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.

Objective To investigate the operation timing and operative procedure for serious acute pancreatitis(SAP).Method To analyze retrospectively the clinic data of 56 cases treated by operation.Result 54 cases were cured,who treated by operation within 48h after SAP onset. All the 2 cases dead of multiple organs failure who underwent operation 5-6d after SAP onset.Conclusions When SAP advanced to have indications of operative treatment,an-operation should be done as early as possible, no metter the time from the onset of SAP is long or short.

Objective:To investigate the quality of Herba Leonuri Preparations sold in market. Methods: The alkaloid content in preparations was determined according to the determination method in China Pharmacopoeia (1995). Results: There were significant differences among Herba Leonuri Preparations from different pharmaceutical factories, place of origin and batches. Conclusions: It is suggested that the determination item of stachydrine hydrochloride be added.

This paper described the treatment of itaconic acid strain of Aspergillus terreus As 3 2811 with uv irradiation and high temperature The mutant was obtained which grew in culture media containing succinic acid as the only carbon source Its productivity of itaconic acid was 5 times higher than the original strain The producing acid conditions were optimized by orthogonal experimental design By batch feeding glucose fermentation ,the itoconic acid productivity could be improved by 39 92%

BACKGROUND:Heavy load exercises can induce the ultrastructural changes in the skeletal muscle by the depolymerization and/or degradation of tubulin in the skeletal muscle, thereby lessening contraction activities of the skeletal muscle. OBJECTIVE:To observe the effects of heavy load exercise and acupuncture on tubulin levels, and to analyze their roles and mechanisms in skeletal muscle injury and repair. METHODS:138 male Sprague-Dawley rats aged 8 weeks were randomly divided into acute exercise group (n=114) and long-term exercise group (n=24). The acute exercise group included four subgroups:sedentary group (n=6), exercise group (n=36), acupunctured group (n=36) and exercise plus acupuncture group (n=36). In the acute exercise experiment, rats were acupunctured after a medium-large intensity downhil running. Rat’s soleus samples were taken immediately, 6, 12, 24, 48 and 72 hours after exercise and/or acupuncture. In the long-term exercise experiment, rats underwent exercise and acupuncture for 3 weeks, and rat’s soleus samples were col ected at 24 hours after the last training. Expressions ofα-tubulin and microtubule-associated protein 4 (MAP4) in the soleus were detected by western blot assay. RESULTS AND CONCLUSION:After acute exercise, expression ofα-tubulin and MAP4 was up-or down-regulated transiently. After acute exercise combined with acupuncture, the protein expressions ofα-tubulin and MAP4 changed slightly. However, the long-term exercise induced an increase inα-tubulin protein expression, while a significant decrease in MAP4 protein expression. It was worth noting that acupuncture treatment reduced long-term exercise-induced variations of MAP4 expression. These results suggest that the heavy load exercise can induce the depolymerization of tubulins in the skeletal muscle, and acupuncture may relieve this effect.

Objective To investigate the economic losses in kidney transplant patients with healthcare-associated lower respiratory tract infection(LRTI).Methods All transplant patients in a hospital from 2008 to 2012 were in-vestigated,patients with LRTI were in infection group(n=45),and patients without LRTI were in control group(n=266),hospitalization expenses and hospitalization days between two groups were compared.Results A total of 383 kidney transplant patients were included in the study,the incidence of LRTI was 11 .75% (n=45),median ex-pense of infection group and control group was ￥79 291 .82 and ￥72 185.14 respectively,the difference was not statistically significant (P >0.05).The largest increased expense in patients with LRTI was medicine (increased by￥5 429.82),medicine and examination expense in infection group were significantly higher than control group (￥39 123.17 vs ￥33 693.35;￥702.52 vs ￥593.73;P <0.05 ).The median hospitalization days in infection group and control group was 28.38 days and 21 .47 days respectively,there was significant difference between two groups(P <0.05 ).Conclusion Kidney transplant patients with LRTI suffer from a heavy financial burden,and their hospitalization days are prolonged,so measures should be taken to prevent the occurrence of LRTI and save limited medical resources.

OBJECTIVE:To provide identification reference for the clinical use of Cinnabaris. METHODS:TCM micro-macro-scopical identification method and microscopic identification method were used. RESULTS:The micro-macroscopical characteristics were obtained:irregular granule or sheet block,different forms,wide bright red,opuque translucent with some luster; some sam-ples showed irregular lump with big shape,red scale on surface,dulling or gray-black. The were microscopic characteristics ob-tained:different forms of irregular granule,some sheet block,wide bright red,with some luster,occasionally with yellow gran-ules. CONCLUSIONS:The method for micro-macroscopical identification and microscopic identification of Cinnabaris is simple and convenient,and it can be used for the rapid verification of Cinnabaris.

Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.

Objective To study the clinical characteristics, diagnosis, treatment and prognosis of primary pulmonary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods Two cases of primary pulmonary PTCL-NOS were studied and relevant literature were reviewed. Results Case 1 diagnosed as primary pulmonary PTCL-NOS was a 44 years old woman and disease progressed after GLD (Gem+L-OHP+ DXM) chemotherapy regimen. At last, the patient died of respiratory failure after one month. Case 2 diagnosed as primary pulmonary PTCL-NOS was a 46 years old man and reach partial response after CHOP regimen, and still alive now.Conclusion Primary pulmonary PTCL-NOS is very rare. It is easy to be misdiagnosed due to non-specific clinical and imaging manifestations. Acquiring enough tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no standard chemotherapy regimen for these patients, the prognosis is relatively poor.

Objective:To observe influence of mitochondrial manganese superoxide dismutase (MnSOD ) on vascular alkaline phosphatase (ALP) activity ,transcription factor :Runx2 and Osterix expression levels in MnSOD‐Tg mice model of vascular calcification .Methods :A total of 20 wild type (WT) mice were selected as WT group and 20 Mn‐SOD‐Tg mice were enrolled as MnSOD‐Tg group ,then mice model of vascular calcification was established .Vascu‐lar ALP activity ,expression levels of transcription factor Runx2 and Osterix were compared and analyzed between two groups .Results:After successful model establishment ,compared with WT group ,there were significant reduc‐tions in ALP activity [ (75.89 ± 4.17) vs .(61.32 ± 3.12)] , expression levels of transcription factor Runx2 [ (0.928 ± 0.016) vs .(0.694 ± 0.007)] and Osterix [ (0.472 ± 0.036) vs .(0.257 ± 0.013)] in MnSOD‐Tg group , P<0.01 all .Conclusion:Manganese superoxide dismutase may be improving atherosclerosis via reducing activity of vascular alkaline phosphatase ,expression levels of transcription factor Runx2 and Osterix .