Objective To investigate the role of motility of Oddi's sphincter in pigment gallbladder stone formation in the model of guinea pigs.Methods Thirty-four general adult male Hartley guinea pigs were divided randomly into two groups.Control group (10 guinea pigs)and pigment stone groups (24 guinea pigs,which were divided into 4 subgroups with 6 guinea pigs each according to the time they were sacrificed),fed with pigment lithogenic diet.After 3,6,9 and 12 weeks later,Oddi's sphincter manometry and myoelectric activity record were obtained by multifunctional physiograph at each stage.Results The incidence of pigment gallstone formation was 0,0,16.7％ and 66.7％ in 3w,6w,9w and 12w group,respectively.The frequency of myoelectric activity decreased apparently in the 3w group(P ＜ 0.05).The amplitude of myoelectric activity had the tendency of decreasing but not statistically significant.The motility frequency of Oddi's sphincter decreased greatly in the 9w group (P ＜ 0.05).The basal pressure of Oddi's sphincter and common bile duct increased markedly in the 12w group [from (25 ± 8) mmHg (1 mmHg =0.133 kPa) to (41 ± 12) mmHg and from (22 ± 8) mmHg to (39 ± 12) mmHg,P ＜ 0.05)].Conclusions Pigment lithogenic diet may induce dysfunction of Oddi's sphincter.The disturbance of Oddi's sphincter motility may play a role in pigment gallstone formation.

Objective To study the effect of the recombinant Lentivirus containing calcitonin gene related peptide (CGRP) gene on cells biological activity and differentiation of rat bone marrow stem cells(MSCs).Methods Rat MSCs were isolated and cultured by granulocytes adherent.MSCs were transfected with Lenti-EGFP CGRP(MSCsCGRP+/+ group),While MSCs were transfected with Lenti-EGFP as control group.Cell transfection rate was detected by flow cytometry,protein secretion in the above-mentioned MSCsCGRP+ + supernatant was detected using ELISA method.Cells surface markers weare detected by flow cytometry and immunohistochemistry.Trypan blue was used to examin the survive rate,β galactosidase staining was used to examin aging of MSCs transfection,and MTT was used to examine cell vitality.Results At first day after transfecting with Lenti-EGFP-CGRP,fluorescence was not observed by fluorescence microscope,but a small amount of CGRP protein was detected by ELISA in MSCsCGRP+/+ group,at 3 days and 4 days after transfecting with MSCs,strong fluorescence was observed by fluorescence microscope (the cell transfection rates were 77.87％ and 79.58％).The CGRP expression was significantly higher in MSCsCGRP+ + group than in control group [(19.53±0.50) pg/ml vs.(3.12±0.00) pg/ml,t=48.964,P＜0.01].At three days after transfection with MSCs,CD29 and CD90 expression were significantly higher,as compared with control group,CD31 expression was increased in MSCsCGRP+ /+ group.Seven days after transfection with MSCs,CD31 expression was significantly increased in MSCsCGRP+ + group,vWF expression was significantly increased in MSCsCGRP+ + group after MSCs were transfected with LentiEGFP CGRP for 14 days,but a SMA expression was decreased in MSCsCGRP+ +group.At 3 days and 7 days after transfection with Lenti-EGFP-CGRP,the proliferation,survive and aging showed no difference in MSCsCGRP+/+group and in control group (the proliferation of cell:t=0.253,0.290the survive of cell t=-0.307,0.690,all P＞0.05).At 14 days after transfection with Lenti-EGFP-CGRP,aging of cell were decreased in MSCsCGRP+ + group as compared with control group (t=2.446,P＜ 0.05).Conclusions After MSCs are transfected with Lenti EGFP-CGRP,biological characteristics of MSCs has no significant effects,there is still proliferation and differentiation activity.Cell secretion of CGRP can promote the endothelial cell differentiation,and inhibit the differentiation to smooth muscle cells.The CGRP modification of MSCs may play a role in the regulation of angiogenesis.

Objective:To investigate the expression of NADPH Oxidase2 (NOX2) in gastric cancer tissues and its correlation with vascular endothelial growth factor(VEGF) level.Methods:The gastric cancer tissue and the adjacent tumor tissue were obtained from the patients who received radical operation for gastric cancer during July 2014 to July 2015 in Provincial Hospital Affiliated to Shandong University.The expression of NOX2 in the tumor tissue and the adjacent tissue were detected by the immunohistochemistry(IHC) and Western blot.The VEGF level were detected by IHC in gastric cancer tissues.The spearman rank correlation were used to detected the correlation between the NOX2 and VEGF.Results:The positive expression rate of NOX2 in gastric cancer tissue was 47.2％ (58/123),and the positive expression rate in the adjacent tissue was 8.13％ (10/123),mostly expression in the adjacent was weak positive.The outcome of Western blot show that the NOX2 was up-regulated in the tumor tissue compare to the adjacent tissue [39.0％(48/123)].The expression of NOX2 and the relationship of clinical-pathology showed the expression of NOX2 had no correlation with gender,age,differentiation of tumor (X2 value were 0.852,0.150,5.062,P＞0.05).The result of spearman rank correlation showed that the NOX2 was positively correlated with that of VEGF.Conclusion:NOX2 plays an important role in the genesis and development in the gastric cancer,the expression of NOX2 was closely correlated with the VEGF.

The robustness of sliding mode control is utilized to improve the adaptability of the control system to changes in vascular mechanical properties of different patients.Adaptive sliding mode control is designed to adapt the controller to the needs of different virtual environment simulations through an adaptive mechanism,thereby weakening the chattering of sliding mode control.The extrapolation prediction algorithm is invoked under the adaptive sliding mode control to reduce the effects of delay on the control and improve force feedback transparency.The experimental results demonstrate that adaptive sliding mode predictive control can enhance system stability,force feedback control accuracy,and fidelity of force feedback control system for flexible surgical instruments.The study has important theoretical significance and practical value for the design of systems with flexible control objects and the improvement of force feedback fidelity.

Objective:To investigate the expression of soluble T cell immunoglobulin and mucin domain-3 (Tim-3) in peripheral blood of patients with pancreatic cancer and its diagnostic value in combination with serum Carbohydrate antigen 19-9 (CA19-9) .Methods:106 newly diagnosed pancreatic cancer patients and 65 age and sex matched healthy individuals were enrolled. Tim-3 concentration was quantitatively determined by enzyme-linked immunosorbent assay (ELISA). According to the expression levels of soluble Tim-3 and serum CA19-9, a binary logistic regression model of receiver operating characteristic (ROC) curve was established to compare the diagnostic effects of serum CA19-9 and soluble Tim-3 alone or combined with the two tests.Results:The levels of soluble Tim-3 in the pancreatic cancer group were significantly higher than those in the healthy control group ( P<0.001). The expression level of soluble Tim-3 was significantly higher in patients with stage III-IV pancreatic cancer than in patients with stage I-II ( P=0.003). The AUC of soluble Tim-3 diagnosis for stage I-II pancreatic cancer was 0.856 (95%CI: 0.765 to 0.992 P<0.001), Serum CA19-9 The AUC used for the stage I-II pancreatic cancer diagnosis was 0.862 (95%CI: 0.772 to 0.926 P<0.001), The AUC for the combined diagnosis was 0.949 (95%CI: 0.880 - 0.985 P<0.001) ; In a healthy population and in patients with stage III-IV pancreatic cancer, the AUC of soluble T I I-IV pancreatic cancer in stage III was 0.927 (95%CI: 0.873 to 0.963 P<0.001), the AUC of serum CA19-9 used for the diagnosis of stage III-IV pancreatic cancer was 0.933 (95%CI: 0.881 to 0.968 P<0.001), the AUC for the combined diagnosis was 0.989 (95%CI: 0.956 to 0.999 P<0.001) . Conclusions:The combination of soluble Tim-3 and serum CA19-9 can improve the diagnostic rate of pancreatic cancer patients.

Objective: To explore the effect of Teach-back health education model on health education for patients after percutaneous coronary intervention (PCI). Methods: Eighty patients after PCI operation in cardiology were selected, 40 patients selected from February to March as control group and 40 patients selected from April to May as observation group according to the time of admission in 2018. The control group used the routine health education method, based on this, the observation group used the "Teach-back" health education model to healthy educate patients. Three months after the intervention, the results of body mass index (BMI), triglycerides, total cholesterol, low-density lipoprotein, Seattle angina questionnaire (SAQ), and Morisky questionnaire were evaluated. Results: After 3 months of intervention, the triglyceride, total cholesterol, and low-density lipoprotein in the observation group were (1.35±0.43), (3.99±0.57), and (2.32±0.24) mmol/L, which were lower than the control group (1.63±0.38), (4.31±0.73), (2.61±0.28) mmol/L, the difference between the two groups was statistically significant (t=3.082, 2.717, 5.048, P<0.01 or 0.05). After 3 months of intervention, evaluate the SAQ score of the observation group, the degree of physical limitation, the stability of angina pectoris, the degree of angina pectoris, the satisfaction of treatment, and the disease cognition were respectively (76.16±5.03), (88.75±14.92), and (84.25±12.17), (84.76±5.11), (82.79±9.64) points, which were higher than the control group (68.94±9.80), (80.63±17.44), (76.25±12.34), (70.80±7.00), (70.50±13.85) points, the differences were statistically significant (t=-4.145, Z=-5.848--2.166, P < 0.05). After 3 months of intervention, the Morisky questionnaires of the observation group and the control group were (2.43±0.78) and (3.80±0.41) points, and the difference was statistically significant (Z=-6.848, P<0.05). Conclusion The application of Teach-back health education model to patients after PCI has a good effect.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.