Objective To investigate the potential factors which have impact on the working space for surgeons in gasless laparoscopic cholecystectomy and to probe into the specifications of gasless surgeries.Methods Clinical data of 49 cases of gasless laparoscopic cholecystectomy between March 2007 and July 2010 were summarized.The impacts of body mass index,bowel preparation and means of anesthesia on operation time and conversion to laparotomy were analyzed.Results For patients with body mass index ≤25and ＞ 25,operation times were (43.0 ± 5.4) min,and (52.8 ± 7.4 ) min,respectively,and rates of conversion to laparotomy were 0/34 and 4/15,respectively.Both indices in the first group were higher.For patients with and without bowel preparation,operation times were (44.5 ± 5.4) min and (46.1 ± 8.0)min,respectively,and rates of conversion to laparotomy were 2/26 and 2/23,respectively.For patients with epidural anesthesia and lumbar/epidural anesthesia,operation times were (46.5 ± 7.9) min and (44.1 ±6.8) min,respectively,and rates of conversion to laparotomy were 2/24 and 2/25,respectively.Conclusions The operation time of gasless laparoscopic cholecystectomy could be affected by many factors,such as body mass index.Gasless operations can be improved by evaluating the conditions of patients correctly and by selecting suitable operation methods,anesthesia means and bowel preparation.

SUMMARY Diffusion spectrum imaging ( DSI) , a newly developed MRI technique, affords the capacity to map complex fiber architectures in tissues with sufficient angular resolution by imaging the spectra of tissue water diffusion. By contrast, diffusion tensor imaging (DTI) , the currently widely used technique based on the 2nd order tensor model, obtains an approximation of the complex diffusion, and provides only one global maximal direction corresponding to the primary eigenvector for each voxel. As a generalized model-free diffusion imaging technique, firstly, DSI employs the probability density function to describe the diffusion process in each voxel; secondly, a sufficient dense signal sample derived from repeated applications of diffusion-weighed gradients ensures its capability to resolve the diffusion probability density function; thirdly, specific computer visualization techniques are used to extract the diffusion information and reconstruct the geometrical properties of tissue microstructure. The capacity to unravel complex tissue architecture, recent improvements in hardware and ongoing optimization of sequence design and algorithm enable a rapid growth of DSI for research use and future incorporation into clinical protocols. This paper introduces the basic principles of DSI and then compares the characteristics of DSI and DTI schemes. Finally, the typical applications of DSI to date are reviewed.

Objective To investigate the reverse effect and mechanism of the extracted solution of chinese medicine MBC on the drug-resistance of K562/ADM in vitro. Methods MTT assay was used to determine the IC50 of ADM on K562/ADM cell line and the reverse multiples of the drug-resistance before and after MBC treatment. Flow cytometry(FCM) was applied to assess the intracellular concentration of Rh123. Results 8?10 -1 ?g/ml MBC increased cytotoxic effect of ADM on 562/ADM cells, the reverse multiple was 6 28, and MBC could increase the intracellular concentration of Rh123. Conclusion MBC could increase killing effect of ADM on the drug-resistant K562/ADM cell and partly reverse the drug-resistance of K562/ADM cell.

Objective To investigate the pile protein (paxillin) and carbonic anhydrases Ⅸ (CA Ⅸ)expression and its significance in duodenal papilla carcinoma patients.Methods Eighty-seven cases of duodenal papilla carcinoma were enrolled as our subject.Immunohistochemical staining was used to detect the expressions of paxillin and CAⅨ in site of tumor,adjacent tissue and duodenal papillitis tissue.Results Sixtyfive cases (74.7％ (65/87)) were showed a higher expression of paxillin in cancer site than that of adjacent tissue (41％ (16/39),P ＜ 0.05) and duodenal papillitis tissue (41.3％ (19/46),P ＜ 0.05),and the difference was statisically significant (x2 =19.869,P ＜0.05).While a higher expression of CA Ⅸ in 62 cases (71.3％) in cancer site was seen,higher than that of adjacent tissue (33.3％ (13/39),P ＜ 0.05) and duodenal papillitis tissue (30.4％ (14/46),P ＜ 0.05),and the difference was statisically significant (x2 =26.936,P ＜ 0.05).As the increase of the cancer tissue malignant degree and the surrounding tissue invasion or distant metastasis degree,paxillin and CA Ⅸ expression increased.Conclusion The paxillin and CAⅨ might served as the early indicators for diagnosis and judgment of prognosis of duodenal papilla cancer.

Objective To establish a rapid, sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of acyclovir (the metabolite of valacyclovir hydrochloride) in human plasma. Methods After addition of ganciclovir as internal standard (IS), plasma samples were prepared by one-step protein precipitation using acetonitrile as precipitant, followed by an isocratic elution with 0.1% formic acid 3.5μm) column. Detection was performed on a triple-quadrupole mass spectrometer utilizing electrospray ionization (ESI) interface operating in positive ion and selected reaction monitoring (SRM) mode with the precursor to product ion transitions m/z 226.2→152.1 for acyclovir and m/z 256.2→152.1 for the IS. Results The analytical results demonstrated a good linearity over the ranges from 0.005 to 4μg/mL (r=0.9999) for valacyclovir hydrochloride. The relative standard deviations (RSD) of intra-batch and inter-batch were less than 4.06% and 9.23%, respectively. The limit of detection and lower limit of quantification in human plasma were 2ng/mL and 5ng/mL, respectively. Conclusion The method was simple, sensitive, accurate and reproducible and has been successfully applied to a bioequivalence study of valacyclovir hydrochloride capsules in Chinese healthy male volunteers.

OBJECTIVE:To evaluate the research of antidepressive agents from the literatures perspectively in order to develop antidepressive agents in China.METHODS:The literatures about antidepressive agents recorded in PubMed database from Jan.1st,1998 to Oct.31th,2008 were analyzed with bibliometric methods.RESULTS:A total of 17784 literatures on antidepressive agents were recorded and the total number increased slowly.A total of 96 literatures were collected from Chinese literatures which increased rapidly in recent years.34 literatures among 74 literatures during 1998～2007 are in English and 40 in Chinese involved 56 institutes and 51 magazines.Literatures collected from Beijing took up the greatest proportion.CONCLUSION:It is needed to enlarge investment and scale of scientific research on antidepressive agents continuously.

A sensitive and selective method using high-performance liquid chromatography coupled with elec-trospray ionization tandem mass spectrometry (HPLC–ESI–MS) to determine the concentration of tor-asemide in human plasma samples was developed and validated. Tolbutamide was chosen as the internal standard (IS). The chromatography was performed on a Gl Sciences Inertsil ODS-3 column (100 mm ? 2.1 mm i.d., 5.0 mm) within 5 min, using methanol with 10 mM ammonium formate (60:40, v/v) as mobile phase at a flow rate of 0.2 mL/min. The targeted compound was detected in negative io-nization at m/z 347.00 for torasemide and 269.00 for IS. The linearity range of this method was found to be within the concentration range of 1–2500 ng/mL (r?0.9984) for torasemide in human plasma. The accuracy of this measurement was between 94.05%and 103.86%. The extracted recovery efficiency was from 84.20% to 86.47% at three concentration levels. This method was also successfully applied in pharmacokinetics and bioequivalence studies in Chinese volunteers.

Electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) techniques for liquid chromatography–tandem mass spectrometry (LC–MS/MS) determination of levonorgestrel were evaluated. In consideration of difference in ionization mechanism, the two ionization sources were compared in terms of LC conditions, MS parameters and performance of method. The sensitivity for detection of levonorgestrel with ESI was 0.25 ng/mL which was lower than 1 ng/mL with APCI. Matrix effects were evaluated for levonorgestrel and canrenone (internal standard, IS) in human plasma, and the results showed that APCI source appeared to be slightly less liable to matrix effect than ESI source. With an overall consideration, ESI was chosen as a better ionization technique for rapid and sensitive quantification of levonorgestrel. The optimized LC–ESI–MS/MS method was validated for a linear range of 0.25–50 ng/mL with a correlation coefficient≥0.99. The intra-and inter-batch precision and accuracy were within 11.72%and 6.58%, respectively. The application of this method was demonstrated by a bioequivalence study following a single oral administration of 1.5 mg levonorgestrel tablets in 21 Chinese healthy female volunteers.

Objective To explore the effect of community comprehensive rehabilitation on quality of life in patients with stroke sequelae under the family medical service mode. Methods From October, 2013 to October, 2014, 51 patients with stroke sequelae received compre-hensive rehabilitation intervention for three months, including rehabilitation training, rehabilitation guidance, health education and psycho-logical counseling. They were assessed with modified Barthel index (MBI), WHO-Disability Assessment Schedule (WHO-DASⅡ), Short Form 36 Health Survey Questionnaire (SF-36), Brain Injury Community Rehabilitation Outcome Scales (BICRO-39), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) before and after intervention. Results The scores of physical functionning, role physical, general health, mental health, social functioning and the total score in SF-36 increased after intervention (t>2.072, P<0.05). The scores of so-cial contact, locomotivity, self handling transaction ability and the total score in BICRO-39 decreased after intervention (t>2.434, P<0.05), as well as the scores of getting along with people, housework and society and participation in WHO-DAS II (t>2.507, P<0.05). Conclusion In the community health service, comprehensive rehabilitation guided by multidisciplinary rehabilitation team can facilitate to improve the quality of life in patients with stroke sequela.