Common bile duct stones are among the most common diseases in elderly patients.In the past 20 years,minimally invasive techniques,including endoscopic retrograde cholangiopancreatography and laparoscopic common bile duct exploration,have been developed rapidly and provided more options for patients.Choosing appropriate treatment plans will help reduce postoperative complications and lead to better outcomes in elderly patients with common bile duct stones.

ObjectiveTo observe the influence of the recombinant human growth hormone (rhGH) on nutritional status and immune function in patients with acute respiratory distress syndrome(ARDS).Methods60 ARDS patients with mechanical ventilation hospitalized in the ICU ward were randomly divided into the treatment group and the control group,each group had 30 cases.The patients of the two groups were given the same treatment program of nutritional support,and the patients of the treatment group were administered with rhGH 8u/d,subcutaneous injection,treatment course was 7d.1d before treatment,4d,7d after treatment,the nutrition indicators and changes in immune parameters of the two groups were detected.ResultsThe nutritional status before treatment and the cellular immune parameters of the two groups were lower than normal.4d after treatment,the transferrin requirements(TFN),prealbumin(PA),CD3,CD4,CD8 and CD4/CD8 ratio of the treatment group increased significantly( all P ＜0.05 ) ;7d after treatment,TFN,PA,CD3,CD4,CD8,CD4/CD8 ratio of the treatment group increased significantly compared with the control group ( P ＜ 0.01 ).ConclusionLow-dose hormone therapy combined with the nutritional support could improve the nutritional status,the immune function of ARDS patients with mechanical ventilation and enhance the success rate of patients in emergency.

[Objective] To investigate the effects of Eucommia on renal interstitial fibrosis and its mechanism.[Methods]Using renal interstitial fibrosis in rats with Unilateral Ureteral Obstruction(UUO).Adult female SD rats(n=32) were randomly divided into 4 groups: Sham operation group (Sham); UUO group,Irbesartan group; Eucommia group.Undergo light microscopy by Masson and HE staining to observe the renal interstitial fibrosis index.To detect the expression of MMP-2 by immunohistochemistry 2w after surgery.[Results] 1.The levels of BUN and Scr in UUO group were significantly higher than in Sham group.Compared with UUO group,the levels of BUN and Scr in irbesartan and eucommia groups were significantly lower.There was no significant difference between irbesartan group and eucommia group.2.The renal tissue was stained with HE.There was no change in Sham group.But in UUO group,there was tubular epithelial cells denaturalization,renal tubular expand or atrophy,interstitial macrophage and monocyt infiltration,interstitial expand,and there was no glomeruli change.While the change in irbesartan and eucommia group was slighter than that in UUO group.There was no significant difference between irbesartan group and eucommia group.3.The renal tissue Masson staining showed that there was interstitial expands fibrous tissues proliferation and there was no glomeruli change in UUO group.Compared with UUO group,the level of pathological change in irbesartan and eucommia groups was significantly lower.There was no significant difference between irbesartan group and eucommia group.4.The expression and distribution of MMP-2 were strong in Sham group,while in other groups lower in renal interstitial.Compared with UUO group,the level in irbesartan and eucommia groups was significantly higher.There was no significant difference between irbesartan and eucommia groups.[Conclusion] Eucommia inhibits the renal interstitial fibrosis lesion up-regulating the MMP-2 expression and blocking renal fibrosis.

Objective To explore the clinical application of fiberoptic bronchoscopy with bronchoalveolar lavage(BAL) in patients with mechanical ventilation.Methods Sixty patients with mechanical ventilation were randomly divided into control group ( n =30) and treatment group ( n =30).All patients accepted anti-infection,nutritional support treatments.The patients in the control group accepted routine treatment;others in the treatment group were treated with BAL.The therapeutic effects in the two groups were evaluated and compared.Results The treatment effects in treatment group was better than that in control group( P ＜0.05).The improvement of blood gas analysis in treatment group was better than in control group (P ＜ 0.05 ),the time of mechanical ventilation,length of stay in treatment group were shorter than those in the control group ( P ＜ 0.05 ).The number of success to remove ventilator,organs failure and hospital mortality in treatment group were less than those in the control group ( P ＜ 0.05 ).Conclusion Fiberoptic bronchoscopy with BAL treatment could be safe and effective for patients with mechanical ventilation.It deserves to be popularized.

Objective To study the effects of serum from a patient with acute motor axonal neuropathy (AMAN) on the sensory and motor neurons culture in vitro from embryonic rats. Methods Dorsal root ganglions and spinal ventral tissue were isolated from embryonic rats and digested into dissociated cell suspenstion for culture. The cells were identified by immunohistochemistry stain. When culturing for a week, AMAN serum was exposed in a 25% concentration, with normal human serum as control group. The AMAN serum was tested by anti-Penner O∶19 campylobacter jejuni lipopolysaccharide antibody positive. The changes of motor and sensory neurons were observed and the neurons were stained by using Guillery Shirra and Webster method which was sensitive to degeneration of nerve fiber. Results After normal serum exposure, neurons and their neurites were normal and stained in yellow color without silver granular deposition by using Guillery Shirra and Webster method. While after AMAN serum exposure, the axon from motor neuron became degenerating and stained in brown-black color increased silver-phile property. Conclusion The serum of AMAN patient might be specifically toxic to the neurites of motor neuron and might cause the degeneration of axon following soma changes. The damage of axon might be the response of campylobacter jejuni lipopolysaccharide antibody without participation of macrophage and complements.

BACKGROUND: Glial cell line-derived neurotrophic factor (GDNF) ischaracterized by its trophic function on motor neurons, but there is stilllack of quantitative data concerning the influence of different concentra tions of the neurotrophic factor on the growth of in vitro cultured motorneurons. OBJECTIVE: To observe the influence of GDNF on neuronal growth byobserving fetus rat spinal cord motor neurons cultured in vitro. DESIGN: Verifying observation taking in vitro cultured cells as subjects. SETTING: Neurological Department of the Second Hospital Affiliated toHebei Medical College. MATERIALS: This experiment was conducted in the laboratory of Neu rological Department, the Second Hospital Affiliated to Hebei Medical College, between January 2001 and September 2002. Adult male and female rats were raised together in the same cage, embryonic rats at 15 days of gestation were obtained for spinal cord separation. METHODS: Ventral spinal tissues were obtained from embryonic rats at 15 days of gestation for prinary in vitro culture. They were divided into four groups according to the density of GDNF, namely 1, 10, 50 and 100 μg/L GDNF groups, while the culture medium in control group did not contain GDNF. Neurons were cultured in 8 wells foreach group, which was repeated for two batches. Then the influence of GDNF on spinal cord motor neu rons was observed from the perspective of cell morphology with MTF method. MAIN OUTCOME MEASURES: The survival rate of motor neurons andthe length of cell processes. RESULTS: ① The length of spinal cord motor neuronal processes: It was found obviously longer in GDNF 1 μg/L group, 10 μg/L group, 50 μg/L group and 100 μg/L group than in control group [(107.4±35.406 8,160.5±38.564 9, 450.5±60.640 3, 293.5±67.381 4, 82.8±7.972 5) μm, t=2.610-2.647, P ＜ 0.01]. ② Cell survival rate: It was higher in GDNF 1 μg/L group, 10 μg/L group, 50 μg/L group and 100 μ g/L group than in control group [(13.9±0.899 9, 16.1±0.668 0, 20.1±0.667 9, 26.0±0.603 0,10.5±0.782 0) μm, t=2.211-2.312, P ＜ 0.05]. ③ MTT colorimetric analy sis: It was obviously higher in GDNF 1 μg/L group, 10 μg/L group, 50 μg/Lgroup and 100 μ g/L group than in control group [(0.350±0.059 8, 0.366 7±0.071 9, 0.381 9±0.063 8, 0.395 3±0.060 5, 0.285 8±0.032 5) μm,t=2.259-2.577, P ＜ 0.05]. CONCLUSION: GDNF of different concentrations exerts different effects on in vitro cultured embryonic spinal cord motor neurons.

Objective To study the relationship between quality of life and social support and ex-plore effective ways to improve quality of life in patients with cardiomyopathy. Methods In-hospital pa- tients (50 cases) with eardiomyopathy were randomly selected and inquired by applying general quality life inventory(GQOLI-74) and social support rating seale(SSRS),compared with 45 normal people as the con- trol group. Results Compared with the control group, quality of llfe (P < 0.05) and social support (P <0.01 ) in patients with eardiomyopathy decreased significantly.Social support was positively related with quality of life (r =0.614, P < 0.01 ). Conclusions Quality of life is closly related with social support in patients with cardiomyopathy. Improving quality of life by social support in patients with cardiomyopathy should be emphasized and make effective use of in the courses of nursing.

AIM:To investigate the effects of survivin inhibitor YM155 {4,9-dihydro-1-(2-methoxyethyl)-2-methyl-4,9-dioxo-3-(2-pyrazinylmethyl)-4,9-dihydro-1H-naphtho[2,3-d]imidazolium bromide} on the apoptosis, mito-chondrial membrane potential (Δψm) and cytochrome C (Cyt C) of retinoblastoma Y79 cells, and to analyze the mitochon-drial mechanisms of apoptosis .METHODS:Y79 cells were cultured in vitro and treated with YM155 at concentrations of 0, 0.5, 1, 2, 4 and 8 nmol/L.The cells in control group were treated without YM 155.The proliferation of Y79 cells were measured by CCK-8 assay and bromodeoxyuridine ( BrdU) labeling assay .Y79 cells were randomly divided into 4 groups:control group ( with equal volume of RPMI-1640 nutrient medium ) , positive control group ( 10 nmol/L topotecan ) , low-dose (1 nmol/L) YM155 group and high-dose (2 nmol/L) YM155 group.The effects of YM155 on the apoptosis, the changes of Δψm , the mitochondrial distribution and the protein level of Cyt C in the Y 79 cells were evaluated by flow cytom-etry with Annexin V-FITC/PI staining, JC-1 staining, immunofluorescence analysis and Western blot , respectively.RE-SULTS:Compared with control group , YM155 significantly inhibited the proliferation of Y 79 cells and induced apoptosis (P<0.05).YM155 significantly reduced Δψm of the Y79 cells, promoted Cyt C which released from mitochondria to the cytosol and reduced the protein level of Cyt C in the mitochondria (P<0.05).CONCLUSION:YM155 inhibits Y79 cell proliferation and induces apoptosis , and the possible mechanisms may be involved in the mitochondrium-mediated apoptotic pathway .

Objective:To establish a method for the determination of phenyl salicylate in compound titanium dioxide cream. Meth-ods:The HPLC assay was carried out on an Agilent Zorbax SB C18 (250 mm × 4. 6 mm, 5 μm) column with methanol -water (78∶22) as the mobile phase. The sample was detected at 308 nm with a UV detector. The column temperature was set at 25 ℃ and the flow rate was 1. 0 ml·min-1 . Results:Phenyl salicylate could isolate from the other materials by HPLC. The linear range of phenyl salicylate was 59.460-198.200 μg·ml-1(r=0.999 5). The recovery was 101.84% with RSD of 0.64%(n=9). The content of phenyl salicylate in 3 batches of compound titanium dioxide cream was 107. 7%, 107. 5% and 109. 8%, respectively. Conclusion:The method is simple, rapid, exclusive, accurate and sensitive, which is suitable for the determination of phenyl salicylate in com-pound titanium dioxide cream.

Objective : To investigate the effect of aluminum exposure on expression of miR-497-5p, wingless murine breast cancer virus integration site family member 3a (Wnt3a), β-catenin protein, glycogen synthase kinase-3β (GSK-3β) protein and tau protein in rat adrenal pheochromocytoma PC12 cells, so as to provide insight into unraveling the mechanisms underlying aluminum exposure-induced abnormal phosphorylation of tau protein. Methods: PC12 cells were exposed to Al(mal)3 at concentrations of 0, 100, 200, 400 μmol/L for 24 h. The viability of PC12 cells was measured using cell counting kit-8 (CCK-8) assay. The relative expression of miR-497-5p and Wnt3a was detected using a real-time fluorescent quantitative PCR (RT-qPCR) assay, and the expression of Wnt3a, β-catenin, GSK-3β, P-GSK-3β (Ser9), tau and p-tau (Ser396) proteins were determined using Western blotting. Results : The viability of PC12 cells appeared a tendency towards a decline with the increase of aluminum dose (Ftrend=323.473, P=0.001). RT-qPCR assay detected that the relative miR-497-5p expression appeared a tendency towards a rise with the increase of aluminum dose (Ftrend=14.888, P=0.031), and the relative Wnt3a expression appeared a tendency towards a decline with the increase of aluminum dose (Ftrend=165.934, P<0.001). The miR-497-5p expression negatively correlated with the relative Wnt3a expression (r=-0.693, P=0.012). The expression of Wnt3a (Ftrend=357.656, P=0.001), β-catenin (Ftrend=208.750, P=0.001) and p-GSK-3β (Ser9) proteins (Ftrend=512.583, P<0.001) appeared a tendency towards a decline with the increase of aluminum dose, and the expression of GSK-3β (Ftrend=39.965, P<0.001), tau (Ftrend=277.929, P=0.006) and p-tau (Ser396) proteins (Ftrend=96.247, P=0.002) appeared a tendency towards a rise with the increase of aluminum dose. Conclusion Up-regulation of miR-497-5p and GSK-3β expression and down-regulation of Wnt3a and β-catenin expression may be a mechanism underlying aluminum exposure-induced abnormal phosphorylation of tau protein.