Objective To explore the technique of laparoscopic reoperation in the treatment of common bile duct stones.Methods A retrospective analysis of the clinical data of 54 cases of common bile duct stones undergoing laparoscopic common bile duct stone surgery in our hospital from January 2011 to December 2015 was conducted.Through the choice of puncture hole, the exposure of the liver surface and the confirmation of the common bile duct, T-tube drainage and primary suture of common bile duct were carried out for the treatment of bile duct stone.Results The laparoscopic operations were successful in 52 cases, while conversions to open surgery were required in 2 cases.During the operation, the amount of bleeding was about 40-150 ml (average, 70 ml), the operation time was 75-180 min (average, 120 min), and the postoperative gastrointestinal function recovery time was 24-48 h (average, 27±13 h).There were 1 case of duodenal perforation injury, 2 cases of bile leakage, and 2 cases of residual stones after operation, which were cured with laparoscopic repair, prolonged drainage time, and choledochoscope treatment via abdominal sinus.Postoperative hospital stay was 6-9 d (average, 7±1.5 d).A total of 54 cases were followed up for 3-24 months (mean, 14.8 months).All the patients recovered well, without bile duct stricture or stone recurrence.Conclusion As long as the application of skilled laparoscopic surgery methods and separation of surgical area skills, laparoscopic bile duct surgery for the treatment of common bile duct stones is safe and feasible.

Thermoablation is a local treatment effectively used to prevent metastasis of colon cancer in the liver and can retain peripheral normal liver tissues. Ablation therapy is less invasive, easier to use, and more repeatable than surgery. This form of therapy also allows the local control of unresectable diseases. Furthermore, thermoablation can be applied as an alternative therapy for small re-sectable lesions in patients who manifest insufficient hepatic function after surgery or those with severe complications. Ablation therapy can artificially increase the surgical margin, thereby increasing the resection rate in patients. Multiple lesions in the liver and surgically inaccessible or unresectable diseases can also be removed. However, several limitations, including the local recurrence of the disease and treatment-related complications in patients, are also observed. The treatment outcome of thermoablation therapy can be further im-proved because this technique is used as a part of multimodality treatment.

BACKGROUND: Xingnao kaiqiao acupuncture is a series of systematic acupuncture methods with yin channels in domination, assisted by specified standards of quantity manipulation, which was founded according to the pathogenesis of stroke, and it is effective in treating stroke.OBJECTIVE: To observe the effects of xingnao kaiqiao acupuncture on blood lipids and blood viscosity in stroke patients of different syndrome types.DESIGN: A comparative observation.SETTINGS: Institute of Acupuncture and Moxibustion, and Special Care Ward of Acupuncture, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine.PARTICIPANTS: Totally 750 stroke inpatients (466 males and 284 females) were selected from the Special Care Ward of Acupuncture, the First Affiliated Hospital of Tianjin College of Traditional Chinese Medicine between January and December in 2001, the average age was (64±12) years,the disease course ranged from 2 hours to 3 years. All the patients were informed and agree with the therapeutic program.METHODS: ① The traditional Chinese medicine (TCM) syndrome differentiations of stroke were in reference to the fifth edition of Traditional Chinese Medicine and Internal Medicine. There were 688 cases of stroke of meridian and collateral type and 47 cases of stroke attacking zang-fu organs type. ② Huatuo filiform needles produced by Suzhou [1.0-1.5 cun in length, 0.32-0.38 mm in diameter (No. 30-28)] were used in the xingnao kaiqiao acupuncture. Firstly, the acupoints of bilateral Neiguan were acupunctured perpendicularly for about 0.5-1.0 cun, the reducing manipulation by twirling as well as lifting and thrusting the needle was performed for 1 minute; Secondly, the needle was inserted at Renzhong towards nasal septum for about 0.3-0.5 cun, the manipulation of heavy bird-peck needling was used till the eyeballs were wet or tears fell down; Then Sanyinjiao was acupunctured, the needle was inserted along the medial border of tibia at an angle of 45° with skin for about 1.0-1.5 cun, the reinforcing manipulation by lifting and thrusting the needle was performed till the ipsilateral lower limb had three tics; The acupoint of Weizhong was selected by lying and lifting the leg, the needle was inserted perpendicularly for 0.5-1.0 cun, and the reducing manipulation by lifting and thrusting was applied till the ipsilateral lower limb had three tics; The acupoint of Jiquan was acupunctured at 1 cun below the source point along the channel in avoidance of axillary hairs, the needle was inserted perpendicularly for 1.0-1.5 cun, and the reducing manipulation by lifting and thrusting was applied till the ipsilateral upper limb had three tics; The elbow was flexed to 120° for acupuncture at Chize, the needle was inserted perpendicularly for 1.0 cun, the reducing manipulation by lifting and thrusting was applied till the ipsilateral upper limb had three tics. Twice a day for 7 days as a course. ③ After four courses averagely, the whole blood viscosities were detected with the hemorrheologic detector, and the normal ranges for lowshear, middle-shear and high-shear of whole blood viscosities were 6.50-9.25, 4.35-5.45 and 3.65-4.40 mpa ·s respectively. The levels of total cholesterol and triglyceride were detected with blood lipid detector, and the normal ranges were 3.38-6.5 mmol/L and 0.56-0.147 mmol/L.MAIN OUTCOME MEASURES: The effects of xingnao kaiqiao acupuncture on the blood lipids and blood viscosity in stroke patients of different syndrome types were observed.RESULTS: Totally 690 and 721 cases finished the detections of whole blood viscosities and blood lipids respectively. There were obviously fewer cases with normal whole blood viscosities in the patients with stroke of meridian and collateral than in those with stroke attacking zang-fu organs (10.3%, 15.4%, P ＜ 0.01), but markedly more cases with higher total cholesterol and triglyceride than in those with stroke attacking zang-fu organs (80.5%, 91.5%; 64.1%, 71.3%; P ＜ 0.01).CONCLUSION: The levels of blood lipids in the patients with stroke of meridian and collateral are more abnormal than in those with stroke attacking zang-fu organs, but their blood viscosities are better than in those with stroke attacking zang-fu organs.

The paper designs and implements a digitalized information resources platform for Mongolian medicine based on ASP.NET.The system adopts VS2008 + SQL SERVER2005 and the 3-tier architectural pattern,integrates functional modules such as News Information,Mongolian Medicine,Mongolian Doctors and Q&A,realizes the digitalization of Mongolian medicine resources and establishes a sharing system.Upon testing,the system operates well and achieves the expectations.

AIM: To investigate the role of PPAR ? or ? ligands in regulating the expression of extracellular matrix metalloproteinase inducer(EMMPRIN).METHODS: THP-1 monocytes were induced into macrophages and foam cells in vitro then interfered with clofibrate and pioglitazone.The cells and supernatant were collected after 24 h,respectively.EMMPRIN gene and its protein were assessed by real-time PCR and Western blotting in different interferences.The concentration of matrix metalloproteinases(MMP-9) was measured with ELISA method and the activity of MMP-9 was detected with gelatin zymography.RESULTS: Two known PPAR ? or ? ligands,colfibrate and pioglitzaone,were found,both of which inhibited EMMPRIN expression in macrophages and foam cells.The inhibition was correspondent to the secretion and activity of MMP-9 simultaneously.CONCLUSION: Both PPAR ? and ? ligands inhibit EMMPRIN expression,which may account for their effect on inhibition of MMPs.

Objective Cathepsin K (CTSK) played an important role in adipocyte differentiation.The activation of CTSK needs to convey by mannose-6-phosphate receptors (M6PR) in osteoclasts. The aim of the present study was to identify the effects of mannose-6-phosphate (M6P) in adipocyte differentiation and its underlying molecular mechanism. Methods Oil red O staining, accumulation of cytoplasmic triglycerides and glycerine release were used to assess its effects on adipocyte differentiation in the 3T3-L1cell line. The enzyme activity of CTSK was observed by laser confocal microscopy. The proliferation of 3T3-L1 preadipocytes was detected by MTT methods. mRNA expression of M6PR was determined by RTPCR. Results M6P could prevent adipocyte differentiation in a dose-dependent manner as evidenced by absence of triglyceride accumulation and glycerol content. Statistical significance was showed when the concentrations of M6P were 5.0 mmol/L and 8. 0 mmol/L respectively(P ＜0. 05). The mRNA expression of M6PR was detected during the whole process of adipocyte differentiation. With the increase of M6Pconcentration, enzyme activity of CTSK was inhibited in a concentration-dependent manner. MTT method showed that the absorbance at 570 nm of 3T3-L1 preadipocytes was 0. 057 ±0. 091, increased about 62. 9%at 10. 0 mmoL/L compared with the control group (P ＜ 0. 05 ). Conclusion M6P inhibits the terminal differentiation of adipocyte, which may be associated with its effect of blocking CTSK activity by competitive binding with M6PR.

Astemizole is nitrasoted with sodium nitrite in 0.12 mo l/L HAc solution at boiling bath for 25 min. The nitrosation product of astemizo le shows a reduction peak by single-sweep oscillopolarography. The peak potenti al is -0.72V (vs.Ag/AgCl). The first-order derivative peak current is propo rtional to the concentration of astemizole in the range of 4.0×10-7～1.6 ×10-5 mol/L (r=0.9997), with detection limit of 2.0×10-7 mol/L . The proposed method has been applied to the determination of astemizole in pha rmaceutical tablets.

Objectives To observe the clinical efficacy and safety of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemia.Methods 29 older patients with acute myeloid leukemia treated from June 2010 to December 2016 were randomly divided into observation group and control group.Observation group(n=14)were treated with decitabine combined with half of CAG(aclacinomycin,cytarabine,granulocyte colony-stimulating factor)regimen.The control group(n=15)were treated with CAG regimen.Results The overall effective rate was higher in observation group(78.6%)than in control group(53.5%),but there was no statistically significant difference(χ2=2.042,P=0.153).The rate of lung infections was significantly lower in observation group(28.6%)than in control group(73.3%),(χ2=5.811,P=0.016).The survival time of patients was significantly longer in observation group(17.5±5.7 months)than in control group(12.6±6.2 months),the difference was statistically significant(t=2.211,P=0.018).Conclusions The treatment program of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemiais is safe and effective,which is worthy of clinical promotion.

Objective To study the effects of community nursing interventions on stroke patients with attention disorders.Methods A total of 60 stroke patients fulfilling eligibility were divided randomly into two groups.Their data were collected between December 2010 and February 2012.The intervention group was treated by community nurses while the control group trained by family members.Attention was assessed by simple reaction time (SRT) and number cancellation test (NCT).Modified Barthel index was used to assess the activities of daily living (ADL).Both groups were evaluated before and after a 2-month intervention.Results Before treatment,the control group had(0.71 ± 0.25),(662.8 ± 152.7) and(31 ±8)scores at SRT,NCT and MBI respectively.And the intervention group yielded(0.69 ± 0.19),(652.7 ±131.0) and (30 ± 8)scores at SRT,NCT and MBI respectively.There were no significant differences in average value of SRT,NCT and MBI between training and control groups at pre-treatment (P ＞ 0.05).After 2 months,the control group had (0.68 ± 0.20),(637.4 ± 151.7) and (33 ± 8) scores at SRT,NCT and MBI respectively.And the intervention group yielded (0.56 ± 0.16),(540.3 ± 125.9) and(37 ± 8) scores at SRT,NCT and MBI respectively.Very significant difference existed in attention scale scores at Month 2 (P ＜ 0.01) and the difference in ADL scale scores was also significant (P ＜ 0.05).Conclusion For stroke patients with attention disorders,strengthening community nursing interventions may help to improve attention and boost activity of daily living.