Objective To evaluate the safety,feasibility of primary closure after laparoscopic common bile duct exploration (LCBDE).Methods We retrospectively analyzed the clinical results of laparoscopic common bile duct exploration for common bile duct stones in 119 cases between July 2009 and August 2012.After all stones were removed,there were 63 cases with primary closure of the common bile duct (group A),and 56 cases with T tube drainage (group B).Results All operations were finished laparoscopically.There was significant difference in terms of operation time,postoperative hospital stay and fluid replacement between the two groups.There was no postoperative extrahepatic duct stenosis and biliary residual stones in the two groups.Conclusions Primary closure of common bile duct after LCBDE for common bile duct stones is safe,efficient and feasible.

Objective To observe the clinical effect of α1-antitrypsin gene therapy in the treatment of diabetes.Methods 81 cases with type 1 diabetes were randomly divided into conventional treatment group,islet stem cell transplantation group and gene therapy group,27 cases in each group.The conventional treatment group received the insulin therapy,the stem cell transplantation group received the islet cell transplantation,and the gene therapy group received stem cell therapy of α1-antitrypsin gene.The clinical effect of these three groups were observed.Results The insulin concentration of the gene therapy group was significantly higher than the islet stem cell transplantation group and the conventional treatment group at five time points(F =1 349.379,1 831.186,1 068.173,416.080,257.810,all P ＜0.05).The glucose concentration of the gene therapy group was significantly lower than the other two groups at six time points (F =1 212.243,586.057,962.495,582.887,650.015,1 181.808,all P ＜ 0.05).The degree of inflammatory cell infiltration in the gene therapy group was significantly lighter than in the islet stem cell transplantation group.Conclusion α1-antitrypsin gene therapy can significantly improve the therapeutic effect of diabetes,which is worthy of clinical application.

中国康复医学经过几十年的发展，已经初具规模。面对庞大的康复群体，康复事业的发展任重而道远。本文从中国康复事业的发展与成就、新理念新亮点、展望及思考等方面进行阐述，为我国康复医学的发展和进步提供一些建议和参考。

The choice of the topic area and specific problem on which to conduct research is the mostimportant step in the research process.This paper focused on the development and execution of a clinical re-habilitation research study. The choice of the topic area. principle of research design. data collection and dataanalvsis of a research study have been discussed.

To evaluate the fatigue behavior of nitinol stents, we used the finite element method to simulate the manufacture processes of nitinol stents, including expanding, annealing, crimping, and releasing procedure in applications of the clinical treatments. Meanwhile, we also studied the effect of the crown area dimension of stent on strain distribution. We then applied a fatigue diagram to investigate the fatigue characteristics of nitinol stents. The results showed that the maximum strain of all three stent structures, which had different crown area dimensions under vessel loads, located at the transition area between the crown and the strut, but comparable deformation appeared at the inner side of the crown area center. The cause, of these results was that the difference of the area moment of inertia determined by the crown dimension induced the difference of strain distribution in stent structure. Moreover, it can be drawn from the fatigue diagrams that the fatigue performance got the best result when the crown area dimension equaled to the intermediate value. The above results proved that the fatigue property of nitinol stent had a close relationship with the dimension of stent crown area, but there was no positive correlation.
Alloys ; Computer Simulation ; Equipment Failure Analysis ; Finite Element Analysis ; Stents