Objective To explore the management of Ttube following laparoscopic common bile duct exploration.Methods A total of 420 cases of extrahepatic with or without intrahepatic bile duct stones were given laparoscopic common bile duct exploration with T-tube drainage from July 1997 to October 2004 in this hospital.The common bile duct stones were identified and then a laparoscopic choledochotomy was carried out to remove the stones.After stone clearance,the choledochotomy wound was closed with primary duct suture or with T-tube drainage.Results The primary closure of the bile duct was performed in 27 cases((6.4%)) while the T-tube drainage was conducted in 393 cases(93.6%).The stones were completely removed during the operation in 236 cases(56.2%).Stone removal under choledochoscope was required in 184 cases(43.8%) after operation.The T-tubes were removed in 209 cases after a T-tube cholangiogram at 3~4 postoperative weeks showing no residual stones.Follow-up examinations for 3(months ~ 6) years(mean,47.5 months) in 420 cases revealed 3 cases of recurrence.Conclusions After laparoscopic common bile duct exploration,the T-tube should be removed at 3~4 postoperative weeks in the absence of residual stones on T-tube cholangiogram.However,if residual stones were found on T-tube cholangiogram,a choledochoscopy is needed for stone removal at 6 postoperative weeks after the tubes clamped for 2 weeks.

Objective To evaluate short term effects of a single photodynamic therapy (PDT) treatment with visudyne (CIBA Vision Corp.) for choroidal neovascularization (CNV) in age ralated macular degeneration (AMD). Methods Thirty cases (35 eyes) diagnosed as AMD patients with classic CNV were treated with PDT. The data of visual acuity testing, fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography (OCT) were used to evaluate the effects of a single treatment of PDT before and 1 week, 1 ,3 month after treatment. Results The visual acuity of 34 eyes were stable or improved in 3 months follow up;and the visual acuity of 1 eye was decreased. Decrease or dispearance of fluorescein leakage from CNV was noted in 19 eyes. No serious complication occurred. Conclusion Single treatment of PDT for CNV in AMD can achieve short term decrease or cessation of fluorescein leakage from CNV without loss of visual acuity.

Objective To investigate the effect of xenon intervention on delayed neuropsychologic sequelae (DNS)in acute carbon monoxide(CO)poisoning.Method Adult Wistar rats were randomly divided into sustained group,early intervention group,and control group.CO(150 ml/kg)was infused by intraperitoneal injection to produce DNS model.In sustained intervention group(S-group),xenon(150 ml/kg/d)was infilsed by intraperitoneal injection for 2 weeks;in control group(C-group),xenon was replaced by equal volume air;and in early intervention group(E-tvoup),xenon(150 ml/kg/d)was,employed in the first 3 days and air(150 ml/kg/d)was substituted for xenon in the following days until 2 weeks after CO poisoning.Morris maze test was used to evaluate the intelligence of rats.The long-term potentiation(LTP)of hippocampus Was detected by neuroelectricity recording.The apoptosis rates in brain was detected by TUNEL staining.The data were expressed as(x±s)and analyzed with student's test and analysis of variance.A P value less than 0.05 indicated statisfical significance.Results After exposure to CO,poisoned rats showed intelligence decline,demyeliation ofwater matler and cell apoptosis increased,which were consistent with DNS.In S-group and E-group,the rates of DNS and apoptosis were significantly lower than those in C-group,whereas the rote of LTP in S-group and E-group Was significantly higher than those in C-group.Conclusions Early xenon intervention can effectively decrease the rates of DNS occurred after acute CO poisoning.

Objective To reduce the risk of blood transfusion ,and discuss the serological characteristic and cross‐match test of those patients who got positive both in autoantibody test and direct coombs test .Methods With absorption‐elution testing ,antibody screening cells and panel cells belong to different manufactures and batch numbers were applied to distinguish autoantibody from al‐loantibody within serum and reagent red cells for absorption test .Appropriate donors were selected to do cross matching test ;the specificity of autoantibody and alloantibody and the relationship between ABO blood type ,diseases ,anemic and the efficacy of blood transfusion were analysed .Results Among the 139 study subjects ,all of them were identified positive both in autoantibody and di‐rect antibody test ,including 20 cases just have autoantibody ,59 cases accompanied with Rh system or MNs system or Kidd system antibody ,47 with autoantibody except for alloantibody ,13 with drug resistant or other system antibody .Within the 221 cases of blood transfusion ,none of them has hemolytic transfusion reaction .We found a positive correlation(P<0 .05)between the intensity of agglutination of autoantibody and direct antibody and anima ,while a negative correlation(P<0 .05)with the efficacy of transfu‐sion .Similarly ,there is a positive correlation(P<0 .05)between the intensity of autoantibody and the sensitization of autologous e‐rythrocyte ,most of which are immunologic diseases ,while has no correlation with ABO blood type(P>0 .05) .Conclusion To those cases which were identified positive both in autoantibody and direct antibody test ,the degree of anaemia ,the numbers of transfusion and the efficacy of transfusion were associated with the intensity of agglutination of autoantibody and direct antibody .In order to de‐crease the risk of blood transfusion and make it highly efficient ,we should affirmed it if there is any autoantibody .In this process , an appropriate procedure and assay must be adopted .Besides ,relative antigen‐negative donors or high frequency local autoantibody need to be matched with corresponding the donors who have the same type of antigen .

Objective To compare the characteristics between indocyanine green angiography (ICGA) and fundus fluorescence angiography ( FFA ) in patients with age-related macular degeneration ( ARMD ). Methods Twenty-five cases ( 35 eyes ) were diagnosed as exudative ARMD by ocular examination. Their age ranged from 60 to 81 years. The visual acuities were 1.0 at FC/30 cm before eye. We analyzed and compared the characteristics of FFA and ICGA in these patients. Results 5 eyes ( 14.3% ) with classic choroidal neovascularization ( CNV ) were found by FFA examination. 15 eyes ( 42.9% ) with classic CNV were found by ICGA examination. Of 20 eyes with occult CNV considered by FFA, 7 eyes had classic CNV by ICGA. Of 3 eyes considered as serous retinal pigment epithelial detachment ( PED ) without classic CNV by FFA, 1 eye had serous PED with classic CNV and 2 eyes had classic CNV by ICGA.1 eye was diagnosed as serous PED with CNV by FFA, and as occult CNV by ICGA. Conclusions ICGA raise detectability and accuracy of CNV in ARMD compared with FFA. It is contributive to early treatment in ARMD.

Objective To explore the clinical effect of procedure for prolapse and hemorrhoids (PPH) treating for Ⅲand Ⅳ degree hemorrhoid under the local anesthesia.Methods One hundred and fifty patients with Ⅲ and Ⅳ degree hemorrhoid were divided into two groups randomly.One group was the local anesthesia group (LA group) which included 73 cases,the other one was the combined spinal epidural anesthesia group (CSE group) which included 77 cases.Compared the safety and efficacy of different procedure.Results The original symptom of the two groups were improved.There was a significant difference in the time of hospitalization time and the hospitalization expense between the two groups (P＜0.05).The LA group was(4.8±1.1)days with(3980±639)yuan,and the CSE group was(6.8±1.1) days with(5128±728)yuan.The rates of two groups of urine retention were 9.6% and 24.7% (P＜0.05) after the operation respectively,and there were no significant differences in recovery normal activity time,the pain index,copracrasia and pruritus,the bleed,the anal fistula,the prolapse of hemorrhoid,the skin tag (P ＞0.05).Conclusion PPH under the local anesthesia is safe,compare to the combined spinal epidural anesthesia,it excels in shortening the hospitalization time and reducing the hospitalization expense,also it can reduce significantly the rate of urine retention after operation.

Objective To investigate the basic data of risk estimation of lung cancer among non-uranium miners in China.Methods 2836 workers from 24 mines in 9 provinces/regions were face-to-face interviewed to collect information including age at exposure,exposure duration,cigarette smoking among others.Results Age of the investigated non-uranium miners ranged from 17 to 72(36.9±8.0)years.The miners received low and poor education,3% of them were illiterate,58% with primary and middle school education,only 7% with junior college and higher education.Seventy-five percent of the uranium miners are migrant rural workers.Ethnic minority miners accoungted for 16% of all the investigated miners.Among the migrant rural workers age at initial exposure was estimated to be 29.6±8.0 years.By the time of the investigation,46.7% of the miners had worked in the mine for five years and longer,working years in the mine was 6.7±6.8 years with a median of 4.1years.3.4% of the non-uranium miners began the initial radon exposure in mines before their 18 years of old.17.5% of the investigated miners reported working more than 8 h every working day.Among the males,58.0% were current smokers with a median of 16 cigarettes per day.Age to begin the cigarette smoking was 20 years on average.Current smoking rate was age-dependent,the rate as high as 69.2% for the males aged 15-19 years.Current smoking rate was significantly statistically lower in coal mines than that in other mines,49.0% vs 62.5%.Compared with other miners,more frequent mechanical ventilations were reported by coal miners,Conclusions In China non-uranium mines,75% were migrant rural workers,by the time of the investigation about half of them had worked in the mines for at least five years.Non-uranium miners began their mining at 30 years on average,with a very small percentage of 3%,exposed to the mining radon before their 18 years.Current cigarette smoking rate in non-uranium male miners was the same as the general male population in China.

Objective To evaluate the cancer risk among the inhabitants around a certain nuclear facility of Gansu Province after operation for nearly 50 years.Methods Specially developed forms were filled by countryside doctors in the villages 30 km on the leeward or at the lower reaches of Yumen City,Gansu Province where a nuclear facility had operated for nearly 50 years,to register the relevant data of those who died of solid cancer and leukemia during the period from 1 January 2004 to 31 December 2008 based on the relevant data and household survey.A town 90 km away from the nuclear facility with 4181 people were regarded as control area.Results The crude mortality and standardized mortality rate(SMR) of cancer were 95.51×10-5 and 93.56×10-5.respectively.The crude mortality and SMR of leukemia were 2.44×10-05 and 2.22×10-05, respectively.and the crude mortality and SMR of cancer were 106.88×10-05, and 89.31×10-5, respectively.The crude mortality and SMR of leukemia were 2.44×10-05 and 2.22×10-5, respectively in the investigated area,and the crude mortality of leukemia was 3.56×10-5 (only one leukemia cage died)in the control area in the same time.The cancer and leukemia mortality rates of the investigated area were similar to those of control area.Conclusions Nuclear facility does not significantly increase the cancer mortality among the residents living nearby.