Hepatolithiasis is a common disease in China with a high rate of residual stones up to 30％-90％ after surgery.Patients often require re-operation because the high rate of residual stones and stone recurrence.Because the calculi are deeply distributed in the liver,and the condition is often accompanied by anatomical variations,distortion and biliary strictures,traditional preoperative imaging examinations do not easily locate the lesioos precisely,making diaguosis and treatment difficult.In recent years,three-dimensional computed imaging and visual simulation have provided a novel preoperative diagnostie method for hepatolithiasis,and have offered a clearer radiologic basis for surgical planning.The value of digital medical technology in the diagnosis and treatment of hepatolithiasis is discussed in this article.

Objective To investigate the therapeutic effects of melatonin (MT) on human pancreatic cancer in Balb/c nude mice subcutaneous xenograft model. Methods Pancreatic cancer model was established high dose MT(20 mg· kg -1 · d-1 ) , gemcitabine( GEM,50 mg· kg -1 · d-1 ) and high dose MT combination with GEM. Tumor size was measured regularly. The tumor growth curve was drawn. The activity of mice spleen natural killer cell was determined by MTT. Results Compared with the controls [ ( 1. 476 ± 0.075) cm3 ], tumor volumes in low dose MT group[ (0.998 ±0.112)cm3], high dose MT group[ (0.756 ±0.128) cm3], GEM group [ (0. 746 ± 0. 115 ) cm3 ], combination group [ (0. 305 ± 0. 111 ) cm3 ] were significantly decreased ( P <0.01), and the tumor size in high dose MT group was smaller than that in low dose MT group, while the tumor size in combination group was the smallest. The activity of mice spleen natural killer cell was ( 18.07 ± 1.23) %in control group, and they were (44.27 ±3.19)% ,(45.16 ±3.20)% and (30.29 ±2.91)% in low dose MT group, high dose MT group, combination group, which were significantly higher than those in the control group;the activity of natural killer cell in GEM group was ( 14.24 ± 2.70) %, which was significantly lower than that in the control group (P <0.05), but the activity of natural killer cell in combination group was significantly higher than that in the GEM group (P < 0.01 ). Conclusions MT could improve the immune function of mice,inhibit the growth of tumor, and MT combination with GEM may have more potent antitumor effect.

Objective To study the clinical pathological features of Wegener's granulomatosis (WG) in middle-aged and elderly patients,and enhance understanding of this disease.Methods Totally 21 patients with WG (11 males,10 females,aged 45 to 76 years,mean age 58.1 years) in our hospial from February 1999 to July 2012 were selected.The clinical and pathological data of WG patients were retrospectively analyzed.34 biopsies including 2 autopsies from different organs were paraffin embedded and stained by hematoxylin and eosin and histochemistry.13 renal biopsies were all examined by immunofluorescence and electron microscope.Results The average time from the onset of clinical symptoms to the diagnosis was 5.3 months (from 24 days to 11.0 months).Eyes,nose and salivary glands were the most commonly involved parts at the beginning of Wegener's granulomatosis (52.4％,11 cases).The percentages of the skin,lung and renal involvement were 14.3％ (3 cases),81.0％ (17 cases) and 71.4％ (15 cases),respectively.Among 21 patients,18 patients were examined with anti-neutrophil cytoplasmic antibody (ANCA).c-ANCA was positive in 72.2 ％ patients (13 cases,13/18),p-ANCA was positive in 16.7％ patients (3 cases,3/18),and ANCA was negative in 11.1％ patients (2 cases,2/18).3 major pathological manifestations were observed:7 kinds of vasculitis including capillaritis,acute vasculitis,chronic vasculitis,fibrinoid necrosis in vasculitis,necrotizing granulomatous vasculitis,non-necrotizing granulomatous vasculitis and cicatricial vascular changes; 4 kinds of granulomatous inflammation including scattered giant cells,palisading histiocytes,poorly formed granulomas and microabscess surrounded by granulomatousinflammation;2 kinds of parenchymal necrosis including geographic necrosis and microabscess.13 kinds of histopathologic features in 3 major manifestations were found from 2 autopsies,but various kinds histopathologic features presented in small biopsy samples.Minor manifestations such as diffuse pulmonary hemorrhage were found at the periphery of WG.Conclusions The wide variation and broad spectrum of pathologic features can occur in WG.Vasculitis,granulomatous inflammation and parenchymal necrosis are the most important histopathological features.The correct diagnosis of WG requires careful correlation of pathology with complicated clinical features.

Objective To evaluate the effects of exogenous hydrogen sulfide on inflammatory responses during acute myocardial ischemia in rats.Methods Twenty-four adult male Sprague-Dawley rats,weighing 250-290 g,were randomly divided into 3 groups (n =8 each):sham operation group,acute myocardial ischemia group,and sodium hydrosulfide (NaHS) group.The animals were anesthetized with intraperitoneal chloral hydrate.The model of acute myocardial ischemia was established by ligating the left anterior descending branch of coronary artery.Normal saline 2 ml/kg and NaHS 3.12 mg/kg were intraperitoneally injected at 3 h of ischemia in AMI and NaHS groups,respectively.The rats were sacrificed at 6 h after ligation and hearts were removed for determination of interleukin-1β (IL-1β),IL-6 and tumor necrosis factor-α (TNF-α) contents (by ELISA) and intercellular adhesion molecule-1 (ICAM-1) mRNA expression (by semi-quantitative PCR) in myocardial tissues and for examination of myocardial ultrastructure with transmission electron microscope.Results Compared with S group,IL-1β,IL-6 and TNF-α conte.nts and ICAM-1 mRNA expression in myocardial tissues were significantly increased in AMI group (P ＜ 0.05).Compared with AMI group,IL-1β,IL-6 and TNF-α contents and ICAM-1 mRNA expression in myocardial tissues were significantly decreased in NaHS group (P ＜ 0.05).The damage to myocardial ultrastructure was significantly alleviated in NaHS group when compared with AMI group.Conclusion The mechanism by which exogenous H2S alleviates the acute myocardial ischemia injury is related to inhibition of the inflammatory responses in rats.

Objective To assess the value of 14 common food allergens specific IgG in children with chronic digestive diseases.Methods The specific allergen food IgG was measured by utilizing enzyme-linked immunosorbent assay(ELISA) in 69 children with chronic digestive diseases,who had chronic abdominal pain and recurrent vomiting above three months with no organic disorders,incurable chronic diarrhea and anorexia with failing to thrive.Results The food allergen specific IgG increased was detected in 68 cases.The positive cases were 98.55%.There was one to nigh kind of food allergen specific IgG increased in 68 patients.Positive above two kind of specific IgG was 86.96%.The most specific IgG was to egg 92.8% and milk 73.9%;the other rates were: wheat 40.6%,soybean 27.5%.Chicken and pork were negative.All the patients changed their daily diet according to the assay results.More than 58.46% cases improved with their symptoms significantly in four weeks,about 26.15% cases improved to some extent.15.38% cases did not improved.After followed four months,there were 70.70% cases improved with their symptoms significantly,18.46% cases improved to some extent,only 10.76% cases no improved.Conclusion The detection of 14 common food allergens specific IgG might be significant valuable in assessment and treatment children with chronic digestive diseases.

Objective To investigate effects of H2 S on myocardial ischemia injury in rats and explore the possible mechanism from oxidative stress.Methods Fourty-eight male SD rats were randomly divided into 6 groups:sham operation group,ischemia group,ischemia + NaHS low,middle and high dose groups and ischemia + PPG group.The acute myocardial ischemia model was established by ligating the left anterior descending coronary artery(LAD) of the rats.Saline was intraperitoneally administrated in ischemia group.LADs were not ligated but only threaded in sham operation group in rats.In ischemia + NaHS low,middle and high dose groups or ischemia + PPG group,sodium hydrosulfide(NaHS) or DL-propargylglycine(PPG) was intraperitoneally injected respectively at 3 hours after ischemia.All rats were killed at 6 hours after the operation.The content of malondialdehyde (M DA),and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in myocardial tissue were respectively measured.The pathological changes of myocardial tissue were observed with electron microscope.Results Compared with those of sham operation group,the myocardial structural damage was increased,the content of MDA was significantly increased,and the activities of SOD and GSH-Px were significantly decreased in ischemia group in rats ((P ＜ 0.01).Compared with those of ischemia group,the myocardial structural damage was alleviated,the content of MDA was significantly decreased,and the activity of SOD was significantly increased in ischemia + NaHS low,middle and high dose groups ; the activity of GSH-Px was significantly increased in ischemia + NaHS middle and high dose groups in rats (P ＜ 0.05).Compared with those of ischemia group,the myocardial structural damage was increased,the content of MDA was increased,the activities of SOD and GSH-Px were decreased in ischemia + PPG group in rats (P ＜ 0.05).Conclusion The administration of H2S could significantly alleviate the myocardial injury by increasing the activities of SOD and GSH-Px,and decreasing the MDA synthesis in acute myocardial ischemia.

With the development of modern imaging technologies,three-dimensional (3D) reconstruction techniques based on the computed tomography (CT) or magnetic resonance imaging (MRI) data has been gradually applied in clinical diagnosis and treatment of hepatobiliary diseases.In order to study the characteristics of the 3 D model of portal branches and collateral circulation in various types of portal hypertension,the data of 64-slice spiral CT scan of5 patients with portal hypertension were collected and imported to the abdominal medical image three-dimensional visualization system (MI-3DVS) for sequence segmenting and 3D reconstruction,and then the results of 3D models were compared with operation findings.The 3D models were vividly,visually and clearly displayed the portal system and the collateral circulation,which is helpful in the diagnosis and treatment of the portal hypertension.

Objective To study the medical image three dimensional visualization system(MI-3DVS)in the diagnosis and treatment of hepatolithiasis.Methods The data of 64-slice spiral computed tomography of 54 patients with hepatolithiasis who were admitted to the Zhujiang Hospital of the Southern Medical University from August 2008 to August 2010 were collected.The liver and bile duct were three dimensionally(3D)constructed.Preoperative diagnosis and pathological classification were made according to the results of the 3D model of liver and bile duct.The optimal surgical procedure was determined by simulating operations based on the 3D model.The compliance of simulated operation and actual operation was observed,and residual stones were detected by cholangiography.Results Of the 54 patients,11 were with type Ⅰ,5 with type Ⅱ(including 2 patients with type Ⅱ a and 3 with Ⅱ b),38 with type E.There were 23 patients with intrahepatic bile duct stricture and 27 with atrophy-hypertrophy syndrome complex.The anatomy of intra-and extrahepatic bile duct,dilation and stricture of the bile duct,site,size and number of the bile duct stones were clearly displayed in the MI-3DVS.The compliance rate of simulated surgery and actual surgery was 94%(51/54).There was no residual stones in 51 patients who received elective surgery and the rate of residual stone of the 54 patients was 6%(3/54).Conclusion Acurate preoperative diagnosis and intraoperative precise operation can be achieved and the rate of residual stone can be reduced by using the MI-3DVS.

"Jajie" means antidote in Dai language. As an important part of theories of Dia ethnic medicine, "Jajie" focuses on antidote before treatment. With wide application and exact effect, "Jajie" plays an important role in preventing and treating diseases, especially liver disease, digestive system diseases, metabolic diseases, skin diseases and so on. Therefore, systematic collection, analysis and studies on Dai ethnic medicine "Jajie" is an important content in the development of the theory of Dai ethnic medicine as well as new drugs. This essay briefs the general situation of "Jajie" and the advance of its studies, and gives comments on Jajie's development.
Antidotes ; therapeutic use ; China ; ethnology ; Humans ; Medicine, Chinese Traditional

Objective To analyze the effectiveness of chronic disease management among suburb residents to secure an optimal health management model. Methods Since 2002, physical examinations had been conducted for rural residents aged≥40. Hypertensive patients detected on health check received medical evaluation and risk factor intervention. Results The incidence of high blood pressure decreased from 26.57% in 2002 to 11.99% in 2007-2008. The mortality of cerebrovascular disease declined from 68.00% to 5.26%. The incidence, disability rate, and death rate of hypertension related-stroke were also significantly reduced. Conclusion Primary healthcare center-based chronic disease screening, along with the health management network, can largely decrease the incidence, disability rate, and mortality of stroke associated with high blood pressure.