Objective To summarize the experience of combination use of biliary stent placement and drainage with primary suture of the common bile duct in the treatment of choledocholithiasis. Methods Laparoscopic common bile duct exploration combined with flexible choledochoscopy was performed in 16 patients with choledocholithiasis from June 2005 to March 2006. During the operation, a patented “biliary stent for internal drainage” was introduced into the common bile duct, and primary sutures were performed to close the bile duct. Postoperatively, the stent was removed under gastroscope or duodenoscope. Results All the 16 operations were successfully accomplished without conversions to open surgery. The operative time was 90~260 min (mean, 145 min). The biliary stent was removed 5~7 days after the surgery. Follow-up for 3~12 months showed no residual stones or biliary stenosis. Conclusions Combination use of biliary stent drainage and primary suture of the common bile duct in the treatment of choledocholithiasis is safe and feasible.

500 mg,frequency was reduced in rats treated with tamsulosin (P500 mg,and the combined ?1a/?1dAR antagonist tamsulosin reduces urinary frequency more than the ?1aAR selective antagonist 5MU.This finding supports the hypothesis that the ?1dAR is important in mediating irritative symptoms.

Objective To discuss the relationship between lung function before and after radiotherapy and radiation-induced pneumonitis in locally advanced non-small-cell lung cancer.Methods 76 patients were evaluated by pulmonary function tests before radiotherapy and in 1 month and 3 month after radiotherapy respectively.Results All patients were treated radiotherapy with irradiation dose of 60-70 Gy,the radiation pneumonitis occurred in 26 patients (group A),22 patients were grade 1,3 patients were grade 2,1 patient grade 3 and no patient was grade 4 and 5.50 patients without radiation pneumonitis were group B.There were significant difference between group A and group B for FEV1 before radiotherapy [(51.67±19.03) ％,(69.03± 14.54) ％,t =2.34,P ＜ 0.05].There were no significant difference between in 1 month and 3 months after radiotherapy for FVC (P ＞ 0.05).There was significant difference between in 1 month and 3 months after radiotherapy for DLCO (group A,P ＜ 0.01; group B,P ＜ 0.05).Conclusions For locally advanced non-small-cell lung cancer patients,the lower of FEV1 before radiotherapy inclineds to develop radiation pneumonitis,DLCO levels are lower significantly in patients prones to radiation pneumonitis.FEV1 and DLCO are sensitive indicators to predict radiation pneumonitis.

Objective To investigate the detection of BJ-75A-9 mHNA, WNX and CK19 mRNA in peripheral blood cells of lung cancer patients and evaluate its diagnostic value. Methods The expression of BJ-TSA-9, LUNX and CK19 mRNA in peripheral blood cells was delected from 84 lung cancer patients, 32 benign lung lesions and 20 healthy volunteers by nested reverse transcription polymerase chain re-action (Nested-RT-PCR). Results The positive detection rates of BJ-75A-9,LUNX and CK19 mRNA in the peripheral blood of the pa-tients with lung cancer were 59.5%,40.4%and 22.6% respectively. In the 32 peripheral blood samples of the patients with benign lung le-sions,the positive detection rate of BJ-TSA-9,LUNX and CK19 mRNA were 9.3%, 12.5% and 6.3% respectively. No expression of BJ-TSA-9,LUNX and CK19 was detected in lhe samples of the healthy volunteers. The expression level of BJ-TSA-9, WNX and CKI9 mRNA in the peripheral blood of lung cancer stage IV patients was significantly higher than those of stages II and ID (P< 0.05). Conclusion RT-PCR amplification of BJ-TSA-9, LUNX and CK19 mRNA are an efficient way to detect early haematogenous dissemination of cancer cells for lung cancer patients. The detection of BJ-TSA-9 expression is sensitive and specific for lung cancer,and it is superior to both LUNX and CK19 mRNA. The expression of BJ-7SA-9 mRNA in peripheral blood might predict the hematogenous metastatic spreading of lung cancer cells.

Objective To observe the uhrasenographical characters of liver and spleen of residents and their changes in endearic areas of schistosomiasis japonica in Poyang Lake region.Jiangxi Province and to explore the value of ultrasonography for assessment of the morbidity of the disease.Methods All permanent residents aged above 3 years old were examined by ultrasonography and Kato-Katz method.Results The schistosome positive rates of fecal examinations decreased obviously from 16.29%in 1995 to 8.54%in 2007(P<0.01).However,the rates of hepatomegaly and splenomegaly between 1995 and 2007 were not significantly changed(P>0.05),with the rates of 8.82% and 20.33% in 1995 and 8.54% and 21.34% in 2007,respectively.The abnormal rate of portal vein diameter decreased significantly.from 32.47%in 1995 to 6.50% in 2007.The abnormal rate of liver parenehyma increased remarkably(P<0.01),from 34.85% to 51.83%.The changes of liver parenchyma Grade I showed a bidirectional trend,29.90% of them chased into Grade 0(normal image on ultrasonngraphy),and 34.02% changed into Grade 2 and above.The abnormality of various indices of uhrasonography examinations were related to age,occupation and schistesome infection status.Conclusions Ultrasonography can show the damages of liver and spleen of patients infected with Schistosoma japonicum directly.but it is necessary to study further on the sensitive indices that reflecting early pathological changes and the best combination of the indices for the assessment of schistosomiasis-related morbidity.

Objectives To explore the correlation between the population characteristics of sero-reactivity with quantitative antibody based-IHA and the transmission parameters,such as epidemic situation,transmission status or infection trend in population.Methods The residents in one endemic administrative village were simultaneously examined by Kato-Katz technique for parasitological stool examination,as well as by immuno-diagnostic technique IHA for detection of IgG antibody against soluble egg antigen for two consecutive years.The results of examination were analyzed and compared on the diagnostic parameters of IHA,the correlation of the changes of positive rates and antibody levels of IHA with the changes of infection trend in population and the distribution of antibody levels between 'the true negative' and 'the true positive'.Results When Kato-Katz technique based on 2 stool samples,each read in 3 thick smears,was used as the reference,the overall sensitivity of IHA was high (from 77.27% to 85.48%) with a relatively poor specificity of lower than 60%,the negative predict value (NPV) was excellent of higher than 94%.The specificity of IHA decreased with the increase of the age in different age-groups of population,showing the highest among the younger less than 15 years old.The distribution trends of positive rates of antibody in different age groups by IHA showed similar to that of egg positive rate detected by Kato-Katz although the positive rates of IHA were higher than these by Kato-Katz,which showed that a higher false positive (from 41.90% to 44.56%) and a certain false negative (from 14.52% to 22.73%)existed in IHA.The positive rate of antibody decreased slowly among the individuals with S.japonicum infection,who received treatment.There was an overlap in the distribution of antibody levels between ' the true negative' and ' the true positive'.Conclusions Under the current schistosomiasis epidemic situation in China,IHA is valuable in the epidemiologic surveys.It should be of further deliberation applying IHA as the screening approaches for identification of target individuals for treatment or determination of the infection rate in community and IHA needs to be combined with the parasitological examination.

Objective To observe the effect of artemether in the control of prevalence and acute infection of Schistosoma japonicum in humans in high endemic areas. Methods During the transmission season (May-October), the residents in the pilot village took artemether with a 15- day interval to prevent the infection of S. japonicum. Results By the end of the transmission season, the egg positive rate was 0.83% and no acute case occurred in the artemether group, while 15.01% and 3 acute cases were observed in the placebo group. Conclusions Oral administration of artemether at a 15-day interval shows an effective protection from infection of S. japonicum, with a protection rate of 94.47% in residents of a high endemic area and it also shows marked effect to prevent acute schistosomiasis.

Objective To explore the relationship between vegetation and the distribution of Oncomelania snails inside and outside the embankments of Poyang Lake region. Methods The plantation and Oncomelania snails were surveyed at 4 villages and their related marshlands in Yugan, Nanchang and Jinxian counties by the stratified systematic sampling method. The investigation was targeted to the vegetation species,height,coverage and frequency of plantation and synchronously to the distribution of snails and infection of snails in marshland of high, middle and low altitudes,adjacent beaches as well in cultivated and waste land inside embankment. The relationship between vegetation dominant association and the distribution of snails in those area was analyzed. Results The vegetation inside and outside the embankment were remarkably diverse. Inside the embankment, the species of vegetation varied greatly and distributed randomly,and no snail was found. While outside the embankment,the distribution of vegetation characterized an unregulated annulus or patch. Plant's association types were distinct on marshlands. The snails mainly distributed in areas at 15-17 m altitude,closely related to the species of vegetation. The coverage of dominant plants,Carex cinerascen and Miscanthus sacchariflorus showed a quadratic curve correlation with the density of snails. Conclusions In the Poyang Lake region,plants and snails are impacted by common environmental factors,which then lead to their close association in distribution. It might be attributed to integrated impacts of changes in ecological factors that Oncomelania snails disappear gradually in areas inside embankment after construction of embankment.

Objective To examine the feasibility of using the serous-lined tunnel technique for orthotopic neobladder, continent cutaneous diversion and ureteral replacement by the intestinal segment. Methods In 31 patients of orthotopic ileal neobladder, the serous-lined tunnel techniques were used for antirefluxing ureteral implantation: In 13 patients of continent ileal pouch, the techniques were adopted for continent-valve construction and for uretersl implantation: In 3 patients (with lower ureteric cancer), the same techniques were applied for constructing the ileal ureters with a proximal antirefluxing mechanism. Results With a mean follow-up of 27 mon( 12-132 mon), 88 ureters implanted into ileal neobladders or continent pouches functioned well with neither obstruction nor reflux: 12 in 13 continent valves functioned well with no incontinence. 3 patients with ileal ureters showed no ileo-ureteric reflux and had reduced hydronephrosis comparing to that of before surgery.Conclusions Ureteral reimplantation and continent valve formation achieved by adopting the serouslined tunnel technique provide satisfactory results. The versatility of the technique is obvious in the present experience and the creative application of the serous-lined tunnel technique should be possible in urinary reconstruction.

Objective To explore the impact and change regularity of Oncomelania hupensis snails and vegetation in the marshlands of Poyang Lake caused by the impoundment of the Three Gorges Project. Methods By using the methods of stratified systematic sampling and pinpoint navigation,the succession of vegetation was observed and the distribution of O. hupensis snails was investigated in a period of 8 years on 4 typical marshlands in Poyang Lake. The regularity of changes in vegetation and O. hu-pensis snails was analyzed on the marshlands at high,medium and low elevations,respectively. Results After the impoundment of Three Gorges Project,the average flooding days of these 4 marshlands in 2004 and in 2008 were reduced of 74.8 and 65.8 days compared with those in 2002,the year just before the impoundment of the project,respectively. The change of spatial distribution pattern and the succession of dominant species of vegetation on the marshlands of Poyang Lake have taken place since 2005,and several vegetations showed a trend of moving toward the center of the lake. The hygrophilous vegetation has degenerated and gradu-ally been replaced by mesophily meadow in the marshland area above 14 m elevation. Carex,Phalaris arundinacea and Polygo-num appeared in large area and expanded slowly towards the center of the lake on the marshland below 14 m elevation. O. hupensis snails were mostly found under the Carex association. The tendency of decreasing in density of snails and of migration of snail habi-tats towards low terrain was observed. Conclusions The impoundment of Three Gorges Project has had a significant impact on hy-drological regimes,and a new succession of vegetation has taken place in the marshlands of Poyang Lake. O. hupensis snails and the mesophily vegetation show a trend of migrating slowly to the areas of low elevation in the marshlands.