Objective To observe the clinical efficacy of three types of drainage in the treatment of malignant obstructive jaundice.Methods 84 patients with malignant obstructive jaundice were selected,40 cases were treated with bridge drainage,24 cases were undergone percutaneous transhepatic cholangial drainage(PTCD) and 20 cases were treated with Roux-En-Y anastomosis.The changes of total bilirubin and direct bilirubin were detected 1,3,7 and 14 days after operation.Results The total bilirubin and direct bilirubin after 1,3,7 and 14 days had significantly decreased compared with pre-treatment(P ＜0.05),the decline rates in bridge drainage group were faster than the other two groups (P ＜ 0.05).Conclusion The three types of drainage for treating malignant obstructive jaundice have exact effect,and the bridge drainage can reduce the bilirubin to lower levels more quickly than the other two methods.

Objective:To design a software to read and display CT and RT structure and draw a new contour without treatment planning system (TPS).Methods: In order to display the contour information drawn by doctors, the first step was to match CT images and RT structure then the same screen rendering of CT and RT structures could be applied. In order to add contour in RT structure obtaining the coordinates interactively, connecting coordinate points were the essential steps. Then a unique identity was given in the area of that contour to ensure its unique results. Results: The software successfully read and displayed CT and RT structures and drew a new contour without TPS.Conclusion: In this study, the software establishes a basis to improve the precision of the radiotherapy dose.

BACKGROUND: It is well known that central noradrenergic system takes part in learning and memory, but there are a few researches focused on the effects of impairing the central noradrenergic system on rat' s P3-like cognitive potential.OBJECTIVE: To study the effects of impairing the central noradrenergic system on rat's P3-like cognitive potential.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Department of physiology in a medical college of a university.MATERIALS: Totally 30 male SD rats, clean degree, weighing from 500 to 600 g, were selected from the Experimental Animal Center of Sun Yat-sen Medical University(certificate: 26-99A018), drank freely and fed timely under the normal condition. After Y-maze test of all the rats, 24 rats with normal learning and memory function, which met the criteria specified in the description of Y-maze test, were randomly divided into three groups(8 rats in each group): control group, 6-oxidopamine (6-OHDA) injection group and saline control group.INTERVENTIONS: The models of central norndrenergic system impairment were made by injecting 6-hydroxysopamine(6-OHDA) into the bilateral dorsal noradrenergic bundle in dentate granule(DG). Then Y-type maze test and elicitation of P3-likewere carried out respectively before and after the models were built.MAIN OUTCOME MEASURES: Main outcome: P3-like latency, total reaction time(TRT) and error number(EN). Secondary outcome: Results of P3-like test recorded in the 12 days after the models were built.RESULTS: As compared with the controls, the model rats' P3-like latency and total reaction time(TRT) prolonged and error number(EN) increased statistically ( P ＜ 0.05 ).CONCLUSION: Central NE takes part in the activities of learning and memory and plays a certain role in the production and integration of P3 -like.

In order to study the expression of melatonin receptors Mel1a and RORβ in the human brain,and to furthe investigate the melatonin's function in Alzheimer's disease,two melatonin receptor cDNAs were cloned and introduced into pBluescript Ⅱ (KS+)vector.The recombinant plasmids were identified by using restriction enzymes and then sequenced.The results indicated that the cloned DNA sequences and the Genbandk Sequences were inentical.The cRNA probes made from them can be used in the in situ hybridization immunohistochemistry to detect the mRNA expression level in the future study.

There are obvious advantages of the integrated traditional Chinese and western medicine on the treatment of severe acute respiratory syndrome (SARS). Combining the ancient and present literature with the special epidemic patterns, pathological changes and clinical symptoms of SARS, the paper discussed the methods of application of the integrated traditional Chinese and western medicine on the treatment of SARS, and some matters needing attention in clinic.

ObjectiveTo investigate the effect of endoscopic retrograde cholangiopancreatography(ERCP)combined with laparoscopic resection (LC) in the treatment of patients with cholecystic stone.Methods100 patients with cholecystic stone were randomly divided into observation group and control group.The patients in the control group (50 cases) received traditional open surgery,and the patients in observation group(50 cases) were given ERCP combined with LC.The effects of two groups were observed.ResultsThe operative time was (49.2 ± 8.5 ) min and intraoperative blood loss was(54.0 ± 12.2 )ml in the observation group.The operative time was (80.2 ± 15.7 )min and intraoperative blood loss was ( 114.5 ± 27.5 ) ml in control group.There were statistically significant differences between two groups(P ＜0.05 ).The hospital stay time and postoperative infection rate of the observation group was significantly lower than that of the control group ( all P ＜ 0.05 ).ConclusionIt was a safe and effective method to treat patients with cholecystic stone by ERCP combined with LC,which had the advantages of less trauma,faster recovery,less hospitalization time and could reduce the financial burden on patients,thereby it was worthy of clinical application.

ObjectiveTo systematically evaluate the therapeutic effect of gastroesophageal devascularization( GD),portasystemic shunt( PSS),devascularization plus portasystemic shunt ( GD + PSS) for the treatment of 4250 cirrhotic portal hypertension cases reported in Chinese literature. MethodsThe literatures about the effect of gastroesophageal devascularization,portasystemic shunt,devascularization plus portasystemic shunt on portal hypertension were collected from Wanfang databases, China National Knowledge Infrastructure(CNKI) from 1980 to 2011.RevMan 4.2 and SPSS 13.0 were used for data analysis. ResultsIn this study 17 reports were enrolled into the meta-analysis.The results of the mta-analysis showed that long term survival rate in the group of GD plus PSS was higher than that in group of GD [OR=1.73,95％CI (1.23,2.44),P ＜0.01].That in group of PSS was similar with the group of GD [ OR =0.87,95 ％ CI (0.63,1.20),P =0.40 ].That of group GD plus PSS was similar with the group of PSS [ OR =1.73,95％ CI (0.95,3.13),P =0.07 ].For recurrent variceal bleeding rate,that in group of PSS was lower than that in the group of GD[ OR =0.46,95％ CI (0.35,0.61 ),P ＜0.01 ].That in the group of GD plus PSS was lower than that in the group of GD [ OR =0.25,95％ CI (0.18,0.35),P ＜ 0.01 ].The group of GD plus PSS was similar to that of group of PSS [ OR =0.72,95％ CI ( 0.40,1.29 ),P =0.27 ].Encephalopathy rate was higher in the group of PSS than the group of GD [ OR =3.57,95％ CI (2.43,5.23 ),P ＜0.01 ].That in group of GD plus PSS was lower than that in the group of PSS[ OR =0.37,95％ CI (0.20,0.69),P ＜0.01 ],while that in GD plus PSS was similar to the group of GD[ OR =1.58,95％ CI (1.02,2.43),P =0.04 ].ConclusionsThe only significant factor influencing the long term result in Chinese patients with portal hypertension is preoperative liver function.The three types of operation have different benefits and disadvantages.

Objective To establish the measuring methods and relevant influencing factors of liver zone speed index (ZSI) by sound velocity tissue quantification (SVQ) technology in healthy subjects.Methods Liver ZSI were obtained in 49 healthy volunteers using SVQ technique with Zonare Z.one Ultra system.In the first 15 subjects,ZSI were acquired at four positions (superficial and deep parts of right lobe,superficial and deep parts of left lobe).Then the achievement rate in different position of liver was calculated to select the suitable measuring position.The reproducibility was analyzed with intra-group correlation coefficient(ICC).The last 34 healthy subjects received ZSI measurements in the appropriate position only.The reference value of ZSI was calculated using x-± 1.96 s.Results It was stable to measure values of ZSI with SVQ technique.The achievement rate was higher in right lobe with being 1 cm below the liver capsule for the optimal measuring point.There was no significant difference of ZSI value between male and female groups.There was no significant correlation between age and values of ZSI while a significant negative correlation was found between body mass index (BMI) and values of ZSI (r =-0.63,P =0.000).The reference value of body mass index between 18.5-23.9 kg/m2 was 5.67-36.29 m/s.Conclusions ZSI values of liver measured with SVQ technique shows a good stability and may be a new promising method for assessment of liver elasticity quantitatively.

Objective To investigate the effect of S-phase kinase-associated protein 2 antisense oligodeoxynucleotide (Skp2 ASODN) on the growth and proliferation of colorectal cancer cells SW480 and its mechanism .Methods The liposome-mediated dif-ferent concentrations of Skp2 ASODN was adopted to transfect SW480 cells ,the final concentrations of 0 .050 ,0 .125 ,0 .250 ,0 .500 , 1 .000 ,2 .000 ,4 .000 μmol/L were respectively set up with Skp2 nonsense oligodeoxynucleotides(NSODN) and blank group as con-trol .Then the inhibited effect of growth and proliferation of colorectal cancer cells were measured by the inverted microscope obser-vationandmethylthiazolyltetrazolium(MTT),thecellcyclewassurveyedbytheflowcytometry(FCM).TheexpressionofmRNA and protein of Skp2 and P27kip1 were inspected by reverse transcription-polymerase chain reaction(RT-PCR) and immunocytochem-istry methods .Results The inverted microscope observed that the SW480 cells had no change in form and grew at a slower speed . When the Skp2 ASODN concentration reached 0 .125 μmol/L ,the inhibition rate was 14 .48% (P<0 .05) .As the Skp2 ASODN concentration increase ,its inhibition action on the growth and proliferation of SW480 cells was enhanced in a dose-dependent man-ner(P<0 .01) .The SW480 cells were increased in G0/G1 phase(P<0 .01) and decreased in S phase(P<0 .05) ,the progression of cell cycle was blocked .RT-PCR and the immunocytochemistry showed that both Skp2 mRNA and protein levels were down-regula-ted(P<0 .05) .Although the P27kip1 mRNA level had no change(P>0 .05) ,but its protein expression was elevates obviously (P<0 .01) .Conclusion Skp2 ASODN can inhibit the growth and proliferation of SW480 cells .Its possible mechanism is that the ubiq-uitin degradation of the Skp2 to P27kip1 is decreased by the gene occlusion effect of Skp2 ASODN ,thus the cell cycle progression is arrested .

Objective To investigate the differences of platelet membrane glycoprotein PAC-1 and CD62P expression in patients with cerebral small vessel disease and its subtype and large artery atherosclerotic stroke and to compare the traditional platelet activation markers and inflammatory chemokine platelet factor 4(PF4).Methods Peripheral blood platelet PAC-1,CD62P positive rates and serum PF4 concentration in 30 patients with large artery atherosclerotic stroke,45 patients with cerebral small vessel disease and 30 controls were detected using flow cytometry and enzyme-linked immunosorbent assay.The differences between the groups were compared.Results The PAC-1,CD62P positive rates and serum PF4 concentration in the large artery atherosclerotic stroke group were 63.21% ± 9.78%,55.91% ± 8.17%,and 30.55 ± 15.56 ng/ml,respectively.They were significantly higher than 40.65% ± 17.42%,36.49% ± 14.60%,and 12.59 ±5.57 ng/mlin the cerebral small vessel disease group(all P=0.000),and the latter was still higher than 13.55% ± 3.14%,9.00% ± 2.32%,and 4.95 ±2.82 ng/ml in the control group(all P = 0.000).There were significant differences in all the subtypes groups of cerebral small vessel disease between the PAC-1,CD62P positive rates and serum PF4 concentration.The leukoaraiosis with lacunar infarction group(n = 15;47.72% ±15.52%,43.75% ± 12.54%,and 13.96 ± 5.23 ng/ml)and the simple lacunar infarction group (n = 15;49.87% ± 14.65%,43.98% ± 10.55%,and 14.41 ± 5.53 ng/ml)was significantly higher than the simple lacmar infarction group(n = 15;24.44% ± 8.45%,21.74% ± 7.19%,and 9.40 ±4.99 ng/ml)(P =0.000,0.000,and 0.013,respectively).There was no significant difference between the forrner 2 groups(P = 0.658,0.952,and 0.858,respectively).The peripheral blood platelet PAC-1 positive rate had significant correlation with CD62P positive rate in patients with ischemic cerebral disease(r= 0.964,P= 0.000),and the serum PF4 concentration showed linier correlation with the PAC-1(r =0.846,P =0.000)and CD62P(r =0.857,P =0.000)positive rates.Conelusions The platelet membrane glycoprotein PAC-1 and CD62P expression showed linear correlation,and they were consistent with the changes of PF4 concentration.This sugested that platelet activation and its mediated inflammatory mechanisms played an important pathophysiological role in the processes of atherosclerosis and thrombosis.This mechanism had significant difference between the different lesion types.