Objective To investigate the effectiveness of choledochoscopy and duodenoscopy in the treatment of residual calculus of the intrahepatic bile duct. Methods Clinical data of 573 cases of choledochoscopy and 36 cases of duodenoscopy from February 1985 to June 2004 were analyzed. Results Stones were completely removed under choledochoscope by way of T-tube sinus tract in 96.02% of patients (507/528) and by way of subcutaneous blind loop in 84.62% of patients (22/26). Percutaneous transhepatic choledochoscope placement was successfully conducted in 84.21% of patients (16/19) and stones were completely removed in 78.95% of the patients (15/19). The success rate of duodenoscopic cholangiography was 91.67% (33/36) and stones were completely removed under duodenoscope in 80.56% of patients (29/36). Conclusions Treatment of residual and recurrent calculus of the intrahepatic bile duct by choledochoscopy and duodenoscopy is effective and convenient.

Objective To analyze the efficacy of umbilical one trocar laparoscopic appendectomy (UOTLA) in treatment of complicated appendicitis in children. Methods Clinical data of 78 cases of children patients with complicated appendicitis from January 2012 to October 2015 was summarized, including 44 cases as UOTLA group received umbilical one trocar laparoscopic appendectomy, 34 cases as OA group received open appendectomy. Then statistically analyzed all the patients' operation time, postoperative hospital stay, postoperative abdominal abscess, incision infection, early inflammatory intestinal obstruction and pain level. Results The laboratory test results of C reaction protein (CRP) had no significant difference between the two groups, while peripheral white blood cell count decreased more significantly in UOTLA group than that in OA group; the operation time of UOTLA group was shorter than that in OA group with no statistical difference [(66.59 ± 33.24) vs (72.86 ± 30.36) min, P > 0.05], but postoperative hospital stay was shorter [(8.21 ± 1.67) vs (9.21 ± 2.01) d, P < 0.05]. Abdominal abscess after operation: 3 cases in UOTLA group, while 1 case in OA group (P > 0.05); incision infection: 6 cases in UOTLA group, 9 cases in OA group (P > 0.05); early inflammatory intestinal obstruction: 1 cases in UOTLA group, 5 cases in OA group (P > 0.05); the pain level, postoperative recovery time was significantly shorter in UOTLA group compared with OA group (P < 0.05). The average expenses comparison of the two groups has no statistical difference [(10639.37 ± 2970.92) vs (10765.04 ± 2902.64) yuan, P > 0.05]. Conclusion UOTLA is safe and effective for complicated appendicitis in children due to minimally invasive, less pain and faster recovery without significant increase in the cost and postoperative complications. It can be applied in children with purulent, perforated appendicitis and gangrene, perforated appendicitis and other complicated appendicitis.

With the continuous improvement of various imaging techniques, the morbidity of polypoid lesions in gallbladder is increasing year by year. However, owing to the lack of effective means of diagnosis before undergoing the surgery, there is a large number of patients who do not have definite indications of surgery for prophylactic cholecystectomy. Therefore, this text will carry out a comprehensive narration of the imaging features, epidemiological characteristics and pathological types about the polypoid lesions in gallbladder, summarizing the experience of diagnosis and treatment of the disease, helping the option in clinical treatments.

OBJECTIVE: To find out the rules of therapeutic methods, formulas and medicines of traditional Chinese medicine (TCM) for primary liver cancer (PLC). METHODS: The frequencies of treatments and medicines of TCM in 978 pieces of documents concerning PLC were analyzed. RESULTS: Among the 165 therapeutic methods, 277 formulas and 459 kinds of herbs, the methods for activating blood circulation, the formulas for regulating qi-flowing and the herbs for invigorating qi are the most commonly used. CONCLUSION: Therapeutic methods such as invigorating qi, regulating qi-flowing and activating blood circulation are the main choices for PLC, and the methods such as clearing heat, removing dampness and nourishing yin are used as supplements.

Objective To explore the role of ERK1/2 in the central pathogenesis of migraine.Methods Healthy adult male SD rats were randomly divided into five groups:normal group (group C),sham operation group(group C),migraine model group(group M),DMSO group (group D)and PD-98059group (PD group),with 12 rats in each group.The extracellular discharge frequency in the spinal trigeminal nucleus was recorded and ERK1/2 phosphorylation was tested.Results (1) The percentage of extracellular discharge frequency change:Two hours after treatment,the percentage of discharge frequency change was (325.9±47.32)％.The percentage of extracellula discharge frequency change in group M (325.9±47.3)％ was higher than that in group N (100.0± 0.0) ％ and group C(107.3± 16.4)％.There was no significant difference in the percentage of discharge frequency change between group D(319.3±42.5) ％ and group M (325.9±47.3) ％.The percentage of discharge frequency change in group PD(218.5±31.7)％ was lower than that in group M(325.9±47.3)％ and group D(319.3± 42.5)％.(2) ERK1/2 phosphorylation:the ERK1/2 phosphorylation in group M and group D was higher than that in group N and group C.There was no significant difference in ERK1/2 phosphorylation between group D and group M.The ERK1/2 phosphorylation in group PD was lower than the other four groups.Conclusion During the process of central sensitization to migraine,neuronal excitability and ERK1/2 phosphorylation were increased.ERK1/2 inhibitor (PD98059) reduced ERK1/2 phosphorylation and neuronal excitability.These indicated that ERK1/2 may play a role in central sensitization of migraine in rats.

ObjectiveTo retrospectively analyze the distribution of artery involvement above the aortic arch and differences incidence of cerebral ischemic in patients with Takayasu’s arteritis (TA) by color Doppler flow imaging (CDFI).MethodsA total of 84 cases (aged from 11 to 70 years old, median age 39 years old) continuous observed from August 2005 to June 2013 were included in this study. All patients were detected by CDFI and confirmed by digital subtraction angiography (DSA) and clinical examination. The distribution of the involved arteries were analyzed.ResultsA total of 924 vessels (84 patients) was detected, 352 (38.1%) arteries involved inflammatory lesions. The prevalence rate of female was higher than male (92.9% and 7.1%) significantly. The symptoms of cerebral ischemic included dizziness, syncope, TIA, amaurosis etc. The involvement rate of common carotid artery (CCA) was the highest (94.0%), followed by the subclavian arterythe (SA) (82.1%). The detecting rate of bilateral CCA was higher than that of bilateral SA, 75% and 50% (χ2=15.732,P=0.003), respectively. The rate of combined lesions of CCA and SA were higher in left (64.3%) than the right 56% (χ2=12.777,P=0.001). Most patients had multiple vascular (≥ 3
vessels) diseases (69.1%). No significant difference was found in the incidence of cerebral ischemia symptoms in patients with bilateral CCA or SA lesions (74.6% with78.6%) (χ2=0.219,P=0.411). No significant difference was found inthe patients with left or right CCA combined with SA lesions (76.5% with 76.4% ,χ2=1.230, P=0.602) also. The incidence of cerebral ischemia for greater than 3 vessel disease was significantly higher than less vessels (69.1% with 30.9%) (χ2=6.674,P=0.010).ConclusionThe study in the distribution of aortic arch vascular lesion for the patients with Takayasu arteritis by CDFI is valuable for the early detection and treatment of vascular lesions, and decresing the incidence of ischemic cerebrovascular disease.

Objective To investigate the effect of gastric capsule combined with psychological intervention on immune function and quality of life in patients with advanced gastric cancer.Methods A total of 130 patients with advanced gastric cancer were enrolled in this studyfrom July 2014 to August 2016 in our hospital,andrandomly divided into two groups.Twogroups were treated with chemotherapy,andobservation group was treated anotherwithWeinaian capsule.The immune indexes, quality of life and side effects of the 2 groups before and after chemotherapy were compared and analyzed.Results After chemotherapy,CD4+、CD8+、CD4+/CD8+、CD3+ and NKlevel of observation group were better than that of control group(all P<0.05).After chemotherapy,SF-36 score of physical function, health status, vitality, emotional and mental health scores of observation group werebetter than that of control group(all P<0.05).During chemotherapy,proportion of gastrointestinal reaction and liver and kidney injury of observation group were 35.38% and 21.54%,lower than that of control group 63.08% and 40.00%(all P<0.05).Conclusion Weinaian capsule can improve immunologic function of advanced gastric cancer patients undergoing chemotherapy and reduce adverse reactions,so as to improve the quality of life of patients.

Objective: To explore the effect and mechanism of Longzhu ointment in the treatment of allergic contact dermatitis.Methods: Allergic contact dermatitis mouse model was induced by dinitrobenzene (DNFB) and the mice were randomly divided into the model group, matrix group, Longzhu ointment group and hydrocortisone butyrate group.0.5% DNFB was used for sensitization on abdomen of mice one and two days before the administration, and 0.2% DNFB was used on the right ears of mice after 6-day administration to establish mouse ACD model.A day after the excitation of dermatitis, the ear swelling degree was determined, the changes of histopathology was observed, and the immunohistochemical methods were performed to quantify the expression of TNF-γ and macrophage surface markers CD68 in the tissue samples.Results: The ear swelling degree in the group treated with Longzhu ointment was significantly reduced (P <0.01).Compared with the postive control group,the difference was not statistically significant(P＞0.05).HE staining showed that tissue edema decreased obviously.The immunohistochemistry analysis revealed that the expression of INF-γ in Longzhu ointment group was obviously reduced.Under the microscope with magnification of 200 times, CD68 positive cells in Longzhu ointment group was significantly reduced than those in the model group(P＜0.01).The expression of CD68 positive cells in butyric acid hydrocortisone group was not significantly different from that in Longzhu Ointment group.Conclusion: Longzhu ointment can inhibit allergic contact dermatitis obviously, and the mechanism may be related to the inhibition of lymphocyte secretion INF-γ and the reduction of macrophage infiltration.

Objective:To investigate the characteristics of the sleep quality and health-related quality of life (HRQoL), and analyze the different effects of sleep quality on HRQoL among young and middle-aged people.Methods:A cross-sectional study recruited 1 976 participants.All participants completed a self-designed questionnaire for the adults' general condition, the Pittsburgh sleep quality index (PSQI) and Short-Form health survey (SF-36). All participants were divided into 3 age groups: 18-29-year-old group( n=1 148), 30-44-year-old group( n=586) and 45-59-year-old group ( n=242). SPSS 23.0 software was used for statistical analysis.Chi-square test was used to analyze the general characteristics of the three age groups.Non-parametric test was used to analyze the scores of the three age groups in different dimensions of sleep quality. One-way ANOVA was used to analyze the mean scores of the three age groups in different dimensions of HRQoL. Stepwise regression analysis was used to analyze the effect of sleep quality on HRQoL among the three groups after control the confounding factors such as marital status, education, smoking, drinking and exercise habits and past medical history. Results:In terms of sleep quality, the total PSQI scores of 18-29-year-old, 30-44-year-old and 45-59-year-old groups(4(2, 6), 4(2, 6), 4(2, 6)) showed statistically significant differences ( Z=10.951, P=0.004). In terms of HRQoL, there were statistically significant differences in physical component summary scores (18-29-year-old: 82.51±12.62, 30-44-year-old: 80.72±13.63, 45-59-year-old: 82.04±13.07, F=3.667, P=0.026) and mental component summary scores(18-29-year-old: 76.09±15.46, 30-44-year-old: 77.20±16.14, 45-59-year-old: 81.82±14.14, F=13.649, P<0.001) among young and middle-aged people in different age groups.Regression analysis found that daytime dysfunction was an independent influencing factor for HRQoL in young and middle-aged population ( β=-0.308--0.425, all P<0.01). Sleep disorders significantly decreased Physical Component Summary of HRQoL in young-aged people ( β=-0.127--0.215, all P<0.01). The use of hypnotic drugs significantly reduced the scores in the physiological field in the young adults aged 30-44 ( β=-0.076, P<0.05). The duration of sleep significantly decreased the scores in the mental domain of young adults aged 30-44 ( β=-0.112, P<0.01). Subjective sleep quality was an independent factor that significantly decreased HRQoL in young adults aged 18-29 and 30-44 years ( β=-0.089--0.169, all P<0.01). Conclusion:Sleep quality and HRQoL of young and middle-aged people in different age groups show different characteristics.The effect of sleep quality on HRQoL is different among people in different ages.Taking targeted interventions for people of different ages to improve the sleep quality may be an effective way to improve their HRQoL.

ObjectiveTo explore the normal range of the volume of internal capsules in Chinese adults of the Han nationality and its relationship with age,body habitus,and craniocerebral volume.Methods One thousand healthy volunteers (age range =18 to 80 years) were divided into 5 groups according to their age;Group A ( 18 to 30 years old),group B (31 to 40 years),group C (41 to 50 years),group D (51 to 60 years),and group E (61 to 80 years).Each group consisted of 100 males and 100 females.MR imaging was performed in all of the volunteers using T1 weighted three-dimensional nagnetization prepared rapid acquisition gradient echo sequence. After three dimension data reconstruction,the volumes of bilateral internal capsules were manually measured. The volumes of bilateral internal capsules were compared by paired sample t test.The internal capsule volumes were compared between male and female by independent sample t test,and the differences among 5 age groups were compared by one-way ANOVA.The relationship between the volumes of internal capsule and age,body habitus or cerebral volume were analyzed using bivariate correlation.ResultsThe left and right internal capsule volumes were (2809 ± 393) and (2677 ± 343 ) mm3 respectively.The left internal capsule volumes were significantly larger than that of right (t =12.078,P ＜ 0.05 ).The left and right side of internal capsule volumes in male were (2863 ± 396) and (2744 ±358) mm3 respectively,and (2754 ±385) and (2609 ±314) mm3 in female.The left and right internal capsule volumes were larger in males than in female (t =1.982,2.851 ;P ＜ 0.05 ).The left internal capsule volume of the 5 age groups were ( 3273 ± 361 ),( 2943 ± 299 ),( 2777 ± 255 ),( 2607 ± 199 ),(2444 ±213) mm3,and the right were (2993 ± 361 ),(2814 ± 270),(2682 ± 239),(2543 ± 219),(2351 ±210) mm3.There were significant differences among 5 age groups between left and right internal capsule volume ( F =55.244,34.493 ; P ＜ 0.05 ).There was significant negative correlation between the volume of left and right internal capsule and age ( r =- 0.718,- 0.637 ; P ＜ 0.05 ).Conclusions1.5 T MR scanner can be used to accurately measure the internal capsule volumes.There is a significant negative correlation between age and internal capsule volumes.