The clinical data of 31 patients with calculus, cholecystitis or polyps of gall bladder who underwent two-hole laparoscopic cholecystectomy (LC) were analyzed. The procedures were accomplished successfully in 29 cases, and the surgical module was alternated to four-hole LC in 2 cases. There were no complications related to the surgical procedures. The results suggest that two-hole LC is a safe and effective method with minimal invasion.

Surgery is the treatment of choice for pancreatic carcinoma.However,only 20％ of patients are eligible for surgery,and local control of disease and survival are not good.Although non-surgical treatments result in poor outcome,chemotherapy has been shown to be an effective treatment.The role of irradiation has not been well-established.Modern irradiation technology has shown promising results but there is still lack of strong prospective research evidence to support its widespread use.Irradiation brings along problems which need to be resolved,including target motion,definition of irradiation target,optimal fractionation,total treatment time and the treatment sequence of surgery,chemotherapy and radiation therapy.

Objective To observe the clinical efficacy ofToutongning Formula in the treatment of migraine. Methods Totally 100 cases of migraine patients (wind disturbance, blood stasis syndrome) were randomly divided into two groups. Patients in the experimental group were treated withToutongning Formula orally, and patients in the control group were treated with flunarizine capsules 5 mg orally, for 30 d. The scores of number, degree, duration and accompanying symptoms of episodes before and after treatment were observed, the total scores were calculated, and adverse reactions were recorded, to evaluate the clinical efficacy and safety.Results Clinical total efficiency was 92.0% (46/50) in experimental group and 64.0% (32/50) in the control group; the incidence rate of adverse reactions was 20.0% (10/50) in experimental group and 80.0% (40/50) in the control group; there was statistical significant differences in efficacy and adverse reactions between the two groups (P<0.05). After the treatment, the differences in the scores of number, degree, duration and accompanying symptoms of episodes, and in the total scores between the two groups was statistically significant (P<0.05). There was statistical significance in the different value of above indexes before and after treatment between the two groups (P<0.05).ConclusionToutongning Formula can not only improve symptoms significantly in patients with migraine (wind disturbance, blood stasis syndrome), but also reduce adverse reactions, with more safety and efficacy than flunarizine capsules.

The small-for-size syndrome (SFSS) is widely recognized as one of the most serious clinical complications. It substantially contributes to a poor prognosis after adult living donor liver transplantation. Currently, there is still no consensus on the exact definition and pathogenesis of SFSS. We reviewed the progress on research of pathogenesis of SFSS and put forward some relevant preventive and treatment measures, including donor selection, graft assessment, reduction of high portal vein perfusion, dual grafts technology, advanced molecular medicine and other innovative approaches. Also, we offered some relevant insights into the future research directions of SFSS.

Objective To prepare a kind of P-selectin antibody loaded-targeted ultrasound contrast agent,and to investigate its ability of targeting in vitro.Methods P-selectin antibody loaded-targeted ultrasound contrast agent was prepared via an avidin-biotin bridge.Its basic property was determined.Human umbilical vein endothelial cells (HUVECs) were stimulated to express P-selectin by applying different doses of recombinant human interleukin-4 (rhIL-4) and histamine.The expression level of P-selectin was detected by immunofluorescence technique,and explored rhIL-4 optimal stimulation dose.The experiment group was divided into 3 groups,including targeted ultrasound contrast agent,isotype control ultrasound contrast agent and blank ultrasound contrast agent.Targeting abilities of 3 groups were observed by adhering to treated HUVECs and untreated HUVECs,respectively.Results P-selectin antibody loaded targeted ultrasound contrast agent was prepared successfully.The average diameter was (2.24 ± 0.71)μm.The average Zeta potential was (-2.75 ± 0.84)mV.The concentration was (3.0 ± 0.3) × 109/ml.The rate of antibody binding was as high as 99.80％.RhIL-4 and histamine could stimulate HUVECs to express P-selectin,and optimal stimulation dose was obtained.Targeting experiment showed that targeted ultrasound contrast agent could preferably adhere to HUVECs stimulated by optimal dose of rhIL-4 and histamine.Compared with other groups,there were significant differences.Conclusions P-selectin antibody loaded targeted ultrasound contrast agent was prepared successfully via an avidin-biotin bridge.The targeted ultrasound contrast agent could effectively adhere to HUVECs stimulated by rhIL-4 and histamine.

Objective To investigate the effects of ult rasonic cavitation on cell membrane cultured in vitro. Methods The rat pulmonary artery vascular smooth muscle cells were divided into three groups, control group, simple ultrasound radiation group and contrast plus ultrasound radiation group.The latter two groups were exposed to ultrasound(665 kHz, 0.5- W/cm 2) for 20 s but the last group with contrast agent. Immediately after the experiment or 24 hours after treatments, electron microscopic scanning was used to observe the membrane change. Results Compared with control group, the cell structure and cell surface had no apparent changes in the second group treated with ultrasound alone. In the third group, nearly 20% cells exhibited small holes with diameter mostly about 1-2 ?m in the cell surface and returned to normal appearance after 24 hours later. Conclusions Ultrasonic cavitation can cause small transient holes in cell surface and hence increase permeability of the cell membrane. It might be the main mechanism for gene delivery with ultrasound contrast agents.

Objective To explore whether the 25 kD protein component was a specific decrease in skeletal muscles of the patients with myasthenia gravis (MG). Methods The muscular proteins were extracted from 21 cases of normal objects,18 cases of patients with myasthenia gravis and 20 cases of patients with other neuro-muscular disorders with Guba-Straub solution. The components of protein were analysed by SDS-PAGE in double blind. Components of glycoprotein were detected by using the ConA/HRP.Results SDS-PAGE patterns showed that the concentration of protein bands with mass of about 25 kD in the MG muscles was much lower than that of muscles in both normal and other neuro-musclular disorders. The value of density for 25 kD protein bands was 1.6?0.7 in the MG muscles,but was 3.4?1.5 and 3.7?1.5 in the muscles of normal and other neuro-musclular disorders,respectively. In addition,25 kD protein was found as a glycoprotein,but it was different from AChR in the molecular weight.Conclusion (1) It was suggested that the pathogeny or developing of MG could be associated with 25 kD protein of the skeletal muscle because of its specific decrease. (2) 25 kD protein was a glycoprotein which was unassociated with the AChR molecule.

Objective To make a plan for the backup of electronic medical records. Methods The background of electronic medical records backup was analyzed, and NTBACKUP tool and batch technology were used to realize the backup plan. Results An automatic-execution backup plan raised the security of electronic medical records greatly. Conclusion The automatic-execution backup plan satisfies the basic demands for medical information security, though there is room for further improvement in data synchronization.

Objective To investigate the accuracy of image registration with computed tomograpby (CT) and magnetic resonance imaging(MRI) and to determine gross tumor volume(GTV) of hepatocellular carcinoma(HCC).Methods Thirteen patients were enrolled in this study.CT image was taken in inhala tion phase,and MRIT2 image at the time of peak exhalation.Additional MRIT2 image was taken by fast scanning(MRIT2F) in peak inhalation phase in 6 patients.After mutual information method to CT/MRI im age registration,manual adjustment was made to optimize the accuracy of image fusion.The GTV and liver of each patient was independently contoured by two observers on CT,MRIT2 and MRIT2F images.The accura oy of image fusion was assessed by the ratio of liver overlap(P-LIVERCT-MRIAT2 ,P-LIVERCT-MRIT2F) ,and the dis tance between bone markers(DCT-MRIT2,DCT-MRIT2F) of CT and MRI on the fused image.The volumes of GTV contoured on CT (V-GTVCT),MRIT2 (V-GTVMRIT2),MRIT2F (V-GTVMRIT2F) and their overlap (V GTVCT-MRIT2,V-GTVCT-MRIT2F) and composite volumes (V-GTVCT+MRIT2,V-GTVCT+MRIT2F)were measured.The percentage of V-GTVCT and V-GTVMRIT2 on V-GTVCT+MRIT2,V-GTVCT and V-GTVMRIT2F on V-GTVCT+MRIT2F,V GTVCTMRIT2 and V-GTVCT-MRIT2F on V-GTVCT was also calculated,respectively.Results The mean DCT-MRIT2 and DCT-MRIT2F were 2.7±0.8 mm and 2.1Q±0.9mm.The mean P-LIVERCT-MRIT2 and P-LIVERCT-MRIT2F were 85.9% ± 4.1% and 92.7%± 1.5%.Interobserver difference was significant for GIN defined by CT,but not by MRIT2.V-GTVCT,V-GTVMRIT2 and V-GTVMRIT2F were 387±396 cm3 ,488 ±461 cm3 and 597 ±541 cm3 ,respectively.The percentage of V-GTVCT and V-GTVMRIT2 on V-GTVCT+MRIT2 was 66.2%±13.5% and 88.7% ± 10.2% ,while V-GTVCT and V-GTVMRIT2F on V-GTVCT-MRIT2F was 71.3%±12.7% and 93.5%± 4.8%,respectively.Conclusions CT and MRI for image fusion should be obtained in the same respirato ry phase and in the same treatment position.Automatic registration using mutual information method by auto matic registration software is useful.CT and MRI image should be integrated for HCC GTV delineation.GTV used for planning should be the sum of CT-defined GTV and MRl-defined GTV.

Objective To investigate whether pulsed ultrasound-mediated microbubbles destruction could effectively enhance the efficiency of liposome delivery plasmid to hepatoma cells.Methods The cultured HepG2 cells were divided into six groups.The first group was as contrast group and the second group was given proper dose of liposome and plasmid.Pulsed-ultrasound exposed liposome was the third group.Add plasmid and microbubbles to the fourth group and exposed to pulsed-ultrasound.Add plasmid and liposome to the fifth group and exposed to pulsed-ultrasound,too.Liposome with plasmid and microbubbles were applied to the sixth group and exposed to ultrasound.After 24 hours,the EGFP expression in the hepatoma cells was detected by fluorescence microscopy and MTT.Results Green fluorescence intensity and transfection efficiency of the fifth group were higher than that of other groups,and cell viability had no significant difference.Although they were high in the sixth group,cells were partly died.Conclusions The liposome delivered EGFP expression efficiency in hepatoma cells was increased with the administration of pulsed ultrasound-mediated microbubbles destruction.In certain condition,microbubbles can enhance the efficiency of plasmid.