Objective To study the therapeutic methods of cholecystic duct stones. Methods A retrospective analysis of the clinical data of 158 cases of cholecystic duct stones treated in the recent 6 years was made. Results 97 of the 158 cases of cholecystic duct stones were removed by open surgical operation and 61 cases by laparoscopic cholecystectomy(LC).In 49 of the 61 cases treated with LC,the cholecystic duct stones were removed together with removal of the gallbladder, and 12 by duodenoscopy after LC. Conclusions One should strive to extract the cholecystic duct stones while removing the gallbladder. If the stones or stone fragments escape into the common bile duct, they could be removed through a choledochotomy at the time of the open operation ,or by postoparative duodenoscopy in cases undergoing LC. The latter method of treatment is associated with minor trauma, quick recovery and definite therapeutic results.

BACKGROUND:Brain microvascular endothelial cel s (BMECs) are important tools in the field of neuroscience research;therefore, how to obtain highly purified BMECs is a key and difficulty in vitro.
OBJECTIVE:To develop a simple method of isolating and culturing highly purified BMECs.
METHODS:C57BL/6 mice aged 6-8 weeks old were selected, and microvessels were obtained using enzyme digestion and gradient centrifugation. Further, endothelia cel s were purified by certain drugs, fol owed by identified by CD31 and GFAP immunofluorescence staining. The expression of Claudin-5 was detected using immunofluorescence staining with anti-Claudin-5 antibody.
RESULTS AND CONCLUSION:Mouse BMECs grew and arranged in spiral or cobblestone-like. Immunofluorescence staining showed that the purity of BMECs reached above 99%and Claudin-5 was highly expressed. In conclusion, a simple method of easy accessibility is developed to obtain highly purified primary mouse BMECs.

Objective:To discuss the diagnotic and therapeutic value of endoscopy on chro-nic pancreatitis(CP).Methods:To analyse the results of endoscopy in 72 cases respectively.Results:Of 72 cases,69 cases finished the endoscopy,and the success rate was 96%.ERCP showed duodenal papillary stenosis in 61 cases,and thin-diameter-pancreatic duct in 7 cases.After therapentic endoscopy,including ERCP,endoscopic sphincterotomy,and endoscopic stent-placement,the symptoms of the patients relieved at different extent,and the effective rate was 100%.Conclusion:The thinning change of the pancreatic duct is one of imaging feature in chronic pancreatits.Simple duodenal papillary stenos is may be the unigue sign during ERCP.Duodenal papillary stenosis and stone are the main cause of chronic pancreatitis.Therapeutic endoscopy can protect some patients from surgery.

Objective: To investigate the clinicopathological features of oral melanotic neuroectodermal tumor of infancy (MNTI). Methods: We retrospectively reviewed the clinical and pathological data of 13 cases of oral MNTI treated in Peking University School and Hospital of Stomatology from 1980 to 2007. Results: The age of patients ranged from 2 to 7 months old. Nine lesions occurred in the maxilla, 3 in the mandible and 1 in the cheek. The most common symptom of the disease was swelling. Five tumors were found purple-reddish or blue-blackish. The neoplasm grew rapidly. Only 1 case was diagnosed as MNTI and 3 cases were diagnosed as malignant tumor before biopsy. Two of 9 cases with follow-up information recurred in one month after surgery and 1 case dead of the tumor. One case with remnants of tumor did not recur after 19 years postoperatively. Conclusion: Oral MNTIs appear to occur in certain locations and people of certain age. Special attention should be paid to the color of the tumor during intra-oral examination. This tumor grew rapidly and invasively and the patients require close follow-up within the first 6 months postoperatively. The pathologic differential diagnosis of MNTI should include other pe-diatric "small round cell" neoplasms. Conservative excision is the preferred treatment choice.

Objective To assess the anal and pelvic floor function in patients with rectocele (RC),and to afford the evidence for the treatments of RC.Methods Patients with functional constipation (FC) and healthy controls were consecutively enrolled,and all the subjects underwent defecography and anorectal manometry.According to defecography,the subjects were divided into four groups as no RC,mild RC,moderate RC and severe RC.The t-test,analysis of variance,rank sum test and Chi-square test were performed to compare the results of anorectal manometry between different RC groups in FC patients,and the results of anorectal manometry between moderate RC group in FC patients and control group with moderate RC were also compared.Results A total of 54 FC patients and 17 healthy controls were enrolled.No RC was found in all of male subjects.Of 48 female patients with FC,nine cases (18.8％) had no RC,seven (14.6％) had mild RC,18(37.5％) had moderate RC,and 14(29.2％) had severe RC.Three of the 12 female controls had no RC,one had mild RC,and eight had severe RC.Among all female patients with FC,the defecation rectal pressure in severe RC group ((34.4 ± 14.2) mmHg,1 mmHg=0.133 kPa) was significantly higher than of no RC group ((20.8 ± 13.1) mmHg,t=3.663,P=0.001),mild RC group ((19.1± 15.1) mmHg,t=3.719,P＜0.01) and moderateRC group ((25.6±16.3) mmHg,t=2.525,P=0.010).The left rectal pressure after defecation in mild RC group ((55.1 ± 19.7) mmHg) was significantly higher than that of moderate RC group ((43.3±17.6) mmHg,t=2.507,P=0.019) and severe RC group ((40.0±20.9) mmHg,t=2.619,P=0.006).The anal relax ratio in mild RC group (3.0％,0.5％ to 25.5％) was significantly lower than that of moderate RC group (19.5％,10.0％ to 29.0％,Z=-2.583,P=0.010) and severe RC group (22.0％,7.3％ to 54.5％,Z=-2.830,P=0.005).There were no significant differences in rectal and anal resting pressure,anal squeezing pressure,rectal sensory threshold and constituent ratio of manometry among four groups (all P＞0.05).The left rectal pressure after defecation in FC patients with moderate RC ((43.3 ± 17.6) mmHg) was significantly higher than that of controls with moderate RC ((26.3±20.8) mmHg,t=2.997,P＜0.01),and anal relax ratio was significantly lower than that of controls with moderateRC ((23.4±20.2)％ vs (55.2±16.3)％,t=-5.266,P=0.008).Conclusions RC is found in female and also found in individuals with normal defecation.FC patients with mild RC lack enough anal relax during defecation.However,defecation is relatively coordinate in FC patients with severe RC,which indicates that severe RC may be part of manifestation of pelvic floor relaxation.

Objective:To summarize and analyze the clinical characteristics of patients with infective endocarditis (IE) complicated with cerebral hemorrhage.Methods:The clinical data of 15 IE patients with intracerebral hemorrhage diagnosed in the Affiliated Hospital of Xuzhou Medical University from January 2010 to December 2021 were analyzed retrospectively, and their clinical characteristics were analyzed, including the mode of onset, cranial imaging characteristics, associated diseases, echocardiography, hematology, etiology, chest computed tomography (CT), cerebrospinal fluid characteristics, treatment methods and prognosis of patients.Results:Cerebral hemorrhage in IE patients were acute or subacute onset. Head CT scanning showed that cerebral hemorrhage usually occurred in the brain lobe, can be combined with rheumatic heart disease, congenital heart defect or immune system diseases, etc. Ultrasonic cardiogram can be used to determine the location of vegetations in the heart cavity, the damage of the valve and the hemodynamic changes. The hematologic examination showed elevated hemogram and increased erythrocyte sedimentation rate. Staphylococcus aureus or streptococcus viridans were often detected on the etiological examination. Lung infection was often seen on a chest CT, and inflammatory changes were seen in the cerebrospinal fluid. IE was treated with sufficient course of antibiotics and valve replacement with valve damage. The case fatality rate was 3/15.Conclusions:Young patients presented with lobar hemorrhage, headache, fever and rheumatic heart disease should be thought of the possibility of IE combined with cerebral hemorrhage. IE with intracerebral hemorrhage has a poor prognosis and a high mortality.