Objective To reduce or prevent the incidence of bile duct injury in the laparoscopic cholecystectomy,and reduce the postoperative complications of Bile duct injury in the laparoscopic cholecystectomy by time and exact treatment during the surgical procedure.Methods We retrospectively analyzed the clinical data of 8700 cases of LC, including 12 cases of bile duct injury, from September 1991 to today. The corresponding treatment was used in LC to avoid bile duct injury, when bile duct injury occurred, the injury was recognized and immediately repaired by surgery. Result The mean follow-up period after surgery was 5-10 years,all 12 patients with bile duct injury were cured and discharged. Conclusions We should correctly handle the relationship of various duct and avoid burn or cut duct for reducing incidence of the extrahepatic bile duct injury. Correct treatment can reduce or avoid the incidence of postoperative complications.

Surgical resection remains the only curative option of treatment for hepatocellular carcinoma,but centrally located tumors remain problematic.Extended right or left hepatectomy removes 60％ to 85％ of the hepatic parenchyma and is associated with more hepatic failure.Mesohepatectomy,resection of central hepatic segments (Couinaud's segments Ⅳ,Ⅴ,Ⅷ) and leaving the right and left segments in situ,preserves more functional hepatic tissues than extended hepatectomy.Despite its technical demands,mesohepatectomy should be considered as an alternative treatment for central huge hepatic tumors.

To detect the expression of p16 protein and Ki-67 antigen in gastric mucosa-associated lymphoid tissue lymphoma(MALTL)and normal gastric mucosa and to investigate the clinical significance of their expression in the occurrence and development of gastric MALTL.Methods 47 samples of gastric MALTL diagnosed pathologically in the department of pathology of the PLA General Hospital from March 1993 to June 2005 were collected.By using immunohistochemial methods,the expression of p16 protein and Ki-67 antigen was detected in 20 samples of normal gastric tissue and the 47 samples of gastric MALTL.Results The positive rate of p16 protein Was 21.3%(10/47)and 90.0% in gastric MALTL and normal gastric tissue respectively.The positive rate of p16 protein in gastric MALTL was lower than that in normal gastric tissue(P<0.05).The expression of p16 was related to the degree of lymph node metastasis.The positive rate of Ki-67 labelling index(LI)in gnstric MALTL was hiigher than that in normal gastric tissue.A negative correlation was found between the expression of p16 protein and Ki-67 LI(P<0.05). Conclusions Detection p16 and Ki-67 may help to predict the possibility of lymph node metastasis and prognosis in gastric MALTL.

Objective To observe apoptosis and its relationship between the expression of caspase-3 and programmed cell death 5 (PDCD5) protein in perihematoma tissue after intracerebral hemorrhage in rats and to investigate the injury mechanism after intracerebral hemorrhage. Methods A total of 54 male Wistar rats were randomly divided into sham operation and intracerebral hemorrhage groups, and the latter were redivided into 3,6, 12 hours, days 1,2,3, 5, and 7 subgroups (n = 6 in each group). A model of intracerebral hemorrhage was induced by injecting 50 μL autologous tail artery blood into the caudate nucleus. Apoptosis was detected by TUNEL method. The expressions of Caspase-3 and PDCD5 was observed by immunohistochemistry. Results The apoptotic cells were found in perihematoma tissue of rats at 3 hours,they reached the peak at day 2 to day 3 and reduced gradually after 3 days. Caspose-3 and PDCD5 positive cells were found in perihematoma tissue of rats at 3 hours, they reached peak at day 1 to day 2 and reduced gradually after 3 days. The numbers of Caspase-3 (r =0. 971, P ＜0. 01 ) and PDCD5 (r = -0. 334, P ＜0. 01 ) positive cells were positively correlated with those of apoptotic cells in perihematoma tissue after intracerebral hemorrhage in rats. Conclusions The perihematoma tissue of intracerebral hemorrhage in rats existed apoptosis, and it was consistent with the expressions of Caspase-3 and PDCD5. Caspase-3 and PDCD5 may promote apoptosis in perihematoma tissue after intracerebral hemorrhage.

Astragalus polysaccharides was lounded to 4-(2-aminoethylphenol), followed by labeling the APS-Tyr with fluorescein-5-isothiocyanate (FITC) at the secondary amino group. The absorption enhancement effects of low molecular weight chitosan and protamine on astragalus polysaccharides were evaluated via Caco-2 cell culture model. The results show that the fluorecent labeling compound has good stability and high sensitivity. On the other hand low molecular weight chitosan and protamine also can promoted absorption of the astragalus polysaccharides without any cytotoxity, and the absorption increase was more significant with increasing the amount of low molecular weight chitosan and protamine. At the same time, the low molecular weight chitosan has slightly better effect. The transepithelial electric resistance (TEER) of Caco-2 cells show that absorption enhancers could improve its membrane transport permeability by opening tight junctions between cells and increasing the cell membrane fluidity.
Absorption ; Astragalus Plant ; chemistry ; Biological Transport ; Caco-2 Cells ; Fluorescein-5-isothiocyanate ; chemistry ; Fluorescent Dyes ; chemistry ; Humans ; Plant Extracts ; chemistry ; pharmacokinetics ; Polysaccharides ; chemistry ; pharmacokinetics

Mean hemoglobin (Hb) concentration of about 3 500 subjects derived from 17 studies of Himalayan highlanders (Tibetans, Sherpas, and Ladakhis) was compared with lowlanders (Chinese Han, Indian Tamils) lived in the Himalayas, and European climbers during Everest expeditions as well as Andean natives. The results found that Hb concentration in Himalayan highlanders was systemically lower than those reported for Andean natives and lowland immigrants. These comparative data demonstrated that a healthy native population may successfully reside at high altitude without a significant elevation in Hb, and the lower Hb levels of Himalayan highlanders than those of migrated lowlanders and Andean natives are an example of favourable adaptation over the generations. In addition, excessive polycythemia has frequently been used as a marker of chronic mountain sickness (CMS). Altitude populations who have a higher Hb concentration also have a higher incidence of CMS. The low Hb in Himalayans suggested as showing adaptation over many generations in Tibetan stock. Recent work in Tibet, suggested that Tibetans there may have adapted to high altitude as a result of evolutionary pressure selecting for genes which give an advantage at altitude. All of the population genomic and statistical analysis indicated that EPAS1 and EGLN1 are mostly likely responsible for high altitude adaptation and closely related to low Hb concentration in Tibetans. These data supported the hypothesis that Himalayan highlanders have evolved a genetically different erythropoietic response to chronic hypoxia by virtue of their much longer exposure to high altitude.
Adaptation, Physiological ; Altitude ; Asian Continental Ancestry Group ; genetics ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; Evolution, Molecular ; Hemoglobins ; genetics ; Humans ; Hypoxia-Inducible Factor-Proline Dioxygenases ; genetics ; Tibet

Objective To find out the difference of responses to HDT between females and males of different occupations.Methods Healthy female employees(group A,n=11)and female pilots(group B,n=10)and male special pilots(group C,n=14)and male employees(group D,n=7)were tested with-30? head-down tilt for 45 min.Results Heart rate(HR)of females and males all decreased with time during HDT,especially male employees group and female pilots group(P

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

Comprehensive biochemistry experiment,which is interlocked and has difficulties in a certain degree,requires considerable knowledge,multiple techniques and long time.In order to ensure the smooth progress of the experiment,biochemistry and molecular biology department of Hebei medical university has taken following measures in teaching preparation and teaching implementation:building a specialized laboratory;performing collective lesson preparation and pre-experiments;technical teaching;teaching with multimedia equipments;students submitting experimental preparatory reports before class and then completing the experiments in groups.These measures achieved the intended purpose of setting up a comprehensive experiment.

Objective To evaluate the clinical efficacy of tacrolimus and cyclophosphamide (CTX) on lupus nephritis.Methods The clinical trials on treatment of lupus nephritis with tacrolimus and CTX published before October 2012 were searched at Cochrane library,PubMed,OVID,Wanfang database,Chinese Journal full-text Database,Chongqing Weipu Database by using the methods of Cochrane systematic review.At the same time the information from related journals,professional data and network were hand-searched.The homogeneous evaluation was performed by Meta-analysis.Statistical analysis of clinical data was performed by using Stata11 software.Results A total of 4783 reports were found,while only 9 papers (8 randomized controlled trials and 1 cohort study) met the inclusion criteria.Tacrolimus group got better complete remission ratio (Z =4.05,P ＜ 0.01),similar partial remission ratio (Z =0.44,P =0.661),and better overall remission ratio (Z =4.29,P ＜ 0.01) as compared with CTX group.There were no significant differences between tacrolimus group and CTX group in the incidence of infection (Z=1.75,P=0.081),renal damage (Z=0.88,P=0.38) and abnormal glucose metabolism (Z =1.91,P =0.070).Side effects such as liver function impairment (Z =2.65,P＜0.01),gastrointestinal discomfort (Z=2.31,P＜0.05),menstrual disorders (Z=3.88,P＜0.01),bone marrow suppression (Z =3.29,P ＜ 0.01) in tacrolimus group were lower than those in CTX group.Conclusions Compared with CTX,tacrolimus has better complete remission ratio and overall remission ratio,with less side-effects in the treatment of lupus nephritis.However,large scale,multicenter,well-designed clinical trials should be adopted to further confirm the conclusions.