Injury of choledocho-pancreatico-duodenal junction refers to the penetrating injury of the bile duct, pancrea-tic duct or duodenal wall in the region of ampulla of Vater. It is often caused by improper operation of surgical instruments, and may lead to leakage of bile, pancreatic or duodenal contents into retroperitoneal space and chemical corrosion in a wide range of retroperitoneal soft tissue, which result in severe secondary infection or even death. Leakage of contrast media, hypertrophy of tissue and anatomical changes were the evidences for injury of choledocho-pancreatico-duodenal junction. Injury of choledocho-pancreatico-duodenal junction can be. divided into 4 types, and treatment selected according to different types of injury is neces-sary for the prognosis of patients.

Hepatolithiasis is a common disease of abdominal surgery,although its incidence appears to decline,China is still a high incidence area with millions of patients with hepatolithiasis.Because of the complex pathogenesis,progressive development and frequent recurrence,it is seriously affecting physical and mental health of patients and quality of life,as well as difficult to define the diagnosis and select treatment methods for hepatolithiasis.The Guideline of the Diagnosis and Treatments of Hepatolithiasis and the Expert Consensus of the Laparoscopic Treatments of Hepatolithiasis (2013 edition) proposed a concise and practical classification system of the hepatolithiasis and summarized the principles of surgical treatments,which includedresecting the lesions,cleaning the stones,correcting the stricture,recovering the drainage and preventing the recurrence .Meanwhile,the application of laparoscopic technique in the treatments of bepatolithiasis was proposed,which played an important role to promote the standard diagnosis and treatments of hepatolithiasis in China.Recent years,more and more evidences from evidence-based medicine further proved the importance of the anatomical hepatectomy in the treatments of hepatolithiasis.With the soaring development of laparoscopic surgery,the combination of laparoscopic hepatectomy with the assistance of other endoscopies are applied more and more frequently.The concept of precise surgery also brings new vitality to the standard diagnosis and treatments of the hepatolithiasis.

Objective To elevate the efficacy and complications of partial splenic embolization(PSE) using the alginate microglobe(AMG) as embolic material for hypersplenism in cirrhosis.Methods 42 patients with hypersplenism and cirrhosis were treated by PSE,AMG of 250～450 ?m were injected into the arteries of inferior splenic pole,the embolization degree was ranging from 40% to 70%.Results 42 times of embolization were performed in 42 patients,after operation, 35 patients had fever and lasted for 3~15 d,38 patients had abdominal pain,of them, 27 patients needed treatment with analgesic.Treatable a little hydrothorax appeared in 6 ,and no serious complication occurred.WBC and PLT counts were increased 24 hour later(P

Mesenchymal stem cells belong to multipotential stem cells, which is easy to isolate and culture. Many researchers have been exploring various ways to induce bone marrow mesenchymal stem cells into muscle cells. MSCs were induced into muscle cells by using biochemical and biomechanics approaches. These muscle cells could be used for such clinical applications, as treatment for ischemic cardiomyopathy and post-traumatic repair for muscular tissue. In this article we reviewed the research progress on induction of bone marrow mesenchymal stem cells into muscle cells and isolation, purification, and identification of MSC.

Objective To develop a method for the determination of the dynamic parameters of interaction between methotrexate(MTX)enantiomer and dihydrofolate reductase(DHFR).Methods An affinity capillary electrophoresis(ACE)method was adopted.Using bare fused-silica capillary,the electrophoresis buffer was 50 mmoL/L sodium tetraborate with 0.2%Brij-35,pH 9.50.The temperature of separation was controlled at 25℃ and a voltage of 25 kV was applied.The separation of the reaction mixture was performed at a wavelength of 254 nm.The difference of peak areas about the product was used to calculate the inhibitory rate and IC50 values.Results We establish the detection method for the dynamic parameters of interaction between MTX enantioner and DHFR.The separation of the reaction mixture could be achieved within 30 min.The IC50 value of D-(-)-MTX and L-(+)-MTX were 3.17×10-7 and 2.48×10-8mol/L,respective.The IC50 value of the D-(-)-MTX was 31.67×10-8mol/L,the L-(+)-MTX was2.48×10-8mol/L.The IC50 value of the D-(-)-MTX was about 13 times higher than that of the L-(+)-MTX.Conclusions ACE is a rapid.simple and accurate method that can be used to monitor DHFRdynamic reaction.The IC50 values of MTX enantiomer were quite different.The result first indicated that reaction between MTX enantiomer and DHFR had three-dimensional selection.

Objective To evaluate the clinical application value of a new type of Bard Max-Core coaxial biopsy system and com-pare the effectiveness and safety of different diameter biopsy guns.Methods This retrospective study included 286 patients who re-ceived CT-guided percutaneous lung biopsy using Bard MC disposable biopsy system.We divided patients into three groups:1 6G, 18G,and 20G group.Then,we evaluated the biopsy effectiveness,histological diagnosis rate and complication incidence of this new type of Bard Max-Core coaxial biopsy system.Results All lung biopsy specimens were successfully obtained.The total histological diagnosis rate was 80.8%.Patients with malignant lesions had higher histological diagnosis rate than patients with benign lesions. The histological diagnosis rate in 1 6G group was the highest among three groups.There was no significant difference among three groups regarding to the rate of diagnosis of malignant lesions.Group with 1 6G had the highest histological diagnosis rate among three groups in diagnosing begin lesions.The incidences of pneumothorax in three groups had no significant difference.The incidence of bleeding in 1 6G group was the highest among three groups.Conclusion The new Bard MC disposable coaxial biopsy system is a safe and effective instrument for lung biopsy.We should select the biopsy needles with appropriate diameter according to the fully as-sessment of patients'preoperative conditions.

The action of Tetrahydroberberine ( THB ) on arrhythmias of the animal models were studied. The arrhythmias induced by CaCl2 and BaCl2 were significantly counteracted by THB ( 30mg/kg ip ) without markedly changing the hemodynamic parameters of rats, but those evoked by aconitine or ouabain were not inhibited in rats or guinea pigs. THB ( 40mg/kg ip) was used to be prevented the arrhythmias induced by ischaemia-reperfusion of left anterior des-cending coronary artery in rats. It could decrease the incidence of vetricular fibrillation, short restored time of the sinus rhythm and diminish the mortality. THB ( 10mg/kg iv ) effectively reduced the incidence of the ventricular arrhythmia induced by hypothalamic electric stimulation in rabbits. The results indicate that THB possess significant antiarrhythmic effect. It may be concerned the action of THB to blok calcium entry

Objective To observe the feasibility and safety of carotid artery stenting(CAS) for treating the patients with symptomatic carotid artery stenosis.Methods 60 patients who were diagnosed with symptomatic carotid artery stenosis by DSA were performed CAS.Among them, 52 cases were onset stenosis of carotid artery,8 cases were extracanical stenosis.The degree of stenosis was 50%～70% in 14 patients,70%～90% in 28 patients and≥90% in 18 patients.64 stents were placed,and 15 filter protection devices were used.Results The drgree of stenosis was decreased from (73.4?9.5)% to (12.5?8.2)%. The plaques were disappear in 53 cases, many debris were found in 5 filter protection divices. The clinical symptoms of all patients were disappear within one week, the mild paralyse was recover in all patients. There were 53 cases with heart rate slowdown during or after operation,the blood pressure declined in 48 cases,and there were 5 patients with vasospasm, as well as one case with cerebral embolization,one case with sydrome of high perfusion and one case with sydrome of low perfusion or swoon. During flowing up for 3 months to 2 years,no one case was found TIA or cerebral infarction,however,only one case was found mild restenosis by DSA.Conclusions CAS is a safety and efficient method for treatment symptomatic carotid artery stenosis. Lowering the risk of operation is done by handling indication seriously and operation skillfully.

Objective To develop LabVIEW-based digital PCG analyzer. Methods A kind of Digital PCG analyzer based on LabVIEW was designed. It included a heart sound sensor, an analog filtering circuit and amplifying circuit, an AD converter, a digital data transferring model and a software for PCG analyzing. Meanwhile, a kind of 3-lead ECG sampling circuit and a display model in LabVIEW were designed as a reference signal for PCG. distinction. Results This digital PCG analyzer had the functions of heart sound sampling from body surface, PCG real-time displaying on the software, spectrum analyzing for the PCG data and PCG database managing. Conclusion This kind of digital PCG analyzer based on LabVIEW can be used for assistant diagnosis of cardiac Arrhythmia and cardiac abnormal noise, and as a teaching tool for clinical auscultation.