Objective To evaluate the timing,feasibility and necessity of early laparoscopic cholecystectomy (LC) in management of patients with mild to moderate acute pancreatitis with gallbladder stones.Methods The clinical data of 75 patients with mild to moderate acute pancreatitis and gallbladder stones treated from September 2010 to August 2014 in our hospital were analyzed retrospectively.32 patients underwent LC within 48 hours of the pancreatic attack.The results were compared with those from 43 patients with delayed LC.Results All the patients were operated by experienced surgeons.There were no significant differences between the two groups in operation time,postoperative complications,intraoperative blood loss,conversion rates,white blood cell count,percentage of neutrophils and blood amylase before and after the operation (P ＞0.05).Patients who received delayed LC had longer hospital stay [(10.6 ± 1.3) vs (17.1 ± 1.8),P ＜ 0.05].The readmission rate in patients with delayed LC was 30.2％ (13/43),and most admissions occurred within 2 ～4 weeks of hospital discharge.In patients with early LC,one patient developed necrotic pancreatitis and died of septic shock.All the remaining patients were cured.Conclusions It is safe,feasible and necessary to perform LC within 48 h in patients with mild to moderate acute pancreatitis and gallbladder stones.Such patients have a high readmission rate and the best timing of delayed LC is within 2 ～ 4 weeks after discharge from hospital.

Fifty-three patients with facial spasm were treated by acupuncture therapy. Taichong (LR 3), Fengchi (GB 20), Yifeng (TE 17), and Sanyinjiao (SP 6) were selected as main points, and others points were selected based on symptom. Of the 53 cases, 9 cases were cured,13 cases were markedly effective, 27 cases were effective, and 4 cases were ineffective, with an effective rate of 92.5%.

[Objective]To evaluate the feasibility of the minic microgravity as a method and the layered cylindric collagen-chitosan-?-tricalcium phosphate composite as a scaffold for the cartilage tissue engineering after an observation of how it absorbs the chondrocytes and affects the cell behavior.[Method]The chondrocytes were isolated and multiplied in vitro,and then the chondrocytes were seeded onto the porous collagen-chitosan-?-tricalcium phosphate composite scaffold and were cultured in both minic microgravity and ordinary environment for 3 weeks.The effects of the composite scaffold on the cell adhesivity,proliferation,morphological changes and synthesis of the extracellularmatrix were observed by the growth curve,phase-contrast microscopy,histology,scanning electron microscopy and immunohistochemistry.[Result]The chondrocytes that adhered to the scaffold increased significantly and secreted extracellular matrix in the center of the porous scaffold around the chondrocytes under minic microgravity compared with ordinary environment.Immunohistochemistry of type Ⅱ collagen was positive.[Conclusion]The minic microgravity environment will be a good method for the cartilage tissue engineering.And the layered cylindric collagen-chitosan-?-tricalcium phosphate composite scaffold has a good cellular compatibility.It will be an ideal scaffold for the cartilage tissue engineering.

Objective To investigate the exposure level to vehicle exhaust pollution for population by different commuting modes in roadside environment in Wuhan. Methods Eight air monitoring sites were selected in the six main roads in urban area of Wuhan, Hubei province. The concentrations of NO2, CO, total hydro carbon (THC), PM10, benzene, toluene and xylenes (BTX) emitted from the vehicles were monitored and analyzed in winter and summer of 2007, respectively and combined with breathing rate and time spent of the population in traffic environments, exposure doses of different subpopulation were calculated as indicators in order to evaluate their exposure level to traffic exhaust. Results The PM10 was the primary pollutant on the roadside. Compared with the Ambient Air Quality Standard, the rate of exceeding standard limit for PM10 was 8% in summer and 100% in winter. As for on the roadside, the exposure level for adults was higher than that for the children (P

To investigate the degradation features of HA and PDLLA/HA composites in different proportion in vitro. Four kinds of foams consisting of PDLLA, PDLLA/HA (5%wt), PDLLA/HA (20%wt), and PDLLA/HA (35%wt) were immersed in distilled water. Changes in pH, mass loss, viscosity-average molecular weight, and strength against pressure were observed and compared to study degradation features of specimens in vitro. There were statistically differences in the indexes between the PDLLA/HA (20%wt) composite and the other foams after 12 weeks (P

Objective To investigate the risk factors affecting early mortality in spontaneous rupture in patients with hepatocellular carcinoma (HCC)and explore the effective treatment.Methed A retrospective study of 34 consecutive patients with spontaneous rupture of HCC from January 1998 to January 2008 was conducted.Followup was conducted for more than 3 years.18 clinical ,biochemical and pathological factors influencing 30-day mortality were analyzed.Results 30-day mortality rate was 38% (n=13).Univariate analysis showed that presence of cirrhosis,Child's C status,shock on admission,higher blood transfusion requirement,raised α-fetoprotein (AFP),raised alkaline phosphatase(ALP)and raised aspartate transaminase(AST)were all associated with increased risk early death (P＜0.05).Multivariate analysis displayed that shock was an independent risk factor affecting early death.The median survival time was 14.4 months in 8 patiens receiving emergency curative rescection and 44.4 months in 5 cases underwent delayed curative resection,and the 1-and 3-year survival rate were 63% (5/8)and 13% (1/8)in the former group and 80% (4/5)and 60% (3/5)in the latter group.Conclusion Poor prognosis of spontaneous rupture of HCC is associated with poor liver reservation,advanced disease and large volume of haemorrhage.Shock and blood transfusion requirement are the independent factors affecting early mortality.Curative resection is a definite treatment and delayed curative resection following initial haemostasis has a safer and more effective result.

DNA methylation is a normal modification mode of eukaryon, there is an intimate relationship between aberrant promoter methylation of tumor-related genes and the generation or development of neo- plasms,emerging significantly biological effectiveness. Aberrant promoter methylation of tumor-related genes as the epigenetic markers, maybe play a very important role in the incidence, diagnosis, therapeutic effects, prognosis judgements and other aspects in gallbladder carcinoma.

This review introduces the system, model, and method of the US ailitary medical logistic supply and support, analyzes the characteristics of the global sourcing and distribution, and highlights the information system development, cen-tral management, efficiency and effective improvement.By learning from the experience of the US Armed Forces, we can be helped to set up new systems and enhance the power of our military medical logistic support.

Objective To study the variation of serum thyroid hormones in each trimester of pregnancy and their relationship with thyroid peroxidase antibody(TPOAb).Methods Three-hundred and seventy-seven pregnant women in different trimesters were enrolled,the serum TSH,FT3,FT4,TT3,TT4,and TPOAb were determined by ICMA assay.Results Serun TSH in normal pregnant group was gradually increased as the pregnant trimester grew up ( all P＜0.05 ).The median of TSH in positive TPOAb group was higher than that of negative TPOAb group( P＜0.05 ).The prevalences of both clinical and subclinical hypothyroidism in positive TPOAb group were also higher than those in negative TPOAb group( all P＜0.05 ).The prevalences of subclinical hypothyroidism were 23.61％ and 18.04％,while those of clinical hypothyroidism were 0.27％ and 5.84％ by using TT4 and FT4 determination,respectively( P＜0.05 ).Conclusions More attention should be paid to the difference between FT4 and TT4 in hypothyroidism diagnosis during both second and third trimesters of pregnancy.Establishment of normal thyroid hormoues cut-off points in each trimester of pregnancy and screening for TPOAb is necessary.

AIM: To validate the alternations of flow velocity patterns in the infarct-related artery (IRA) during no-reflow phenomenon in a canine model of acute myocardial ischemia and reperfusion by transthoracic Doppler echocardiography (TTDE) combined with myocardial contrast echocardiography (MCE) by means of administration of Albunex. METHODS: Nineteen dogs first underwent 60 min myocardial ischemia and then followed by 60 min,120 min and 180 min reperfusion ( n = 6, 6 and 7, respectively). The perfusion defect area determined by MCE at 60 min myocardial ischemia was regarded as risk area (RAMCE). The perfusion defect area defined by MCE after reperfusion was considered as no-reflow area (NRAMCE). The ratio between NRAMCE and RAMCE ≥ 25 %was regarded as the development of no-reflow phenomenon and the ratio of NRAMCE to RAMCE＜25% was considered as the myocardial reflow. The coronary flow velocity parameters in IRA were determined through TTDE. RESULTS: Two dogs died during experiment and the remaining seventeen dogs completed throughout the procedure.There were seven dogs in reflow group and ten dogs in noreflow group. No significant difference was present in reflow group between at baseline and at 60 min reperfusion in systolic peak velocity (PVs), systolic velocity time integral (VT Is), corrected systolic flow duration (cFDs),diastolic peak velocity (PVd), diastolic velocity time integral (VT Id), corrected diastolic flow duration (cFDd),diastolic deceleration rate (DDR), corrected diastolic deceleration duration (cDDD) (P＞0.05), however, a significant difference was found in no-reflow group between at baseline and at 60 min reperfusion in PVs,VTIs, cFDs, PVd, VTId and cFDd (P＜0.05). The most marked alterations during diastolic phase were the increase of DDR and reduction of cDDD. CONCLUSION: The impaired microvasculature may profoundly affect the coronary flow velocity pattern in the IRA. The increase in microvascular resistance and decrease in coronary perfused pressure can contribute to the changes.Transthoracic Doppler echocardiography combined with MCE has the capability of noninvasive assessment of coronary flow velocity pattern in the IRA during no-reflow phenomenon.