Objective To discuss the diagnosis and surgical management of acute gangrenous cholecystitis (AGC) early after EST and ERCP. Methods Clinical and pathological data of 1468 cases receiving EST and ERCP in our hospital from 2005 to 2007 were retrospectively analyzed. Results AGC occurredin 16 cases and the incidence was 1.09%. Its main manifestations were pain in the right upper abdomen with local pertonitis and fever 1 to 3 d after operation, blood WBC exceeding 15.0× 109/L in 15 cases (93.8%), gallbladder tumefaction and double layer structure by B mode ultrasound, the diagnostic accuracy before operations was 81.3 %. We performed cholecystectomy in 10 cases, cholecystectomy and choledochotomy for common bile duct exploration and stone removal and T-tube drainage in 2, partial cholecystectomy in 3, cholecystostomy in 1. Pathological examination showedthat it was AGC in all the patients. Conclusion Latency in 1 to 3 d, local pertonitis, high blood WBC and B mode ultrasound are main managements in diagnosis of AGC and it should be diagnosed carefully distinguished from perforation and severe acute pencreatitis. It is suggested to undergoing early surgi-cal management once diagnosed definitely.

Lymphatic metastasis is an important prognostic factor for pancreatic cancer.However,lymphatic metastatic status (N0 or N1) can not reflect the degree of lymphatic metastasis.Lymph node ratio,which is defined as the number of positive lymph nodes divided by total examined lymph nodes,can reflect the degree of lymph metastatic metastasis and give consideration to examined lymph nodes.Lymph node ratio is superior to lymph metastatic status in staging,guiding treatment,and predicting prognosis.However,currently,lymph node ratio cannot replace lymph metastatic status for the undetermined minimum number of examined lymph nodes and cut-off value.Further evidence is needed to prove its clinical value.

Objective To investigate the effects of leptin on the oxidative damage in human retinal pigment epithelial (RPE) cells.Methods Human RPE cells (ARPE-19) were cultured in vitro,and randomly divided into control group and insulin resistance group.RPE cells were treated with 0,10,100 ng/mL leptin for 24,48,72 hours respectively.Then the levels of reactive oxygen species (ROS) expression in RPE cells were detected by 2',7'-dichlorofluorescin-diacetate (DCFH-DA),and the levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG) expression in RPE cells were observed by immunocytochemistry (ICC),and the levels of human 8-oxoguanine DNA glycosylase 1 (hOGG1) expression in lysate were measured by Western blot.Results After 24,48,72 hours,the level of ROS (Control group:F=37.136,37.178,49.634; P＜0.05.Insulin resistance group:F=9.822,28.881,71.150;P＜0.05),8-OHdG (Control group:F =88.643,390.920,1039.276; P ＜ 0.05.Insulin resistance group:F =273.311,299.155,82.237;P＜0.05) and hOGGl (Control group:F=470.062,1073.113,295.456;P＜0.05.Insulin resistance group:F =240.032,592.389,527.760 ; P＜0.05) expression increased significantly with the increase of leptin concentration in control group and insulin resistance group.Under the same leptin concentration,the level of 8-OHdG has a trend that it was higher in the insulin resistance group than the control group.After 24 hours,the difference of hOGGl expression between control group and insulin resistance group was not significant (F=23.392,P＞0.05).After 72 hours,the level of hOGGl expression was significantly higher in the insulin resistance group than the control group (F=129.394,P＜0.05).The level of hOGGl expression was significantly higher at 48 hours than that at 24 hours and 72 hours (P＜ 0.05).Conclusion Leptin could induce the oxidative damage of RPE cells in normal and insulin resistance status.With the increase of leptin concentration and time extended,the degree of oxidative damage and its repair were both increased.The degree of oxidative repair increased with the increase of leptin concentration,but decreased with time extended.

This study examined the predictive value of plasma cystatin C, creatinine and estimated glomerular filtration rate (eGFR) as risk factors for cardiovascular disease in Chinese. Plasma cystatin C and creatinine were measured in 466 coronary heart disease (CHD) patients recruited from 4 hospitals and 349 healthy controls from local communities in Wuhan, China. Cockroft-Gault formula was used to estimate the glomerular filtration rate (GFR) after adjusting for body surface area. With each measure, the study population was divided into quintiles. The results showed that the patients had significantly higher levels of plasma cystatin C, creatinine, and lower level of eGFR than controls. Lower eGFR was associated with a higher risk of cardiovascular events. As compared with the first (highest) quintile, the hazard ratios (and 95% CIs) after multivariate adjustment for CHD were as follows: third quintile, 2.98 (1.54-5.78); fourth quintile, 3.34 (1.58-7.09); fifth quintile, 4.37(1.84-10.35). With higher cystatin C quintiles (≥1.00 mg/L and ≥1.17 mg/L), the hazard ratios for CHD were 2.16 (1.23-3.81) and 2.34 (1.25-4.38), similar to those of creatinine 2.21 (1.21-4.03) and 2.03 (1.07-3.84). However, it was plasma cystatin C not eGFR or creatinine had stronger association with ischemic stroke. The highest quintile had the hazard ratio of 4.51 (1.45-14.08) after multivariate adjustment. It was concluded that plasma cystatin C, associated with renal function, is not an independent risk factor for cardiovascular disease. eGFR is a better risk predictor for CHD than plasma cystatin C and creatinine. But for ischemic stroke, plasma cystatin C is a better risk factor than creatinine and estimated GFR.

Objective:To investigate the effect of four different limbs postures on leg loading and stability of stand-to-sit (StandTS) in hemiplegic stroke patients.Method:30 hemiplegic stroke patients and 30 healthy individuals participated in this study.The duration,mean lower limb loading,and sway of the center of gravity (COG) in mediolateral directions (COGX) were measured during StandTS at four postures.Result:There were no significant differences in duration,mean lower limb loading,and COGX between the two arm positions during StandTS in hemiplegic stroke patients (0.05＜P＜0.1).In hemiplegic stroke patients performing StandTS,there were significant differences in duration,lower limb loading,and COGX between the different foot positions (P＜0.05).When hemiplegic stroke patients placed the paretic foot posterior,the weightbearing asymmetry between lower limbs was greatly improved,compared with the asymmetry when the non-paretic foot was posterior (P＜0.05).Furthermore,when the non-paretic foot was posterior,the duration to complete the StandTS movement increased (P＜0.05),and the postural stability during StandTS improved(P＜0.05).There were no significant differences in duration,mean lower limb loading,and COGX among four different limbs positions during StandTS in healthy individuals (0.05＜P＜0.1).Conclusion:Changing the upper limb position did not affect lower limb loading and postural stability during StandTS in stroke patients.However,changing the foot position significantly influenced the lower limb loading and postural stability during StandTS in hemiplegic stroke patients.

PURPOSE To investigate the clinical value of the T-antigen monoclonal antibody method on screening of large intestinal carcinoma. METHODS The T-antigen monoclonal antibody method and the galactose oxidase method were simultaneously used to detect T-antigen in large intestinal mucus of 207 cases. RESULTS There was not obvious difference in screening value between the T-antigen monoclonal antibody method and the galactose oxidase method, for that they had similar sensitivity (69. 2%, 67. 3%) and specificity (64. 2%, 65. 6%) in diagnosis of large intestinal carcinoma. CONCLUSION The T-antigen monoclonal antibody method was convenient, eligible and valuable on screening of large intestinal carcinoma.

The proliferation of splenic lymphocytes, the humoral immune response to sheep red blood cells and the phagocytotic function of intraperitoneal macrophages of mice were all stimulated by ig the flesh of Meretrix meretrixL. (FM) 20 g/kg and 10 g/kg for 7 days. FM 20 g/kg and 10 g/kg ig for 15 days also enhanced the activity of serum T-SOD, and decreased the level of serum MDA in old mice. The anti -stress effect of FM, such as increasing the swimming time of mice in 20癈 water by ig FM 20 g/kg and 10 g/kg for 7 days, was also achieved.

[Objective]To observe the effect of opposing needling accompanying continual static stretch(CSS) on high-spasticity poststroke.[Methods]80 patients with high spasticity poststroke were randomly divided into four groups.A group:treated with opposing needling accompanying CSS;B group:treated with opposing needling;C group:treated with CSS;D group:acupoints selected from anti-spasm muscle.The therapeutic effect of the four methods was evaluated on proving spasm degree and motor function.[Results]Four methods had effect on high muscle tension in patients poststroke.The marks of Ashworth scale and Fugl-Meyer scale of the four groups had remarkable difference(P

Objective To compare the effects of clopidogrel and ticlopidine in combination with aspirin in preventing direct coronary stenting complication in patients with acute myocardial infarction.Methods The clinical data of 74 cases with ST-segment elevation myocardial infarction were retrospectively analysed. The patients were divided into two groups. Before direct coronary stenting, clopidogrel,300mg loading dose then 75mg once daily or ticlopidine 250mg twice daily in addition to aspirin 100mg once daily were given to two groups respectively. Hemorrhage, neutropenia, thrombocytopenia were observed during 4 weeks. The frequency of clinical cardiovascular events (including cardiac mortality, myocardial re-infarction, need for revascularization) were followed up at 6 months. Results The incidence of major cardiac events in clopidogrel group was less than ticlopidine group ( 21.1% with Clopidogrel and 44.4% with Ticlopidine,P= 0.031). The incidence of light hemorrhage patents individually were 6(15.8%) vs 14(38.9%). The mean number of neutrophile white celll individually were 5.8 ?1.7 vs 4.2 ?3.6 (?10 9/L). The platelet count were 130.3 ?42.1 vs 89.2 ?53.3(?10 9/L), P

Objective To study the effect of of human cytomegalovirus (HCMV) infection on the expressions of Hox genes.Methods Forty eight kunming mice were randomly divided into infection group (n=32) injected with HCMVAD169 and control group (n=16) injected with saline into their brain.After 7,15,30,and 60 days,the cerebral lesions were observed by pathological method.HCMV antigen was detected by immunohistochemical method and HCMV DNA was detected by polymerase chain reaction (PCR). On the basis of developing HCMV mouse model. reverse trancriptase-polymerase chain reaction (RT-PCR) was applied to determine the expressions of Hox gene in the brains of infected mice.The expression of Hox genes were also analysed with Northern-blot by isotope labelled Hox genes oligonucleotide probes. Results A HCMV infection model was developed and extensive pathological damages in brain tissue of infected mice were observed.Meanwhile.the HCMV-LA and HCMV-DNA were also found in brain tissues of HCMV infected mice.The expression level of Hox genes in control and infected mouse brain were determined by RT-PCR and Northern-blot.RT-PCR and Northern-blot showed that mouse brain expressed Hox-A9,Hox-A10,Hox-A11,Hox-A12,and Hox-A13,but they did not express Hox-B13.After HCMV infection,murine brain was induced to express Hox-B13 gene(P＜0.01),and reached the peak at 30 d after infection.Comparing with the control group,the expression of Hox-A9 and Hox-A11 were down-regulated in infected group (P＜0.05);the expression of Hox-A10 and Hox-A13 were significantly higher in infected groups (P＜0.05).Conclusion The results suggest that HCMVAD169 is able to cause mouse CNS infection and induced the abnormal expressions of Hox genes. which provides more information for understanding the mechanism of congenital abnormal due to HCMV infection and a valuable method of clinical prevention and treatment of HCMV infection.