278) were improved by PBL teaching. The students in experimental group illustrated their attitudes in satisfaction of teaching; interests of clinical training, participation of teaching and understanding of knowledge were superior to the control group. The differences demonstrated statisti-cally meanings. Conclusion PBL teaching got a good effect in neurosurgical clinical training. This method, which improved students' participation and motivation of study and contributed to the training of medical students' comprehensive abilities, is suitable for modern neurosurgical clinical training.

Asian Continental Ancestry Group ; China ; epidemiology ; Fatty Liver ; epidemiology ; Humans ; Hyperlipidemias ; epidemiology

ObjectiveTo summarize the curative effect of l aparoscopic cholecys tectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) for cholelithiasis concurrent with choledoc holithiasis.MethodsERCP and EST were applied in 210 patients suspected for c holedocholithiasis before (164 cases) or after (46 cases)LC.Results ERCP dis closed choledocholithiasis in 69 patients before LC, and then stones were comple tely removed by EST in 63 patients, with a clearance rate of 91 3% (63/69); ERC P revealed residual cholelith in 9 patients after LC, and 8 of them were cured by EST, with a clearance rate of 88 9% (8/9).ConclusionsLC co mbined with ERCP and EST for cholelithiasis concurrent with choledocholithiasis is safe and effec tive, keeping patients free from open surgery.

Objective To evaluate imaging diagnosis, differential diagnosis, surgery and interventional therapy of hepatic angiomyolipoma associated with tuberous sclerosis.Methods Clinical features, imaging appearances and interventional therapy for 2 cases of HAML in TS were retrospectrively analyzed. Results The features of HAML in TS are as following:(1) Two cases were female with no history of hepatitis and hepatocirrhosis, liver function test and alpha feto protein were normal. (2) the tumor was shown as a multiple hyperechoic mass with sharp margin on ultrasonography; well defined, fat density and intensity mass on computerized tomography (CT); hypervascular mass with early drainage of hepatic vein and tumor staining on angiography. (3) One case underwent interventional therapy. After 42 month follow up, the tumor was found to be diminished in size. Another case was under monitored with only the enucleating of left renal mass. The hepatic tumor showed no change after 10 months.Conclusions The imaging appearances of HAML in TS are relatively characteristic. Superselective arterial embolization is an effective treatment for HAML in TS.

Lu's acupuncture was found by two senior doctors, Lu Shou-yan and Zhu Ru-gong. As one of large schools in acupuncture academic circles in our country, Lu's acupuncture has relatively complete academic thought and theoretical system, and unique characteristics of clinical diagnosis and treatment. Doctor Su Zhao-jia studied under doctor Lu Shou-yan and inherited Lu's academic thought and diagnostic and therapeutic techniques. In decades of clinical practice, doctor Su adhered to Lu's acupuncture's treatment idea, treated diseases under the guidance of meridian theory and on the basis of syndrome differentiation, paid attention to acupuncture manipulation and accumulated relatively abundant clinical experience in applying acupuncture to composite treatment of senile vaginitis.