Objective To investigate the cause,prevention and treatment of bile leakage. MethodsThe clinical data of 22 cases with bile leakage treated from Jan.1993 to Dec.1998 were reviewed retrospectively. Results Of the 19 cases treated with nonoperative therapy,1 patient died,3 patients were transferred to be operated later, and the other 15 cases were cured. The cure rate of nonoperation was 79%(15/19). 3 patients were cured with emergent operation at the beginning of bile leakage. Of the 3 cases who were transferred to be operated later,2 cases were finally cured by operation while the other 1 patient was not cured.The total cure rate was 91%(20/22). ConclusionBile leakage often oocurs in cholecystectomy procedure and after removal of a T tube, which is mainly related to inflammation, adhesion, abnormality of anatomy and incorrect manipulation. In order to prevent it,surgeons should pay more attention to the 3 links of prirnary procedure, including preoperative preparation,operative management and postoperative treatment. Different treatments are optional according to the degree of leakage and the condition of patients.

Objective To investigate the causes and preventive measures of recurrent pain after laparoscopic cholecystectomy (LC). Methods From January 2000 to January 2006,168 patients developed recurrent pain after LC. The pain was caused by non-incisional wound,postoperative complications,relapse of preoperative symptoms,cholecystitis complicated with gallbladder stones,or other diseases. The data of the cases were reviewed in this study. Results Among the cases,24 patients had neck and shoulder pain,and 5 cases complained of puncture pain; 71 cases showed consistent abdominal pain,among which 28 had bile leak; 23 developed secondary common bile duct stones,6 suffered from acute pancreatitis,and 8 had residual cholecystitis or cholecystic stones; inferior hepatic space inflammatory fluid was detected in 5 cases,duodenal bulbar ulcer in 1 case; and 32 cases suffered from paroxysmal pain in the abdominal cavity,9 of them were diagnosed as bowel hyperperistalsis,and 23 had biliary dyskinesia; 31 patients had jaundice complicated with abdominal pain,right focal dilation of the intrahepatic bile duct was detected in 7 of them,residual stones in the extra hepatic bile duct in 11 cases,ampullary carcinoma in 2 cases,carcinoma in the inferior bile duct in 1 case,and ascariasis of the biliary tract in 2 cases; two patients developed abdominal pain because of abdominal distension,and one was induced by severe nausea and vomiting. In this series,the symptoms were relieved in all of the cases,86 of them were cured by a second operation or ERCP plus EST,and the other 82 received conversational therapy. The patient was followed up for 1 to 36 months,during the period,no complications occurred. Conclusions The causes of recurrent pain after LC involve in each component of perioperation procedures.

OBJECTIVE To investigate the causes and preventive measures of postoperative pneumonia due to cervical part and upper thoracic part esophageal carcinoma surgery. METHODS Fifty seven cases with cervical part or upper thoracic part esophageal carcinoma from 2001 to 2005 were studied restropectively. RESULTS One patient died of aspiration pneumonia,one died of anastomotic leakage,and three died of adult respiratory distress syndrome(ARDS).The tracheotomy and mechanical ventilation were applied.Pneumonia was confirmed among sixteen patients at different degree. CONCLUSIONS Many causes contribute to postoperative pneumonia on patients with cervical part or thoracic part esophageal carcinoma,and the lesion of recurrent nerve is an important reason.Protection of recurrent nerve may decrease postoperative pneumonia.

For many years, TCM formula granules, as a new form of decoction pieces reform, have been favored by people with its three features—Three Efficacy, Three Small and Five Conveniences. As a result, it has become the ideal product in the course of TCM internationalization. In the face of growing sales, to formulate its standard becomes imminent. Therefore, how to establish a system that is unique to standardization of TCM formula granules has become a research hotspot of scholars. This article summarized Results of recent research on the preparation, quality control, pharmacology studies and clinical evaluation of TCM formula granules, with a purpose to put forward relevant suggestions, and provide references for standardization of TCM formula granules.

Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.

Objective To study the correlation between spiral CT(SCT)feature of non-small cell lung cancer(NSCLC)and the levels of soluble Fas(sFas)and FasL(sFasL)in serum.Methods 32 cases of NSCLC proved pathologically and examined with SCT were analyzed retrospectively.Serum level of sFas and sFasL were determined by double antibody sandwich Enzyme linked immunosorbenl assays(ELISA).The SCT features were compared with level of sFas and sFasL.Results No significance was found between serum levels of sFas and sFasL and tumor type and size(P

Objective To investigate the relationship between growth inhibiting effect of arsenic trioxide(As_2O_3) and phosphorylation of P27kip threonine residue 187(P27T187) in human hepatocellular carcinoma(HCC) cell line SMMC-7721.Methods SMMC-7721 were treated for 72 h with 2 ?mol/L As_2O_3.The cell growth inhibition was detected by cell counting and the cell cycle was detected by flow cytometry(FCM).The expression and localization of P27,T187 phosphorylated P27(p-P27T187) were detected by Subcellular Fractionation,Western blot and immunoflurescence.Results As_2O_3 significantly inhibited the proliferation of SMMC-7721 cell and cell cycle was arrested in G2/M.A significant decrease in p-P27T187 expression and a reciprocal increase in P27 expression were found in 2 ?mol/L As_2O_3-treated SMMC-7721 cell.Meanwhile,As_2O_3 decreased the protein levels of Cdk2 and cyclinE.The location of P27 was transferred from cytoplasm to nuclei and the expression of p-P27T187 was decreased in nuclei.Conclusion As_2O_3 inhibits the phosphorylation of P27T187,thereby promoting P27 accumu-lation in SMMC-7721 cell nuclei,inducing cel1 cycle arrest and growth inhibition.

Objective To investigate the expression of C-JUN activation domain binding protein 1(JAB1)and its relationship with expression of P27 protein in human hepatocellular carcinoma(HCC),and to determine whether JAB1 is associated with clinicopathological parameters and prognosis of HCC.Methods Immunohistochemical analysis was performed to investigate the expression of JAB1 and P27 in 76 cases of HCC and adjacent nontumorous tissues.Fresh tumor tissues and their adjacent nontumorous tissues from 8 cases of HCC were collected for Western blot and immunoprecipitation assays.Results The expression of JAB1 in HCC was significantly higher than that in adjacent nontumorous tissues.In contrast,P27 level was higher in nontumorous liver tissues than that in HCC.JAB1 overexpression was correlated with histological differentiation,serum alpha-fetoprotein(AFP)level and metastasis(P

OBJECTIVE: Panel reactive antibody (PRA) can induce acute rejection following kidney transplantation, however, it is poorly understood which PRA is more associated with rejection. Therefore, the aim of this study is to analyze the correlation between PRA and rejection by observing the change of PRA Ⅰ and PRA Ⅱ prior to and after the kidney transplantation. METHODS: Levels of PRA Ⅰ and PRA Ⅱ were observed in 100 patients received kidney transplantation at the Department of Urology, Beijing Chaoyang Hospital Affiliated to the Capital Medical University. During these 100 patients, 18 patients had PRA changes after operation. The relationship between PRA changes after kidney transplantation and acute rejection were analyzed. RESULTS: Totally 18 patients were included in the final analysis. Nine of them occurred acute rejection with obviously increased PRA Ⅱ (P=0.040), however, the PRA Ⅰ had no significant changes (P=0.707). The changes of PRA Ⅰ and PRA Ⅱ had no significance in the remaining 9 patients prior to and after kidney transplantation. The overall level of PRA increased in 7 patients, in 5 patients with increased PRA Ⅱ, 4 patients suffered acute rejection, 1 of which was renal allogreft failure; 2 cases with PRA Ⅰ increasing did not occur acute rejection. The overall level of PRA declined in 11 patients, including 5 patients with PRA Ⅱ decreased, 1 patient occurred acute rejection; 4 patients in 6 patients with PRA Ⅰ declined suffered acute rejection. CONCLUSIONS: The increased PRA Ⅱ after transplantation easily result in acute rejection, which has definite correlation to acute rejection, however, the PRA Ⅰ changes has no impact on acute rejection.

Objective To study the effect of the Periopeiative manngement on successful surgical treatment of congenital esophageal atresia with severe pneumonia.Method To review the Periopeiative manngement in congenital esophageal atresia with severe pneumonia.Result 33 cases were healed and one csse had anastomotic stoma leak and 2 cases died.Conclusion The key of one stage successful surgical treatment of congenital esophageal atresia with severe pneumonia is the good Pefiopeiative manngement.