Objective To investigate the influence of laparoscopic cholecystectomy (LC)versus open cholecystectomy (OC)on postopera-tive systemic infection and immune response in patients with acute cholecystitis complicated by choleperitonitis.Methods A prospective randomized controlled trial was performed for 45 patients who had a definite diagnosis of acute calculous cholecystitis complicated by cho-leperitonitis in Shanghai Liqun Hospital from January 2014 to June 2016.According to surgical procedures,the patients were randomized in-to LC group (23 patients)and OC group (22 patients).The length of hospital stay,postoperative complications,and deaths were evaluated in both groups.Blood samples were collected from all patients before surgery and at 1,3,and 6 days after surgery to compare the changes in neutrophil count,serum levels of C -reactive protein (CRP)and interleukin -6 (IL -6),and erythrocyte sedimentation rate (ESR),as well as the incidence of endotoxemia.The t -test was used for comparison of continuous data between groups,and the chi -square test was used for comparison of categorical data between groups.Results The LC group had a significantly shorter length of hospital stay than the OC group (5.4 ±2.7 d vs 10.2 ±3.5 d,t = -5.46,P <0.001).One patient (4.3%)in the LC group and 6 (27.3%)in the OC group ex-perienced peritoneal abscess after surgery,and there was a significant difference in the incidence rate of complications between the two groups (χ2 =4.77,P =0.03).In all patients,the mortality rate was 17.8% (8 /45),with 1 (4.3%)in the LC group and 7 (31.8%)in the OC group,and there was a significant difference between the two groups (χ2 =5.16,P =0.02).Of all patients in the OC group,4 died of peritoneal abscess,1 died of pulmonary embolism,and 1 died of myocardial infarction;of all patients in the LC group,1 died of my-ocardial infarction.There were no significant differences in inflammatory markers before surgery between the two groups.At 1,3,and 6 days after surgery,the LC group had significantly lower neutrophil count,serum levels of CRP and IL -6,and ESR (except at 1 day after surger-y)than the OC group (all P <0.05).Furthermore,the OC group had a significantly higher concentration of endotoxin than the LC group (P <0.05),but the level of endotoxin returned to normal at 2 days after surgery in both groups.Conclusion Compared with OC,LC can reduce the probability of endotoxemia,help with the establishment of immunological defense,and reduce the risk of postoperative infection.

OBJECTIVE:To determine camphor in compound menthol nose drop by RP-HPLC.METHODS:Waters No-va-pak C 18 was taken as the chromatographic column,the mobile phase was composed of chloroform-methanol-water(14∶52∶30)with a flow speed at1.0ml/min and detection wavelength at289nm,the column temperature was35℃.RESULTS:The linear range for camphor was0.8～5.6?g/ml(r=0.9998)and the average recovery rate was99.4%(RSD=0.7%).CONCLUSION:The method is specific,convenient and accurate,which can be used for the quality control of the preparation.

Objective:To evaluate bone formation in human extraction sockets with absorbed surrounding walls augmented with Bio-Oss(R) and Bio-Gide(R) after a 6-month healing period by histologic and histomorphometric analyses.Methods:Six fresh molar tooth extraction sockets in 6 patients who required periodontally compromised moral tooth extraction were included in this study.The six fresh extraction sockets were grafted with Bio-Oss(R) particle covered with Bio-Gide(R).The 2.8 mm × 6.0 mm cylindric bone specimens were taken from the graft sites with aid of stent 6 months after the surgery.Histologic and histomorphometric analyses were performed.Results:The histological results showed Bio-0ss(R) particles were easily distinguished from the newly formed bone,small amounts of new bone were formed among the Bio-Oss(R) particles,large amounts of connective tissue were found.Intimate contact between the newly formed bone and the small part of Bio-Oss(R) particles was present.All the biopsy cylinders measurement demonstrated a high inter-individual variability in the percentage of the bone,connective tissues and BioOss(R) particles.The new bone occupied 11.54％ (0-28.40％) of the total area;the connective tissues were 53.42％ (34.08％-74.59％) and the Bio-Oss(R) particles were 35.04％ (13.92％-50.87％).The percentage of the particles,which were in contact with bone tissues,amounted to 20.13％ (0-48.50％).Conclusion:Sites grafted with Bio-Oss(R) particles covered with Bio-Gide(R) were comprised of connective tissues and small amounts of newly formed bone surrounding the graft particles.

Objective:To compare the bone dimensional changes following tooth extraction alone with extraction plus ridge preservation ( using deproteinized boving bone mineral Bio-Oss? and bioresorbable collagen mambrane Bio-Gide?) in periodontal compromised extraction sockets .Methods: Eighteen molars of sixteen subjects requiring tooth extraction because of periodontal destruction were enrolled in this study .The subjects were assigned to the control group ( extraction alone , EXT) or to the test group ( ridge-preservation procedure with Bio-Oss? and Bio-Gide?, RP) .Parallel periapical X-rays and cone-beam computed tomography ( CBCT ) scans were taken immediately after tooth extraction alone or plus ridge-preservation ( baseline ) and 6 months later .The changes of horizontal ridge width and vertical ridge height were assessed .Results:At the central buccal aspect , the ridge height increased 2 .9 mm in RP group, and reduced 1.0 mm in EXT group.At the distal buccal aspect , the ridge height increased 1.45 mm in RP group, and reduced 1.45 mm in EXT group.The differences between the groups reached statistical significance (P<0.05).The mean ridge width increased at the 1 mm below the crest (the horizontal ridge width was measured with grafting material at three levels at 1 mm below the most coronal aspect of the crest,HW1), which amounted to 3.40 to 5.80 mm in RP group, and 1.45 to 2.90 mm in EXT group.The mean ridge increased at the 4 mm below the crest ( the horizontal ridge width was measured with grafting material at three levels at 4 mm below the most coronal aspect of the crest ,HW4 ) , which amounted to 0.40 to 3.50 mm in RP group, and reduced 0.10 to increased 0.15 mm in EXT group.The test group and the control group were not significantly different (P>0.05).Conclusion:The ridge-preservation approach using Bio-Oss? in combination with Bio-Gide? can significantly increase vertical ridge height and horizontal ridge width after tooth extraction compared with extraction alone in periodontal compromised molars .

Objective To investigate the effect of oxcarbazepine(OXC) and sodium valproate(VPA) on electroencephalogram(EEG) and peripheral blood levels of homocysteine(Hcy) and asymmetric dimethylarginine(ADMA) in adult patients with partial epilepsy.Methods From May.2014 to May.2015,a total of 100 patients with partial epilepsy were enrolled and randomly divided into treatment group(treated with OXC) and control group(treated with VPA),with 50 cases in each group.After treatment,changes of EEG indices,Hcy,ADMA,cognitive function and adverse reaction were analyzed.Results Before treatment,there was no significant difference of EEG indices between the two groups(P>0.05).After treatment,the incidence rates of α wave decreasing more than 0.5 Hz,increasing of θ wave and increasing of δ wave were significantly different(P< 0.05).Before treatment,there was no significant difference of serum Hcy and ADMA levels between the two groups(P>0.05).After treatment,serum Hcy and ADMA levels were both significantly increased(P<0.05).Before treatment,Mini-mental State Examination(MMSE) scores of the two groups were without significant difference(P>0.05).After treatment,MMSE score of treatment group was higher than that of control group(P<0.05).In treatment group,there were 1 case of skin rash and 2 cases of gastrointestinal discomfort,which were self-improved.In control group,there were 3 cases of dizziness,5 cases of skin rash and 1 case of gastrointestinal discomfort,which were self-improved.Conclusion The effects of OXC and VAP on peripheral blood levels of Hcy and ADMA could be similar,and compared with VAP,OXC could significantly improve cognitive function in patients with epilepsy.

Objective:To investigate the changes of the vertical height and width of the alveolar bone six months after the alveolar ridge preservation in periodontal compromised molar sites of severe alveolar bone defects with clinical direct measurement,parallel periapical radiographs,and cone-beam computed tomography (CBCT),and to analyze the effect of the three different methods of measurement.Methods:In this study,20 subjects requiring tooth extraction on account of periodontal disease with a total of 23 ex-tracted molars were enrolled.Extractions were performed atraumatically and patients were received alveo-lar ridge preservation procedure with Bio-Ossand Bio-Gide.Clinical direct measurements were taken after tooth extraction and during the implant surgery 6 months later,CBCT scans and parallel periapical radiographs were taken immediately after ridge preservation and 6 months later.The changes of alveolar ridge width and vertical height after six months were measured and analyzed through the above-mentioned three methods and the similarities and differences of the measured effect were compared.Results:There were no significant difference of alveolar vertical height in the center of the extraction sites,the center of distal aspect,and distobuccal aspect between the clinical direct measurements and the CBCT measure-ments (P>0.05),alveolar vertical height in other points and alveolar width measurements were statical-ly significant (P<0.05).After 6 months,1 0 sites of 1 0 subjects were received a flap and re-entered to perform dental implants surgery.The vertical height in the center of alveolar increased significantly and the changes of alveolar vertical height of clinical direct and CBCT measurement were (6.1 5 ±1 .73)mm and (6.59 ±2.53)mm,respectively.The measurements of the width of the alveolar bone were (8.45 ± 1 .1 8)mm and (8.52 ±1 .27)mm,respectively.The measurements of the two methods were not statisti-
cally significant (P>0.05).The change of the alveolar height in the center of the extraction socket after six months measured by parallel periapical was (5.84 ±4.28)mm,which was closed to the clinical di-rect measurement and the CBCT measurement.Conclusion:Clinical direct measurement and CBCT measurement were largely consistent in the evaluation of the alveolar bone height and width after the alveolar ridge preservation using deproteinized boving bone mineral (DBBM,Bio-Oss)and bioabsor-bable collagen membrane (Bio-Gide)in periodontal compromised molar sites of severe bone defects.

Objective To evaluate the clinical efficiency and complications of deferred limited TURP for treating urinary retention after 125I seed implantation.Methods From Jan.2006 to Jan.2014,36 prostate cancer patients with severely dysuria or retention were performed with deferred limited TURP 6 months after 125I seed implatation.The average age was 66 (57 to 82) years.The average PSA was 8.5 (3.5 to 25.6) μg/L before seed implantation.The average prostate volume was 78 (45 to 110) ml.Before limited TURP,the average IPSS was 16.5 (13 to 32),the average QOL score was 5.5 (5 to 6),the Qave was 5.6 (2 to 9) ml/s,the average PVR was 285 (120 to 550) ml.The urination state,QOL and complications were evaluated the second day after catheter removal and one,three and six months after limited TURP.Results Limited TURP was successfully performed in all 36 patients.The average operation time was 45 (35 to 60) min.The average fellow-up time was 42 (6 to 84) mon.The second day after catheter removal,the average IPSS was 4.5 (3 to 6),the average QOL score was 2 (1 to 3),the Qave was 14.5 (12 to 21) ml/s,the average PVR was 35 (20 to 50) ml.One month later,the average IPSS was 3.5 (2 to 5),the average QOL score was 2.0 (1 to 3),the Qave was 15.5 (12 to 23) ml/s,the average PVR was 30 (20 to 40) ml.Three months later,the parameters continued to improve and stabilized.The second day after catheter removal and one,three and six months after limited TURP,all parameters had significant improvement compared with those before limited TURP with statistical significance (P ＜ 0.05).Four cases had mild incontinence,no case had urethral ischemia and necrosis.Conclusions 6 months after 125I seed implatation,prostate cancer patients with severely dysuria or retention can be safely and effectively treated with limited TURP.

Objective To explore the biomechanical property on Suture-Button and conventional screw fixating the distal tibiofibular syndesmosis injury.Methods The distal tibiofibular syndesmosis injury models were made by cutting the anteroinferior tibiofibular ligaments,posteroinferior tibiofibular ligaments,interosseous tibiofibular ligaments or deltoid ligaments of 8 fresh frozen calves.These models were randomly and equally divided into the two groups.The two groups were respectively fixed by Suture-Button and conventional screw.The contact area and peak intra-articular pressure of tibiatalar joint were measured by biomechanical testing methods and the stress and strain sensing technology.Results The maximal contact area and peak intra-articular pressure of Suture-Button fixation group had no significant differences with the conventional screw group by the four kinds of ankle flexion-extension angles in the sagittal plane (t =3.52,4.49,5.93,4.75,all P ＞ 0.05),peak intra-articular pressure was also similarly improved (t =3.61,3.97,4.68,2.41,all P ＞ 0.05).But biomechanical markers of two fixation groups had an improvement trend.Conclusion Suture-Button fixing the distal tibiofibular syndesmosis injury had similar biomechanical effect to compare with traditional conventional screw,and two fixation groups both improved trend to compare with ligament-cut group.

Objective: To investigate the cinlical features and therapeutic methods of unex-pected gallbladder carcinoma. Methods: A retrospective analysis was performed in 19 cases of unexpected gallbladder carcinoma treated in our hospital from April 2002 to April 2008. Results: Ten cases in early stage were perfomed gallbaldder resection and local lymph node removal, and the average survival time was 18.7 months; 4 cases were perfomed extend radical resection, and the average survival time was 12.3 months; 5 cases were performed palliative resection, and the survival time was less than 6 months. Conclusions: Frozen section examination during opera-tion is key to diagnose unexpected gallbladder carcinoma. Radical resection is the first option once the diagnosis is confirmed, and the method can be decided according to Nevin classification and B ultrosound scaning during opreation.

[ ABSTRACT] AIM:To investigate the effect of Jia-jian-yi-yin decoction on endothelium-dysfunction in ovariecto-mized rats.METHODS:The ovariectomized rats were treated with Jia-jian-yi-yin decoction or turbid liquid of estradiol va-lerate for 8 weeks.The vascular ring tension was measured.Scanning electron microscopy and Western blotting were ap-plied to assess the function of endothelium-dependent dilation, aortic endothelial morphology and the expression of endothe-lial lipase.The pathologic sections were prepared to observe the effect of Jia-jian-yi-yin decoction on the uterus.RE-SULTS:In ovariectomized rats, the decrease in endothelium-dependent relaxation to acetylcholine ( ACh) was reversed to normal level, the endothelial morphology returned to normal without lipid accumulation and the endothelial lipase expression was decreased by Jia-jian-yi-yin decoction.Furthermore, no obvious change of the wet weight of uterine between the ovari-ectomized rats with or without Jia-jian-yi-yin decoction treatment was observed.CONCLUSION:Jia-jian-yi-yin decoction may have protective effects on endothelium-dependent vasodilation and aortic endothelial morphology in estrogen-deficient animals.