Objective To explore how to improve the curative effects and reduce the complications of duodenoscopy in the treatment of bile duct diseases. Methods Clinical data of 292 cases of endoscopic sphincterotomy (EST) and 104 cases of endoscopic nose biliary drainage (ENBD, including 9 post-EST cases) from February 1995 to February 2003 were retrospectively reviewed. Results The success rate of EST was 92.1% (269/292). Among 272 cases of common bile duct calculus, stones were completely taken out in 235 cases (86.4%). Among 15 cases of intrahepatic duct calculus, stones were completely removed in 4 cases. Biliary duct foreign bodies were removed at once in 3 out of 5 cases. EST related complications were found in 16 cases (7 cases of acute pancreatitis, 5 cases of bleeding at the site of incision, 2 cases of severe cholangitis, 1 case of duodenal perforation and 1 case of instrumental break-off), with an incidence rate of 5.5% (16/292). Satisfactory outcomes were achieved in 92 cases receiving ENBD. No death occurred in the study. Conclusions Proper selection of patients and skillful performance of EST is the key to improve its curative effects and reduce its complications.

BACKGROUND: Mesenchymal stem cells, a kind of popular seed cells for cell transplantation after myocardial injury, have become a hot research topic in the treatment of ischemic heart diseases. OBJECTIVE: To review the new progress of mesenchymal stem cell transplantation in the treatment of ischemic heart diseases. METHODS: We searched Medline, Ovid Embase, PubMed Central, Cochrane Library, Chinese Periodical Full-Text Database, Chinese Biomedical Literature Database, VIP database, Wanfang Database for relevant articles in Chinese and English languages, and the retrieval time was from 1985 to 2015. Articles related to randomized controlled trials or clinical research on mesechymal stem cell transplantation for treatment of ischemic heart diseases were included, and relevant review were also included. Observational studies, casereports, study protocols with no standard or rational design, reviews with no normative and rigorous inclusion criteria, cross-test studies, cluster randomized trials, and studies that have nothing to do with the topic were excluded.RESULTS AND CONCLUSION: Through literature screening, we summarize the research progress in the mesenchymal stem cell transplantation, including cell source, safety, efficacy, action of mechanism and injection mode, and analyze the merits and demerits of mesenchymal stem cell transplantation. Bone marrowmesenchymal stem cell transplantation provides a new insight into the clinical treatment of myocardial infarction,but there are still many problems to be solved, such as cell quality, cell dose, transplantation mode, transplantation timing and patient selection, which so limit the clinical application of mesenchymal stem cell transplantation.

Objective To study the histopathological changes of skin after phenol chemical peeling.Methods Immunohistochemical staining (ABC method) and transmission electron microscopy were used to investigate the skin of changes 15 cases of freckle.Results After phenol chemical peeling,the melansomes in basal layer cells decreased dramatically, the elastic and collagenous fibers in dermis enlarged ,and the skin thickened .Conclusions After phenol chemical peeling,the melansomes in cuticular layer cells decrease remarkably and the freckle disappears.The proliferative activitities of fibroblasts in dermis have been improved,resulting in thickness of elastic and collagenous fibers in dermis. It may be the reason why the skin delays to be aged.

BACKGROUND: The expression of main histocompatibility antigen in cornea of rats is similar to that of human. It is verified in early experiments that penetrating corneal transplantation in rats is more repetition and reliability, and the operation difficulty is lower than that in mice.OBJECTIVE: To establish rat model of penetrating corneal transplantation and analyze the reasons of complications during model preparation and the corresponding managements and probe into the method for improving the success rate of rat model of corneal transplantation.DESIGN: Randomized controlled experiment was designed.SETTING: Department of Ophthalmology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Department of Ophthalmology in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from March to May 2004. Seventysix outbred female Wistar rats of two months old were employed and randomized into experimental group and control group with 38 rats in each,without eye disease, of clean grade, body mass varied from 180 to 200 g and their right eyes were taken as acceptors. Thirty-eight SD female rats were employed and their both eyes were taken as donors. All of the animals were provided from Experimental Animal Center of Tongji Medical College of Huazhong University of Science and Technology.METHODS: Central penetrating corneal transplantation in situ was adopted and the model was established on the right eye of Wistar rat. Ten minutes before operation, tropicamide eye drops was administrated twice to amplify adequately the pupil of the right eye up to 4.0 mm. According to body mass, general anesthesia was done with abdominal injection of 3.0 mL/kg chloral hydrateand dicaine eye drops was applied twice 5 minutes before the operation with 0.1 volume fraction. Routine sterilization was done on the head of rat, the eyes kept in horizontal level and respiration kept smooth. The clip in dental-ophthalmology department was used to fix the posterior of the operated eye and make it to be semiluxated. The ring driller 3.5 mm in diameter was used to collect corneas of both eyes in SD rat as the implant tissue and place in culture dish with endothelial part upward, covered with methyl cellulose of 20 g/L mass weight concentration. The ring driller, 3.0 mm in diameter was used to collect the cornea of the right eye in Wistar rat to be the graft foreman, and the implant tissue was sutured into the graft foreman on the right eye of Wistar rat with 10-0nylon thread intermittently. Eight stitches were done in corneal transplantation in the experimental group and 6 stitches in the control group. After operation, ofloxacin eye drops was administrated and the operated eye was covered with plaster. Corneal rejection was observed and the evaluation was done in 3 items, named, turbidity, edema and neogenetic vessel. The total score of 3 items was taken as the rejection index on the day. Rejection was determined if the rejection index on the day ≥5 or corneal turbidity reached the 3nd grade. x2 and Fisher definite probability methods were used for statistical examination.plant tissue and corneal rejection.RESULTS: Of 76 Wistar rat acceptors, 5 rats were dropped out, among which, 1 rat was died accidentally after operation in the experimental group, 2 rats were died accidentally after operation in the control and 2 rats were injured cornea on the operated eyes due to fighting. But by supcomplications after corneal transplantation: In the experimental group, the number with anterior adhesion of sclera, non-round pupil; limited wound healing and non-formation of anterior chamber was lower than that in the implant tissue and corneal rejection: the survival time of corneal implant tissue was similar basically in both experimental group and the control [(8.9±2.3), (8.6±2.3) days, P ＞ 0.05]. Rejection presented in both groups in 16 days after corneal transplantation and the incidence of rejection was 100%.CONCLUSION: With stitches maintained and without intervention, the acute rejection is similar in rat corneal transplantation and human corneal transplantation. It is explained in the experiment that 8 stitches in corneal transplantation in which the rat implant tissue of 3.5 mm matches graft foreman of 3.0 mm can reduce the complications of rat corneal transplantation and becomes a satisfactory animal model of corneal transplantation.Skillful microscopic operation techniques, satisfactory operation instruments and adequate amplilfied pupil can reduce to the most extent the postoperation complications in rats.

Objective To Analyze CD4+ cell count which embodies curative effect in HIV and patients with AIDS, who have treated with TCM for half a year. Methods According to CD4+cell count, the patients were divided into 4 phases. Their CD4+cell count were analyzed before and after the treatment. Results 1.Rank sun test showed that CD4+cell count were significantly improved in people who used TCM treatment. On the whole, CD4+cell count was(317.76±175.61) in 1 cu mm before treatment, which was(350.60±175.92) in 1 cu mm after treatment, P<0.01. 2. Ridit showed that patients whose CD4+cell count more than 500 were in phase I. Their R=0.614, and the 95%confidence interval was 0.5702 to 0.6579. Patients whose CD4+cell count more than 350 and less than 500 were in phase II. Their R=0.575, and the 95%confidence interval was 0.5439 to 0.6062. Patients whose CD4+cell count more than 200 and less than 350 were inphase III. Their R=0.460 and the 95%confidence interval was 0.4347 to 0.4849. Patients whose CD4+cell count less than 200 were in phase IV. Their R=0.428, and the 95%confidence interval was 0.3971 to 0.4589. There was no overlap between phase III, phase IV and phase I, phase II in 95% confidence interval. Conclusion TCM has the advantages in strengthening vital qi, but that is worse than western medicine in effort of expelling pathogen.

Objective To observe the surgical results of milling technique in treating mandibular angle hypertrophy through an intraoral approach and the effect of three-dimensional computer tomography (3D-CT) reconstruction.Methods Milling-technique was used to treat mandibular angle hypertrophy of 43 patients through intraoral approach under local anaesthesia.3D-CT was applied preoperatively and postoperatively,the data of mandibular angle and masseter muscle thickness were compared preoperatively and postoperatively.The facial contour improvement was also observed.Results Of 43 cases,33 cases were followed-up for 4 to 24 months after operation.The majority of patients were satisfied with the aesthetic results,changes of anterior and lateral view of basifacial part were obvious,the curve of the mandibular angle was smooth and the shape was natural; no major complications such as facial nerve injury or malfracture were seen.Conclusions Milling-technique is a safe,effective and simple method for mandibular angle reduction,and 3D-CT reconstruction has a positive effect preoperatively and postoperatively.

Objective To investigate the value of serum pentraxins-3 (PTX-3) together with triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) as predictor risk factors of future acute coronary syndrome(ACS). Methods One hundred and seventy-one cases of selective coronary angiography from July 2008 to December 2009 were collected and analyzed. According to the situation on admission and coronary angiography, patients were divided into three groups: normal control group (25 cases), stable angina pectoris (SAP) group (23 cases) and ACS group (123 cases). Fasting venous blood was extracted for measuring serum PTX-3 and lipids (TG, HDL-C) in the next morning, and the statistical significanc was analyzed. Results The level of serum PTX-3 and the ratio of TG to HDL-C in ACS group [(6.39 ± 3.01)μ g/L, 2.38 ± 2.00] were significantly higher than those in SAP group[(3.87 ± 2.05 ) μ g/L, 1.70 ± 1.01] and normal control group [(2.90 ± 1.94)μg/L,0.95 ±0.35] (P ＜0.01 or ＜0.05). Conclusion Increased serum PTX-3 levels and ratio of TG to HDL-C in patients are closely related with ACS, both of which increase the accuracy of early diagnosis of ACS.

Objective To analyze the difference of soft and hard tissues between beautiful face and ordinary face in young Han women for providing data basis for modification of lower facial contour.Methods 38 cases of young Han women were selected with craniofacial spiral CT scanning,three-dimensional reconstruction and histomorphometry of the mandibular angle region (12 cases of beautiful face and 26 cases of ordinary face).Results The difference of bony bigonial breadth,lower face width,angle of mandibular angle,mandibular branch width and height,the distance between the mandibular angle point and pogonion in mandibular angle region had statistical significance (P ＜ 0.05);the difference of mandibular angle thickness had no statistical significance (P＞0.05);the difference of masseter muscle length,width and thickness had statistical significance (P ＜ 0.05).Conclusions In clinical lower facial contour modification practice,we can refer to the data of soft and hard tissue of mandibular angle region of beautiful face,combining with the specific circumstances of the pursuit of beautiful people and select the appropriate surgical approach for lower facial contour modification.

Objective To explore an ideal surgical method for mid-low face lifting.Methods In this procedure,the first surgical step was subcutaneous undermining that was performed through the incision along temporal hairline,anteriorear,and mastoideae.It extended distally beyond the furthest skin fold and along the mandibular border or the midline of the neck if nacessary.Then three layers suspension were performed,which included three procedures:first,SMAS was purse string sutured in certain direction;secondly,the malar fat pad was suspended to tow directions backward and upward and anchored in the periosteum of zygoma and SMAS too;lastly,through traction suture of reducing tension step-by-step,lots of the tension was relieved from the incision;at the same time,new retaining ligaments between flap and SMAS were reestablished.And redundant skin was removed in incision at the end of the procedure.Results A total of 22 cases received this operation.16 cases were followed up from 3 months to 24 months after operation.The results of operation were divided into three degrees:excellent,acceptable and poor;and those were evaluated by patients themselves.14 cases obtained excellent result (87.5 ％),2 cases regarded that their results were acceptable (12.5 ％).The total satisfactory rate was 100 ％.None serious complication occurred in those eases except some slight complications,such as local edema,skin numbness and small hematoma which relieved in 3 to 6 months after operation.Scar was inconspicuous.Conclusions This technique can correct the posies of lower tow-third face better,especially for mitigating the nasolabial fold and enhancing the elastic of face skin.Simultaneously,it is an effective,safe and simple technique.

Objective To explore the clinical effect of transplantation of autologous fat with stromal vascular fraction for breast augmentation.Methods From September 2012 to March 2014,15 people accepted breast augmentation by transplanting autologous fat with SVF under local anaesthesia.Three-dimensional computer tomography reconstruction (3D-CT reconstruction) was applied preoperatively and postoperatively,the data of the thickness of breast's subcutaneous tissue was compared to observe the breast contour improvement.Results Autologous fat was injected 2 times in 3 cases,and the rest were 1 time.6 months after operation,13 cases were satisfied with the results,and 2 cases were quite satisfied.3D-CT reconstruction was performed before operation and 6 months after operation;statistics showed that before operation the thickness of breast subcutaneous tissue of the right side was (11±4) mm,the left side was (11±6) mm;6 months after operation the right side was (14±3) mm,the left side was (16±3) mm (P＞0.05).The breast was soft,no major complication such as nodules,cysts or calcification were seen.Conclusions The transplantation of SVF with autologous fat is a safe,effective procedure for breast augmentation.3D-CT reconstruction can show more details of breast structures,which is a more effective method to guide and evaluate the lipotrans plantation.