This paper reported 65 cases of hepatectomy on patients with intrahepatic cholelithiasis, among which 62 were left lateral lobectomy, 2 left hemihepatectomy and 1, right hemihepatectomy. The incidence of postoperative complication was 21.5%: incision infection (8 cases), subphrenic abscess (3 cases), biliary fistula (1 case), and septicemia and duodenal fistula which caused the death of the patients (one each). The complications are related to the number of previous operations, the biliary infection and the improper drainage. Attention should be paid to the following aspects to prevent complications: (1) strict observation of indications for hepatectomy; (2) correct management of the raw surface; (3) adequate maintenance of bile drainage; (4) proper choice of drains.

Objective To investigate the diagnostic value of tumor marker measurement in biliary juice obtained during endoscopic retrograde cholangiopancreatography (ERCP) in differential diagnosis of suspected biliary-pancrentic diseases.Methods ERCP was performed in patients with suspected biliarypancreatic lesions that could not be diagnosed by routine methods including ultrasonography,MRCP,blood biochemistry and serum tumor marker test,and biliary juice was obtained to measure tumor markers including CEA and CA199.A total of 29 patients with definitive diagnosis were recruited and divided into benign and malignant groups.Serum biochemical findings and tumor markers were compared between 2 groups.The diagnostic value of uhrasonography,EUS,MRCP,ERCP and ERCP combined with biliary tumor markers were also compared.Results There was no significant difference in serum biochemical findings,serum CEA,serum CA19-9 or biliary CA19-9 between 2 groups,while the average biliary CEA in malignant group was significandy higher than that in benign group (P＜0.001).The accuracy of ERCP combined with biliary tumor markers in diagnosing suspected biliary-pancreatic diseases was 69.0%,which was higher than that of ultrasonography (6.9%),MRCP (37.9%) and ERCP (41.4%),respectively.Conclusion The diagnostic accuracy of suspected biliary-pancreatic diseases can be improved through ERCP combined with biliary CEA test,which is helpful in differential diagnosis between benign and malignant lesions.

Diabetic peripheral neuropathy is one of the common chronic complications of diabetes, and TCM has unique advantages in the treatment of diabetic peripheral neuropathy. The article summarized the experimental research progress in the TCM intervention in treatment of diabetic peripheral neuropathy in recent years from the aspects of oxidative stress, metabolic disorders, neurological nutrition factor and neural microvascular dysfunction, with a purpose to provide better efficacy in clinical treatment.

Objective The aim of this study was to analyze the influence of combined therapy with L-carnitine and erythropoietin on renal anemia and nutritional status in patients treated with maintenance hemodialysis.Methods The combination of computer and manual searches were used.A Meta analysis was made regarding the effect of combined therapy with L-carnitine and erythropoietin on the improvement of renal anemia and nutritional status in patients treated with maintenance hemodialysis.The quality of the 9 studies was evaluated with the Jadad score.Statistical analysis was carried out by RevMan 5.0.Results A total of 428 patients in 9 reports were analyzed.Metaanalysis showed that there were significant improvement in hemoglobin (Hb) [WMD =9.21,95％ CI (7.69 ～10.73)] and hematocrit (Hct) [WMD =2.61,95％ CI (2.28 ～ 2.93)],albumin (ALB) [WMD =1.64,95％ CI (1.04 ～ 2.24)] and total protein (TP) [WMD =2.72,95 ％ CI (0.67 ～ 4.77)] in the treatment group compared with the control group.The level of erythropoietin dosage [WMD =-38.24,95％ CI (-76.87 ～ 0.39)] was decreased significantly.But there were no significant differences in triglyceride and serum phosphorus.Conclusion Combined therapy with L-carnitine and erythropoietin in patients treated with maintenance hemodialysis leads to significant improvement of renal anemia and nutritional status.

Objective To investigate the clinical features of small bowel Crohn's disease(CD).Methods From January 2009 to September 2012,a total of 138 patients diagnosed as CD who underwent examinations of colonoscopy,digestive tract radiography,capsule endoscopy,double-balloon enteroscopy and computed tomography (CT) enterography were enrolled.According to the Montreal Classification criteria,the disease was typed by the age at diagnosis,location of the lesions and behavior of the disease.The clinical symptoms,laboratory examinations,diagnostic methods and recurrence condition were also evaluated.Through the comparison of the clinical features of ileocolonic and colonic CD,the clinical features of small bowel CD were analyzed.Measurement data were analyzed with t-test,analysis of variance or non parametric test.Chi square test was performed for count data.Spearman's correlation analysis was used for correlation analysis and multivariate Logistic regression analysis was used for risk factors screening.Results A total of 62 (44.9％) cases were simple small bowel CD.Fifty-three patients (85.5％) were male,and the mean age at diagnosis was 35.3 years old.The age of 67.7％(42/62) of small bowel CD patients were less than 40 years old when diagnosed.The ratio of stricture in small bowel CD group (35.5％,22/62) was significantly higher than that of ileocolonic (18.8％,6/32) and colonic CD group (13.9％,5/36) (x2=6.594,P=0.037).Jejunal involvement was an independent risk factor for structure in CD (OR=3.481,95％ CI:1.250 to 9.693).The patients with obstructive symptoms as primary symptom in small bowel CD (38.7％,24/62) were more than those with colonic CD (16.7％,6/36) (x2 =5.210,P=0.022).However,patients with diarrhea as primary symptom in small bowel CD (21.0％,13/62) were less than those with ileocolonic (37.5％,12/32) and colonic CD (44.4％,16/36) (x2=6.512,P=0.039).Patients with two or more extraintestinal manifestations in small bowel CD (3.2％,2/62) were also significantly less than those with ileocolonic (15.6％,5/32) and colonic CD (19.4％,7/36) (x2=7.957,P=0.019).The score of CD activity index was generally low,and with no statistical correlation to serum inflammation markers such as C reaction protein.The average time duration between induction of remission and clinical recurrence of small bowel CD ((23.64 ± 17.08) months) was shorter than that of ileocolonic type ((35.07±29.84) months,t=-4.285,P=0.002) and colonic CD ((32.35 ± 28.46) months,t =-3.700,P =0.004).However,there was no significant difference in the rate of clinical recurrence between small bowel CD and ileocolonic,colonic CD.Conclusions Patients with small bowel CD account for a large proportion in patients with CD,especially in males.Stricture is more common in jejunum CD.The time duration between induction of remission and clinical recurrence of small bowel CD is short.

Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a unique primary epithelial tumor of the liver classified by the WorldHealth Organization (WHO) as a tumor containing elements of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC).The clinical diagnosis is established by histopathology and a firm pathological diagnosis from definitive evidence of HCC and CC differentiation.HCC-CC's clinical features tend to resemble hepatocellular carcinoma in regards to venous infiltration and like cholangiocarcinoma with respect to lymph node metastasis.To date,the biological behavior of HCC-CC remains ill-defined; however its prognosis seems to be worse than just HCC.Conversely,it is unclear whether the prognosis of HCC-CC is better than that of only ICC.This paper reviews recent studies on the clinicopathological behavior of HCC-CC.

In this paper the protective effect and facillitating reconverting effect of polypeptide from chlamys farreri (PCF) on thymocytes irradiated by 60 Co ? ray were studied using the MTT chromatometry .The results showed that:(1)the damaged extents of thymocytes were increased with the radiative intensity of 60 Co ? ray elevated at the range of 3GY to 9GY compared with that in no-exposure to 60 Co ? ray group.(2)PCF could reduce 60 Co ? ray damage on thymocytes with dose dependence .In the 0.25%~4% concentration range the higher concentration of PCF the stronger protective effects of it ,but the protective effect of PCF at the concentration below 0.5% disappeared while the radiative intensity of 60 Co ? ray was at 9GY.(3)PCF could facilitate the renovation ability of thymocytes after exposure 60 Co ? ray for two hours .And only 2% concentration of PCF showed the facilitating repair process of thymocytes after radiated by 60 Co ? ray for 7 hours .(4) PCF could decrease the activity and facilitate the death of the dying thymocytes after exposure 60 Co ? ray for 19 hours. The results suggested that the protective effect and facilitating repair effect of PCF on the thymocytes damaged by 60 Co ? ray may be mediated by the antisuperoxidation of PCF.

We used retroviral vector pLXSN to construct recombinant retroviral vectors with the human apoptosis gene, interleukin-l? converting enzyme (ICE). The vectors were introduced into packaging cell line PA317 by electroporation method. The G418 resistant colonies were selected, and the supematants of the colonies were used to infect the human hepatocellular carcinoma cell line SMMC7721. G418 resistant colonies of SMMC7721 were named SMMC7721-MCE and SMMC7721-neo. The results of RT-PCR analysis showed that exogenous hICE gene had successfully integrated into the genome of SMMC7721-hICE cells. The proliferation rate and tumorigenicity of cells in nude mice were examined. Our data showed that the growth rate and the tumorigenicity of SMMC7721-hICE cells in nude mice were considerablely decreased comparing with parent SMMC7721 and SMMC7721-neo. These results suggested that the retroviral vector expressing hICE gene was successfully constructed and could suppress the growth ability and tumorigenicity of human hepatocellular carcinoma cells, which provided a basis for further investigation of hICE gene therapy.

The goal of this work is to understand the difference between vertical structure and horizontal structure on data management. We take adverse event report as an example to find out the relationship between the storage space and the factors related to the trail. From the study we find out the difference of storage space between horizontal structure and vertical structure goes up with the increase of the storage space of each adverse event record and the number of adverse event allowed to record in the horizontal structure and goes down with the increase of the happening rate and the average times of the adverse event. When using the most widely used study design, vertical structure always takes less storage space than the horizontal structure. This vertical structure database is more suitable for the data management than the horizontal structure database.

Objective In this study we investigated the expression and protective mechanisms of Hsp22 and VEGF in brain tissue following cerebral ischemic reperfusion in gerbils and whether they are correlative. Method Forty five gerbils were randomly divided into there groups: Normal Group (n =5) ,Sham-operated Group and Ischemia-Reperfusion Group (I/R). Sham-operated Group and I/R Group were divided into four subgroups (each group has five animals) : 6 hours group, lday group, 3days group, 7days group. Histological analysis of tissue injury was carried out by staining with haematoxylin and eosin haematoxylin and eosin (HE). Result The tissues of normal group and sham-operated group was integrated, but that of I/R were changed with gliocyte hyperplasia and hypertrophia, interstitial edema, cellular edema, gliocyte and neuron edema , neuron necrosis. The data presented here provided a positive correlation between expression of Hsp22 and VEGF. Conelusions There was a positive correlation between expression of Hsp22 and VEGF after gerbils brain I/R injury.