Objective To investigate the techniques,safety,and efficacy of intraoperative holmium laser lithotripsy under cholangioscopic visualization for refractory intrahepatic stones. Methods A total of 38 patients with refractory hepatolithiasis underwent cholangioscopic holmium laser lithotripsy.The laser setting was: the wavelength of 2.1 ?m,the maximum mean output power of 100 W,the pulse peak power of up to 6 kW,and the laser fiber of 400 ?m in diameter.Results The stones were entirely removed on one session in all the 38 patients.The lithotripsy time was 3~5 min,the times of fragmentation was 3~8,and a total of 65 stones were fragmented.No bile duct injuries or biliary leakage happened.Cholangiography and B-ultrasonography at 2 postoperative months found no residual stones.Follow-up for 6 months found no recurrence.Conclusions Application of holmium laser lithotripsy under cholangioscopic visualization for the management of refractory intrahepatic stones is safe and effective.

Objective To observe effect of hemiplegic gymnastics on motor function and activities of daily living(ADL)of stroke patients.Methods 60 stroke patients were randomly divided into the rehabilitation group and hemiplegic gymnastics group with 30 cases in each group.All patients of two groups received conventional physical therapy and occupational therapy training,using neural technology for development.The course was eight weeks.At same time the patients of the gymnastics group also received hemiplegic gymnastics treatment.Before and after treatment,all patients of the two groups were assessed with Fugl-Meyer Assessment(FMA)for motor function and Modified Barthel Index(MBI)for ADL respectively.The changes of FMA and MBI scores of patients in two groups were compared.Results Before treatment,there was no significant difference in FMA and MBI scores between two groups(P>0.05);after treatment,the FMA and MBI scores of the patients in the gymnastics group were superior to that of the rehabilitation group(P<0.01).Conclusion Hemiplegic gymnastics combined with conventional rehabilitation training can improve motor function and ADL of stroke patients.

Objective To study the association of MIF-173 locus polymorphism and the risk of prostate cancer (PCa) in China. Methods A case control study including 259 PCa patients and 301 age-matched controls was conducted. The polymorphisms of MIF-173 locus were analyzed by poly-merase chain reaction restriction fragment length polymorphism (PCR-RFLP) technique using genomic DNA isolated from peripheral blood lymphocytes. The correlations between the susceptibility to PCa and different genotypes were compared. The effect of age, smoking method and family history of canc-er were also analyzed. Results The rate of the MIF-173 * C variant allele of the PCa patients(n=259) was significantly higher than that of the controls (n=301) (36.0% vs 15.0%). The MIF-173 *C variant allele could significantly increase the risk of PCa (OR=2.96,95%CI: 1.92-4.57). Peo-ple with older age (age>70) or family history of cancer, who carried MIF-173 * C allele demonstra-ted a significantly increased risk in comparison with those carrying wild genotype of G/G(OR=3.66, 95%CI=2.02-6.62;OR=3.26, 95%CI=1.24-8.55). Conclusion These results suggested that polymorphisms of MIF-173 locus appear to influence the risk of PCa and may have synergistic effect with age and family history of cancer.

Objective To discuss the method, safety and clinical value of biliary stenting combined with 125I seed implantation intracavitary irradiation in treating malignant obstructive jaundice. Methods A total of 36 patients with malignant obstructive jaundice were enrolled in this study. PTCD was carried out in all patients, which was followed by biliary stenting combined with 125I seed implantation intracavitary irradiation treatment. The results were analyzed. Results During the interventional management, displacement of the stent and 125I seeds were observed in two cases, and the displaced stent and 125I seeds were replaced to the right position with the help of biliary biopsy forceps. The technical success rate was 100%, and the remission rate of the jaundice was 100%. All the patients were followed up for 1-23 months. No radioactive particles leaking or complications such as radiation enteritis occurred. No in-stent obstruction due to tumor recurrence was observed although slight dilatation of intrahepatic bile duct was detected in 25%of patients, which was resulted from intimal hyperplasia at the stent mesh and/or biliary stone formation. The median survival time was 10.9 months. Conclusion For the treatment of malignant obstructive jaundice, biliary stenting combined with 125I seed implantation intracavitary irradiation is safe, reliable and effective. This technique can prolong stent patency time as well as the patient’s survival time.