Objective To study the diagnosis and therapy of recurrent cholelithiasis caused by peripapillary duodenal diverticulum.Methods The clinical data of 40 patients with repeated formation of bile duct stones caused by peripapillary duodenal diverticulum were retrospectively reviewed,and the data on surgical treatment were analyzed.Results All the patients underwent duodenal diverticulum operation and subtotal gastrectomy (Billroth Ⅱ).Twenty-one patients in addition underwent R-Y cholangiojejunostomy,14 patients and 5 patients underwent choledochotomy with T-tube drainage and duodenotomy with Oddi sphincterotomy,respectively.In forty patients,three patients presented temporarily biliary fistula,two patients lost touch,three-eighty fully recover from an illness in three years.Conclusion Recurrence of bile duct stones caused by peripapillary diverticulum may be cured by duodenal diverticulum operation combined with bile duct surgery,which is a feasible and efficacious treatment.

Objective To investigate the influence of CO_2 pneumoperitoneum on intestinal mucosa permeability in rats with liver cirrhosis.Methods Fifty rats were randomly divided into following groups: control group(n=5),cirrhosis group(n=5) and pneumoperitoneum group(n=40);the pneumoperitoneum group was further divided into 8 mm Hg group(n=20) and 13 mm Hg group(n=20).Four time points were chosen,including 0.5,2,6,and 12 hours after the end of pneumoperitoneum.After rat models with cirrhosis were established successfully,the abdominal cavity was insufflated with CO_2 and maintained under the pressures of 8 mm Hg and 13 mm Hg respectively for two hours.The portal venous blood was collected and the levels of D-lactic acid and endotoxin were measured.Results The levels of endotoxin and D-lactic acid in cirrhosis group were much higher than those of control group(P0.05).Conclusion The intestinal mucosa permeability is increased in rats with liver cirrhosis.It can be further increased under CO_2 pneumoperitoneum with certain pressure and time and in a pressure-dependent manner.The permeability can decrease after removal of pneumoperitoneum.

Objective To observe the influence of long-term smoking on the expression of p53 and K-ras in rat lung tissues, and to study the relationship of smoking to the mutation of p53 and K-ras gene. Methods The model of Wistar rat smoking was built up. Seventy-two healthy male Wistar rats were divided into the experimental group and control group at random. The rats of the experimental group were compelled to smoke, and the rats of the control group were given the same condition as the experimental group was, without smoking. The rats of the experimental group were smoked for 6 months. At the end of each month, 6 rats were chosen from the two groups respectively, their lung tissues were sampled and immunohistochemistry was applied to observe the expression of p53 and K-ras in lung tissues. Finally, the mutation which might happen in the exon 5, 6, 7-8 of p53 and the exon 1 of K-ras was examined by PCR-SSCP. Results The p53 protein was expressed in cell nucleus and K-ras in cytoplasm. The positive ratio of protein expression was increased with the extension of smoking time. The mutation of p53 was increased as the smoking time extended. But the effect of smoking time was not that significant on the mutation of K-ras.Conclusion Smoking can strengthen the expression of p53 and K-ras protein and can also result in gene mutation. As the time of smoking extended, those phenomenons were tending to rise. That provided the theoretical evidence which can be used to judge the lesion of lung tissues caused by smoking and help the early diagnosis of smoking-related lung carcinomas. It is of great theoretical and application values.

Objective To investigate the effect of expressions of P53 and VEGF in smoking lung cancer and surrounding lung tissue,and to offer us with theorial evidence of early diagnosing smoking-related lung carcinoma clinically.Methods126 lung cancer patients were recruited,including 96 long-term smoking and 30 nonsmoking patients.All clinical data was integrity and the patients had clear smoking history.None of patients underwent chemotherapy,radiotherapy and other tumor treatment.The bronchial epithelium,cancer tissues,pericancer lung tissues,surrounding lung tissues were observed by light microscopy,and the expressions of P53 and VEGF of lung cancer tissues,pericancer lung tissues and surrounding lung tissues were detected by Immunohistochemical methed in smoking and non-smoking group.The experimental data was analyzed by SAS statistical software and the degree of difference between the groups was compared accordingly.ResultsThere were different levels of expansion of alveolar wall in lung tissues of smokers,and alveolar wall became capsular to expand.Respiratory bronchioles were cystic expansion and small bronchial wall becomed thickening,with severe bronchial epithelial membrane ranking nuts-chaos and peeling.Goblet cells and the cell surface of the cavity mucous secretions and suppositories were more than those of non-smokers.The P53 protein was expressed in cell nucleus and VEGF expressed in the cytoplasm and endothelial cells of neovascularization.Both their positive behavior was granular brown.Either for smoking or for non-smoking lung cancer,the expressions of P53 and VEGF were higher in tumor tissues than that of in the pericancer and surrounding lung tissue(P

Objective To improve some surgical model techniques of rat orthotopic liver transplantation.Methods Two-cuff(portal vein and infrahepatic vena cava) technique was applied to the production of the animal model in SD and Wistar rats.Results With the improvements a successful rate of 85% was achieved in the production of the experimental model with anhepatic period of an average 21 minutes.Conclusion The results show that the model is stable and can be used in the experiment of liver transplantation in the rats.

OBJECTIVE: To determine the clinical characteristics and cognitive dysfunction of bipolar depression and unipolar depression. METHODS: Fifty patients with unipolar depression, 48 bipolar depression, and 50 normal controls were assessed with Hamilton Depression Scale, Hamilton Anxiety Scale, Life Events Scale, and The Wisconsin Card Sorting Test. General demographic data, clinical data, and the scores of recognitive function in the 3 groups were compared. RESULTS: The patients with bipolar depression occured at young age and had obvious family history compared with those with unipolar depression. The patients with bipolar or unipolar disorders had lower scores in most neuropsychological tests than those in the control group (P<0.05). The patients with bipolar depression in understanding memory and Wisconsin card sorting test were worse than those with unipolar depression (P<0.05). CONCLUSION There is cognitive dysfunction in patients with bipolar or unipolar disorder. Understanding memory and executive function damage may be cognitive features in bipolar disorder.
Adolescent ; Adult ; Bipolar Disorder ; complications ; diagnosis ; physiopathology ; China ; Cognition ; physiology ; Cognition Disorders ; complications ; physiopathology ; Depressive Disorder ; complications ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Neuropsychological Tests ; Young Adult

Introducing the multidisciplinary cooperation model into the clinical teaching of residents has gradually been paid attention to, and the relevant multi-disciplinary teaching teams participate in and formulate teaching plan. The Department of Urology of the Peking University Third Hospital carries out multidisciplinary cooperative teaching of residents based on network platform to improve residents' autonomous learning ability and teaching effect. This model has certain advantages in mobilizing students' subjective initiative and cultivating learning interest. It is of great significance for the training of urology residents.

Purpose: Pancreatic duct decompression relieves pancreatic duct stone (PDS)-associated abdominal pain, though a consensus indication for the drainage procedure of the main pancreatic duct (MPD) is lacking. Moreover, major prognostic factors for postsurgical long-term pain relief and recurrence are largely unknown. Methods: The clinical outcomes of 65 consecutive PDS patients undergoing surgery from 2008–2012 with 3+ years of follow-up were assessed. Results: At postsurgical follow-up (median, 4.5 years; range, 3–7 years; procedure: Partington, n = 32; Frey, n = 27; pancreatoduodenectomy, n = 3; distal pancreatectomy, n = 3), the early complication and complete stone clearance rates were 29.2% and 97%, respectively. Long-term, complete and partial pain relief were 93.9%, 83.1%, and 10.8%, respectively. The risk of pancreatic fistula was higher in the <8 mm group than in the >8 mm group (P < 0.05), and 80% of the pancreatic fistula cases occurred in the <8 mm group. A shorter pain duration (P = 0.007), smaller MPD diameter (P = 0.04), and lower Izbicki pain score (P < 0.001) predicted long-term pain relief. Pain recurrence after initial remission occurred in 5 patients and was only related to pain duration (P = 0.02). Stone recurrence and pancreatic exocrine functional and endocrine functional deterioration occurred in 2, 5, and 11 patients, respectively. Conclusion Surgery provides excellent stone clearance, long-term pain relief, and acceptable postoperative morbidity. Using 8 mm as the criterion for drainage surgery can minimize the postoperative pancreatic fistula risk. Individualized and timely surgical treatment may improve the effect of surgery.