Objective To evaluate the rationale and indcations for exploring common bile duct through cystic duct without placing"T"tube after choledochotomy.Methods Exploring 30 patients'common bile duct through cystic duct without placing"T"tube after choledochotomy.The results was compared with that of traditional procedure.Results Average postoperative hospital stay was 8 days.while 16 days in patients with a"T"tube drainage.Complications often seen in"T"tube drainage were avoided.Conclusion When properly,exploring of common bile duct through cystic duet without"T"tube was safe.

ObjectiveTo study of the impact on dose distribution by electron width of energy spectrum and angular distribution using Monte Carlo simulation.MethodsThe simulated electron energy spectrum and angular distributions was as the input parameters and percentage depth dose (PDD) and offaxis curves were simulated by a modified PENELOPE code package. Results PDD and off-axis dose distribution curves are almost the same and are not sensitive to energy spectrum width and angular distribution with the exception of energy spectrum width of 2.5 MeV with obviously different curves.ConclusionsIn the situation of clinical treatment,spectrum and angular distributions can be ignored when their width are not very large.It is helpful to save about 9％ time by using monoenergy beams in treatment planning system development.

Objective To evaluate the biological safety of 125I-filled carbon nanotubes covered with metallic esophageal stent with regard to the normal esophagus before clinical application.Methods 125I-filled carbon nanotubes covered with metallic esophageal stent was prepared.Eighteen of New Zealand rabbits were randomly divided into three groups with 6 rabbits in each group.Three groups of stents,non-radioactive,low radio-activity ( 3.7 - 5.6 MBq),and high activity ( 11.1 - 13.0 MBq ) were placed in the midpiece of esophagus of rabbits.Esophagus opacification and three-diamensions DSA were performed at 0.5 h,7,14 and 30 d after insertion of the stents,respectively.The rabbits were killed at 30d after insertion of the stents,and histologic examinations of the esophageal walls were performed.Results In non-radioactive and low activity groups,1 of 6 rabbits died of wound infection at 1 and 3 d after surgery due to pulmonary infection,respectively.All specimens were obtained from 16 rabbits.Microscopically,in all rabbits of low activity and high activity groups,there were membrana mucosa necrotic and swell and breakage of the muscle fiber in esophageal submucosa and muscularis,submucosal inflammation,which were more severe in high activity group.In low activity group,one esophagus ectal membrane was involved,however,esophageal perforation did not develop.In high activity group,3 of 6rabbits esophageal perforation had developed,in which one esophagus mediastinum fistula developed,without inflammation.In non-radioactive group,it was almost normal in mucosa layer,a small amount of inflammatory cells were found in submucosal layer,and part of muscle fibers was fractured and no pathological changes of necrosis was found.Conclusions Radioactive 125I carbon nanotubes covered metallic stent with low activity(3.7 -5.6 MBq) can be used as intraluminal palliative brachytherapy,which is safe and effective.

OBJECTIVETo investigate the dynamic features of angiogenesis in residual tumors after high intensity focused ultrasound (HIFU),and to determine the temporal effect and mechanism of hypoxia inducible factor-2 alpha (HIF-2a) in the angiogenic process of residual tumors.

METHODSXenograft tumors of HepG2 cells were generated by subcutaneously inoculating athymic BALB/c nu/nu mice with the hepatoma cells.About 30 days after inoculation,all mice (except in the control group) were treated by HIFU and assigned randomly to the following 7 groups according to various time intervals post-treatment:1st,3rd,5th day and 1st,2nd,3rd,4th week when the residual tumor tissues were obtained from the experimental groups.Protein levels of HIF-2a and vascular growth factor A (VEGF-A) were quantified by immunohistochemistry and western blotting,and mRNA levels were measured by (real-time quantitative) qPCR. Microvascular density (MVD) was calculated by counting the CD31-positive vascular endothelial cells identified by means of an immunohistochemical staining method.

RESULTSCompared with results from the control group,the protein and mRNA levels of HIF-2a expression reached the highest level in the experimental mice at the 2nd week (P=0.000 and P < 0.01 respectively),and were decreased thereafter(3rd week and 4th week, P=0.000 and P < 0.05).VEGF-A expression in the residual tumor tissues group that received HIFU was significantly decreased,compared with the control group,at all time points uPto 1 week (all P=0.000 and P < 0.01),but the levels increased compared to controls in the 2nd through 4th week (all P=0.000, P < 0.05). Similar results were obtained for MVD.

CONCLUSIONHIFU treatment can inhibit angiogenesis in residual hepatoma tissues in the short-term (1 to 2 weeks post-treatment) in mice with hepatocellular carcinoma,but can promote angiogenesis overtime (2 to 4 weeks post-treatment); the angiogenic process may involve the HIF-2α/VEGFA pathway.

Animals ; Blotting, Western ; Carcinoma, Hepatocellular ; pathology ; Hep G2 Cells ; High-Intensity Focused Ultrasound Ablation ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Immunohistochemistry ; Liver Neoplasms ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Neovascularization, Pathologic ; Vascular Endothelial Growth Factor A ; metabolism

Objective To determine ED50 and ED9 5 of etomidate for combined remifentanil used in elderly patients in gastroscope.Methods Twenty-three patients were scheduled to receive gastros-copy aged 65-78 years old including males 13 and females 10,weighting 45-76 kg and ASA Ⅰ-Ⅲ. They were slowly injected remifentanil 0.3 μg/kg,and then etomidate 0.20 mg/kg,gastroscopy was performed after their eyelash reflex disappeared.The dosage of etomidate were determined by modified up-and-down methods,0.20 mg/kg was initial dosage.During the gastroscope,restlessness, frowning,swallowing,choking cough could be seen.The adjacent experimental interval dosage was 0.05 mg/kg,the trial was ended when there was the seventh cross-sectional,and determined the ED50 and ED9 5 of etomidate and (95%confidence interval)of them for gastroscope with probability a-nalysis methods.Results The ED50 of etomidate was 0.1 7 mg/kg and 95%CI 0.14-0.21 mg/kg,and the ED9 5 was 0.23 mg/kg,95%CI 0.20-0.42 mg/kg respectively.Conclusion The ED50 and ED9 5 of etomidate combined with remifentanil used for elderly patients for gastroscope respectively are 0.1 7 mg/kg and 0.23 mg/kg.

This study was aimed to observe the influence of Catalpol on real-time gait analysis of early recovery after permanent middle cerebral artery occlusion (pMCAO) in rats to evaluate its effect on the improvement after cerebral ischemia. Rats were randomly divided into 6 groups, which were the normal control group, model group, Tianbaoning group, Catalpol 15, 30, 60 mg·kg-1 group. Rats were trained on the gait instrument for 7 days before pMCAO, 3 times/day. After the training, pMCAO model was made. And continuous infusion was performed from the 3rd to the 14th day after the operation. Then, the real-time gait behavior was detected on the 14th day. The re-sults showed that 14 days after the surgery, compared with the normal control group, the models had a significant extending in the duty cycle (P < 0.01), and obvious increasing of the average body angle of absolute value (P <0.05), the shortening of the two feet supporting time (P < 0.05), and extending of three feet supporting time (P <0.01), and increasing of the coordination index (P < 0.01). Compared with the model group, the Catalpol of 30 mg·kg-1 and 60 mg·kg-1 group has obviously decreased duty cycle and average body angle of absolute value (P <0.05, or P < 0.01). The Catalpol of 30 mg·kg-1 can obviously reduce the coordination index of the right front foot relative to the other three feet (P < 0.05), which improved the coordination of cerebral ischemia animals. It was concluded that Catalpol can improve the real-time gait behavior changes of cerebral ischemia model rats. There-fore, Catalpol have a neural protective effect on cerebral ischemia.

Objective To systematically evaluate the postoperative pancreatic fistula rate,overall postoperative morbidity rate,overall postoperative mortality rate and length of stay in external stent group versus no stent group for pancreaticcoduodenectomy.Methods The Cochrane Library,PubMed,Embase and CBM data bases were searched to identify randomized controlled trials that compared the effectiveness of external stent versus no stent for pancreaticcoduodenectany.Meta-analysis was performed using the software RevMan 5.2.Results Four trials with 416 patients comparing external stent with no stent were included,the external stent group with 207 patients and the no stent group with 209 patients.The Meta-analysis revealed that,compared the external stent group with the no stent group,the rate of postoperative pancreatic fistula was significantly reduced in the external stent group [RR =0.57,95％ CI(0.41,0.80),P =0.001],especially for the patinets of pancreatic diameter ≤ 3.0 mm[RR =0.55,95 ％ CI(0.37,0.82),P =0.003] and soft pancreatic [RR =0.67,95 ％ CI(0.45,0.99),P =0.040],the overall postoperative morbidity rate of external stent group versus.no stent group was reduced[RR =0.79,95 ％ CI (0.64,0.98),P =0.030],and length of stay was shortened [WMD =-3.98,95％ CI(-6.42,-1.54),P =0.001].There was no difference between the two groups regarding the postoperative pancreatic fistula rate of diameter ＞ 3.0 mm [RR =0.37,95 ％ CI(0.08,1.83),P =0.220],and the overall postoperative mortality rate [RR =0.86,95 ％ CI(0.28,2.65),P =0.800].Conclusions Exental stent significantly reduced the postoperative pancreatic fistula rate and overall postoperative morbidity rate 、shortened the length of stay,and thus it can be identified as a preferable option for Pancreaticcoduodenectomy.

Objective To explore the relationship between the gait behavior changes and cognitive function in APP/PS1 transgenic mice .Methods 16 APP/PS1 transgenic mice were divided into model group and Huperzine A group, C57/BL6J mice with the same age were chosed as control group .After a 150 days consecutive treatment , Morris water maze(MWM) was used to detect the learning and memory ability and Gait analysis system (GAS-2) was used to detect the gait behavior after the treatment when the mice were 8-month-old.Results The escape latency of the model group was significantly higher than that of the control group ( P <0.05 ) , the time spended in the target quadrant , swimming distance in the target quadrant significantly lower than that of the control group ( P <0.05 ) , the first time passing through the platform prolonged significantly than the control group (P <0.05), and the number of passing though the platform reduced significantly than the control group (P <0.05).In the gait behavior experiments , compared with the control group, the average walking speed of the model group reduced significantly (P <0.05), the average walking cycle, the absolute average body angle and lateral movement increased significantly (P <0.05);The percentage of support time in a walking cycle of the left and right foot increased significantly (P <0.05).Accordingly, the percentage of swing time in a walking cycle of the left and right foot reduced significantly (P <0.05).The propulsion index of the left hand , right hand, right foot increased significantly ( P <0.05), and then the braking index of the above three feet decreased significantly ( P <0.05) .Huperzine A can improve the cognitive function , rectify the changes in the gait behavior .The two behavioral relevance shows that cognitive function and the front two feet braking , propulsion index have a high correlation index (correlation coefficients were -0.433, -0.379, P values were 0.039,0.079), the others were not. Conclusion APP/PS1 transgenic mice of 8-months-old have a remarkable impairment of learning and memory ability and disorder of gait behavior , and these two behaviors have a correlation in some extent .

Objective To explore the correlation of fatigue with health-promoting lifestyle in the udnergraduate students, so as to provide scientific evidence for the intervention. Methods A cross-section trial was carried out in the undergraduate students from a medical university in Guangzhou. By a self-designed questionnaire, the incidence of fatigue in the undergraduate students was figured out after data processing and statistical analysis. Results A total of 6 100 questionnaires were released, and 5 843 were responded, with a respondent rate being 95.79%. The number of effective questionnaires arrived 5 676. The results showed that the prevalence of fatigue among undergraduate students was 49.6%. The female had a higher risk than the male ( 51.6% vs 45.8%, P<0.01). The prevalence of fatigue in grade 1-3 students was 49.4%, 48.1% and 52.1% , respectively, the difference being insignificant among the three grades (P>0.05). The students with poor level of health-promoting lifestyle had a higher risk of suffering from fatigue (OR=6.647, 95%CI: 4.913-8.993). Conclusion Fatigue is prevalent among the undergraduate students. The incidence of fatigue can be reduced by increasing the level of self-actualization, physical exercise and pressure management.