Bile dut injury (BDI) is one of the severe complications of laparoscopic cholecystectomy (LC).The classification,diagnosis and treatment of the BDI caused by LC are partly controversial.The most efficient classification of the BDI is Strasberg-Bismuth's classification and the three modes and four classes developed by the Biliary Surgery Group of Surgery Branch of Chinese Medical Association.Although the success rate of intraoperative diagnosis for the BDI is very low,in most cases,the BDI is diagnosed by clinical manifestations and assistant examinations.Accurate classification and early diagnosis could help us to make a specific one for each patient according to certain situation.In this review,we focus on the classification,diagnosis and treatment of the BDI caused by LC.

Through studying Marxism philosophy,medical graduate students can master scientific methodology and dialectic thought.This is helpful to analyze and comprehend rightly different kind of complicated issues and to improve cognition level and practice ability.It is also very important for medical graduate students to guide political education and moral cultivation,medical practice and science research.

Hedgehog( Hh)signaling pathway is evolutionarily conserved in vertebrates,its excessive activation is associated with abnormal cell differentiation, over proliferation, apoptosis resistance and promotion of invasion and metastasis of tumor cells. Hh signaling pathway involves in the formation and maintenance of esophageal columnar epithelium in embryonic stage,however,undetectable or barely expressed in matured esophageal squamous epithelium. Studies have shown that esophageal Hh signaling pathway can be activated by gastric acid and bile salts. Aberrant activation of Hh signaling pathway can cause the gradual transition of squamous epithelium to columnar epithelium and intestinal-type epithelium,ultimately induces the occurrence of Barrett’s esophagus( BE). Therefore,targeted inhibiting the Hh signaling pathway may be a new strategy for the treatment of BE. This article reviewed the advances in study on Hh signaling pathway in the pathogenesis of BE.

Colorectal cancer remains a major threat to people’s health around the world. Researchers have paid more and more attention to colorectal cancer epigenetics. From two main aspects of colorectal cancer epigenetics: DNA methylation and histone modiifcation, this article analyzes the similarities and differences between patients with colorectal cancer in Eastern and Western countries. This review brielfy introduces epigenetic modiifcation of genes that were used to be biomarkers and therapeutic targets. Although there are some common features of colorectal cancer in the world, analysis has showed that some obvious epigenetic differences do exist in different races. For example, it had been conifrmed in the studies that there are differences in speciifc gene methylation, histone modiifcation sites and the degree of methylation and acetylation among countries, which provide the basis for speciifc diagnosis, treatment and prognosis of colorectal cancer in different ethnic groups. With improved research methods and increased sample size, more and more special molecular targets of colorectal cancer tissues will be found, and then personalized therapy for colorectal cancer can be achieved.

Objective To investigate the effect of tetramethylpyrazine(TMP), a traditional Chinese herbal medicine, on the neural injury caused by spinal cord ischemia and reperfusion in rabbit.Methods Twenty-two male New Zealand white rabbits were anesthetized with isoflurane. Spinal cord ischemia was induced by 20min by infra-renal aortic occlusion. Animals were randomly allocated to 3 groups. Group C received no pharmacologic intervention. Group P and T received 30 mg?kg -1 TMP infused iv at a constant rate over 30min before aortic crossclamping(prevention) and after reperfusion(therapeutic) respectively. Neurologic deficit was assessed at 4, 8, 12, 24 and 48h after reperfusion using neurologic dificit score(NDS 4 = normal, 0 = paraplegia) . The animals were sacrificed at 48h after reperfusion and spinal cords (L 5-7) were removed immediately for histopathologic study.Results All animals survived the experiment. The NDSs at each observation interval were significantly higher in group P and T than those in group C (P

Objective To improve the biocompatibility of the metallic stent used for interventional treatment. Methods Inner coatings, outer coatings and micro-porous coatings were made using the solution-injection method, and salt crystallite with demanded size was added in order to develop micro-porous coatings. Results The optical concentrations of polyurethane solution and of salt crystallite (for micro-porous coatings) were obtained, and the corresponding processes were developed. Conclusion The poly-coated stent retains its elasticity, and it become very convenient to develop stents carrying drugs. Its effects on animals ard under test.

Objective To assess the clinical feasibility and safety of coronary artery angiography(CAG) and intervention through transradial approach. Methods 134 patients received coronary artery angiography and interventions through transradial approach were selected. The complications such as hematoma, thrombus were observed. Results Transradial puncture succeed in 126 cases, the successful rate of transradial coronary intervention was 94.0%.The complication occurred in 12 patients (8.9%). Conclusion This investigation demonstrated the safety and feasibility of transradial approach for coronary angiography with less procedure complications and pain for patient.

Objective To investigate the effects of rehabilitation training on the microenvironment for axon regeneration and the possible mechanisms promoting axon regeneration,reconstruction and functional compensation after spinal cord injury (SCI) in beagle dogs.Methods Fifteen beagles were divided into a sham operated group,an SCI model group and a rehabilitation training group.Spinal cord hemi-transection injury was carried out.From the 8th day after SCI,the rehabilitation training group was given treadmill training.All dogs were sacrificed 60 days postinjury and samples were harvested.Chondroitin sulphate proteoglycan (CSPG) expression of astroglial cells around the injured area was observed using an immunofluorescence technique.The expression of glial fibrillary acidic protein (GFAP) and CSPG protein in each group were semi-quantified by Western blot analysis.Axon regeneration was observed by silver staining.Motor function was assessed using modified Tarlov scores.Results In the rehabilitation training group,compared with the model group astroglial production of CSPG was reduced remarkably.Both CSPG expression and axon regeneration were enhanced and functional deficits improved.Conclusions Rehabilitation training can inhibit astroglial production of CSPG,improve the microenvironment for injured axon regeneration,and promote reconstruction and functional compensation after traumatic SCI.

Selective courses are different from compulsory courses in teaching objective,students' study demand,teaching content.Different teaching designs should be used according to different teaching objectives in selective courses for graduates.Targeted scientific thoughts and methodological training should be designed with respect to the fact that students will begin their experimental studies after the selective lessons.We analyzed the current status of selective course of neuroanatomy for graduates and proposed some solutions.

Objective To evaluate the clinical application of computer-aided electromagnetic imaging navigation in nasal endoscopic surgery.Methods Twenty-two cases of nasal endoscopic surgery with intraoperative imaging navigation were retrospectively reviewed,including 16 cases of sinusitis with or without polyp;5 cases of nasal inverting papilloma; 1 case of maxillary capillary hemangioma.All cases were operated with computer-aided electromagentic imaging navigation and nasal endoscope.Results The preoperative preparing time would take 4-10 minutes.In 22 cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1 mm.The optic nerve and other anatomical landmarks could be orientated accurately in intraoperative procedures.No complication occurred.Conclusions Nasal endoscope combined with computer-aided electromagnetic imaging navigation provides accurate anatomical localization of nasal cavity,sinuses and anterior skull base.It could improve the effectiveness and decrease surgical complications,especially in complicated cases.