Objective To explore the prevention and management of biliary tract injury during laparoscopic cholecystectomy(LC) in patients with acute cholecystitis.Methods Between October 1999 and October 2008,368 patients with acute cholecystitis received LC in our hospital,7 of them developed biliary tract injury during the operation,and therefore underwent the biliary repair or Roux-en-Y anastomosis between the common bile duct and jejunum as well as T-tube drainage.Results Among these 7 cases,5 cases was converted to open abdominal operation during the procedure of LC,of which 2 cases(1 with total bile duct transection and 1 with electric burn of bile duct) showed stenosis of the bile duct in 12 and 3 months respectively after the T tube was removed,and then was cured by a second Roux-en-Y anastomosis.Two of the 7 patients received biliary repair because of electric burn;cholangiography showed no stenosis after 3-month T-tube drainage.In one patient who had severe injury to the common bile duct,Roux-en-Y anastomosis was performed,and then the patient was discharged from the hospital in 2 weeks with the T tube;one month later,re-examination by cholangiography showed that the case was cured.In the 7 patients,jaundice was observed in 2 cases in 3 to 5 days after the surgery;ERCP showed biliary stenosis in one of them,and complete biliary atresia in another.Subsequent abdominal exploration on the two cases revealed complete common bile duct occlusion in one and partially occluded common hepatic duct in the other.Roux-en-Y anastomosis between the bile duct and jejunum combined with T-tube drainage was therefore made on the patients.The 7 cases were followed up for 0.5 to 6 years,during the period,none of them showed biliary stenosis,residual stones or other complications.No patient died during the follow-up.Conclusion Biliary tract injury during LC in patients with acute cholecystitis can be avoided as long as we choose the right time for LC as well as for conversion to an open surgery.

Objective To study features and causes of biliary duct re-operations and evaluate their therapeutic efficacy for avoiding its occurrence and decreasing its number.Methods 32cases of the clinical data of all de patients receiving bile duct re-operations in our hospital from 1996 were retrospectively analyed.Results 32 cases have no surgical operation complications,with 23 cases visit 5 years and only 2 cases are poor.Conclusions The main cause for re-operations is bile ston.The purpose of re-operations is to clean up stones,correct strictures and build pathway for bile flow.

Objective To evaluate the effect of endoprostheses for short and long term management of common bile duct stones in elderly patients(70 89 years). Methods Fifty two patients over 70 years with common bile duct stones undergone endoscopic biliary stenting(Group S, 28 cases) or common bile duct exploration (Group D, 24 cases) were followed up for 14 85 months. The two groups were similar to each other in clinical manifestations. Results One patient (4 2%) died because of breath and circulation exhausting on the 3rd day postoperation in Group D. Early complications were 14 4% and 33 3% respectively ( P

OBJECTIVE:To prepare oxymatrine pellets and study the pellets' properties.METHODS:Oxymatrine pellets were prepared using an experimental low-temperature extrusion-spheronization granulator.L9(34)orthogonal design was used to obtain optimal formulation.The micromeritic properties and in vitro dissolution of the pellets at different dosage were determined.RESULTS:Oxymatrine pellets prepared by extrusion-spheronization were round and smooth and well-distributed.The optimal technical conditions were as follows:water∶MCC=0.90∶1;spheronization velocity=35 Hz;spheroniza-tion time=5 min;extrusion velocity=40 Hz.The in vitro dissolution was more than 75% within 30 minutes.CONCLUSION:The process of preparing pellets by extrusion-spheronization was simple and feasible and the quality of pellets was excellent.

Objective　The covered tracheal stent in shape of a straight tube or a fork-like tube was placed clinically to treat tracheal stricture and tracheal fistula caused by malignant tumour in order to maintain the normal function respiration and to keep the fistula closed.Methods　The stent was made of stainless steel in shape of "Z"covered with membrane partially or entirely.An instrument with tube in three sheathes was used to place the stent in position.Results　The tracheal stents were placed successfully in 9 cases at first time and the esophageal stents were placed for 6 cases among them in the meantime.Dyspnea of patiants was remarkably alleviated.The tracheal fistula of them was closed effectivelly.Follow-up for 4～12 monthes all cases demonstrated no adverse effects.Conclusion　The application of the covered stent is a safe effective method to treat the tracheal stricture and tracheal fistula.

Background and purpose:MiR-224 is overexpressed in hepatocellular carcinoma, and participate in invasion and metastasis of cancer. The aim of this study was to investigate the effects of miR-224 antisense oligonucleotide (ASO) on the proliferation and apoptosis of Hep3B cells.Methods:After transfection with miR-224 ASO, and detecting the miR-224 mRNA expression of Hep3B cells by real-time quantitative PCR; the miR-224 expression in Hep3B cells was measured and cell proliferation was analyzed by MTT assay and the colony formation experimentin vitro andin vivo. The cell apoptosis was analyzed by flow cytometry.Results:Compared with the control group, miR-224 ASO significantly reduced the miR-224 mRNA expression in the Hep3B cell(P<0.05), MTT assay results showed that Hep3B cells survived rate decreased greatly after transfection with miR-224 ASO. Clone formation assay revealed that the colony formation rate in miR-224 ASO group was significantly lower than that in the control group.In vivo study further confirmed that miR-224 ASO could inhibit the proliferation of Hep3B cells,and miR-224 ASO group grew substantially slow compared with the negative control. Flow cytometry indicated that miR-224 ASO group promoted apoptosis significantly.Conclusion:miR-224 was overexpressed in Hep3B cells. Reducing the expression of miR-224 can effectively inhibit the growth of Hep3B cells and promote apoptosis. miR-224 may become a new target for the regulation of gene expression in hepatocellular carcinoma.

Objective T o establish a gas chrom atography-m ass spectrom etry (G C-M S ) m ethod for the determ ination of sulfide ion in blood and apply it to the practical cases. Methods T he 1, 3, 5-tribro-m obenzene w as selected as an internal standard, and 0.2 m L blood sam ple w as collected and analyzed using G C-M S after α-B rom o-2, 3, 4, 5, 6-pentafluorobenzyl brom ide derivatization. Results T he m ass concentration of sulfide ion in blood had good linearity in the range of 0.2-40μg/m L w ith a lim it of detection (L O D ) of 0.05μg/m L . T he m ass concentration of sulfide ion w as less than 0.05μg/m L in blank blood from different sources such as healthy subjects and dead cases. In 3 sulfide poisoning cases, sul-fide ion w as detected in the blood sam ples of 6 victim s, and the m ass concentration range w as 1.02-3.13μg/m L . Conclusion T his study establishes a m ethod for investigation of sulfide ion in blood w hich has been applied successfully to the cases of fatal sulfide poisonings.

Objective To explore the long-term health effects of overexpose to radiation.Methods The 32 -41-year medical followed-up observations were performed for 25 persons exposed to ionizing radiation in the dose range of 0.10 -0.33 Gy. Observations were made of clinical symptom,eye lens,cytogenetics,immune function and endocrine function for these persons. Results The incidence of neurasthenic symptom was higher in exposed group than that in control group.2 cases suffered from liver cancer and esophageal cancer,respectively. Posterior capsule punctate phacoscotasmus of the lens wereobserved in 7 cases.There was I case of cataract in the exposed group. The frequencies of chromosomeaberration and micronucleis in peripheral blood lymphocyte in the exposed group were significantly higherthan those in control group (x2 =8.88,8.71,40.60,45.63,P ＜ 0.05 ).The average value of serum IgG was higher(t =2.16,P ＜0.05 ),while that of IgM was obviously lower in the exposed group (t =2.03,P ＜0.05).The average values of serum triiodothyronine (T3),thyroxine (T4 ) and thyroid-stimulating hormone (TSH) in the exposed group were obviously lower than those in the control group (t =2.40,3.54,2.13,P ＜0.05 ).Conclusions Overexposure has effect on lens,immune function,cytogenetics to some degree.It is important to observe the long-term health effect on overexposed persons.

Objective: To study the expression of negative costimulatroy molecule B7-H4 in non-small cell lung cancer (NSCLC) tissues and its relationship with the clinical features of NSCLC. Methods: Fifty-two NSCLC specimens from pa-tients who were pathologically diagnosed in our hospital during January 2008 to April 2009 were included in the present study. B7-H4 expression and infiltration of CD3~+ T cells in NSCLC tissues were detected by immunohistochemistry. The correlation between B7-H4 expression, CD3~+ T infiltration, and the clinical features of NSCLC was studied. Results: The positive rate of B7-H4 in 52 NSCLC tissues was 48.08% (25/52), and B7-H4 expression in normal lung tissues was neg-ative or low (P <0.05). B7-H4 expression was positively correlated with the clinical tumor stages and lymph node metas-tasis of NSCLC (P < 0.05), and negatively correlated with tumor infiltration of CD3~+ T cells (P < 0.05), but had no re-lationship with clinicopathologie parameters of NSCLC (P > 0.05). Conclusion: Negative costimulatroy molecule B7-H4 may play important roles in the development of NSCLC. Positive expression of BT-H4 is correlated with the clinical tumor stages and lymph node metastasis of NSCLC, which provides a foundation for diagnosis and therapy of NSCLC.

Objective To observe late effect of 60Co radiation accident on eye lens in the victims.Methods Medical observations of eye lens were performed on ten victims accidentally exposed to 60Co sources in four radiation accidents that have occurred from 1986 to 2000 in Henan Province.Pathological changes of the eye lenses were examined by using slit lamp microscopy after mydriasis with compound tropicamide.Results Of these ten victims, Liang in a radiation accident in Kaifeng (in 1986), Mei in Xinxiang (in 1999) and Xu in Xuchang (in 2000) all had typical radiation-induced cataract 2, 3 and 6 years after irradiation, respectively.Follow-up observation of the lens showed the punctate and/or granular opacities present in the eye posterior subcapsular of Yan in Kaifeng accident, Jie in Zhengzhou (1987), and Tian, Yong and Yi in Xinxiang accident, featuring the early changes of radiation-induced cataract, but the posterior subcapsular opacities were not observed in Wang and Min in Xinxiang accident.Conclusions Focus should be on the eye lens as the target organ of radiation exposure in long-term follow-up of victims accidentally exposed to radiation source.Severity of the lens opacity induced by ionizing radiation is closely associated with radiation doses.