Objective To determine the clinical value of intraoperative cholangiography in mini-cholecystectomy. Methods The clinical data of 506 patients receiving intraoperative cholangiography in minicholecystectomy from 1992 to 2006 in our hospital were analyzed retrospectively. Results Intr-aoperative cholangiography was successfully completed in 403 patients. The success rate was 97.4%.Stones in the bile duct in 49 patients,abnormal bite duet in 4 patients and bile duct injury in 4 patient were found. The cuts were extended in 16 patients. Conclusion Intraoperative cholangiography is of great value in inducing postoperative complications and improving the quality of MC. Therefore, it can be used to prevent residual stone after operation, avoid bile duct exploration or injury, decrease the chance of extending the cut and make sure of abnormal bile duct.

BACKGROUND:With the development of spinal cord injury study, different methods of establishing spinal cord injury models have emerged, including spinal cord contusion, fal ing weight, spinal compression, chemical burn, radiation, hormone, spinal transection and hemi-section. However, lots of them are not perfect enough.
OBJECTIVE:To design the injury device of spinal cord injury and establish different degrees of spinal cord injury models.
METHODS:To design the device of producing spinal cord injury and establish different degrees of spinal cord dorsal compression injury in Sprague-Dawley rats by various weights (m1=10 g, m2=20 g, m3=30 g) and time points (T1=3 s, T2=5 s). Rats were randomly divided as m1T1, m2T1, m3T1, m1T2, m2T2 and m3T2 groups. While sham group was also made.
RESULTS AND CONCLUSION:Basso-Beattie-Bresnahan (BBB) score in injury groups decreased significantly after operation, when compared with the sham group (P<0.01). The m 1T1 group showed no significant difference in BBB score from other groups (P<0.01). The BBB score of m1T2 group was significant higher than m2T2 group and m3T2 group at 8 weeks after operation (P<0.05). The somatosensory evoked potential and motion evoked potential of injury groups were longer than sham group at 8 weeks after operation (P<0.01). The motion evoked potential of each injury groups were significantly longer after operation (P<0.05). The somatosensory evoked potential was significantly longer in injury groups, except m1T1 and m1T2 groups (P<0.05). The self-designed device can be applied to establish different degrees of spinal cord injury models.

Objective To investigate the effect of laparoscopic lymphadenectomy in patients with adenocarcinoma of esophagastric junction (AEG).Methods 105 patients with AEG underwent open or laparoscopic surgery from June 2014 to September 2015 were enrolled in the study and divided into minimally invasive group (n = 70) and laparotomy group (n = 35). The baseline data, lymphadenectomy result and perioperative data were compared between the two groups.Results Total number of splenic hilar lymph nodes dissection in minimally invasive group was significantly more than that in laparotomy group (P < 0.05). But there were no significant differences in the total number of lymph node dissection, number of positive lymph node dissection, positive rate of all node, number of positive splenic hilar lymph node dissection and positive ratef of splenic hilar lymph node between two groups (P > 0.05). Operation time, intraoperative blood loss, length of incision, positive proximal margins rate, thoracoabdominal resection rate and spleen resection rate in minimally invasive group were significantly lower than that in laparotomy group, esophagus resection length was significantly bigger than that in laparotomy group (P < 0.05). No death occurred postoperatively in all patients. The time of anus exsufflation, first intake liquid diet and postoperative ambulatory episode in minimally invasive group were significantly lower than that in laparotomy group (P < 0.05). There were no significant differences in the incidence of complications between two groups (P > 0.05).Conclusions Compared with open surgery, laparoscopic surgery is superior in splenic hilar lymph nodes dissection of AEG, with longer esophageal cutting distances, lower thoracoabdominal resection and spleen resection rate. It is safe and feasible, worthy of clinical promotion.

[Abstract ] In recent years, induced pluripotent stem cells (iPSCs) technology has played an important role in basic and clini-cal application research of Parkinson′s disease ( PD) and acquired significant progress .The neural progenitor /stem cells or dopamine ( DA) neurons which were obtained through iPSCs technique and direct differentiation technique from somatic cells were used for the study of cell therapy in PD , and good results were achieved .The cell models of DA neurons were established from PD patients carrying LRRK2, PAKK2, PINK or SNCA mutations via iPSCs technology , and the mitochondrial function and morphology , oxidative stress,α-synuclein ( SNCA) accumulation , and other aspects were studied on the pathogenesis of PD .This article briefly reviews the latest pro-gress of iPSCs technology in transplantation for treatment of PD and the establishment of cell model of PD disease , and provides refer-ence for further research .

Objective To investigate the relationship between carotid arteriostenosis and atheromatous plaques with cerebral in-farction.Methods Cervical spiral CT angiography of 56 cases with cerebral infarction and 49 cases without cerebral infarction were retrospectively analysed .The difference between the two groups was compared with regard to the distribution ,nature of plaques and the degree of carotid artery stenosis.Results Of 56 patients with cerebral infarction,126 atheromatous plaques were detected in 42 patients,of which 39 were soft,34 were calcified,53 exhibited a combined nature of both calcified and soft plaque and 7 cases were plaque ulcerations (soft plaque and mixed plaque accounted for about 73%).Plaque location for carotid artery was in the bifurcation. 102 carotid arteries stenosis were found in 38 patients,which included mild stenosis in 29,moderate in 40,severe in 27 and occlusion in 6(moderate and severe stenosis accounted for about 65.7%).In the control group,28 plaques were detected in 1 1 cases,of which 6 were soft,13 were calcified and 9 exhibited a combined nature of both calcified and soft plaque.1 1 carotid arteries stenosis were found in 7 patients,included mild stenosis in 10,moderate in 1.A significant difference (P <0.05)in carotid arteriostenosis and ath-eromatous plaques between the two groups was found.Conclusion Carotid plaques and stenosis are important risk factors of cerebral infarction.Multi-slice spiral CT angiography(MSCTA)has important value in analysis of carotid artery stenosis and atheroderotic plaques.

Objective To explore the relationship between ERG4 gene overexpression and azole resistance in clinical Candida albicans strains. Methods The National Committee for Clinical Laboratory Standards (NCCLS)M27-A2 broth microdilution method was conducted to evaluate antifungal susceptibility of 34 clinical Candida albicans isolates in vitro. Total RNA was extracted from these Candida albicans strains and transcribed into cDNA. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of ERG4 gene. Statistical analysis was carried out by a two-sample t-test. Results The expression level of ERG4 mRNA was significantly higher in fluconazole-resistant than in -sensitive Candida albicans strains (4.20 ± 2.56 vs. 1.72 ± 1.33, t = 3.99, P < 0.05), higher in itraconazole-resistant than in -sensitive Candida albicans strains (3.60 ± 2.47 vs. 1.66 ± 1.61, t = 3.71, P < 0.05), and higher in voriconazole-resistant than in -sensitive Candida albicans strains (3.99 ± 2.72 vs. 2.07 ± 1.58, t = 2.91, P <0.05). Further more, increased ERG4 mRNA expression was also observed in isolates cross-resistant to all the three azole antifungal agents compared with those susceptible to all of them (4.49 ± 2.73 vs. 1.69 ± 1.82, t = 3.81, P < 0.05). Conclusions The overexpression of ERG4 gene may be associated with cross resistance to fluconazole, itraconazole and voriconazole in clinical Candida albicans strains, but its exact role is expected to be investigated through downregulation of the ERG4 gene.

0.05).The Nestin and C-kit expressions can be detected in all cases of GISTs by RT-PCR and Western Blot.Conclusion In conjunction with C-kit,Nestin may be a useful marker for diagnosis of GISTs but it cannot be used as a tumor differentiation index.

Objective To evaluate the relationship between aged diabetes mellitus and cognitive impairment in community elders.Method 308 type Ⅱ diabetic patients, including 225 diabetes patients and 164 diabetes with hypertension patients, were random selected in our study. 225 hypertension and 186 healthy elders were random selected as controls. Mini-Mental State Examination (MMSE) was tested on each case. According to DSM-IV, all participants were classified into three groups ( normal, MCI and dementia) .Result MMSE scores in diabetes patients were lower than that in healthy controls(25. 87±3.33 vs 26. 86 ±2. 82, F = 9.62, P < 0. 01), and scores in diabetes with hypertension group (24. 68 ±4. 36 ) were much lower than that in healthy controls ( F =37. 16, P <0.01). Conclusion Senile diabetes were positive correlated with cognitive impairment. Diabetes were a risk factor of dementia in seniles. Diabetes with hypertension can increase cognitive impairment in community elders.

Objective To investigate the clinical efficacy of three-dimensional (3D) laparoscopic surgery in treatment of hepatic cystic echinococcosis.Methods The retrospective cross-sectional study was conducted.The clinical data of 40 patients with hepatic cystic echinococcosis who underwent 3D laparoscopic surgery in the Qinghai Province People's Hospital from March 2016 to July 2017 were collected.All the 40 patients were treated using 100 mg hydrocortisone on preventing intraoperative anaphylaxis.The experienced surgeons with proficiency in the laparoscopic technology in the same team finished surgery.Patients underwent respectively 3D laparoscopic excision of internal capsule in hepatic echinococcosis + residual cavity treatment,external capsule resection in hepatic echinococcosis and partial hepatectomy based on their conditions.Observation indicators:(1) intraoperative situations:operation completion,surgical procedures,operation time,volume of intraoperative blood loss and blood transfusion;(2) postoperative recovery situations:time to initial anal exsufflation,time for initial fluid diet intake,time for out-of-bed activity,time of indwelling drainage-tube,wound healing,postoperative complications and duration of postoperative hospital stay;(3) follow-up:number of patients with follow-up,follow-up time,oral anti-echinococcosis medical therapy during follow-up,hepatic echinococcosis recurrence and abdominal cavity implantation metastasis.Follow-up using outpatient examination and telephone interview was performed to detect the abdominal symptoms,oral anti-echinococcosis medicine,hepatic echinococcosis recurrence and metastasis up to September 2017.Measurement data with normal distribution were represented as (x)± s.Measurement data with skewed distribution were described as M (range).Results (1) Intraoperative situations:all the 40 patients underwent successful laparoscopic surgery,including 17 undergoing excision of internal capsule in hepatic echinococcosis + residual cavity treatment,15 undergoing external capsule resection in hepatic echinococcosis and 8 undergoing partial hepatectomy.Two patients were combined with abdominal and pelvic hydatids and underwent 3D laparoscopic excision.Operation time and volume of intraoperative blood loss of 40 patients were respectively (100 ± 28) minutes and (86± 24) mL,without intraoperative blood transfusion.(2) Postoperative recovery situations:time to initial anal exsufflation and time for initial fluid diet intake in 40 patients were (2.4± 1.8)hours and (1.7±0.9)days.Forty patients had out-of-bed activity on the day of surgery.Of 40 patients,abdominal drainage-tubes of 39 were placed for 2-3 days;abdominal drainage-tube of 1 with postoperative residual cavity-induced bile leakage was indwelled for 2 months and then was removed.Wound healing and duration of postoperative hospital stay in 40 patients were Class-A healing and (10.5 ± 2.1) days.During hospitalization,39 patients didn't have bleeding,bile leakage,anaphylactic shock,intestinal adhesion and obstruction;1 patient with postoperative residual cavity-induced bile leakage had indwelling drainage-tube removal at 2 months postoperatively.(3) Follow-up:all patients were followed up for 2-15 months,with a median time of 9 months.During the follow-up,40 patients were not complicated with discomforts and received oral antiechinococcosis medical therapy,without hepatic echinococcosis recurrence and abdominal cavity implantation metastasis.Conclusion The 3D laparoscopic surgery is safe and feasible in the treatment of hepatic cystic echinococcosis,and has an obvious advantage in the treatment of irregular hepatic cystic echinococcosis,with good short-term outcomes.