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.

Objective: To observe the preventive effect of alkaline drinking water on hyperuricemia in mice. Methods: Sixty male SPF Kunming mice were randomly divided into six groups: pH 7.3, pH 8.0, pH 9.3 intervention groups, in which the mice were given water with pH values of 7.3±0.5, 8.0±0.5 and 9.3±0.6, respectively; the control group, model group and positive drug group ( with 2 g/L allopurinol ) were given double distilled water. Except for the control group, the mice in each group were given yeast by gavage (1.5 g/mL) for 13 days. On the 14th day, the mice were injected with 300 mg/kg potassium oxyzinate by intraperitoneal injection, and then fasted for 1 day. On the 16th day, serum uric acid, creatinine and urea nitrogen were detected, and renal tissues were stained to observe the morphology.The expression levels of neutrophil gelatinase-associated lipocalin ( NGAL ), tissue inhibitor of metalloproteinase 1( TIMP1 ), organic anion transporter 1 ( OAT1 ) and urate transporter 1 ( URAL-1 ) in renal tissues were determined bywestern blotting. The mRNA expression levels of URAL-1 and OAT1 were detected by real-time fluorescent quantita⁃tive polymerase chain reaction. Results: The level of serum uric acid was higher in the model group than in the control group and in the pH 9.3 intervention group (both P<0.05). The number and area of renal tubular lesions were less in the pH 9.3 intervention group than in the model group (all P<0.05). The relative expression levels of NGAL and URAT-1 proteins were lower in the pH 9.3 intervention group than in the model group, and the relative expression level of OAT1 protein was higher in the pH 9.3 intervention group than in the model group ( all P<0.05). The relativeexpression level of URAT-1 mRNA was lower in the pH 9.3 intervention group than in the model group, and the rela⁃tive expression level of OAT1 mRNA was higher in the pH 9.3 intervention group than in the model group ( all P<0.05 ). Conclusion Alkaline drinking water with pH value of 9.3±0.6 can effectively prevent hyperuricemia and acute kidney injury in mice.

Objective To explore the value of Multiple b value DWI ( MbDWI ) in the short-term efficacy evaluation of cyberknife radiotherapy for locally advanced pancreatic cancer ( LAPC ) .Methods A total of 36 patients underwent both conventional sequence and respiratory triggered MbDWI ( b=0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1 000 s/mm2 ) before cyberknife radiotherapy, 1month and 3 months after the radiotherapy, respectively.ADCtot, f, Dfast and Dslow were calculated using single and double exponential model and the changes before and after radiotherapy were observed.Results Before radiotherapy, 1 month and 3 months after radiotherapy, the ADCtot values of solid lesions were (1.56 ±0.29) ×10-3 mm2/s, (1.75 ±0.31) ×10 -3 mm2/s and (18.6 ± 0.46) ×10 -3 mm2/s;the values of Dslow were (1.10 ±0.73) × 10 -3 mm2/s, ( 1.19 ±0.97 ) ×10 -3 mm2/s and ( 1.49 ±04.6 ) ×10 -3 mm2 s/; the values of Dfast were (83 .33 ±62 .57) ×10 -3 mm2/s,(124.57 ±123.10) ×10 -3 mm2/s and (108.07 ±96 .67) ×10 -3 mm2 /s; f values were (26.81 ±23.74)%,(23.61 ±22.75)% and (21.34 ±15.36)%, respectively.ADCtot values 1 month and 3 months after treatment were significantly higher than those before treatment and Dslow 3 months post-treatment was higher than that before treatment, and the differences were statistically significant ( both P<0.05) and no other differences between two groups were significant.There were no statistical differences on Dfast and f before and after radiotherapy.Conc lusions ADCtot and Dslow both showed a significant growth trend after cyberknife radiotherapy.The advanced degree of parenchymal cystic in the targeted lesion could reflect the short-term efficacy of cyberknife treatment.

Objective To evaluate the short-term therapeutic efficacy of Cyberknife in alleviating the pain of locally advanced pancreatic cancer (LAPC) and explore the application of DWI in the pain evaluation.Methods Visual analogue scale (VAS) and Quality of life score KPS were conducted in 36 LAPC patients before and 1 month,3 month after radiotherapy,who underwent conventional MRI examination and DWI scan.The changes of VAS and KPS scores were observed before and after the treatment,as well as the apparent diffusion coefficients (ADC) changes of region of interest (ROI) in the DWI images,and the correlation of ADC with KPS and VAS was analyzed.Results VAS before and at 1 month and 3 month after the treatment was (4.89 ± 2.89),(1.08 ± 2.06) and (0.51 ± 1.48).KPS before and at 1 month and 3 month after the treatment was (72.47 ± 14.74),(93.33 ± 10.69) and (92.86 ± 10.73).ADC of DWI before and at 1 month and 3 month after the treatment was 1.47 ± 0.28,1.79 ± 0.33 and 1.94 ± 0.41,and the differences were statistically significant (all P values ＜0.001).VAS was obviously decreased at 1 month and 3 month after the treatment,while KPS and ADC were greatly increased,and the differences were statistically significant (P value ＜ 0.05).There was no statistical difference between those at 1 month and those at 3 month.There was no obvious correlation between ADC and VAS and KPS at 1 month and 3 month after the treatment.Conclusions After Cyberknife treatment,the pain was obviously relieved and the life quality was greatly improved within short period,but ADC of DWI can not sensitively monitor the changes of the pain.