Objective To explore the clinical feasibility of three-port laparoscopic cholecystectomy(LC).Methods From April 2006 to April 2007,364 patients with acute or chronic cholecystitis underwent LC using three-port method.The clinical data of the patients were analyzed retrospectively.Results All of the 364 patients were cured.Three-port LC were completed in 357 of them with a success rate of 98%.Seven patients were converted to four-trocar LC because of frozen Callot's triangle and gallbladder atrophy.The operation time was 30-80 min(mean,55 min).No severe complications including bile duct injury,bile leakage,and hemorrhage,occurred in our patients.Among the patients who were treated with three-trocar LC,250 were followed up for 1 to 13 months with a mean of 5 months.During the follow-up,no bile duct stenosis,gallbladder pouch,or residual stones were found.Conclusion Three-port LC is safe,effective,and feasible for patients with cholecystitis,if the surgeons have grasped the techniques of four-port LC.

A total of 123 type 2 diabetics was randomised into 3 groups to receive gliclazide-MR, gliclazide or glibenclamide treatments for 16 weeks.All the subjects took self-monitoring of blood glucose (SMBG) during the trial.The effect of therapy was similar in 3 groups.The subtraction value between maximum and minimum blood glucose, mean postprandial maximum blood glucose, postprandial 2 h blood glucose, postprandial 2 h serum insulin and hypoglycaemia events were lower in gliclazide-MR group than those in glibenclamide group (all P＜0.01).The data suggest that SMBG is an useful method to evaluate blood glucose excursion.

Objective To explore the effects of subclinical hyperthyroidism (SH) on heart and bone and the optionof treatment. Methods Forty-three patients with endogenous SH were divided into two groups by the TSH level: group A (21 cases,TSH 0.03-0.60 mIU/L) and group B (22 cases, TSH

Objective To explore the association of-11377 site single nucleotide polymorphism in promoter region of adiponectin gene and carotid intima-media thickness(CIMT)in patients with type 2 diabetes mellitus.Methods The adiponectin gene-11377C→G polymorphism was identified by PCR-restriction fragment length polymorphism(RFLP)in 504 patients with type 2 diabetes mellitus(250 patients with increased CIMT and254 Datients with normal CIMT). Serum lipid and fasting plasma glucose were detected by full automatic biochemical analysor.fasting serum insulin(FINS) was measured by radioimmunoassay,and serum adiponectin level was assessed by ELISA.Results The frequencies of adiponectin gene-11377C→G genotype and allele were different between type 2 diabetic patients with normal and increased CIMT(P

Objective To investigate and find a multiple treatment to reduce the mortality of sepsis patients induced by severe surgical abdominal infection.Methods While treating to severe surgical abdominal infection,inflammatory mediator bacteria,extoxin and endotoxin,immunity,dysfunction of microcirculation,nutrition and metabolism and the function of organs should be paid more attention on and considered as a whole.We also carried out 14 concrete treating measurement.Combined high dosage of anisodaminum and dexamethason were used in sbort-term.Bring forward nourishment support according to different stage of MODS and applying it in clinic could significantly reduce the companion syndrome.Oral administration of“JIE-DU-GU-BEN-TANG”which developed by our division could regulate the imbalance of immunity and inflammatory mediator.Results There were 46 patients died in 368 patients,mortality was 12.50%. Conclusion It was difficult to treat sepsis patients induced by severe abdominal infection and our new multiple treatment could significantly reduce the mortality of severe sepsis.

A new system of blood flow block for control of bleeding in abdominal operation is composed of an abdominal magnetic blocking unit, an abdominal external electromagnet unit and other non-magnetic operation instrument. The abdominal external electromagnetic unit is placed in advance in the operation bed. The abdominal magnetic blocking unit can be placed directly on the ventral of the large vessels when need to blocking the abdominal large vessels during the operation. According to the non-contact suction characteristics of magnetic materials, the two magnetic units will attract each other and compression the vessels. Using this system for vascular occlusion does not need clear exposure and without separating vessel. There is the advantage of rapid, accurate and reliable for the system.
Abdomen ; blood supply ; Blood Loss, Surgical ; prevention & control ; Electromagnetic Phenomena ; Equipment Design ; Surgical Equipment

OBJECTIVETo investigate the association of serum pigment epithelium-derived factor (PEDF) level and polymorphisms in PEDF gene promoter region -358G→A with non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM) of Han Nationality in Fujian Province.

METHODSA total of 282 T2DM patients with NAFLD (DM1 group) and 170 age- and gender-matched T2DM patients without NAFLD (DM2 group) were examined for PEDF gene SNP-358G→A polymorphisms using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Serum pigment epithelium-derived factor(PEDF) level, fasting plasma glucose (FPG), fasting insulin (FINS) and glycosylated hemoglobin (HbA1c) were also measured.

RESULTSThe patients in DM1 group showed a significantly higher mean level of serum PEDF than those in DM2 group (P<0.05). Logistic regression analysis revealed that PEDF level was an independent risk factor for NAFLD in T2DM. The frequencies of PEDF gene -358G→A genotypes (GG, GA, and AA) and alleles (G/A) differed significanly between DM1 and DM2 groups (P<0.05). In terms of PEDF gene SNP -358G→A alleles, the GA genotype carriers had a 2.032 times higher risk of developing NAFLD compared with the GG genotype carriers, and the risk increased to 2.068 times in the carriers of the A allele (GA and AA genotypes; P<0.05).

CONCLUSIONSerum PEDF level is an independent risk factor of NAFLD in T2DM. Elevated serum PEDF level is a protective factor against insulin resistance. In T2DM patients, PEDF gene promoter region -358G→A polymorphism is associated with NAFLD, and the A allele contributes to an increased risk of NAFLD.

Alleles ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; genetics ; Ethnic Groups ; Eye Proteins ; genetics ; Genotype ; Humans ; Insulin Resistance ; Nerve Growth Factors ; genetics ; Non-alcoholic Fatty Liver Disease ; genetics ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; Risk Factors ; Serpins ; genetics