Objective:To study the safety and efficacy of primary closure of non-dilaed common bile ducts (CBD) after laparoscopic common bile duct exploration.Methods:A retrospective study was conducted on the clinical data of 120 patients who underwent primary closure of CBD after laparoscopic CBD exploration (LCBDE) at the Shengjing Hospital of China Medical University from April 1, 2014 to November 30, 2019. There were 44 males and 76 females, aged 22.0 to 88.0 years, (average age of 57.2 years). These patients were divided into the dilated CBD group (diameter of CBD >8 mm) and the normal CBD group (diameter of CBD ≤8 mm). The following factors, including operating time, intraoperative bleeding, postoperative hospitalization stay, abdominal drainage tube indwelling time and postoperative complications were compared.Results:The dilated CBD group consisted of 76 patients, with 25 males and 51 females, and a median age of 62.5 years. The normal CBD group consisted of 44 patients, with 19 males and 25 females, and a median age of 57.5 years. There were no significant differences in gender, age, albumin level, total bilirubin and other baseline data between groups ( P>0.05). The operation times of the two groups were: the normal CBD group [106.6(87.3, 146.3] min vs the dilated CBD group [112.0(90.5, 134.5)] min; intraoperative blood loss [the normal CBD group 20(10, 30)ml vs dilated CBD group 20(10, 20)ml]; postoperative hospital stay [the normal CBD group 7.0 (5.3, 9.0) d vs the dilated CBD group 7.0 (5.0, 7.0) d]; and postoperative abdominal drainage tube removal time [the normal CBD group 6 (4, 7) d vs the dilated CBD group 5 (4, 6)d]. The differences were all not significant ( P>0.05). There was also no significant difference in the incidences of postoperative complications (including bile leakage, biliary stricture, and stone recurrence between groups, all P>0.05). Conclusion:In patients with a normal diameter (≤8 mm) common bile duct, it was safe and efficacious to perform primary closure after laparoscopic common bile duct exploration.

ObjectiveTo discuss the experimental method and the mechanisms on treating diseases by acupuncturing the ST36(Zusanli).MethodsUsing Positron Emission Tomography(PET) and functional Magnetic Resonance Imaging(fMRI) to obtain the experimental data about glycometabolism and cerebral blood stream,using SPM and ROI image-analytical method to obtain the visual experimental evidence when acupuncturing the ST36. ResultsThere are certain increases of glycometabolism and cerebral blood stream in ipsilateral hypothalamus and bilateral temporal lobe, when acupuncturing the ST36. Conclusions Acupuncturing the ST36 can lead to the functional changes in vegetative nerve center and temporal lobe, which is close correlated with the therapeutical effects of ST36.

Molecular methods and fluoroscopic techniques suggest that rich microbial diversity exist in the marine environment, but less than 1% of these microbes can be cultured in the laboratory conditions, and that the cultivable dominant species were even less. This limitation has long been a barrier to the development of environmental microbiology and the utilization of marine resources. In the past decade, novel methods for culture and detection of these uncultured marine microbes have successfully applied to obtain several conventionally-uncultured microbes including those from extreme environments. Those progresses have inspired researchers greatly. Developments in the research of marine microbial resources are an important basis for the study of the micro-world and deserve increasing scientific attention.

Objective To investigate the changes of cardiac sinus node connexin 45 (Cx45), connexin 31.9(Cx31.9) of gap junction in rabbits'' sinus bradycardia model caused by dexmedetomidine, and to discuss whether the negative frequency and negative conduction caused by Dexmedetomidine are related to the expression changes of connexin.Methods Forty-eight healthy adult New Zealand rabbits were divided into three groups (n=16).Sinus bradycardia rabbits were prepared by intravenous injecting Dexmedetomidine through ear vein.After rabbits were anesthetized by sodium pentobarbital, basic procedures were quickly completed in order to monitor MAP and ECG.Rabbits in group C were injected with normal saline.Rabbits in group D1 were injected a loading dose of dexmedetomidine 10 μg/kg for 10 min, and then continuously pumped 5 μg·kg-1·h-1 for 50 min.Rabbits in group D2 were pumped a loading dose of dexmedetomidine 60 μg/kg for 10 min, and then continuously pumped 30 μg·kg-1·h-1 for 50 min.After observation hearts were quickly removed and sinus node tissue was dissected.The average optical density of sinus node Cx45, Cx31.9 were detected by immunohistochemistry, and the genes expression were detected by real-time quantitative.Results Cx45 gene expression of group D2 showed remarkable increase than groups C and D1(P<0.05), there were no significant differences between groups D1 and C, Cx45 average optical density change were consistent with the gene expression.Cx31.9 gene expression of group D1 showed a more remarkable increase than group C(P<0.05), there were no significant differences between groups D2 and C,D1 and D2, Cx31.9 average optical density changes were consistent with the gene expression.Conclusion Dexmedetomidine increases the expression of low electrical conductivity Cx45, Cx31.9 of gap junction on rabbits'' sinus node, which is one of the possibly reasons that slow down cardiac conduction velocity in sinus node.

Objective To analyze the health-related quality of life of elderly people living alone in Shanghai according to the survey data. Methods The data were extracted from the fifth national health services survey of Shanghai, and the data of 11 103 elderly people from 17 districts were analyzed. The elderly people living alone and those not living alone were matched using propensity score matching method, and the health-related quality of life of elderly people was measured by the European quality of life 5-dimensions (EQ-5D). The health-related quality-of-life indicators between the elderly people living alone and not living alone, including selection of EQ-5D dimensions, EQ-5D scores and EQ-VAS scores, were compared by Chi-square test and Mann-Whitney U test. Results The baselines of the elderly people living alone and not living alone matched well by propensity score matching, and there were no significant differences in selection of each dimension of the health-related quality of life, EQ-5D index scores or EQ-VAS scores between the two groups. Conclusion There is no difference in health-related quality of life between elderly people living alone and not living alone in Shanghai.

Objective To know about the two-week prevalence of the elderly people living in Shanghai and its influencing factors, so as to provide evidence for the health management of the elderly. Methods The data were extracted from the fifth national health services survey of Shanghai, and the data of 11 103 elderly people from 17 districts in Shanghai were investigated by multi-stage stratified cluster sampling, including the basic situation, healthy physical examination within a year and two-week prevalence. Univariate analysis was performed by Wilcoxon rank sum test and Kruskal-Wallis H test, and multivariate analysis was performed by logistic regression to explore the factors influencing the number of two-week prevalence of the elderly people aged 60 years and above in Shanghai. Results The total number of the two-week prevalence of the elderly people was 8 943, and the two-week prevalence rate was 805.458‰. The highest frequencies of two-week diseases were hypertensive and diabetes, accounting for 59.4% (5 314/8 943) and 14.9% (1 332/8 943), respectively. Results of univariate analysis and multivariate analysis showed that the main influencing factors of two-week prevalence were age, employment status, type of occupation, and physical examination within one year. Conclusion The two-week prevalence of elderly people in Shanghai is higher than the national average. Health guidance should be given to the factors influencing of the two-week prevalence in order to achieve a healthy aging.

ObjectiveTo observe the injured changes of brain myelin sheath structure and myelin basic protein (MBP) content induced by amyloid β peptide (Aβ) and effect of GETO on these changes.MethodsThe experimental rat model of Alzheimer's disease was established with Aβ1-42 injection into hippocampus. 4 weeks later, the myelin sheath structure of the CA1 area of the rat hippocampus was taken and observed by electromicroscope, and distribution and content of MBP were examined with immunohistochemical method.ResultsThe electromicroscope showed that the structure of myelin sheath became relaxing, disorder, homogenization and default of hippocampus CA1 in the model rats. In GETO treated group, the structure of myelin sheath was integrity and continuum. Immunohistochemical test showed that the staining and numbers of myelin sheath of model rats was thinner than that of normal rats and GETO treated rats. The numbers, mean area and mean density of positive staining axon in hippocampus CA1 of MBP in the model rats were significantly different from those in the normal group and GETO group (P<0.01).ConclusionAβ1-42 injection into hippocampus in rats can impair myelin sheath to make MBP release and GETO can ameliorate these changes.

Aim To explore the effect of Neu-P11,a novel melatonin agonist with similar function of melatonin,on IOP of acute high IOP animals and the related mechanism.Methods The experiment used the Trendelenburg position(head low feet high position of 80°)to establish acute high IOP model.Rats were placed in the Trendelenburg position and used Tonopen XL contact tonometer to measure IOP(every 5 minutes measured once IOP,and the maximum value in 20 minutes)in 8 :00～9 :00 am.And then,thirty Sprague-Dawley rats(8 week-old)were divided into five groups: normal IOP+normal saline,high IOP+normal saline,high IOP+10 mg·kg-1 Mel,high IOP+20 mg·kg-1 Neu-P11,high IOP+50 mg·kg-1 Neu-P11.Put in a flat to rest 2 h,animals were placed in Trendelenburg position again and then,IOP was measured every hour in the flat by 6 hours.After excessive sodium pentobarbital administration continuous for 1 week,the serum was collected and stored for subsequent detection at the end of the experiment.The level of MDA,SOD and GSH-Px enzyme activity of the rat serum was tested by kit accordingly.HE staining method was used to identify the SD rat retinal morphological changes.Results Trendelenburg position could induce IOP of model group rats,which was increased by 202.9％(P<0.01)and the content of MDA,reduced the activity of SOD and GSH-Px enzyme,retinal thickening was observed and its level was not clear.Neu-P11/Mel could significantly improve oxidative stress level and retinal edema in rats.Conclusion Neu-P11 could reduce IOP of the acute high IOP animals,which might be involved in the lower level of oxidative stress in the body.

Objectives:To observe the changes of the tongues in rats with blood-stasis syndrome induced mainly by cold. To explore the evidence that tongues were the target of blood stasis syndrome and the target of medication. Methods: Rats with blood-stasis syndrome induced by cold (BSC group) were dipped into ice water (0 ℃) for 5 minutes every day and lasted 20d individually. Different drugs were given orally after the model establishment. And then we took photos of tongues of all rats by digital camera, analyzed the gray scale value of all rats' tongues using image analysis software, and observed the capillaries in tongues by electron microscope. Results: The tongues of rats which had been frozen in ice water for 20 d (once a day) were dark purple, the same as that of models induced by chemical materials .While as for the normal rats, the tongues were lustrous and ruddy. The changes of color of the tongues persisted about 1 week and were great obvious at the 3rd day after the model establishment among different time-points. After given different drugs, the degree of dark purple tongue degraded, showed significant difference (P < 0.01) from that of model rats. The capillary stegnosis and nucleus turgescence of vascular endothelial cell were observed in tongues in BSC group by using electron microscope. After medication, the above changes recovered. Conclusion: The degree of dark purple tongue indicates the degree of diseases with blood-stasis syndrome. The tongue probably is a target of drug treatment.

Objective:To investigate frequency of blood stasis syndrome(BSS) defined by traditional Chinese medicine in cerebral infarction and its correlations with carotid atherosclerotic plaque(CAP).Methods: All subjects comprised 151 patients aged 40 to 80 years(Mean ? SD age,65 ?11 years) with 67.9% for males and 32.1% for females.With the use of ACUSON7 color Doppler ultrasound,carotid atherosclerosis was evaluated by the plaque score,the left plaque score,the right plaque score,the numbers of the plaque respectively as defined by the sum of all plaque heights in bilateral carotid arteries.On the basis of neurological signs and symptoms,medical history,and brain MRI,we diagnosed stroke and its subtypes as follows: stroke(n=117),and vertebrobasilar insufficiency(VBI)(n=34) without the history of the stroke,which were based on Diagnostic Criteria for Cerebral Vascular Diseases in 2005.Diagnosis for syndromes defined by traditional Chinese medicine were made according to Diagnostic Criteria for Stroke in 1994.One-way ANOVA was used in comparison between groups,and multivariant Logistic Regression Analysis was conferred in correlations between several variables.Results: 47.0% of all cases with cerebral infarction presented the BSS,with as lower than syndrome of fire-heat(51.0%),as but significantly higher than syndrome of Qi deficiency(32.0%),liver-wind syndrome(27.0%),phlegm syndrome(23.0%) and syndrome of asthenic yin causing predominant yang(6.0%).There is a significant difference between groups for 44(79.0%) cases of 56 patients with cerebral infarction and the BSS have CAP,and only 35(57.0%) cases of 61 patients with cerebral infarction but without the BSS have CAP(P