Objective To investigate the salty, efficacy and feasiblify on eholedochotomy with endobiliary drainage and prumary closure of the common bile duct. Methods There were 20 partients without introhepatic or re-tained stones and biliary stricture underwent common bile duet exploration. 20 of them with endobiliary tube drainage and primary CBD closure and the other 20 patients with T tube drainage. Results The average of the time to return routine home was (9. 2 ±1. 3)d, (15. 2 ± 3.6) d(P < 0. 01). The hospital expense of postoperation was (3 252± 312)Yuan,(4 116±388)Yuan(P<0.01). Conclusion Choledochotomy with endobiliary catheter and primary closure of CBD is a safe, effective and feasible procedure for the management of choledochohthiasis.

ObjectiveTo study the diagnosis and trea tm ent of bilateral renal angiomyolipomas.MethodsThe clin ic data of 13 cases of bilateral renal angiomyolipoms were reviewed.There were 2 male and 11 female patients with an average age of 42.Preoperative ultrasonogra phy and CT scanning have been undertaken in all.Renal angiomyolipoma was diagnos ed in 11 and cancer nodules could not be ruled out in the other 2.Unilateral and bilateral renal sparing surgerys were carried out in 5 and 8 cases respectively .ResultsAll cases were examined with rapid frozen sect ion analysis at operations.The renal function of all the patients except 1 was n ormal after operation except 1 with a temporary rise in Scr (350 ?mol/L).The pa tients have been followed up 1 to 4 years after discharging from hospital and th e renal function became normal in all.No recurrence was found.Conc lusionsUltrasonography and CT are important methods to diagnose ang iomyolipoma with specific manifestations.Rapid frozen section analysis at operat ions is helpful to diagnose and to choose the correct surgical technique.Attenti on should be paid to reserve the renal tissues as much as possible and renal fun ction should be protected properly.

Objective To evaluate the capability of virtual non-contrast (VNC)of the second-generation dual-source CT (DSCT), and to display the adipose tissue of gastric serosa.Methods 48 patients with gastric cancer undergoing preoperative DSCT and sur-gery were enrolled.The true non-contrast (TNC)values and VNC values of perigastric adipose tissue were measured and compared with conventional non-contrast scanning and VNC of arterial phase and venous phase.The VNC values of perigastric adipose tissue were compared between serosal involvement group and non-serosal involvement group.Results There was statistical difference be-tween TNC values and VNC values of perigastric adipose tissue (P <0.05),the absolute differences were under 13 HU.The differ-ence of VNC values between serosal involvement group and non-serosal involvement group was significant (P <0.05).Conclusion VNC of the second-generation DSCT can clearly display the adipose tissue of gastric serosa.It has certain capability in judging sero-sal involvement.VNC has the proficiency to replace conventional non-contrast scanning.

Objective To estimate the effect of itermittent subglottic secretions drainage(ISSD)on management of artificial airway to prevent tube-related pulmonary pneumonia.Methods One hundred ICU patients with intubation for artificial airway were divided equally into control and experiment group by random digits table.Both were managed with construction of artificial airway and besides the experiment group received ISSD. The two groups were compared in terms of incidence and occurrence time of catheter-related pneumonia, time for airway opening and ICU stay.Result The incidence and the occurrence time of pneumonia, time for airway opening and ICU stay time in the experiment group were significantly lower or shorter than those in the control group with statistical difference(all P<0.05).Conclusion ISSD is effective in decreasing the incidence of catheter related pneumonia, shortening the occurrence time of catheter related pneumonia and ICU stay time for the patients with artificial airway.

Objective To evaluate the efficacy and safety of lamivudine combined with thymosin α1 therapy for patients with chronic hepatitis B.Methods Sixty-eight eligible patients with chronic hepatitis B were enrolled in this multi-center randomized controlled rlinical trial.Patients were randomized into the trial group and the control group(n=34 for each).Patients in trial group received thymosin α1 for 6 months and lamivudine for 12 menths:patients in control group received lamivudine for 12 months only.The rates of serum HBV DNA clearance.HBeAg loss,HBeAg seroconversion,ALT normalization and the safety of thymosin α1 were observed at 3rd.6th,12th and 18th month during and after the treatment.Results At 12th month of the treatment,there were significant differences in the rates of serum HBV DNA clearance,HBeAg loss and ALT normalization between two groups(χ2=31.17,7.17 and 5.92,P＜0.05);at 6th month after the treatment.there were significant differences in the rates of sernm HBV DNA clearance and HBeAg loss between two groups(χ2=4.53 and 7.17,P＜0.05).HBV DNA was not detected in 2 patients during 6-month follow-up study and no sever side effect was observed throughout the study.Conclusion The conlbination of lamivudine and thymosin α1 is safe and has better effect than the monotherapy of lamivudine in patients with chronic hepatitis B.

Objective To investigate the value of external counterpulsation and traction therapy on patients with vertebral artery insufficiency syndrome by use of transcranial Doppler (TCD). Methods Based on the criteria of clinical diagnosis, 86 patients with vertebral artery insufficiency syndrome and 60 healthy persons were examined by EME 4004 type TCD. The peak velocity (Vp) and mean velocity (Vm) of blood flow of the vertebral artery (VA) and basilar artery (BA) were detected and analyzed before and after rehabilitation treatment. Results The blood flow velocities of the vertebrobasilar artery (VBA) of the patient group were much lower than that of the control group ( P 0.05). Conclusion TCD examination while rotating neck could provide valuable information for the diagnosis and rehabilitation assessment of patients with vertebral artery insufficiency syndrome. External counterpulsation and traction therapy are effective in the treatment of the vertebral artery insufficiency syndrome.

Objective To explore the blood-saving and conservation effect and clinical prognosis of extracorporeal circulation circuits designed individually by using medical polymeric materials for adults and infants in cardiac surgical procedures.Methods A total of 41 new extracorporeal circulation circuits designed based on the operation requirements,including 20 for adults and 21 for infants,were applied on adults and infants (body weight less than 10 kg),and the results were compared with that of the conventional circuits on adults (20) and infants (19)respectively.Total priming volume,priming and intraoperative blood products consumption,pump pressure,intraoperative blood hemoglobin (Hb) level,free Hb (f-Hb),platelet (Plt) count,mixed venous oxygen saturation (SvO2),colloid osmotic pressure (COP),lactate (Lac) level,Hb level after modified ultrafiltration,endotracheal intubation time and ICU time were all collected in two groups.Results Priming volume,priming and intraoperative blood consumption and f-Hb level in the blood-saving and conservation circuits group were significantly lower than that of conventional circuits group (P＜0.05).There were no significant differences (P＞0.05) between the two groups in pump pressure,intraoperative blood Hb level,Plt,SvO2,COP,Lac level,Hb level after modified ultrafiltration,endotracheal intubation time and ICU time.Conclusions The minimized blood conservation extracorporeal circulation circuit plays an important role in reducing priming volume and blood transfusion.It maintains a normal level of hemodynamics,oxygenation and tissue perfusion level during cardiopulmonary bypass in cardiac surgery for adults and infants.Red blood cell destruction can be reduced by improving blood compatibility,and physical data are all stabilized intra and post operation.This new circuit is secure,with its better outcome,expected in application.

Objective:To construct an ethical system to guide the practice of rehabilitation in China based on the ethical principles of health services, in conjunction with the environment and ethical concepts of rehabilitation services in Chinese community. Methods:To review the ethical historiography of rehabilitation medicine, analyze the ethical setting of rehabilitation medicine, and summarize the practice of ethical conducts of rehabilitation medicine in national rehabilitation institutions. Results:The development of ethics in rehabilitation medicine was systematically analyzed, the principles and methods of ethical setting in rehabilitation institutions were elaborated, and the methods of ethical setting and practice in national-level rehabilitation institutions were explored. Conclusion:The connotation and methods of ethical setting in rehabilitation and the path and methods of practicing ethical guidelines in national-level rehabilitation institutions were systematically discussed.

OBJECTIVETo explore the effect of emodin on endoplasmic reticulum (ER) stress of pancreatic acinar AR42J cells.

METHODRat pancreatic acinar AR42J cells were cultured in 6-well plates, and divided into the normal control group, the model group (with the final concentration at 1 x 10(-7) mol · L(-1) for cerulean and lipopolysaccharide at 10 mg · L(-1)) and the emodin group (10, 20, 40 μmol · L(-1)). Cells in each group were cultured in three multiple pores for 24 h, and their supernate was removed after cell attachment. The normal control group was added with haploids, the model group was added with the modeling liquid for haploids, and the treatment groups were added with different concentrations of emodin at 15-20 min before the modeling liquid. The cells were continuously cultured for 3 h under 37 °C and 5% CO2. Their intracellular protease and lipase expressions were detected with kits. The cellular morphology was observed under optical microscope. The level of calcium in endoplasmic reticulum was measured under laser confocal microscopy. Western blot assay were used to determine the protein expression of ER-related signaling molecules.

RESULTEmodin could significantly inhibit levels of amylase, lipase and intracellular calcium and ER.

CONCLUSIONEmodin could reduce pancreatic acinar cell injury induced by the combination of cerulean and lipopolysaccharide. Its action mechanism is correlated with the inhibition of intracellular calcium overload and ER stress.

Animals ; Calcium ; metabolism ; Cell Line, Tumor ; Emodin ; pharmacology ; Endoplasmic Reticulum Stress ; drug effects ; Pancreatic Neoplasms ; metabolism ; pathology ; Rats ; Unfolded Protein Response ; drug effects

Objective To study the correlation between expression of COX-2,Ki-67 and neoadjuvant chemotherapy in breast cancer.Method COX-2 and Ki-67 were examined by immunohistochemical staining in 48 breast cancer samples.Results The overall response rate and clinical benefit rate to neoadjuvant chemotherapy were 70.8% and 95.8%,respectively.The expression of COX-2 and Ki-67 after the chemothempy [41.7% and (33.23±18.11)%] was significantly lower than those in prechemotherapy [62.5% and (46.81±23.17)%],P<0.05.Ki-67 index Was higher in COX-2 positive tumom than that in the COX-2 negative ones before and after neoadjuvant chemotherapy,P<0.01.The effect of neoadjuvant chemotherapy had a significantly negative correlation with COX-2 expression.Patients with high expression of Ki-67 were more likely to respond to treatment.Conclusion The expression of COX-2 and Ki-67 as molecular markers could be a guide for chemotherapy and prediction for neoadjuvant's response to chemotherapy in breast cancer.