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.

Various hypotheses have been put forward to explain the pathogenesis of hemorrhoidal diseases. However, the etiology and mechanisms of hemorrhoids are far from clear, and as a consequence the present therapeutic objective is just to relieve or abolish the symptoms of hemorrhoids. In this review, the recent research advances on the pathophysiological characteristics that are closely associated with hemorrhoids are analyzed and discussed, which include constipation, high anal resting pressure, anal mucosa damage, aging of the anal cushion supporting tissue, blood and vessel alterations, obstruction of microcirculation and biochemical changes.

Objective; To elucidate the mechanism of the role of ER-a in fat metabolism by regulating the expression of ER-a in SD rats marrow mesenchymal stem cells during differentiating into adipocytes in vitro. Methods ;SD rats marrow mesenchymal stem cells were separated and cultivated. The ER-a was transfected into the rBMSCs in group one. Tamoxifen Citrate was used to restrain the expression of ER-a in group two, the group without any treatment was used as control. Western blot was used to identify the difference of ER-a expression among different groups and Oil-Red-0 staining was employed to identify the adipocytes in vitro. Results; There was significant difference between the number of lipids and different groups (P <0. 01) ,the number of lipid droplet changed concomitantly with ER-a: Low-expression ER-a group > Control group > High-expression ER-a group. Conclusion; ER-a in SD rats marrow mesenchymal stem cells may restrain the adipocyte differentiation.

Sunitinib malate (SU11248 ,Sutent) is an orally available small-molecule multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities.In 2006 sunitinib was approved by FDA for imatinib intolerant gastrointestinal stromal tumors (GIST) patients or imatinib resistant GIST patients.This article review the molecular-based mechanism,the mechanism of resistance,the biomarker,the clinical trials and the adverse effects of sunitinib in the treatment of imatinib-resistant GIST.

With advancements in the field of cancer stem cells,the hypothesis that colon cancer originates from stem cells has not only been introduced but also receives substantial supports by separating a subpopulation of colon cancer cells through primitive cells markers.Unlike most non-tumourigenasis colon cancer cells,these tumor-initiating cells have many specific characters both in vitro and in vivo.An improved understanding of drug resistance based on cancer stem cells and molecular pathways that regulate proliferation and differentiation of gastrointestinal cancer stem cells could doubtless translate into new therapeutic strategies.

Objective To investigate the effects and safety of mechanical continue heart chest compression ventilation (CCV) and interrupt pressure ventilation (30∶2) on cardiopulmonary resuscitation (CPR).Methods According to the mechanical pressure ventilation different way,90 patients with cardiopulmonary resuscitation (CPR) in our hospital emergency center were admitted into control group (30∶2 group) with 48 cases and observation group (CCV group) with 42 cases,with a before and after case-control study to compare the recovery effects [rate of spontaneous circulation restoration (ROCS),successful recovery rate,the ROCS time,withdraw machine time,and Glasgow coma scale(GCS) in successful recovery patients] and recovery of adveme events (fracture,skin lesions,hemopneumothorax,and visceral injury).Results With comparison between two groups,CCV group had shorter ROCS recovery time and withdraw machine time [(9.31±4.32) min vs (12.67±4.86) min,(32.07 t4.84) min vs (36.33 ± 3.37)min,P ＜0.05],higher rate of ROCS and successful recovery rate (42.9％ vs 22.9％,21.4％ vs 6.3％,P ＜ 0.05) than 30∶2 group;while both were no difference in Glasgow coma scale (GCS) in successful recovery patients (P ＞ 0.05).The incidence of adverse events were not different in both (11.9％ vs 8.3％,P ＞0.05).Conclusions Mechanical continue chest compression ventilation (CCV) compared to interrupt pressure ventilation (30∶ 2) can effectively shorten the ROCS recovery time and withdraw machine time,improve the ROSC recovery rate and success rate of recovery,but failed to improve nerve functions.Two groups have a lower incidence of adverse events,which is safe to use.

Objective To explore the time-related expressions of TGF-?1mRNA during the healing process of rat skin wounds. Method Using the method of the reverse transcriptase polymerase chain reac-tion (RT-PCR) on intra-vital rat skin incised wounds (0.5h, 1h, 3h, 6h, 48h, 72h, 96h, 168h after incision) and postmortem rat skin incised wounds (0.5h, 1h, 3h after incision) to detect the dynamics of expression Ievel of TGF-?1mRNA. The strength of the expression of TGF-?1mRNA in scanned image was using ID-Advanced software. Results The results of RT-PCR showed that TGF-?1mRNA Ievel increased at 0.5h after incision and elevated significantly after 3h. The peak of TGF-?1mRNA occurred at 48h. There was no obvious expression of TGF-?1mRNA in postmortem incised wounds. Conclusion The characteristics of the TGF-?1mRNA expression were potentially indicative for the wound aging. RT-PCR was a sensitive method for detection of the expression of cytokines in genic level.

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.

Objective: To study the relation of condylar morphology with different vertical facial types in the development of patients with skeletal Ⅲ malocclusions. Methods:180 cases with skeletal Ⅲ malocclusion were divided into children(5-11 years old), adolescence(12-17 years old) and adult(18-30 years old) groups with 60 cases in each group. Orthopantomograms of the patients with different vertical facial types were retrospectively investigated by computerized cephalometric analysis. Condylar morphology were compared among different age groups of the same vertical facial type. Results:In patients with high angle, ramus height(RH) was getting bigger with ageing(P0.05). In patients with low angle h and RH in adult group were bigger than those in adolescence or in children(P