Objective To observe the clinical effect of small endoscopic sphincterectomy (SES) combined with endoscopic papillary balloon dilation (EPBD) in the treatment of large common bile duct stones.Methods The patients were randomly divided into 3 groups:normal endoscopic sphincterotomy(EST),EPBD,SES combined with EPBD.The incidence of pancreatitis at 1 week after operation and the recurrence rate of inner duct stone within 15 months after operation were statistically analyzed.Results At 1 week after treatment,the incidence of pancreatitis was lower in group EST and group SES combind with EPBD than in group EPBD [3.3％ (1/30),3.3％ (1/30) vs.20.0％ (6/30),both P＜0.05].After 15 months of treatment,the recurrence rate of inner duct stone were lower in group B and group C than in group A 3.3％ (1/30),3.3％ (1/30) vs.23.3％(7/30),both P＜0.05).Conclusions In the treatment of large common bile duct stones,SES combined with EPBD can reduce the incidence of postoperative acute pancreatitis and the longterm recurrence rate of common bile duct stones.

Objective To study the effect of indomethacin preventing post-ERCP pancreatitis ( PEP ) on the patients younger than 50 years undergoing small endoscopic sphincterotomy (sEST) combined with endoscopic papillary balloon dilation(EPBD) in the treatment of choledocholithiasis. Methods 202 patients younger than 50 years with choledocholithiasis were divided into two groups, 101 patients in treatment group before surgery were rectal administrated with indometacin, 101 patients in control group were administered with placebo, all patients underwent sEST combined with EPBD in the treatment of choledocholithiasis.After operation,the abdominal pain NRS score, amylase, incidence of pancreatitis and hospitalization time were recorded, and the rates of heartburn, rash, gastrointestinal bleeding were recorded.Results In the treatment group, pain NRS score 24 hours after operation was(0.327 ±0.763), amylase 24 hours after operation was (116.87 ±113.97) U/L, there were 3 cases of postoperative pancreatitis (2.97%) in the treatment group,and the postoperative hospitalization time was (6.42 ±2.11) days.In the control group, pain NRS score 24 hours after operation was ( 0.634 ±1.027 ) , amylase 24 hours after operation was ( 185.38 ±160.60 ) U/L, there were 11 cases of postoperative pancreatitis (10.89%) in the control group, and the postoperative hospitalization time were (7.29 ±2.71) days.The differences of NRS pain score, amylase, incidence of pancreatitis, postoperative hospitalization time between these two groups were statistically significant ( P<0.05 ) .The differences of the rates of postoperative heartburn, rash, gastrointestinal bleeding between these two groups were not statistically significant.Conclusion Indomethacin rectal administration can prevent post-ERCP pancreatitis ( PEP ) on the patients who undergoing sEST combined with EPBD in the treatment of choledocholithiasis,and this administration is quite security.

Objective To investigate the effect of mindfulness on anxiety and depression of gynecological oncology patients.Methods Using objective methods,80 patients with gynecological oncology were divided to the usual care group and mindfulness training group according to random number table,40 cases in each group.The self -rated anxiety scale and self -rated depression scale were used to compare the effects at three times.Results There were 3 patients lost and 77 patients were analyzed finally.The ANOVA showed that there were significant differences on anxiety and depression scores of SAS (F =4.614,P =0.035) and SDS (F =4.070,P =0.044) between the two groups,and the scores of SAS (F =15.115,P <0.001) and SDS (F =7.034,P =0.002) had interaction effects. Conclusion Mindfulness can adjust the psychology state of gynecological oncology patients and decreased the level of anxiety and depression.

Background Human Tenon fibroblasts (HTFs) are the main cell component in scar tissue after antiglaucomatous filtrating surgery.To study the in vitro growth and proliferation features will offer an approach to the preventing and treating of scarring following antiglaucomatous filtrating surgery.Objective The goal of present study was to investigate the growth characteristics of HTFs in vitro from patients with bleb scarring after antiglaucomatous filtrating surgery.Methods This study process was approved by Ethic Committee of Beijing Chaoyang Hospital,and informed consent was obtained from each subject prior to the initaion of the study.The specimens of scaring tissue were obtained during the secondary trabeculectomy from 8 eyes with bleb scaring after initial antiglaucomatous filtrating surgery with the tissue size of 4 mm×5 mm,and the normal Tenon capsule specimens were acquired during the strabismus surgery from 8 eyes in the same way.HTFs were primarily cultured and passaged by tissue explants adherent method and identified using immunoinfluorescence technique with vemintin antibody.Nest PCR was used to exclude the mycoplasma infection during the culturing process.The morphology,growth curve and population doubling time (PDT) of the fifth generation of cells were examined and calculated by luminescence method cell vitality method 0,4,7,11,14 days and compared between the patients and normal groups.The stability of the cell growth was assessed by comparing the morphology,growth curve and PDT between the fifth generation and fifteenth generation of HTFs.Results Primarily cultured cells reached confluence 1-2 weeks with the similar shape to HTFs.The growth properties of the cells were same between the scarring group and normal group and showed positive response for vemintin antibody.No react band for mycoplasma was detected.The PDT was (20.54±3.51) hours and (18.86±2.91) hours in the scarring group and normal group,respectively,showing insignificant difference between them (t=0.634,P=0.561).No significant differences were found in the number of cells in 4,7,11 and 14 days after passage (t =2.663,P =0.081; t =0.194,P =0.863 ; t =3.338,P =0.053 ; t =0.627,P =0.565),with a consistent growth curve with the lapse of time between the two groups.The HTFs from scarred Tenon capsule fibrosis were cultured and passaged until the fifteenth generation.The PDT was gained to be (20.54 ±3.51) hours in the fifth generation of cells and (22.84±4.15) hours in the fifteenth generation of cells,without significant difference between them (t =0.733,P =0.505).The number of cellsin 4,7,11 and 14 days was not significantly different between the fifteenth generation and the fifth generation of cells (t=1.528,P=0.235;t=0.269,P=0.786;t=1.954,P=0.139;t =0.730,P =0.506).In addition,a good and stable growth curve also was exhibited in the fifteenth generation of cells compared with the fifth generation of cells.Conclusions Bleb scar-derived HTFs present good and stable growth in vitro.This result demonstrates HTFs were target cells in antifibrosis study after antiglaucoma filtrating surgery.

Objective To investigate the bettertherapeutic method and clinical efficacy of discoid meniscus injury under arthroscope.Methods Forty-one patients with discoid meniscus injury were selected as our subjects from Nov.2011 to Feb.2013,who were treated by arthroscopic surgery and performed with meniscus plasty.Thirt-eight patients were received ultra Fast-fix meniscal repair system.Joint function exercises were performed on bed within 1 month after operation.Incomplete weight bearing were performed after 1 month postoperation.After 3 month postoperation,they were permitted for full weight bearing.Results All patients were treated successfully with surgery and no postoperative complications occurred.The patients were followed up from 3.0 to 18.0 months and average was 10.5 months.The preoperative Lysholm scores were(68.28 ±8.04)) lower than that at the postoperation (88.17 ± 7.49)) and the difference were significant (t =11.59,P ＜ 0.05).Furthermore,according to Ikeuchi criterion,the outcomes were 28 cases with excellent,10 cases with good and 3 cases with general rank.Conclusion Discoid meniscus plasty and suture under arthroscope is proved to be a better approach with less trauma,recovery quickly and fewer complications.It should be a preferred method for discoid meniscus injury.

Objective:To explore the surgical techniques in posterolateral mini-incision total hip arthroplasty and clinical effcacy.
Methods:A total of 94 patients (98 hips) had posterolateral mini-incision total hip arthroplasty, from December 2006 to December 2008, and were randomly divided into a posterolateral mini-incision total hip arthroplasty group (Group A) and a conventional group of posterolateral incision for total hip arthroplasty (Group B). Forty-nine patients (50 hips) in Group A had posterolateral small incision total hip arthroplasty [26 males, 23 females, between 37.0 and 95.0 years (average 68.9 years), body mass index (BMI) between 20.3 and 29.7 (average BMI 25.4)]. Forty-ifve patients (48 hips) in Group B had the conventional posterolateral incision [27 males, 18 females, between 45.0 and 92.0 years (average 69.7 years), BMI between 18.7 and 34.1 (average BMI 26.9)]. The incision length, blood loss, drainage, operation time, and postoperative Harris scores were compared between the 2 groups.
Results:The incision length was 6.0~10.5 (average length 7.4) cm, average blood loss was 387.6 (140.0~1000.0) mL, average drainage was 143.1 (63.0~375.0) mL, average blood transfusion was 77.6 (0~400.0) mL, average operation time was 84.6 (63.0~130.0) min, and vitalock abduction angle imaging after the operation was 41.6° (averagely 38.0°~57.0°) in Group A. The incision length was 15.0~23.0 (average length 20.0) cm, average blood loss was 513.1 (210.0~1350.0) mL, average drainage was 152.3 (70.0~520.0) mL, average blood transfusion was 142.2 (0~800.0) mL, average operation time was 84.0 (71.0~115.0) min, and postoperative radiographic acetabular cup abduction angle was 42.3° (37.0°~54.0°) in Group B. The follow-up showed that the prosthesis of the 2 groups was in a good position, Harris score was significantly improved with no complications after total hip arthroplasty in the 2 groups.
Conclusion:With the correct selection of indications and adept operation skills and other circumstances, posterolateral mini-incision total hip arthroplasty may do little damage to the soft tissue with a small scar on the skin. The imaging evaluation after the operation and the Harris score show no difference between the 2 groups. Patients are satisfied with their joint function and postoperative recovery.

Due to the poor repair and regeneration capacity of articular cartilage, traditional treatment cannot get satisfactory curative effect on it. However, tissue engineering provides a new way for repairing articular cartilage defects. Present research focus has come down to the following issues: the stability of cell characters and phenotypes during mass amplification of seed cells, the control of directional differentiation, the combination of multi-scaffold materials, the synergistic effect of multi-growth factors, the gene transfer technology for maintaining the expression of growth factors, etc. This article reviews the advances in seed cells, scaffold materials, growth factors of articular cartilage tissue engineering, pointing out their advantages and disadvantages as well as the research direction in the future.

ObjectiveTo study central venous oxygen saturation (ScyO2) in controlled hemorrhagic shock rabbits resuscitation process as a transfusion trigger and traditional transfusion trigger of comparison.MethodsSelection New Zealand pure line of rabbit 32 only,simple randonly divided into 4 groups,groups A and B for the observation group,groups C and D as control group,groups of eight only.A,B,C,D four groups respectively by ScvO2 ≤70％,ScvO2 ≤75％,hemoglobin (Hb)≥8g/dl,blood loss for the whole blood volume≥30％ as transfusion trigger.From right femoral artery bloodletting 10 minute inside,made the MAP to about (40 ± 5 )mmHg,and maintained the blood pressure 60 minutes,established controlled hemorrhagic shock rabbits of animal model.And then started to resuscitate,with colloid and crystalloid infusion according to the proportion 1∶2,infusion rate of about 10 ～ 15ml/( kg · h),according to the blood pressure and heart rate,and proper adjustment according to the different requirements of each group conducted a blood transfusion.Monitoring based value,shock,shock treatment 30 minutes,60 minutes,120 minutes,180 minutes all time points,and various indexes of blood loss,blood transfusions,crystalloid and colloid fluid volume and so on.ResultsIn shock treatment observation group A late blood pressure,pH,BE,HCO3-,O2ER etc compared with the other three groups had obvious statistical differences ( P ＜ 0.05 ),group B with C and D two groups at the same time points each monitoring were no significant differences ( P ＞0.05 ).The volume of transfusion group C was most,compared with the other three groups were significant difference ( P ＜ 0.05 ),group D of blood transfusions than A,B two groups (P ＜ 0.05 ),groups A and B infused colloid fluid,crystal fluid volume than groups C and D ( P ＜ 0.05 ),each group blood lossed without significant difference.ConclusionScvO2 for controlled hemorrhagic shock rabbit resuscitation monitoring can guide controlled hemorrhagic shock rabbit of blood transfusions,according to ScvO2 ≤75％ transfusion with traditional according to Hb or blood loss transfusion trigger comparison,can achieve the same resuscitation effect,and can more accurately and individualized guide transfusion,reduce unnecessary blood transfusions,save resources.

The aim of this research is to evaluate the effect of tetramethylpyrazine (TMP) and connective tissue growth factor (CTGF) miRNA plasmids on the expressive levels of CTGF, transforming growth factor-beta (TGFbeta) and type I collagen of rat hepatic stellate cells (HSC) which are stimulated by high glucose. The rat HSCs which were successfully transfected rat CTGF miRNA plasmids and the rat HSCs which were successfully transfected negative plasmids were cultured in vitro. After stimulus of the TMP and the high glucose, the protein levels and gene expressive levels of CTGF, TGF-beta and type I collagen were tested. The results indicated that high glucose increased the expression of CTGF mRNA, CTGF protein, TGF-beta mRNA,TGF-beta protein and type I collagen (P < 0.05). The expressive levels of CTGF mRNA, CTGF protein, TGF-beta mRNA, TGF-beta and type I collagen in TMP group were lower than those in high glucose group and showed statistically significant differences (P < 0.05). Compared with high glucose group, the expressive levels of CTGF mRNA, CTGF protein, TGF-beta mRNA, TGF-beta and type I collagen in rat CTGF miRNA plasmid interference group were significantly lower (P < 0.05). However, no statistically significant difference was found in CTGF mRNA and CTGF protein levels between TMP group and CTGF miRNA group (P > 0.05), while type I collagen levels showed statistically significant differences (P < 0.05). It is concluded that high glucose could promote the expressions of CTGF, TGF-beta and type I collagen, and TMP and rat CTGF miRNA plasmids could reduce the expressions of CTGF, TGF-beta, type I collagen.
Animals ; Cells, Cultured ; Collagen Type I ; metabolism ; Connective Tissue Growth Factor ; genetics ; Culture Media ; pharmacology ; Glucose ; pharmacology ; Hepatic Stellate Cells ; drug effects ; metabolism ; MicroRNAs ; genetics ; Plasmids ; Pyrazines ; pharmacology ; RNA, Messenger ; Rats ; Transfection ; Transforming Growth Factor beta ; metabolism

Objective:To investigate the status of viral reservoirs in prostate tissue of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to investigate the effect of highly active anti-retroviral therapy (HAART) on HIV-1 DNA in prostate tissue of HIV/AIDS patients.Methods:Twelve patients with HIV infection and hyperplasia of prostate who required surgical treatment and admitted to Guangzhou Eighth People′s Hospital from July 2017 to October 2019 were included. Blood and prostate specimens of these patients were collected, and HIV-1 RNA in plasma, CD4 + T lymphocyte count in peripheral blood and HIV-1 DNA level in prostate tissue were tested respectively. The independent sample t test or Mann-Whitney U test was used for statistical analysis. Results:Among the 12 patients, the CD4 + T lymphocytes was (519.8±121.5)/μL and HIV-1 DNA in the prostate tissue was 2 602 (365, 10 700) copies/10 6cells in six patients who had not started HAART. The CD4 + T lymphocytes was (182.8±69.7)/μL and the HIV-1 DNA in the prostate tissue was 144 (36, 563) copies/10 6cells in the six patients who underwent HAART for over six months. There were statistically significant differences in CD4 + T lymphocytes and HIV-1 DNA in the prostate tissue between the two groups ( t=-5.889 and Z=-2.082, respectively, both P<0.05). Conclusion:Prostate tissue can be used as an HIV-1 virus repository with or without HAART, and the size of the prostate tissue virus repository can be reduced by HAART after immune reconstitution.