Objective To establish a reversible partial obstruction model of the common bile duct(CBD) in dogs and explore the influence of partial obstruction of CBD on the motility of sphincter of Oddi(SO).Methods Adult mongrel dogs were anesthetized.In the partial obstruction(PO) group,a double ligature was performed around both a cannula(1 mm in diameter) and the common bile duct near to its bifurcation,then the cannula was withdrawn,while in the control group,only sham operation was done.The serum of venous blood was obtained before and on day 1,3,5,7,14,28 after operation.Liver specimens were obtained by biopsy on postoperative day 3,7,14.SO motility was recorded on postoperative day 28.Results All the obsrtuction of CBDs were removed in PO group,the structure of hepatocytes and liver function recovered to normal on day 28 after operation.SO basal pressure(SOBP),SO amplitude(SOAP) and frequency of SO phasic contraction(SOF) significantly decreased,whereas the duration of SO contraction did not change.Conclusion Partial obstruction of CBD inhibited the motility of SO.The clinical manifestation of this model is similar to that of patients with temporary obstructive jaundice that influenced the motility of SO.This model was relatively simple,easy and reliable.

Tendons are dense connective tissues that mediate the attachment of the muscle system to the skeletal system. While the methods for clinical tendon repair remain less satisfactory, tissue engineering may pro- vide promising future. Therefore, understanding the natural tendon development process is important for tendon en- gineering. Scleraxis and Tenomodulin are relatively specific molecule makers for tendon and ligment and play im- portant roles in the tendon development. This article gives review of the molecular structure, the expression regula- tion, and the roles of Scleraxis and Tenomodulin in tendon development, in order to better understand the process of tendon development.

Objective To explore advantages of laparoscopic sphincter preserving surgery for ultra low rectal cancer . Methods From April 2006 to January 2015, we performed laparoscopic sphincter preserving surgery in 108 cases of ultra-low rectal cancer.After laparoscopic mesorectal resection and lymph node dissection were completed , transection of the rectum was performed with the Endo-GIA at 2 cm from the lower margin of the tumor .The right lower abdomen main operation port was expanded to remove the lesion and introduce the stapler base .The proximal colon was returned and the pneumoperitoneum was re-established .A colorectal end-to-end anastomosis was conducted through the anus by using a carliber 29 circular stapler . Results Laparoscopic operation was successfully accomplished in all the 108 cases.No conversion to open surgery was required .No operative mortality was encountered . The operation time was 68 -145 min ( mean, 104 min ) , the intraoperative blood loss was 10 -100 ml ( mean, 40 ml ) , the postoperative flatus time was 1-3.5 d (mean, 2.3 d), and the number of removed lymph nodes was 8-37 (mean, 12.5).There were 98 patients followed up for 6-62 months (mean, 24.6 months).No tumor metastasis or recurrence was found . Conclusion Laparoscopic total mesorectal excision of ultra low sphincter preserving operation is feasible .

Objective To observe the clinical effect of treatment of duodenal trauma intubation duodenal decompression jejunostomy jointly by the duodenal catheter decompression.Methods 60 patients with duodenal trauma were randomly divided into two groups,30 cases were treated with simple duodenal catheter decompression as control group,30 cases treated with duodenal catheter decompression joint jejunum ostomy intubation duodenal decompression as the observation group,generally observed two groups of patients surgery and postoperative complications,in the day of surgery and postoperative 7d evaluation of patients with nutritional status.Results The surgical time and blood loss of the two groups had no statistically significant difference(P＞0.05),the observation group had no case of duodenal fistula and four cases in the control group(13.33％)occumed duodenal fistula.The difference between the two groups was statistically significant(x2=4.286,P＜0.05).Postoperative concurrent abdominal abscess,lung infection,wound infection had no statistically significant differences(P＞0.05).After observation group 7d body mass and right upper arm muscle circumference stability was significantly higher than that in the control group(x2=7.519,9.868,both P＜0.05).Conclusion Jejunostomy joint duodenal catheter decompression intubation duodenal decompression in treatment of duodenal trauma surgical decompression had significant effect,can significantly reduce the incidence of fistula,improve patients nutritional status,promote the duodenal wound healing.

Objective To evaluate the application of the inlay butterfly cartilage graft technique in myringoplasty.Methods Thirty--eight ears in 38 patients (experiment group) with dry central drum perforations were treated with inlay butterfly cartilage myringoplasty,and 46 ears in 46 patients with underlay temporalis fascia myringoplasty (control group).Results After a mean follow-up of 6 months,the healing rate did not differ between two groups (92.1% in experiment group,91.3% in control group,P＞ 0.05).Average pure-tone hearing threshold improved than 10 dB and closure of the air-bone gap (ABG) within 10 dB were not different (P ＞ 0.05).The cured patients were followed up for 12-38 months,there was no ear perforation of drum in experiment group,but 4 ears in control group.Condusion Inlay butterfly cartilage myringoplasty is the reliable and ideal method for tzeating dry central drum pedoration with high success rate.

Objective To evaluate indwelling intrapulmonary artery catheter thromolysis for acute pulmonary embolism.Methods From June 2011 to June 2013 56 cases of acute pulmonary embolism were diagnosed by multi-row spiral CT and admitted at the Department of Vascular Surgery.The average age was (56 ± 11) years.Inferior vena cava filter was implanted and pulmonary angiography,catheter thrombectomy,indwelling pulmonary intraarterial thrombolytic therapy was performed.Postoperatively low molecular weight heparin and warfarin was given,dosage adjusted by prothrombin international normalized ratio at 2-3.Results Mean pulmonary arterial pressure (mPAP) decreased from (43 ± 7) mmHg to (22 ± 6) mmHg (P ＜ 0.05),arterial partial pressure of oxygen (PO2) rose from (49 ± 8) mmHg to (83 ± 9) mmHg (P ＜ 0.05).Clinical symptoms significantly relieved in 51 out of the 56 cases (91％).45 patients were followed up for an average of (15 ± 4) months,with one recurrence.There was no filter migration,vena cava thrombosis,chronic obstructive pulmonary disease and other complications.Conclusions Emergency pulmonary artery indwelling catheter thrombolysis is safe and effective therapy for acute pulmonary thromboembolism.

Objective To evaluate the diagnostic value of bedside lung ultrasound on severe pneumonia in elderly patients.Methods Bedside lung ultrasound lung ultrasound and chest CT were performed in 104 elderly patients admitted to the emergency department for suspected severe pneumonia,from November 2010 to January 2013.According to the characteristics of the chest CT image,patients were divided into consolidation group (big leaf or lung segment distribution density shadow) and the unconsolidation group (for the performance of the cable sample,ground glass sample,or small patch sample changes).Differences in ultrasonic characteristics were compared between the two groups.Results Ultrasonic image characteristics were pulmonary consolidation,subpleural lesion,pleural changes and parapneumonic effusions in patients with severe pneumonia.Among 65 patients with chest CT image of pulmonary consolidation in consolidation group,60 patients were found pulmonary consolidation by lung ultrasound,and all 39 patients in unconsolidation group were not found pulmonary consolidation by lung ultrasound,and there was a significant difference in detect rate by lung ultrasound between the two groups (x2 =87.546,P＜ 0.001).The number of subpleural lesion and pleural changes were (1.16 ± 1.07) and (3.14 ± 2.20) respectively in consolidation group and (3.85 ± 1.93) and (11.73 ± 3.69) respectively in unconsolidation group,which had significant differences between the two groups (t=7.439,12.133,both P＜0.001).There was no significant difference in the incidence of parapneumonic effusions between the two groups (45/65 vs.29/39,x2 =0.086,P=0.496).Conclusions Ultrasound image characteristics of severe pneumonia in elderly patients included pulmonary consolidation,pleural lesions,pleural changes and parapneumonic effusions.Ultrasonic characteristics will be pleural lesions,pleural changes in severe pneumonia patients without chest CT image of pulmonary consolidation.

OBJECTIVE To analyze the condition of nosocomical systemic fungus infection and make preventive and control measures against nosocomial systemic fungus infection.METHODS The 496 fungus-cultured positive cases with average age of 61.04 years old among the discharged patients from Jan 2003 to Dec 2005 were reviewed and analyzed.RESULTS The rate of nosocomical systemic fungus infection was 0.53%,from which the over 60 age senile patients accounted for 63.1%.Lower respiratory tract and urinary tract were the most frequent infection sites.The Candida albicans was accounted for 70.71%.The death rate of patients with nosocomial systemic fungus infection was 27.82%.The major correlated factors of nosocomial systemic fungus infection were the widespread use of broad-spectrum antibiotics and not be standardized and the iatrojenic injury of respiratory and urological tracts.CONCLUSIONS The causes of nosocomial systemic fungus infection are closely related to medical treatment;the death rate of patients with nosocomial systemic fungus infection is obvious higher than that without it;to prevent and control nosocomial systemic fungus infection is the key point of nosocomial treatment.

Objective To screen and determine the effective silencing targets of β2-microglobulin(B2m)gene at the cellular level in marmoset.Methods By homology comparison of the b2m gene in human and the B2m gene in marmoset, choose homology small hairpin RNA(shRNA)sequences targeting marmoset B2m gene were designed, We choose homology small hairpin RNA(shRNA)sequences targeting designed B2m gene to make homology analysis, and insert into lentivirus-based gene silencing constructs FUGW-TDT.The vectors were transfected into HEK293T cells induced by polyethylenimine(PEI).The suppression of B2m mRNA was detected by real-time PCR.Results Two gene-silencing sequences were screened that lied in 290~310 bp and 665~685 bp of the marmoset B2m mRNA, and have statistical significance in the silencing rate:(46.54±7.91)% (P < 0.05) and(83.22±4.37)%(P < 0.0001).Conclusions Two effective silencing target sequences are screened at cellular level, which can be further used in studies on gene silencing in marmoset.

OBJECTIVE To analyze the cause,clinical characteristic and preventive measures in nosocomial infection of multiple sites. METHODS A total of 123 cases of nosocomial infection in multiple sites in our hospital in 2004 were prospectively monitored and analyzed retrospectively. RESULTS Among 1645 cases of nosocomial infection,123 cases suffered from nosocomial infection in multiple sites.The main infection sites were lower respiratory tract and urinary tract.The main risk factors were over usage of broad-spectrum antibiotics and invasive operation.The serious result was prolongation of duration in hospital,increase in mortality and expensiveness. CONCLUSIONS The nosocomial infection in multiple sites is a main object to be monitored.To prevent,discover and control nosocomial infection in time is an effective measure to reduce the risk of nosocomial infection.