Objective To discuss surgical techniques of laparoscopic treatment for intrahepatic stones.Methods A total of 57 cases of intrahepatic stones from March 2000 to March 2005 were studied. Under laparoscopic visualization,openings of left and right hepatic bile ducts were exposed through a longitudinal incision in the common hepatic duct to the bifurcation of left and right hepatic ducts.Stones in left and right hepatic bile ducts were evacuated with the use of a lithotomy forceps,a tiny basket,or pressure irrigation.Then openings of secondary hepatic ducts were exposed through the dilated primary ducts for the removal of stones in secondary hepatic ducts.Sometimes even openings of tertiary hepatic ducts could be seen for stone removal.When mud-or sand-like calculi were encountered,repeated irrigation of bile ducts was carried out.Results Conversions to open surgery were required in 3 cases(3/57,5.3%).The time of operation was 75～275 min(136?54 min).Residual stones were found in 49 cases(49/57,86.0%),which required postoperative choledochoscopy for 1~4 times to clear the intrahepatic stones.Complete clearance of all intrahepatic stones was achieved in 53 cases(53/57,93.0%).In 2 cases of calculi impacted in the lower common bile duct,laparoscopic electrohydraulic lithotripsy was performed for stone extraction.Postoperative bile leakage occurred in 5 cases(5/57,8.8%),and was cured with tube drainage.Follow-up observations for 0.5~5 years(2.3+1.5 years) in 43 cases showed excellent outcomes in 38 cases(88.4%),good outcomes in 3 cases(7.0%),and poor in 2(4.6%).Conclusions Intrahepatic stones can be removed laparoscopically through a longitudinal incision in the common hepatic duct to the bifurcation of left and right hepatic ducts for the exposure of primary and secondary hepatic ducts,or even tertiary hepatic ducts.

Objective To inverstigate the effect and safety of refractory intrahepatic and extrahepatic bile duct stones treated by choledochoscope holmium laser combined with electrohydraulic lithotripsy.Methods The cllnical data of 67 cases of postoperative intrahepatic and extrahepatic bile duct stones treated with combined endoscopic holmium laser and electrohydraulic lithotripsy were analysed retrospectively.Results After 1 to 7 times of biliary endoscopic holmium laser electrohydraulic lithotripsy treatment,65 patients had complete removal of all residual stones with the success rate of 97%,and without complications.Conclusions After holmium laser combined with electrohydraulic lithotripsy,the effect of choledochoscopic removal of intrahepatic and extrahepatic bile duct residual stones can be greatly improved It is a safe method for treatment of refractory intra-and extra-hepatic bile duct stones.

Objective To explore the expression of heat shock protein 90?(HSP90?)in colon carcinoma tissues and HCT-8 cell line,and to investigate the relationship of HCT-8 cells to chemoresistance.Methods The expression of HSP90 ? in colon carcinoma tissues was detected by immunohistochemistry and the relationship of HSP90? expression with the Dukes stage and pathological grade was analyzed,The medium effective concentration(IC50)of vincristine(VCR)to colon cancer parent cells HCT-8 and drug resistance cells HCT-8/VCR was detected by MTT method.The expression difference of HSP90?mRNA in of HCT-8 cells and HCT-8/VCR cells was detected by RT-PCR to investigate its relationship to the chemoresistance.Results The positive expression rate of HSP90 ? was higher in colon carcinoma tissues(41.67%)than non-cancerous colon tissues(16.67%)(P0.05).The drug resistance of HCT-8/VCR cell line to VCR was significantly higher than that of HCT-8 cell line(P

[Objective] To investigate the therapeutic status of laparoscopic management for gallbladder stones and common bile duct stones. [Methods] A Retropective study were adopted to analysize the therapeutic scheme,effect for patients with gallbladder stones and common bile duct stones who were treated from January 1996 to September 2004. [Results] 68 cases were diagnosed, and most of them underwent single stage laparoscopic cholecystectomy (LC) and common bile duct exploration (LC BDE). A few of them were treated through endoscopic procedure in combination with LC, or open surgery when the minimal invasive surgery failed. [Conclusions] Both them indicated that patients by LC+LCBDE have shorter hospital stay, easier recovery and less complications. LC+LCBDE has obvious advantage over the other methods with appropriate operative time and high success rate. For choledochlithiasis patients, the single laparoscopic management should be a better, major option.

Objective To establish a mouse model of acute graft-versus-host disease (aGVHD) after allogeneic bone marrow transplantation,and using exogenous interleukin-7 receptor alpha (IL-7Rα) intervene mice aGVHD and analyse its possible mechanism.Methods The BALB/C (H-2d) female mice as recipients were grouped by rat: the irradiation group (group A),irradiation transplantation group (group B) and IL-7Rα in the intervention group (group C),each 10.ALL mice were accepted 9 Gy60Co total body irradiation.1×107 bone marrow cells and 2×107 spleen cells of donor C57BL/6 (H-2b) via the tail vein were infused to recipient mice.The signs of the recipient mice,hematopoietic functional recovery and survival time of change,and pathology,chimerism and cytokine levels in checkwere observed.Results Mice in A group after irradiation were gradually death,in group B and group C mice after transplantation had typical aGVHD symptoms,but lighter signs and a longer survival time of Group C than in group B.WBC count in Group C was +14 d (4.53± 0.21) ×109/L,+21 d (3.63±0.06) ×109/L,+28 d (4.31±0.04) ×109/L,was hematopoietic recovery compared with Group B [+14 d (1.81±0.05) ×109/L,+21 d (1.32±0.04) ×109/L,+28 d (1.76±0.04) ×109/L],the difference was statistically significant (t =0.237,0.108,0.359,P ＜ 0.05).The pathological results of liver,spleen,skin histopathology in group C were better than group B.Chimera implants,plasma IL-7 levels after transplant +7 d,concentration was significantly increased.IL-7 concentration in group C was +14 d (194.32±1.02) pg/ml,+21 d (131.63±1.54) pg/ml and in group B was +14 d (330.24±8.08) pg/ml,+21 d (184.09±2.05) pg/ml,the difference was statistically significant (t =1.590,1.285,P ＜0.05).Conclusion The stable aGVHD mouse model was established.In aGVHD early,plasma IL-7 levels were significantly increased.Exogenous IL-7Rαcan reduce the plasma IL-7 levels,thereby reducing the incidence of aGVHD after allogeneic bone marrow transplantation.

Objective To investigate the relationship between atherosclerosis and cardiovascular risk factors in the elderly,thus to provide new method for detection of atherosclerosis in the elderly.Methods From November 2010 to October 2011,348 elderly who addmitted to or had physical examination in our hospital were recruited in the study.All participants were interviewed through questionnaire,and medical history was recorded,Brachial-ankle pulse wave velocity (baPWV) was measured.Simultaneously,height,body weight,waist circumferrence,triglyceride ( TG ),total cholesterol ( TC ),high density lipoprotein-cholesterol ( HDL-C ),low density lipoprotein-cholesterol(LDL-C) were measured.The association between baPWV and cardiovascular and atherosclerosis was investigated.Results The incidence of higher baPWV was increasing as the number of risk factors of cardio vascular disease adding.Logistic regression analysis show that:Age ( OR =5.223,95％ CI 3.606 -7.564),LDL-C( OR =4.554,95％ CI 2.413 - 8.593 ),Smoking ( OR =6.007,95％ CI 3.775 - 9.560),Obesity( OR =3.019,95 ％ CI 2.363 - 3.857 ),Hypertension ( OR =6.938,95％ CI 3.591 - 13.404 ),High-salt diet( OR =2.555,95％ CI 2.108 -3.096)were independent risk factors of baPWV increase (P ＜0.05); Exercise and good sleep were the protective factors for baPWV increasing.BaPWV levels were significantly lower in the exercise group (exercise time ＞ 1 h/d)than in the few exercise group (exercise time ＜ 1h/d) (t =2.719,P =0.012 ),and lower in good sleep group participants than in insomnia participants (t =2.561,P =0.017 ) (P ＜ 0.05 ).BaPWV levels were significantly higherin the group with essential hypertension ( 1852.0 ± 46.7 cm/s),with Type 2 Diabetes Mellitus ( 1693.0 ± 38.2 cm/s),with coronary heart disease ( 1729.0 ± 40.4 cm/s) than in the healthy group ( 1356.0 ± 3 1.3 cm/s) ( P ＜ 0.05 ).There was no statistical difference between the essential hypertension group and the hypertension complicated with cerebral infarction group,as well as between the coronary heart disease group and the myocardial infarction group.Conclusion Age,LDL-C increasing,smoking,obesity,hypertension and high-salt diet were independent risk factors of baPWV increase;Exercise and good sleep were protective factors.BaPWV could be one of the methods for early detection of atherosclerosis.