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

BACKGROUND: Present studies have verified that Baicalin has protective effects on various brain damage in the nervous system.OBJECTIVE: To study the possibility of intravenous transplantation of human umbilical blood mesenchymal stem cells (hUBMSCs) and Baicalin after hypoxic-ischemic brain damage (HIBD) in neonatal rats.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Laboratory of the Department of Neurology, First Affiliated Hospital, Nanchang University from February 2007 to January 2008.MATERIALS: Totally 10 umbilical blood samples from healthy full-term pregnant women were obtained from the Department of Obstetrics, First Affiliated Hospital, Nanchang University. A total of 85 clean Sprague Dawley neonatal rats aged 7 days were randomly assigned to a normal control group (n=15), a model group (n =20), a cell transplantation group (n =25), a cell transplantation + Baicalin group (n =25).METHODS: The umbilical blood mononuclear cells were isolated by the gelatin sedimentation + density gradient centrifugation method, and amplified in vitro. Cells at the fifth passage were used for transplantation. Cells were labeled by DAPI at 6-12 hours before use. Neonatal rats in the model, cell transplantation and cell transplantation + Baicalin groups were used to establish HIBD models. Rats in the blank control group were left intact. At 2, 3,4, 5 weeks following model induction, rats in the cell transplantation and cell transplantation + Baicalin groups were injected with DAPI-labeled hUBMSCs (5-10 μL/g) via caudal vein at the density of 1 ×10~9/L. From the first day of transplantation, rats in the cell transplantation + Baicalin group were injected with 120 mg/kg Baicalin via intraperitoneal injection, once a day, for three successive days.MAIN OUTCOME MEASURES: The following parameters were measured: brain tissue lesion, DAPI-positive cell number, location of hUBMSCs following transplantation.RESULTS: Lesion rate of brain tissue was significantly lower in the cell transplantation + Baicalin group compared with the model and cell transplantation groups at 4 weeks following transplantation (P < 0.05). Compared with the cell transplantation group,DAPI-positive cell number was significantly increased in the cell transplantation + Baicalin group at 1, 2, 4 weeks (P < 0.01). From the 3~(rd) week following model induction, abundant DAPI-labeled cells were found surrounding the lesion site, without obvious boundary integrated with the host brain. Few DAPI-positive hUBMSCs were found in non-ischemic region. At 4 and 5 weeks following model induction, DAPI-positive cells were significantly decreased in the lesion site.CONCLUSION: The third week following HIBD is an optimal time for cell transplantation. Baicalin can make a large number of hUBMSCs across the blood-brain barrier to distribute and scatter around the disease focus integrated with host brain tissue.

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 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 discuss the implications of orbital septum repairing and crimpling in the plastic surgery of lower eyelid bags. Methods The ultimate results were analyzed in the patients (aged less than 40) who received three different operations from six months to five years and the effect of operation and recrudescence of lower eyelid sag were observed. The procedures included simple fat removal, fat removal plus orbicularis oculi hanging, and orbicularis oculi hanging plus orbital septum repairing and crimplling. Results Since 2002, 157 cases were treated, and the ultimate effects of patients were analyzed. 86 cases treated with orbicularis oculi hanging plus orbital septum repairing and crimplling reached the best results without recurrence. 71 cases treated with simple fat removal or fat removal plus orbicularis oculi hanging experienced recurrence in different degree within a short period. Conclusion The weakness and laxation of the former wall causes the formation of lower eyelid bag, the appearance and recrudescence mainly locate below the former wall. Orbital septum repairing and crimpling most effectively strengthen the underside of the former wall. Orbicularis oculi hanging strengthens the top of the former wall and prevents any complications. The effects of the last procedure are better than that of the other two in the near future or in the long term.

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.

Objective To explore the pathogenesis of irritable bowel syndrome (IBS) by detecting serum levels and the colonic mucosa expression of inflammatory cytokines,peptide YY (PYY),and claudin-1,and to analyze their correlation.Methods From April 2013 to April 2015,50 outpatients with IBS and 20 healthy controls were selected.Serum levels of PYY,interleukin (IL)-10,tumor necrosis factor (TNF)-α and claudin-1 were detected by enzyme-linked immunosorbent assay (ELISA).The expression of IL-10,TNF-α,PYY and claudin-1 in colonic mucosa was determined by immunohistochemistry.Single factor analysis of variance,least significant difference (LSD) method,chi-square test,and Pearson correlation analysis were performed for statistical analysis.Results Among the 50 patients with IBS,27 cases were diarrhea-type irritable bowel syndrome (D-IBS),and 23 cases were constipated-type irritable bowel syndrome (C-IBS).The serum level and the positive expression rate of PYY in colonic mucosa of D-IBS group were significantly higher than those of healthy control group ((16.28± 2.75) ng/L vs (10.12± 1.55) ng/L;66.7 ％ (18/27) vs 30.0 ％ (6/20)),and the differences were statistically significant (LSD-t=10.19,x2 =6.182,both P＜0.05).The serum level and the positive expression rate of IL-10 in colonic mucosa of D-IBS group were both significantly lower than those of healthy control group ((2.95 ±0.24) ng/L vs (3.58±0.35) ng/L;22.2％(6/27) vs 50.0％ (10/20)),and the differences were statistically significant (LSD-t =4.52,x2=3.948,both P＜0.05).The serum level and the positive expression rate of TNF-α in colonic mucosa of D-IBS group were both significantly higher than those of healthy control group ((8.73±0.41) ng/L vs (7.73±0.51) ng/L;66.7％(18/27) vs 30.0％(6/20)),and the differences were statistically significant (LSD-t=8.43,x2 =6.182,both P＜0.05).There was no statistically significant difference between C-IBS group and healthy control group in the serum levels of PYY ((10.24±1.34) ng/L vs (10.12± 1.55) ng/L),IL-10 ((3.43 ± 0.71) ng/L vs (3.58 ± 0.35) ng/L),TNF-α ((7.81±0.26) ng/L vs (7.73 ±0.51) ng/L),and thus the positive expression rate in colonic mucosa (39.1％(9/23) vs 30.0％(6/20),56.5％(13/23) vs 50.0％(10/20),34.8％ (8/23) vs 30.0％(6/20);all P＞0.05).The serum level of claudin-1 and its positive expression rate of PYY,IL-10,TNF-α in colonic mucosa in D-IBS group were both lower than those of healthy control group ((94.44 ± 6.61) ng/Lvs (103.64 ± 5.47) ng/L;11.1％ (3/27) vs 40.0％ (8/20)),and the differences were statistically significant (LSD-t=5.76,x2 =5.349;both P＜0.05).However,the serum level of claudin-1 and its positive expression rate in colonic mucosa in C-IBS group were both higher than those of healthy control group ((115.54±3.42) ng/L vs (103.64±5.47) ng/L;73.9％ (17/23) vs 40.0％(8/20)),and the differences were statistically significant (LSD-t=5.56,x2 =5.055;both P＜0.05).The serum levels of IL-10 and PYY,TNF-α and claudin-1 were negatively correlated in the D-IBS group (r=-0.874 and -0.863,both P＜0.05).While the serum levels of TNF-α and PYY,IL-10 and claudin-1 were positively correlated (r =0.865 and 0.876,both P＜ 0.05).Conclusions There may be the imbalance of proinflammatory factors and anti-inflammatory factors in IBS patients.PYY may decrease the expression of claudin-1 by promoting IL-10 and inhibiting TNF-α,and thus ameliorate the inflammation reaction of IBS patients.

Objective: To seek the optimal acupuncture time for primary dysmenorrhea and provide clinical basis for optimal acupuncture treatment protocol. Methods:A total of 90 eligible cases were randomly allocated into three groups, 30 cases in each group. Points Guanyuan (CV 4), bilateral Zusanli (ST 36) and Sanyinjiao (SP 6) were selected for patients in all three groups, with a different treatment duration: 15 min in group A, 30 min in group B and 45 min in group C. Then the clinical efficacy in each group was evaluated by pain symptom scoring. Results:As for the pain symptom scores, there were statistically significant intra-group differences between before and after treatment in three groups (allP<0.05); coupled with statistically significant inter-group differences between group B and the other two groups (bothP<0.05). As for clinical efficacy, there were statistical differences between group B and the other two groups (bothP<0.05), indicating that 30 min of acupuncture is the optimal duration in the treatment of dysmenorrhea. Conclusion:With the same needling manipulation, 30 min of acupuncture treatment achieves a better efficacy for primary dysmenorrhea.

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.