Ectopic opening of the common bile duct into the duodenal bulb with recurrent choledocholithiasis: A case report

BACKGROUND Ectopic opening of the common bile duct is a condition with low incidence.Patients with an ectopic common bile duct opening have a high incidence of common bile duct stones and acute cholangitis.Patients with atypical symptoms and imaging findings are easily misdiagnosed;moreover,it is difficult to retrieve stones by endoscopic retrograde cholangiopancreatography,and common bile duct stones are prone to postsurgical recurrence.CASE SUMMARY A 45-year-old male patient presented with“intermittent upper abdominal pain and elevated liver enzymes for 1 wk”.Transabdominal ultrasound indicated dilation of the common bile duct and the presence of stones.Magnetic resonance imaging showed that the common bile duct was dilated with stones and that its opening was ectopic.Endoscopic retrograde cholangiopancreatography revealed an abnormal opening of the common bile duct into the duodenal bulb and the presence of common bile duct stones.Laparoscopic extrahepatic choledochectomy and hepatoenteric anastomosis were performed.After surgery,the patient recovered well and was discharged.The patient has been followed up for 2 years since the operation.He has not experienced stone recurrence,and his liver function and quality of life are good.CONCLUSION Improved understanding of ectopic opening of the common bile duct is needed for clinicians to provide patients with appropriate treatment.

Effect of Certain Toxicants on Gonadotropin-Induced Ovarian Non-Esterified Cholesterol Depletion and Steroidogenic Enzyme Stimulation of the Common Carp Cyprinus carpio in vitro

Isolated ovarian tissues from the common carp, Cyprinus carpio were incubated in vitro to obtain a discrete effect of four common toxicants of industrial origin, namely phenol, sulfide, mercuric chloride and cadmium chloride, on gonadotropin-induced alteration of nonesterified and esterified cholesterol and steroidogenic enzymes, △5-3β-HSD and 17β-HSD activity. Stage II ovarian tissue containing 30-40% mature oocytes were shown to be most responsive to gonadotropins in depleting only nonesterified cholesterol moiety and stimulating the activity of both. Safe doses of above mentioned toxicants when added separately to stage II ovarian tissue with oLH (1 μg/incubation) gonadotropin-induced depletion of nonesterified cholesterol and gonadotropin-induced stimulation of the activity of both enzymes was significantly inhibited. Esterified cholesterol remained almost unaltered. Findings clearly indicate the impairment of gonadotropin induced fish ovarian steroidogenesis by the four toxicants separately.

Some thoughts on the common issue of psychotherapy in different cultures——report on the China conference of psychoanalysis

Distinguished Chairman,Dear colleagues,ladies and gentlemen,Good morning!It is my great honors to have the presentation here,share my thoughts with you,you may agree or disagree but start a discussion,as Chinese says:(Pao Zuan Yin Yu)throw away a brick in order to get a gem;Today in this hall,more than 1000 colleagues from almost 30 different countries,nations or districts,get together,to share our common interests

Lead to Elevate the Temperature and Speed of Emergency Rescue and Nursing Care of Common Carotid Artery Rupture and Massive Hemorrhage after Operation of Typical Esophageal Cancer

Objective:Objective To explore the first aid and nursing of patients with anastomotic fistula after radical resection of esophagus carcinoma complicated with major carotid hemorrhage.Methods:The clinical data of anastomotic fistula complicated with carotid artery rupture and massive hemorrhage after radical resection of typical esophageal carcinoma were analyzed and summarized.Results:Through the close cooperation of medical care,the rescue was successful.Conclusion:Earlier prevention observation,raising first aid consciousness and actively cooperating with doctors can improve the success rate of rescue.

New Evidence on the Common Ancestry of Tetrapods and Lungfish

As reported in a recent issue of Nature (Aug. 15, 2002),two Chinese scientists pinpoint their newly discovered fossil fish as the most direct piece of evi dence on the common ancestry shared by tetrapods (all land verte brates including human beings) and lungfish. This latest advance in studying the origin and evolution of early fishes was jointly made by Professor Zhu Min from the CAS Institute of Vertebrate Paleontology & Paleoanthropology and his colleague Yu Xiaobo, now a Professor at the Biology Department of Kean University (New Jersey, USA).……

Promoting the Common Development of Education and Protection of Environmental Rights

Environmental fights are im- portant fights that have been written into fundamental hu- man rights since the 1970s. With economic globalization and sci- entific and technological progress, it is more and more important to educate and protect environmental rights world- wide. As a large developing country, China has significant responsibilities in the field of global environmental safety. However, the awareness and status of environmental rights protection are still not suited to people＇s demands for environmental rights, making it an important task to carry out scientific planning and environmental rights edu- cation and improve citizens＇ enjoyment of environmental rights. We propose to start from defining the constitutional status of environmental rights and pro- mote the education and protection of environmental rights at the same time, so as to enhance mutual influence and contribute to creating a good environ- ment for mankind.

Territory and territorial behavior of migrating Common Coot (Fulica atra)

Territory and territorial behavior of the Common Coot（Fulica atra） were studied in two breeding sites,Anbanghe Nature Reserve and Daqing Longfeng wetland,in Heilongjiang Province,China from April to October in 2008 and 2009.In the breeding season,the breeding pairs occupied an area and protected it throughout the reproduction,and both interspecific and intraspecific conflicts were observed.Territory activities became severe since early May,the peak of territory behaviors appeared at late May,and then declined gradually.The territorial activities level was higher than that in the nest building period than in the laying and incubation periods.The most adopted behavioral model was expelling,which was the least energy cost.The degree of territorial behavior tended to be descended since the development of breeding phase.The territory size differed from 1 333 m2 to above 5 000 m2.Wintering population was observed in Poyang Lake of Jiangxi Province.The coots gathered in the open water;however,there was no territory behavior both in the interspecies and intraspecies in wintering sites.The hypotheses why there was territory behaviors for coots both in the interspecies and intraspecies were also discussed.

Common carotid arterial thrombosis associated with ulcerative colitis

A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient’s bowel disease.

Information entropy-based fitting of the disease trajectory of brain ischemia-induced vascular cognitive impairment

The present study investigated the disease trajectory of vascular cognitive impairment using the entropy of information in a neural network mathematical simulation based on the free radical and excitatory amino acids theories. Glutamate, malondialdehyde, and inducible nitric oxide synthase content was significantly elevated, but acetylcholine, catalase, superoxide dismutase, glutathione peroxidase and constitutive nitric oxide synthase content was significantly decreased in our vascular cognitive impairment model. The fitting curves for each factor were obtained using Matlab software. Nineteen, 30 and 49 days post ischemia were the main output time frames of the influence of these seven factors. Our results demonstrated that vascular cognitive impairment involves multiple factors. These factors include excitatory amino acid toxicity and nitric oxide toxicity. These toxicities disrupt the dynamic equilibrium of the production and removal of oxygen free radicals after cerebral ischemia, reducing the ability to clear oxygen free radicals and worsening brain injury.

An In-depth Interpretation of the Universal Declaration of Human Rights With the Common Values of Humanity As the Research Paradigm

Interpreting the Universal Declaration of Human Rights from political,juridical and philosophical perspectives is es-sential for promoting the guiding principles of the Declaration,build-ing consensus on human rights,and advancing human rights practice in the new historical context.To conduct an academic,systematic in-terpretation of the Declaration that conforms to the trends of the times and answers the fundamental questions of the world,it is necessary to find a new research paradigm.The common values of humanity,namely peace,development,equity,justice,democracy and freedom,put forward by Xi Jinping,general secretary of the Communist Party of China(CPC)Central Committee,provide the most explanatory and penetrating scientific paradigm for reaching the issue.This paper an-alyzes and reflects on the views,value foundation and principled(con-tractual)consensus of human rights in the Declaration,and narrates and foresees the far-reaching significance of the three global initia-tives(namely,the Global Development Initiative,the Global Security Initiative,and the Global Civilization Initiative)with the common val-ues of humanity as the soul in advancing the modernization of global human rights governance and building a new form of human rights civilization.

Li Dazhao’s Conception of Modern State Before the New Culture Movement

Based on the following two points that one is the social disorder resulted from the“republic”since the Revolution of 1911 and the other is constant reflection on the recognition of the political values of western political parties,Li Dazhao places his hope on awakening and strength of the people to deal with the gap between republican political ideal and social reality of the Republic of China finally.This kind of emphasis and expectation on the power of people makes up a key factor assisting Li Dazhao’s early conversion to Marxism.

Theory of unpremeditated joint principal offender

The social benefit of people＇s common behaviors is high. However, once there is the negligence, the harm to the interests of law will also be great. When more than two people implement the dangerous common behaviors, each doer has the common duty of care. If they commonly violate the duty of care which leads to the occurrence of the crimes, the unpremeditated joint principal offender establishes. China should take reference from the research experience of other countries in the world, to regulate people＇s common behaviors with the theory of the unpremeditated joint principal offender, to prevent and reduce the accidents from happening.

Relationship between pancreaticobiliary maljunction and gallbladder carcinoma: a meta-analysis

BACKGROUND: Reports on the relationship between pancreaticobiliary maljunction (PBM) and gallbladder carcinoma (GBC) are conflicting. The frequency of PBM in GBC patients and the clinical features of GBC patients with PBM vary in different studies. DATA SOURCES: English-language articles describing the association between PBM and GBC were searched in the PubMed and Web of Science databases. Nine case-control studies fulfilled the inclusion criteria and addressed the relevant clinical questions of this analysis. Data were extracted independently by two reviewers using a predefined spreadsheet. RESULTS: The incidence of PBM was higher in GBC patients than in controls (10.60% vs 1.76%, OR: 7.41, 95% CI: 5.03 to 10.87, P<0.00001). The proportion of female patients with PBM was 1.96-fold higher than in GBC patients without PBM (80.5% vs 62.9%, OR: 1.96, 95% CI: 1.09 to 3.52, P=0.12). GBC patients with PBM were 10 years younger than those without PBM (SMD: -9.90, 95% CI: -11.70 to -8.10, P<0.00001). And a difference in the incidence of associated gallstone was found between GBC patients with and without PBM (10.8% vs 54.3% OR: 0.09, 95% CI: 0.05 to 0.17, P<0.00001). Among the GBC patients with PBM, associated congenital dilatation of the common bile duct was present with a higher incidence ranging from 52.2% to 85.7%, and 70.0%-85.7% of them belonged to the P-C type of PBM (the main pancreatic duct enters the common bile duct). No substantial heterogeneity was found and no evidence of publication bias was observed.CONCLUSIONS: PBM is a high-risk factor for developing GBC, especially the P-C type of PBM without congenital dilatation of the common bile duct. To prevent GBC, laparoscopic cholecystectomy is highly recommended for PBM patients without congenital dilatation of the common bile duct, especially relatively young female patients without gallstones.

Nocturnal to Diurnal Transition in the Common Ancestor of Haplorrhines:Evidence from Genomic-Scan for Positively Selected Genes

Transition from a nocturnal to a diurnal lifestyle represents a major shift in primate evolution, plays a central role in the adaptation of these species to new habitats, and is involved in modifications to their physiological and social behaviors （Heesy and Ross, 2001; Shultz et al., 2011）. However, two core problems concerning the circadian rhythm transition re- mains unresolved. First, there is controversy concerning the activity pattern of the ancestral primate （Heesy and Ross, 2001; Tan et al., 2005）. Second, the transition process for circadian rhythm in primate evolutionary history is unre- solved. Although most research suggests that primates trans- formed from a nocturnal to a diurnal circadian rhythm in the lineage leading to the common ancestor of the anthropoids or the haplorrhines （anthropoids and tarsier） （Ross, 2000; Heesy and Ross, 2001）, evidence has been insufficient to determine whether this occurred in the lineage leading to the common ancestor of the haplorrhines or the anthroooids.

For the Common Good

A consensus has been reached, and if s time to translate it into concrete action. That is what the G20 leaders are expected to do after their London meeting earlier this month. The G20 London summit’s generous rescue plan is good news for the world economy, finally dismissing earlier doubts about whether

Development and Peace, the Common Pursuit of Women of the World—Greeting the UN Fourth World Conference on Women

THE United Nations Fourth World Conference on Women is soon going to be held in Beijing, the biggest international meeting China has ever hosted in its history. This Conference is also a

Speaking for the Common People and Taking Action for Women

WU QING has become a well-known figure among an increasing number of people in recent years. Those in the literary world know her as the daughter of Bing Xin, the most celebrated contemporary writer in the country. Wu has often participated in important events in literary circles on her mother’s behalf. People in academia know her as an excellent English professor at the Beijing University of Foreign Languages Studies. Her educational philosophy of teaching and cultivating morals simultaneously makes many of