Reflux cholangitis is a common complicatian follawing cholangio-jejunostomy,During a period between July 1981 and June 1994 the authors have performed plastic valve in 116 cases undergo- ing Cholangrojunostomy adding a plastic valve to each of three forms of cholang iojejunostomy that was Y-shape,loop-shape,and interposition-shape in Order tO prevent reflux.There was no inhospital mor- tality and fistula,and symptoms related to biliary tract disappeared in 92 cases(79.3%)during fouow- up.

AIM:To study the expression of microRNA (miRNA)-181a in different human lung adenocarcinoma cell lines, and to investigate the effect of miRNA-181a on cell function and its mechanism in human lung adenocarcinoma drug resistant cell A549/DDP.METHODS:Real-time PCR was used to detect the expression of miRNA-181a in BEAS-2B cells, A549 cells and A549/DDP cells.The A549/DDP cells were transfected with pGenesil-miRNA-181a eukaryotic ex-pression plasmid.At the same time, the untransfection group and negative transfection group were also set up .The expres-sion of miRNA-181a, cell viability, cell growth inhibition and apoptosis rate during cis-diamminedichloroplatinum ( DDP) treatment, cell cycle, cell invasion, the protein expression of miRNA-181a target genes bcl-2 and p53 in the A549/DDP cells were determined by real-time fluorescence quantitative PCR , MTT assay, flow cytometry, Transwell method and West-ern blot, respectivly.RESULTS:The expression of miRNA-181a in A549 cells and A549/DDP cells was significantly lower than that in BEAS-2B cells, and the lowest expression level was observed in A 549/DDP cells (P<0.05).The expression of miRNA-181a in A549/DDP cells was significantly increased after transfection with pGenesil-miRNA-181a (P<0.05).The cell viability, cell cycle and invasion ability of the A549/DDP cells were inhibited after miRNA-181a transfection (P <0.05).The cell growth inhibition rate and apoptotic rate of the A 549/DDP cells were increased (P<0.05).The expression of Bcl-2 was reduced, but the expression of P53 was increased after transfection with miRNA-181a in A549/DDP cells (P<0.05).CONCLUSION: miRNA-181a may be correlated with the development of human lung adenocarcinoma .miRNA-181a can serve as a new target for treatment of lung cancer .

Objective To observe the effects of Chinese herbal compounds (alkaloid of Coptidis Rhizoma 40%, total saponin of panax notoginseng 35%, and polysaccharide of Ophiopogonis Radix 25%) on levels of blood glucose, fructosamine, and insulin of diabetic rats, and explore mechanism of action.Methods Ten rats were randomly chosen as blank control group, and other rats were used to establish diabetic rat models by STZ intraperitoneal injection. Successfully molding rats were randomly divided into Chinese herbal compounds high, medium, low dose groups, metformin group, and model group, 10 rats in each group. Each rat received gavage for continuous 4 weeks. Then rat blood was collected by cutting head and taking caudal vein. FBG was detected by glucose oxidase method;insulin level was detected by radio-immunity double antibody method;fructosamine content was detected by fructosamine method.Results Compared with the blank control group, model group the levels of FBG, froctosamine content increased, while fasting insulin level were lower after 4 weeks'medication. Compared with the model group, the levels of FBG, froctosamine content in Chinese herbal compounds high and medium dose groups and metformin group were lower, while fasting insulin level increased after 4 weeks'medication (P<0.05).Conclusion TCM herbal compounds can increased the basic insulin level by decreasing the contents of FBG and fructosamine.

This study run through the process of developing behavioral medicine discipline in a general hospital with action research method,based on the balanced scorecard (BSC) framework.The four perspectives of the behavioral medicine BSC covered the main areas in hospital discipline development,including patients and community,healthy financial disciplines,clinical service process and efficiency,and research,innovation and growth.By the implementation of the discipline BSC,this hospital clarified its discipline development strategy,provided a communication platform,determined the objective and monitored the discipline effectively,and provided a mode which can integrate the discipline development and providing clinical services.The hospital set up the first neurology behavioral medicine clinic in Jinan Region though the exploration of the path and methods for developing behavioral medicine discipline,which had practical guiding significance for behavioral medicine development and services.

Objective To explore the technique and the clinical value of Neuroform stents in combination with Guglielmi detachable coil(GDC) to treat wide-necked basilar artery aneurysms.Methods 30 cases with wide-necked basilar artery aneurysms were treated with Neuroform stent combined with GDC.Of 30 wide-necked basilar artery aneurysms,the location of lesions was at basilar tip in 16,basilar trunk in 9 and the beginning of the basilar in 5.Results In 30 cases,total occlusion was achieved in 25 and partial occlusion in 5 patients.The thrombosis within stent occurred in 2 patinets,and remainder of patients recovered well.There were no thromboembolic events in 20 cases followed up for 3~6 months.Twenty-two patients were angiographically followed up for 3 months after the procedure,among them,the aneurysms visualized and the arteriae burdened aneurysms were passed free in densely packed and 3 aneurysms with neck remnant.Conclusion The Neuroform stent is a easy and safe intracranial stent for embo1ization of wide-necked intracranial aneurysms,especially suitable for wide-necked basilar artery aneurysms with severely tortuous intracranial artery.

Objective To study the clinical law and imaging characteristics of intracranial primary malignant lymphoma.Methods The clinical law and imaging finding in 27 cases of intracranial primary malignant lymphoma confirmed by pathology were analysed CT scan was performed in all cases.MRI examination were carried out in 20 cases simultaneously.Results The first symptom in most cases was headache,and other symptoms were epileopsy,dizziness,hemiplegia,etc.This lesion was mostly seen in male around 40 years old.The lesions were mostly equal or high density on CT,equal or low signal intensity on T 1WI and closed to grey matter signal intensity on T 2WI.Tumors were enhanced obviously on contrast-enhanced scans,necrosis of center of focus was seen in 1/3 cases.The lesions were single or multiple.Conclusion The accuray diagnosis of intracranial primary malignant lymphoma can be done by combined clinical data with imaging features.

Aim To investigate and evaluate the effect of ligustrazine on the expression of scavenger receptor type AI, the human ?-interferon activation site (GAS) elements regulatory systems of SR-AI expression wasfirst established in the Xenopus oocytes. Methods A plasmid, in which the human SR-AI gene was constructed downstream from the GAS elements, was microinjected into the nucleus of Xenopus oocytes. The oocytes then were cultured in the smooth muscle cell conditioned medium (SCM), In which the cell were cultured with the treatment of oxLDL for 2 days. In the other groups, the oocytes were treated with SCM containing the nature medicines ligustrazine, and the positive control drug ?-interferon respectively. Results The results demonstrated that SCM could upregulate the expression of SR-AI in this system, this action was suppressed by ligustrazine and ?-interferon. Conclusion Similar to the action of ?-interferon, ligustrazine can prevent the over-expression of SR-A induced by oxLDL, via their effect on the GAS elements regulatory pathway.

Objective To investigate the effect of folic acid intervention on plasma homocysteine (Hcy) metabolic changes and pulse wave velocity(PWV)in patients with type H hypertension. Methods Patients(hos-pitalized from March 2014 to December in our hospital)with H type hypertension were randomly divided into treat-ment group and control group randomly ,and were given routine antihypertensive drug therapy. Treatment group was given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patient were treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients(Han nationality)with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratio of men and women is 1.3:1. The most common diseases were coronary heart disease and type 2 diabetes mellitus. 2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months(average duration in 8 months). After treatment,the difference between plasma Hcy(Z=-7.63,P=0.000)and PWV(Z=-3.16,P=0.002)levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantly reduce the level of plasma Hcy in patients with type H hypertension ,slow down the progression of atherosclerosis and reduce the risk factors of cardiovascular disease.

Objective To assess the causes of sildenafil failure and the feasibility of successfully rechallenging non-responding patients. Methods A total of 126 consecutive erectile dysfunction (ED) patients from Jan 2009 to Dec 2009 who claimed poor response to sildenafil (sildenafil 100 mg on demand, at lease 4 epiodes) were enrolled into the study. All patients received sexual reeducation and were treated with sildenafil, taken on a daily dose of 50 mg for 4 weeks. The International Index of Erectile Function-5 (IIEF-5), Rigiscan, serum testosterone or penile Doppler were used to evaluate ED and the cause of on-demand sildenafil failure. End point efficacy of rechallenging was evaluated using the IIEF-5 and the sexual encounter profile (SEP) 'Were you able to insert your penis into your partner's vagina?' and 'Did your erection last long enough to achieve successful intercourse?'. Results The recruited patients comprised of 41 cases with psychological ED, 39 cases with hypogonadism ED, 28 cases with diabetes mellitus ED and 18 cases with vascular ED. Compared with pretreatment and on-demand sildenafil baseline, daily administration of sildenafil significantly enhanced all efficacy outcome variables. The IIEF-5 was significantly improved after daily sildenafil (12.3 ± 2.9 vs18. 8±4.4, P＜0.01), 78 patients responded to daily sildenafil. The overall salvage rate was 61.9%(78/126). Conclusions Sexual reeducation and daily administration of sildenafil may be able to salvage many patients with ED who were sildenafil non-responders.

Objective To estabalish a new conception, Erectile Dysfunction-no sexual life (ED-NS), so as create an evaluating questionnaire, Self-estimation Index of erectile function-No sexual life (SIEF-NS) so as to investigate its clinical reliability. Methods The conception of ED-NS was identified and the SIEF-NS questionnaire was established. Patients who complained of ED-NS and normal controls were enrolled into the research and assessed the erectile function was assessed with SIEF-NS.The SIEF-NS includes 12 questions, such as sexual libido, general erectile function, nocturnal penile erection, erectile function during foreplay, erectile function during audio-video sexual stimulation,confidence, depression, etc and each question has 5 point scales. Results Sixty-one ED-NS patients and 57 controls were enrolled into the study and assessed erectile function with SIEF-NS. The mean score of each question and integral score of SIEF-NS in ED-NS patients were significantly different from normal controls (P＜0. 05). When the integral score was 35 points according to the ROC curve of integral score, the sensitivity of SIEF-NS was 88.5% and specificity was 96. 5%. Conclusions ED-NS is a new conception to define patients who have erectile dysfunction without sexual life. SIEFNS is suggested to be a useful method for the evaluation of ED-NS patients.