Objective To summarize clinical experience of laparoscopic cholecystectomy (LC) for acute cholecystitis.Methods Two hundred and eighty patients with acute cholecystitis underwent LC in our hospita1.Results The LC was successfully completed in 268 cases,the other 12 patients were converted to open surgery because of massive adhesion at the Calot triangle (5 cases),severe hemorrhage (2 cases),Mirizzi syndrome (3 cases),Common bile duct injury (2 cases) were exectuted by bile duct repair and T tube drainage' and were Roux-en-Y chole-enterostomy).None of the patients had intra-abdominal hemorrhage,biliary leakage,or subphrenic abscess after the operation.Conclusions LC is safe and feasible in the treatment of acute cholecystitis,and successful surgery should be based on the skilled techniques and the knowledge of key points in the operation.Conversion to open surgery is necessary when LC is difficult.

Objective Toanalyzedrugfreeforpatientswithseverementalillnessandfollow-upof82cases, inordertoprovidebasisforthedivisionoffreedelivery.Methods 82severementalillnesspatientswhowereincon-formity with the conditions of rescue,were given free drug and followed up for 2 years.Before the admission and fol-lowed up for 2 years,the social function evaluation(SDSS)and compliance were evaluated,the recurrence rate was compared.Results Comparisonofcompliance:beforetheadmission,thecompletecompliancein33cases,thepartial compliance in 27 cases,22 cases of non-compliance;After 2 years follow-up,the complete compliance in 52 cases, the partial compliance in 21 cases,9 cases of non-compliance.The difference was statistically significant(u=3.34, P<0.01).Comparison of social function:social withdrawal:before the admission (1.32 ±0.75)points,after 2 years follow-up (0.96 ±0.34)points,the difference was statistically significant(t=3.93,P<0.001 );Family activities:before the admission (1.44 ±0.69)points,after 2 years follow-up (0.87 ±0.31)points,the difference was statisti-cally significant (t=6.78,P<0.001);Personal care:before the admission (1.29 ±0.68)points,after 2 years follow-up (0.95 ±0.62)points,the difference was statistically significant(t=3.33,P<0.001);Interest in the outside world:before the admission (1.23 ±0.63)points,after 2 years follow-up (0.97 ±0.41)points,the difference was statistically significant(t=3.05,P<0.025);The total score:before the admission (15.42 ±7.23)points,after 2 years follow-up (9.56 ±6.89)points,the difference was statistically significant(t=5.28,P<0.001).Compari-son of the recurrence rate:2 years before the admission,the recurrence in 33 cases (40.2%),after 2 years follow-up the recurrence in 15 cases(18.3%),the difference was statistically significant (χ2 =10.64,P<0.001).Conclusion Drug free for patients with severe mental illness and follow-up can improve the social function and the implementation of free administration of patients with severe mental illness,and reduce the recurrence rate and improve compliance.

Objective To investigate the molecular mechanism of P75NTR gene-induced apoptosis in tongue squamous cell carcinoma Tca8113 cell lineage.Methods P75NTR specific siRNA was transferred into P75NTR positive tongue squamous cell carcinoma Tca8113 cells.P75NTR positive Tca8113 cells were divided into 4 groups:blank group (without transfection),negative control group (transfected with negative control siRNA ), experiment group-776 (transfected with siRNA-P75NTR-776 ) and experiment group-1234 (transfected with siRNA-P75NTR-1234).Transfection efficiency and cell apoptosis were detected by flow cytometry.The interference effect of P75NTR mRNA expression was detected by fluorescence quantitative PCR. 3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2H-tetrazolium bromide assay was applied in measuring cell prolife-ration.The protein changes of P75NTR were detected by Western blotting.The distributions of nuclear factor-κB(NF-κB)of cells were observed by cell immunofluorescence labeling method.Results The transfection efficiency was 30%.The apoptosis rate of experiment group-776,experiment group-1234 and negative control group was (20.35 ±0.18)%,(12.32 ±1.51)% and (2.63 ±0.10)% respectively.Compared with the negative control group,the differences of the former two group had statistical significance (t =177.20,P <0.005;t =37.12,P <0.005).The P75NTR gene interference was successful.The inhibition rate of P75NTR protein reached 31% in experiment group-776.The cell viability of Tca8113 cells after P75NTR-siRNA inter-
ference was 70.02%,78.01% and 95.81% in experiment group-776,experiment group-1234 and negative control group.And there were significant differences between experiment group-776 and negative control group (χ2 =235.3,P <0.010),and between experiment group-1234 and negative control group (χ2 =117.5,P <0.005 ).NF-κB distribution was increased in cell cytoplasm in the interference group than that in control group.Conclusion P75NTR may promote the proliferation or inhibit the apoptosis of tongue squamous cell carcino-ma,and the molecular mechanism may be correlated with hindering the transportion of NF-κB into cell nuclear.

Objective To explore the value of magnetic resonance imaging (MRI)different planes in the diagnosis of uterine sep-tum.Methods The MR images of 28 cases with hysteroscopy surgery proved congenital uterine septum were analyzed retrospective-ly.The MRI findings in different planes of uterine septum were compared.Results 28 cases of congenital uterine septum malforma-tion were shown by magnetic resonance imaging in different planes.The sensitivity of oblique coronal for the uterine septum was not only higher than the conventional axial and oblique axial,but also higher than normal coronal (P <0.05).The oblique coronal was the most sensitive MRI imaging position for diagnosis of uterine septum,especially for complete uterine septum malformation.The uterine septum morphology and signal characteristics was fully visualized and accurately measured by the oblique coronal T2 WI.The oblique axial T2 WI displayed a continuous cross-sectional image of uterine septum and played a complementary role on the diagnosis of uterine septum.In contrast,a poor display was observed for uterine septum on sagittal plane.Conclusion Congenital uterine sep-tum can be clearly demonstrated by MRI oblique coronal and oblique axial joint application.

OBJECTIVETo study the biological characteristics of p75 neurotrophin receptor positive (p75(NTR+)) tongue squamous cell carcinoma cells which were separated by flow cytometry cell sorting.

METHODSTo determine the biological characteristics of p75(NTR+) cells which were separated from Tca-8113 and Cal-27 tongue squamous cell carcinoma cells by flow cytometry cell sorting, including study the capacity of cloning, 3-(4,5)-demethylthiazo(z-y1)-3,5-diphenytetrazoliumromide (MTT) assay, wound healing assay. p75(NTR+) cells with non-sorted cells were as control group.

RESULTSIn Tca-8113 and Cal-27 tongue squamous cell carcinoma cell lines, the percentage of p75(NTR+) cells were 3.1% and 1.9%. Compared with p75(NTR+) cells with non-sorted cells, p75(NTR+) cells possess higher capacity of cloning (Tca-8113, P=0.024; Cal-27, P=0.009). The percentage of p75(NTR+) cells of the progeny cells generated from monoclonal p75(NTR+) cells decreased to 14.5% (Tca-8113) and 5.8% (Cal-27) after cultured two weeks. p75(NTR+) cells possessed higher proliferation ability and higher metastasis ability than non-sorted cells.

CONCLUSIONp75(NTR+) cells isolated from tongue squamous cell carcinoma have the characteristics of cancer stem cells.

Objective To study the abdominal and pelvic adipose tissue volume and distribution in patients with malignant gynecologic tumor and benign gynecologic disease prospectively .Methods Eighty patients with malignant gynecologic tumor and eighty patients with benign gynecologic disease were underwent abdominal and pelvic CT scan by 64‐slice spiral CT and QCT cali‐bration phantom .The area and the volume of TAT ,VAT ,SAT of abdomen and(or) pelvis(TFV ,VFV ,SFV and VFV/SFV) were measured and calculated .The differences between the malignant gynecologic tumor group and the benign gynecologic disease group and between the different stages or types of malignant gynecologic tumor groups were compared ,then the distribution of AT was analyzed .Results (1)Except the VFV of abdomen and pelvis ,there were differences in TFV ,VFV and SFV between the malignant gynecologic tumor group and the benign gynecologic disease group(P<0 .05) ,the former was higher .(2)There were differences in abdominal and pelvic TFV ,VFV ,SFV between the early‐stage and the advanced‐stage malignant gynecologic tumor group and be‐tween the early‐stage and the benign gynecologic disease group(P< 0 .05) ,the early‐stage group was the highest;there was no difference between the advanced‐stage and the benign gynecologic disease group(P>0 .05) .There were differences in VFV/SFV between the early‐stage and the benign gynecologic disease group and between the advanced‐stage and the benign gynecologic dis‐ease group(P<0 .05) ,the benign gynecologic disease group was the highest ;there was no difference between the early‐stage and the advanced‐stage group(P>0 .05) .(3)There was no difference in abdominal and pelvic TFV ,VFV ,SFV ,VFV/SFV between the en‐dometrial carcinoma and the cervical carcinoma group(P>0 .05) .(4)There were positive correlations between abdominal or pelvic VFV ,SFV and abdominal and pelvic TFV ,the abdominal SFV was the highest .Conclusion The patients with malignant gyneco‐logic tumor ,especially in the early‐stage ,were much fatter than the patients with benign gynecologic disease .In malignant gyneco‐logic tumor patients ,the SAT increased more significantly than the VAT ,and had the highest correlation with TAT ,and was the mainly composition of obesity .

OBJECTIVE: To evaluate image quality of female pelvic computed tomography (CT) scans reconstructed with the adaptive statistical iterative reconstruction (ASIR) technique combined with low tube-voltage and to explore the feasibility of its clinical application. MATERIALS AND METHODS: Ninety-four patients were divided into two groups. The study group used 100 kVp, and images were reconstructed with 30%, 50%, 70%, and 90% ASIR. The control group used 120 kVp, and images were reconstructed with 30% ASIR. The noise index was 15 for the study group and 11 for the control group. The CT values and noise levels of different tissues were measured. The contrast to noise ratio (CNR) was calculated. A subjective evaluation was carried out by two experienced radiologists. The CT dose index volume (CTDIvol) was recorded. RESULTS: A 44.7% reduction in CTDIvol was observed in the study group (8.18 +/- 3.58 mGy) compared with that in the control group (14.78 +/- 6.15 mGy). No significant differences were observed in the tissue noise levels and CNR values between the 70% ASIR group and the control group (p = 0.068-1.000). The subjective scores indicated that visibility of small structures, diagnostic confidence, and the overall image quality score in the 70% ASIR group was the best, and were similar to those in the control group (1.87 vs. 1.79, 1.26 vs. 1.28, and 4.53 vs. 4.57; p = 0.122-0.585). No significant difference in diagnostic accuracy was detected between the study group and the control group (42/47 vs. 43/47, p = 1.000). CONCLUSION: Low tube-voltage combined with automatic tube current modulation and 70% ASIR allowed the low CT radiation dose to be reduced by 44.7% without losing image quality on female pelvic scan.
Adult ; Aged ; Body Mass Index ; Feasibility Studies ; Female ; Genital Diseases, Female/diagnosis/*radiography ; Humans ; Middle Aged ; Pelvis/*radiography ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted ; Signal-To-Noise Ratio ; *Tomography, X-Ray Computed

At present, the experimental examination of medical morphology courses in most medical colleges and universities still adopt traditional specimen examination or PPT examination, and there are many disadvantages. This paper introduces how to build a system with B/S architecture based on the local area network, and how to set up an examination system to realize the functions of user management, online examination database updating, free examination paper formation, examination running and automatic marking. Through its application in our school in recent years, the medical morphology online picture exam system has effectively promoted the reform of the examination methods, the style of study and the effect of experimental teaching. However, there are still some problems, such as high investment cost and limited examination room.

At present, the experimental examination of medical morphology courses in most medical colleges and universities still adopt traditional specimen examination or PPT examination, and there are many disadvantages. This paper introduces how to build a system with B/S architecture based on the local area network, and how to set up an examination system to realize the functions of user management, online examination database updating, free examination paper formation, examination running and automatic marking. Through its application in Chengdu Medical College in recent years, the medical morphology online picture exam system has effectively promoted the reform of the examination methods, the style of study and the effect of experimental teaching. However, there are still some problems, such as high investment cost and limited examination room.

Objective To explore the efficacy and safety of evolocumab in elderly patients with high-risk cardiovascular diseases.Methods A total of 153 patients with poor lipid control after conventional statin therapy who were hospitalized in the cardiologic departments in the First,Sec-ond,Sixth and Eighth Medical Centers of Chinese PLA General Hospital from November 2019 to November 2022 were included,and divided into non-elderly group(＜60 years old,46 cases),eld-erly group(60-74 years old,66 case)and very elderly group(≥75 years old,41 cases).They were all given evolocumab treatment according to guidelines.Another 50 over-75-year-old patients with high-risk cardiovascular diseases and poor lipid control who were hospitalized in the above cardiologic departments during the same period were treated with a statin drug combined with ezetimibe,and served as conventional treatment group(control group).The baseline clinical data and the blood indicators at 4th and 12th week after drug administration,and the occurrence of ad-verse drug reactions and major adverse cardiovascular events(MACE)within 12 weeks were com-pared among the groups.Results The levels of LDL-C and TC were significantly decreased in the three evolocumab treatment groups at 4 and 12 weeks after medication when compared with the baseline values(P＜0.05,P＜0.01),but there were no obvious differences in the 2 levels among the 3 groups at 12 weeks(P＞0.05).At the time point,no statistical difference was observed in the incidence of adverse events in the three groups(2.2％vs 3.0％vs 2.4％,P＞0.05).The levels of LDL-C and TC were decreased significantly in the very elderly group and the conventional treatment group at the 12th week when compared with the baseline levels(P＜0.05,P＜0.01),and the LDL-C level at the week was notably lower in the very elderly group than the convention-al treatment group(1.36±0.44 mmol/L vs 1.87±0.56 mmol/L,P＜0.01).But no difference was seen in the incidence of MACE between the 2 groups(12.2％vs 16.0％,P＞0.05),either in sur-vival rate between them(P=0.576).Conclusion For patients of all ages,evolocumab has good short-term efficacy in lipid control,and for those over 75 years old,the drug also shows good effi-cacy and sound safety.