Objective To investigate the feasibility and timing of laparoscopic cholecystectomy(LC) for the treatment of acute pancreatitis accompanying gallstones. Methods A retrospective analysis was made on clinical data of 21 patients with acute pancreatitis accompanying gallstones treated by LC between January 1999 and August 2003 in this hospital. Results The LC was performed 20~40 days after the onset of pancreatitis and 15 days after the recovery of serum and urinary amylase levels.An abdominal drainage tube was placed in 9 patients.Postoperative recovery was uneventful in 19 patients,who got out of bed on the surgery day or on the first postoperative day and began to take food 12 hours after operation,with the abdominal drainage tube removed 24~72 hours postoperatively and no complications encountered.Recurrence of acute pancreatitis happened in 2 patients on the 3 postoperative days and was relieved from symptoms with conservative treatment.The duration of postoperative hospital stay was 4~20 days(mean,7 days).Follow-up checkups in the 21 patients for 6 months ~ 5 years(mean,19 months) found no recurrence. Conclusions Laparoscopic cholecystectomy is feasible and safe for patients with acute pancreatitis accompanying gallstones in the period of 20~40 days after the onset of pancreatitis.Careful patient selection,proper peri-operative treatment,strict adherence to techniques,and use of postoperative drainage are considered essential.

OBJECTIVE To investigate the application of risk management in the practice of the sterilization supply department.METHODS Through the risk management theory to identify and evaluate the latent risk factor and achieve the purpose of preventing and controlling.To improve the awareness and ability of risk guarding among nurses by strengthening professional training and establish and perfect the regulations,we insisted on "zero fault" management idea and adopted irregular spot-checking and quality overruled system.We also bought the results into bonus-penalty system and continue for the quality improvement.RESULTS It strengthened the risk and quality cognition and the responsibility of the nurses and reduced the occurrences of the small defects and defaults.CONCLUSIONS The risk and quality management is binding with each other.Through the applications of risk management the most high quality sterilized goods are offered to our clinical practice due to the decreasing in risk factors.

Objective To investigate the effect of glutamine on the serum carcino embryonie antigen (CEA) , alpha fetal protein (AFP) and T cell immune function in postoperative patients with gastric cancer.Methods 52 postoperative patients with gastric cancer from Yiwu Central Hospital were selected and randomly divided into control group and experimenal group, 26 cases in each group.The control group received routine nutritional therapy, and experimental group received alanyl -glutamine injection on the basis of control group.The serum nutritional parameters, CEA, AFP, CD4 +T, CD8 +T levels were compared post-treatment.Results Compared with control group post-treatment, the serum albumin (ALB) and pre-albumin (PA) levels were higher (P<0.05), the CEA and AFP levels were lower (P<0.05),the serum levels of CD4 +T and CD4 +T/CD8 +T were higher (P<0.05),CD8 +T level were lower (P<0.05).Conclusion Glutamine could significantly improve the clinical symptoms of patients with gastric cancer after surgery,and it is speculated that the mechanism may be the increase of serum ALB, PA levels, the decrease of CEA, AFP levels and the improvement of immune function.

Objective To analyse effect of ShenQi FuZheng injection on serum carbohydrate antigen 19-9(CA19-9), C-reaction protein(CRP) and CD4 +lymphocyte subsets in patients after laparoscopic radical resection of colon cancer.Methods 58 patients after laparoscopic radical resection of colon cancer were collected.All patients were randomly divided into experimental group and control group according to the different drugs, 29 cases in each group.Patients were given the corresponding drug treatment after operation, after the treatment, the serum levels of CA19-9, CRP and venous blood T lymphocyte level were detected in all patients.Results Compared with before treatment, CA19-9 and CRP level in serum were lower (P<0.05) , CD4 +cells, CD4 +/CD8 +, and NK cells were higher(P<0.05);Compared with control group after treatment, the serum CA19-9 and CRP level were lower in the experimental group (P<0.05); the levels of venousblood CD4 +cells, CD4 +/CD8 +and NK cells were higher in the experimental group (P<0.05).Conclusion ShenQi FuZheng injection can significantly reduce the serum CRP and CA19-9 levels in patients after laparoscopic radical resection of colon cancer, improve the levels of venous blood CD4 +cells, CD4 +/CD8 +and NK cells, improve immune function, and have a guiding significance for clinica.

Calcium calculi account for about 80% of urolithiasis with high incidence and recurrence rate. Recurrent urolithiasis increases the risk of hypertension and chronic kidney disease. Comprehensive metabolic evaluation is of paramount importance for the prevention of calcium calculi. With deepening of the study on the pathogenesis of calculi, we find crystallization inhibitors, inflammation and oxidative stress molecules play an important role in the formation of calculi, and susceptibility gene sites of urinary calculi are identified in succession. These may be used as novel markers for the prevention and evaluation of urinary calculi. Models that predict the risk of kidney stone recurrence can help warn people at high risk.

Objective To investigate whether ?OH radical species present in the acid oxidation-potential water (AOW). Methods Electron paramagnetic resonance spectroscopy (EPR) coupled with the spin trapping technique was used for determination of ?OH radicals. Results A seven-line spectrum characteristic of 5, 5-dimethyl-2-pyrrolidone-N-oxyl (DMPOX) was formed at first, at 60 min the spin adducted DMPO-OH with four-line spectrum characteristic and at 120 min, no spectrum was observed. Conclusion ?OH can be detected in AOW at 60 min and it may come from the interaction of active substance in the AOW.

Objective To investigate operative methods and indications for the surgical repair of hypospadias. Methods Clinical data of 91 cases of hypospadias repaired in this hospital between 1997 and 2003 were retrospectively analyzed. Results Postoperative urethral fistula took place in 15 cases, with an overall incidence of 16 5% (15/91), including 6 cases treated by Duckett procedure, 4 cases treated by Duckett combined with Duplay procedure, 1 case treated by Mathieu procedure, 2 cases treated by scrotal island flap procedure (Onlay procedure), 1 case treated by Denis-Browne procedure, and 1 case treated by Snod-grass procedure. Conclusions For patients with hypospadias associated with serious chordee, because the urethral plate can not be preserved, adaptable methods should include scrotal island flap procedure, Duckett procedure, or Duckett procedure combined with Duplay procedure. Urethral plate conserving operations are suitable for hypospadias without chordee or with mild chordee, involving the Mathieu procedure, Onlay procedure, Snod-grass procedure and Denis-Browne procedure.

Objective A fingerprint of Rhizoma Alismatis Orientalitis' decoction pieces was established by HPLC-ELSD. Methods The gradient elution mode was applied in chromatographic separation by mobile phase of methanol and water at flow rate of 0.5 mL? min-1 in a Diamonsil TM C18 chromatographic column (250 mm ? 4.6 mm, 5 ? m), and recording time was 70 minute. The parameters of evaporative light scattering detector were set as follows: the temperature of the drift tube was 82.5 ℃ and gas flow rate was 1.9 L ? min-1.The data was analyzed with cluster analysis and similarity calculation software. Results The fingerprint showing 15 common peaks was obtained. The results of cluster analysis and similarity calculation showed there existed differences in fingerprints of 16 batchers of medicinal slices of Rhizoma Alismatis Orientalitis. Conclusion The method is effective and reproducible for the quality control of medicinal slices of Rhizoma Alismatis Orientalitis.

Objective To summarize the changes of nutrition and metabolism after laparoscopic Roux-en-Y gastric bypass surgery (LRYGBP) in the treatment of morbid obesity. Methods LRYGBP was performed in 121 patients with morbid obesity (male, 40 patients; femal, 81 patients). The body mass index (BMI) was measured 1 month before and 6 months after the operation. A comparative analysis was conducted on serum levels of ferrum (Fe), calcium (Ca), zincum (Zn), selenium (Se), vitamin A (VitA), vitamin D (VitD), vitamin B_ 12 (VitB_ 12 ), and parathyroid hormone (PTH) at 6, 12, and 24 months after operation. Results The BMI was declined from 47.00?7.15 kg/m~2 preoperatively to 33.79?6.06 kg/m~2 postoperatively, with a decrease of 0.26~42.58 kg/m~2 (13.21?5.47 kg/m~2) (t=26.103, P=0.001). The postoperative serum levels of Fe, Ca, Zn, Se, VitA, VitD, and VitB_ 12 were all within the normal limits. However, the levels of Zn, Se, and VitA were lower than the normal in 19.5% (17/87), 22.7% (20/88), and 3.7% (28/83) of patients at 6 months after operation, and in 6.0% (2/30), 11.5% (3/26), and 17.2% (5/29) of patients at 2 years after operation, respectively. The serum PTH levels were 11~161 pg/ml (66?34 pg/ml), 24~154 pg/ml (72?34 pg/ml), and 21~194 pg/ml (75?40 pg/ml) at 6, 12, and 24 months after operation, respectively (normal limits, 9~44 pg/ml). Conclusions Laparoscopic Roux-en-Y gastric bypass surgery is a reliable and safe option for patients with morbid obesity. The serum levels of calcium, zinc, selenium, and PTH will be influenced following the surgery. Supplementation of multi-vitamins and mineral substances should be strongly advised in all patients.

BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh sweling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh sweling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.