Objective To evaluate the clinical effectiveness of laparoscopic cholecystectomy ( LC) combined with endoscopic sphincter-otomy ( EST) for treatment of gallstones with common bile duct stones. Methods Clinical data of 652 patients who were treated by LCs and ESTs were retrospectively analyzed. Results ESTs were successfully accomplished in 634 patients (97. 2%), and LCs were successfully ac-complished in 621 among the 634 patients (97. 9%) after ESTs. The mean length of hospitalization after LCs was 4 days (2~15 days). In all 652 patients, there were 233 cases of acute pancreatitis, including 171 cases before ESTs and 62 cases (13. 1%) after ESTs, and they were all cured after ESTs. In 621 patients after LCs, bile leakages occurred in 8 patients (1. 2%) and they were cured with intraoperative drainages. Local fluid accumulations occurred in 120 patients (19. 0%), and 118 cases of them healed without management, and the other 2 cases were cured with percutaneous tube-placement drainages guided by ultrasonography because of abscesses. Conclusion It is safe and effective to treat gallstones with common bile duct stones by LC combined with EST because of its high success rate, short hospital stay and mild complications.

Objective To investigate the expression and clinical significance of CDx2 and hepatocyte antigen(Hep) in gastric carcinoma.Methods The expression of CDx2 and Hep in 9 cases of nomal gastric mucosa,15 cases of small intestinal mucosa,8 cases of colon mucosa,15 cases of intestinal metaplasia of the stomach and 130 cases of gastric carcinoma were detected with immuohistochemical EnVisionTM Systems measures.Results The positive rates of CDx2 expressed in the nomal gastric mucosa were 0,small intestinal mucosa 80%(12/15),colon mucosa 87.5%(7/8),intestinal metaplasia of the stomach 86.7%(13/15),gastric carcinoma 37.7%(49/130);The positive rate of Hep was 11.1%(1/9),86.7%(13/15),12.5%(1/8),100%(15/15),55.4%(72/130) respectively.There was much higher positive expression of CDx2 in intestinal-type carcinoma than in diffuse-type gastric carcinoma(P

Objective To explore the genotype distribution of methylenetetrahydrofolate reductase ( MTH-FR)C677T,A1298C and methionine synthase reductase (MTRR) A66G involved in the folic acid biosynthetic path-way among Chinese Han gestational age women in Sanhe City .Methods 601 samples were recruited from Sanhe re-gion,genomic DNA was obtained from the oral mucosa cells .The detections of MTHFR and MTRR gene polymor-phisms conducted with Taqman -MGB technology .The distribution of gene polymorphisms of this study was analyzed and compared with partial regions of China ,which were reported.Results The frequency of MTHFR 677TT among Sanhe women(37.40%) was significantly different to Yanbian (28.30%),Zhenjiang(21.84%),Songzi(15.40%), Deyang(13.80%),Huizhou(10.90%),Qionghai(6.14%),Zibo(43.6%) (χ2 =12.60,87.44,151.95,233.02, 61.87,446.90,7.27,all P<0.05).The frequency of MTHFR 1298CC(2.30%) was significantly different to Zibo (1.44%),Zhenjiang(3.50%),Songzi(2.60%),Deyang(6.26%),Huizhou(7.20%),Qionghai(7.13%) (χ2 =5.84,6.49,14.32,32.54,22.94,53.12,all P<0.05).The frequency of MTRR 66GG (7.50%) was significantly different to Qionghai (9.25%),Songzi(6.40%)(χ2 =16.34,4.10,all P<0.05).Conclusion The MTHFR, MTRR polymorphism distribution of Han women in Sanhe City is region specific ,respective .

Objective To evaluate the effect of surgical management of primary venous reflux disease in lower extremity. Methods Literatures about the surgical management of venous reflux disease in lower extremity were collected and reviewed. Results In patients with primary venous reflux disease,comprehensive surgical management of concomitant superficial,deep and perforating veins might greatly improve the clinical effect.Conclusion Comprehensive surgical management will be the direction of surgical management of primary venous reflux disease in lower extremity.

Objective To evaluate the localization of mitral valvular(MV)prolapse by transthoracic echocardiography(TTE),transesophageal echocardiography(TEE)and explore the interrelationship between the different subregions of MV prolapse and mitral regurgitation(MR).Methods Total of thirtythree patients with MV prolapse and more than moderate MR were included.TEE was used to further judge the location of scallop lesions and the result of both TTE and TEE were compared with the surgical findings respectively.The relationship between the different subregions of MV prolapse and MR was analyzed.Results Compared with the surgery findings,the accuracy rate of TTE and TEE in diagnosis of MV prolapse was 100％ qualitatively,80％ for TTE and 94％ for TEE in localizing the diseased region with the anterior and posterior MV,the result of TEE was significantly different from TTE(P＜0.05).MR level was related to the location of MV prolapse.Conclusions Compared with the TTE,TEE had more advantages in localizing the position of the MV prolapse.Mitral regurgitation is related to the location of MV prolapse.

Objective To investigate the CT signs of small intracranial aneurysm and the application value of multi-slice spiral CT angiography (MSCTA) before and after clipping surgery and in follow-up.Methods MSCTA imaging data of 81 patients with highly suspected small intracranial aneurysms from March 2013 to March 2015 were analyzed retrospectively.The confirmed patients underwent clipping surgery of small intracranial aneurysms.The imaging findings before and after clipping surgery were analyzed and compared with those by DSA and what observed during surgery.Results The relative accuracy,sensitivity and specificity of MSCTA over DSA and surgical diagnosis were 93.83％,93.75％ and 94.12％respectively,and MSCTA gained high relative consistency over DSA and surgical diagnosis (Kappa=0.825).The accuracy of MSCTA for diagnosing small intracranial aneurysm was not significantly different from those by DSA and surgical diagnosis.MSCT plain scan mainly showed subarachnoid or intracranial hemorrhage,and found 71 rhomboic or saccular aneurysms in 60 patients before operation.Totally 64 patients went through clipping surgery,60 ones had satisfactory results in the reexamination by MSCTA 2 weeks after surgery,and there were no abnormality found in 36 patients in 6 to 12-month follow-up.Conclusion MSCTA can provide abundant information for clipping surgery of small intracranial aneurysms,and can be used as the preferred imaging method for postoperative evaluation and follow-up.

To investigate the efficacy and safety of minimal y invasive endovascular techniques treatment of hydronephrosis in pregnancy complicated by infection.
65 cases of pregnancy hydronephrosis coinfected patients with minimal y invasive endovascular treatment. Patients were fol owed up for 3-12 months, compared with 48 patients with the same period of conservative treatment .
Ureteral perforation and other surgery-related complications occurred in 65 patients in the observation group has not occurred. The patient's duration of hospitalization、the recurrence rate of postoperative infection, antibiotic duration of treatment, fever days were significantly lower than the control group(P<0.05).
Compared with conservative treatment, minimal y invasive endovascular technical treatment of gestational hydronephrosis co-infection with faster recovery, shorter hospital stay, can significantly reduce the number of days of fever patients and reduce the number of days of antibiotic use, can be used as conventional means of treatment of gestational hydronephrosis infection combined conventional.

ObjectiveTo explore the expression of Glut1, HIF-1α and Ki-67 in hepatocellular carcinoma (HCC) and their relationship between their expression and clinicopathological features.MethodsImmunohistochemical study (EnVision method) for Glut1, HIF-1a and Ki-67 were performed on tissue microarray which consisted of 171 cases of HCC, 55 cases of adjacent non-neoplastic liver tissues, and 22cases of normal liver tissues.ResultsThe expression rate of Glut1 ,HIF-1α and ki-67 in 171 cases of HCC was 15.2％, 19.9％ and 66.1％, respectively, which was much higher than that in the adjacent non-neoplastic liver tissues (1.8％ ,1.8％and 5.5％) and normal liver tissues(all negative).The expressions of Glut1 and HIF-1α were positively correlated with the differentiation degree of HCC and TNM stage(P ＜0.01, P ＜0.05).The expression of ki-67 was positively correlated with the differentiation degree of HCC.There was a significant positive correlation between the expressions of Glut1 and HIF-1α in HCC (r1 =0.553, P ＜0.05), the expressions of Glut1 and HIF-1α were positively correlated with ki-67(r2 =0.560,r3 =0.613, P ＜0.05).ConclusionsGlut1, HIF-1α and ki-67 may play a role in the tumorigenesis and progression of HCC in some degree.Combined detection of Glut1, HIF-1α and Ki-67 may be helpful to judge the degree of malignancy and potential metastasis and evaluate the prognosis.

Objective To explore the effects of cyclosporin A (CsA) and tacrolimus (Tac) on biological behaviors of lung cancer A549 cells in nude mice.Methods Thirty-six models of transplanted tumor in Balb/c mice were established by using lung cancer A549 cells and divided into three groups:control group,without given any immunosuppressant; CsA group,intraperitoneally given CsA; Tac group,intraperitoneally given Tac.The transplanted tumor growth curve was drawn according to the transplanted tumor volume,and the influencing ratio was calculated according to the final tumor weight.The changes in cell migration ability were observed by using Transwell system.Terminal deoxynucleotidyl transferase mediated UTP nick end labeling (TUNEL) assay was used to examine the apoptosis index of the transplanted tumor.Quantitative RT-PCR was used to detect the expression levels of Bcl-2 mRNA and Bax mRNA.Results The growth of transplanted tumor in CsA and Tac groups was faster than in control group.Final tumor volume and final tumor weight in CsA and Tac groups were greater than those in control group.The influencing ratio in CsA and Tac groups was 19％ (P＜0.05) and 25％ (P＜0.05),respectively.The migration ability was greater in CsA and Tac groups than in control group (P＜0.01).The apoptosis index of the transplanted tumor in CsA and Tac groups was lower than in control group (P＜0.05).The expression level of Bcl-2 mRNA was higher in CsA and Tac groups than in control group (P＜0.05),and that of Bax mRNA was lower in CsA and Tac groups than in control group (P＜0.05).Conclusion Both CsA and Tac can promote the growth of transplanted tumor in nuce mice bearing 549 cells and enhance the invasion forces,which is probably related with the apoptosis induction of tumor cells.

Objective To investigate the relationship of plasma homocysteine with the genotype distribution of MTHFR and MTRR among Chinese Han women in Xiangtan. Methods MTHFR C677T, A1298C and MTRR A66G geno?typing was analyzed to detect the distribution of gene polymorphisms among 1 701 women from Xiangtan city then the data were compared with the rest of the Han women in Zibo, Zhengzhou, Yantai, Zhenjiang, Songzi, Huizhou, Qionghai. Plasma Hcy levels from 110 patients were measured and analyzed the correlation with gene polymorphisms. Results The frequency of MTHFR C677T genotype and allele frequencies in Xiangtan is 12.6%which is higher than Huizhou (10.9%) and Qionghai (6.1%) but lower than Zibo (43.6%), Zhengzhou (36.8%), Yantai (32.2%), Zhenjiang (21.8%) with statistically significant dif?ference (P<0.05). There is no significant different in MTHFR C677T between Xiangtan and Songzi. The frequency of MTH?FR A1298C genotype and allele frequencies in Xiangtan is 4.8%which is lower than Qionghai(7.1%)but higher than Zibo (1.4%),Zhengzhou(2.4%), Yantai(1.8%), Zhenjiang(3.5%)and Songzi(2.6%)with statistically significant difference. The frenquency of MTRR A66G genotype and allele frequencies in Xiangtan is 6.8%which is higher than Zibo (4.8%) but lower than Qionghai (9.3%) with statistically signifcant difference. Plasma Hcy concentration correlate with MTHFR C677T, Hcy concentration in TT population is higher than that in CT and CC population(μmol/L:8.52±2.01 vs 5.94±1.47 vs 5.71± 0.18);Plasma Hcy concentration also correlate with MTHFR A1298C and Hcy concentration in CC population is higher than AA and AC population(μmol/L:9.83 ± 2.26 vs 6.35 ± 2.13 vs 5.55 ± 1.75);Plasma Hcy concentration does not correlate with MTRR A66G. Conclusion The gene polymorphism of MTHFR C677T, A1298C and MTRR A66G among the Han women in Xiangtan was statistically different from other selected regions of China. Mutation in MTHFR C 677T and A1298C were associated with elevated plasma levels of Hcy.