Objective To explore the feasibility and safety of day surgery laparoscopic cholecystectomy . Methods From January 2015 to June 2015, 78 cases of day-case laparoscopic cholecystectomy were performed in our hospital .The clinical data were retrospectively reviewed .These patients were diagnosed as having cholelithiasis or cholecystic poypus .They had no severe heart or lung diseases, no history of epigastric operation , and agreed to accept day-case laparoscopic cholecystectomy without overnight hospitalization. Results Of the 78 patients, 74 patients (94.9%) successfully accepted the surgery and were discharged no more than 4 h after surgery, including 2 patients with combined laparoscopic transcyctic common bile duct exploration ( LTCBDE).The remaining 4 patients (5.1%) were admitted for overnight hospital stay , including 1 patient (1.3%) with Mirizzi syndrome type Ⅰwho was given abdominal drainage , 2 patients (2.6%) with severe nausea and vomit , 1 patient (1.3%) with airway obstruction after operation.All the 4 patients were discharged within 24 h after the surgery.The operating time was 35-152 min (mean, 80.0 ±19.7 min).The hospitalization expenses was 5688-9768 yuan (mean, 8318.0 ±848.5 yuan).The hospitalization time was 5.6-23.9 h (median, 7.4 h).Postoperative follow-up at the day of surgery, the first and the seventh postoperative day showed that none of the patients suffered from severe complications . Conclusion Day-case laparoscopic cholecystectomy is safe and feasible , on the basis of strictly selected patients , experienced surgeons , and close cooperation with anesthetists and nurses .

Objective To explore the chronic effect of low levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin(TCDD) exposure on the protein expression profile in the serum of rats and to get the further understanding of the molecular mechanism of TCDD toxicity.Methods Thirty-two male SD rats were randomly divided into three TCDD exposed groups treated with TCDD at the doses of 875,350 and 140 ng /kg by gavage,once a week,for 29 consecutive weeks respectively and one control group treated with single corn oil.The proteins in the serum were separated and analyzed by two-dimensional gel electrophoresis and mass spectrometry,the histopathological examination of livers was performed at the same time.Results TCDD induced significant fatty degeneration and necrosis in the livers.Several interesting volume-altered protein spots were identified.Among these proteins,Bal-647 was down-regulated,apolipoprotein E was up-regulated by TCDD and fetuin-like protein was only expressed in the group of 875 ng/kg.Conclusion The differentially expressed proteins may contribute to a better understanding of the toxicity induced by TCDD and may be used as the biomarkers of effect for TCDD exposure.

BACKGROUND: A mass of unknown remains are founded in sodium hyaluronate product when it was tested for quality control. OBJECTIVE: To qualify and quantify unknown residual solvents of sodium hyaluronate product and determine hazardsaccording to standard toxicological data. DESIGN, TIME AND SETTING: A quality and quantity study with combined gas chromatography mass spectrometry was performed at National Institute for the Control of Pharmaceutical and Biological Products from May to June 2007.MATERIALS: Experimental samples were spot-checked, and purified water was also used.METHODS: The samples were qualified and quantified using combined gas chromatography mass spectrometry.MAIN OUTCOME MEASURES: Methanol, xylene and ethyl benzene were qualified and quantified.RESULTS: Combined gas chromatography mass spectrometry demonstrated that residual solvents in the sodium hyaluronateproducts were methanol, xylene, and ethyl benzene. The quantization of methanol was 414.365 μg/mL, the quantization of o-xylene was 0.19 μg/mL, and the quantization of ethyl benzene was 0.22 μg/mL. CONCLUSION: Methanol, xylene, and ethyl benzene were firstly identified as residual solvents in sodium hyaluronate products. Besides, we discussed methods of qualifying and quantifying these three residual solvents.

Objective To examine aortic dissection by using T1W/TFE sequence and to observe the imaging characteristics of aortic dissection in T1W/TFE sequence. Methods Twenty patients confirmed as aortic dissection by CT and ultrasound received MRI scanning of T1W/TFE sequence on inclined sagittal and SE sequence on transaxial at Philips Gyroscan 1.5 MR imager. The signal changes of aortic dissection in T1W/TFE sequence were observed. Results In T1W/TFE sequence, we observed not only an intimal flap, a double lumen and range of aortic dissection, but also the site of intimal tear and thrombus in the false lumen. Conclusion By using T1W/TFE sequence we obtained the high quality image of aortic dissection and high contrast of imaging. Combined with SE sequence , T1W/TFE sequence can provide reliable information for analyzing and curing aortic dissection in clinic.

In this commentary article, we introduce the definition, evaluative contents and methods of comprehensive geriatric assessment (CGA), as well as its successful application in Western countries. CGA is a multidisciplinary diagnosis and treatment process that identifies medical, psychosocial, and functional capabilities of elderly adults to develop plans including overall treatment, nursing, and follow-up to maximize overall health with aging. How to change this situation has become an important challenge due to the significant increase in postoperative complications, mortality, and treatment costs for elderly patients with surgical diseases. Current clinical evidence from Western countries supports that CGA can significantly improve recovery of function, reduce complications and mortality, greatly cut down medical cost, and improve medical utility of elderly patients with burn, trauma, and surgical diseases. Therefore, we advocate that CGA should be routinely used in elderly inpatients before non-cardiac surgical operation in our country.

Objective To investigate the effect of tea polyphenols on global cerebral ischemia reperfusion injury in rats.Method Forty-five pathogen-free male SD rats weighing 180-220 g were randomly divided into 3 groups( n =15 each):sham operation group (group S),cerebral ischemia reperfusion group (group IR) and tea polyphenols group (group TP).Global cerebral ischemia reperfusion injury was establish by four-vessel occlusion method.At 24 h of reperfusion,five rats were chosen and Evan's blue(EB) was injected iv,and then sacrificed and brain was removed for determination of EB content; another five rats were sacrificed and brain was removed for determination of water content; five rats were chosen for Morris water maze test.Result Compared with group S,EB content and water content in brain tissue were increased in groups IR and 'rP,and escape latency was prolonged,frequency of crossing the original platform was reduced in group IR ( P ＜ 0.05 ).Compared with group IR,EB content and water content in brain tissue were decreased,and escape latency was shortened,frequency of crossing the original platform was increased in group Tp ( P ＜ 0.05).Conclusion Tea polyphenols can attenuate global cerebral ischemia reperfusion injury in rats.

Objective To discuss the experience of open heart operation on beating in complex and severe congenital heart diseases. Method This kind of operation was put to use in 48 cases of the heart diseases in order to observe the effect of myocardial protection, prevention from air embolism,exposure of the operative field, and cardiopulmonary bypass. Results Operation field exposure was clear enough to finish the manipulation. One cases was eventiful postoperatively and died(2.08%). Conclusion Open heart operation on beating with slight hypothermia might have much feasibility in the part of complicated and severe congenital heart diseases.

Objective: To investigate the discrepancy of crown-root morphology of upper and lower central incisors in adult patients with different skeletal malocclusions using cone-beam CT (CBCT). Methods: Patients visiting the Department of Orthodontics, College of Stomatology, Xi′an Jiaotong University from January 2015 to December 2017 were selected, including 108 cases (52 males, 56 females, aged from 18 to 30 years, mean age 25.8 years). According to CBCT data and cephalometric analysis, 66 patients with average angle were selected as the sagittal skeletal group, including 24 Class Ⅰ patients, 20 Class Ⅱ and 22 Class Ⅲ patients. In the other selected 66 skeletal Class Ⅰ patients including 21 low angle patients, 24 average angle patients (from the sagittal skeletal Class Ⅰ subgroup) and 21 high angle patients. Invivo 5 software was used to locate the CBCT image three dimensionally and then obtain the middle labio-lingual section of right central incisor. Auto CAD 2007 software was applied to measure the angle formed by the long axis of root and the extension line of the long axis of crown (Collum angle), and the angle between the long axis of crown and the lip tangent line passing through the center of the labial surface of crown (labial surface angle). One-way ANOVA and Scheff were used to analyze the discrepancies among classifications and Pearson correlation analysis was used to determine the correlation between the Collum angles and labial surface angles. Results: Significant differences were found in Collum angles and labial surface angles among different sagittal skeletal patterns (P<0.05). The Collum angle of maxillary central incisors in Class Ⅱ patients was 5.18°±4.97° and the average labial surface angle was 17.78°±3.74°, which were both significantly higher than that of maxillary central incisors in Class Ⅰ and Ⅲ subgroups (P<0.05). Similarly, the above two angles of mandibular central incisors in Class Ⅲ were 5.59°±5.64° and 15.32°±3.05°, which were significantly higher than that of mandibular central incisors in Class Ⅰ and Ⅱ subgroups (P<0.05). There was no significant difference among different vertical skeletal patterns (P>0.05). Notably, the Collum angles of maxillary or mandibular central incisors presented significantly positive correlation with labial surface angles (maxillary: r=0.723, P<0.001; mandibular: r=0.752, P<0.001). Conclusions The long axis of the crown of the maxillary central incisor in skeletal Class Ⅱ patients and the mandibular central incisor in skeletal Class Ⅲ patients are obviously deviated toward the lingual side relative to the long axis of the root, and correspondingly there is a greater labial surface angle of the crown, which indicates that equivalent positioning deviation during bracket bonding can cause greater torque expression error.

Objective To find out the cognition and participation of people in the disease areas of Shandong Province on prevention and treatment of iodine deficiency disorders (IDD), and to evaluate the effectiveness of a health education project on prevention and control of IDD. Methods From 2011 to 2015, a prospective research was used in study, 46 iodine-deficient counties (cities, districts) were selected as project counties in Shandong Province each year, and 3 townships (towns) were chosen in each project county. Health educational activities on IDD prevention and control knowledge were carried out in the central primary school, 3 villages were chosen in each selected township (town) where the health educational activities in the community were carried out. Before and after the healthy education activities, questionnaire surveys on IDD prevention and control knowledge were conducted among 30 students of grade 5 in the central primary school and 15 housewives lived near the schools in each selected township ( town ) . Results After the health education activities , the knowledge awareness rates of students and housewives on IDD prevention and control were 96.06％ ( 61232/63471 ) and 95.44％(32576/34131), respectively, which increased significantly compared with those before the intervention [ 79 . 00％ ( 50038/63342 ) and 81 . 25％( 27281/33576 ) ] , and the differences were statistically significant (χ2 = 8435.19, 3326.19, P < 0.05). Among the primary school students and housewives, the knowledge awareness rates of IDD prevention were increased by 17.06％ and 14.19％, respectively. Conclusion After implementing the intervention measures of IDD health education, the awareness rate of IDD prevention and control knowledge in iodine deficiency areas in Shandong Province is significantly increased, which has achieved the effectiveness of IDD health education behavioral intervention.

Objective To compare biomechanical characteristics of external fixator, Kirschner’s wire, elastic stable intramedullary nailing (ESIN) for fixing proximal humeral fractures in children by finite element method.Methods The CT scanning data from the healthy humerus of an 8-year-old patient with proximal humeralfractures were collected, and the image data were imported in Mimics 21. 0 to establish the rough humeralmodel, which was imported in Geomagic 2013 to construct the three-dimensional (3D) model of cancellous and cortical bones of the humerus. After the model was assembled with 3 fixators ( external fixator, Kirschner’swire, ESIN), it was imported in ANSYS 2019 to simulate the upper limb under quiet, abduction, adduction, flexion, extension, external rotation, internal rotation working conditions. The maximum displacement of the distal humerus, the maximum stress of the fixture, and the maximum displacement of the distal fracture surface were analyzed. Results The minimum values of the maximum displacement of the distal humerus in models fixed by external fixator, Kirschner’s wire, ESIN appeared under extension (2. 406 mm), external rotation (0. 203 mm), external rotation (0. 185 mm) working conditions, respectively. Conclusions External fixator is the most unstable fixation of proximal humeral fractures in children, and the biomechanical performance of ESIN is better than that of external fixator and Kirschner’s wire fixation