Digital medical technology pioneered the three dimensional (3D) era of the surgery.The 3D reconstruction and visualization technology made a breakthrough of the bottleneck of clinical diagnosis and therapy of the biliary surgery,and are widely used for the treatment of biliary disease such as hepatolithiasis and hilar cholangiocarcinoma,and achieved digital anatomy,procedural diagnosis and visualized surgery,just as provide a 3D Ⅹ-ray vision to surgeons.With the development of the digital medical technology and the wide application of 3D laparoscopy and robotic system,biliary tract surgery access to a 3D era.

OBJECTIVE To discuss the effect of the central sterilization and supply center in controlling the infection in hospital.METHODS Eliminated the old supply pattern,to implement centralized management for the supply office.The whole sterilization and supply center was rebuilded according to the standard,cleared the function,standardized the procedure and strengthened the management.RESULTS The centralized sterilization and supply center could form effective and standard circulatory system for cleaneiness,sterilization and antiseptic,and ensure the quality of disinfectants.CONCLUSIONS The centralized sterilization and supply center is better to the management and control of quality, it can reduce the pollution,simplify operational procedures,reduce hospital infection,and realize the zero flaw of aseptic goods.

In view of risk characteristics of surgical site infection,the risk factors of the infection were graded and classified while the risk indicators system and risk assessment matrix for surgical site infection were built,based on literature analysis,integrated use of documents analysis,Delphi method and risk quantification matrix.The study indicated that surgical skills of the surgeon and surgical time length are the most important risk factors,followed by insufficient maintenance of the operating room environment and poor baseline assessment of the patient.Risk control of surgical site infection needs to focus on these key factors,optimize utilization of resources and improve the prevention and control ability of surgical site infection.

Point Zigong is an empirical point for acupuncture treatment of gynecological diseases. Now it is widely applied to clinical treatment and has a marked therapeutic effect. The therapeutic effect of point Zigong stimulation on gynecological diseases is closely related to the anatomical position, morphostructure specificity and action effect of the acupoint. In the present study on this acupoint, the single acupoint is seldom applied and the mechanism is not completely clear. It is needed to conduct a thoroughstudy in the future.

Bone mineral density (BMD) of lumbar spines, femoral neck, Ward′s triangle and greater trochanter was lowered, serum calcium, phosphate, alkaline phosphatase and bone Gla-protein levels were raised, and vitamin D receptor (VDR) contents in lymphocyte was lowered in hyperthyroid patients. Both FT 3 and FT 4 were negatively correlated with BMD, suggesting that hyperthyroidism results in high-turnover type of bone loss which causes the abnormalities of bone metabolic indices and VDR content.

ObjectiveTo investigate the expression of miR-21 in diffuse large B cell lymphoma (DLBCL)and normal lymph tissues and its potential relevance with clinicopathological characteristics.MethodsThe expression levels of miR-21 in 50 primary DLBCL and 12 normal lymph node tissue specimens were examined by TaqMan real-time polymerase chain reaction.The expression of bcl-2 and p53 was detected by immunohistochemistry staining. ResultsThe expression of miR-21 was significantly higher in tumor tissues than that in normal tissues, in GCB subtypes higher than in non-GCB subtypes. And it was negatively correlated with bcl-2(P=0.020),while positively correlated with p53(P=0.022). Up-regulated miR-21 expression was low in three years of survival rate. ConclusionMiR-21 may indicate a more aggressive phenotype and serve as a molecular prognostic marker in DLBCL. High-expression of miR-21 is a key feature that is correlated with cell proliferation in DLBCL.miR-21 may have some guiding significance in prognosis.bcl-2,p53 is possibly one of the targets of miR-21 in DLBCL.

Objective To evaluate the therapeutic effect of different types of biliary tract reconstruction on the post- resection of congenital choledochal cyst (CCC). Methods 106 cases of CCC undergoing resection of CCC with Roux-en-Y hepaticojejunostomy as biliary tract reconstruction were followed up and analysed. Results In this series, three kinds of biliary tract reconstruction were performed, including single Roux-en-Y hepaticojejunostomy in 48 cases, intussusceptive valve and rectangular valve lying on the jejunal segmental of Roux-en-Y hepaticojejunostomy in 37 and 21 cases, respectively. 61 cases were followed up for 4.82 years in average. None of them occurred anastomasis stricture. There were 4 cases with ascending cholangitis after primary operation: of them 3 after single Roux-en-Y hepaticojejunostomy; symptoms of 2 out of the 3 cases disappeared after reoperation to set up an intussusceptive valve plasty on the jejunal segmental of Roux-en-Y hepaticojejunostomy; another one was in rectangular valve group. Occasional abdominal pain tooke place in 8 patients, of them, 5 in single Roux-en-Y hepaticojejunostomy group, 2 and 1 in intussusceptive valve and rectangular valve groups, respectively. No patients suffered from ascending cholangitis in the intussusceptive valve plasty group. Conclusions The postoperative ascending cholangitis and anastomasis stricture can be prevented effectively, if a prophylactic intussusceptive valve on the jejunal segmental of Roux-en-Y hepaticojejunostomy is carried out after resection of CCC for biliary tract reconstruction. This procedure corresponds to the biliary tract physiology.

Objective To understand characteristics and research status of literatures related to surgical site infec-tion(SSI)in China.Methods Literatures about SSI published between January 2000 and March 2016 were retrieved from China National Knowledge Infrastructure(CNKI),VIP database,Vanfang Database,and China Biology Medi-cine(CBM)database. Bibliometric method was adopted to analyze external and internal characteristics of literatures. Results A total of 1036 articles in Chinese were included,40(3.86% ),189(18.24% ),and 807(77.90% )were published in 2000-2005,2006-2010,and the first quarter of 2011-2016 respectively. Articles were mainly pub-lishedinChineseJournalofNosocomiology(n= 226,21.81% ),ChineseJournalofInfectionControl(n= 53, 5.12% ),andChineseJournalofDisinfection(n= 27,2.61% ). The research fields included risk factors(n= 277, 26.74% ),infection rates (n= 261,25.19% ),antimicrobial application (n= 208,20.08% ),and pathogens (n=153,14.77% );the infection rates were higher in general surgery and neurosurgery,the main pathogens were Esch-erichiacoli,Staphylococcusaureus,and Pseudomonasaeruginosa,risk factors mainly included the types of incision, duration of surgery,diabetes,age,and body mass index.Conclusion In recent years,articles about SSI research in-creases significantly,research in etiology and epidemiology has gained substantial achievement,but in the interven-tion and economics is still weak,suggesting that SSI research in economics,risk management,and behavioral aspects should be strengthened.

Objective: To investigate protective effects of nicotinamide mononucleotide (NMN) on ethanol-induced DNA damage in L02 cells, so as to provide the evidence for adjuvant therapy of NMN on alcoholic liver diseases. Methods: L02 cells were pretreated with different concentrations of NMN (0, 1, 2, 4 and 8 mmol/L) for 6 h, and then were exposed to 0.4% ethanol for 12 h. The treated cells were divided into the control group, 0.4% ethanol group and different concentrations of NMN groups. Cell viability was analyzed using trypan blue staining for determining the concentration of NMN as a protective agent. The effects of NMN on ethanol-induced DNA damage in L02 cells were evaluated using immunofluorescence detection and reactive oxygen species (ROS) assay. L02 cells were exposed to 0.4% ethanol for 12 h, cultured in a medium containing a protective concentration of NMN, and divided into PBS group and NMN group. Cell viability was detected at 0, 2, 4, 8, 16 and 32 h, and the effects of NMN on repairing ethanol-induced DNA damage were evaluated by alkaline comet assay. Results: The cell viability was lower in 0.4% ethanol group than than in the control group, and was higher in different concentrations of NMN groups than in 0.4% ethanol group (all P<0.05), with no significant difference in the cells viability between 4 mmol/L and higher concentrations of NMN groups and the control group (all P>0.05). Therefore, 4 mmol/L NMN was selected as a protective agent. The cell tail moments, relative immunofluorescence intensities of γH2AX and relative levels of ROS were higher in 0.4% ethanol group than in the control group, and lower in 4 mmol/L and higher concentrations of NMN groups than in 0.4% ethanol group (all P<0.05). The cell viability was increased and the cell tail moment was shortened with the increase of 4 mmol/L NMN intervention time; and the cell viability in 4 h and more of NMN groups were higher, and the cell tail moment were lower than that in PBS group (all P<0.05). Conclusions NMN attenuates DNA damage in a dose-dependent manner and promotes the repair of DNA damage in a time-dependent manner. NMN has a protective effect on ethanol-induced DNA damage in hepatocytes.

Objective To establish a risk warning model for surgical site infection(SSI), provide support for screening high risk population and finding suspected cases.Methods Clinical data of 5 067 patients who underwent abdominal surgery in 6 domestic hospitals from January 2013 to December 2015 were collected retrospectively, all cases were randomly divided into modeling group and validation group according to a 6:4 ratio, warning model was established by employing logistic regression, the area under the receiver operating characteristic curve (AUC) was used to evaluate discriminant ability of evaluation model, the maximum Youden index was as the optimum cut-off point.Results For the warning model of high-risk patients, AUC was 0.823, sensitivity and specificity were 78.81% and 74.33% respectively, positive predictive value and negative predictive value were 19.67% and 97.78% respectively.For the discriminant model of suspected infection cases, AUC was 0.978, sensitivity and specificity were 93.38% and 95.62% respectively, positive predictive value and negative predictive value were 62.95% and 99.45% respectively.Conclusion The early-warning model established in this study has better discrimination ability, which can provide a reference for the development of early warning and discrimination of healthcare-associated infection information system.