Objective To investigate the risk factors for short-term residual common bile duct stones after laparoscopic cholecystectomy (LC),and to provide a reference for clinical prevention and treatment.Methods A total of 18 patients with short-term residual common bile duct stones after LC who were admitted to The First Affiliated Hospital of Nanyang Medical College from January 2014 to January 2016 were enrolled as observation group,and 320 patients without short-term residual common bile duct stones after LC who were admitted during the same period of time were enrolled as control group.The two groups were compared in terms of acute pancreatitis,alanine aminotransferase (ALT),aspartate aminotransferase (AST),emergency surgery,results of preoperative magnetic resonance cholangiopancreatography (MRCP),direct bilirubin (DBil),the gallbladder full of stones,number of gallstones,minimum stone diameter,gallbladder volume,cystic duct diameter,cystic duct length,and sand-like stones.The independent-samples t test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,and a logistic multivariate regression analysis was performed for variables with statistical significance.Results The univariate analysis showed that acute pancreatitis,emergency surgery,sand-like stones,retrograde cholecystectomy,preoperative MRCP,number of gallstones,minimum stone diameter,gallbladder volume,cystic duct diameter,and common bile duct diameter were associated with short-term residual common bile duct stones after LC (x2 =9.801,16.217,5.802,9.865,and 5.145,t =18.314,6.077,7.687,15.678,and 5.512,all P ＜0.05).The multivariate logistic regression analysis showed that acute pancreatitis,retrograde cholecystectomy,common bile duct diameter,and cystic duct diameter were independent risk factors for short-term residual common bile duct stones after LC,while preoperative MRCP was a protective factor.Conclusion Active intervention for risk factors for short-term residual common bile duct stones after LC can reduce the incidence of postoperative residual bile duct stones.

BACKGROUND:Bone marrow mesenchymal stem cels have good proliferation and paracrine functions, which have irreplaceable advantages in the treatment of intestinal diseases. OBJECTIVE:To explore the effects of bone marrow mesenchymal stem cel transplantation on intestinal ischemia-reperfusion injury in rats. METHODS:Forty-eight Sprague-Dawley rats were enroled to make animal models of ischemic reperfusion injury of the intestine, and then model rats were randomized into experimental and control groups. After modeling, 1 mL bone marrow mesenchymal stem cels or the same volume of normal saline were injected into the intestinal mucosa of rats in the two groups, respectively. At hours 0, 2, 6, 24, 72, 120 after injection, serum diamine oxidase,tumor necrosis factor α, and D-lactic acid levels were detected by ELISA method. At 24 hours after injection, rat intestinal tissues were taken and observed pathologicaly under light microscopy, and their close connections were observed under transmission electron microscope. ZO-1 protein levels were detected by immunohistochemistry method. RESULTS AND CONCLUSION:Compared with the control group, the serum diamine oxidase, tumor necrosis factor α, and D-lactic acid levels were significantly lower in the experimental group at hours 6 and 24 after injection (P < 0.05). Intestinal necrosis, vilous edema, intestinal congestion and inflammatory cel infiltration in the experimental group were milder than those in the control group. In addition, the ZO-1 protein expression in the experimental group was higher than that in the control group. Experimental results show that bone marrow mesenchymal stem cel transplantation into the intestinal mucosa can improve the intestinal mucosal permeability in rats with intestinal ischemia-reperfusion injury.

BACKGROUND:Precancerous lesions are a long-term development process in which many factors are involved. Bone marrow mesenchymal stem cel s can repair tissue injury. OBJECTIVE:To investigate the effect of bone marrow mesenchymal stem cel transplantation on gastric precancerous lesions in the rats. METHODS:Thirty-six Wistar rats were randomly divided into control group, model group and transplantation group. Animal models of gastric precancerous lesions were established in the model and transplantation groups. Rats in the transplantation group were given 1 mL of CM-dil-labeled bone marrow mesenchymal stem cel s (3×106 cel s) via the tail vein, once a week, total y three times. Rats in the model and control group were subjected to the tail vein injection of the same volume of normal saline. Then, rats were sacrificed 1 week after final injection, and pathohistological changes in rat gastric tissue sections were observed. The expression of vascular endothelial growth factor in the gastric mucosa and levels of serum cytokines were detected. RESULTS AND CONCLUSION:The severity of gastric mucosal injury in the transplantation group was lighter than that of the model group. The expression of vascular endothelial growth factor was significantly higher in the transplantation group compared with the model and control groups (P<0.05). The levels of serum interleukin-17 and interferon-γwere significantly higher in the model group than the transplantation group fol owed by the control group (both P<0.05). Therefore, bone marrow mesenchymal stem cel s can increase vascular permeability, reduce inflammation, block or ease the occurrence of precancerous lesions by up-regulating the expression of vascular endothelial growth factor in the gastric mucosa lesions and reducing the expression of interleukin-17 and interferon-γ.

OBJECTIVE To take effective disinfection and isolation measures to prevent and control infection after blood sampling and to ensure the safety of the blood donors and the health of the recepients.METHODS Effectively and strictly sterilize and isolate the blood sampling environment,the materials,the donors arms,the medical staff fingers etc;and strictly obey the aseptic technique regulations;and strict sense of disinfection.RESULTS No single case of infection occurred since October,2000.CONCLUSIONS Our measures have prevented and controlled infection after blood sampling;and have ensured the safety of donors.An increasing satisfaction is found from among the donors.More and more citizens are becoming active voluntary blood donors.

Objective To investigate the method and effect of laparoscopic splenectomy(LS) using the Endo-Cutter and the LapDisc.Methods Laparoscopic splenectomy(LS) using the Endo-Cutter and the LapDisc was performed in 12 patients,including 7 patients with hematopathy and 5 patients with benign tumors.The laparoscopic procedure was performed with the surgeon's left hand through the LapDisc.With the left hand providing safe retraction,a harmonic scalpel was used to incise the splenorenal ligament and the splenogastric ligament.After the spleen was mobilized,a vascular stapler(Endo-Cutter) was used to divide the splenic hilum.The spleen was delivered out of the abdominal cavity through the hand-assisted incision.Results All the LS were successfully completed and no conversion to open surgery was needed.The operating time was 35~120 min(mean,80 min),the blood loss during operation was 40~200 ml(mean,127 ml),and the hospital stay,3~6 d(mean,4.5 d).Follow-up in the 12 patients for 6 months found no complications. Conclusions Laparoscopic splenectomy using the Endo-Cutter and the LapDisc is safe and effective.

Objective To observe the early ultrastructural changes of the optic nerves after the brain impact injury. Methods Eighteen 15-week-old Wistar rats were used in the air-pressure brain impact injury examination. All of the rats underwent the procedures of right-parietal-bone fenestration after abdominal cavity anesthesia with 1% sodium pentolbarbital (45 mg/kg), and then they were divided randomly into 3 groups, i.e., mild injury group (8 rats) underwent with 7 kg of air pressure in distance of 11 cm; severe injury group (8 rats) with 7 kg of airpressure in distance of 8 cm; and control group (2 rats) underwent with the parietal-bone fenestration but without impact injury.The ultrastructural changes of the optic nerves were observed 1, 6, 24, and 72 hours after the injury by electron microscopy. Results The difference of ultrastructural changes of optic nerve was not obvious in wild injury group and the control group, and the lanthanum nitrate was only found in the blood vessels in optic nerve. The lanthanum nitrate entered the nerve stroma 1 hour after severe and increased as time goes on. Simultaneously, displayed dilatation of endoplasmic reticulum, cavitation and tumefaction of mitochondrion, vacuolation of nerve stroma, and vacuolation of some axis-cylinder were seen in the glial cells. Conclusion The brain impact injury may cause ultrastructural changes of the optic nerve and increase of permeability of blood vessels.

Objective To establish the rat model of experimental subarachnoid hemorrhage (SAH) and to detect the expression of ADAMTS-4 in early brain injury(EBI) after SAH in rats .Methods Totally 72 adult male SD rats were randomly divided into 2 groups ,the control group and SAH group .The expression of ADAMTS-4 and the content of brain Evans Blue(EB) were detected . The ADAMTS-4 inhibitor α2-macroglobulin was used to study the relationship between the expression of ADAMTS-4 and blood-brain barrier permeability .Results The expression of the mRNA and protein of ADAMTS-4 increased dramatically at 24 h and the contents of EB increased progressively at 12 h after SAH .The protein expression of ADAMTS-4 and the content of brain EB was positive correlated(r=0 .917 ,P<0 .05) .The expression of ADAMTS-4 was inhibited by α2-macroglobulin(P<0 .05) and the con-tents of EB decreased dramatically (P<0 .05) .Conclusion ADAMTS-4 may be involved in the pathological progression of early brain injury after SAH .

Objective To clarify if estrogen increases gastric mucosal injury in portal hypertensive rats and its role in the pathogenesis of portal hypertensive gastropathy. Methods Forty SD rats were divided into 4 groups:P + E, P, S + E and S groups. P + E and P groups received portal vein ligation and the S + E and S groups underwent sham operation. P + E and S + E groups were given estrogen intramascularly. All rats were maintained on their indiuidual treatment for 14 days. One hour before the sacrifice rats were orally lavaged with 2 ml 99% ethanol. Gastric mucosal blood flow, degree of gastric mucosal injury and mucosal NO production were determined. Results The P + E group had the highest gastric blood flow of (103?14) U compared with the other 3 groups (P

Objective To investigate the feasibility of percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. Methods One patient with thoracic disc herniation involved the level of vertebral segment in T11/12 was treated with percutaneous transforaminal endoscopic spine system and followed up for 1 month. The targeted puncture was performed under local anesthesia and fluoroscopic guidance with patient in prone position. The foramen of T 11/12 was enlarged gradually with four trephinations, and the working cannula was inserted transforaminal into the canal. Then the herniation was exposed and removed with full endoscopic technique, including the loosen nucleus pulposus. The dural sac was exposed and released adequately. Drainage was placed during operation. Results The procedure was successfully carried out and the dural sac was completely released. The drainage was removed in the second day of operation. The patient could walk in the third day after operation with obvious relief of back and leg pain. At the follow-up of one month postoperation, the visual analogue scale of leg pain decreased from 8 to 1, and the Oswestry disability index (ODI) decreased from 64 to 4. According to MacNab scale, excellent result was acquired. Conclusion There is the feasibility of the percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. It is a good minimal invasive technique with good results and high technical requirements for surgeons.

BACKGROUND:In esophageal cancer chemotherapy, inhibiting proliferation of tumor cels and tumor stem cels can be effectively improved by using appropriate sensitive agents.
OBJECTIVE:To explore the effect of molybdenum on ECA-109 cel chemosensitivity and p75NTR cel inhibition in esophageal carcinoma cels.
METHODS:ECA-109 cels at logarithmic phase were selected and randomly divided into blank control group, cisplatin group, molybdenum group and molybdenum+cisplatin group (combination group). Molybdenum and cisplatin at different concentrations were used in the three groups. MTT assay was used to detect ECA-109 cel proliferation and growth; flow cytometry was used to detect the proportion of P75NTR cels.
RESULTS AND CONCLUSION:Cisplatin at different concentrations showed a certain inhibitory role in ECA-109 cels, which had an increasing kiling effect on esophageal carcinoma stem cels at dose- and time-dependent manner. Molybdenum alone had no remarkable kiling effects on inhibiting ECA-109 proliferation and esophageal carcinoma stem cels. Combination of molybdenum and cisplatin was found to have an enhanced effect to inhibit ECA-109 cels and to kil esophageal carcinoma stem cels in a dose- and time-dependent manner, which was significantly different from the cisplatin group and blank control group (P < 0.05). These findings indicate that molybdenum can promote and enhance the inhibitory effect of cisplatin on ECA-109 and p75NTR cels, which can be used as a chemosensitizer.