Objective To study the prevention and treatment of bile duct injury during laparoscopic cholecystectomy(LC). Methods 22 cases of bile duct injury during LC were reviewed retrospectively. The features, diagnosis, treatment and efficacy of injury were summarized. Results All patients were successfully treated by Roux-en-Y cholangio-jejunostomy. Besides, 8 patients underwent plastic operation of bile duct of hepatic portal and 3 patients middle lobectomy of liver. 22 cases were followed up at the 1st and 3rd year after surgery, and no bile duct stricture, recurrence of jaundice and cholangitis occurred. Conclusions It's a key to prevent bile duct injury during LC. The management of bile duct injury should be chosen according to injured time, sites and types.

Objective To explore the effect of radiofrequency ablation (RFA) combined with transcatherter arterial chemo-embolization (TACE) and percaulaneous ethanol injection (PEI) for unresectable hepatic malignancies. Methods The clinical data of 41 cases of unresectable liver cancer(URLC)treated by RFA,TACE and PEI were analysed retrospectively. Results There were 30 cases of primary hepatic cancer(PHT) and 11 cases of secondary hepatic cancer in this series.Ultrasound,CT and MRI showed the tumors shrinking or stable in 26 of the 41 patients postoperatively.AFP decreased to normal in 12 cases of 16 AFP positive PHT patients after operation. No severe complication was seen in the series. Conclusions RFA combined with TACE and PEI is a safe, well-tolerated and effective method for unresectable hepatic carcinoma, and may improve the treatment efficacy of URLC.

A modified dye test with microplate was to be established to detect Toxoplasma antibodies with cell-cultured Toxoplasma gondii. Numbers of stained and unstained tachyzoites were estimated in every 100 tachyzoites in each well after dyeing with methylene blue. The dilution with 50% tachyzoites stained was used as final dilution. Better results of the microplate dye test has been received when the concentration of tachyzoites in suspension reaches 109/ml with 1% sodium citrate as accessory factor.

Objective To study the clinical application and value of transcranial Doppler (TCD) monitoring senile cerebral blood flow autoregulation in elderly.Methods Two hundred cases patients with elderly hypertension and 200 cases normal eldly from May 2011 to December 2014 in the Second People 's Hospital of Fengrun District of Tangshan were chosen as hypertension group and control group.Cerebral artery peak systolic velocity,supine with a vertical artery in the brain(MCA) cerebral blood flow difference (CBFV) and X-W wave duration, cerebrovascular hemodynamic parameters of two group were monitored by TCD method and compared.Results The peak values of left vertebral artery (LVA), right vertebral artery (RVA), the left coronary artery(LCS), and right vertebral artery(RCS) of hypertension group were significantly lower than those in the control group((38.01±12.42) cm/s vs (45.21±8.95) cm/s, (35.54±13.25) cm/s vs (43.52±7.06) cm/s, (66.12±9.52) m/s vs (76.54±8.19) cm/s, (71.24± 11.25) cm/s vs (77.98± 10.74) cm/s, (55.34 ±14.52) cm/s vs (61.24±12.58) cm/s,(48.12±15.24) cm/s vs (58.46±18.85) cm/s;t=4.6821, 5.6987,6.2589,4.3671,2.2854,4.9875;P＜ 0.01).The peak Vp, the difference between the horizontal and vertical position CBFV, X-W wave duration, the parameter of DR, Cp, C, Co, Zc, Wv of arterial blood vessels (left internal carotid artery (LICA), right internal carotid artery (RICA), left middle cerebral artery (LMCA), right middle cerebral artery(RMCA) ,left anterior cerebral artery(LACA), right anterior cerebral artery(RACA), left anterior cerebral artery (LOA), right middle cerebral artery (ROA)) of hypertension group were significantly higher than those of control group((96.38±18.85) cm/s vs (83.56±13.41) cm/s, (103.04±35.42) cm/s vs (85.62±29.63) cm/s, (99.85±23.54) cm/s vs (83.12±22.67) cm/s, (102.84± 16.42) cm/s vs (86.23 ±21.34) cm/s, (85.06± 15.36) cm/s vs (73.16± 10.35) cm/s, (85.64± 15.34) cm/s vs (70.52± 18.56) cm/s, (34.85±8.74) cm/s vs (28.56±7.85) cm/s, (35.12± 11.20) cm/s vs (30.05± 6.88) cm/s, (7.22 ± ±2.54) cm/s vs (2.78± 1.87) cm/s, (23.74±5.23) cm/s vs (20.85±4.35) cm/s, (378.35±35.12) Pa? s/cm vs (314.53±36.21) Pa? s/cm, (8.16± 0.62) P/kPa vs (7.25± 0.68) P/kPa, (0.41 ± 0.05) ml/kPa vs (0.33±0.06) ml/kPa, (1.15±0.16) mL/kPa vs (0.84±0.13) ml/kPa, (346.13±42.63) dyn? s/cm5 vs (241.68±50.21) dyn? s/cm5, (21.47± 3.85) V/(cml? s) vs (11.24 ± 3.67) V/(cml? s);t =5.8954, 4.2589,4.8792,6.3985,6.3874,6.9852,5.6387,4.6892,6.0387,4.8562, 11.475,8.041,12.422, 11.820, 12.854,20.412;P＜0.01).Conclusion The function of automatic adjustment shows obvious abnormal cerebral blood flow in patients with hypertension, andthe TCD technology can response of cerebral blood flow autoregulation,which has important clinical value for diagnosis and treatment of cerebral infarction, stroke and other cardiovascular and cerebrovascular diseases.

Objective To explore cognitive change in schizophrenic patients with concomitant metabolism syndrome,and to provide theory basis for early intervention and treatment.Methods According to inclusion standard,56 schizophrenic inpatients with metabolism syndrome and 56 schizophrenic inpatients without metabolism syndrome were included.The matrics consensus cognitive battery(MCCB),stroop test,digit span,UPSA-B were used to assess the cognitive function.Results There were significant differences for test scores of symbol coding subtest,verbal memory subtest,digit sequence subtest,Maze subtest,continue performance among MCCB between schizophrenic patients with and without metabolism syndrome(27.07±10.46 vs 32.18±12.12,16.04±5.07 vs18.71±6.02,13.39±5.18 vs 15.79±5.48,1.38±0.66 vs 1.7±0.68,all P＜0.05),as well as stroop test and digit span test(31.14±11.68 vs 36.57±13.32,13.77±3.64 vs 15.82±4.38,P＜0.05 for both).Conclusion The schizophrenic patients with metabolism syndrome have severer cognitive impairment than those without metabolism syndrome.

Objective:To establish a matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) method for the direct detection of serum M protein without antibody enrichment, and to assess its detection performance.Methods:Method establishment. A total of 712 waste serum samples were collected from patients who applied for the M protein identification test in Beijing Chaoyang Hospital affiliated to Capital Medical University. The immunoglobulin light chain was obtained by reduction of IgG and IgA by TCEP, and the detection method was preliminarily determined. The waste serum samples from 20 healthy people were collected to determine the range of mass-to-charge ratios of κ and λ light chain ions. 8 parallel tubes and 8 batches were set up for intra-and inter-batch reproducibility evaluation. 10-fold, 100-fold and 200-fold diluted M protein from 23 positive samples were detected by established MALDI-TOF MS method, and its sensitivity was evaluated. 3 methods of IFE, SPE and MALDI-TOF MS were used to detect M protein simultaneously, and the coincidence rate between MALDI-TOF MS and IFE and SPE was calculated.Results:The repeatability within and between batches was 100%, respectively. The original, 10-, 100-and 200-fold dilutions of 23 M protein-positive samples were determined, and the detection limit of MALDI-TOF MS for M protein was 0.06-0.18 g/L. IFE as the gold standard, the overall coincidence rates of SPE and MALDI-TOF MS were 85.9% and 92.3%, respectively, and the positive coincidence rates of SPE and MALDI-TOF MS were 72.8% and 99.7%, respectively, of the 712 samples. Among the different types of M-proteins, MALDI-TOF-MS agreed 100% with IFE M-protein results for IgA, IgD, IgM, free light chain type and biclonal group, while the agreements of SPE for IgM, IgA and free light chain samples were only 66.7%, 58% and 19.5%, respectively. One positive sample in the IgG group was not detected by MALDI-TOF MS. 23 M-proteins positive samples were diluted by original, 10, 100 and 200 times to access the sensitivity of MALDI-TOF MS method. The coincidence rate of MALDI-TOF MS was 100% and IFE was 96% at 10-fold dilution. The coincidence rate of IFE was 28% and 23% of MALDI-TOF MS at 100-fold and 200-fold dilution, respectively.Conclusions:A MALDI-TOF MS method for the detection of serum M-proteins was successfully established. This method has the advantages of high detection throughput, fast speed, good sensitivity, specificity and coincidence rate.

English for medical laboratory is an instrumental course,which aims to develop students'competency in reading English literature,writing English scientific papers and conducting international academic exchanges in English.With the continuous expansion and deepening of international exchange and cooperation in laboratory medicine and the demands for training international talents in higher education in China,higher requirements have been put forward for the teaching quality of this course.According to the post competency requirements for professionals of medical laboratory,this paper mainly discusses the teaching mode of English for medical laboratory from the aspectsof educational concept,teaching material construction,teaching mode,assessment mechanism and teachers,hoping to play an active role in the teaching reform of English for medical laboratory at the undergraduate level.

Objective:To establish a candidate reference procedure for the enumeration of cell particles in urine and applied to the multi-center performance evaluation of an automated urine formed elements analyzer.Methods:According to the standardized mannual microscopic examination of fresh non-centrifuged urine samples and the recommended reference method for enumeration of cell particles in urine published by ISLH, we established a candidate reference procedure for the enumeration of cell particles in urine. From four class A tertiary hospitals′ clinical laboratories, three rigorous trained technicians per hospital tested the same specimen respectively using the reference procedure. Each specimen was repeatedly counted 5 times, obtaining the quantitative results of cell particles were obtained in urine. Four hospitals used the established candidate reference measurement procedure and the automated urine formed elements analyzer to detect 40 to 60 urine specimens from September 2020 to January 2021, and evaluate the established reference method, meanwhile evaluate the accuracy and consistency of the each count from automated urinalysis analyzer.Results:Using the candidate reference measurement procedures, the coefficient of variation of results derived from three trained technicians per hospital was less than 6.98% (red blood cells), 6.99% (white blood cells), 13.94% (epithelial cells) and met the quality requirements. The performance evaluation results of automated urine formed elements analyzer showed that the accuracy of red blood cells, white blood cells and epithelial cells met the requirements (bias≤4.98%) and was well consistent with the reference measurement procedure ( R2≥0.989). Conclusions:A candidate reference measurement procedure for the enumeration of urine cell particles was successfully established with satisfactory precision and accuracy. This procedure was applied to multicenter performance evaluation of an automated urine formed elements analyzer with good accuracy and consistency.

Objective:To construct machine learning models based on CT imaging and clinical parameters for predicting progression-free survival (PFS) of locally advanced cervical cancer (LACC) patients after concurrent chemoradiotherapy (CCRT).Methods:Clinical data of 167 LACC patients treated with CCRT at Shandong Cancer Hospital from September 2015 to October 2021 were retrospectively analyzed. All patients were randomly divided into the training and validation cohorts according to the ratio of 7 vs. 3. Clinical features were selected by univariate and multivariate Cox proportional hazards model ( P<0.1). Radiomics models and nomograms were constructed by radiomics features which were selected by least absolute shrinkage and selection operator (LASSO) Cox regression model to predict the 1-, 3- and 5-year PFS. Combined models and nomogram models were developed by selected clinical and radiomics features. The Kaplan Meier-curve, receiver operating characteristic (ROC) curve, C-index and calibration curve were used to evaluate the model performance. Results:A total of 1 409 radiomics features were extracted based on the region of interest (ROI) in CT images. CT radiomics models showed better performance for predicting 1-, 3-and 5-year PFS than the clinical model in the training and validation cohorts. The combined model displayed the optimal performance in predicting 1-, 3-and 5-year PFS in the training cohort [area under the curve (AUC): 0.760, 0.648, 0.661, C-index: 0.740, 0.667, 0.709] and verification cohort (AUC: 0.763, 0.677, 0.648, C-index: 0.748, 0.668, 0.678).Conclusions:Combined model constructed based on CT radiomics and clinical features yield better prediction performance than that based on radiomics or clinical features alone. As an objective image analysis approach, it possesses high prediction efficiency for PFS of LACC patients after CCRT, which can provide reference for clinical decision-making.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.