The extent to which sex influence CYP activity remains unclear in humans. Estrogen have widespread biologic actions especially estradiol , it can be used in ERT and Oral contraceptives. What is the effect of estrogen on drug metabolism and transport? If estrogen can regulate the genes of drug metabolism and transport,what is the mechanism.

Objective To discuss the management of bile duct injuries during laparoscopic cholecystectomy(LC).Methods From March 1992 to October 2006,totally 8876 cases of LC were performed in our hospital.Bile duct injury occurred in 16 of them,among which,the common bile duct was mistakenly cut in 4 cases,partly torn in 5,and wrongly clipped in 5,and electrical burn injury happened in 3.The patients received bile duct repair and T-tube drainage(6),bile duct anastomosis plus T-tube drainage(3),or Roux-en-Y bowel biliary anastomosis(5) after the accidents.In 2 patients,the titanium clips were removed.Results In one of the patients with the bile duct been cut,bile duct anastomosis was performed,and T-tube drainage was continued for 3 months;however,3 to 5 months after the T tube being removed,the patient had to underwent Roux-en-Y bowel biliary anastomosis because of biliary stenosis.No obstructive jaundice occurred in this patient after the Roux-en-Y.Two patients received a second t Roux-en-Y bowel biliary anastomosis owing to anastomotic stenosis.The second operation was carried out 9 or 10 month after the first surgery,and the patients were then followed up for 2 to 4 years.None of them developed cholangitis or calculi during the follow-up.One patient,who suffered a clipped bile duct,underwent Roux-en-Y bowel biliary anastomosis after the LC,but developed recurrent infection of the bile duct after the second operation.Among the 16 patients,12 were cured,10 of them were followed up for 3 to 4 years,during which no one showed biliary symptoms.Conclusions Bile duct injury is one of the major complications after LC.Early prevention and intervention are very important to avoid repeated operations.

Objective To investigate the effects of different operation methods for the treatment of distal tibial pilon fractures.Methods 40 cases of distal tibial pilon fractures were randomly divided into study group and control group,each of 20 cases.The research group used percutaneous insertion of the distal tibia locking plate internal fixation,the control group used the traditional open reduction and anatomical locking plate fixation.The average healing time,the incidence of complications and high rate of fracture healing were compared between the two group.Results The average healing time of the fracture study group(3.0±0.2)months was significantly shorter than that in the control group(4.0±0.3)months.Complication rate in the study group 5.0％ was significantly lower than that in the control group 35.0％.Fracture healing rate of study group 95.0％ was significantly higher than that of control group 65.0％.There was significant difference(P＜0.05).Conclusion The insertion of percutaneous locking plate fixation in the treatment of distal tibia has less trauma,simple operation,ankle joint function recovery,and the complication rate is low.

[Objective]To discuss the postoperative effect of the posteromedial structure injury (medial collateral ligament,MCL,posterior oblique ligament,POL) of the knee.[Method]Fourteen cases of complex posteromedial structure injury were treated from January 2002 to October 2007,twelve of which combined with ACL injury and two combined with PCL injury.Classification of posteromedial structure injury:typeⅠ,8 cases,ruptured from the femur with small bone fragment;type Ⅱ,2 cases,ruptured from the femur without bone fragment;typeⅢ,2 cases,the structure were torn from the body area,and type Ⅳ,2 cases,ruptured from the tibia.The injury were repaired by different techniques according to the classification.Eight cases applied star-shaped steel plate,four with GⅡ anchor screws(2 attached to the femur and 2 to the tibia adhesion respectively),and 2 cases with end-to-end suture.The ruptured ACL and PCL were reconstructed by arthroscopy.Autologous semitendinosus and gracilis were used for 8 ACL reconstruction and B-T-B technique for the other two ACL reconstruction.Two ruptured PCL were reconstructed with allograft of Achilles tendon.[Result]All cases were followed up for twelve months at average(6-18 months) except two cases only for four months.The functional score of the knees were improved from 56.7(50-60) preoperatively to 81.2(74-94) postoperatively in average valued by Lysholm system.Ten cases received normal knee flexion and extension range after repair of the posteromedial structure while 2 cases with restricted 5 degree extension.Nine cases received excellent result in lateral stress test while 2 cases with "+" and 1 case with "++" at zero angle.[Conclusion]Early repaire for the posteromedial structure injury will deliver excellent knee stability.

Objective To evaluate the safety of laparoscopic complete mesocolic excision (CME) in radical resection for right colon cancer. Methods From January 2012 to June 2013, laparoscopic CME was performed in 40 patients with right colon cancer. Another group of 38 patients underwent traditional radical resection from January 2011 to December 2011.Surgical outcomes were compared between the two groups . Results The number of lymph nodes retrieved in the laparoscopic group ( 22.1 ±7.8 ) was significantly more than that in the traditional group (18.6 ±4.3, t =2.436, P =0.017).In patients with stage Ⅲ cancer, the laparoscopic group was associated with higher lymph node counts (23.0 ±6.0 vs.18.2 ±5.1, t=2.699, P=0.000), however, there were no significant differences in those with stage Ⅱ cancer between the two groups (t=0.758, P=0.454).There were no differences in operation time and intraoperative blood loss between the two groups (t=0.716, P=0.476;t=-1.547, P=0.126), but in the laparoscopic group the time to pelvic drainage tube removal , time to first flatus, time to liquid diet intake , duration of hospital stay, and postoperative complications were significantly better than those in the traditional group (t=-2.950, P=0.004;t=-5.767, P=0.000; t =-7.817, P =0.000; t =-6.065, P =0.000; χ2 =4.504, P =0.034). Conclusions CME technique in laparoscopic radical right hemicolectomy is feasible , safe, and effective.CME improves the surgical quality with keeping the integrity of mesocolon , more harvested lymph nodes , and not increasing surgical risks and postoperative complications .

Objective To carry on statistical analysis of tradtional mongolian medicine syndrome in angina pectoris of coronary heart disease, find out the significative indices for syndrome diagnosis, and establish the diagnostic criteria of tradtional mongolian medicine syndrome in angina pectoris of coronary heart disease. Methods Cases of angina pectoris of coronary heart disease were selected according to modern medical diagnostic criteria. Clinical observations were carried on and clinical information was filled in the forms of the clinical cases. Each case was differentiated and made corresponding diagnosis of syndrome according to tradtional mongolian medicine. Clinical cases were grouped according to syndrome of tradtional mongolian medicine and decided the significative indices by statistical analysis. Results Four hundred and ten cases were differentiated which contain tradtional mongolian medicine information about angina pectoris of coronary heart disease, including 358 cases of Chu Si syndrome, 23 cases of Nian Xie syndrome, and 29 cases of Wei Sha syndrome. Through statistical analysis of the various syndromes and the objective indices, diagnostic criteria of tradtional mongolian medicine syndrome in angina pectoris of coronary heart disease was established. Conclusion Diagnostic criteria of tradtional mongolian medicine syndrome in angina pectoris of coronary heart disease was summarized by combination of disease and syndrome, and provides a theoretical basis for the resonable application of mongolian herb.

Objective To investigate the diagnostic value of two-dimensional and color Doppler ultrasonngraphy on diagnosis and judgement of prednisone withdraw in patients with subacute thyroiditis.Methods Sixty-six patients with clinically proved subacute thyroiditis underwent two-dimensional and color Doppler ultrasonography before treatment of prednisone. The ultmsonographic features and bloodtlow distribution in thyroid of these patients were analyzed retrospectively. Target of prednisone withdraw was judged according to ultrasonographic images (36 eases) and clinical symptom (30 cases). Results The ultmsonographic features of subacute thyroiditis mainly presented as bilateral or unilateral diffussion or focal low echogenicity in the affected thyroid, and color Doppler ultrasonography showed the increased vascularity around the lesions. Intraarterial bloodflow feature was low velocity and low resistance pattern, prednisone withdraw was performed according to ultrasonographic images after the treatment of prednisone, then relapse rate was decreased compared with the group of clinical symptom [8.33% (3/36) vs 26.67% (8/30)] (P <0.05). Conclusion Two-dimensional and color Doppler ultrasonography is highly valuable for diagnosing and treating subacute thyroiditis.

Objective To evaluate the effects of recombinant human bone morphogenetic-2-polylactide sustained release nanospheres (rhBMP-2-PLA-Ns) on cultured rabbit osteoblasts in vitro. Methods Rabbit osteoblasts were cultured in vitro, and rhBMP-2-PLA-Ns was added into the medium of the third generation of rabbit osteoblasts. The expression of the proliferating cell nuclear antigen (PCNA) was examined by immunofluoreacence staining, and the formation of tuberculums observed with alizarin red staining. Western blot was used to detect the effects of rhBMP-2-PLA-Ns on the expression of vascular endothelial growth factor (VEGF), which was compared with that in rhBMP-2 group and blank group. Results There was no significant difference in the number of osteoblasts with positive PCNA expression among three groups five days later. Ten days later, the number of osteoblasts with positive PCNA expression in rhBMP-2-PLA-Ns group was significantly higher than that in rhBMP-2 group and blank group, which indicated that rhBMP-2-PLA-Ns could enhance the expression of PCNA. Compared with rhBMP-2 group and blank group, rhBMP-2-PLA-Ns could significantly enhance the formation of tuberculums, with statistical difference (P<0.05). The expression of VEGF was detected in all three groups, and the level of the VEGF expression in rhBMP-2-PLA-Ns group was significantly higher than that in the other 2 groups (P<0.05). Conclusion The biological activity of rhBMP-2-PLA-Ns is superior than that of rhBMP2, and rhBMP-2-PLA-Ns can promote the proliferation, mineralization of osteoblasts and the secretion of VEGF, which has a better prospect in facilitating traumatic bone healing.

Objective To investigate the effects and advantages of laparoscopic hernioplasty for hernia.Methods From June 1995 to June 2005,222 patients with hernia were treated with laparoscopy.Transabdominal preperitoneal hernia repair(TAPP) were performed in 166 patients.Totally extraperitoneal hernia repair(TEP) were performed in 25 patients.Closure of the internal orifice of hernia was performed in 21 patients.Furthermore,incisional hernia in 2 patients, diaphragmatic hernia in 1 patient and mesenteric hernia in 1 patient were performed by laparoscopic hernioplasty and 6 patients with hernia of oesophagus finestra performed hernioplasty combined collapse gastric fundus with laparoscopy.In this series 45 patients associated with other abdominal disease were simultaneously treated with laparoscopy.Results All cases were operated successfully.The span of operation reduration was 42.5 min((10～180 min)).The average length of postoperative hospital stay were 4.6 days.There was one early failure owing to the use of too small a piece of mesh.Conclusion The results indicate that mesh repair of hernias is a satisfactory technique with a low recurrence rate and a low major complication rate.

BACKGROUND:A great development has been achieved in essential research on tissue engineered cartilage. However, its real application in otolaryngology has been rarely reported. It is faced with the topic to explore the simple and convenient method of repairing laryngeal cartilage by tissue engineering technique. OBJECTIVE:To compare the effect of porous spongy poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) seeded with chondrocytes or using senior tissue engineered cartilage in repairing al ogenic thyroid cartilage defects.METHODS:Chondrocytes at passage 3 were harvested from infant rabbits within 3 days. Porous spongy poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) seeded with chondrocytes composites were made by tissue engineering technique. The chondrocyte-poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) composites were co-cultured in vitro to form junior tissue engineered cartilage. And then respectively used for repairing the thyroid cartilage defects and directly transplanted with junior tissue engineered cartilage (experimental group A, n=5), or firstly the junior tissue engineered cartilage to be implanted subcutaneously for a period of time to further maturity for relative senior tissue engineered cartilage and secondly to be transplanted (experimental group B, n=5) into adult New Zealand white rabbits. Simple poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) sponge scaffold (control group A, n=4) and chondrocyte suspensions(control group B, n=4) were used as reparative materials in defect areas as control groups. Final y, the reparative effect was respectively studied grossly and histological y at 4 weeks (experimental group B) and 8 weeks (experimental group A, control group A and control group B) after transplantation. RESULTS AND CONCLUSION:The cartilage defects were wel repaired in the experimental groups. It was smooth between the reparative area and original cartilage without dents and defects. Both were similar grossly. But few chondrocytes at interfacial region between the reparative area and original cartilage and poor matrices were observed in the experimental group A. A Few chondrocytes and more matrices were observed in the experimental group B. Inflammatory cellinfiltration was not obvious in two experimental groups. Control groups showed soft tissue of dark-red color accompanied with local concave in gross specimens. Histological examination and special staining showed there were no cartilage-like structure and secretion of matrix components. The results showed that it is possible to repair thyroid cartilage defect using junior tissue engineered cartilage directly or junior tissue engineered cartilage after in vitro implantation in al ograft rabbits with immunity, and the immunoreaction is not obvious;in the same period, the repairing effect of mature tissue engineered cartilage is better than that of junior tissue engineered cartilage. However, application of junior tissue engineered cartilage directly can save time, costs, workload and operational link, and avoid the pain from secondary skin surgery, which is one of the more practical approaches.