Objective To explore the clinical value of laparoscopy combined with choledochoscopy in repeat surgery for hepatolithiasis. Methods The clinical data on 86 patients who had undergone repeat surgery for hepatolithiasis during January 2010 to December 2015 were retrospectively analyzed. 36 patients received laparoscopy combined with choledochoscopy(laparoscopy group),while 50 patients received laparotomy(laparotomy group). Surgical duration,intraoperative blood loss,intraoperative transfusion,stone clearance rates,length of postopera-tive hospital stay,and rate of complications were observed and analyzed. Results There were no significant differ-ences in surgical duration,intraoperative blood loss,intraoperative transfusion,stone clearance rates,and rate of complications between the two groups(P>0.05). Length of postoperative hospital stay was significantly shorter in the laparoscopy group than in the laparotomy group(P < 0.05). There was no significant difference in recurrence rates of stone and cholangitis within the follow-up period(P>0.05). Conclusions Use of laparoscopy combined with choledochoscopy in repeat surgery for hepatolithiasis is safe and feasible and has a satisfactory efficacy.

@@

Objective To observe the effect of resveratrol on cognitive impairment in rats after chronic cerebral hypoperfusion,and to explore the underlying antioxidant mechanism of resveratrol.Methods The chronic cerebral hypoperfusion model was induced by permanent occlusion of bilateral common carotid arteries (2VO) in rats.Healthy male Wistar rats were randomly divided into 3 groups:sham-operated group,2VO group and 2VO+resveratrol group.Spatial learning and memory were assessed using the Morris water maze at 4 weeks after the occlusion.The levels of 4-Hydroxynonenal (4-HNE) and 8-Hydroxy-2′-deoxyguanosine (8-OHdG) in the cortex and hippocampal CA1 areas were detected using immunohistochemistry staining,for reflecting the lipid peroxidation and oxidative DNA damage.Results The escape latencies from the third day to the fifth day were longer in 2VO group than in sham-operated group[(42.1+5.4)s vs.(25.1±3.3)s,(36.4±4.4)s vs.(12.4±3.3) s,(30.4±4.0)s vs.(8.1±3.4)s,q=10.91、14.54 and 14.07,all P ＜0.01],while the time spent in the object square was shorter in 2VO group than in sham-operated group[(12.9+2.5)s vs.(18.9+2.2)s,q=6.47,P＜0.01].Compared with 2VO group,the escape latencies in 2VO+resveratrol group from the third day to the fifth day were shorter[(29.5+4.0)s,(25.6±4.3)s and (19.8±4.2)s,q=7.71,6.22 and 6.37,all P＜0.01],while the time spent in the object square was longer[(16.5±1.8)s,q=3.83,P＜0.05].Compared with the shamoperated group,the mean integral optical density (IOD) of 4-HNE and 8-OHdG in the cortex and hippocampus CA1 area were increased in 2VO group (265.1 + 9.0 vs.168.2 + 6.0,37.8 + 5.0 vs.24.0+4.0,q=31.89 and 7.48,both P＜0.01).And in the 2VO+resveratrol group,the mean IOD of 4-HNE and 8-OHdG in the cortex and 8-OHdG in hippocampus CA1 area were lower than in 2VO group (195.1±7.0,26.0±4.3,q=23.03 and 6.49,both P＜0.01).Conclusions Resveratrol can improve the cognitive impairment in rats after chronic cerebral hypoperfusion,which may be related to preventing oxidative damage.

Objective To establish a rabbit auricular hematoma model,to observe the process of production and absorption,and to study the location of hematoma and method of its removal Methods Ten health New Zealand rabbits were divided randomly into control group and experimental group.A weight was dropped onto particular locality of auricles 3-6 times until a big hematoma appeared.The pathological processes of hematoma were observed,and the hematoma was formed 1 hour and the hematoma was almost absorbed after 4 days.The drainage experiment was conducted to observe the effect of needle aspiration or incision and drainage on the hematoma.Results All experimen tal auricles formed hematoma.The histopathological study showed that hematoma located between skin and cartilage,did not involve the cartilage.After 4 days,new-formed capillaries and fibroblasts were found,and then hematoma mostly absorbed; fibrous hyperplasia was been found.By cutting the hematoma,the blood clot could be thoroughly removed.Conclusions The auricular hematoma model can be established easily by striking with a heavy weight.Hematoma locates in subcutaneous connective tissue.A large hematoma should be early removed for prevention of auricular deformity.

Objective To explore the effect of LPLD (laparoscopic peritoneal lavage and drainage ) on SAP (severe acute pancreatitis), and to compare its effect with that of non- LPLD (conservative medical management). Methods We collected data from 87 consecutive patients with SAP, from January 2009 to May 2014, including LPLD group (n = 46) and non-LPLD group (n = 41). LPLD was performed in the 1st and 2nd week after the disease onset in LPDP group and other treatment in LPDP group was the same as that in non-LPLD group. Data were comparatively analyzed in two groups about the length of hospital stay, ICU stay, cure rate, incidence of complications and in-hospital mortality. Results In LPLD group, hospital stay, and ICU stay were shorter while cure rate was higher than those in non-LPLD group , and the difference was statistically significant (P < 0.05). In terms of the incidence of complications in two groups, only the incidence of sepsis indicated statistical significance (P < 0.05) and in-hospital mortality did not differ significantly between two groups (P > 0.05). Conclusion Compared with non-LPLD, LPLD is effective in short outcome, which is a promising treatment for SAP.

[Summary] In newly diagnosed diabetic patients, fasting plasma glucose, HbA1C , and plasma lipid profiles were measured to analyze the association between HbA1C and plasma lipid profiles. HbA1C might affect plasma lipid profiles in newly diagnosed diabetic patients. Higher HbA1C was associated with the worse plasma lipid profiles and more severe insulin resistance.

Objective To explore the influence of hospital- based transitional care on the rehabilita-tion of patients with enterostomy, and provide evidence- based reference for specialist care of the enterostomy patients. Methods The randomized controlled trials on the hospital- based transitional care in enterostomy patients were collected by computer using China National Knowledge Infrastructure Database, Chinese Science Technology Periodical Database, Wanfang Periodical Database, Foreign Medical Information Resources Database and PubMed from the building of the database till December 2014, and analyzed by RevMan 5.2 software. Results Sixteen articles were included in the study, involving 1 263 patients with enterostomy. The results of Meta- analysis revealed that the incidence of complications in transitional care patients was lower than that in conventional discharge guidance patients, odds ratio(95% confidence interval) was 0.31 (0.21-0.45), the difference was significant (Z=6.02, P<0.01), and the quality of life was raised (including the physical function, cognitive function, role function, emotional functions, social function and the total quality of life), weighted mean differences (95% confidence interval) were 13.81 (8.23-19.39), 22.00 (17.21-26.79), 15.22(11.71-18.73), 16.68(13.01-20.35), 22.60(16.58-28.62), 17.46(13.53-21.38),the differences were significant(P<0.01). Conclusions The transitional care model giving priority to hospital service resources can provide a higher level professional care for patients after enterostomy, and avoid or reduce the complications, promote the recovery earlier as well as constantly improve the quality of life.

Objective To evaluate the clinical value of percutaneous transhepaticcholangioscopic lithotomy (PTCSL)combined with rigid cholangioscopy in treatment of recurrent hepatolithiasis. Methods Retrospective analysisof therapeutic result of 54 patientswith postoperative recurrent hepatolithiasisduring January 2012 to January 2015. Twenty eight cases were recruited as the observation group (PTCSL group). Twenty six cases were recruited as the control group (Laparotomy group). Following parameters were observed, operation time, intraoperative blood loss, clearance of stones and postoperative hospital stay. Results The operation time, intraoperative blood loss , clearanceof stones , and the postoperative hospital stay of the PTCSL group werebetter than that of the laparotomy group (P<0.05). The number of patients with postoperative pain of the PTCSL group was significantly lower than in the laparotomygroup (P<0.05). There were no significant differences in other complication rates. There was no difference in terms of stone recurrence , incidence of cholangitis and intrahepatic biliary strictures recurrence ratebetween two groups in follow-up period. Conclusions PTCSL combined with rigid choledochoscopywas a safe and effectivemethod with minimal invasion formanagement of the postoperative recurrent hepatolithiasis. It could got a better resultsin the short-term outcomes.

Objective To systematically review the effect of telephone intervention on colostomy patients.Methods The randomized controlled trials (RCTs) of telephone intervention on colostomy patients were searched in CBM,VIP,CNKI and Wanfang database and analyzed by RevMan5.2 software.Results Nine RCTs were included.Results of systematic evaluation showed that there were statistical difference in the self-care status,obeying doctors' order,satisfaction degree,self management ability,quality of life.Conclusions The effect of telephone intervention on colostomy patients was better than that of the traditional intervention.

Objective: To investigate the anti-tumor effect of Glycyrrhiza flavonoids(GF) and its immunological mechanism.Methods: Mice bearing sarcoma 180(S180) were randomized into 3 GF-treated groups and one control group.The mice in GF-treated groups were perfused with GF.Leukocyte and lymphocyte count were taken by the blood cell analyzer.Flow cytometry was performed to detect the percentages of the T cell subsets.Results: Treatment of GF resulted in the tumor inhibition rates of 52.3%(high dose group).Blood total leukocyte and lymphocyte count in GF treated groups were all higher than that in the control group,and there was the most significant increase of the number of immune cells in the high dose GF group(P