Bile dut injury (BDI) is one of the severe complications of laparoscopic cholecystectomy (LC).The classification,diagnosis and treatment of the BDI caused by LC are partly controversial.The most efficient classification of the BDI is Strasberg-Bismuth's classification and the three modes and four classes developed by the Biliary Surgery Group of Surgery Branch of Chinese Medical Association.Although the success rate of intraoperative diagnosis for the BDI is very low,in most cases,the BDI is diagnosed by clinical manifestations and assistant examinations.Accurate classification and early diagnosis could help us to make a specific one for each patient according to certain situation.In this review,we focus on the classification,diagnosis and treatment of the BDI caused by LC.

Through studying Marxism philosophy,medical graduate students can master scientific methodology and dialectic thought.This is helpful to analyze and comprehend rightly different kind of complicated issues and to improve cognition level and practice ability.It is also very important for medical graduate students to guide political education and moral cultivation,medical practice and science research.

Objective To investigate the effect of tetramethylpyrazine(TMP), a traditional Chinese herbal medicine, on the neural injury caused by spinal cord ischemia and reperfusion in rabbit.Methods Twenty-two male New Zealand white rabbits were anesthetized with isoflurane. Spinal cord ischemia was induced by 20min by infra-renal aortic occlusion. Animals were randomly allocated to 3 groups. Group C received no pharmacologic intervention. Group P and T received 30 mg?kg -1 TMP infused iv at a constant rate over 30min before aortic crossclamping(prevention) and after reperfusion(therapeutic) respectively. Neurologic deficit was assessed at 4, 8, 12, 24 and 48h after reperfusion using neurologic dificit score(NDS 4 = normal, 0 = paraplegia) . The animals were sacrificed at 48h after reperfusion and spinal cords (L 5-7) were removed immediately for histopathologic study.Results All animals survived the experiment. The NDSs at each observation interval were significantly higher in group P and T than those in group C (P

Hedgehog( Hh)signaling pathway is evolutionarily conserved in vertebrates,its excessive activation is associated with abnormal cell differentiation, over proliferation, apoptosis resistance and promotion of invasion and metastasis of tumor cells. Hh signaling pathway involves in the formation and maintenance of esophageal columnar epithelium in embryonic stage,however,undetectable or barely expressed in matured esophageal squamous epithelium. Studies have shown that esophageal Hh signaling pathway can be activated by gastric acid and bile salts. Aberrant activation of Hh signaling pathway can cause the gradual transition of squamous epithelium to columnar epithelium and intestinal-type epithelium,ultimately induces the occurrence of Barrett’s esophagus( BE). Therefore,targeted inhibiting the Hh signaling pathway may be a new strategy for the treatment of BE. This article reviewed the advances in study on Hh signaling pathway in the pathogenesis of BE.

Objective To improve the biocompatibility of the metallic stent used for interventional treatment. Methods Inner coatings, outer coatings and micro-porous coatings were made using the solution-injection method, and salt crystallite with demanded size was added in order to develop micro-porous coatings. Results The optical concentrations of polyurethane solution and of salt crystallite (for micro-porous coatings) were obtained, and the corresponding processes were developed. Conclusion The poly-coated stent retains its elasticity, and it become very convenient to develop stents carrying drugs. Its effects on animals ard under test.

Objective To assess the clinical feasibility and safety of coronary artery angiography(CAG) and intervention through transradial approach. Methods 134 patients received coronary artery angiography and interventions through transradial approach were selected. The complications such as hematoma, thrombus were observed. Results Transradial puncture succeed in 126 cases, the successful rate of transradial coronary intervention was 94.0%.The complication occurred in 12 patients (8.9%). Conclusion This investigation demonstrated the safety and feasibility of transradial approach for coronary angiography with less procedure complications and pain for patient.

Colorectal cancer remains a major threat to people’s health around the world. Researchers have paid more and more attention to colorectal cancer epigenetics. From two main aspects of colorectal cancer epigenetics: DNA methylation and histone modiifcation, this article analyzes the similarities and differences between patients with colorectal cancer in Eastern and Western countries. This review brielfy introduces epigenetic modiifcation of genes that were used to be biomarkers and therapeutic targets. Although there are some common features of colorectal cancer in the world, analysis has showed that some obvious epigenetic differences do exist in different races. For example, it had been conifrmed in the studies that there are differences in speciifc gene methylation, histone modiifcation sites and the degree of methylation and acetylation among countries, which provide the basis for speciifc diagnosis, treatment and prognosis of colorectal cancer in different ethnic groups. With improved research methods and increased sample size, more and more special molecular targets of colorectal cancer tissues will be found, and then personalized therapy for colorectal cancer can be achieved.

BACKGROUND: Urinary incontinence can be divided into stress, urgent and mixed types, they can not be easily distinguished only basing on clinical experience, which often result in misdiagnose or improper treatment OBJECTIVE: To discuss the value of urodynamical inspection, especially stress leak point pressure (SLPP) determination in the diagnose of female stress urinary incontinence.DESIGN: Retrospective paralleled comparison observation.SETTING: Center of General Urology Department, Southern Hospital,Third Military Medical University of Chinese PLA PARTICIPANTS: Totally 120 female patients who received medical treatment in the uropoiesis surgical department of the Southwest hospital due to urinary incontinence between January 1996 and May 2002 were enrolled in this experiment.gle was determined and considered as normal if it was ＜100° and abnormal if ＞ 100°. Urethral tilt angle is judged as normal if ＜ 45° and abnormal if ＞45°; Urethrovesical junction (when static state) was judged as normal if not tion: including fulling urinary bladder pressure measurement, static urethral Cystourethrography classification standard: type Ⅰ refers to posterior urethrovesical angle vanished with urethral tilt angle＜45° and the biggest urethra closure pressure＞20 cmH2O; type Ⅱ: refers to posterior urethrovesical angle vanished with urethral tilt angle＞45° and the biggest urethra closure pressure＜20 cmH2O; type Ⅲ refers to normal posterior urethrovesical angle with urethral tilt angle＜45° and the biggest urethra closure pressure ＞20 cmH2O. SLPP classification standard: typeⅠ: SLPP ＞120 cmH2O; type Ⅱ: SLPP of 90- 120 cmH2O; type Ⅲ: SLPP ＜ 60 cmH2O;type Ⅱ/Ⅲ: SLPP of 60 - 90 cmH2O.compared with that of cystourethrographic classification.RESETS: Totally120 patients all remained in the final result analysis.stress urinary incontinence, 64 cases as symptomatic stress urinary incontinence including 28 cases of unstable bladder and 36 cases of low compliclassification: of the 56 genuine stress urinary incontinence, 20 cases were diagnosed as type Ⅰ; 16 cases as type Ⅱ and 10 cases as type Ⅱ/Ⅲ; 10cases as type Ⅲ. Two classification was proved of 100% consistency in type Ⅰ and Ⅲ, and 94.1% and 90.1% in type Ⅱ and type Ⅱ/Ⅲ respectively, difference was not remarkable (P＞0.05).CONCLUSION: SLPP determination can be used to make accurate classification of female genuine stress urinary incontinence, possessing important instructive significance for the treatment.

Objective To analyze the factors related with intraoperative neurophysiological monitoring (IONM) in spine and spinal cord surgery under general anesthesia, in order to increase the effectiveness of IONM. Methods A retrospective study was performed on patients who received somatosensory-evoked potential (SEP) and motor-evoked potentials (MEP) in spine surgery under general anesthesia from Ju-ly, 2011 to January, 2016. Results Data from 104 patients were collected in which 18 cases had abnormal SEP and 17 cases had abnormal MEP. A single factor analysis indicated that abnormal SEP was related to concentration of inhalation anesthetic (CIA), hypothermia in peri-operative period (HTM), and type of anesthesia (χ2>6.219, P<0.05), whereas abnormal MEP was related to CIA, hypotension in periopera-tive period (HTN), and additional muscular relaxants (χ2>4.125, P<0.05). Logistic regression analysis indicated that abnormal SEP was relat-ed to CIA and HTM, whereas abnormal MEP was related to CIA and HTN (P<0.05). Conclusion CIA, HTM, and HTN were possible fac-tors related with IONM in spine surgery under general anesthesia.

Objective To study the innervation between baldder and rectum.Methods The retrograde fluorescent double labeling method was used.Propidium Iodide(PI)was injected into the right wall of the rectum of male SD rats and Bisbenzimide(Bb)into their right wall of urinary bladder.Results The fluorescent double labeled neurons were found in the right L6-S3 and L1-L3 dorsal root ganglia(DRG).Conclusion DRG cells at L6-S3 and L1-L3 simultaneously innervate the rectum and the urinary bladder,explaining that the abnormal micturition due to chronic constipation may be caused by axis reflex at the level of the peripheral process of DRG cells.