ObjectiveTo evaluate the intraoperative combined application of fibercholedochoscopy and B-type ultrasound for the treatment of intrahepatic biliary duct stones. Methods In our department 65 cases of intrahepatic biliary duct stones treated by fibercholedochoscopy and followed up for ten years were used as control. Results were compared with that of 78 cases undergoing combined management.ResultsFollow-up at first 5 years showed that patients treated with fiberbiliascopy had a much lower stone recurrent rate than that without, though difference became less significant within second 5 years. Intraoperative combined application of fibercholedochoscopy and B-ultrasound futher decreases the stone recurrence rate. ConclusionsCombining fibercholedochoscopy with B-type ultrasound intraoperatively enables the operator to locate intrahepatic biliary duct stones, reduces retained stone rate and stone recurrence.

Objective To study the compatibility and feasibility of construct tissue engineer bladder through biocompatibility of hair follicle stem cells (HFSCs) and heterogeneous bladder acellular matrix (BAM) in vitro and vivo.Methods The third-generation of rat HFSCs were cultured with the two-step enzymatic and different adhesion time method.The cells were identified by flow cytometry through detection expression of β1 integrin FITC-Conjugated.The New Zealand rabbit BAM were decellularized by the method of microdissection and chemical washing,and then examined by Masson staing and electron microscope to confirm no cell elements remained.The HFSCs of the rats were implanted in BAM and cultured for about 24 hours.Then the cells growth conditions on the material surface were examined by histology and scanning electron microscopy.The cells-scaffold composites were implanted in rats subcutaneously,samples and histological examination were harvested at 1,2 and 4 weeks after implantation.Results The BAM was white and translucent membranous.There were fiber network structures without cell elements remained under the examination of electron microscope.And the BAM prompted for collagen tissue composition under Masson staining,without significant residual cells.The growth condition of HFSCs beside the BAM was well that observed by inverted microscope at 48 h of co-culture.After 1 week the HFSCs extended and adhered to the matrix surface observed under the scanning electron microscope.No significant inflammatory response in rat subcutaneous implantation experiments,the single-layer cell structure in histological examination could be seen after 1 week,and multi-layer cell structure in histological examination could be seen after 4 weeks of implantation.Conclusion The biocompatibility of HFSCs and heterogeneous BAM is good,which provides a good experiment support for HFSCs to repair the bladder defects disease.

Objective To investigate the correlation of insulin resistance (IR) and benign prostate hyperplasia (BPH). Methods The 200 health examination men were divided into three groups according to the prostate volume (PV). There were 100 healthy subjects as control group (PV≤20 ml), 50 cases in BPH1 group (20 ml＜PV＜50 ml) and 50 cases in BPH2 group (PV≥50 ml).The fasting blood glucose (FBG) and fasting serum insulin (FSI) were determined using hexokinase method and radioimmunoassy, respectively. The IR index (IRI) and body mass index (BMI) were calculated according to the formula in HOMA model. Results There were no statistical differences between BPHl group and healthy control group in IRI (1.10±0. 18 vs. 1.18±0.21) and BMI (22. 0±3.0vs. 21.8±2.7) (t=0.74, 0.18, both P＞0. 05), but the IRI (1.31±0.19) and BMI (24. 8±3.29) increased in BPH2 group (P=0. 01, 0.03). The percentage of hyperglycosemia was higher in BPH patients than in normal controls (25% vs. 5%, P = 0. 00). Of them, the percentage of hyperglycosemia was the highest in BPH2 group (36%, P = 0. 01 ), their IRI ( 1.47 ± 0.21 ) was higher than in euglycemia patients (t=3.92, P=0.00), but the BM1 was unchanged compared with the control group ( 25.8 ± 4.3 vs. 24.3 ± 2.71, P = 0. 95 ). Conclusions There is a positive correlation of IR and hyperglycosemia with severe BPH, and the IR in severe BPH is independent of BMI.

Objective To analyze the regulatory T cell ( CD4 +CD25 +FoxP3 +T) levels in peripheral blood of patients with cavitary tuberculosis before and after surgery .Methods We compared the proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells in 13 patients with cavity tuberculosis pre-and post-operatively and in 10 healthy control subjects with flow cytometry .Results (1) The proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells were significantly higher in patients with cavity tuberculosis and at 1-month postoperatively than that in healthy controls(P<0.01).The proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells had no statistical significance between the patients with cavity tuberculosis at 6-months postoperatively and healthy controls (P>0.05).(2)The proportion of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells decreased significantly af-ter 6 months surgery than preoperatively in patients with cavity tuberculosis (P<0.01).(3)Pre-and post-operative proportions of CD4 +CD25high T cells and CD4 +CD25 +FoxP3 +T cells showed a positive correlation ( r=0.878,P<0.01 ) .Conclusion The proportion of the circulating T regulatory cells increases in patients with cavity tuberculosis , and decreases after surgery .Infection with M.tuberculosis may induce regulatory T cell-surface molecular changes.

Objective To study the clinical pathological features,treatment and prognosis of umbilical metastases of intra abdominal malignancies (sister Mary Joseph nodule, SMJN). Methods From January 1980 to July 2003, 17 SMJN cases were admitted. The clinical features were reviewed. Results The diagnosis of SMJN was confirmed by pathology in all cases, including epithelial ovarian carcinoma in 6 cases, gastric adenocarcinoma in 6 cases,colon adenocarcinoma in 2 cases, and endometrial carcinoma, gallbladder carcinoma and undifferentiated adenocarcinoma without identifying primary site in one each. Mean survival、half year、one year and two year survival rate in 10 palliative excision cases was 13 5 months、60%、20% and 10%, which were significantly better than 8 25 months、14 3%、0% and 0% in 7 conservative therapy cases ( P

Objective To explore the operation points of the steps offront-typehypospadias operation in oral mucosa urethroplasty and scrubbed shaped urethra with meat membrane covering.Methods After correction of chordee of penis of 40 patients with Front -type hypospadias, oral mucosa was transplanted and fixed on albuginea surface at the one-third of ventral penile for all the patients to increase the width of the urethra and form the urethra with the selected appropriate size ureter. The skin of dorsal penile was transferred to ventral penile. After clearing the pedicled skin flap, the subcutaneous layer of meat was kept down, and stamped wholly on forming place of urethral reel (including both sides inferior of cut-off cavernous body of glans penis),forming the glans again.Results There was no ankylo-urethria among the 40 front-type hypospadias operation, ureteroscopy examination after two months of the operation showed that all the transplanted oral mucosa survived, and the stamped subcutaneous layer of meat located at both sides inferior of cut-off cavernous body of glans penis adhered with satisfaction,no glans incision dehiscence,there occurred 2 cases of urinary fistula which had been cured by neoplasty,there was 1 case of transferred flap necrosis which had been cured after dressing change.40 patients were satisfied with penis appearance after operation.Conclusion Following up the operation points of “front-type”hyospadias operation,the success rate of operation can be improverd obviously,the plastic effect is good,and the complications after operation can be reduced.stamped wholly on formed urethra.There is a small probability of incidence of urethral stenosis and urinary fistula after operation.

0. 05) ; whereas Herrmann Ⅲ ,Ⅳand T3 ,T4(depth of invasion) were more often seen in advanced signet cell carcinoma (P 0. 05 ). Conclusion Compared with other pathological types, patients with advanced signet ring cell carcinoma of the stomach are with comparable long term survival.

Objective:To explore the clinical efficacy and safety oflumbrokinase in the treatment of acute and moderate risk pulmonary thromboembolism.Methods:The clinical data of 60 patients with acute and moderate risk pulmonary thromboembolism,who were collected from January 2010 to October 2015 in Hunan Provincial People's Hospital,were retrospectively analyzed.According to the different treatments,60 patients were randomly divided into a lumbrokinase group (lumbrokinase in combination with low molecular heparin and sequential warfarin,n=30) and a control group (low molecular heparin and sequential warfarin,n=30).The clinical efficacy and safety were compared between the two groups.Results:Compared with the control group,maximum short axis,ratio of right and left ventricles,systolic pulmonary artery pressure,and the main pulmonary artery diameter in the lumbrokinase group were significant changed after the treatment for 10,20 and 30 d.NT-proBNP level in the lumbrokinase group after the treatment for 10,20 and 30 d was significantly reduced than that in the the control group (P＜0.05).However,the value of PO2 significantly increased after 10,20 and 30 d,and there was no significant difference between 20 d and 30 d (P＞0.05).D-dimer in the two groups was obviously increased after treatment for 10 d,but it was significantly reduced after treatment for 20 d or 30 d (P＜0.05).The clinical efficacy of the lumbrokinase group was better than that in the control group,with significant difference (P＜0.05).Conclusion:Combination of lumbrokinase with low molecular heparin and sequential warfarin is a safe and efficient strategy in treating the patients with acute and moderate risk pulmonary thromboembolism.It is worthy of clinical popularization and application.

Objective To explore the proliferation characteristics of primary small intestinal epithelial cells of tree shrews and the characteristics of human rotavirus(RV) G1P[8] infection to these cells,and establish a model of tree shrew primary small intestinal epithelial cells infected with human rotavirus G1P[8].Methods The primary small intestinal epithelial cells were obtained by collagenase Ⅺ and dispase I digestion from tree shrew.After purification and identification,the obtained primary small intestinal epithelial cells were infected with RV.Then,culture supernatants of infected cells were collected every 12 hours after infection.Viral titer and viral load were subsequently determined.Western blot and indirect immunofluorescence observation were used to detect the expression of RV protein VP6 in the primary cells.The infectivity of RV to the tree shrew primary cells was finally evaluated.Results After purification and identification of primary epithelial cells from the tree shrew,high purity above 90% primary tree shrew small intestinal epithelial cells was obtained.These primary small intestinal epithelial cells could be infected with RV virus by comparing the virus infectivity to primary renal cells,HCT116 cells and MA104 cells.The virus titer reached to 2.0×105TCID 50/mL at 72 h after infection.Using Western blot and indirect immunofluorescence observation,the specific viral protein of VP6 was determined to be expressed in the tree shrew primary small intestinal epithelial cells,and were located in the cytoplasm from days 1 to 5.Conclusions The separation,purification and cultivation methods of tree shrew primary small intestinal epithelial cells are successful,and the tree shrew model of RV-infected the tree shrew primary small intestinal epithelial cells is successfully established.

ObjectiveTo explore risk factors of colorectal cancer with synchronous liver metastases and its prognosis. Methods From Aug 1994 to Feb 2004, 106 colorectal cancer patients with synchronous hepatic metastases were enrolled. Fifteen clinicopathological parameters were collected for mono-variable and multi-variable analysis. Treatment result was analyzed by Kaplan-Meier method and COX regression. Results Bowel obstruction, ascites, pelvic nodules, peritoneal invasion, serosal infiltration, organs involvement, tumor size, circumference of bowel invasion, depth of invasion were all individually relevant with synchronous hepatic metastasis. Logistic regression demonstrates depth of invasion, serosal infiltration, pelvic nodules and ascites were most important factors resulting in synchronous hepatic metastases. Radical resection(57 cases), palliative resection(39 cases) and laparotomy only(10 cases) resulted respectively in mean survival time and median survival time of 41.0 and 34.0 months,23.6 and 18.0 months,16.5 and 12.0 months,respectively (all P=0.0095).Surgery, location of tumor and pelvic nodules were independent prognostic factors. Conclusions Synchronous liver metastasis may present when primary tumor infiltrates serosa, or pelvic nodules and ascites are present. Radical excision significantly improves survival rate.