Objective To evaluate intraoperative cholangiopancreatography in understanding pathologic changes of congenital choledochal cyst(CCC) with anomalous junction of pancreaticobiliary duct(APBD) and for rational operative procedure. Methods Eighty-two CCC cases were examined by intraoperative cholangiopancreatography(ICP). The morphologies of the biliary tract and types of APBD were recorded. Results Of the 82 CCC cases there were 35 cases of Todani Ia,9 cases of Ib,28 cases of Ic and 10 cases of Ⅳ.APBD was diagnosed in 73 cases and classified according to Komi classification. Of them,37 cases were classified as type I of APBD (bile duct drains into pancreatic duct),30 cases as type II (pancreatic duct drains into bile duct) and 6 cases as type III (complicated APBD with patent accessory pancreatic duct). Of the 44 cases with choledochal cystic dilatations,33 cases were of type I. Of the 29 biliary fusiform dilatations,21 were of type II. Of 21 patients with pancreatitis,17 were of type II (? 2=33.14,P

Objective To explore the value of endovenous laser treatment (EVLT) in treating the variceal ulcer of lower extremities (VULE).Methods Twenty cases of chronic venous insufficiency with VULE were treated with endovenous laser and received regular postoperative follow-up survey.Results No complication,such as burning of skin happened,all superficial varicose veins disappeared,and most of ulcers were healed within 2 -4 weeks after EVLT.Conclusion EVLT is one of the important methods which is minimally invasive and safe to treat VULE.

ObjectiveTo investigate the lethal effect of hyperthermic CO2 pneumoperitoneum on gastric cancer cells and then further study the feasility and safety of inflating hyperthermic CO2 in gastric cancerpatients when performing laparoscopic operation.MethodsAn in vitro hyperthermic CO2 pneumoperitoneum experimental model was built,then according to the experimental purpose,the stomach carcinoma cell-7901 was grouped:hyperthermic CO2 pneumoperitoneum group; pure hyperthermia group; pure CO2 group;control group.After processing according to groups,cell proliferation was detected by Cell Counting Kit-8(CCK-8),cell apoptosis was detected by Annexin V-fluorescein isothiocyanate/propidium iodide flow cytometry and Hoechst 33342/propidium iodide fluorescent microscopy.ResultsThe reaults of cell proliferation detection showed that hyperthermic CO2 pneumoperitoneum could significantly inhibit proliferation of stomach carcinoma cell-7901 when compared with pure hyperthermia group,pure CO2 group and control group (P ＜ 0.05 ).The results of apoptosis detection showed that hyperthermic CO2 pneumoperitoneum could significantly induce apoptosis of stomach carcinoma cell-7901 and the gastric cancer cells apoptosis showing bright blue under the fluorescent microscope.ConclusionsHyperthermic CO2 pneumoperitoneum could significantly inhibit proliferation of stomach carcinoma cell-7901 and probably kill it by inducing apoptosis.

Objective To explore the clinical efficacy of endoscopic transgastric or transpapillary drainage in treatment of pancreatic pseudocyst. Methods 100 patients with pancreatic pseudocyst from March 2014 to March 2015, 80 cases were underwent endoscopic ultrasound-guided transgastric and the other 20 cases were underwent transpapillary drainage. The treatment effect and complications were recorded. Results The success rate was 95.00 %, and cysts completely disappeared in 84.00 % of the patients. Among all the patients there are 10 cases occurred intraoperative bleeding, 3 cases occurred stent clogging or migration and 7 cases occurred infection, the overall incidence of complications was 20.00 %. Conclusion Endoscopic transgastric or transpapillary drainage in treatment of pancreatic pseudocysts has better clinical curative effect, and can also reduce the occurrence of complications, which is worth popularizing clinically.

Objective To investigate the correlation between serum lipoprotein-associated phospholipase A2 (LP-PLA2) and homocysteine (Hcy) level change with cerebral infarction,and clinical value of combined detection of serum LP-PLA2,Hcy and blood lipid level in the diagnosis and differentiation diagnosis of cerebral infarction.Methods The serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in sixty-five cases of cerebral infarction(cerebral infarction group) and contemporaneous 64 healthy persons qualified in physical examination(health control group) were selected as the research subjects.The levels of serum LP-PLA2,TG,HDL,LDL,CHO and Hcy were detected.The differences were compared among various groups.Results The TG and LDL levels had no statistically significant difference between the health control group and cerebral infarction group(P>0.05),but the LP-PLA2 and Hcy levels in the cerebral infarction group were higher than those in the health control group(P<0.01),while serum HDL and CHO levels were lower than those in the health control group(P<0.01).Serum High Hcy and LP-PLA2 levels were the independent risk factors for cerebral infarction,however,high HDL was a protective factor for cerebral infarction.In the combined detection,the combined detection of LP-PLA2 and Hcy was superior to single index detection and other combined detection mode.Conclusion Serum LP-PLA2 and Hcy levels in the patients with cerebral infarction are significantly higher than those in the health control group,indicating that it may be involved in the occurrence of cerebral infarction,and may become an early biological marker for predicting cerebral infarction occurrence.The combined detection of serum LP-PLA2 and Hcy has highly clinical value in the diagnosis of cerebral infarction.

Objective To investigate the relationship between levels of transferring(Tf)and function of male fertility and testic-ular podocyte.Methods Semen samples from male patients with infertility and volunteers with normal infertility were collected and tested for sperm density and motility by using sperm quality analyzer.In additon to that,Tf concentrations of Tf were determined;aseptically excised rat testis and by collagenase and hyaluronidase digestion,podocytes were isolated with high purity and cultured in culture medium,then the concentration of Tf in cell culture medium was determined;Tf concentration were determined by rate nephelometry.Results Tf concentration in semen of male-infertility patients[(15±5)μmol/L]was significantly lower than that of normal-fertility volunteers[(24.5±6.5)μmol/L,P <0.01],which were positively correlated sperm count and motility(P <0.01). Tf concentrations of cell culture medium[(25 ±8)μmol/L]in which testicular podocytes were cultured were significantly higher than that of infertile rat[(15 ±6)μmol/L,P <0.01].Conclusion Determination of semen Tf levels can reflect podocyte function and be used as an indicator for the evaluation of seminiferous tubules spermatogenesis,which was valuable in the diagnosis and treatment of male infertility.

Objective: To systemically review the safety and efficacy of Absorb bioresorbable vascular scaffold (Absorb BVS) versus cobalt chromium-everolimus eluting stent (CoCr-EES) for treating the patients with coronary artery disease (CAD) by percutaneous coronary intervention (PCI).
Methods: We searched relevant literatures in PubMed, Embase, Cochrane Library, CNKI and Wanfang database from 2008-01 to 2015-10, meanwhile, collected published data and randomized controlled trials from meeting abstracts and websites to compare Absorb BVS and CoCr-EES for treating CAD patients. The quality of literatures were assessed and extracted by modiifed Jadad score, Meta-analysis was conducted by STATA 12.0 soft ware.
Results: There were 4 eligible trials with 3,389 patients were enrolled. Absorb BVS group, n=2,164 and CoCr-EES group, n=1,225. During the mean of 1.1 years follow-up period, the following incidences were similar between 2 groups:target lesion failure (OR=1.29, 95%CI 0.95-1.74, P=0.10), all cause death (OR=1.31, 95%CI 0.60-2.87, P=0.50), cardiac death (OR=1.38, 95%CI 0.45-4.24, P=0.57), myocardial infarction (OR=1.30, 95%CI 0.93-1.80, P=0.12), deifnite or probable stent thrombosis (OR=2.08, 95%CI 0.95-4.54, P=0.07), re-vascularization (OR=1.03, 95%CI 0.80-1.33, P=0.81), target lesion re-vascularization (OR=1.06, 95%CI 0.67-1.66, P=0.81) and the patient-oriented composite endpoint (OR=0.95, 95%CI 0.66-1.35, P=0.76).
Conclusion: Absorb BVS and CoCr-EES had the similar safety and efifcacy for treating the low and moderate risk CAD patients who had angina, ischemia while without symptoms. The longer period of follow-up study and larger randomized, controlled clinical trials were needed for Absorb BVS application in clinical practice.

Objective To investigate the infection status of hepatitis B virus(HBV) and hepatitis C virus(HCV) in healthy adult in Xi′an ,in order to provide references for hepatitis prevention and health education .Methods A total of 1 052 healthy adults from 10 communities in Xi′an were collected by using multistage stratified random sampling method .HBV serum markers and anti‐HCV antibody were detected ,and characteristics of distribution of HBV and HCV infection were analysed .Results A total of 37 adults were observed with positive hepatitis B surface antigen(HBsAg) ,the total positive rate was 3 .52% ,and the positive rate of male and female was 4 .08% and 3 .07% respectively ,no statistically significant difference was found between male and female(P>0 .05) .Apart from male adults aged 30 - < 40 and 40 - < 50 ,there were no statistically significant differences between each age groups in male and female ,and between female and male in the same age groups(P> 0 .05) .A total of 31 adults were observed with HBsAg ,hepatitis B e antibody (HBeAg)and hepatitis B core antibody(HBcAb) positive ,the positive rate was 2 .95% .The positive rate of hepatitis B surface antibody(HBsAb) was 54 .18% .Serological patterns between different gender had no statistically signifi‐cant differences(P>0 .05) .A total of 9 adults(0 .86% ) were observed with positive anti‐HCV antibody ,and the positive rate of male and female was 0 .64% and 1 .02% respectively ,no statistically significant difference was found between male and female(P>0 .05) .Conclusion Healthy adults in Xi′an have relatively low infection rates of HBV and HCV ,while for the control of hepatitis B and hepatitis C ,further strengthening the health education ,improving awareness of prevention and routine monitoring infectious dis‐eases and vaccination may still be necessary .

Objective To compare the efficacy and safety of single-incision and conventional three-port laparoscopic appendectomy.Methods According to the Cochrane systematic review methods,literatures on the comparison of the effects of single-incision laparoscopic appendectomy (SILA) and conventional three-port laparoscopic appendectomy (CTLA) were searched for in the PubMed,EMBASE,the Cochrane Controlled Trials Register,CNKI,CBM and VIP database.Data including the operation time,pain visual analogue scales scores,duration of postoperative hospital stay,incidence of postoperative complications,mean time of hospital stay and cost between the SILA and CTLA were compared by 2 reviewers.RevMan 4.2 software was used for Meta analysis,and the heterogeneity of the study was analyzed using the 12 test.Categorical variables were presented by odds ratio and 95％ confidence interval (95％ CI),and continuous variables were presented by weighted mean difference (WMD) and 95％C1.Results Eight randomized controlled trials including 1 444 patients were selected.All the patients were subdivided into the adults group (760 patients) and the children group (684 patients).A total of 721 patients received SILA (SILA group) and 723 received CTLA (CTLA group).The operation time of patients who received SILA in the adults group and the children group were significantly longer than those who received CTLA (WMD =4.40,7.39,95％ CI:2.14-6.66,2.16-12.61,P ＜0.05).There were no significant difference in the pain visual analogue scales scores,incidence of postoperative complications and duration of hospital stay between patients who received SILA and CTLA in the adults group and the children group (WMD =-0.34,95 ％ CI:-1.02-0.33,OR=0.97,95％CI:0.64-1.47; WMD=-0.19,95％CI:-1.14-0.76,P＞0.05).The cost of patients who received SILA was significantly higher than those who received CTLA in the children group (WMD =0.87,95 ％ CI:0.26-1.48,P ＜ 0.05).Conclusions There is no obvious advantages of SILA in perioperative and postoperative outcomes when compared with CTLA.Therefore,SILA is only a possible alternative to CTLA other than the preferred method.

Objective To explore the differential level of hypermethylated SFRP2 gene in colorectal cancers andadjacent nontumorous tissues,to analyze the relation of SFRP2 gene promoter hypermethylation status and its clinicopathologic significance in colorectal carcinoma,and to study the relationship between the level of hypermethylated SFRP2 and the invasion and metastasis of colorectal carcinoma.Methods Real-time quantitative PCR technique was performed to analyze the level of hypermethylated SFRP2 gene promoter in colorectal cancers and adjacent nontumorous tissues taken from 30 colorectal cancer patients.The relation of the level of hypermethylated SFRP2 gene promoter and its clinicopathologic features of colorectal cancers was analyzed.Results SFRP2 gene promoter hypermethylation occurred in both the tumor tissues and the adjacent tissues.The level of SFRP2 gene promoter hypermethylation was significantly higher in the patients with TNM Ⅲ and Ⅳ (7.24 ± 1.13)than in patients with TNM Ⅰ and Ⅱ ( 5.92 ± 0.97 ) ( P ＜ 0.05 ).The level of SFRP2 gene promoter hypermethylation was significantly higher in the patients with lower differentiation(7.31 ± 1.11 ) than in patients with higher differentiation (6.23 ± 1.03) ( P ＜ 0.05 ).No significant association was found between the level of SFRP2 gene promoter hypermethylation and the status of gender,age.tumor location and tumor size ( P ＞ 0.05 ).Conclusions SFRP2 gene hypermethylation in tissues may be a useful objective parameter for the malignant level,invasion,metastasis,recurrence and prognosis of the colorectal cancer.