Objective　To study the value of intraoperative cholangiography(IOCG) in cholecystectomy for gallbladder stone. Methods　The IOCG data of 694 cases in the Affiliated Hospital, Yanan University Medical School were retrospectively analysed. Results　Among 694 cases with IOCG, 65 had positve findings. Bile duct stone occurred in 44 patients, residnal stone in cyst duct in 7, bile duct injury in 2, and Mirizzi syndrom in 3. Among the 44 cases with bile duct stone, the age of 4.3% cases was 22～50 years old, 10.3% older than 50 years. The incidence of bile duct stone occurring after 50 years old increased with age. The accurate rate of IOCG was 98% in this series. Conclusions　IOCG can not only find residual stone, but also find bile duct abnormality and bile duct injury in time, if correct imagic technique is applied.

Objective To explore the normal reference values of infant intelligence in Fagan test of infant Method Fagan test was carried out in 315 healthy infants aged 6.5～14.0 month in Shenyang,Tieling and Jinzhou in Liaoning province.Results Infants with cognitive exponent X≥54.6 might be considered to be normal in development,49.9

Objective To assess quantitative and subjective image quality in computed tomography pulmonary angiography (CT-PA)with dual-energy subtraction methods,and to select the best dual-energy subtraction method.Methods 30 consecutive patients underwent CTPA using a single tube,fast voltage switching technique.One set of routine poly-chromatic images (RPI),two sets of monochromatic images with different optimal contrast-to-noise ratios (OCNR)and three sets of dual-energy subtraction images (DE-SI)were obtained by a dedicated workstation with dual-energy software (AW4.5 Advantage WS;GE Healthcare).For all the six sets of images,CNR and the score of global subjective image quality were calculated.Results DESI 3 got the highest CNR,and DESI 1 got the next high CNR.In global subjective image quality,DESI 1 got the highest score.However,when compared with DESI 2,no significant difference was found.Conclusion CTPA with dual-energy subtraction technique is feasible.DESI 1 affords the best bal-ance between quantitative analysis and subjective evaluation compared with other sets of images.

In order to observe the nutrition state in the severe multiple trauma patients undergoing adjuvant recombinant human growth hormone (rhGH) nutritional support therapy, 45 patients with severe multiple traumas (ISS>25) were randomly divided into 3 groups. All the 3 groups had been supplied with nitrogen and caloricity according to the need of patients for 16 days. The rhGH therapy started 48 h after surgery and lasted for 14 days in two rhGH-treated groups in which rhGH was 0.2 and 0.4 U/(kg . d) respectively, and the resting group served as control one. The levels of nitrogen balance, prealbumin and safety variables (blood sugar, Na+, TT3 and TT4) were observed and compared among the three groups. The levels of nitrogen balance on the postoperative day (POD) 3 and 5 in the rhGH-treated groups were -1.28+/-3.19, 5.45+/-2.00 and -0.18+/-2.55, 6.11+/-1.60, respectively, which were significantly higher than those in the control group (-5.17+/-1.68 and -1.08+/-3.31, P<0.01). The values of prealbumin on the POD 3 and 5 in the rhGH-treated groups were 180.19+/-27.15, 194.44+/-50.82 and 194.94+/-29.65, 194.11+/-16.17, respectively, which were significantly higher than those in the control group (117.42+/-19.10 and 135.63+/-28.31, P<0.01). There was no significant difference between the rhGH 0.2 U/(kg . d) group and rhGH 0.4 U/(kg . d) group in both of the levels of nitrogen balance and prealbumin. It is concluded that the nutritional support therapy with adjuvant rhGH which starts 48 h after surgery improves the nutrition state of the patients with severe multiple trauma. It is safe for severe multiple trauma patients who accept rhGH at the dose of 0.2 and 0.4 U/(kg . d).

Objective To investigate the effects of adhesion mediated by bone nlalTow stroma celh from leukemia patient on chemotherapeutics sensitivity and cell cycle of Jurkat cells in the co-cultured model.Methods Bone mw stroma cells were isohted and cultured from leukemia patients routinely.To construct the co-cultured model.Jurkat cells were co-cultured with BMSCs the irradiated layer by 60Co,and the model was observed with scanning electron microscope.The IC50 values of Jurkat cells expesured to DNR were quantified by MTT.The cell cycles of Jurkat cells after 24h-adhesion in the co-cultured model were analyzed by Facs.The expression of cyclin A,cyclin E and p27 in Jurkat cells adhered to BMSCs for 4h.24h and 48h were detected by Western blot.Results Jurkat ceUs in the co-cultured model showed a decreased sensitivity to DNR.ICSO values for normal BMSCs,leukemic BMSCs and non-adhered control were of 1.78Ixmol/L,2.30pznol/L and 0.45p,mol/L,respectively.The percentages of Go-Gl phase for leukemic BMSCs group and non-adhered control group were of 48.74％±8.77％and 27.83％壬1.86％.Respectively.The percentages of Gz-M phase for leukemic BMSCs group and non-adhered control group were of2.01％±1.17％and 20.33％±1.84％。Respectively.Compared with eomrol group,the 24h-ad- hesion mediated by BMSCs from leukemia patients up-regulated the percentage of Go-G1 phase of Jurkat cells(P

OBJECTIVETo observe the therapeutic effect of expanded supraclavicular island flaps for facial and cervical scar.

METHODSFrom Oct. 2010 to Nov. 2013, a series of 16 patients with facial and cervical scars were treated by the expanded supraclavicular island flaps, pedicled by the supraclavicular cutaneous branch of transverse cervical artery. In the first stage, the soft tissue expanders (ranging from 400 ml to 600 ml in volume) were implanted in the anterior thoracic region. In the second stage, the facial and cervical scars were removed and the contructures were released, the expanded flap was transferred to cover the defects. The wounds at the donor sites were closed directly.

RESULTSThe flaps size ranged from 12 cm x 7 cm to 22 cm x 11 cm. All flaps survived with no flap necrosis. Hematoma occurred in one case and healed by debridement. 16 patients were followed up for 3-12 months. The color and texture of all flaps matched well with the surrounding skin tissue, no bulky appearance or hypertrophic scar were noticed.

CONCLUSIONSThe expanded supraclavicular island flap is a good choice for repairing facial and cervical scar. The appearance and function can be improved.

Cicatrix ; surgery ; Face ; surgery ; Humans ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; transplantation ; Thoracic Wall ; Tissue Expansion Devices

Purpose To investigate the value of bedside ultrasonography for emergent patients in the diagnosis of vasa previa and umbilical cord prolapse. Materials and Methods The bedside ultrasonography data of 12 emergent cases of vasa previa and 18 emergent cases of umbilical cord prolapse were retrospectively analyzed for detection rate. Results Nine out of 12 emergent patients with vasa previa were detected by bedside ultrasonography;2 were misdiagnosed as umbilical cord prolapsed;and 1 patient who had missed diagnosis suffered fetal demise during vaginal labour. Fifteen out of 18 emergent patients with umbilical cord prolapse were detected by bedside ultrasonography;2 were misdiagnosed as vasa previa; and 1 missed diagnosis (no death case was reported). The detection rates for both groups of patients had no significant difference (P>0.05). Conclusion Bedside ultrasonography for emergent patients can visualize the traveling of vasa previa and umbilical cord prolapse so as to promptly provide evidence for clinical diagnosis and reduce perinatal mortality.

Insulin resistance (IR) is a complex metabolic disorder related to several diseases including type 2 diabetes (T2DM), hypertension and dyslipidemia. These diseases are all independent risk factors for cardiovascular disease. Lipid metabolism disorder has toxic effects on cells and may cause or aggravate IR in performance of elevated plasma levels of triglyceride (TG) and free fatty acids (FFA), the last one is an independent risk factor for IR. It has been clear that FFA may induce IR by endoplasmic reticulum (ER) stress, oxidative stress, apoptosis and inflammation, although the specific mechanisms remained unknown. The present paper summarizes the related molecules involved in the pathogenic process of IR and its mechanism, might provide a theoretical basis for the molecular mechanism of IR caused by FFA, and therapeutic reference for clinical treatment of IR and prevention of T2DM.

Stroke seriously endangers people's life and health because of its high prevalence, disability and recurrence rate. Among them, large vessel occlusive stroke (LVOS) has the worst outcome. Rapid recovery of cerebral perfusion is the key to improve the outcomes of patients with LVOS. As a new type of treatment, endovascular treatment can effectively recanalize the occluded blood vessels and extend the treatment time window. The level of collateral circulation determines the severity of symptoms, treatment choices, treatment effects and outcomes in patients with LVOS. This article summarizes the clinical factors related to collateral circulation compensation in patients with LVOS, and focuses on the application value of imaging technology in the evaluation of collateral circulation.

BACKGROUNDTo investigate the expression level and its clinical significance of the multi-drug resistance (MDR) associated protein in lung cancer specimens.

METHODSThe expression levels of Pgp, MRP, GST-π and TopoII of MDR associated protein were detected in 60 lung cancer samples and 30 paracancerous tissues by S-P immunohistochemistry method.

RESULTSThe positive rate of Pgp, MRP, GST-π and Topo II in the lung cancer tissues was 40.0% (24/60), 61.7% (37/60), 45.0% (27/60) and 81.7% (49/60) respectively, which was significantly higher than those in paracancerous tissues (P < 0.01). No significant correlation was observed among the expression of multi-drug resistance-related protein and TNM staging, pathological type, cell differention and lymph node metastasis status (P > 0.05).

CONCLUSIONSLung cancer has overexpression of multi-drug resistant-related genes during the oncogenesis. Combined detection of these genes may be useful for guiding the lung cancer chemotherapy.