Objective To explore the feasibility and value of laparoscopic cholecystectomy (LC) for acute cholecystitis complicated with incarcerated gallstones. Methods From January 2005 to December 2007,71 patients with acute cholecystitis complicated with incarcerated gallstones received laparoscopic cholecystectomy by using four trocars in our hospital. The Arteria cystica and ductus cysticus were operated successively. For widened ductus cysticus,we ligated the duct first and then cut it off. Afterwards,the wound on the liver bed and its margin were electrocoagulated. After the operation,a drainage tube was placed under the liver. Results Of the patients,the LC were successfully completed in 67 cases (94.4%),4 cases were converted to open surgery (2 of them had a disease course of less then 3 days,and one over 3 days). No biliary injury or death occurred in this series. The patients were discharged from hospital in 2-6 days (mean,3 days). No complication was found during a 6-month follow-up. Conclusions With the improvement of operator's proficiency and skills,LC becomes feasible and safe for acute cholecystitis complicated with incarcerated gallstones.

Objective To Study on regularity of iron deficient anemia(IDA) in gravida, provide preventive methods and improve hygienic quality.Methods IDA incidence rate of 12W～19W, 20W～27W, 28W～35W, 36W～pregnant duration were anlyzed in 521 gravida.Results The incidence of IDA in gravida was 16 87% and increased with the development of pregnancy.After 20 weeks of pregnancy,the incidence of IDA markedly increased accompanied with by the decreased Fe, SF and TS, especially during the 28～35 weeks of pregnancy, which reached the peak with the anenia incidence of 26 37%,and 80 50% of cases was irom deficient symptom,it suggesting iron deficiency in this stage and Fe, SF, TS decreased to the lowest level and the stored iron was almost exhausted and ZPP increased.Conclusions After 12 weeks of pregnancy,gravida should be supplemented with iron agent. It's also suggested that those gravida with gestational age older than 28 weeks with the Hb levels of less than 105g/L should be considered as IDA and should be treated with iron supplement. [

Objective To compare the concentrations of alpha-enolase (ENO1),CYFRA21-1,and CA125 in the patients with malignant pleural effusion ,tuberculous exudative pleural effusion ,or parapneumonia pleural effusion. To explore the clinical value of ENO1 in pleural effusion combined with serum CYFRA21-1 and CA125 in diagnosis of malignant pleural effusion. Methods Enzyme-linked immunosorbent assay(ELISA)was used to detect the concentration of ENO1 in pleural effusions. The concentrations of CA125 and CYFRA21-1 in the blood samples were measured using chemiluminescence and magnetic particle-based chemiluminescence respective-ly. The sensitivity and specificity of ENO1 combined with serum CYFRA21-1 and CA125 detection were calculated. Results The concentration of ENO1 in malignant pleural effusion group was significantly increased(P<0.001);the concentrations of ENO1 did not differ significantly between tuberculous exudative pleural effusion and parapneu-monia pleural effusion(P>0.05). The sensitivity and specificity of ENO1 combined with serum CYFRA21-1 and CA125 detection in malignant pleural effusion were 94％ and 74％,98％ and 98％,respectively. Conclusions ENO1 combined with serum CYFRA21-1 and CA125 detection can improve the sensitivity of diagnosis of malignant pleural effusion and enhance the diagnostic rate of malignant pleural effusion.