Objective To evaluate the effect of a biodegradable paclitaxel-eluting biliary stent on bile duct scar formation and biliary stricture by observing the healing process after stent placement in a porcine billiary model.Methods A novel biodegradable paclitaxel-eluting biliary polylactide stent was manufactured by immersion method.The efficacy of drug release for paclitaxel-eluting biliary stent was investigated by HPLC.Paclitaxel-eluting stent were surgically inserted in the bile duct of fifteen swines in experimental group while stent without paclitaxel were placed in other fifteen swines in control group.Animals were sacrificed after 1,3,6 months.The anastomic healing of the common bile duct was observed.The size of anastomosis was measured and compared between the two groups.Result A novel biodegradable paclitaxel-eluting biliary stent was manufactured.The total amount of paclitaxel released was about 281 pg (30.4％) over a month as determined with HPLC methods.There was no death,no leakage.The diameter of anastomosis in the experimental group was significantly larger than that in control group.Cholangiography did not show obvious bile duct dilatation in experimental group.Histologic examination showed less hyperplasia of the bile duct wall in the experimental group than that in control group.Conclusion Release of paclitaxel via a biodegradable stent relieves billiary stricture in porcine model and have no obvious negative influence on wound healing of the common bile duct.

Objective To investigate the possibility to obtain the cranial subtraction computed tomography perfusion imaging (sCTP) from the CTP examination, and to explore preliminary application value of sCTP. Methods Cerebral sCTP obtained from source imaging data of 11 patients (10 with stroke and 1 with brain tumor) were analyzed with subtraction software and perfusion 3 software at GE AW4.2 workstation. The parametric maps and region of interest (ROI) value of blood flow (BF), blood volume (BV), mean transit time (MTT) and/or permeability surface (PS) were generated from the CTP and sCTP imaging data respectively. Results ①The technical success rate of cranial sCTP created from CTP sources imaging data was 100%, and the post-processing time of sCTP was about from 1.0 to 2.5 h. The mappings and values of BF, BV, MTT and PS of ROI were all successfully obtained from sCTP and CTP imaging data. ②The cerebral mappings of BF, BV, MTT and PS obtained from sCTP were similar to those from CTP, which all depicted accurately the lesions and their microcirculation hemodynamics changes. ③Just like those from CTP, the values of BF, BV, MTT and PS of nidus obtained from sCTP were significantly different from those of the near and the contralateral corresponding cerebral tissues (P<0.025). Conclusion sCTP can be generated successfully with subtraction and perfusion imaging software. It is an alternative solution for functional diagnosis of stroke and brain neoplasms.

Three hundred and thirty eight patients with type 2 diabetes mellitus( DM) admitted from January 2006 to June 2009 and 50 healthy subjects (control group) were enrolled in the study. Platelet glycoprotein PAC-1 and CD62P levels were measured in both groups. Compared with control group, plasma PAC-1 and CD62P levels of DM patients increased significantly (P ＜0.01). Patients were divided into three groups according to their urinary albumin excretion rate ( UAER) . PAC-1 and CD62P levels in macroalbuminuria group (UAER≥200μg/min) were significantly higher than those in normoalbuminuria group( UAER <20μg/min) and microalbuminuria group (20μg/min≤UAER ＜ 200μg/min) (both P＜ 0.05). The results indicate that plasma levels of PAC-1 and CD62P, which reflect platelet activation, are the independent risk factors for diabetic nephropathy.

Dact proteins belong to a structure-related protein family. Recent studies have demonstrated that Dact proteins play an important role in tumorigenesis via modulation of wnt and TGF-p signaling. Delin-eation of the physiological function of Dact proteins would enhance our understanding of look for new strategy targets for cancer and suggests a potential strategy for therapeutic control of wnt and TGF-β signaling in canc-er.

MAL gene expresses in the mediate and late stage of T-lymphocyte,correlated with carcinoma.Hereditary factors and epigenetic mechanisms play important roles in the pathogenesis of colorectal carcinoma.One of the main epigenetic modifications to be identified is methylation of DNA.the hypermethylation and abnormal expressions of MAL gene play a key role in the development,invasion,metastasis and prognosis of colorectai carcinoma.Therefore MAL gene may be another promising early diagnostic marker,which provide new evidence for early stage prediction,classification,prognosis,chemoprevention of colorectal carcinoma.

Objective To study the effects of different operation time of laparoscopic cholecystectomy(LC) on systemic stress response.Methods A total of 40 patients conducted by LC were divided into the Group A(

Objective:To investigate the correlation between preoperative blood platelet-to-lymphocyte ratio (PLR) and clinico-pathological features, as well as the effect of PLR on the prognosis of non-small cell lung cancer (NSCLC) patients after surgical resec-tion. Methods:Retrospective analysis was performed for 255 cases with histologically confirmed NSCLC that underwent curative re-section from January 2004 to December 2007. All patients were classified into two groups based on the median value of PLR. The rela-tionship between PLR and clinicopathological features was studied. Univariate and multivariate analyses were performed to assess the prognostic effect of preoperative PLR. Results:The median value of preoperative PLR was 130 (range:45.45 to 272.66). Based on the cut-off value of 130, all patients were divided into two groups:low PLR (≤130, n=127) and high PLR (>130, n=128). PLR was corre-lated with tumor site, T stage, and clinical stage. Five-year survival rates of low and high PLR patients were 49.6%and 33.6%, respec-tively, which indicated a statistically significant difference (χ2=12.577, P<0.001) between the two groups. Univariate analysis showed that smoking status, histological differentiation, clinical stage, T stage, N stage, postoperative adjuvant therapy and PLR were associat-ed with survival (P<0.05 for all). Multivariate analysis identified N stage, postoperative adjuvant therapy, and PLR as independent prog-nostic factors of all the patients. In addition, stratified analysis showed that the five-year survival rate of the low PLR group was higher than that of the high PLR group with or without lymph node metastasis, and the differences were statistically significant (P=0.020 and 0.037). Conclusion:An elevated blood preoperative PLR indicates poor prognosis in NSCLC patients. Preoperative PLR is an indepen-dent prognostic factor of NSCLC after curative resection.

Objective To investigate the clinical value of multidisciplinary team (MDT) assessment for chronic constipation.Methods The clinical characteristics of 346 patients with chronic constipation who were admitted to the Third Peolep's Hospital of Hangzhou from January 2010 to December 2013 were multidisciplinarily assessed.The muhidisciplinary team was involved surgeons from the department of colorectal surgery,urology,gynecology,psychiatry and psychology,and tools including questionnaires,defecography,anorectal manometry,colon transit study,urodynamic tests,gynecological examination were applied in the study.The measurement data with normal distribution were presented as (x) ± s,the comparison between groups was analyzed using the ANOVA,and the count data were analyzed using the chi-square test.Results Three hundred and forty-six patients who met criteria of this research were selected,including 86 males and 260 females with the ratio of 1 ∶ 3;the mean age was (55 ± 11)years.Of the 346 patients,slow transit constipation accounted for 7.52％ (26/346),defecatory disorder for 60.98％ (211/346),and mixed constipation for 31.50％ (109/346).A total of 93.85％ female patients (244/260) had anterior rectocele,75.43％ (261/346) patients had internal rectal mucosal prolapse,66.76％ (231/346) patients had perineum descending,23.99％ (83/346) had achalasia or inappropriate contraction of internal anal sphincter,18.79％ (65/346) had puborectalis rectocele muscle thickening,5.49％ (19/346) had rectal prolapse.A total of 82.37％ (285/346) patients were involved in other subjects than colorectal surgery.A total of 28.61％ (99/346) patients presented with urinary symptoms,including 65 cases with stress urinary incontinence,23 cases with unstable bladder and 19 cases with bladder neck obstruction (some patients had multiple urological systoms).The incidence of reproductive organ prolapse in female patients was 31.92％ (83/260),the incidence of uterine prolapse and anterior vaginal prolapse were 26.15％ (68/260) and 29.23％ (76/260),respectively.Patients with anxiety and/or depression accounted for 36.13％ (125/346).The male and female patients of slow transit constipation,defecatory constipation and mixed constipation were 10 vs 16,30 vs 79,46 vs 165,respectively,the age was 60 ± 12,56 ± 11,52 ± 10,showing no significant differences (x2=4.046,F =2.877,P ＞ 0.05).In the three kinds of constipation,patients with urinary diseases accounted for 26.92％ (7/26),26.61％ (29/109) and 29.86％ (63/211),patients with gynecological diseases accounted for 11.54％ (3/26),20.18％ (22/109),27.49％ (58/211),patients with psychological diseases accounted for 38.46％ (10/26),39.45％ (43/109),34.12％ (72/211),respectively,showing no significant difference (x2=4.090,P ＞ 0.05).Conclusion MDT assessment for patients with chronic constipation can reflect comprehensively clinical characteristics of chronic constipation,therefore multidisciplinary team should be emphasized in clinical diagnosis and treatment of chronic constipation.

ObjectiveTo evaluate the past 5 years' clinic experience of diagnosis and treatment of the pediatric soft-tissue foreign body (STFB),and to probe new strategies for its clinical management.MethodsTotally 165 consecutive children with small radiopaque STFB were involved.All the children were diagnosed with X-rays.CT (enhanced CT in 9 children)and virtual anatomy imaging (VAI) were performed in 40 children.Percutaneous foreign body forceps removal guided with C-arm video-fluoroscopy was performed and the effect was evaluated.ResultsThe longest dimension of STFB ranged from 1 mm to 40 mm,and the shortest dimension ranged from 1 mm to 5 mm,including scrap-iron,broken iron nails and needles,and glass pieces embedded in soft tissues under surface of the limbs,neck,chest,abdomen and pelvis.Seventy-six (76/165,46.06 ％) children received interventional therapy,and 73 were completely cured (73/76,96.05 ％),2 were partially cured (2/76,2.63 ％),and 1 was failed (1/76,1.32 ％).VAI accurately depicted STFB closely to large vessels even associated vascular complication with local large hematomas or pseudoaneurysms,helped to select the treatment methods and the forceps removal roads.Hematoma,infection,neural damages and other serious complications did not occur during and after operation.ConclusionVideo-fluoroscopy-guided percutaneous foreign body forceps removal is minimally invasive,safe and effective for small radiopaque STFBs,but may not suitable for the one very close to large blood vessels with or without vascular injuries complications.Preoperative CT VAI is helpful to locate STFB within complicated anatomic structures,selecting optimal intervention pathway and assessing the risk of intervention.

Objective To investigate the technical protocols and feasibility of subtraction computed tomography perfusion imaging (sCTP) on observation of ischemic necrosis of femoral head (ANFH) on dog. Methods Sixteen laboratory canines underwent CT perfusion imaging (CTP) of femoral head before and after selective femoral circumflex artery embolization, and ANFH were observed. Then new sequence imaging data, created by sources imaging of CT perfusion scan using subtraction software, were analyzed at workstation (AW 4.2) with CT perfusion 3 analysis program, and data of sCTP were obtained. The parametric maps and indexes of capillary-level hemodynamics including blood volume (BV), blood flow (BF) and mean transit time (MTT) of CTP and sCTP were compared. Results ①The technical success rate of sCTP post-processing created from CTP sources imaging data was 100%. The values and mappings of BF, BV and MTT of region of interest (ROI) were all obtained from subtraction sequence images data. The post-processing time of sCTP was about 1-5 h. ② sCTP depicted ANFH well, though the values and mappings of BF, BV and MTT were different from those obtained with conventional bone CTP. Conclusion sCTP can be generated with subtraction and perfusion analysis program and techniques. It can be applied to bone CT perfusion imaging and early quantitative diagnosis of necrosis.