Objective To evaluate the applied of selected intraoperative cholangiography(SIOCG) during cholecystectomy.Methods The SIOCG data of 39 patients who had indications for exploration of common bile duct were analysed retrospectively.Results Among 39 cases with SIOCG,abnormal findings were detected in 19 cases(48.72%),in which choledocholith in 16 cases;stenosis of common bile duct at the third part in 3 cases.Positive findings in exploration of common bile duct were 14 cases(73.68%),in which,choledocholith were 12 cases inflammatory stenosis 1 case and tumor of common bile duct at the third part 1 case.Negative patients in exploration of common bile duct were 5 cases(26.32%).Normal imaging in 20 patients who did not underwent exploration of common bile duct had no disorders in follow-up.Conclusion SIOCG is safe,convenient,and useful in preventing the remnant stones and biliary tract damage and improving the quality of cholecystectomy.

Objective To analyse the pathogenesis,diagnosis and therapy for severe lung contusion.Methods 38 cases of severe lung contusion were observed.On the basis of lung contusion,the patients suffered from mltiple organs trauma,or abdomino-thoracic combinative trauma all of the patients were comprehansive treated with assited ventilation,antishock,high dasage hormone in short-time,dehydrating agent and diuretics therapy etc.Simultaneously,all of concurrent trauma were also reasonably managed timely which including closed thoracic drainage,open chest hemostasis,scavenging hematoma with craniotomy laparosplenotomy,hepatospleno-repair,gastroenterostomy,lower or upper extremity open reduction and extration etc.Results By oxygen inhalation comprehensive treatment did not improve the dyspnea symptom of severe lung contusion when the blood oxygen saturation was lower than 85% and further fall,the severe lung contusion patients were obviously improved by assited ventilation with respirator.Conclusions Using assited ventilation could raise the cure rate for the severe lung contusion,and simultaneously,early diagnosis and comprehansive treatment in time have identical importance.

We reported a case of nasal malignant granular cell tumor. The patient was a 51 years old man who went to the hospital because of "right nasal intermittent bleeding for half a year". The pathological examination after resection showed malignant granular cell tumor. No recurrence was noted during a year after resection. The etiology and pathogenesis, clinical features, pathological features and treatments of malignant granular cell tumor were reviewed.
Epistaxis ; Granular Cell Tumor ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Nose ; Nose Neoplasms ; pathology ; surgery

Objective　To study the distribution of insulin-like Growth Factors (IGFs) in liver、 spleen、kidney、thymus and supraadrenal glands of fetus from 16 to 24 weeks.Method　Using ABC immunohistochemistry. Results　 IGF-I positive cells were found in these organs during this period of fetal life, but the differences of number and reaction intensity of IGF-I positive cells appeared in different organs and individuals.Conclusion　These organs tissues can express IGF-I during fetal development and play paracrine and/or autocrine role in cellular proliferation and differentiation of these fetal tissue.

Objective To investigate the relationship between ovary excision and serum levels of TNF ?, TGF ? 1. Methods Serum levels of TNF ? and TGF ? 1 in ovariectomized rats were measured by ELISA. Results The serum levels of TNF ? were increased〔(53 88?16 35)ng/L〕, but the TGF ? 1 were decreased 〔(6 78?0 75)?g/L〕 in ovariectomized rats when E 2 decreased compared with those of the Sham group( P

At present, the formal bariatric surgery approved by the American Society for Metabolic and Bariatric Surgery (ASMBS) includes adjustable gastric banding (AGB), sleeve gastrectomy (Sleeve gastrectomy, SG). ), Roux-en-Y gastric bypass (Roux-en-Y gastric bypass, RYGB), biliopancreatic diversion with duodenal switch (BPD-DS), mini gastric bypass (Mini-gastric bypass, MGB), single anastomosis gastric bypass (OAGB) and partial endoscopic surgery. According to the Chinese Society for Metabolic and Bariatric Surgery (CSMBS), the Chinese Obesity and Metabolic Surgery Database (COMES Database), and the Chinese Obesity and Metabolic Surgery Database (COMES Database), the Chinese Society for Metabolic and Bariatric Surgery (CSMBS) Chinese Obesity and Metabolic Surgery Collaborative, COMES Collaborative), Shanghai Weight Loss and Diabetes Surgery Data Management System, Shandong Province Weight Loss and Metabolic Surgery Case Registration System, Jiangsu Province Weight Loss and Metabolic Surgery Data Registration System, Great North China Weight Loss and Metabolic Surgery Statistics from the clinical data database and the Greater China Weight Loss and Metabolic Surgery Database. The domestically developed and approved bariatric surgery methods include RYGB, SG, MGB, OAGB, BPD-DS, AGB, combined sleeve gastrectomy (SG Plus), Jejunoileal Bypass (Jejunoileal Bypass, JJB), single stoma duodenal transposition (SADI-S), intragastric balloon (Balloon). However, there are still some irregular bariatric surgeries in China, which will cause some uncommon complications and bring great pain to patients. At the same time, it is also a huge challenge for regular bariatric surgeons who perform corrective surgeries. This article will review the revision surgery after bariatric surgery in China in the past 20 years, discusses a series of problems caused by non-standard bariatric surgery and the development of regular bariatric surgery.

In this paper, a carbon dioxide trans-critical refrigerating system which is different from a conventional subcritical refrigerating cycle was studied. The trans-critical carbon dioxide refrigerating systems are based on the Gustav Lorntzen cycle. Emphasis was focused on how to determine the optimal discharge pressure of compressor in CO2 trans-critical cycle. The factors related with the optimal discharge pressure were analyzed. A formula was developed based on cycle simulation, which could be used to predict the optimal discharge pressure of a basic CO2 trans-critical cycle. After further studies on CO2 trans-critical cycles with a regenerator or expander, two more formulas were also developed. These formulas could provide an access to improve the COP of CO2 trans-critical cycle.

Polyunsaturated fatty acids (PUFA) was a functional component extracted from fish oil. The experiment results indicate that PUFA might inhibit platelet agglomeration induced by Adenosine diphosphate (ADP) in rabbit and rat. The results also suggested that PUFA has extent effect of anti-coagulation in mice. These effects are related with dosage of giving drug.

Objective To observe multiple metabolic changes within one year after Roux-en-Y gastric bypass (RYGB) surgery in obese patients with type 2 diabetes mellitus, and to evaluate the index of the gastric bypass surgery and the determination of applicable population. Methods The clinical and laboratory data before and after surgery in 112 patients diagnosed as type 2 diabetes mellitus by RYGB were included in this study. According to BMI, these patients were divided into two groups: normal group (≤ 25kg/m2), and the overweight group (> 25 kg/m2). The physiologic and biochemical indexes of the patients were followed up at 1, 3, 6, 12 months, respectively. The statistical analysis was performed by SPSS17.0 software. Results Compared with the preoperative period, the levels of HbA1c and HOMA-IR in the postoperative period were significantly increased in the two groups. Principal component analysis showed that the postoperatively contributions of BMI and HbA1c in 6 months was bigger than that of the other indexes, while HOMA-β, HOMA-IR had larger contributions after 6-month postoperative period. Conclusion Various metabolic indexes in patients with type 2 diabetes improve significantly within one year after surgery, and the complete remission rate is gradually increased. The indexes including weight, blood glucose, serum lipids, HOMA-βand HOMA-IR in overweight and obese group have more significant improvements than those in normal group. Obese patients are more appropriate for the surgical treatment. The indexes, such as BMI, HbA1c,HOMA-βand HOMA-IR, should help to evaluate the operating effectiveness and preoperative indications.

Objective To investigate the application value and feasibility of enhanced recovery after surgery (ERAS) in thoracoscopic and laparoscopic esophagectomy for esophageal cancer.Methods The clinical data of 304 patients with esophageal cancer who were admitted to the Affiliated Cancer Hospital of Zhengzhou University from December 2013 and July 2014 were retrospectively analyzed.All the patients underwent esophagogastric partial resection, esophagogastric cervical anastomosis and 2-field lymph node dissection under general anesthesia.The management of 195 patients guided by ERAS were allocated to the ERAS group and 109 patients receiving perioperative traditional treatments were allocated to the control group.Observing indicators included : (1) enteral and parenteral nutritional support treatments;(2) nutrient indexs: levels of serum albumin (Alb) and prealbumin;(3) the recovery of gastrointestinal function: time to anal exsufflation and defecation;(4) postoperative complications and the grading according to Clavien standard;(5) duration of postoperative hospital stay and treatment expenses;(6) risk factors affecting postoperative complications by multivariate analysis;(7) independent risk factors affecting occurrence rate of postoperative complications by univariate analysis.Measurement data with normal distribution were presented as (x) ± s and analyzed using the t test.Nonnormal distribution data were analyzed by the Wilcoxon rank sum test.Comparison of repeated data was analyzed by the repeated measures ANOVA.Categorical variables were analyzed using the chi-square test or Fisher's exact probability.The multiple linear regression analysis and Logistic regression were used to measure the multivariate analysis of continuous variables and binary variable, respectively.Results (1) During the enteral and parenteral nutritional support treatments, 11 patients with surgery-related complications in the ERAS group didn't receive oral intake at postoperative day 1,26 proceeded the intravenous rehydration at postoperative day 4 due to calorie intake less than 80％ of calorie requirement, and enteral nutritional support treatment was well-tolerated in the control group.(2) Comparison of nutrient indexs : the levels of serum Alb and prealbumin at postoperative day 1, 3 and 5 were (37.2±3.9)g/L, (39.1 ±3.5)g/L, (38.5 ±3.0)g/L and (0.20 ±0.06)g/L, (0.13 ±0.04)g/L, (0.13 ±0.04)g/L in the ERAS group, (37.7 ±2.8)g/L, (39.0 ±3.6)g/L, (38.4 ±3.8)g/L and (0.18 ± 0.06) g/L, (0.13 ± 0.04) g/L, (0.13 ± 0.04) g/L in the control group, respectively, showing no significant difference in the postoperative changing trends between the 2 groups (F =0.357, 0.453, P ＞ 0.05).(3) The recovery of gastrointestinal function : time to first anal exsufflation and first defecation were (2.1 ± 0.8) days and (3.4 ± 1.2) days in the ERAS group, (3.2 ± 0.9) days and (5.5 ± 1.5) days in the control group, respectively,showing significant differences between the 2 groups (t =-10.505,-13.174, P ＜0.05).(4) There was no death in the perioperative period.The overall incidences of postoperative complications and number of patients with severe complications were 26.15％ (51/195) and 8 in the ERAS group, 30.28％ (33/109) and 8 in the control group, with no significant difference between the 2 groups (x2=0.594, 1.469, P ＞ 0.05).Eight and 10 patients in the ERAS and control groups underwent gastrointestinal decompression, 6 and 8 patients in the ERAS and control groups underwent retreatment in the intensive care unit (ICU), 3 and 2 patients in the ERAS and control groups were readmitted to the hospital at 3 weeks after discharge, with no significant difference in the above indexes (x2=0.185, 2.892, P ＞0.05).(5)The duration of postoperative hospital stay and treatment expenses were (6.8 ±2.4)days and (25 088 ±10 336)yuan in the ERAS group, (11.1 ±3.4)days and (38 819± 14 854)yuan in the control group, showing significant differences between the 2 groups (t =-12.782,-9.452,P ＜ 0.05).(6) The age, gender, preoperative weight loss ＞ 10％, tumor staging, tumor differentiation,neoadjuvant chemotherapy and time of food intake were risk factors affecting incidence of postoperative complication in patients with esophageal cancer by the univariate analysis (x2=2.484, 2.333, 0.061, 8.553,2.459, 0.163, 3.462, P ＜ 0.05).(7) The age, preoperative weight loss ＞ 10％, tumor staging and neoadjuvant chemotherapy were independent risk factors affecting incidence of postoperative complication in patients with esophageal cancer by the multivariate analysis (OR =0.365, 10.761,0.290, 8.140, 95％ confidence interval :0.198-0.671, 4.122-28.095, 0.130-0.645, 3.946-16.791, P ＜0.05), but time of food intake was not an independent risk factor (OR =0.540, 95％ CI: 0.280-1.041, P ＞ 0.05).Conclusions ERAS in the esophageal minimally invasive surgery for esophageal cancer is safe and feasible, with the advantages of shorter recovery time of gastrointestinal function and duration of hospital stay, lower treatment expenses and a better application value compared with traditional treatment.