BACKGROUND:The operation of bile duet has always been the most difficult part in the general surgery.The Patients have a high morbidity of the post-operative complications,such as bile duct stenosis,repeated biliary tract infection,and even biliary hepatocirrhosis.Therefore.we are seeking for some kind of artificial bile dlIct to take the place of the damaged one.and then solve the problem in bile duct's repair and reconstruction.OBJECTIVE:This paper reviewed the Iong-term plenty of related studies and litcratures.and then summarized the latest progress of the design and improvement of artificial bile duct.So we could design the optimum artificial bile duct.RETIUEVAL STRATEGY:A computer-based online search of PubMed database (http://www.pubmed.gov/)was undertaken to identify articles about artificial bile duct published in English from January 1959 to December 2007 with keyword of"artificial bile duct,stem cell,tissue engineering".Meanwhile,Chinese articles about artificial bile duct published from January 1994 to October 2007 were retrieved in China National Knowledge Infrastructure(CNKI,http://www.cnki.net),the keyword was"artificial bile duct,stem cell,tissue engineering"in Chinese.Inclusion criteria:①laboratorial and clinical researches about artificial bile duct;② clinical researches about the stem cells;③researches about tissue engineering and biocompatible materials.Exclusion criteria:repeated study.Initial reading these literatures and finding the full text,37feferences were included from the gleaning 414 literatures.LITERATURE EVALUATION:A total of 37 articles were involved.ineluding 10 about background.5 about autotransplant,5 about stem cell technique,2 about nanotechnology,1 about structure of mechanical bile duct,2 about macromolecular materials.and 12 about the latest progress.DATA SYNTHESIS:To analyze and sort out these literatures.the artificial bile duct from biocompatible materials and biomedical engineering is analyzed.The developments in autotransplantation,mechanical structure,nanotechnology,stem cell technique and tissue-engineered macromolecule material have been retained.So far,the tissue-engineered macromolecule material is the best one.Further study aiming at the better artificial bile duct is needed.CONCLUSION:There have been great progresses in research of artificial bile duct,however,there is no significant achievement because of the inextricable shortcomings and limits in autotransplantation,mechanical structure,nanotechnology and stem cell teehnique.Therefore.the tissue-engineered macromolecule material has become the best material for artificial bile duct.

BACKGROUND: Fluoroelastomer-246B has better histocompatibility than polyethylene and polypropylene, which is the same as expanded polytetrafiuoroethylene (ePTFE). Besides, fluoroelastomer-246B has better rigidity than ePTFE, so it is hard to deform.OBJECTIVE: To investigate the feasibility of fluoroelastomer-246B as a human implant in vivo and a substitute of human bile duct by the test of bile soak, routine sterilized method, and implantation into rat abdominal cavity.DESIGN: A controlled observation.SETTING: First Hospital of Jilin University & Key Laboratory of Education Ministry for Supramolecular Structure and Material of Jilin University.MATERIALS: This study was performed at the Key Laboratory of Education Ministry for Supramolecular Structure and Material of Jilin University from June 2006 to March 2007. A total of 35 male Wistar rats of clean grade, aged 4-5 weeks,weighing 140-160 g, were provided by Laboratory Animal Center, School of Basic Medical Sciences, Jilin University [Permission No. SCXK (Ji) 2003-0001]. Prior to surgery, the Wistar rats were fasted for 5 hours, but they were allowed to access to water freely. The main materials used in the present study were as follows: fluoroelastomer-246B (Yangzhong Municipal Rubber & Plastics Plant, China), ePTFE(Shanghai Suo-Kang Medical Implants Co.,Ltd., China).METHODS: Rectangular fluoroelastomer-246B thin slices (50 mm×10 mm×0.5 mm) made were placed in a beaker filled with fresh bile, and preserved in a 37 ℃ thermostat container. The tensile strength, thermal decomposition temperature and glass transition temperature of fluoroelastomer-246B were tested after 30 days, and the results were compared to those before soaking to investigate whether the physical-chemical properties of fluoroelastomer-246B slices would change after soaking in the bile environment for a long time. The rectangular fluoroelastomer-246B thin slices made as above were sterilized by boiling method, formaldehyde vapors fumigating method, and formaldehyde fluid soaking method. The indices mentioned above were measured, and the data were compared to those before sterilizing to identify whether fluoroelastomer-246B could be used after sterilizing. The same-size slice of fluoroelastomer-246B,ePTFE, polypropylene and polyethylene was separately implanted into rat abdominal cavity. The slices were taken out after 30 days, and the pathological sections of surrounding tissues were made to observe whether allergic response and/or inflammatory reactions existed.MAIN OUTCOME MEASURES: After fluoroelastomer-246B thin slices were soaked in bile for 30 days, their tensile strength, thermal decomposition temperature and glass transition temperature were tested, and the results were compared to those before soaking. After fluoroelastomer-246B thin slices were sterilized by boiling method, formaldehyde vapors fumigating method, and formaldehyde fluid soaking method, the indices mentioned above were measured, and the data were compared to those before sterilizing. The numbers of cells with allergic response and cells with inflammatory reaction were counted.RESULTS: After soaking in the fresh bile for 30 days, the tensile strength, thermal decomposition temperature and glass transition temperature of fluoroelastomer-246B changed slightly compared to before soaking (P＞0.05).Fluoroelastomer-246B could well antagonize mechanical stress after bile soaking and sterilizing. Under going sterilizing by boiling method, formaldehyde vapors fumigating method and formaldehyde fluid soaking method separately, the tensile strength, thermal decomposition temperature and glass transition temperature of fluoroelastomer-246B had no marked changes (P＞0.05). No noticeable allergic response was observed after fluoroelastomer-246B was implanted into rat abdominal cavity, whereas slight inflammatory reaction was detected, which was similar to ePTFE (P＞0.05).CONCLUSION: The primary physical-chemical properties of fluoroelastomer-246B do not change after soaking in bile for 30 days. Fluoroelastomer-246B can well antagonize mechanical stress and be used after sterilizing without metaphysis or allergic response. Therefore, fluoroelastomer-246B can be used as a substitute of bile duct.

0.05). At day 30 after operation,half-pipe blockage occurred,and some yellow-green sediments were observed on the pipe wall in the straight tube group; a few of yellow-green sediments were found at top of wall,and some white floc sediments were observed in lumen but nothing was observed on valve in the venous valve tube group; a few of yellow-green sediments were found on pipe wall near the living valve,and some white floc sediments were observed in bile in the living valve tube group. At day 30 after operation,epithelium of mucous membrane was not intact,and gland proliferated lightly in the straight tube group; epithelium of mucous membrane was generally intact,and proliferation of gland was not found in the venous valve tube group; epithelium of mucous membrane was exactly intact,and glandular epithelial cells were not heteromorphism in the living valve tube group. CONCLUSION:The artificial bile ducts with a valve structure and living value structure has a good patency and plays an effective role of anti-reflux after a short-term observation,suggesting that a valve structure acts as a similar function to Oddis sphincter.

Objective To evaluate the diagnosis and treatment of residual gallbladder.Methods The diagnosis of residual gallbladder depends on a history of previous cholecystectomy and postoperative existent symptoms suggesting cholecystitis.In this series the diagnosis was finally established by ultrasonography and laparotomy in 52 cases.Results Ten cases received laparoscopic residual cholecystectomy,32 cases underwent residual cholecystectomy,7 cases did residual cholecystectomy plus common bile duct exploration,1 case was treated with residual cholecystectomy,common bile duct exploration and left lateral lobe hepatectomy,1 case with residual cholecystectomy,common bile duct exploration,cholangioenterostomy,1 case by radical resection of residual gallbladder cancer.Conclusions Residual gallbladder is a secondary disease,diagnosis is not difficult,surgery has certain difficulty,the application of intraoperative ultrasound and choledochoscope has great value.

Objective To evaluate effects of two different preoperative biliary drainages on patients of malignant obstructive jaundice complicated with acute cholangitis.Methods Retrospective analysis was made on effects of two preoperative biliary drainages of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD) in cases of malignant obstructive jaundice complicated with acute cholangitis.Results Days of preoperative drainage(t =3.217,P ＜ 0.05) and declines of bilirubin level after drainage (t =3.178,P ＜ 0.05) were significantly better in ENBD group (26 cases) than PTCD group (22 cases).There were no significant differences between two groups in operation time length and intraoperative blood loss after drainage.However,postoperative hospital stay (t =2.542,P ＜ 0.05) and overall stay (t =3.172,P ＜ 0.05) were significantly shorter in ENBD group compared with PTCD group.Conclusions When preoperative biliary drainage is indicated in the cases of malignant jaundice before radical surgery,ENBD should be the first choice over DTCD.

Objective:To observe the stoichiometry of vascular endothelial growth factor receptor 2 (VEGFR2) on the retinal vascular endothelial cell membrane by single-molecule fluorescence imaging.Methods:Rhesus monkey retinal vascular endothelial cells (RF/6A) were divided into blank control group (normal culture) and plasmid transfection group [transfected with VEGFR2-green fluorescent protein (GFP) recombinant plasmid]. The expression of GFP in the plasmid transfected group was observed by confocal microscope, and the expression of VEGFR2 in the cells was detected by real-time fluorescent quantitative polymerase chain reaction (qPCR) and Western blot. The fluorescence intensity distribution and bleaching steps of single VEGFR2-GFP molecule on the cell membrane were recorded by single-molecule imaging. The distribution of fluorescence intensity and the number of fluorescence bleaching steps of GFP were recorded.Results:GFP green fluorescence was observed in the transfected cells 12 hours after transfection. qPCR results showed that the expression of VEGFR2 and GFP mRNA in the plasmid transfected group was significantly higher than that in the blank control group ( t=11.240, 12.330; P<0.001, 0.001). Western blot results showed that the expression of VEGFR2 protein in the plasmid transfected group was significantly higher than that in the blank control group ( t=8.346, P<0.01). The results of single-molecule imaging showed that the fluorescence intensity distribution of VEGFR2-GFP on the surface of RF/6A cell membrane without ligand stimulation was bimodal, in which monomer and dimer were 86.0% and 14.0% respectively. By counting the steps of GFP fluorescence bleaching, the proportions of receptor monomer, dimer, trimer, and tetramer were 81.4%, 12.9%, 5.5%, and 0.3% respectively. Conclusion:In the absence of ligands, VEGFR2 coexists in the form of monomers and dimers on the surface of RF/6A cell membrane, and monomers are dominant.

Objective: To explore the international development trends and research hotspots of outdoor activities affecting the progression of children’s myopia, and to provide a reference for researching on effective ways to prevent children’s myopia. Methods: Totally 291 relevant documents included in the "Web of Science" core set database were used as research objects, and CiteSpace software was used for visual analysis. Results: At present, the publications in this field were mainly in the United States(81), China(80), Australia(76), and Singapore(33); the top three research institutions were "Natl Univ Singapore"(29), "Australian Natl Univ"(27), "Capital Med Univ"(25); the main authors were "Saw SM", "Morgan IG", "Mitchell P". The field has been developed on the basis of "Ophthalmology", "Public, Environmental and Occupational Health", and has been integrated into 32 disciplines. The research content included "exploration of high risk factors for the progression of children’s myopia" and "outdoor activities", "intervention in children’s progression of myopia" and "longitudinal tracking of children’s vision development". Randomized clinical trials that longitudinally track the correlation between changes in eyeballs and the progression of myopia and the effects of outdoor activities on the biological characteristics of children’s eyeballs have become a hot topic in this field. Conclusion Research on the effects of outdoor activities on the progression of myopia in children has increased dramatically. The study of increasing outdoor activities to interfere with the progression of myopia in children and the vertical tracking of key factors affecting the biological characteristics of children’s eyeballs have become the current international trends.

Objective: To evaluate the efficacy and safety of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy. Methods: A retrospective analysis was carried out on 184 patients who underwent laparoscopic pancreaticoduodenectomy using Hong's pancreaticojejunostomy (the Hong’s pancreaticojejunostomy group) compared with 100 patients who underwent laparoscopic pancreaticoduodenectomy using traditional pancreaticojejunostomy (the traditional pancreaticojejunostomy group) at Department of Second Hepatobiliary and Pancreatic Surgery, the First Bethune Hospital of Jilin University, from April 2016 to December 2018. The differences between the two anastomotic methods in operation time, pancreaticojejunostomy time, intraoperative blood loss, postoperative hospital stay, postoperative complications, and incidences of pancreatic fistula were compared. Results: The operation time, pancreaticojejunostomy time and intraoperative blood loss of the Hong's pancreaticojejunostomy group were significantly less than the traditional pancreaticojejunostomy group [(278.2±49.3) min vs. (337.3±67.4) min, (33.7±6.6) min vs. (46.8±8.5) min, (123.1±44.7) ml vs. (203.8±138.6) ml], respectively, (all P<0.05). There were no significant differences in postoperative hospital stay and pancreatic fistula rates between the two groups (all P>0.05). Conclusions Hong's pancreaticojejunostomy was safe, rapid and effective compared with traditional pancreaticojejunostomy. It did not increase the incidence of pancreatic fistula.

Pain in the cervical region of air force pilots, who are exposed to high G-forces, is a specifically occupational health problem. To minimize neck problems, the cervical muscles need specific strength exercise. It is important that the training for the neck must be carried out with optimal resistance in exercises. The model NSE-1 neck training machine for pilots was designed for neck strengthening exercises under safe and effective conditions. In order to realize the functions of changeable velocity and resistant (CVR) training and neck isometric contractive exercises, the techniques of adaptive hydraulics, sensor, optic and auditory biological feedback, and signal processing were applied to this machine. The training system mainly consists of mechanical parts (including the chair of flexion and extension, the chair of right and left lateral flexion, the components of hydraulics and torque transformer, etc.), and the software of signal processing and biological feedback. Eleven volunteers were selected for the experiments of neck isometric contractive exercises, three times a week for 6 weeks, where CVR training (flexion, extension, right, left lateral flexion) one time a week. The increase in relative strength of the neck (flexion, extension, left and right lateral flexion) was 70.8%, 83.7%, 78.6% and 75.2%, respectively after training. Results show that the strength of the neck can be increased safely, effectively and rapidly with NSE-1 neck training machine to perform neck training.
Aerospace Medicine ; Aircraft ; Equipment Design ; Exercise ; physiology ; Humans ; Military Personnel ; Neck Muscles ; injuries ; physiology ; Neck Pain ; etiology ; prevention & control ; Physical Education and Training ; Posture

Objective To investigate the value of urodynamic study(UDS)in guiding the treatment of lower urinary tract dysfunction(LUTD)in elderly patients with ischemic stroke(IS)during convalescence,in order to provide reference for clinical treatment.Methods A total of 50 LUTD patients with IS who were admitted to the First Affiliated Hospital of Xinxiang Medical University during Jan.2020 and Jan.2022 were selected.Oral tolterodine was administered to patients with detrusor overactivity(DO),clean intermittent catheterization(CIC)to those with no detrusor reflex and symptomatic increased residual urine,and oral administration of tamsulosin to those with functional obstruction of bladder outlet.The lower urinary tract symptoms(LUTS)relief rate,UDS parameters and quality of life(QoL)scores were compared before treatment and 3 months after treatment.Results The UDS examination results showed that 25 cases(50.0％)had simple DO,9 cases(18.0％)had DO with impaired detrusor muscle contraction function,5 cases(10.0％)had DO with bladder outlet functional obstruction,4 cases(8.0％)had no detrusor reflex,and 7 cases(14.0％)had simple bladder outlet functional obstruction.After 3 months of treatment,the symptoms of LUTS,including frequent urination,urgent urination,incontinence,dysuria and urinary retention were significantly improved(P＜0.05).The maximum urine flow rate and urine output were significantly increased,the residual urine volume was significantly reduced,QoL scores were significantly reduced,with significant differences(P＜0.001).Conclusion UDS is significant in guiding the treatment of LUTD in elderly patients with IS during convalescence.