Objective To explore the extrahepatic bile duct stones after reoperation cause analysis and coun-termeasures.Methods Clinical data of 150 patients with liver surgery gallstone surgery again were retrospectively analyzed,according to the first reason for liver from gallstone surgery will be divided into the three groups:group hepa-tolithiasis ( group A,100 cases) ,gallstones group ( group B,30 patients) ,common bile duct stones group ( group C, 20 cases) .The reasons for reoperation were analyzed.Results In intrahepatic bile duct stones reoperation patients, the recurrence of liver gallstones was 98 cases(65.3%),common bile duct cysts and Caroli disease was 35 cases (23.3%),anastomotic stenosis in 17 cases(11.3%);The postoperative complication rate of group A(44.0%) was significantly higher than that of group B(13.3%) and group C(15.0%)(χ2 =9.32,5.88,all P<0.05);The sec-ondary and post-operative inflammation stone recurrence within 5 years of group A was 32.0%,which was significant-ly higher than 6.7%of group B and 10.0%of group C(χ2 =7.67,3.97,all P<0.05).Conclusion The intrahe-patic bile duct stones are the main types of reoperation after liver gallstones,gallstones and liver recurrence is the main cause of its secondary surgery.It should be make clear the disease cause of preoperation, take a different surgical options for patients with different types of stones,prevention,and avoid the occurrence of postoperative complications, which can effectively reduce the risk of secondary surgery to alleviate the suffering of patients.

The left to right shunt rate(F)and the transverse seetional area of ductus arteriosus(A)were calculated by color Doppler flow convergence method in 20 patients with patent ductus arteriosus.The results indicated that the shunt rate(F)was correlated fairly with Qp-Qs,Qp/Qs(measured by pulsed wave Doppler),the pressure gradient(△P)and the diameter of left ventricle(DLV)(r=0.81,0.62,0.69 and 0.53;P＜0.001,0.005,0.001 and 0.01,respectively).The transverse sectional area of ductus arteriosus(A)was also correlated closely with the diameter of ductus arteriosus(Dd)measured directly in two-dimensional view(r=0.81,P＜0.001).The F value of group Qp/Qs≥2:1 was apparently higher than that of group Qp/Qs＜2:1(P＜0.005).The color Doppler flow convergence method can rapidly and exactly evaluate the left to right shunt severity of patent ductus arteriosus.

BACKGROUND:FoxO1 participates in diverse processes of cellphysiology, including cellproliferation and apoptosis, reactive oxygen species, longevity, cancer, the regulation of cellcycle and metabolism. Vibration loading is believed to promote metabolism, delay muscle fatigue, and facilitate adaptive bone reconstruction. OBJECTIVE:To investigate the effects of whole-body vertical vibration on the protein expression of FoxO1 in tibia and bone marrow cellof ovariectomized (OVX) osteoporosis rats.
METHODS:Thirty-six healthy 3-month-old female Sprague-Dawley rats were randomly divided into the fol owing three groups by body weight:sham-operation (sham) group, OVX group, and OVX whole-body vertical vibration (OVX+V) group. At the 11th week after operation, the OVX+V group rats were vibrated on a vibration platform twice per day for 7 weeks according to the fol owing schedule:whole-body vertical vibration for 15 minutes, with an interval of 10 minutes. The frequency was 90 Hz and the amplitude was 0.5 mm. Within 24-48 hours after the last treatment, the fifth lumbar vertebra as wel as the right femur and tibia were isolated. The bone mineral density of the fifth lumbar vertebra and right femur was detected by dual-energyΧ-ray absorptiometry. The FoxO1 protein expression in proximal tibia and bone marrow cells was detected by western blot assay.
RESULTS AND CONCLUSION:As revealed by the results of bone mineral density, the bone mineral densities of the proximal and distal femur as wel as the fifth lumbar vertebra in OVX+V group were significantly increased while no significant difference could be seen in the mid shaft. As revealed by the results of western blot, there was no FoxO1 protein expression in the tibia, but it could be detected in the bone marrow cells. Compared with the sham group, there was no significant difference in FoxO1 protein expression in bone marrow cells of OVX group;compared with the OVX group, the protein expression level of FoxO1 in bone marrow cells of the OVX+V group was significantly reduced. The results suggested that whole-body vertical vibration could inhibit the protein expression of FoxO1 in bone marrow cells of osteoporosis rats.

Objective To study the genotoxicity of 3 kinds of different brands shampoo to Vicia faba root tip cells. Methods To take root tip cells of Vicia faba as the subjects,genetic safety tests were conducted on those materials treated with shampoo of a certain concentration(0.25% ) for 2-8 h of continual mutagenesis and accumulative mutagenesis respectively,micronucleus and chromosomal aberration was observed and calculated,the rate of tap water was used as the control. Results Three kinds of shampoo could induce root tip cells of Vicia faba to produce micronucleus and chromosomal aberration,the peak was in the continual mutagenesis for 4 h and accumulative mutagenesis for 8 h respectively,which showed dose-effect relationship. There were significant differences between the control group and the experimental groups( P

Objective To investigate the effects of changes in protein bile sugar chain structure for differen-tiating benign and malignant biliary tract disease .Methods 100 patients with biliary tract diseases who were treated in Department of General Surgery ,Qingdao Haici Medical Group were selected in this study .According to benign or malignant biliary disease ,the patients were divided into control group ( benign biliary tract disease ) and observation group ( cholangiocarcinoma ) ,50 cases in each group .Two groups of patients with bile drops on the nitrocellulose mem-brane,through the comparison of wheat germ agglutinin (WGA),Datura stramonium agglutinin (DSA),lentil lectin (LCA),concanavalin A(CONA) positive rate of test,to explore the relationship between sugar chain of glycoprotein in bile and bile duct benign and malignant diseases .Results In control group,the positive rates of WGA,DSA,LCA, CONA agglutinin test were 22.0%,14.0%,2.0%,76.0%,those in the observation group were 76.0%,66.0%, 76.0%,82.0% respectively.No statistically significant difference between the two groups of CONA agglutinin test positive rate was observed(P>0.05).The WGA,LCA,DSA agglutination test positive rates in observation group were significantly higher than those in the control group ,the differences were statistically significant (χ2 =29.17,28.17, 57.55,all P<0.05).Conclusion Changes in bile glycoprotein chain structure are closely related to benign and ma -lignant biliary tract disease ,positive rates of WGA ,LCA,DSA agglutination test can be used to determine the benign and malignant biliary disease ,it should be popularized in clinical practice .

Objective Few researches have been reported on the gene methylation in children with steroid-sensitive nephrot-ic syndrome (SSNS) or steroid-dependent nephrotic syndrome (SDNS).This study aimed to investigate the possible pathogenesis and therapeutic target of SSNS and SDNS by screening differentially methylated genes ( DMGs) and bioinformatic analysis using DNA meth-ylation microarray. Methods This study included 3 hospitalized children with SSNS and another 4 with SDNS, all treated with full dose of prednisone ( 2 mg per kilogram of the body weight per day or 60 mg per m2 per day).Negative urine protein was achieved within 4 weeks in the former group , while the latter , though sensitive to hor-monal therapy , relapsed within 2 weeks after drug withdrawal or dose reduction .DNA was extracted from the peripheral blood of the patients in both groups for screening DMGs and bioinformatic analysis using DNA methylation microarray . Results Compared with the patients with SSNS, 318 DMGs were found in the SDNS group , among which 193 were hypermethylated and the other 125 hypomethylated .These abnormal genes were mainly located in the open reading frame of DNA and the CpG island region .DMGs were mainly involved in Rho guanyl-nucleotide exchange factor activity , nucleoside-triphosphatase regulator activity , GTPase activator activity , and other molecular functions .The biological processes were chiefly associ-ated with the regulation of the generation of precursor metabolites and energy , antigen processing and presentation , regulation of Rho and Ras protein signal transduction , lamellipodium assembly , regeneration , and other biological processes .The cell composition was mainly related to MHC protein complexes , perichromatin fibrils , and the MHC class I protein complex .Analysis of the KEGG signaling pathway showed that DMGs participated in 9 signaling pathways , involving type I diabetes , starch and sucrose metabolism , allograft re-jection, autoimmune thyroid disease , and others. Conclusion The heterogeneity of methylation is widespread in children with SDNS and may be one of the causes of steroid dependence , which has provided a basis for searching for potential therapeutic targets .

microRNAs play an important regulative role in body's growth and development,and the development of the disease process.Much microRNAs can maintain normal kidney function and regulate kidney pathological process,the miR-30a has extensive effect on kidney development and progression of renal diseases.In this review,a brief overview on the role of miR-30a in renal pathology is presented.

Steroid-resistant nephrotic syndrome (SRNS) is a relatively difficult clinical type of treatment.The major therapy measures in present include steroid and immunosuppressant.Commonly used immunosuppressant include tacrolimus,cyclosporin,cyclophosphamide,mycophenolate mofetil,ect.Tacrolimus-induced clinical remission rate is superior to other immunosuppressive agents,has been the first-line agent of SRNS.Because of the individual difference in metabolism,the drug concentration of tacrolimus should be determined periodically.In order to obtain optimal efficacy of tacrolimus and reduce renal toxicity,the treatment protocols of small doses with long courses for children with SRNS were recommended.

Objective Through selecting abnormal DNA methylation of children steroid resistance nephrotic syndrome and bioinformatics analysis to find the pathogenesis of steroid resistance nephrotic syndrome and provide new targets for therapy. Methods We use illumine 450K methylation chip to detected blood gene DNA methylation of 9 cases of children primary nephrotic syndrome. 9 cases were divided into 2 groups: G1 is the group of steroid sensitive nephritic syndrome, a total of 4 cases; G2 is the group of steroid resistance nephrotic syndrome, a total of 5 cases. Selected the abnormal DNA methylation in children steroid resistant nephritic syndrome, clarified the function of those genes through using functional annotation of gene GO, enrichment analysis and KEGG pathway analysis, conducted the preliminary analysis on children with steroid resistant nephrotic syndrome of gene methylation. Results Compared with the control group, G2 has a number of genes that were extensively methylated. According to the results of bioinformatics analysis, the abnormal DNA methylation in G2 is the components of the various kinds of organelles and cell membrane. They also regulated the polymerization and composition of cytoskeleton and actin, as well as involved in the process of metabolism of many amino acids and drug. Conclusions The abnormal DNA methylation in the group 2 have extensive role, offering possibility of clinical prediction and provided potential therapeutic targets.

Objective:To analyze the clinical materials of 2 patients with lung cancer complicated with syndrome of inappropriate secretion of antidiuretic hormone (SIADH),and to improve the clinical awareness and management.Methods:One patient was treated with lung cancer chemotherapy alone for 7 courses.The other patient received the strictly limited for liquid intake and tolvaptan by oral against hyponatremia without chemotherapy.Results:With the relapsing and advancing of lung cancer,the hyponatremia and its relevant symptoms of the first patient were poorly relieved.While the level of serum sodium of the second patient returned to the normal level 3 d after administration of tolvaptan.Conclusion:About one-third of the patients with hyponatremia have SIADH.The etiological treatment and symptomatic therapy of hyponatremia should be given to the patients in clinical treatment.