Objective To investigate the correlation between anatomical structure and recurrence of common bile duct stones.Methods The clinical data of 195 patients with common bile duct stones were studied,including 37 patients with recurrent bile duct stones.The correlation between anatomical structure and the recurrence of common bile duct stones were analyzed by univariate and multivariate analysis.Results Univariate analysis revealed that history of cholecystectomy,choledocholithotomy,periampullar diverticu-lum,papilla hypertrophy or stenosis,intramural duodenal bile duct abnormalities,common bile duct stric-ture,choledochectasia and angulated common bile dust were risk factors of recurrence.Multivariate logistic regression analysis showed that past history of cholecystectomy,periampullary diverticulum,angulated com-mon bile dust,choledochectasia were independent risk factors for the recurrence of common bile duct stones. Conclusion Patients with anatomical structure of past cholecystectom,periampullary diverticulum,choledo-chectasia,angulated common bile dust are prone to recurrence of common bile duct stones.

Objective To study the risk factors for contralateral breast cancer(CBC) in women after regular treatment of the primary breast cancer.Methods Between January 1997 to December 2002,the clinical data of 340 breast cancer patients at our institution were retrospectively analyzed.In all the patients a detailed analysis was carried out with respect to age,operation type,radiation therapy technique and dose,the use of chemotherapy or hormone therapy,and other clinicopathologic characteristics.The Kaplan-Meier method was used to estimate the actuarial rate of CBC.The Cox proportional hazard regression model was used to estimate the relative risk factors of CBC.Results Fourteen cases were diagnosed to be CBC,thus overall incidence of CBC was 4.1%.Ten-year CBC incidence(2.7%) was higher than 5-year incidence of CBC(1.4%).Univariate analysis showed that the risk factors of CBC at 5-year and 10-year included: ≤45 years old,medullary carcinoma,family history of breast cancer and being taken without endocrine therapy(P0.05).Mutivariate analysis showed that ≤ 45 years old and being internal breast radiotherapy were independent risk factors of CBC at 5-year and 10-year(P

OBJECTIVE To comprehend characteristics and risk factors of lower respiratory tract infection after tracheotomy.METHODS Lower respiratory tract infection condition of 60 cases with tracheotomy was investigated.Risk factors were analyzed.RESULTS The prevalence of nosocomial infection was 93.3%,mainly lower respiratory tract infection(82.1%).The most common pathogens were Gram-negative bacilli.This group of patients had the seriously underlying diseases.In the treatment they carried on the trachea intubation,the tracheotomy,oxygen inhalation,sputum aspiration,atomization and so on.The time the tracheotomy and days in hospital be longer,the lower respiratory tract infection be higher.CONCLUSIONS The trachea intubation,the tracheotomy,the time of tracheotomy and the longer days in hospital may be the risk factors which can cause the lower respiratory tract infection.

Objective To study the diagnosis and management of renal artery stenosis in kidney transplants. Methods 8 cases of transplant renal artery stenosis (TRAS) were reviewed and studied . Results Color-flow Doppler has been helpful in the diagnoses for 5 of the 8 cases with a specificity of 78% and a positive predictive value of 62.5%. 7 patients underwent PTRA and have been cured of the renal stenosis in a short term. On follow up for 3～12 months, the creatinine was 186.2～121.3 ?mol/L; 1 patient underwent nephrectomy. Conclusions TRAS should be considered when ever there is hypertension of unknown cause, a sudden reduce of urine volume and on increase of creatinine after kidney transplantation. Color-flow Doppler is indicated for the screening of TRAS whereas PTRA is the procedure of first choice for the management.

0.05).CONCLUS_ION:The present study in rabbits showed no significant interaction between ciprofloxacin and tacrolimus after combined administration of these two drugs in a single dose.

BACKGROUND:Intertrochanteric fractures can be generaly treated by surgical treatment. Along with deep research on the biomechanics of the proximal femur, proximal femoral locking compression plate appears recently. The locking plate fixation is not strong, can reduce the local stress shielding, and maintain optimal system stability, but fracture fixation failure often occurs due to the inappropriate choice of nail plate. OBJECTIVE:To evaluate the value of digital orthopedics technology in preoperative planning in locking plate fixation for intertrochanteric fracture. METHODS: Forty intertrochanteric fracture patients receiving CT tomography femur upper segment were selected and divided into two groups. In the conventional group, after reading X-ray films and CT images, patients received locking plate fixation. In the computer planning group, before repair, fracture model was established using Mimics software to segment fracture fragments, simulate operation reset and 3-matic software was used to reconstruct locking plate and screws. Locking plate was assembled with Mimics to obtain the best plate position, best screw angle and screw length. Proximal femoral locking compression plate fixation was performed. Fluoroscopy times, operation time, blood loss and fracture healing time were compared in both groups. RESULTS AND CONCLUSION: Three-dimensional models of proximal femur were reconstructed, and a series of data were obtained. The optimal position of each plate was obtained from each patient. The screw length was predicted, so preoperative operation planning was realized. Al patients were folowed up for 6-20 months. Fluoroscopy times, operation time, and blood loss were significantly less in the computer planning group than in the conventional group (P < 0.05). No significant difference in fracture healing time was detected between the two groups (P > 0.05). These findings suggest that digital orthopedics technology used in intertrochanteric fracture can simulate the locking plate position, determine the screw placement angle and length of the screw in advance, and reduce fluoroscopy times, operation time, blood loss and screw position misalignment.

Objective To study the expression of HER4 in renal cell carcinoma and elucidate therelationship between HER4 expression and the clinical features of renal cell carcinoma. Methods Seventy-five cases of paraffin-embedded tissues from renal eell carcinoma were tested for the expres-sion of HER4 by immunohistochemistry.Forty-six cases were male,29 cases were female,the median age was 49 years old.All of these cases were diagnosed as renal cell carcinoma(51 cases of clear cell carcinoma,1 5 cases of granular cell carcinoma,and 9 cases of papillary adenocarcinoma).The control group was 20 cases of normal renal tissue 5 am away from the tumor.Descriptive analysis was applied to compare the differences used the x2.test.Statistical analysis was done by SPSS 10.0. Results HER4 was overexpressed in 78.7%RCC(9 cases with weak positive,18 cases moderate positive,41 caseS intensive positive and 7 cases negative)cases.The expression of HER4 was negative in all nor-mal tissue.The overexpression of HER4 was correlated with the lymph node metastasis and TNM staging(P<0.05). Conclusions HER4 overexpressionis correlated with Stage of RCC.

Objective To evaluate whether serum cystatin C (SCys C) could be used as an ideal index to assess renal function of renal transplant recipients during posttransplant follow-up.Methods Seventy patients who were followed up for at least 6 months after renal transplantation in our centre were recruited in the study. SCys C and serum creatinine (SCr) were determined during the follow-up period, and glomerular filtration rate (GFR) was measured using an isotope Tc99m DTPA.The correlation between SCys C, SCr and GFR was analyzed. The performance of SCys C and SCr in diagnosing the mild impairment of renal allgraft function (GFR ＜ 1 ml/s) was evaluated using ROC curve. Results Both SCys C and SCr had a linear negative correlation with GFR (r = -0. 82 and -0. 66 respectively, P＜0. 01 ). The sensitivity, specificity and positive predictive values (PPV) of SCys C for diagnosing the mild impairment of renal allgraft function were higher than those of SCr,but the AUC of SCys C did not differ from that of SCr significantly (0. 935 vs. 0. 877, P＞0. 05).Conclusion SCys C could be used an ideal index to evaluate the allograft renal function for its better correlation with actual GFR.

Objective To analyze the clinical efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy for great saphenous varicosity and summarize the experiencein order to achieve better results.Methods From January 2014 to June 2015,45 patients (52 limbs,including 17 males and 28 females,aged 36 to 68 years) diagnosed as great saphenous varicosity received endovenous laser treatment combined with transilluminated powered phlebectomy.Thirty-eight cases was unilateral great saphenous vafcose veins,7 cases was bilateral large saphenous varicose veins.The clinical efficacy was analyzed.Results All cases were performed successfully.The mean operation time was (68.4 ± 15.1) minutes,the average bleeding volume was (23.5 ± 10.7) ml,the number of mean operative incision quantity was (5.8 ± 1.9) and the average hospitalization time was (5.9 ± 1.6) days.All patients had no serious complications.During a mean follow-up time of 22 months (12 to 30 months),only one patient recurred.Conclusions Endovenous laser treatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective and safe.It also has the advantages of shorter operation time,less bleeding,shorter hospitalization time,small trauma and better cosmetic results.

Objective To study the expression of BRG1 gene in colon cancer and its relationship with histological grade and clinicopathological stages characteristics.Methods The expression of BRG1 -positive cancer cells were detected by immunohistochemistry in 100 cases of colon cancer,and the relationship with histological grade and clinicopathological stages characteristics was analyzed.Results Of the 100 colon cancer specimens analyzed,the positive expression rate was 82.0%.The expression of BRG1 in colon cancer tissue with histological grade and TNM staging was significantly different (χ2 =23.509,P =0.024;χ2 =25.659,P =0.002).The higher the histological grade,the stronger the BRG1 expression in colon cancer tissue.BRG1 expression in advanced colon cancer tissue was significantly enhanced in the early stage.Conclusion The appearance of BRG1 -positive cancer cells is associated with histological grade and clinicopathological stages characteristics.BRG1 might play an important role in the development of colon cancer.