Objective To investigate the use of endoscopic retrograde cholangiopancreatography(ERCP)combined with laparoscopic cholecystectomy(LC)one-stage approach in the treatment of gallstones complicated with calculus of common bile duct in a hybrid operating room.Methods 21 patients with gallstones complicated with calculus of common bile duct were selected to undergoing ERCP bile duct stone removal under total intravenous anesthesia or combined intravenous and inhalation anesthesia,followed by LC.Results 18 successfully completed the one-stage surgery of ERCP combined with LC,3 were changed to laparoscopic common bile duct exploration(LCBDE),there was no laparotomy,8 cases were complicated by hyperamylemia after surgery,and there were no serious complications such as pancreatitis,gastrointestinal bleeding and perforation.Conclusion It is safe and feasible to use ERCP combined with LC one-stage approach to treat gallstones complicated with calculus of common bile duct in the hybrid operating room,which simplifies the surgical process.

Objective To investigate the ameliorating effect of salidroside(SAL)on cisplatin(CIS)-induced damages of cochlear hair cells(CHC)and spiral ganglion neurons(SGNs)and its relationship with cyclic adenosine monophosphate(cAMP)/protein kinase A(PKA)/cAMP response element binding protein(CREB)pathway.Methods The cochlear basilar membranes of newborn C 57BL/6 mice were isolated and separated into control(C)group,CIS group,SAL group,SAL+SQ22536(cAMP inhibitor)group and SAL+H-89(PKA inhibitor)group,20 per group.Immunofluorescence staining was applied to observe the damages of CHC and SGNs.The kits were applied to detect the contents of ROS and cAMP in the basement membrane of the cochlea.Western blot was applied to detect the protein levels of PKA,p-CREB,CREB,Bcl-2,BDNF,and NF-M.Results CHC in CIS group were disorderly arranged and enlarged in size,SGNs had fragmented nuclei and lost neurites.SAL alleviated the damages of CHC and SGNs.Compared with the C group,the numbers of CHC and SGNs in the CIS group were less(P＜0.05),the contents of ROS and cAMP,and the levels of PKA,BDNF,NF-M,Bcl-2 proteins and p-CREB/CREB were higher(P＜0.05).Compared with the CIS group,the numbers of CHC and SGNs in the SAL group were higher(P＜0.05),the content of ROS was lower(P＜0.05),the content of cAMP,and the levels of PKA,BD-NF,NF-M,Bcl-2 proteins and p-CREB/CREB were higher(P＜0.05).Both SQ22536 and H-89 reversed the pro-tective effects of SAL on CHC and SGNs.Conclusion SAL may promote the expression of anti-apoptotic proteins and neuroprotective factors by activating the cAMP/PKA/CREB pathway to alleviate the damages of CHC and SGNs caused by CIS.

Objective To compare the safety and effectiveness of two different flow diverter devices between Tubridge flow diverter(TFD)and Surpass Streamline flow diverter(SFD)in the treatment of unruptured intracranial aneurysms.Methods A retrospective analysis from August 2020 to December 2023 was performed on the clinical data of 62 cases of unruptured aneurysms in the Department of Interventional Radiology(Shinan Branch),the Affiliated Hospital of Qingdao University treated with flow diverter.According to the type of implanted stents,they were divided into TFD group(32 cases)and SFD group(30 cases),general information about patients was collected,including age,sex,and past history(hypertension,diabetes,coronary heart disease),hospitalization time,surgical time(anesthesia start to anesthesia awakening time)and aneurysm location(anterior circulation,posterior circulation),type(giant aneurysm:maximum diameter ≥ 25 mm,large aneurysm:maximum diameter 15-＜25 mm,medium aneurysm:maximum diameter 5-＜15 mm,small aneurysm:maximum diameter＜5 mm),aneurysm morphology(saccular aneurysm,simple fusiform aneurysm,dissecting aneurysm),aneurysm maximum diameter,aneurysm neck,parent artery diameter,aneurysm wall enhancement in preoperative high-resolution MRI scan.Different types of flow diverters were selected according to the results of Surpass intracranial aneurysm embolization system pivotal trial to treat large or giant wide neck aneurysms(SCENT)and intracranial aneurysms managed by parent artery reconstruction using Tubridge flow diverter study(IMPACT).If"ejection sign"was found at the aneurysm neck on angiography immediately after the release of flow diverters,appropriate amount of coils were packed.Tamponade until there is no contrast filling in the aneurysm body on cerebral angiography,at which time the operation is terminated.If there is no"ejection sign"immediately after the release of the flow diverter,the procedure is terminated.Angiography was performed immediately after operation to evaluate the parent artery stenosis(patency[stenosis rate ≤50％],stenosis[stenosis rate＞50％]or occlusion[stenosis rate 100％])degree of aneurysm occlusion.O'Kelly-Marotta(OKM)classification was used to evaluate the degree of aneurysm occlusion.Effectiveness evaluation:DS A follow-up was performed≥1 month after operation,and the final angiographic result was taken as the final follow-up result to evaluate the postoperative aneurysm occlusion(OKM grade D:complete aneurysm occlusion,other grades:incomplete aneurysm occlusion),parent artery stenosis or occlusion.Safety evaluation:the clinical efficacy of patients at the last postoperative follow-up was evaluated by modified Rankin scale(mRS)score(mRS score 0-2:good clinical prognosis,mRS score 3-6:poor clinical prognosis),and perioperative(≤2 weeks after surgery)complications(ischemic complications,bleeding complications and other complications)were counted.The clinical effects and complications of the two groups were compared.Results A total of 62 aneurysms in 62 patients were included in the study.All patients were treated with a single flow diversion device.There were 28 males and 34females,aged 32 years to 76 years,with an average of(57±10)years.There were 39 anterior circulation aneurysms and 23 posterior circulation aneurysms.Among 62 patients,43 patients had saccular aneurysm,4 patients had simple fusiform aneurysm and 15 had dissecting aneurysm.Among them,38 saccular aneurysms were located in the anterior circulation and 5 in the posterior circulation;1 simple fusiform aneurysm was located in the anterior circulation and 3 in the posterior circulation;all dissecting aneurysms were located in the posterior circulation.The maximum diameter of the aneurysm ranged from 2.0 mm to 27.0 mm,with a median of 7.0(5.0,12.0)mm,and the aneurysm neck ranged from 2.0 mm to 18.5 mm,with a median of 5.0(4.0,6.7)mm.(1)There were statistically significant differences in aneurysm location and shape distribution between TFD group and SFD group(both P＜0.05),but there were no statistically significant differences in other general data(all P＞0.05).(2)The incidence of perioperative complications was 6.3％(2/32)in TFD group and 10.0％(3/30)in SFD group,and there was no significant difference between two groups(P=0.940).The good clinical outcome rate of both groups were 100.0％at the last follow-up.(3)All patients were followed up with DS A after operation.The follow-up time ranged from 55 d to 1 150 d,with a median follow-up time of 205.0(108.0,360.0)d.There was no significant difference in OKM classification distribution immediately after operation(P=0.607)and complete occlusion rate at the last follow-up(53.1％[17/32]vs.63.3％[19/30],P=0.416)between two groups.At the last follow-up,no parent artery stenosis or occlusion occurred in either group.Conclusions TFD has comparable efficacy and safety as SFD in the treatment of unruptured intracranial aneurysms.The results of this study need to be further verified by prospective large sample study.

Objective To compare the safety and effectiveness of two different flow diverter devices between Tubridge flow diverter(TFD)and Surpass Streamline flow diverter(SFD)in the treatment of unruptured intracranial aneurysms.Methods A retrospective analysis from August 2020 to December 2023 was performed on the clinical data of 62 cases of unruptured aneurysms in the Department of Interventional Radiology(Shinan Branch),the Affiliated Hospital of Qingdao University treated with flow diverter.According to the type of implanted stents,they were divided into TFD group(32 cases)and SFD group(30 cases),general information about patients was collected,including age,sex,and past history(hypertension,diabetes,coronary heart disease),hospitalization time,surgical time(anesthesia start to anesthesia awakening time)and aneurysm location(anterior circulation,posterior circulation),type(giant aneurysm:maximum diameter ≥ 25 mm,large aneurysm:maximum diameter 15-＜25 mm,medium aneurysm:maximum diameter 5-＜15 mm,small aneurysm:maximum diameter＜5 mm),aneurysm morphology(saccular aneurysm,simple fusiform aneurysm,dissecting aneurysm),aneurysm maximum diameter,aneurysm neck,parent artery diameter,aneurysm wall enhancement in preoperative high-resolution MRI scan.Different types of flow diverters were selected according to the results of Surpass intracranial aneurysm embolization system pivotal trial to treat large or giant wide neck aneurysms(SCENT)and intracranial aneurysms managed by parent artery reconstruction using Tubridge flow diverter study(IMPACT).If"ejection sign"was found at the aneurysm neck on angiography immediately after the release of flow diverters,appropriate amount of coils were packed.Tamponade until there is no contrast filling in the aneurysm body on cerebral angiography,at which time the operation is terminated.If there is no"ejection sign"immediately after the release of the flow diverter,the procedure is terminated.Angiography was performed immediately after operation to evaluate the parent artery stenosis(patency[stenosis rate ≤50％],stenosis[stenosis rate＞50％]or occlusion[stenosis rate 100％])degree of aneurysm occlusion.O'Kelly-Marotta(OKM)classification was used to evaluate the degree of aneurysm occlusion.Effectiveness evaluation:DS A follow-up was performed≥1 month after operation,and the final angiographic result was taken as the final follow-up result to evaluate the postoperative aneurysm occlusion(OKM grade D:complete aneurysm occlusion,other grades:incomplete aneurysm occlusion),parent artery stenosis or occlusion.Safety evaluation:the clinical efficacy of patients at the last postoperative follow-up was evaluated by modified Rankin scale(mRS)score(mRS score 0-2:good clinical prognosis,mRS score 3-6:poor clinical prognosis),and perioperative(≤2 weeks after surgery)complications(ischemic complications,bleeding complications and other complications)were counted.The clinical effects and complications of the two groups were compared.Results A total of 62 aneurysms in 62 patients were included in the study.All patients were treated with a single flow diversion device.There were 28 males and 34females,aged 32 years to 76 years,with an average of(57±10)years.There were 39 anterior circulation aneurysms and 23 posterior circulation aneurysms.Among 62 patients,43 patients had saccular aneurysm,4 patients had simple fusiform aneurysm and 15 had dissecting aneurysm.Among them,38 saccular aneurysms were located in the anterior circulation and 5 in the posterior circulation;1 simple fusiform aneurysm was located in the anterior circulation and 3 in the posterior circulation;all dissecting aneurysms were located in the posterior circulation.The maximum diameter of the aneurysm ranged from 2.0 mm to 27.0 mm,with a median of 7.0(5.0,12.0)mm,and the aneurysm neck ranged from 2.0 mm to 18.5 mm,with a median of 5.0(4.0,6.7)mm.(1)There were statistically significant differences in aneurysm location and shape distribution between TFD group and SFD group(both P＜0.05),but there were no statistically significant differences in other general data(all P＞0.05).(2)The incidence of perioperative complications was 6.3％(2/32)in TFD group and 10.0％(3/30)in SFD group,and there was no significant difference between two groups(P=0.940).The good clinical outcome rate of both groups were 100.0％at the last follow-up.(3)All patients were followed up with DS A after operation.The follow-up time ranged from 55 d to 1 150 d,with a median follow-up time of 205.0(108.0,360.0)d.There was no significant difference in OKM classification distribution immediately after operation(P=0.607)and complete occlusion rate at the last follow-up(53.1％[17/32]vs.63.3％[19/30],P=0.416)between two groups.At the last follow-up,no parent artery stenosis or occlusion occurred in either group.Conclusions TFD has comparable efficacy and safety as SFD in the treatment of unruptured intracranial aneurysms.The results of this study need to be further verified by prospective large sample study.

Objective To discuss the treatment method and opportunity for patients with gallbladder stones and extrahepatic bile duct stones who failed endoscopic removal of common bile duct stones by endoscopic retrograde cholangiopancreaticography (ERCP). Methods 12 patients, with gallbladder stones and extrahepatic bile duct stones, failed endoscopic stone extraction (ESE), underwent emergency one-stage laparoscopic cholecystectomy (LC) and Laparoscopic common bile duct exploration (LCBDE). Results All of the patients were successfully completed LC +LCBDE and stones were completely removed. Hyperamylasemia occurred in 3 cases and there was no bile leakage, intestinal leakage, cholangitis, pancreatitis, biliary bleeding and other complications. Conclusions Emergency LCBDE has been shown to be a safe and effective salvage procedure for failed ESE.

The protective effects of Da Chai Hu Granules (DCHKL) on islet cells which were incubated with 4 mmol x L(-1) alloxan (AXN) were studied. The viability of islet cells were measured with MTT. Insulin released into medium and in islets was detected by radioimmunoassay. Cell apoptosis rate was determined by flow cytometry. The expression of anti-apoptotic gene Bcl-2 and pro-apoptotic gene Bax in islet cells were measured with RT-PCR (reverse transcription polymerase chain reaction). Serum containing DCHKL can promote the activity of islet cells significantly (P < 0.01). Basal insulin secretion and high glucose-stimulated insulin secretion increased significantly (P < 0.01). Serum containing DCHKL can inhibit apoptosis of islet cells, the ratio of apoptosis was decreased. Serum containing DCHKL increased expression of Bcl-2 mRNA and decreased expression of Bax mRNA. DCHKL can significantly promote proliferation of islet cells and increase the amount of basal secretion of pancreatic islet cells and high glucose-stimulated insulin secretion. The expression of Bcl-2 increased significantly. The expression of Bax decreased significantly. DCHKL have a protective effect on the islet cells.

Objective To observe the characteristics of electromyography of sphincter of Oddi (SO) in patients with cholelithiasis after common bile duct exploration,and investigate new methods for detecting the motility of SO.Methods The basal pressure of SO(SOBP)and electromyography of SO were detected in 33 patients with cholelithiasis who were reexamined at the Southwest Hospital from January to October,2010.All patients were divided into low SOBP group,normal SOBP group and high SOBP group.The amplitude,frequency and duration of SO spike burst(SOSB)of the three groups were compared.Results The numbers of patients in the low SOBP group,normal SOBP group and high SOBP group were 14,13 and 6,respectively.The mean SOBP of the low SOBP group,normal SOBP group and high SOBP group were(3.1±1.2),(18.5±7.6),(39.8±4.8)mm Hg (1 mm Hg=0.133 kPa).The amplitude,frequency and duration of SOSB were(41±27)μV,(5.8±1.6) times/minutes and(2.7±0.6)s in the low SOBP group,and(150±71)μV,(6.9±1.4)times/minutes and (3.4±0.7)s in the normal SOBP group,and(301±109)μV,(7.8±1.2)times/minutes and(4.2±0.7)s in the high SOBP group,respectively,with significant difference among the three groups(F=50.751,4.293,13.159,P<0.05).Conclusion The results of electromyography of SO could reflect the function of SO,and it is possible to be a prospective method in the clinical research of SO.

Objective To study the protective effects of tripterine on experimental lupus nephritis glomerulosclerosis.Methods Different doses of tripterine were injected peritoneally to BW F1 mice at different stages.The levels of 24 hour urine protein excretion and serum anti dsDNA antibodies,and the expressions of renal collagen type Ⅰ,type Ⅳ,MMP 2,TIMP 2,and transforming growth factor (TGF) ? 1 mRNA were analyzed.Results ①Tripterine suppressed the development of proteinuria,decreased the level of serum anti dsDNA antibodies,reduced the local expressions of TGF ? 1,collagen type Ⅰ,type Ⅳ,TIMP 2 and improved the expression of MMP 2 in murine kidney.②The use of tripterine before occurence of proteinuria got more obvious protective effects than it did after the occurence of proteinuria.③No significance was found between both 3 mg/kg (a week) tripterine treated and 6 mg/kg (a week) groups.Conclusion Tripterine has a definite protective effect on glomerulosclerosis of the lupus murine model.The decrease of renal collagen type Ⅰ and type Ⅳ is probably due to its suppressive effects on the expression of local TGF ? 1,TIMP 2 and its improvement effect on the local expression of MMP 2.

Objective To explore the possible mechanism of nitric oxide(NO) involved in iron-mediated cytotoxicity on renal tubular cells, meanwhile to estimate the effect of reactive oxygen sepcies scavenger on iron-mediated cytotoxicity and its relation to nitric oxide. Methods in this study, the relationship between NO production and lactate dehydrogenase(LDH) release were observed in primary subconfluent proximal tubular cells coincubated with different doses of NTA-Fe and lipopolysaccharide(LPS) alone or in combination. NO production was monitored by NO2 -- concentration in supernatant based on Griess reaction. Meanwhile, semi-quantitative RT-PCR was applied to detect the inducible nitric oxide synthase (iNOS) mRNA level induced by NTA-Fe and LPS together. In addition, experimental groups were exposed to reactive oxygen species (ROS) scavengers to determine the impact of the interaction between NO and ROS on iron-mediated cytotoxicity. Results After 12-hour coincubation, NTA-Fe could increase both LDH release and NO2 production in a dose-dependent manner (P 0. 05 ) although tubular injury was aggravated (P