Objective Discuss the clinical experience of laparoscopic common bile duct exploration and primary suture in operation for choledocholithiasis. Methods From August 2010 to December 2012, 53 patients with choledocholithiasis were treated with laparoscopic common bile duct exploration and primary suture laparoscopic common bile duct exploration and primary suture,not T tube drainage in Dept. of General Surgery First,Wenjiang branch courts of Sichuan provincial people's hospital. Their clinical data were selected and retrospectively analyzed. Results 53 cases have successfully operated (100%), the operated time was 100-180 minutes, and the postoperative hospitalization time was 6-12 days. 4 cases occured bile leakage (7.5%), but they were cured through abdominal cavity drainage. All the patients were follow-up visited in 2-14 months. There was no bile leakage, bile duct stenosis, bile duct bleeding or residual calculi. Conclusion Under the strict conditions for mastering operative indications, laparoscopic common bile duct exploration and primary suture is a safe, effective, more minimally invasive, faster recovery treatment for choledocholithiasis.

Objective To explore the clinical curative effect of laparoscopic cholecystectomy (LC) in treatment of patients with acute calculouscholecystitis in acute stage. Methods We retrospectively analysed the data of 1353 patients with acute calculouscholecystitis in acute stage who received laparoscopic cholecystectomy in Dept.of General Surgery, The First Affiliated Hospital of Nanyang Medical College and Dept.of Hepatopancreatobiliary Surgery 3,The 2nd Affiliated Hospital of Kunming Medical University from August 2008 to December 2012. Results In 1353 patients, 1316 patients were performed LC successfully (97.27%) . One patient was found with bile duct injury and was cured after Laparoscopic T tube drainage. Two patients were found with postoperative bile leakage, one of them was found with wing hole effusion after removal of the abdominal cavity drainage tube, and was cured after continuous drainage. The operation time was 26-168 minutes, with an average of 47 minutes, the hospitalization time was 3-15 days, with an average of 7.3 days. No incision infection was found . 37 patients were transferred to laparotomy because of common bile duct injury in 2 cases, unclear gallbladder triangle in 23 cases, difficult operation after decompression result from high gall bladder pressure caused by big calculus incarceration in the gallbladder neck in 3 cases, gallbladder gallstone disease in 2 cases, atrophic and vitrified acute cholecystitis and biliary calculus in 2 cases, gallbladder artery bleeding in 4 cases and severe abdominal cavity adhesion in 1 case. Conclusion For patients with acute calculous cholecystitis in acute stage, LC is asafe, effective, and minimally invasive treatment method with quick recovery and low cost, but the operator must be familiar with the anatomy of Calot triangle,and has skilled LC operation skills.

Objective To compare the cost-effectiveness of intervention protocols with or without rehabilitation approaches for burn patients.To explore the pros and cons of the two treatment programs,especially in terms of efficacy.Methods Data on 164 burn patients hospitalized in four hospitals in Hunan Province were collected and compared in terms of the therapeutic interventions employed,the direct medical costs and the effects obtained at the end of the first two months of hospitalization.The patients were divided into an early rehabilitation therapy group and a control group,based on the interventions they received.Results The average total direct medical cost of the early rehabilitation group was significantly lower than that of the control group [((￥)59 380.80 ±196.87) versus ((￥)67 471.62 ±217.23)].The average Vancouver scar scale (VSS) results in the early rehabilitation group were significantly better than those of the controls,but their Zung's Self-rating Anxiety Scale and Barthel index scores were not.The average cost-effectiveness ratio (C/E) of the early rehabilitation group as judged by these scores was lower than that of the control group.Conclusion Early rehabilitation can improve the therapy of burns patients and reduce subsequent expenditures.It is a cost-effective approach to treating burns patients.

Objective To discuss the efficacy and safety of covered Cheatham-Platinum stent (CCPS) implantation in treating coarctation of the aorta (CoA).Methods The clinical data of 11 patients with CoA who had received CCPS implantation were retrospectively analyzed.Results Successful implantation of single CCPS was accomplished in all 11 patients.After the implantation,the diameter of coarctation site was immediately dilated from preoperative (4.76+0.89) mm to postoperative (12.86+0.90) mm (t=24.86,P＜0.001),and the average systolic blood pressure difference across the coarctation was immediately reduced from preoperative (38.55+10.02) mmHg to postoperative (9.82+6.60) mmHg,the difference was statistically significant (t=10.8,P＜0.001).The patients were followed up for 3-79 months,with a mean of (31.91±27.58) months.The clinical symptoms were relieved in all patients and the activity tolerance was obviously improved.No complications such as endoleak,acute injury of aortic wall,re-coarctation or re-stenosis,vascular injury of puncture site,or death occurred in all patients.Conclusion For the treatment of CoA,implantation of CCPS has excellent short-term and mid-term effect,meanwhile,this technique can effectively avoid complications such as aortic wall iniurv.(J Intervent Radiol.2017.26:211-214)

Objective: To investigate the association between obesity and insomnia among adults, so as to provide insights into obesity control and sleep health improvements among adult populations. Methods: Sixteen communities were randomly sampled from Longgang District, Shenzhen City using a multistage cluster sampling method, and permanent residents at ages of 18 years and older living in these communities were recruited as study subjects. Subjects' gender, age, educational level and marital status were collected using a self-designed questionnaire, and the body mass index ( BMI) was calculated. The sleep quality was evaluated using the Insomnia Severity Index ( ISI ), and the correlation between obesity and insomnia was evaluated using a multivariable logistic regression model. Results: A total of 10 434 questionnaires were allocated, and 9 425 valid questionnaires were recovered, with an effective recovery rate of 90.33%. The respondents included 3 448 men ( 36.58% ) and 5 977 women ( 63.42% ), and 6 940 respondents ( 73.63% ) were at ages of 18 to 44 years. There were 778 respondents with underweight ( 8.25% ), 5 522 with normal weight ( 58.59% ), 2 209 with overweight ( 23.44% ) and 916 with obesity ( 9.72% ). Among all respondents, 1 149 respondents were detected with insomnia, with a detection rate of 12.19%, including 839 subjects with mild insomnia ( 8.90% ), 247 subjects moderate insomnia ( 2.62% ) and 63 subjects with severe insomnia ( 0.67% ). Multivariable logistic regression analysis showed a statistically significant correlation between obesity and insomnia ( OR=2.179, 95%CI: 1.824-2.603 ). Conclusions There is a significant correlation between obesity and insomnia. Body weight management and sleep health education shall be intensified among adults.