Objective To explore the feasibility and value of laparoscopic cholecystectomy (LC) for acute cholecystitis complicated with incarcerated gallstones. Methods From January 2005 to December 2007,71 patients with acute cholecystitis complicated with incarcerated gallstones received laparoscopic cholecystectomy by using four trocars in our hospital. The Arteria cystica and ductus cysticus were operated successively. For widened ductus cysticus,we ligated the duct first and then cut it off. Afterwards,the wound on the liver bed and its margin were electrocoagulated. After the operation,a drainage tube was placed under the liver. Results Of the patients,the LC were successfully completed in 67 cases (94.4%),4 cases were converted to open surgery (2 of them had a disease course of less then 3 days,and one over 3 days). No biliary injury or death occurred in this series. The patients were discharged from hospital in 2-6 days (mean,3 days). No complication was found during a 6-month follow-up. Conclusions With the improvement of operator's proficiency and skills,LC becomes feasible and safe for acute cholecystitis complicated with incarcerated gallstones.

A microcapsule is a spherical, with a diameter that can be controlled in the range of 200 -1500 μm and biocompatible semipermeable membrane, which allows the bidirectional diffusion of nutrients,oxygen, secreted therapeutic product, and waste but prevents the penetration of high molecular weight substances from the microcapsule, such as antibodies and immunocytes. In comparison to monolayer culture and multicellular tumor spheroid model, orthotopic injection of microencapsulated tumor cells has uncomparable advantages in cell proliferation, mimicking the in vivo situation, making orthotopic tumor model and distant organ metastases model. Microencapsulated tumor assay has the potential of being widely used for in vitro anticancer drug screening and evaluation of the effects. This article mainly reviews the advantages of microencapsulated tumor assay and its application.

Pancreatic cancer is a highly malignant tumor. Animal models of pancreatic cancer included xenograft models, carcinogen induced models, genetically engineered models. Xenograft models are relatively reliable and feasible, but the growth pattern is different between serve immunodeficienct animals and human beings. Carcinogens induced models simulated the environmental factors to reconstruct the development of pancreatic cancer. But carcinogens could have other biological effects. Genetically engineered models could make the occurrence of pancreatic cancer at the molecular level. But it is difficult to control the transgenic product accurately. No model could meet all the needs of different experiments. It is important to choose a suitable animal model in different experiments.

Objective To evaluate reoperations for benign bile duct strictures after a prewousRoux-en-Y hepaticojejunostomy.Methods Clinical date of 28 patients with previous reconstruction of Roux-en-Y hepaticojejunostomy for benign bile duct strictures were retrospectively analyzed.For data staftstical analysis t-test and stepwise logistic regression analysis were used.Results Reoperative surgery was performed for residual biliary stones with bile duct stricture in 10 cases(35.7%),simple anastomotic stricture of hepaticojejunostomy in 11 cases(39.3%),remained biliary stricture after initial rear in 6 cases (21.4%).anastomotic leakage with duodenal leakage in one case(3.6%).Mode of reoperation:18 cases (64.3%)underwent hepatic lobectomy with Roux-en-Y hepaticojejunostomy,liver splitting approach to Roux-en-Y hepaticojejunostomy in 5 cases(17.9%),right hemihepatectomy in one case(3.6%),resection of anastomotic stenosis involved segment and Roux-en-Y hepaticojejunostomy in one case(3.6%),abdominal drainage and duodenum fistulization and jejunum ostomy in one case(3.6%),choledocholithotomy with T-tube drainage in 2 cases(7.1%);Thirteen patients(46.4%)developed postoperative complications.Conclusion Biliary tract stenosis remains the main cause for reoperation in patients undergoing a faeled reconstruction.Wide and patent biliary tract drainage and reconstruction somenmes necessitate a hepatic lobectomy.

Objective To explore the influence of self-concealment level on patients'quality of life and clinical curative effect for curing refractory chronic prostatitis(RCP)by high-intensity focused ultrasound(HIFU). Methods Patients of RCP who meet the diagnostic criteria were assessed with the Self-Concealment Scale(SCS), TDL's table of self-assessing quality of life and National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI).The patients whose SCS score were above the average score plus a standard deviation were taken as the high SCS group,and whose SCS Score were below the average score minus a standard deviation were taken as the low SCS group.The scores for CPSI and TDLs table of self-assessing quality of life and the clinical curative effect of the two groups were determined before and after the treatment by HIFU, respectively.Results The SCS score(35.75±10.34) of the RCP patients before HIFU treatment was significantly higher than the norm for male college students(29.20±8.73)(t=4.26,P<0.01).Two and six weeks after the HIFU application,the CPSI of both the high and the low SCS group decreased significantly(P<0.01),and the CPSI of the low SCS group de-creased more greatly than that of the high SCS group(P<0.01).The scores for TDL Life Quality Scale of low SCS group were significantly higher before and after two and six weeks'HIFU treatment than that of high self-concealment group(P<0.01).The TDL quality of life scale score of thelow SCS group increased respectively after two and six weeks'HIFU treatment (P<0.01),while for the high SCS group,this score increased only after six weeks' HIFU treatment(P<0.05).Six weeks after HIFU treatment,the clinical curative effect for the low SCS group was, observably better than that for high self-concealment(P<0.05).The SCS scores was significantly positive with CPSI scores(P<0.01),and significantly negative with the scores of TDL Life Quality Scale (P<0.01).Conclusion The symptom abatement,quality of life and clinical curative effect the RCP patients with a high self-concealment level were respectively worse after the HIFU treatment than that for whom with a low self-concealment level.

0.05); while in the 12th month, BMD markedly increased in group A and decreased in group B (P 0.05) but ?-CTX level increased after treatment (P

Objective To explore the value of diffusion weighted imaging (DWI) in combination with susceptibility weighted imaging (SWI) in prognosis prediction of traumatic axonal injury (TAI).Methods A retrospective study of 75 patients with TAI was performed to analyze the clinical data and the follow-up prognosis in the 6 months after injury.The detection rate of TAI lesion by DWI,SWI and conventional MRI was compared.Multiple factors analysis applied logistic regression analysis to analyze the relationship between associated factors and prognosis.Results The average detected TAI lesions were (19.92 ± 8.62) by DWI and (22.17 ± 11.72) by SWI,which had no significant differences (t=1.24,P＞0.05),but there was a significant difference bettween by conventional MRI and by DWI or SWI (all P＜0.05).DWI was more sensitive to non-hemorrhagic lesions and SWI was more sensitive to hemorrhagic lesions.However,the lesions revealed by them existed the overlap of location and pathology of lesions.Patients with poor outcomes had more number of central lesions than those patient with good outcomes (t=2.455,P＜ 0.05).Logistic regression analysis revealed that the predictive accuracy provided by the combination with imaging and clinical factors was 95.7 ％.Conclusions DWI and SWI both are sensitive to TAI lesions,and have ability to detect the lesions with different pathological characteristics,separately.Accurate prognosis prediction for patients with TAI may be provided by the combination of clinical and imaging factors.

Objective To study the clinical characteristics and diagnosis of the solid-psendopapillary tumor of pancreas (SPT).Methods The clinical data of 40 SPT from January 1996 to January 2008 were retrospectively analyzed. The average age was (32.9 + 13.6 )years. The average clinical course was (8.6±0.1) months.Clinical symptoms usually included distensible pains and secret anguish in abdomen (60.0%).No jaundice appeared in any case.Results The surgical resection was favorable for the treatment of SPT,which had excellent prognosis.No tumor recurrence were found in those following-up patients. Grossly,the cut surface showed areas of solid and papillary tissue,cystic degeneration,hemorrhage,and necrosis.Pathological features included a combination of solid and cystic components with pseudopapillae formation and degenerative regions without glands.Conclusions SPT has its uniquely clinical and pathological characteristics.Its main diagnosed points are helpful for clinical doctors to make timely diagnosis and reduce the rate of misdiagnosis and mistreatment.

OBJECTIVE:To create an in vitro harvesting method of culturing a large number of adult bone marrow MSCs(BMSCs) DESIGN,TIME AND SETTlNG:The randomized, controlled study was performed at the Shanghai Institute of Digestive Surgery (Key Laboratory of Education Committee of Shanghai City),as well as Department of General Surgery and Organ Transplantation Center,Ruijin Hospital,Medical College.Shanghai Jiao Tong University from September 2005 to April 2006.MATERIALS:Bone marrow samples were collected from normal persons.who did bone marrow examination at the Department of Hematology,Ruijin Hospital,Medical College.Shanghai Jiao Tong University.Donors were volunteers who signed the informed consent.METHODS:Human BMSCs were harvested using Pemoll gradient centrifugation and adherence method.and then incubated in microcarrier cytodex3.Common monolayer polystyrene was incubated as controls.Cell phenotype and proliferative activity were tested utilizing flow cytometry and MTT.MAIN OUTCOME MEASURES:Collection.incubation,morphology of human BMSCs.and prolireration and cell cycle of human BMSCs on the cytodex 3 were measured.RESULlTS:Flow cytometry detection showed that the surface marker of human BMSCs on the cytodex3 was ldentical to that on the common monolayer polystyrene;BMSCs were positive for CD29,CD44 and CD105.but negative for CD14,CD34,CD45,VLA-1 and HLA-DR.MTT detection demonstrated that human BMSCs were in the adaptive phase at days 1-3.and entered logarithmic phase frOm day 3.No significant difference was detected in human BMSCs on the monolayer polystyrene and cytodex3(P＞0.05).On the monolayer polystyrene,human BMSCs entered degenerating stage from day 6,whereas on the cytodex3,human BMSCs were still in the logarithmic growth phase at day 9(P＜0.05).Flow cytometry detection confirmed that the cell cycle of human BMSCs was the same both on the monolayer polystyrene and cytodex3 (P＞0.05). CONCLUSION:Using cytodex3 culture technique,a large amount of human BMSCs can be obtained,and the proliferative activity of these BMSCs is good.

BACKGROUND: Hepatocyte/polymer interface with good biocompatibility is the key factor in bioreactor design andconstruction, however, bioreactor used in the clinical practice currently is not an ideal one.OBJECTIVE: To establish human hepatocyte compatible polypropylene interface and to lay a foundation for establishingbioartificial liver reactor with polypropylene hollow fiber.DESIGN, TIME AND SETTING: The comparative observation, cell compatibility experiment was performed betweenFebruary and October 2003 at Shanghai Jiao Tong University, Shanghai, China.MATERIALS: Polypropylene Photochemical graft polymerization modification technique was used to graft hydrophilicacrylamide groups on the surface of polypropylene membrane by chemical bonds to form modified polypropylenemembrane.METHODS: L02 human hepatoeytes were seeded on polypropylene membrane, modified polypropylene membrane andpolystyrene membrane, and polystyrene membrane was used as normal control.MAIN OUTCOME MEASURES: Static water contact angle of polypropylene membrane before and after graftmodification; morphology, adherent rate and proliferation activity of L02 human hepatocytes on different material surfaces.RESULTS: Static water contact angle after polypropylene membrane graft modification was smaller than that before graftmodification (P < 0.05). The adherent rate of L02 human hepatocytes on the surface of modified polypropylene membranewas 0, and the proliferation activity of them, which grew as spherical aggregates, was markedly higher than that of cells onpolystyrene membrane and polypropylene membrane without graft modification.CONCLUSION: Grafting polyacrylamide on the surface of polypropylene can establish good interface of L02 humanhepatocytes/polypropylene and form hepatocyte spherical aggregates through simple static culture.