Gallbladder cancer is the most common malignant neoplasm in biliary system,with a high degrade of malignancy,invasion and metastasis.The prognosis is heartbreaking.Radical surgery is the only possible way for curing.The current understanding of China's doctors at all levels on radical surgery of gallbladder cancer is chaotic.Based on the latest version eighth TNM staging of the American Joint Committee on Cancer(AJCC)of gallbladder cancer,making a review of the literature,combined with the author's personal experience,we have interpreted the reasonable selection of hepatectomy of gallbladder cancer,in order to improve the doctors at all levels to regulate the understanding of hepatectomy and the prognosis of gallbladder cancer.

Objective To evaluate the clinical usefulness of manometry of esophgeal varices with endoscopic balloon technique. Methods The variceal pressure was measured by endoscopic balloon technique in 26 patients with portal hypertension, at the same time , laboratory parameters of liver function were determined. ResultsDetermination of variceal pressure was successful in 23/26 patients, while no side effects was observed. The intraobserver coefficient of variation was 7.18% ?2.64%,and there was a significant(P

Objective To explore the role of intravenous nutrition and enteral nutrition in the treatment of gastroplegia after gastrectomy. Methods The clinical data of 63 cases of gastroplegia after gastrectomy were retrospectively analyzed. Among the 63 cases, 30 were treated by gastrodynamic drugs and intravenous nutrition(intravenous nutrition group), and the other 33 cases were treated by gastrodynamic drugs and enteral nutrition(enteral nutrition group). Gastrointestinal decompression amount and recovery time of gastroplegia between the two groups were compared. Results Enteral nutrition group had a short recovery time of gastroplegia and less gastrointestinal decompression amount compared with intravenous nutrition group(P

[Objective]Extracellular signal-activated kinases(ERK),c-Jun N-terminal kinase(JNK) and P38 signal transduction pathway were three members of the MAPK family which mediated cellular proliferation,differentiation and apoptosis.The purpose of this study was to investigate the effects of ERK,JNK and P38 MAPK on pathogenesis and progression of human osteosarcoma.[Method]EnVisionTM immunohistochemical technique was used to detect the expressions of ERK,JNK and P38 protein among the 48 osteosarcoma and 25 osteoblastic benign tumor samples,and their differences were compared.[Result]The positive rates of ERK,JNK and P38 protein were 83.3%(40/48),72.9%(35/48) and 85.4%(41/48) respectively in 48 osteosarcoma,and 16.0%(4/25),12.0%(3/25) and 20.0%(5/25) in 14 osteoblastic benign tumor,the statistical analysis of the positive rates were performed using analysis of variance with P

With the strengthening of nuclear weapon development and the expanding of neutron application in economic area,the injury accidents of neutron radiation are happening from time to time.Neutron exposure,with high linear energy transfer,has high casualty rate,severe symptom and poor prognosis.In comparison with low-LET radiation damage,neutron irradiation induced injuries are more difficult to rescue.This review focused on the recent research progresses of radiation effects,intrinsic mechanisms and clinical prevention measures of neutron radiation,and to provide a theoretical clue for establishing an effective prevention protocol of neutron radiation damage.

Objective To investigate the diagnostic values of ultrasound in rheumatoid knee arthritis and the clinical significance of ultrasonic scoring system.Methods From July 2013 to December 2015,500 cases of patients with rheumatoid knee arthritis in two grade A class 3 hospitals of Lishui City were collected as the observation group and contemporaneous 500 healthy adults were collected as the control group.The knee joint synovial thickness,vascular detection rate in hyperplasia synovium,ultrasound score,rheumatoid arthritis disease activity score,erythrocyte sedimentation rate (ESR),C reactive protein (CRP),suprapatellar bursa effusion,infrapatellar bursa effusion,joint effusion,knee joint cartilage and bone surface were observed in the two groups.Results Compared with the control group,the observation group got a significant increase in knee joint synovial thickness [(0.50±0.19)cm vs.(0.13±0.05) cm,P=0.000)];depth of suprapatellar bursa fluid [(0.62±0.27)cm vs.(0.23±0.05) cm,P=0.000];depth of infrapatellar bursa fluid [(0.58±0.12)cm vs.(0.21±0.04) cm,P=0.000];joint fluid depth [(0.48±0.28)cm vs.(0.12±0.08) cm,P=0.000];ESR [(43.29±12.58)mm/h vs.(12.95±4.39) mm/h,P=0.000)];CRP level [(8.95±3.29)mg/L vs.(3.29±1.54) mg/L,P=0.000)];vascular detection rate in hyperplasia synovium (84.20% vs.13.00%,P=0.000).Moreover the ultrasound score was positively corrected with rheumatoid arthritis disease activity score,CRP level,ESR,suprapatellar bursa fluid depth,infrapatellar bursa fluid depth and joint fluid depth in the patients with rheumatoid arthritis (r=0.583,0.258,0.383,0.219,0.228,0.248;P<0.05).Conclusion Ultrasound has good diagnostic value in the patients with rheumatoid arthritis,and the ultrasonic scoring system can better reflect the severity of the disease.

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.
Algorithms ; Arm ; physiopathology ; Artificial Intelligence ; Humans ; Movement ; Recovery of Function ; Reproducibility of Results ; Software ; Stroke Rehabilitation

Objective To explore an accurate,objective and simple method for barrel distortion correction and lesion area measurement by assistance of computer.Methods The software of Panaroma tool was employed to correct barrel distortion of endoscopy and Image J to measure lesion size and manage the relative measurement error.Computed measurement in vitro of lesion area was established,firstly,by identification of correction factor of Panorama tool to minimize measurement error; then by determination of influence of object distance change between the lens and the image.This measurement was used on patients with gastric ulcer for focal area.Results were compared with those of traditional method.Results Number of 0.1was determined to be the correction factor for barrel distortion of endoscopy.Prior to the correction of the barrel distortion,the relative error of measurement gradually increased with the increasing distance between endoscopy and the image.However,different object distances did not exert influence on the relative measurement error when barrel distortion was corrected by Panaroma tool ( P =0.141 ).A total of 50 foci of gastric ulcer were measured,results from combinational treatment of Panorama tool and Image J showed the areas (35.0 ± 5.0) mm2 were significantly larger than those determined by traditional method [ ( 29.1 ± 4.1 ) mm2,P =0.000 ],with a correlation coefficient of 0.988.Conclusion Computed endoscopic lesion measurement is a relatively accurate,objective and simple method to determine the area of gastric lesions.

Objective To observe the diffusion characteristics and pathology changes with DTI in rabbit models with mild cerebral contusion and laceration (CCL). Methods Thirty rabbits were randomly selected and made into models of mild CCL by free fall, while other 10 rabbits were cut only in the skull as control. T2WI and DTI were performed 1, 3, 6, 12, 24, 48 and 72 h after the operation. DTI value of average diffusion coefficient (DCavg) and fractional anisotropy (FA) of mild CCL and its peripheral area were measured and compared. Histological examination was also performed. Results One hour after operation, CCL area showed high signal on T2WI, and no abnormal signal was found in the peripheral area, but both had abnormal color on DTI map. T2WI signal intensity in peripheral area of 22 rabbits (73.33%) increased gradually and had much abnormal color on T2WT map after 3 h. There was significant difference of FA and DCavg between CCL and the mirror region, the peripheral area and the mirror region (P<0.05). The value of FA decreased slightly since 12 h. More prominent tissue necrosis, edema and hemorrhage were found in CCL area than in the peripheral area with pathology examination. No abnormal manifestations of the brain were detected with both pathology and MR examination in the control rabbits. Conclusion DTI is sensitive for detecting mild CCL and can show it directly on color map, and thus may be used as a routine examination in the evaluation of mild CCL.

Objective To investigate the effect of resveratrol on high glucose-induced oxidative stress and cardiomyo-cyte hypertrophy and possible mechanism .Methods H9C2 cardiomyocytes were divided into normal glucose group , high glucose group , resveratrol group and resveratrol +DAPT group respectively .The cell surface was measured by rhodamine-labeled phalloidin .Reactive oxygen species generation was measured using DCFH-DA.The contents of SOD and MDA were evaluated by colorimetry .The mRNA and protein levels of Notch 1, Hes1, ANP and BNP were evaluated by RT-qPCR and western blot .Results High glucose exposure significantly increased cell surface area ( P<0.01) and enhanced ROS and MDA generation ( P <0.01 ) with concomitant decrease of SOD activity ( P <0.01).It also decreased the mRNA and protein expressions of Notch 1 and Hes1(P<0.05), and increased the ex-pression levels of ANP and BNP ( P<0.05 ) .Resveratrol treatment inhibited cell surface expanding ( P<0.01 ) and decreased ROS and MDA generation (P<0.01) with concomitant enhance SOD activity (P<0.01), as well as in-creased the expression level of Notch 1 and Hes1 ( P<0.05 ) , and decreased the expression of ANP and BNP ( P<0.05).Conclusions Resveratrol may inhibit high glucose induced H9C2 cardiomyocytes hypertrophy by improving oxidative stress and activating Notch 1/Hes1 signaling pathway .