[Objective]To approach the methods of difficult laparoscopic cholecystectomy.[Methods ]The clinical data of 116 patients with Mirizzi syndrome,severe adherence of abdominal cavity and Calot'triangle,liver cirrhosis underwent difficult laparoscopic cholecystectomy since 2004 were retrospectively analyzed.[Results]Except 3 patients treated by abdominal operation,other patients were treated by laparoscopic cholecystectomy successfully.[Conclusion]The rates of open operation midway and complications are not increased in difficult laparoscopic cholecystectomy as long as dealing with them properly.

Objective The purpose is to report the clinical result of repairing defection in hand surgery by using both the vascular tissue flap and external fixators. Methods The vascular tissue flap including bone flap and joint flap to repair the complex defection (soft tissue, bones and joints) in hand and forearm were applied in 9 cases. At the same time in surgery,injured bones and joints were fixed by A-O and mini external fixators in order to keep the non-injured joint actively and accelerate the cure of bones. Result All 9 cases were applied successfully with the all transplanted tissue survived. Pulling about the external fixator about 10- 12 weeks after surgery showed bone union and the f unction of hand recovered satisfactorily' Conclusion it is a reliable method for repairing the complex tissue defection in hand and forearm by combining external fixation of traumarology and microsugery technique. And it is also characterized by a minor injury in transplanted bones,early exercise for joints,flap circulation observed conveniently,and nursing easily.

[Objective]To analyze the clinical and biological characteristics of suspected malignant thyroid nodules associated with Hashimoto thyroiditis .To summarize different characteristics of benign and malignant nodules,diagnosis and treatment of suspected malignant nodules associated with Hashimoto's thy-roiditis. [Methods]Surgical y and pathological y confirmed, 58 cases of suspected malignant thyroid nodules associated with Hashimoto's thyroiditis were retro-spectively analyzed with clinical and pathological data. The differences of gender, age, number of nodules, calcification, and thyroid hormone and thyroid an-tibodies levels between malignant and benign nodules were compared from January 2009 to December 2011 .[Results] The average age of malignant thyroid nodules coexisting with HT group was significantly lower than that of benign nodules coexisting with HT group( P<0.05). The proportion of nodular calcifi-cation in malignant thyroid nodules coexisting with HT group was significantly higher than that in benign nodules coexisting with HT group( P<0.05). Pre-operative TSH and anti-TG levels in malignant thyroid nodules coexisting with HT group were significantly higher than that in benign nodules coexisting with HT group. Preoperative FT3, FT4, anti-TPO levels, sex ratio and number of lesions between the two groups were not statistical y significant. [Conclu-sions] The key point of preoperative diagnosis:patients of malignant thyroid nodules coexisting with HT are associated with youth, calcified nodules, elevated serum TSH and anti-TG levels.

Objective To explore the relationship between insluin resistance(IR)and plasma fibrinogen, blood lipids levels in patients with gestational diabetes mellitus (GMD).Methods Totally 127cases pregnant women in their 24 -28 gestational weeks were divided into GDM group(n =37),gestational impaired glucose tolerance test (GIGT)group(n =30)and normal glucose tolerance(NGT)group(n =60)based on the American Diabetes Associ-ation(ADA)2009 GDMdiagnostic standards.All selected cases's height,weight,fasting blood glucose (FBG),fasting insulin (FIN),blood lipids and fibrinogen(FIB)level were tested,and their body mass index(BMI)and IR index (HOMA -IR)were calculated.Results During the mid -trimester,the levels of BMI,FIB,HOMA -IR,FBG,FIN, triglyceride (TG),cholesterol(TC),low density lipoprotein -cholesterol (LDL -C)in the GDM group were signifi-cantly higher than the GIGT and NGT groups.However,high density lipoprotein -cholesterol (HDL -C)was signifi-cantly lower (F =69.29,98.15,70.32、141.43、61.92,106.06,157.06,90.59,25.25,all P <0.01).FIB was sig-nificantly positively correlated with BMI,FBG,FIN,HOMA -IR,TC,TG,LDL - C (r =0.441,0.682,0.506, 0.599,0.493,0.591,0.633,all P <0.01 ),and negatively correlated with HDL -C(r =-0.419,P <0.01 ).Multiple stepwise regression analysis indicated that BMI,LDL -C,FBG and TG were independent risk factors affect-ing FIB(t =7.683,2.678,3.184,3.844,all P <0.01);FIB,BMI,FBG,FIN and TC were independent risk factors influencing HOMA -IR(t =68.784,3.201,29.702,58.100,2.904,all P <0.01).Conclusion Pregnant women have IR and blood lipid disorders during the mid -trimester,the overexpression of FIB is closely related to it.

Objective:To evaluate the effects of periodontal treatment with scaling and root planning supplemented with chlorhexidine on plasma lipids in patients with chronic periodontitis and hyperlipidemia(CPH).Methods:6 1 patients with CPH were randomly as-signed into control-treatment group(n=30)and intensive-treatment group(n=31).Patients in the control-treatment group underwent a standard cycle of supragingival mechanical scaling and polishing.Patients in the intensive-treatment group underwent the adjunctive full-mouth intensive removal of subgingival dental plaque biofilms with the use of scaling and root planning.Periodontal parameters,to-tal cholesterol(TC),triglycerides(TRG),high-density lipoprotein(HDL)and low-density lipoprotein(LDL)were measured before treatment and 2 and 6 months after treatment.Results:2 and 6 months after treatment,TRG was significantly lower in the intensive-treatment group than that in the control-treatment group(P<0.05),the levels of HDL were significantly higher(P<0.05);however, the levels of total cholesterol and LDL,in the intensive-treatment group were not significantly different from those in the control-treat-ment group 2 and 6 months after therapy.Conclusion:Intensive periodontal treatment may improve serum lipid levels in patients with hyperlipidemia and chronic periodontitis.

Objective To assess the efficienty of operation in humeral intercondylar fractures by section, reposition, internal fixation by composition nail and replacement of elbow joint. Methods From January, 1999 to May, 2009, Forty-six cases of the humeral intercondylar fracture were treated with operation. Thirty-eight cases were followed for 17 months. Their affected elbow joint function were evaluated by Cassebaum rating system, patients treated with total elbow replacement evaluated by Mayo elbow score, DASH score additionally. Results According to Cassebaum rating system,there were 22 cases rated as excellent,eight cases rated as good,five cases rated as poor,three case rated as poor. The fineness rate is 78. 9% (30/38). Mayo score in patients with joint replacement ranged from 75.0 - 90. 0, averaged 84. 4 ± 1.7. DASH score ranged from 25.0 to 75.0,averaged 41. 1 ±0. 8. There was 1 case of superficial soft tissue nonhealing and 2 cases of ulna nerve symptoms. Myodynamia in elbow joint bend and stretch was Ⅳ in 1 cases. Conclusion It is a good method to treat the humeral intercondylar fracture with rational use of open reduction or elbow replacement according to fracture type and patient condition.

The core protein (CP) of the classical swine fever virus (CSFV) is one of its structural proteins. Apart from forming the nucleocapsid to protect internal viral genomic RNA, this protein is involved in transcriptional regulation. Also, during viral infection, the CP is involved in interactions with many host proteins. In this review, we combine study of this protein with its disorders, structural/functional characteristics, as well as its interactions with the non-structural proteins NS3, NS5B and host proteins such as SUMO-1, UBC9, OS9 and IQGAP1. We also summarize the important part played by the CP in CSFV pathogenicity, virulence and replication of genomic RNA. We also provide guidelines for further studies in the CP of the CSFV.
Animals ; Classical Swine Fever ; virology ; Classical swine fever virus ; genetics ; metabolism ; pathogenicity ; Genome, Viral ; Swine ; Viral Core Proteins ; chemistry ; genetics ; metabolism ; Virulence

Objective To explore the relationship of serum ferritin with insluin resistance(IR)and inci-dence of fatty liver in adults with simple obesity.Methods According to body mass index (BMI),78 adults with simple obesity were divided into three groups,including 34 cases in Ⅰ degree obesity group,30 cases in Ⅱ degree obesity group and 14 cases in Ⅲ degree obesity group,and 35 adults with simple overweight and 67 healthy adults were also enrolled as control group.The height,weight,waistline,hip circumference,incidence of fatty liver,fasting blood glucose (FBG),fasting insulin (FIN),blood lipids and ferritin(SF)level were tested,and the body mass index (BMI),WHR and IR index (HOMA -IR)were calculated.Results When BMI increased,levels of SF,HOMA -IR, FBG,FIN,triglyceride (TG),cholesterol (TC),low density lipoprotein -cholesterol (LDL -C)were gradually increased(F =378.92,12.01,55.50,123.96,90.09,127.65,23.81,all P <0.01).However,high density lipopro-tein -cholesterol (HDL -C)was gradually degraded(F =114.56,P <0.01).The incidence of fatty liver had signifi-cant differences in Ⅰ,Ⅱ,Ⅲ degree obesity groups((t =24.872,7.885,all P <0.01),and with the degree of obesity increased,the rate of fatty liver increased significantly.SF range interquartile and level in fatty liver group was signifi-cantly greater than the non fatty liver group,the difference was statistically significant (t =22.99,P <0.01).SF was positively correlated with BMI,WRH,FBG,FIN,HOMA -IR,TC,TG,LDL -C (r =0.863,0.719,0.789,0.703, 0.617,0.785,0.717,0.771,all P <0.01),and negatively correlated with HDL -C(r =-0.530,P <0.01).Multi-ple stepwise regression analysis indicated that BMI,FIN,LDL -C,HOMA -IR were independent risk factors affecting SF(t =4.646,2.595,-5.073,6.666,all P <0.01).SF,BMI,FBG,FIN,LDL -C were independent risk factors influencing HOMA -IR(t =6.535,3.254,18.827,61.227,2.154,all P <0.05).Conclusion Simple obesity adults had obvious blood lipid disorders and IR,easy to complicated with fatty liver,the incidence of fatty liver associ-ated with severity of obesity,the overexpression of SF is closely related to it.

Objective To report the clinical result of repairing complex tissue defect in limb caused by traffic accident using both tissue flap transplantation and external fixer. Methods The vascular tissue flap including bone flap and muscular flap to repair the complex tissue defection(soft tissue, bones, joints) in forearm, hand, leg, ankle and foot were applied in 36 cases. At the same time in surgery, injured bones and joints were fixed by external fixer for stabilizing and accelerating cure. Results All 56 eases were applied successfully with transplanted tissue combined with external fixation. The external fixers were moved away about 10-16 weeks(upper extremity) or 6-8 months(lower extremity) later and all the cases recovered satisfactorily. Conclusion It is a reliable method for repairing the complex tissue defection in the limb caused by traffic accident by external fixer of traumarology and microsurgery technique. And it is also characterized as a minor injury method on transplanted bones, enables early exercise for joints, convenient observation of flap circulation and easy nursing.

Objective To analyze the urine trace albumin(mALb)/creatinine(Cr) ratio and blood uric acid(UA),and other various metabolic index level in patients with diabetic nephropathy(DN),combined with clinical data such as patients' age,body mass index(BMI),course of diseases,to explore the related mechanism of occurrence and development of DN.Methods 76 DN patients were selected.The microalbuminuria group(urinary mALb/Cr<300μg/mg) had 46 cases,the clinical albuminuria group(urinary mALb/Cr≥300μg/mg) included 30 cases,another 49 diabetic patients without kidney damage were seleted as control group.The urinary mALb/Cr,blood UA,fasting blood glucose(FBG),triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein(HDL),low density lipoprotein(LDL),glycosylated hemoglobin(HbA1c) levels were determined.The BMI and the length of the course of the disease calculate.Results The patients' age,course of the disease,urinary mALb/Cr,blood UA,FBG,TC,TG,LDL,HbA1c and BMI level in the clinical albuminuria group and microalbuminuria group were significantly higher than those in the control group,the differences were statistically significant (F=6.18,12.48,141.43,12.48,8.49,4.98,6.18,3.89,3.17,3.89,all P<0.05).The high uric acid hematic disease rates of the clinical albuminuria group and microalbuminuria group were 26.09% and 26.09%,which were significantly higher than 10.20% of the control group,the differences were statistically significant(x2=4.074,24.833,all P<0.05).Urinary mALb/Cr was positively correlated with age,duration,BMI,UA,TG,TC,LDL,FBG,HbA1c(r=0.120,0.299,0.148,0.340,0.157,0.149,0.103,0.487,0.103).Multiple linear stepwise regression analysis suggested that duration,blood UA,FBG were independent risk factors of urinary mALb/Cr;TG,BMI,urinary mALb/Cr were independent risk factors for blood UA.Conclusion Urinary mALb/Cr and blood UA are the independent risk factors,high uric acid hematic disease may participate in the development process of DN,and diabetes duration,UA,BMI,TG,TC,LDL,FBG,HbA1C associated with increased urinary mALb/Cr excretory DN patients,the effective monitoring can improve the symptoms of DN and quality of life.