Objective To investigate the short term efficacy and security of different diameters of ampulla balloon dilation in the treatment of choledocholithiasis. Methods 80 patients with extrahepatic bile duct stones treated by EPBD were included in this study. All the patients were divided into 8 mm group, 10 mm group, 12 mm group, 14 mm group, which were according to the diameter of common bile duct (CBD) and stones. CBD stones were removed with retrieved balloon, Dormia basket, and/or mechanical lithotripsy if necessary. The incidence of 24 h hemorrhage, acute pancreatitis, hyperamylasemia and intestinal perforation were observed, and the incidence of pneumobilia and duodenobiliary reflux two weeks after EPBD. Then analyzed the short-term efficacy of the four groups. Result The overall success of stone removal in all groups were 100.0%, there was no significant differences in bleeding, intestinal perforation, hyperamylasemia, pancreatitis between each group (P > 0.05) . There shows significant differences in pneumobilia and duodenobiliary reflux two weeks after EPBD (P < 0.05). The incidence of pneumobilia and duodenobiliary reflux increased with the size of the balloon. Conclusion The application of EPBD is effective and safe for bile duct stone removal, while with the increasing of balloon diameter, the function of Oddi sphincter has severely influenced.

Objective To investigate the effect of acupuncture on cholinergic anti-inflammatory pathway in the hippocampus of aged rats during global cerebral ischemia-reperfusion ( I∕R ) . Methods Ninety-six clean-grade healthy male Sprague-Dawley rats, aged 17-22 months, weighing 440-580 g, were divided into 3 groups ( n=32 each) using a random number table method: sham operation group ( group S), global cerebral I∕R group (group I∕R) and acupuncture group (group AP). Global cerebral I∕R was induced by 4-vessel occlusion method described by Pulsinelli in group I∕R and group AP. Baihui and Feng-chi were stimulated for 14 consecutive days before ischemia in group AP. Four rats were sacrificed at 1, 3, 5 and 7 days of reperfusion, and brains were removed for determination of neuronal apoptosis by TUNEL. Four rats were sacrificed at 1, 3, 5 and 7 days of reperfusion, and brains were removed for determination of the expression of α7 nicotinic acetylcholine receptor (α7nAChR), choline acetyltransferase (ChAT), tumor necrosis factor-α ( TNF-α) and interleukin-1β ( IL-1β) in the hippocampal CA1 region by Western blot. The apoptosis rate was calculated. Results Compared with group S, the apoptosis rate of hippocam-pal neurons was significantly increased, and the expression of α7nAChR, ChAT, TNF-α and IL-1β was up-regulated at each time point of reperfusion in I∕R and AP groups ( P<0. 05) . Compared with group I∕R, the apoptosis rate of hippocampal neurons was significantly decreased, the expression of α7nAChR and ChAT was up-regulated, and the expression of TNF-α and IL-1β was down-regulated at each time point ofreperfusion in group AP (P<0. 05). Conclusion The mechanism by which acupuncture mitigates global cerebral I∕R injury may be related to activating cholinergic anti-inflammatory pathway in the hippocampus of aged rats.