Objective To discuss the feasibility and superiority of EST combined with LC in treating cholecystolithiasiswith common bile duct stones.Methods Patients underwent LC(laparoscopic cholecystectomy) preceded by EST(endoscopic sphincterotomy) and removal of common bile duct stones.ENBD(Endoscopic nasal biliary drainage tube)was placed if EST failure and then the patient underwent LC+laparoscopic biliary duct exploration(LCBDE),or open operative bile duct exploration.Results In 91 of the 99 cases,LC preceded by EST and stone removal was successful,while EST following LC was successful in 3 cases,and stone removal by EST was unsuccessful in 3 cases.Two cases less than 15 years of age underwentLC+LCBDE through the cystic duct and did not undergo EST.Three cases,who had EST failure,underwent LC+LCBDE with primary suture of the common bile duct or LCBDE with T-tube drainage of commonbile duct,or open bile duct exploration with primary suture of the common bile duct(ENBD was in place).All patients were discharged from hospital without serious complications.Conclusions EST combinedwith LC in treating cholecystolithiasis with common bile duct stones is a safe and effective method.Combination of endoscopic and laparoscopic procedures fully reflects the advantage of minimally invasive therapy.

Aged ; Female ; Humans ; Leukocyte Common Antigens ; metabolism ; Peroxidase ; metabolism ; Sarcoma, Myeloid ; metabolism ; pathology ; Vulva ; metabolism ; pathology ; Vulvar Neoplasms ; metabolism ; pathology

To study ecology suitability rank dividing of the total alkaloid content of Coptis Rhizoma for selecting artificial planting base and high-quality industrial raw material in Chongqing province. Based on the investigation of PCB and DEM data of Chongqing province, the relationship between the total alkaloid content in Coptis Rhizoma and topographical conditions was analyzed by statistical analysis. The geographic information systems (GIS)-based assessment and landscape ecological principles were applied to assess eco logy suitability areas of Coptis Rhizoma in Chongqing. slope, aspect and altitude are main topographical factors that affect the content of the total alkaloid content in Coptis Rhizoma The total alkaloid content in Coptis Rhizoma is higher in the lower altitude, shady slope and bigger slope areas. The total alkaloid content is higher in the south areas of Chongqing province and lower in the northeast. Terrain conditions of the southern region of Chongqing are most suitable for The accumulated of total alkaloid Coptis Rhizoma content.
Alkaloids ; analysis ; metabolism ; China ; Coptis ; chemistry ; Ecology ; Environment ; Geographic Information Systems ; Geography ; Plants, Medicinal ; Rhizome ; chemistry

Objective:To investigate the influence ofpidotimod combined with budesonide aerosol inhalation on the IL-4,IFN-γ,immunoglobulin and T cell subsets of children with bronchial asthma.Methods:92 cases of children with bronchial asthma in our hospi tal from June 2015 to June 2016 were selected as the research objects and randomly divided into the observation group and the control group.The control group was given budesonide suspension treatment,and the observation group was treated by pidotimod oral liquid on the base of the control group.The changes of serum IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+CD8+ before and after treatment were de tected and compared between the two groups.Results:Before treatment,there was no significant difference in the serum IL-4,IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+/CD8+ between two groups (P＞0.05).Compared with those before treatment,the serum level of IL-4 was significantly decreased,in the observation group,while the IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD4+/CD8+ levels were significantly increased afrer treatment (P＜0.05).The IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+/CD8+ of control group showed no significant change before and after treatment (P＞0.05),only the serum IL-4 level was significantly decreased (P＜0.05).After treatment,the IL-4,IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+/CD8+ of observation group were better than those of the control group (P＜0.05).Conclusion:Compared with budesonide alone,pidotimod combined with budesonide could significantly regulate the immune function of children with bronchial asthma.

Objective:To observe changes of serum uric acid (UA)level and red cell distribution Width (RDW)in se-nile men With chronic heart failure (CHF),and explore their correlation With cardiac function.Methods:A total of 60 senile male CHF patients Were enrolled,including 28 cases of NYHA cardiac function class Ⅱ and 32 cases of NYHA class Ⅲ-Ⅳ.Another 30 cases With normal cardiac functionWere regarded as normal control group.Levels of UA,RDW and high sensitive C reactive protein (hsCRP)Were measured,and patients received color-coded Doppler echocardiography,change of every index Was compared among patients With different cardiac function class.Results:Compared With normal control group,there Were significant rise in serum levels of UA [(318.2± 54.3)μmol/L vs.(434.7±72.7)μmol/L],RDW [(13.84±0.60)% vs.(15.79±0.74)%]and hsCRP [(2.23 ±0.56)mg/L vs.(6.35±2.34)mg/L]in CHF group,and they significantly rose alongWith cardiac function class aggravated,P <0.01 all;there Were significant decrease in transmitral early diastolic peak floW velocity/transmitral late diastolic peak floWvelocity [E/A,(1.02±0.36)vs.(0.75±0.13)]and left ventricular ejection fraction [LVEF,(59±9)% vs.(49±9)%]in CHF group,and they significantly reduced along With cardiac function aggravated, P <0.01 both;in CHF group;UA,RDW and hsCRPWere negatively correlatedWith E/A and LVEF (r =-0.391~-0.731,P <0.05 all);RDW Was positively correlated With hsCRP (r =0.491,P <0.05).Conclusion: Serum uric acid and red cell distributionWidth are correlated to cardiac function in senile male patients,Which can help to judge the severity of heart failure and guide clinical treatment.

Objective: To explore the correlation among serum prealbumin (PAB) level, red cell distribution width (RDW) and cardiac function in advanced aged male patients with chronic heart failure (CHF). Methods: Research objects included 60 patients with heart failure（28 cases with NYHA class Ⅱ and 32 cases with NYHA class Ⅲ-Ⅳ, heart failure group）and 30 cases with normal cardiac function admitted in the same period（normal control group）. Serum PAB, hemoglobin (Hb) concentration and RDW, red blood cell (RBC) count were measured. Patients all received echocardiography examination. Changes of all indexes were compared among patients with different cardiac function class. Results: ① Compared with normal control group, there was significant decrease in serum PAB level [(252±49) mg/L vs. (185±36) mg/L] and significant increase in RDW [(13.84±0.60) % vs. (15.79±1.33) %] in heart failure group, and compared with class Ⅱ group, there was significant decrease in serum level of PAB and significant increase in RDW in class Ⅲ-Ⅳ group, P<0.01 all; ② Compared with normal control group, there were significant decrease in E/A [(1.02±0.36) vs. (0.75±0.18)] and left ventricular ejection fraction [LVEF, (59±9) % vs. (49±11) %] in heart failure group, and the worse cardiac function was, the lower these two indexes were, P<0.01 all; ③ Pearson linear correlation regression analysis indicated that PAB was positively correlated with E/A and LVEF (r=0.451, P<0.05; r=0.596, P<0.05), and RDW was negatively correlated with E/A and LVEF (r=-0.391, P<0.05; r=-0.574, P<0.05) in heart failure group. Conclusion: Prealbumin and red cell distribution width are closely correlated to cardiac function class in advanced aged male patients. Both of them can indirectly reflect cardiac function in advanced aged patients with chronic heart failure.

Furthering of the health reform calls for better health care system,greater public financing,and deepened reform of public hospitals.Introduced in this paper are the actions taken and outcomes of the health reform in Changchun city,including the essential medicines system to minimize drug prices,improvement of the primary healthcare system to minimize people's financial burden,greater public spending to enhance public welfare nature of medical institutions,enhanced competencies of primary medical institutions to introduce rational classification of patient flow,and enhanced equity of public services to promote people's health.On such basis,further reform proposals were made for Changchun's health reform.

Objective To study the applied value of diffusion weighted imaging-DWIBS(diffusion weighted imaging with background suppression) in detecting the body tumour.Methods 10 healthy volunteers and 20 patients with histologically proven tumour were examined by diffusion Weighted MR with different techniques of background/fat body signal suppression.STIR-EPI sequence and spin echo-echo planar imaging(SE-EPI) sequence with chemical shift selective(CHESS) pulse were compared in terms of their degree of fat suppression.The diffusion weighted imaging features of control group and patients with tumour were observed and the values of ADC were measured.Results Fat suppression with STIR-EPI sequence in neck,chest,spine and extremity was well and SE-EPI with CHESS pulse in chest,abdomen,pelvic was satisfying.Signal to noise ratio(SNR) wss higher in SE-EPI with CHESS than that in STIR.The glands,spleen,peripheral nerves,lymph nodes and so forth could be showed by DWIBS in control group.85% malignant lesions were well visualized and appeared as high signal intensity and lower signal intensity in similar PET imaging,but the lesions only in 3 patients are not well visualized including pancreas cancer(1 case),rectum cancer(1 case),prostate cancer(1 case).PET scan was performed in 3 patients and well corresponded with diffusion weighted imaging in 2 cases,the other one was not visualized on diffusion weighted imaging.The highest ADC of malignant tumors was(1.58?2.06)?10-3mm2/s,the lowest ADC of malignant tumors was(0.88?0.74)?10-3mm2/s,the mean values of ADC of malignant tumors was(1.34?0.79)?10-3mm2/s.Conclusion DWIBS is a new method of diffusion-weighted MR,it has high spatial resolution,high contrast to noise ratio(CNR) and high SNR. This technique can be used as a powerful screening tool for tumour and evaluating the pathological lesions by measuring the values of ADC.

Objective:To optimize and improve the content determination method for nitroglycerin ointment. Methods:An HPLC method was used,the column was Hypersil ODS(150 mm × 4. 6 mm,5 μm),the mobile phase was acetonitrile ∶water(50 ∶50),the detection wavelength was set at 220 nm,the flow rate was 1 ml·min-1 ,the column temperature was 30℃,and the injection volume was 20 μl. Results: The results showed a good linear relationship within the concentration range of 0. 020 3-0. 203 3 mg · ml-1 ( r =0. 999 9),and the average recovery was 99. 51%(RSD=1. 06%,n=9). Conclusion: The method is rapid,accurate and reproduci-ble,and can be used to determine the content of nitroglycerin in nitroglycerin ointment.

Background The biomeasurement and imageology of retinal nerve fiber layer(RNFL) thickness showed the damage of retinal structure in the early and middle stage of glaucomatous eye,however,the subtle functional damage of glaucoma can not be timely reflected only with automatic static perimeter.Microperimetry is a method of quantitatively assessing mean sensitivity (MS) of macular zone.Objective This study was to evaluate and compare the macular functional change in early and middle stage of primary open angle glaucoma (POAG) and chronic angle-closure glaucoma (CACG) with MP-1 microperimeter.Metbods This trail protocol was approved by Ethic Committee of Peiking University Third Hospital,and written informed consent was obtained from each subject prior to entering the study group.A cross-sectional and case-controlled study was designed.A total of 126 eyes from 126 subjects were enrolled in the trail,including 53 eyes of 53 normal subjects,50 eyes of POAG patients and 23 eyes of CACG patients.A macular 10° program was set with MP-1 microperimetry to record the MS of various subareas.The macula was zoned into central 2°,6°,and 10° visual fields and 4 quadrants in each ring.The MS of different rings and subareas was detected and compared among POAG patients,CACG patients and normal controls.Results The MS values of central 2°,6°,10° and whole macular area were (15.09 ± 3.03),(15.72 ± 3.22),(13.99 ± 3.63) and (14.91±3.07)dB in the POAG group,which were significantly lower than those of (17.29±1.59),(18.05±1.24),(16.76±1.89) and (17.37±1.46)dB in the normal control group (all at P=0.000).The MS values of central 2°,6°,10° and whole macular area was (16.00±2.39),(15.83±2.63),(14.45±3.15) and (15.42±2.54) dB in the CACG group,and the reduced MSs were seen at the 6°,10° rings and whole macular area in the CACG group compared with the normal control group (P =0.004,0.013,0.011).Within the 6° ring,the MS values in the inferotemporal quadrant were declined in the POAG group and CACG group compared with the normal control group (P =0.000,0.022),but the difference was not statistically significant between the POAG group and the CACG group (P =0.311).In addition,the MS value in the inferonasal quadrant was significantly lower than that of the normal control group (P =0.005); while that in the CACG group was not significantly different in comparison with the normal control group (P=0.119).In the POAG group,the MS value of the inferotemporal quadrant was significantly lower than that of the superonasal or superotemopral quadrant (P =0.043,0.016),but no significant differences were found among the 4 quadrants in the CACG group (all at P＞0.05).Conclusions The mild damage of retinal function appears in the early and middle stage of POAG and CACG.More serious MS reducing occurs in the inferotemporal and inferonasal quadrants of POAG.