Objective To evaluate the feasibility and safety of laparoscopic surgery in the treatment of acute pyogenic cholecystitis. Methods From January 2005 to May 2008,laparoscopic surgery was performed on 156 cases with acute pyogenic cholecystitis in our hospital. The clinical data of the patients were retrospectively reviewed. Four trocars were used for cholecystotomy. Major resection of the gallbladder or cholecystostomy was carried out if the anatomy of the Calot triangle was complex. Results Among the 156 operations,laparoscopic cholecystectomy was succeeded in 139 cases (89.1%); cholecystostomy was performed on 6 cases (3.8%); and 11 patients (7.1%) received laparoscopic subtotal cholecystectomy (LSC). None of the patients were converted to open surgery. The operation time ranged from 35 to 180 minutes with a mean of 75. Thirteen patients showed increased level of direct bilirubin and/or stones in the common bile duct (revealed by cholangiography during the bile duct dilation),and were cured by removing the stones under laparoscope and T tube drainage. The T tube was withdrawn in 2 months after cholangiography. Follow-up was available in all of the patients for 3 to 6 months. No jaundice,abdominal pain,fever or other complications occurred during the period. Conclusion Laparoscopic surgery is feasible,effective,and safe for acute pyogenic cholecystitis.

Objective:To observe the effect on ovarian cancer immunotherapy by dendritic cells (DC) which activated by Epithelial cell adhesion molecule (EpCAM) induce antigen-specific CD8+ cytotoxic T lymphocytes (CTL) and to provide some help to ovarian cancer immunotherapy.Methods: Interleukin (IL)-12,and IL-10 of DC were tested after inducing by EpCAM.Subsequently,EpCAM specific CTL CD8+ was induced by EpCAM-DC.The therapeutic effect and interferon (IFN)-γ of EpCAM-DC-CD8+ CTL on normal ovarian epithelial cells IOSE80 and ovarian cancer cell SKVO3 was detected.After treatment of EpCAM-DC-CD8+ CTL,the volume of ovarian tumor of bearing BALB/c-nu/nu mice was detected.Meanwhile,the morphology changes of tumor tissue were observed by HE staining.Results: Compared with PBS,EpCAM stimulation significantly inceased surface markers DC80,DC83,DC86 and HLA-DR levels,and added up to 4.79,4.85,4.60 and 10.91 times (P<0.05).EpCAM stimulation significantly increased the expression of IL-12 and reduced the secretion of IL-10 (P<0.05).Both of DC-CD8+ CTL and EpCAM-DC-CD8+ CTL resulted in minute amount of IOSE80 cell killing (P>0.05).However,the killing rate of EpCAM-DC-CD8+ CTL on SKVO3 cells was 6.82-folds as much as that of DC-CD8+ CTL.Animal experiments showed that ovarian cancer transplantation tumor volume ratio after EpCAM-DC-CD8+ CTL treatment,was significantly lower than PBS group and DC-CD8+ CTL group,which reached 0.27 and 0.28 times,respectively (P<0.05).HE staining showed that EpCAM-DC-CD8+ CTL treatment resulted in significant changes of tumor tissues in pathology.Conclusion: EpCAM protein stimulated the maturation of DC that induced the production of EpCAM specific CD8+ CTL.EpCAM-DC-CD8+ CTL can effectively kill ovarian tumor cells and delay the growth of tumor,which is of great significance for the immunotherapy of ovarian cancer.

Objective To investigate the interference effect of nerve growth factor (NGF) on apoptosis of retinal cells in experimental retinal detachment (RD). Methods Twenty seven Sprague-Dawely rats were selected, and the left and right eyes were in the experimental control group and NGF group, respectively. After the RD model was set up by subretinal injection with sodium hyaluronate, 5 ?l NGF (1 ?g?l) was injected into the vitreous body of the right eyes which were in the NGF group; 5 ?l PBS was injected into vitreous body of left eyes which were in the experimental control group. The injection was performed once every 4 days till the end of the observation period. The eye balls of the 27 rats were extrafted 1.5, 3, 6, 12 hours, 1 day, 2, 4, 8, 16, and 32 days after the RD model was established. Another 2 rats were selected as the normal control, which underwent none of the injections but eyeball extraction at the end of the observation period. TUNEL and transmission electron microscopy were used to detect the apoptosis of the retinal cells. Cell counts and statistical analysis were used to assess results. Results Typical apoptosis cells were observed in the early time of RD. Apoptosis was found in each retinal layers, especially in inner and outer nuclear layers. The number of apoptosis cells increased as the time of RD was prolonged(P

Through comparing problem-based learning and lecture-based learning, the PBL teaching can improve the learning interest and self-learning ability of students and also can accomplish the task of teaching better.

Objective:To review and compare the clinical features and treatment outcomes of oral and maxillofacial space infection (OMSI)between diabetic and non-diabetic patients.Methods:Clinical data of 43 diabetic patients with OMSI(simultaneoustly treated by blood sugar control)and 84 of non-diabetic patients with OMSI were reviewed,the clinical features and treatment outcomes were compared.Statistical analyses were conducted by T test,the chi square test and variance analysis.Results:Diabetic patients with OM-SI were older(P =0.000),had more spaces involved concurrently(P =0.035 )and had higher blood sugar at presentation(P =0.000).There was no significant difference between groups about the use and change of antibiotics,the incision times,hospital stay durition and the incidence of the complications.Conclusion:The prognosis of the diabetic patients with OMSI under the strict control of the blood glucose concentration has no significant difference from the non-diabetic patients with OMSI.Diabetic patients with OMSI have older age and more spaces involved,and special attention should be paid.

AIM To develop an HPLC method for the simultaneous content determination of berberine hydrochloride,jatrorrhizine hydrochloride,palmatine hydrochloride,kaempferol,luteolin and apigenin in Qingre Zhili Pills (Berberidis Radix and Portulacae Herba).METHODS The analysis of methanol extract of this drug was performed on a 35 ℃ thermostatic Agilent TC-C18 column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.02％ potassium dihydrogen phosphate flowing at 0.9 mL/min in a gradient elution manner,and the detection wavelengths were set at 265 nm and 360 nm.RESULTS Six constituents showed good linear relationships within their own ranges (r≥0.999 3),whose average recoveries were 97.16％-99.90％ with the RSDs of 0.62％-1.48％.CONCLUSION This simple method can be used for the rapid quality control of Qingre Zhili Pills.

Objective To investigate the impact of nutritional risk of preoperative patients with different parts of colorectal cancer. Methods 385 cases of surgical patients diagnosed with colorectal cancer were selected in the retrospective study in April 2008 to March 2009, Gastrointestinal Surgery Center of West China Hospital in Sichuan University. Patients were divided into the right colon cancer group, the left colon cancer group, the rectal cancer group, using internationally recognized NRS- 2002 Scale and serum nutrition indicators to assess their preoperative nutrition. Results NRS-2002 score in the right colon cancer group showed higher than the left colon and rectal cancer group, but no statistical difference between the latter two rates; serum concentrations of HGB, TP, ALB, A/G were lower in the right colon cancer group than the other two groups, but the concentrations of ALT, AST, Ca2+, PO43-showed no statistical difference among three groups. Conclusions The proximal colon (right colon cancer) were more susceptible to the risk of preoperative malnutrition, the patients with different parts of colorectal cancer should be given to the corresponding preoperative nutritional assessment and nutritional support.

BACKGROUND:Human femur medul ary cavity has torsional anatomic structure. If the femur medul ary cavity’s torsional structure is copied to the stem of the prosthesis, the prosthesis wil transform the force loaded to torque between femur medul ary cavity and prosthesis stem, and the torque is transmitted to the proximal femur when the prosthesis is inserted in the medul ary cavity and load force on the prosthesis. OBJECTIVE:To optimize the force transmission of the proximal femur, and to avoid the stress shielding at the proximal end of the prosthesis. METHODS:We reconstructed a three-dimensional (3D) model of the femoral canal with the CT images of specimen femur and took the 3D model as the design model for prosthesis stem. The customized stem model and the proximal model of standard prosthesis could be put together to form customized prosthesis. We took advantage of robot grinding technology to manufacture the customized prosthesis, and matched it with specimen femur canal. Finite element analysis simulation and experimental methods were used to analyze the relationship between the loading force on the prosthesis and the micromotion of proximal end of the prosthesis. RESULTS AND CONCLUSION:The simulation and experimental results showed that the torsional structure matching by femoral canal and stem could effectively transmit the force on the prosthesis to the proximal end of the prosthesis in the form of torque. The torsional fretting of the proximal end of the prosthesis was related to the movement of the handle body. However, stem micromotion can be control ed by varying the matching size between stem and medul ary cavity.

Objective:To evaluate the effectiveness of syncope unit in improving the diagnosis efficiency and treatment prognosis of patients with suspected syncope.Methods:The standardized syncope unit was established in the Affiliated Nanyang Second General Hospital of Xinxiang Medical College in 2018. Patients with suspected syncope attending from November 2018 to April 2019 (before the establishment of syncope unit) and from May to October 2019 (after the establishment of syncope unit) were enrolled in the study. There were 109 cases attending before the establishment of syncope unit (control group) and 126 cases attending after establishment (syncope unit group). The positive rate of examination, the treatment and its cost before and after the establishment of syncope unit were compared. After one year, the follow-up rate, recurrence rate, rehospitalization rate, treatment satisfaction and quality of life of patients were documented and compared between two periods.Results:The positive rates of tilt table test [61.90%), Holter monitoring [64.29%(81/126)], exercise stress test [7.14%(9/126)] invasive electrophysiology [40.48%(51/126)], cardiac imaging [9.52%(12/126)] and 24-h blood pressure monitoring [55.56%(70/126)] in syncope unit group were significantly higher than those in control group [44.95%(49/109), 36.70%(40/109), 5.50%(6/109), 10.09%(11/109), 2.75%(3/109) and 40.37%(44/109); χ2=19.28, 23.11, 6.93, 28.18, 15.85 and 11.61,respectively; all P<0.01]. The diagnostic rate of etiology in syncope unit group was significantly higher than that in control group [87.30%(110/126) vs. 77.06%(84/109), χ2=21.70, P<0.01].The time from onset to cardiac assessment and hospitalization time in syncope unit group were significantly shorter than those in control group[(3.68±1.93)h vs. (7.31±2.64)h;(6.17±1.52)d vs. (10.83±2.09)d]. The hospitalization rate [3.17%(4/126) vs. 8.26%(8/109)], hospital mortality [0.79%(1/126) vs. 2.75%(3/109)] and treatment cost [(4.91±1.14) thousands Yuan vs. (7.05±2.53) thousands Yuan] in syncope unit group were significantly lower than those in control group ( t=14.49, P<0.01; t=8.62, P=0.02;χ2=15.83, P<0.01;χ2=10.03, P=0.01; t=6.17, P=0.03).The outpatient follow-up rate [82.54%(104/126)] and treatment satisfaction rate [91.35%(95/104)] in syncope unit group were significantly higher than those in control group [61.47%(67/109) and 64.18%(43/67)]; and the recurrence rate [14.42%(15/104)] and rehospitalization rate [7.69%(8/104)] in syncope unit group were significantly lower than those in control group [40.30%(27/67) and 23.88%(16/67)](χ2=17.30, 20.37, 18.56, 15.08,all P<0.01). The scores of psychological status, physiological status, environmental status, social relations and overall quality of life in contral group were significantly lower than those in syncope unit group (43.62±12.84 vs. 59.13±13.95,43.10±11.31 vs. 5.86±12.09,52.35±12.76 vs. 63.58±13.05,54.87±12.08 vs. 67.91±14.23,58.42±11.87 vs. 69.28±13.51; t=7.74, P=0.03; t=7.50, P=0.03; t=8.66, P=0.02; t=9.77, P=0.01; t=8.46, P=0.02, respectively). Conclusion:The establishment of standardized syncope unit is helpful to improve the diagnosis efficiency and the prognosis of patients with suspected syncope, and also reduce the cost of diagnosis and treatment.

Objective:To observe the clinical efficacy of combining neuromuscular joint facilitation (NJF) with floating needle treatment in treating stroke survivors with painful shoulder subluxation.Methods:Thirty-nine stroke survivors with painful shoulder subluxation were randomly divided into an NJF group, a floating needle group and a combination group, each of 13. In addition to the basic treatment for shoulder subluxation and pain (including positioning, physiotherapy, active and passive motor function training, progressive training of the upper limbs, and using shoulder pads to protect the affected shoulders when standing or walking), the 3 groups were also given NJF, floating needle therapy or both as their group names imply six days per week for 4 weeks. Shoulder subluxation was evaluated using ultrasonography to measure the acromion-greater tuberosity distance (AGT). Pain was self-reported using a visual analogue scale. And the Fugl-Meyer assessment (FMA) was applied to quantify the treatments′ efficacy.Results:Before the treatment, no significant differences were found among the 3 groups in terms of their average AGTs, pain ratings or FMA scores. Afterward, significant improvement was observed in all of the measurements in all 3 groups, with the combination group′s average results significantly better than those of the other two. The combination group′s overall effectiveness was 85%, significantly better than that of NJF group (54%) and the floating needle group (62%).Conclusions:Floating needle treatment combined with NJF and routine rehabilitation can significantly improve motor functioning and relieve the pain of shoulder subluxation after a stroke.