Objective To study the therapeutic methods of cholecystic duct stones. Methods A retrospective analysis of the clinical data of 158 cases of cholecystic duct stones treated in the recent 6 years was made. Results 97 of the 158 cases of cholecystic duct stones were removed by open surgical operation and 61 cases by laparoscopic cholecystectomy(LC).In 49 of the 61 cases treated with LC,the cholecystic duct stones were removed together with removal of the gallbladder, and 12 by duodenoscopy after LC. Conclusions One should strive to extract the cholecystic duct stones while removing the gallbladder. If the stones or stone fragments escape into the common bile duct, they could be removed through a choledochotomy at the time of the open operation ,or by postoparative duodenoscopy in cases undergoing LC. The latter method of treatment is associated with minor trauma, quick recovery and definite therapeutic results.

Objective To cleave double-stranded RNA(dsRNA) into small interference RNAs(siRNAs) that can target multiple sites within an mRNA.Methods A549 cells were isolated to incubate with 5 g/L IL-1? for different times to detect the time-dependent expression of COX-2.To generate the long dsRNA,the COX-2 gene(728 bp) was amplified by PCR with a specific forward primer that contained a T7 promoter and a specific reverse primer that contained an SP6 promoter.Then,sense strand RNAs were generated by T7 RNA polymerase and antisense strands RNAs were generated by SP6 RNA polymerase.These single strands RNAs were annealed by the standard method.We mixed dsRNA with Dicer in reaction buffer.We recovered siRNAs using RNA Purification Column.Transfections with diced siRNAs were performed using the TransMessenger Transfection Reagent in accordance with the manufacturer's instructions.COX-2 mRNA and protein were determined by RT-PCR and Western blot respectively.PGE2 was measured by ELISA.Results IL-1? induced COX-2 protein expression in A549 cells.We recovered siRNAS that have been generated in vitro by Dicer.D-siRNAs significantly suppress the expression of COX-2 in human pulmonary epithelial.Conclusion D-siRNAs significantly suppress the expression of COX-2 in human pulmonary epithelial.

Objective To investigate the relationship of the level of serum C-peptide(C-P)with albumin-to-creatinine ratio(ACR)and nerve conduction velocity(NCV)in patients with T2DM.Methods The study included 132 patients with T2DM and 30 healthy controls.The NCV,ACR,fasting C-P and C-P at 2hOGTT(FC-P and 2hC-P)and plasma glucose(PG)were measured.The patients were separated into three groups of Ⅰ(45 cases),Ⅱ(52 cases)and Ⅲ(35 cases).The patients were further classified into two groups of normal NCV(70 cases)and abnormal NCV(62 cases).Results ①The differences of FC-P and 2hC-P among the ACR groups were significant(all P<0.05).②The ACR was correlated with course,2hC-P,2hPG significantly(all P<0.01).The sequence of the impact degree on ACR was from course(Beta:0.592)to 2hC-P(Beta:-0.297)and to 2hPG(Beta:0.201).③The levels of serum 2hC-P were significantly and gradually decreased in the groups of NCV(P<0.01).④The serum 2hC-P concentration was associated with ACR and NCV in different stages(P<0.01).Conclusions ①The level of serum C-P is tightly correlated with the vascular and neural dysfunction in T2DM.②Course,2hPG and 2hC-P may be the risk factors for ACR

Objective To assess the status of mental health of nursing students of secondary technical school and provide targeted guidance for mental health education. Methods 642 nursing students of secondary technical school were assessed using Mental Health Diagnostic Test Scale (MHT Scale). Results There were 0.78% of nursing students with serious psychological problems (scores≥65), 4.52% of nursing students with less serious psychological problems (scores < 65 and≥ 56). Students in different grades had significant difference in learning anxiety, allergic tendency, physical symptoms anxiety. Conclusions Nursing students of secondary technical school were in good mental health in general, but there were many students had learning anxiety, allergic tendencies and physical symptoms anxiety, which were different among various grades. Secondary nursing schools should further strengthen the mental health education, and seek close collaboration with parents,provide appropriate intervention measures to the nursing students with psychological barriers, in order to enhance the overall mental health of nursing students.

Animals ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Differentiation ; Humans ; Mouth Neoplasms ; metabolism ; pathology ; Oral Medicine ; Osteoblasts ; cytology ; Osteoclasts ; cytology ; Tooth ; metabolism ; Wnt Proteins ; metabolism ; physiology ; Wnt Signaling Pathway ; physiology ; beta Catenin ; metabolism

Objective BOLD-fMRI was used to observe the activated auditory cortex evoked by pure tone stimuli in patients with sensorineural hearing loss and this paper is to discuss the objective measure for patient with sensorineural hearing toss. Methods BOLD-fMRI examinations were taken in 22 patients with unilateral moderate to severe sensorneural hearing loss and 15 control subjects. The volumes and intensities of the two hemispheres of the activated auditory cortex were analyzed quantitatively. Results Significant activation was found in the temporal lobe in control subjects, and significant differences in the volume and intensity were noted between the contralateral and ipsilateral activated auditory cortexes in them (P<0.01), exhibiting clearly eontralateral predominance. When the normal ear of patients with sensorineural hearing loss received signals, there was no significant difference be-tween contralateral and ipsilateral activated auditory cortexes (P>0.05). Conclusion When the normal ear of pa-tients with sensorneural hearing loss was stimulated by pure tone, the contralateral hemisphere predominance disap-peared. This result seems to show the plasticity of auditory cortex of patients with unilateral hearing loss.

Objective: To investigate the effect of chronic intermittent hypoxia (CIH) on liver injury and the expression of fractalkine in rats and explore its possible mechanism.
Methods: A CIH murine model was established to mimic the pathophysiology of obstructive sleep apnea-hypopnea syndrome (OSAHS) in humans. Thirty healthy male Spraque-Dawley rats were randomly assigned to 3 groups: a 5% CIH group, a 5% CIH+RH (removal of hypoxia) group and a control group ( 10 rats in each group). The 5% CIH and 5% CIH+RH groups were exposed to CIH for 3 weeks, 8 h/d, and the frequency of hypoxia was 20 times/h. The 5% CIH+RH group was then exposed to normal gaseous environment for another 3 weeks. After the experiment, liver sections were stained with hematoxylin-eosin (HE) and the liver pathology was observed. The expression of fractalkine in the liver tissues was detected by immunohistochemical method.
Results: 1) Compared with the control group, the hepatic steatosis and inflammatory activities in the 5% CIH and 5% CIH+RH groups were more severe (allP<0.01 ); compared with the 5% CIH group, the hepatic steatosis and inflammatory activity in the 5% CIH+RH group were dramatically reduced (P<0.01 ). 2) Compared with the control group, the fractalkine expression in the 5%CIH and 5% CIH+RH groups was increased (bothP<0.01). The fractalkine expression in the 5% CIH+RH group was dramatically downregulated compared with that in the 5% CIH group (P<0.01).
Conclusion: CIH can induce liver injury and high fractalkine expression in rat liver tissues.

Objective To investigate the clinical value of medical image-three dimensional visible system (MI-3DVS) in percutaneous transhepatic cholangioscopy lithotripsy (PTCSL) for the treatment of hepatolithiasis.Methods The clinical data of 66 patients with hepatolithiasis (55 were from the First People's Hospital of Shunde City and 11 were from the Zhujiang Hospital) were retrospectively analyzed.The images of computed tomography were three-dimensionally reconstructed with MI-3DVS.The location,number,size,shape of the stones were figured out,and the operation strategies of PTCSL were designed according to the types of the disease.The clinical value of MI-3DVS was evaluated according to the operation results and postoperative recovery of patients.All the patients were followed up via telephone or out-patient re-examination.Results Liver,biliary system,stones and blood vessels were three-dimensionally reconstructed with the MI-3 DVS,and the size,number,shape,location of the stones and location,degree,length of the biliary stricture and its anatomical relationship with adjacent blood vessels were clearly displayed.The coincidence rate of planned and actual operations was 95.5％ (63/66).The mean operation time,intraoperative blood loss,rate of stone clearance,complication rate and duration of hospital stay of 63 patients were (117 ± 9) minutes,(18 ± 1) ml,92.4％ (61/66),6.1％ (4/66) and (15 ± 4) days,respectively.All the patients were followed up till September 2012,the median survival time was 16 months (range,1-69 months),and the recurrence rate of hepatolithiasis was 9.1％ (6/66).One patient died of tumor metastasis and multi-organ dysfunction syndrome postoperatively.Conclusion MI-3DVS could effectively improve the safety and efficiency of PTCSL for patients with hepatolithiasis.

Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) before radiation in pancreatic cancer patients underwent radiation therapy. Methods:Clinical data of 61 patients with pathologically confirmed pancreatic cancer were retrospectirely analyzed. Query index values for each patient were clinically tested through electronic medical records. Overall survival (OS) data were collected through electronic medical records or telephone follow-up. Survival curves were compared using Kaplan-Meier methodology and log-rank test. Cox regression methodolo-gy was used for univariate analysis. Results:Using log-rank test and univariate regression analysis, we found that patients with lower NLR, PLR, CA19-9, increased PNI, and lower TNM-staging lived longer than those with increased NLR, PLR, CA19-9, lower PNI, and high-er TNM-staging, and that the difference was statistically significant. Through multivariate analysis, we found that NLR (P=0.029, OR 2.344, 95%CI:1.090-5.041) and PNI (P=0.026, OR 0.477, 95%CI:0.248-0.917) were independent predictors of OS in patients with pan-creatic cancer. Conclusion:NLR, PLR, and PNI are simple, effective, and reliable indicators for evaluating the prognosis of pancreatic cancer.

Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.