It is a consensus to place stent after cutting bile duct in the hepatobiliary surgery in the past.However,as the development of bile physiological research and surgical technique,especially the raise of medical concepts of rapid recovery,the negative effects which are caused by the placement of stent have been taken seriously gradually.Up to now,whether the stent should be placed after the bile duct is cut has no definite answer yet.

Objective To compare the influence of cardiopulmonary bypass(CPB) on brain injury in the infants with compli‐cated congenital heart disease(CHD) and simple CHD by analyzing and monitoring the perioperative cerebral electric impedance co‐efficient ,serum S‐100βprotein and neuron specific enolase (NSE) .Methods Forty infants with CHD were randomly selected and divided into two groups:the complicated group(n=20 ,13 cases of tertralogy of fallot ,7 cases of transposition of great arteries) and the simple group(n=20 ,8 cases of atrial septal defect ,12 cases of ventricular septal defect) .Blood samples were taken and the cere‐bral electric impedance coefficients before operation(T1 ) ,at 10 min after CPB(T2 ) ,immediately after aortic clamping(T3 ) ,aortic o‐pening(T4 ) ,end of CPB(T5 ) ,at 5 h(T6 ) and 24 h (T7 ) after CPB were measured by the BORN‐BE noninvasive brain edema moni‐tor .Serum levels of S‐100βprotein and NSE were detected by ELISA .Results There was no statistically significant difference in the cerebral electric impedance coefficient ,S‐100βprotein and NSE before surgery(P>0 .05) .The cerebral electric impedance coef‐ficient ,S‐100βprotein and NSE were significantly increased from the beginning to the end of CPB(P< 0 .05) ,and gradually de‐creased after CPB(P<0 .05) .The cerebral electric impedance coefficient ,S‐100βprotein and NSE were obviously higher in the com‐plicated group than those in the simple group at the same time points(P<0 .05) .The cerebral electric impedance coefficient was re‐spectively correlated with S‐100βprotein and NSE .Conclusion The influence of CPB on brain injury in complicating CHD infants is more serious than that in simple CHD infants .The BORN‐BE noninvasive brain edema monitor can be used during CPB periopera‐tive period in complicating CHD infants for conducting the real time monitoring in order to reduce brain damage .

Objective To compare two kinds of strategies of preimplantation genetic diagnosis (PGD) to evaluate embryos for reciprocal and robertsonian translocation carriers. Methods A total of 152 PGD cycles for chromosomal translocation were performed from April 2012 to June 2014 , including 60 aCGH-PGD cycles using blastomere biopsy and fresh embryo transfer, and 92 SNP-PGD cycles using blastocyst biopsy and thawed embryo transfer. The diagnosis results and clinical outcome with these two kinds of strategies were compared. Results No significant difference was found in the cycles of no embryo transfer between SNP-PGD and aCGH-PGD. The normal rate in SNP-PGD was 33.8%, which was significant higher than that of aCGH-PGD. The clinical pregnancy rate per embryo transfer in SNP-PGD was higher than that in aCGH-PGD, but the misscarrage rate and embryo damage rate were lower than those in aCGH-PGD. Conclusions The PGD strategy of applying blastocyst biopsy, SNP array, embryo cryopreservation and thawed ET leads to a better clinical outcome. It may be a promising choice for future PGD treatment for carriers with chromosomal translocation.

Microdialysis, a technique for sampling the biochemical substances of extracellular fluid in vivo, has been widely utilized for physiological, pharmacological and pathological research. The principles and methodology of microdialysis and its applications in neurointensive care was reviewed.

Objective To study the relationship between neural apoptosis and the expression of Bcl-2,Bax proteins in the perihematomal brain tissue of patients with intracerebral hemorrhage(ICH).Methods The rate of neural apoptosis of perihematomal brain tissue was examined by TUNEL method and the Bcl-2,Bax proteins expression were detected by immunohistochemisty method. Correlation analysis was done not only for the expression of Bcl-2,Bax proteins and apoptosis rate with hematoma volume but also for the apoptosis rate with hematoma volume, the scores of clinical nervous impairment and the course of disease.Results The apoptosis rate and the expression of Bcl-2,Bax proteins in the perihematomal brain tissue of ICH patients significantly increased in comparison with the control group (all P

Since 2004,provinces and cities began to implement the national policy that gave the poverty advanced schistosomiasis patients some temporary assistance.The central and local government arranged special funds to provide medical assistance.This paper reviewed the policy of the assistance,the necessity of performance evaluation and research status of advanced schistosomiasis.Finally,it put forward some suggestions on the implementation of performance evaluation of advanced schistosomiasis,so as to provide reference for the government to allocate limited health resources reasonably and optimally and perfect relevant policies.

OBJECTIVE: To sum up the advantages and disadvantages as well as application prospects of several kinds of new devices in airway management, including the laryngeal mask airway (LMA), esophageal-tracheal combitubes (ETC),fribreoptic stylet laryngoscope (FOS), video Macintosh intubating laryngoscope system (VMS) and GlideScope(R) videolaryngoscope(GSVL).DATA SOURCES: Using the terms "airway management", we searched Medline for airway management device-related articles, which were published during January 1990 to February 2006 in English.STUDY SELECTION: The materials were firstly selected. Successful rate of intubation, intubation-related complications and incidence in studying tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen. Inclusive .criteria: ① Randomized and controlled study of adult cases. ② Clinical studies or case report. ③ Including the studies of general airway or difficult airway. Exclusive criteria: ① Study of intubation in children. ② Repetitive study.DATA EXTRACTION: Eighty-six articles about tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen, among which, 36 were included in this study, and 50 were excluded due to study on intubation in children or repetitive study.DATA SYNTHESIS: Correct placement does not affect vocal cord movement, so patients may vocalize while an LMA is in place. Its successful rate is over 90%. Its most attractive advantages are increased speed and ease of placement by both inexperienced personal and experienced anesthesiologists, low frequency of cough and low incidence. The esophageal tracheal combrtube is a supraglottic airway device that functions as an effective alternative to ventilization via mask and tracheal intubation in both the esophageal and tracheal position. It is successful when emergency occurs, but it is only suitable for adults. The flexibility of FOS allows for intubation of patients, without the need for head and neck manipulation. The main disadvantages of FOS are their limited field of view and the high cost of purchase and maintenance. Observation and manipulation in using VMS can be performed in one axis. GSVL provides a clear view of larynx on the monitor instead of directly viewed by the operator.CONCLUSION: These new devices of airway management can relatively decrease the intubation difficulty, increase the successful rate and lead to lower complication incidence. The skills of these new airway management devices should be included in the modern anesthesia residency program.

Fluorocarbon emulsion, a substitute of blood, 20 ml/kg were injected once into dogs intravenously. As a result, part of the substitute deposited in the lympho-retic-ular system and was phagocytized by fixed and free histiocytes (rnonophagocytic system), and the histiocytes then converted into foaming cells.One month after injection, the fluorocarbon's deposits in the foaming cells remained at the peak level in the liver, spleen and other organs of the lympho-reti-cuJar system. After six months,no deposits could be found in all viscera and no signs of any pathological changes, except the spleen under a light microscope.After twelve months, no foaming cells were found in the spleen, liver, and kidney under light cmicroscope,yet but foaming cells could be found in the spleen and liver with the help of an electron microscope and we believed that this sign had no pathological significance in clinic practice.The target cells only showed the action of phagocitizing and depositing.According to our observation, the fluorocarbon emulsion is a non cytoplasmic toxin and an inert biologic substance, so there are no secondary histo-pathologic changes caused by fluorocarbon deposition. It seems that 20 ml/kg of fluorocarbon emulsion (equal to 1200 ml for adult human)injected intravenously is rather safe.

The study was undertaken to determine whether low dose of endotoxin could induce rat brain damage, and its relation to the metabolism of oxygen free radicals. Male Wistar rats were treated with E. Coli endotoxin intraperitoneally (2 mg/kg body wt). Fourteen hours later, the lipoperoxide level was markedly elevated in animals given endotoxin compared with that in the controls (5.0?1.0 vs 3.9?0.7, P

This artical introduces the cutter develop t for basi hospitals to carry out the vitreous resection.It is characterized by simple structure,easy to use and carry,complete fuctions and it is satified with results.