Objective:To study the safety and efficacy of primary closure of non-dilaed common bile ducts (CBD) after laparoscopic common bile duct exploration.Methods:A retrospective study was conducted on the clinical data of 120 patients who underwent primary closure of CBD after laparoscopic CBD exploration (LCBDE) at the Shengjing Hospital of China Medical University from April 1, 2014 to November 30, 2019. There were 44 males and 76 females, aged 22.0 to 88.0 years, (average age of 57.2 years). These patients were divided into the dilated CBD group (diameter of CBD >8 mm) and the normal CBD group (diameter of CBD ≤8 mm). The following factors, including operating time, intraoperative bleeding, postoperative hospitalization stay, abdominal drainage tube indwelling time and postoperative complications were compared.Results:The dilated CBD group consisted of 76 patients, with 25 males and 51 females, and a median age of 62.5 years. The normal CBD group consisted of 44 patients, with 19 males and 25 females, and a median age of 57.5 years. There were no significant differences in gender, age, albumin level, total bilirubin and other baseline data between groups ( P>0.05). The operation times of the two groups were: the normal CBD group [106.6(87.3, 146.3] min vs the dilated CBD group [112.0(90.5, 134.5)] min; intraoperative blood loss [the normal CBD group 20(10, 30)ml vs dilated CBD group 20(10, 20)ml]; postoperative hospital stay [the normal CBD group 7.0 (5.3, 9.0) d vs the dilated CBD group 7.0 (5.0, 7.0) d]; and postoperative abdominal drainage tube removal time [the normal CBD group 6 (4, 7) d vs the dilated CBD group 5 (4, 6)d]. The differences were all not significant ( P>0.05). There was also no significant difference in the incidences of postoperative complications (including bile leakage, biliary stricture, and stone recurrence between groups, all P>0.05). Conclusion:In patients with a normal diameter (≤8 mm) common bile duct, it was safe and efficacious to perform primary closure after laparoscopic common bile duct exploration.

Adrenal Cortex Hormones ; therapeutic use ; Adrenergic beta-Agonists ; therapeutic use ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; drug therapy ; Humans ; Medication Adherence

ObjectiveTo observe the effects of acupuncture combined with massage on shoulder subluxation and motor function recovery of the upper extremities in patients with hemiplegia after stroke.Methods60 hemiplegic patients were randomly divided into two groups for treatment with acupuncture cooperates with massage or usual rehabilition, respectively. The recovery of the patient's shoulder subluxation and movement function of upper extremities were evaluated 2 months after treatment. ResultsThe shoulder subluxation and movement function of the upper extremities were improved after treatment with both therapies (P<0.01), and acupuncture cooperates with massage showed better effect (P<0.01). ConclusionAcupuncture cooperates with massage can facilitate the recovery of shoulder subluxation and motor function of the upper extremities after hemiplegia.

ObjectiveTo investigate the effects of medical chitin degraded membrane on post-surgical abdominal adhesions.MethodsForty adult rabbits were made to form abdominal adhesions and divided randomly into four groups including group A1 and its control group A2, group B1 and its control groups B2 with 10 animals in each group. Medical chitin degraded membrane was applied in the group A and group B to the surfaces of the positions where would be adhered. All animals were cut the belly open again on the 7th, 14th postoperative day; the adhesions about incision and appendix were graded according to the severity, and took on bioscopy.ResultsThe abdominal adhesions model was successful. The severity of adhesions and inflammatory reaction of the group A1 and group B1 was significantly milder than that of the group A2 and group B2 in every different periods ( P<0.05).ConclusionThe medical chitin degraded membrane used intraoperatively might have some efficacy in preventing post-surgical abdominal adhesions.

Objective To explore a new surgical approach for the renovation of laryngotracheal stenosis. Methods the anatomical structures of the anteroventral portion of the digastric muscle along with the blood supply, innervation and periosteal coverage of the mandibular were investigated by observing 23(46 sides) cadaver. Results The anteroventral portion of the digastric muscle rise from the fossae digastrica at the angle of 30.4°±3.5°. Its length was (4.8+0.7) cm and the periosteal coverage averaged (111.6+28.2) mm2. The puncta of rami digastricus stats (2.4+0.7) cm from the arteriae submentalis. Mylohyoid nerve together with rami digastricus enters the muscular tissue. Conclusion Designed with reference to sternocleidomastoid clavicular periosteal flap, the periosteal flap of the anterovent of the digastric muscle-mandible may offer a new way for largngotracheal renouation.

Objective To explore a new surgical approach for the renovation of laryngotracheal stenosis. Methods the anatomical structures of the anteroventral portion of the digastric muscle along with the blood supply, innervation and periosteal coverage of the mandibular were investigated by observing 23(46 sides) cadaver. Results The anteroventral portion of the digastric muscle rise from the fossae digastrica at the angle of 30.4°±3.5°. Its length was (4.8+0.7) cm and the periosteal coverage averaged (111.6+28.2) mm2. The puncta of rami digastricus stats (2.4+0.7) cm from the arteriae submentalis. Mylohyoid nerve together with rami digastricus enters the muscular tissue. Conclusion Designed with reference to sternocleidomastoid clavicular periosteal flap, the periosteal flap of the anterovent of the digastric muscle-mandible may offer a new way for largngotracheal renouation.

OBJECTIVE: To explore role of Nods (nucleotide-binding oligomerization domain Nod Like receptors) kind of pattern recognition receptors (PRR) in patients with allergic rhinitis. METHOD: The mRNA and protein of Nod1, Nod2 of Nalp3 were analyzed in the turbinate mucosa of patients with allergic rhinitis, nasal septum deviation (NSD) nasal mucosa of patients and nasal polyp mucosa with Real-Time RT-PCR, Western blot and immunohistochemistry respectively, and Nod1 expression changes was explored in PBMC with wad explored Western-blot and then the level of IL-4, IL-6, IL-10, IFN-γ were detected in serum of AR after desensitization treatment. RESULT: These Nods like receptors, mainly found in nasal mucosa epithelial cells, glandular epithelium and inflammatory cells (e. g. plasma cells, eosinophils), were expressed in the nasal mucosa tissues. In AR group, Nod1 (mRNA and protein) expression were lower than NSD group (P<0.05), Nalp3 expression were higher than (P<0.05), while, there was no significant difference of Nod2 (mRNA and protein) between groups. After 6 months desensitization therapy, the change of Nod1 in PBMC was negatively correlated with the change of IL-10 in the peripheral blood, r=-0.88, P<0.05; while, change of Nod1 was positively correlated, with the change of IL-6, r=0.57, P>0.05. CONCLUSION Nod1, Nod2 and Nalp3 expression were seen in the two groups,and the Nod1 expression in allergic rhinitis group was lower than other two groups, while, the Nalp3 was higher than other two groups. It showed Nod1, Nalp3 may be involved in the pathogenesis of allergic rhinitis. Expression of Nod1 in PBMC reduced after sublingual desensitization treatment. Besides, the change of Nod1 was negatively correlated with the change of IL-10 in PBMC. So,it seemed that Nod1 may regulate IL-10 changes and be involved in sublingual desensitization therapy.
Carrier Proteins ; metabolism ; Humans ; Interferon-gamma ; blood ; Interleukin-10 ; blood ; Interleukin-4 ; blood ; Interleukin-6 ; blood ; Leukocytes, Mononuclear ; metabolism ; NLR Family, Pyrin Domain-Containing 3 Protein ; Nasal Mucosa ; metabolism ; Nasal Polyps ; metabolism ; Nod1 Signaling Adaptor Protein ; metabolism ; Nod2 Signaling Adaptor Protein ; metabolism ; Receptors, Pattern Recognition ; metabolism ; Rhinitis, Allergic ; metabolism ; Turbinates ; metabolism

Colorectal Neoplasms ; pathology ; surgery ; Humans ; Liver Neoplasms ; secondary ; surgery

Objective To investigate the association between donor complement factor component 7 (C7) rs6876739 gene polymorphisms and risk of early bacterial infection following orthotopic liver transplantation (OLT).Methods A total of 113 patients who had undergone OLT in Shanghai General Hospital between July 2007 and January 2011 were included.A single nucleotide polymorphism (SNP),donor C7 rs6876739 was genotyped and analyzed together with clinical data.Results We demortstrated that donor C7 rs6876739 CC genotype had higher risk of early bacterial infection than TT genotype following OLT (55.6％ vs.26.5％,P =0.021).The multivariate logistic regression analysis revealed that gender (P =0.018),biliary complications (P =0.018),ICU stay after LT (P＜0.001) and donor C7 rs6876739 genotype (P =0.001) were identified as independent factors of early bacterial infection.Conclusion Donor C7 rs6876739 genotype polymorphism is associated with early bacterial infection following OLT and may be a new marker of risk for the development of potentially serious bacterial infection after liver transplantation.

In this study, nattokinase gene was amplified by PCR using bacillus subtilis chromosomal DNA as template and cloned into expressed vector pBV220. After transforming recombinant plasmid into E.coli HB101, the recombinant strain was yielded. It was proved that expression products was secretive and expression protein was 12% of total cell protein by SDS-PAGE. Optimum culture time and inducing time was determined as 6h and 5h respectively. The plasmid stability studies showed that recombinant plasmid has excellent segregational stability but the structural stability was not good in the host cell.