Cholecystocholedocholithiasis is a common disease. The traditional treatment is open surgery which has its inherent invasiveness and slow recovery. The advent of laparoscopic and endoscopic techniques change surgery in many ways. Laparoscopic cholecystectomy is now the gold standard for cholecystitis, while endoscopic procedure is a treatment of choice for choledocholithiasis. To combine them as a laparoendoscopic rendezvous procedure treats cholecystitis and choledocholithiasis in a single stage, and results in a safe, effective and minimal invasive procedure.

Objective To investigate the protective effect of myocardial preconditioning with propofol alone vs propofol and adenosine against ischemia-reperfusion (I/R) injury. Methods Twenty-one mongrel dogs of either sex weighing 11-16 kg were randomly divided into 3 groups ( n = 7 each) : group A I/R; group B propofol + I/R and group C propofol + adenosine + I/R. The animals were anesthetized with intramuscular ketamine and intermittent i.v. boluses of thiopental, intubated and mechanically ventilated. The chest was opened and the left anterior descending (LAD) artery was occluded for 60 min followed by 120 min reperfusion. In group B propofol was infused at 5.6 mg?kg-1?h-1 for 30 min before I/ R whereas in group C adenosine 0.1 mmol was injected at the root of aorta 10 min before I/R in addition to propofol infusion. Left cardiac catheter was placed in left ventricle via left common carotid artery for MAP and left ventricular pressure monitoring. ECG, BP, HR, CVP, left ventricular systolic and end-diastolic pressure (LVSP, LVEDP), left ventricular ejection fraction (EF) cardiac output (CO) and stroke volume (SV) were monitored. Coronary perfusion pressure (CPP= DBP - LVEDP) and heart rate-pressure product (RPP= HR?SBP) were calculated. Regional wall motion (RWM) of the ischemic myocardium was scored. Results Ischemic ECG changes ( S-T segment elevation, abnormal T and arrhythmia) developed immediately after occlusion of LAD artery. LVEDP was significantly increased while CO, SV, EF, CPP and RPP were significantly decreased after LAD artery was occluded as compared to the baseline values in group A. Preconditioning with propofol alone or propofol combined with adenosine attenuated the hemodynamic changes induced by I/R. RWM score was significantly increased after LAD artery occlusion and was significantly lower in group B and C than in group A.Conclusion Propofol preconditioning can protect myocardium against I/R injury but adenosine combined with propofol does not enhance the protective effect.

Objective To discuss the clinical characteristics,treatment and prognostic factors of brain metastasis from gynecological cancers.Methods Clinical records of 25 brain metastasis patients from gynecological cancers admitted from January 1999 to January 2009 were reviewed retrospectively.The curative effects of different treatments were compared.The prognostic factors were determined using the Cox regression model.Results There were 14 cases ovarian malignant tumor,6 cases cervical carcinoma and 5 cases uterine malignant tumor.Seven cases (28％,7/25 ) had solitary metastatic lesion in the brain.Extracranial metastases were detected in 18 cases (72％,18/25 ).Five patients only received one kind of treatment,and the mean survival time was 4.0 months (0.5 to 9.5 months).Sixteen patients received combined treatment,3 of them received combined treatment including surgery,and the mean survival time was 8.4 months (4.1 to 13.4 months) ; 13 of them received chemotherapy and radiotherapy,and the mean survival time was 14.2 months (4.3 to 58.1 months).Four patients received only palliative supportive care,and the survival time was only 0.1 to 1.0 month.The Cox regression model showed that Karnofsky performance status scale,with or without extracranial metastases and the treatment method were the independent prognostic factors of brain metastasis from gynecological cancers ( P ＜ 0.05 ).Conclusion The incidence of brain metastasis from gynecological cancers is low and the prognosis is very poor.Combined treatments may get better effects.

Objective　To clone the partial positive regulatory fragment of Na+/H+ exchanger-1 (NHE-1) gene from human lung cancer cells. Methods　After BamHⅠ and EcoRⅠ cut sites were added to the 5' ends of the upstream and downstream primers respectively, the partial positive regulatory sequence of NHE-1 gene was cloned with the length of 170 bp from genomic DNA of lung cancer cell line A549 cells with PCR method. The cloned fragment was ligated to plasmid pUC18. Finally, the constructed recombinant was identified with enzyme cut, PCR and DNA sequencing. Results　The cloned fragment was about 170 bp in size and successfully ligated to pUC18 with identifiation of double enzyme cut and PCR. DNA sequencing approved that the fragment cloned was objective one with 168 bp in length. Compared with the reported sequence, two t were lost. Conclusion　The positive regulatory fragment of NHE-1 gene from human lung cancer cells was successfully cloned.

Objective: Fungal keratitis is one of the most common diseases leading to blindness.It has a high incidence in China,and its early diagnosis and treatment are of vital importance.We aimed to investigate the value of laser confocal corneal microscopy in the clinical diagnosis of fungal keratitis.Methods: We conducted laser confocal corneal microscopy on 37 patients suspected of fungal keratitis,and compared the results with those obtained from the corneal tissue smears and fungal cultivation.Results: The fungus-infected corneas histologically exhibited defected epithelial cells,damaged subepithelial nerves and disordered stroma with reduced transparence.The hyphae showed bright,disordered,interlaced thread-or short rod-like structures.The positive rates of smear examination,fungus cultivation and laser confocal corneal microscopy were 48.65,62.16 and 78.39% for the 37 eyes,75.00,87.50 and100% for the 16 untreated eyes,and 28.57,42.85 and 61.90% for the other 21 pretreated eyes.Conclusion: Confocal laser corneal microscopy,rapid,effective and noninvasive,can be used as an important new alternative in the diagnosis of fungal keratitis

Objective:Acute retinal necrosis syndrome(ARNS) is a rare disease with high blinding rate.The surgery of vitrectomy,endolaser photocoagulation and silicone oil injection is considered an effective treatment of ARNS.The study investigated the effect of vitrectomy,endolaser photocoagulation and silicone oil injection treating ARNS.Methods:A consecutive 16 eyes of 16 patients with ARNS were treated with vitrectomy,endolaser photocoagulation and silicone oil injection.The 5 eyes without retinal detachment were photocoagulated from the posterior border of necrosis to the ora serrata.The 11 eyes with retinal detachment were treated with subtotal retinal photocoagulation,air/fluid exchange and silicone oil injection.The follow-up time were 6 months at least,16 months in average.Results:The final best-correcting visual acuity was counting fingers in 3 eyes(18.8%),0.02-0.3 in 7 eyes(43.8%),0.4-0.6 in 5 eyes(31.3%),0.7 in 1 eye(6.3%).The silicone oil was uneventfully removed in 14 patients(87.5%) from 3 to 12 months.No one had a recurrent retinal detachment.Conclusion:There is a favorable effect in ARNS with the treatment of vitrectomy,endolaser photocoagulation and silicone oil injection.

Objective:To construct a psychological aging scale,and to provide a tool and indexes for scientific evaluation on aging.Methods:The age-related psychological items were collected through literature screening and expert interview.The importance,feasibilityand the degree of authority for the psychological index system were graded by two rounds of Delphi method.Using analytic hierarchy process,the weight of dimensions and items were determined.The analysis for internal consistency reliability,correlation and exploratory factor was performed to evaluate the reliability and validity of the scales.Results:By two rounds of Delphi method,17 experts offered the results as follows:the coefficient of expert authorities was 0.88±0.06,the coordination coefficients for the importance and feasibility in second round were 0.456 (P＜0.01) and 0.666 (P＜0.01),respectively.The consistency was good.The psychological aging scale for healthy people included 4 dimensions as follows:cognitive function,emotion,personality and motivation.The weight coefficients for the 4 dimensions were 0.338,0.250,0.166 and 0.258,respectively.The Cronbach's α coefficient for the scale was 0.822,the reliability was 0.817,the content validity index (CVI) was 0.847,and the cumulative contribution rate for the 5 factors was5 1.42％.Conclusion:The psychological aging scale is satisfied,which can provide reference for the evaluation for aging.The indicators were representative and well-recognized.

Objective To investigate the interaction of human testis sperm-associated antigen 4 like(SPAG4L) protein containing Sad,UNC-84(SUN) domain with nuclear envelop spectrin repeat proteins 3 (Nesprin-3) containing Klarsicht,ANC-1 and Syne homology (KASH) domain.Methods SPAC-4L protein domains were analyzed with the bioinformatics method.After the SPAG4L plasmid was transfected into Ntera-2 cells,the subcellular localization of SPAG4L was observed.The interaction of SPAG4L with Nesprin-3 was determined by immunofluorescence,co-immunoprecipitation(co-IP) and bimolecular fluorescence complementation (BiFC) technology,respectively.Results Bioinformatics analysis results showed that there was a transmembrane structure in SPAG4L protein.Subcellular localization results demonstrated that SPAG4L protein located in the nuclear membrane and cytoplasm.Immunofluorescence,Co-IP,and BiFC results showed that there was an interaction between SPAG4L and Nesprin-3,and that a LINC(linkers of the nucleoskeleton to the cytoskeletan) complex was formed.Conclusion SPAG4L may interact with Nesprin-3 to form a LINC complex,which is important for understanding the function of SPAG4L protein in spermatogenesis.

Objective To analyze the clinical distribution ,antimicbial resistance and Staphylococcal cassette chromosome mec (SCCmec) genotype characteristics of 346 methicillirrresistant Staphylococcus aureus (MRSA) clinical isolates in the hospital . Methods A total of 784 strains of Staphylococcus aureus isolated from January 2014 to January 2015 in the hospital ,MRSA identi-fication and the SCCmec genotype was conducted by PCR assay .Results 346 strains of MRSA (44 .13% ) were isolated from 784 strains of Staphylococcus aureus ,the detection rate of MRSA from sputum accounted for 43 .06% ,the secretion accounted for 48 .55% .MRSA was resistant to penicillin ,levofloxacin and erythromycin ,sensitive to vancomycin ,linezolid and teicoplanin .SCC-mec genotyping result showed that SCCmecⅡ was identified in 130 ,SCCmecⅢ in 196 ,SCCmecⅣ in 11 ,SCCmecⅤ in 9 .Conclusion SCCmecⅢ is the main genotypes of MRSA from our Hospital ,all of the MRSA strains are multi-resistant to tested antibiotics , but sensitive to vancomycin and teicoplanin .

Objective To explore the characteristics of infection after cardiac-lung transplantation.Methods March 23th 2006,one patient received orthotopic heart-lung transplantation,the clinical data were observed and analyzed.Results Depend on etiology,antibioti and antifungul were selected,the patient recoved.Conclusion It is very important to early etiology diagnosis and reasonable selection of antibiotic.