Objetive To study the medical value of the combined treatment of laparoscopy and duodenoscopy treatment for calculus of extrahepatic bile duct.Methods Retrospectivly analyzed the clinical data of 72 cases with combination of laparoscopy and duodenoscopy treatment for calculus of extrahepatic bile duct between March 2006 and October 2011.There were 11 cases of choledocholithiasis and 61 cases of choledocholithiasis and cholecystolithiasis.Results Three cases of severe abdominal adhesion converted to laparotomy and other 69 cases were cured.The cure rate was 95.83％.There were no complications such as infection,bile duct injury,bile leakage,intraabdominal hemorrhage,bile reflux cholangitis,pancreatitis and cicatrical stenosis of papilary.The examination after operation showed that there weren't any residual bile duct stones.Conclusions The combination of laparoscopy and duodenoscopy treatment for calculus of extrabepatic bile duct has less traumatic,few intercurrent disease,and was safe and reliable with well postoperative recovery.It can be regarded as the preference treatment for calculus of extrahepatic bile duct.

In bacterial cells, selection of the proper division site at midcell requires the specific inhibitions of septation at two other potential sites, locate at each of the cell pole. This site specific inhibition of septation is mediated by the gene products of the min locus including three genes: minC, minD, and minE. Genetic and expression studies have revealed that MinC encode an inhibitor of division that is activated by MinD and toplogically regulated by MinE. Recent localization studies of functional Min proteins tagged with green fluorescent proteins have provide some insight into this topological regulation and revealed a fascinating oscillation of MinC and MinD between the cell halves. In this paper, it is reviewed that the progress on the regulation mechanism of the division site in bacterial cells by introducing the structure and their interaction of the study on Min proteins.

Objective To analyze the clinical characteristics of patients with cholesterol crystal embolism (CCE) after percutaneous coronary intervention. Methods Six patients with atherosclerosis presenting with simultaneous occurrence of acute renal failure and peripheral ischemic changes were diagnosed as cholesterol crystal embolism and their clinical data were analyzed. Results The patients, 5 men and 1 woman, had an average age of 72 years. Most of them had risk factors of atherosclerosis such as hypertension, diabetes and smoking. The levels of serum creatinine increased progressively after coronary angiography. All patients had concomitant skin lesions, including blue toes. Cutaneous biopsy of 1 patient found cholesterol emboli in arterioles. All patients received statins, and 2 received dialysis. Three patients died, and 3 patients remained chronic renal failure. Conclusion Since the morbidity of CCE is growing and the disease is iatrogenic in origin, special attention should be paid to this disease.

AIM:To establish a method for determining the contents of salvianolic acid B,danshensu and protocatechuic aldehyde,the effective components of Shuangdan Oral Solution(Radix et Rhizoma Salviae miltiorrhizae,Cortex moutan) by HPLC.METHODS:Experiment was carried out on a Phenomenex Luna C_(18) column(4.6 mm?150 mm,5 ?m) with a mobile phase methanol-acetonitrile-methane acid-water(30:10:1:59) at a flow velocity of 1.0 mL/min and detection wavelength at 286 nm for salvianolic acid B,a mobile phase methanol-acetonitrile-methane acid water solution [HCOOH:H_2O(2:98)](9:4:87) at a flow velocity of 1.0 mL/min and detection wavelength at 281 nm for danshensu and protocatechuic aldehyde.RESULTS:The average recoveries of salviano-(lic) acid B,danshensu and protocatechuic aldehyde were 98.6%(RSD=1.91%,n=6),99.2%(RSD=2.2%,n=6) and 97.3%(RSD=2.5%,n=6) respectively.CONCLUSION:The results show that this method is easy to operate and accurate,and can be used to determine the contents of the three effective components in Shuangdan Oral Solution.

Objective To evaluate the diagnostic value of homocysteine(Hcy)and high?sensitivity troponin T(hs?TNT)of serum in coronary heart disease(CHD). Methods A total of 310 cases of CHD(CHD group )and 285 cases of healthy individuals(healthy control group)were re?cruited in our hospital from August 2014 to July 2015. The serum levels of Hcy and hs?TNT in all subjects were measured using methods of enzy?matic cycling and electrochemical luminescence. Results Levels of Hcy and hs?TNT of serum sample in CHD group were higher than healthy control group(P<0.05). The positive rate of Hcy combined with hs?TNT was 88.4%,which was significantly higher than the positive rate of indi?vidual detection(P<0.05). Hcy and hs?TNT of patients with myocardial infarction were different from those of patients without myocardial infarc?tion . The differences were statistically significant(P<0.05). Conclusion The combined detection of Hcy and hs?TNT can improve the detec?tion rate of CHD,which has a certain application value in the diagnosis of CHD.

AIM： To study the pathological relationship of vascular cell adhesion molecule-1 (VCAM-1) expression and monocyte/macrophage infiltration with focal brain ischemia. METHODS: Immunohistochemical technique and focal brain ischemia/reperfusion model were used in the study in order to explore profiles and time-course of VCAM-1 expression and monocyte macrophage (ED2 positive cell) infiltration in ischemic rat brain. RESULTS: VCAM-1 was up-regulated in microvascular endothelial cells in ischemic cortex at 1h postischemia, and continuously expressed during the time of reperfusion. ED2 positive cells infiltrated into ischemic cortex at 1h iscehmia/ 2h reperfusion and then ED2 positive cells increased gradually with the time of reperfusion, ED2 positive cell infiltration showed apparently relationship with VCAM-1 expression, and both of them exhibited the some changes of time-dependence. CONCLUSION: Cerebral ischemia induced VCAM-1 expression and ED2 positive cell infiltration and VCAM-1 may regulate the recruitment of ED2 positive cells in the ischemic brain region. The results suggested that VCAM-1 and ED2 positive cells may be participated in the pathogenesis of cerebral ischemic injury.

Objective To explore the diagnosis and treatment of pancreatic duct stones. MethodsClinical data of 29 cases of pancreatic duct stones were analyzed retrospectively. ResultsChronic pancreatitis was complicated in 21 cases, cholelithiasis in 12, pancreatic cancer in 2 . The correct diagnosis rate of ultrosonography, CT, ERCP and MRCP was 89.7%(26/29), 65.0%( 13/20 ),100%(6/6) and 100%(4/4) respectively. Six cases underwent EST,16 cases did transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy, Three cases did sphincteroplasty, pancreaticoduodenectomy and exploratory laparotomy were performed in one each. ConclusionsChronic panreatitis cholelithiasis is the main causes of pancreatic duct stones. Imaging examinations help to make diagnosis preoperatively. Transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy is the therapy of choices for patients with pancreatic duct stones.

Objective To investigate DNA double-strand breaks and radiosensitization in renal carcinoma 786-O cells induced by fludarabine (FA) combined with different ionizing radiations.Methods The 786-O cells were exposed to FA combined with X-ray or heavy ion beam irradiation.Flow cytometry was used to evaluate the percentage of γH2AX-positive cells and cell cycle.The neutral comet assay was used to detect DNA double-strand breaks.The colony-forming assay was used to evaluate the effects of different treatments on cell survival.Comparison between groups was made by one-way analysis of variance or Dunnet' s t test.Results Compared with FA alone or irradiation alone,FA combined with different ionizing radiations increased DNA double-strand breaks as shown by significantly increased levels of γH2AX (P=0.007,0.001);FA combined with heavy ion beam irradiation lead to a cell cycle block at the radiosensitive G2/M phase and significantly increased the expression of γH2AX in the G2/M phase (P=0.000,0.000);the neutral comet assay revealed that FA combined with irradiation significantly increased DNA sublethal damage (P=0.020,0.060);FA significantly reduced the colony-forming rate after irradiation (P=0.000,0.030;0.001,0.040).Conclusions FA enhances the effects induced by X-ray and heavy ion beam irradiation with different properties.Particularly,FA substantially enhances the cell death induced by heavy ion beam irradiation.

Objective: To assess the values of conventional vascular ultrasound (US) and superb micro vascular imaging (SMI) for diagnosing carotid artery stenosis in relevant patients. Methods: A total of 37 patients of extra cranial carotid stenosis (with 70 blood vessels) treated in our hospital from 2014-08 to 2015-03 were retrospectively studied. Digital subtraction angiography (DAS) examination was used as golden standard, the diagnostic efifcacies for carotid artery stenosis by US and by SMI were compared. Results: The accuracy, sensitivity and specificity for diagnosing carotid stenosis by US were 81.42%, 83.33% and 80.95%; by SMI were 91.43%, 92.16% and 89.47% respectively. Conclusion: US and SMI showed good agreement for diagnosing carotid artery stenosis, while SMI was superior to US for accurately assess the degree of carotid stenosis, it might be used as a more reliable method for evaluating carotid plaque and stenosis in relevant patients.

Objective To evaluate the effect of the combination of dexmedetomidine and sufentanil on monitoring anesthesia care during burr-hole surgery for patients with chronic subdural hematoma. Methods 96 pa-tients underwent burr-hole surgery for chronic subdural hematoma with MAC were randomly divided into two groups:Group D and Group DS (n=48 in each group). Local anesthetic block was started at least 10 min after DEX and sufentanil infusion. Ramsay sedation scale of the two groups was maintained to 3. Anesthesia onset time, hemo-dynamics, the amount of rescue midazolam or fentanyl, the time to first dose of rescue midazolam or fentanyl, the to-tal number of intraoperative patient movements, postoperative recovery time, patient and surgeon satisfaction scores, and the adverse events were recorded. Results Compared with group D, anesthesia onset time was significantly less in group DS (13.68 ± 3.13 vs. 11.82 ± 2.43 min, P=0.002). More patients in group D required rescue midazol-am to achieve RSS=3 compared with group DS (31.25%15/48 vs. 12.50%6/48, P=0.023). Compared with group D, significantly fewer patients in group DS required rescue fentanyl to relieve pain (10.42%5/48 vs. 27.08%13/48, P = 0.036). Additionally, the total dose of rescue fentanyl in group DS was significantly higher (89.48 ± 23.27 vs. 125.28 ± 33.52μg, P=0.000), and the time to first dose of rescue fentanyl was longer than group D(18.34 ± 4.45 vs. 14.34 ± 3.63 min, P=0.000). The total number of patient movements during the burr-hole surgery was higher in group D than group DS (35.42%17/48 vs. 16.67%8/48, P=0.036). The time to recovery for discharge from the PA-CU (time to an Aldrete score ≥ 9) was significantly shorter in group DS compared with group D (17.54 ± 5.92 vs. 12.57 ± 5.28 min, P=0.000). Results from the patient and surgeon satisfaction scores showed significant differenc-es favoring group DS (P<0.05). More patients in group D showed higher levels of the overall incidence of bradycar-dia (37.50% 18/48 vs. 18.75% 9/48, P = 0.041) and hypotension(37.50%18/48 vs. 14.58%79/48, P=0.011)com-pared with group DS. Conclusions Compared with DEX alone, DEX-sufentanil associated with fewer number of in-traoperative patient movements, less amount of rescue scheme, could be safely and efficiently used for MAC during burr-hole surgery for patients with chronic subdural hematoma.