ObjectiveTo study the clinical value and efficacy of intracranial hemorrhage smashpuncture needle with YL-1 type disposable under CT monitoring in treatment of hypertensive intracerebral hemorrhage.MethodsThe data of 80 cases with hypertensive intracerebral hemorrhage patients who accepted the transcranial puncture under CT monitoring application of YL-1 type disposable intracranial hemorrhage smash puncture needle and drainage of hemorrhage,punctuated with urokinase washout and drainaged residual blood clot.Evaluation criteria:hemorrhage volume reduction,average operation time,preoperative and postoperative Glasgow coma scale(GCS) score,the clinical effect of long-term follow-up.ResultsOperation time was 15-45 (25.0 ± 2.8) minutes;hemorrhage volume was reduced by an average of 30％-80％ (56.8 ± 3.2)％,the average increase of GCS was(2.3 ±0.3) scores,10 cases death in 80 patients,70 survivors' activities of daily living (ADL) assessments:grade ADL 1 in 17 cases ( 24.3 ％ ),grade ADL2 in 36 cases( 51.4％ ),grade ADL3 in 13 cases ( 18.6％ ),grade ADL4 in 3 cases(4.3％ ),grade ADL5 in 1 case ( 1.4％ ).ConclusionsYL-1 type disposable intracranial hemorrhage smash puncture needle under CT monitoring in the treatment of hypertensive intracerebral hemorrhage is a simple,fast and accurate positioning,without craniotomy and blood transfusion,safe and effective operation,but should pay attention to operation indications.

Objective To investigate the risk factors for cerebral microbleeds (CMBs) and its correlation with the 24 h microalbuminuria (mALB) in patients with small artery occlusion (SAO).Methods The patients with SAO were enrolled.CMBs were detected with susceptibility-weighted imaging.The demographic and clinical characteristics and 24 h mALB of the patients were compared.Multivariate logistic regression analysis was used to identify the independent risk factors for CMB in patients with SAO.Spearman correlation analysis was used to investigate the correlation between the 24 h mALB and the degree of CMBs.Results A total of 90 patients with SAO were enrolled and 35 patients (38.89％) had CMBs.CMBs mainly distributed in basal ganglia/thalamus and infratentorial (62％) regions.The Age (70.8 ± 5.4 vs.67.3 ± 8.1; t =2.461,P =0.016),proportion of hypertension (80.0％ vs.52.7％ ;x2 =6.851,P =0.009),and 24 h mALB levels (16.257 ± 6.031 mg/24 h vs.11.910 ±5.458 mg/24 h; t =3.536,P =0.001) in the CBM group were significantly higher than those in the non-CMB group.Spearman rank correlation analysis showed that the 24 h mALB and the severity of CMB in patients with SAO showed a significant positive correlation (rs =0.795,P =0.000).The higher the 24 h mALB level was,the more severe the CMB degree would be.Multivariate logistic regression analysis showed that only 24 h mALB was the only independent risk factor for CMBs in patients with SAO (odds ratio,1.100,95％ confidence interval 1.031-1.176; P =0.002).Conclusions The 24 h mALB is an independent risk factor for CMB in patients with SAO.The 24 h mALB level is positively correlated with the severity of CMB,and it may be used as a marker for small vascular injury.

OBJECTIVE: To study optimal formulation process of Rutongning granule. METHODS: The ratio of main components to excipients was optimized with hygroscopicity,granulation and dissolubility index. RESULTS: The optimal ratio of extract powder to saccharose was 1 ∶ 1.5. The made granules were characterized with low hygroscopicity, high granulation,high dissolubility and low cost. And its critical relative humidity was 65%. CONCLUSION: The study provides theory evidence for formulation process of Rutongning granule and the control of production environment.

Objective To understand the achievements of clonorchiasis sinensis control in Shandong Province during the past forty years. Methods The data of the previous annual clonorchiasis sinensis investigation in Shandong Province were collected and analyzed. Results From 1960s to 1970s, there were 107 counties existing the prevalence of clonorchiasis sinensis in Shandong Province. The infection rate of population was 1.51%, and 85.70% of the infected people were children below fifteen years old. Through the forty years' control, the decreasing of intermediate hosts such as various kinds of fishes and water-snails due to 85. 00% of ditches and ponds dried up by the lasting drying weather after 1980s, and 90. 00% of rivers polluted by increasing liquid waste, as well as the decreasing of infective chances due to 97. 90% of people breaking off the habit of eating not-well-cooked fishes by popularizing health knowledge, to 2003, the population infection rate dropped to 0.04%, 95.60% of the village where residents had the infection dropped to below 1. 00% , and 60. 00% of counties where no Clonorchis sinensis infection was found. Conclusion The clonorchiasis sinensis transmission areas reduce gradually, the infection rate of population decreases to the lowest in the history and the transmission has been controlled in Shandong Province.

Objective To evaluate combination of cholcdochoscopy or duodenoscopy with therapeutic laparoscopy (LCDCS) in treatment of detail choledochus stones. Methods Laparoscopic cholecystectomy was firstly performed and followed by choledochoscopy or duodenoscopy. Procedures of therapeutic choledochoscopy were as follows: choledochoscopic exploration via cystic duct remnant, choledochotomy, electrohydralic lithothipsy, drainage of bile duct with ureteral catheter via cystic duct remnant, T-tube drainage, or the suture of duct incision. Procedures of therapeutic duodenoscopy were as follows: access to the common bile duct and duodenum through ureteric catheter and zebra guidewire via cholecystic duct remnant, duodenoscopy via oral cavity into the duodenum papilla, papillotomy with needle-knife or arch-like electro-knife along the ureteric catheter or zebra guidewire, and stone clearance in the common bile duct with the reticulation and balloon of duodenescopy. Results Combination therapy were given to 191 cholelithiasis patients with detail choledochus stones. Combined choledochoscopy were performed in 117 patients. Stones were completely removed and average operation time was 114 min. Bile leakage occurred in 7 cases, but was cured with drainage. Postoperative imaging showed 2 cases of bile duct stenosis at primary closure of duct incision. Combined duodenescopic procedures were performed in 74 patients. Papillotomy and stone clearance were successfully performed in 68 patients, 5 others of whom underwent successful papillotomy only, and another underwent other operations. Average operation time was 97 min. Post-operation mild acut pancreatitis developed in 6 patients. No perforation of intestine or bile duct, bleeding, severe pancreatitis, or death was observed in each group. Conclusion LCDCS was safe and effective with appropriate indications.

Objective To explore the operative methods and indications of duodenoscopic papillotomy during the course of operation(IEPT)for cholelithiasis.Methods Cholecystectomy was firstly conducted under the condition of laparoscopy or open laparotomy.For the gross choledochus,the common bile duct was cut open to clear the stones.The ureteric catheter and zebra guidewire were inserted into the common bile duct and duodenum.Then they were inserted via duodenoscopy into thepapillum of duodenum.The papillary stenosis was removed with electro-knife by pin-head-like and arch-like to track along the ureteric catheter and zebra guidewire.For the tiny choledochus,the ureterie catheter and zebra guidewire were inserted via the cholecystic duct remnant into the common bile duct and duodenum.Then they were inserted via duodenoscopy to perform papillotomy to clear the stones of the common bile duct with the reticulation and the balloon of duodenoscopy.Results Forthe gross choledochus,IEPT in laparoscopy was successful in 45 cases and the other 2 received other operation.IEPT in open laparotomy was successful in 5 cases.For the tiny choledochus,IEPT in laparoscopy was successful in 73 cases and the other 1 underwent other operation.IEPT in open laparotomy was successfulin 2 cases.Conclusion If patients are suitable,IEPT is safe and effective in the hands of skilled endoscopiests for laparoscopy and open laparotomy.

Adenosine monophosphate-activated protein kinase (AMPK) is a critical enzyme for energy and metabolic regulation and can effectively maintain the homeostasis of energy and metabolism in cells and the body, and thus it plays an important role in both health and diseases. Current studies have shown that AMPK can regulate inflammatory response in the body through various cytokines and signaling pathways such as nuclear factor-kappa B (NF-κB), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) and has become a potential therapeutic target for a variety of inflammatory diseases. In acute pancreatitis, abnormal activation of trypsin can cause the injury and necrosis of tissue cells, release various inflammatory factors including NF-κB, TNF-α, and IL-6, and induce systemic inflammatory response, leading to organ injury or acute inflammatory disease. Recent studies indicate that the activation of AMPK can alleviate the inflammatory damage of acute pancreatitis. Therefore, AMPK and its signaling pathway may become potential therapeutic targets for acute pancreatitis.

Acute pancreatitis is a local pancreatic and systemic inflammatory disease due to various living and environmental factors, such as alcohol, gallstones, high lipids, and smoking, and its pathogenesis remains unclear. Studies have shown that epigenetic regulation mechanisms, such as DNA methylation, histone modification, and non-coding RNA, play an important role in the development and progression of acute pancreatitis. This article introduces the association between the common causes of acute pancreatitis (including alcohol, gallstones, high lipids, and smoking) and epigenetic regulation mechanisms, as well as the association between inflammatory response and epigenetic regulation mechanisms. The preliminary exploration of epigenetic regulation mechanisms in acute pancreatitis provides new thoughts for further understanding the development, progression, and treatment of acute pancreatitis.

OBJECTIVETo evaluate the effect and safety of enucleation of insulinoma under the Da Vinci robotic surgical system combination with intraoperative ultrasonography(IOUS) for the localization.

METHODSThe clinical materials of 50 insulinoma cases which underwent IOUS and assisted by the robotic surgical system from September 2012 to September 2014 in Peking Union Medical College Hospital were reviewed retrospectively. The patients were followed up by outpatient review and telephone until October 2014. The diagnostic accuracy rate, operation time, blood loss, complications and cure rate were analyzed by t-test.

RESULTSThe locations of tumors were 13 in the head, 21 in the body and 13 in the tail of pancreas, 2 were multiple insulinoma, 1 was ectopic to mesenterium.The average operation time was 142 minutes; the average blood loss was 165 ml.Three(6.0%) patients were transformed to open.One patient experienced postoperative bleeding about 300 ml on the 7(th) day after operation and no infection and perioperative death.Thirty-five cases were of class A and 14 of class B according to the clinical grading of postoperative pancreatic fistula.The blood glucose 60 minutes after tumor dissection was significantly elevated than that before operation ((6.2±1.8)mmol/L vs.(3.7±1.2)mmol/L)(t=-6.89, P<0.01). The cure rate was 100% as all the patients' symptoms were disappeared during follow-up time.

CONCLUSIONSCombination IOUS is a highly sensitive method for the localization of insulinoma, which is helpful in localizing tumors precisely in insulinoma cases assisted by robotic surgical system and shortening operation time.It is safe and effective for insulinoma enucleation.

Blood Glucose ; analysis ; Humans ; Insulinoma ; diagnostic imaging ; surgery ; Operative Time ; Pancreas ; diagnostic imaging ; surgery ; Pancreatic Neoplasms ; diagnostic imaging ; surgery ; Postoperative Complications ; Retrospective Studies ; Robotic Surgical Procedures ; Ultrasonography