Objective The value of endoscopic retrograde choledocho－ pancreatography( ERCP ) to detect narrow－ winding cystic duct and the effect of surgery were studied .Methods The clinical presentations, pathogenesis, diagnostic procedures and outcome of surgery were collected and analysed in 17 patients with this change. All had preoperative ERCP as well as intraoperative cholangiography. The operation was simple cholecystectomy. Results Satisfaction was obtained througthout the followup period for 2～ 5 years . Conclusion Narrow－ winding cystic duct is not a rare biliary disorder with high rate of confirmation by ERCP and fine result following cholecystectomy.

Objective The aim of this study was to exam by image for APBJ, and to further establish the principles in the treatment of APBJ. Methods From December 1979 to October 2001, 64 adult patients with APBJ underwent surgical treatment in our hospital . Cholangiopancreatographic results and surgical treatment outcomes of these patients were reviewed and analyzed. Results Of the total 64 patients 28, 32 and 4 were typed as P - C(43. 8% ) ,C - P(50% ) and Common Channel(6. 2% ) distinctively. Conclusions Patients with APBJ are often associated with biliary tract and pancreatic diseases, early discovery and appropriate surgical treatment could avoid most of the serious complications.

Due to the increasing use of hepatoeytes,the demand of hepatoeytes is increasing consistently in basic clinical research.The application of rational and efficient method of hepatoeyte isolation is a prereq-uisite for its application.At present,there are many methods of hepatoeyte isolation.This review summarizes the latest progress on them.

Objective To detect the expression of p53 and k-ras in benign and malignant gallbladder diseases.Method ABC immunohistochemistry was used to detect p53 and k-ras protein in 101 specimens of chronic cholecystisis with cholecystolithiasis(group A),20 with cholesterol polyp(group B),22 with adenoma of gallbladder(group C),25 with primary gallbladder cancer(PGC)(in which there were 5 with atypical hyperplasia and carcinoma in situ)(group D)in this study.The relationship between p53 or/and k-ras expression and clinicopathologic data were analyzed.Resuit p53 and k-ras expressions were detected in both benign and malignant specimens,with the positive rates increasing from cholesterol polyp,to chronic cholecystisis to adenoma of gallbladder to carcinoma in situ and PGC(p53 was 62.8% in patients with benign lesions,and 92.0%in malignant lesion x2=8.16,P=0.004;k-ras was positive in 66.4% patients with benign lesions,and 92.0% in malignant lesions x2=6.65,P=0.01).In benign lesions the p53 expressions in group C was higher than that in group A and B(x2=6.90 and 6.02,P=0.009 and 0.014).There was higher expression of p53 in chronic chylecystisis with a history more than 10 years than those less than 10 years(80.0%vs.52.9%,x2=8.28,P=0.004).k-ras in cases less than 60 years old was higher than those after 60 years of age(70.4%vs.46.8%,x2=5.79,P=0.016).Conclusion The higher expression rate of p53 in cholecyst adenoma may predict carcinogenesis,while k-ras is negatively correlated with patients'age,which may bespeak the development of carcinoma in patients younger than 60 years old.

Objective To investigate the clinical value of ventricular intracranial pressure monitoring in treatment of severe craniocerebral trauma with high intracranial pressure.Methods A retrospective analysis was conducted on forty cases of severe craniocerebral trauma with GCS score of 3-5 undergone bilateral decompressive craniectomy from October 2010 to January 2012.The patients were divided into three groups:Group A (12 cases received craniotomy after the placement of ventricular intracranial pressure probe) ; Group B (15 cases had craniotomy ahead of the probe placement) ; control group (13 cases had probe placement alone).Intracranial pressure control,dose and duration of administration of dehydrator and prognosis were compared among groups.Results Groups A and B showed a better result in aspects of controlling intracranial pressure within 15 mm Hg,dose and duration of mannitol treatment,and prognosis,as compared with control group (P ＜ 0.05).Furthermore,Group A had seven cases of severe disability or in vegetable state,but only three cases in Group B (P ＜ 0.05).Conclusion Ventricular intracranial pressure monitoring can effectively reduce intracranial pressure,raise treatment success rate and decline the use of mannitol in management of severe craniocerebral trauma.

Objective To observe the clinical efficacy of fire-needle therapy in treating scapulohumeral periarthritis, and to observe the changes of pain score and the motor function of shoulder joint. Method Totally 180 patients were randomized into a fire-needle therapy group of 90 cases and a filiform needle group of 90 cases by randomized single-blinded method. Result There were significant differences between the two groups in comparing the recovery rate, motor function of shoulder joint, and the relapse rate 30 d after the whole intervention (P<0.01), while there were no significant differences in Visual Analogue Scale (VAS) score and total effective rate (P>0.05). Conclusion Compared to filiform needle therapy, fire-needle therapy can produce a better recovery rate and motor function of shoulder joint in treating scapulohumeral periarthritis.

Objective: To investigate the application value of hs-CRP and BNP detection in COPD patients with pulmonary heart disease. Methods: From January 2016 to January 2018, 80 patients with COPD in the Fifth People's Hospital of Datong were selected.Forty-two COPD patients complicated with pulmonary heart disease were selected as COPD and cor pulmonale group, 38 COPD patients without pulmonary heart disease were selected as COPD group, and 30 healthy volunteers were selected as control group.The differences of hs-CRP and BNP levels were compared, and the diagnostic value of hs-CRP and BNP for COPD combined with pulmonary heart disease was analyzed. Results: There were statistically significant differences in hs-CRP[(72.5±20.4) mg/L vs.(37.5±9.8) mg/L vs.(3.7±1.2)mg/L], BNP[(362.8±86.9) ng/L vs.(125.9±34.8) ng/L vs.(28.5±9.9)ng/L] among the COPD and cor pulmonale group, COPD group and control group (F=9.245, 14.668, all P<0.05). The hs-CRP and BNP levels in the COPD and cor pulmonale group were significantly higher than those in the other two groups(t=19.294, 11.576, 21.385, 9.258, 9.258, all P<0.05), which of the COPD group were significantly higher than those of the control group (t=8.912, 12.567, all P<0.05). The best boundary value of BNP in diagnosis of COPD with cor pulmonale was 261.8ng/L, and its diagnostic sensitivity and specificity were 96.2% and 85.4%, respectively, the area under the line was 0.834, which were all higher than those of hs-CRP.With the increase of cardiac function, the levels of hs-CRP[(38.5±10.3) mg/L vs.(51.4±14.8) mg/L vs.(75.1±21.5) mg/L vs.(93.7±31.8)mg/L], BNP[(142.8±56.5) ng/L vs.(285.9±94.8) ng/L vs.(352.5±118.2) ng/L vs.(478.5±130.3)ng/L] increased, the differences were statistically significant (F=13.577, 16.776, all P<0.05). There were significant correlation between hs-CRP, BNP levels and COPD patients complicated with cor pulmonale (r=0.675, 0.766, all P<0.05). Conclusion hs-CRP and BNP have high diagnostic potency for COPD patients combined with cor pulmonale, and are positively correlated with cardiac function classification.

Objective To investigate the effects of damage control surgery (DCS) in the treatment of severe craniocerebral injury patients combined with multiple extremity fractures.Methods The clinical data of 128 patients with severe craniocerebral injury[Glasgow coma scale (GCS) scored 3-8] combined with multiple extremity fractures admitted from May 2011 to August 2015 were retrospectively analyzed by case-control study.There were 81 males and 47 females,with an average age of 37.3 years (range,19-77 years).The patients were treated with intracranial pressure monitoring in addition to the common administration.The patients were subdivided into two groups:87 patients treated with DCS concept as damage control group and 41 patients treated with non-DCS routine concept as control group.The DCS group received craniotomy and fracture fixation operation in stage Ⅰ with selective operation of open reduction and internal fixation.The control group received craniotomy and open reduction and internal fixation in stage Ⅰ.The postoperative intracranial pressure,operation duration,intraoperative blood loss,hospital stay and prognosis [Glasgow outcome scale (GOS)] were analyzed statistically.Results No intracranial infection was found in all patients during the treatment process.In damage control group,the postoperative intracranial pressure was normal in 44 cases (51％),which was significantly better than that in control group [8 cases (20％)] (P ＜ 0.05).In damage control group,operation duration [(150.1 ± 12.4)minutes],intraoperative blood loss [(270.6 ± 15.3)ml],and hospital stay [(29.7 ± 9.3) days] were significantly shortened compared with control group,whose operation duration,intraoperative blood loss and hospital stay were (270.6 ± 9.8) minutes,(460.2 ± 17.5) ml,and (34.4 ± 6.2) days,respectively (P ＜ 0.05).The GOS rating of damage control group (70％) was notably higher than that in control group (42％) (P ＜ 0.05).Conclusion For severe craniocerebral injury patients combined with multiple extremity fractures,the application of DCS contributes to control of postoperative intracranial pressure,which can also shorten the duration of hospitalization and improve prognosis.

OBJECTIVE: To investigate the correlation between allergic rhinitis and obstructive sleep apnea-hypopnea (OSAHS) syndrome in children. METHOD: (1) According to medical history, physical signs, skin-prick test, serum sIgE, endoscopic examination and polysomnography, the incidence of allergic rhinitis was confirmed in 574 cases of childhood obstructive sleeping apnea-hypopnea syndrome in our hospital between July in 2008 to June in 2010. (2) Effects of anti-allergic drugs were observed on 78 children with OSAHS and allergic rhinitis meanwhile. RESULT: (1) 258 cases of allergic rhinitis were confirmed in 574 cases of OSAHS, accounting for 44.9% of the OSAHS cases and 50.4% of all cases of allergic rhinitis during the same period. Most of them were perennial allergic rhinitis (223 cases, 86.4%), and 72.5% of them were aroused by fungal allergen. Compared with other allergen, statistically significant difference was found (P < 0.05). (2) After receiving anti-allergic drugs regularly for 3 weeks, 40 cases suffering from mild and moderate OSAHS and allergic rhinitis, 3 cases out of 38 cases suffering from serious OSAHS and allergic rhinitis showed satisfactory results, while other cases had little improvement. CONCLUSION Allergic rhinitis is closely related to childhood OSAHS, and perennial allergic rhinitis dominates. The most common allergen is fungal allergen, the second is house and flour dust mites. So for patients of mild and moderate OSAHS with allergic rhinitis, regular anti-allergic drugs can lighten OSAHS effectively and may make patients avoid surgery. Severe OSAHS cases can receive surgical intervention if prior anti allergic therapy fails. Anti allergic therapy should be adopted routinely after tonsillectomy and adenoidectomy in case of hypopnea due to hypertrophy of inferior turbinate or tubal torus in allergic rhinitis.
Child ; Child, Preschool ; Female ; Humans ; Lymphoid Tissue ; pathology ; Male ; Rhinitis, Allergic, Perennial ; complications ; pathology ; Sleep Apnea, Obstructive ; complications ; Turbinates ; pathology

Objective To analyze the differential protein expression of three negative breast cancer tissue before and after menopause application of iTRAQ technology, to explore the effects of menopause on three negative breast cancer. Methods Selected premenopausal and postmenopausal women with 8 cases in each by negative pathological diagnosis, differential protein analysis on significant function, difference of protein pathway and difference of protein verify were analyzed by the application iTRAQ technology. Results (1﹚Differential protein interactome was relatively centralized premenopausal, and postmenopausal differences of protein was much, and the distribution of the dispersed. (2﹚In pre menopausal cancer tissue protein differences existed in 5 of the significant difference in differences approach; post-menopausal cancer tissue protein existsed in 15 significantly different pathways. (3﹚Tumor adjacent tissues compared with premenopausal had a total of 214 significant difference proteins, postmenopausal had a total of 360 significant differ-ence proteins. The upregul ated proteins in 81 kinds of premenopausal three negative breast cancer tissues, 133 down regμl ated proteins, postmenopausal up-regμl ated protein 157 types, down 203. Conclusion Using iTRAQ technology to found that the expression has a certain particμl arity differences in three negative breast cancer before and after menopause, indicate three negative breast cancer may have different pathogenesis in the different estrogen environment, may be a new target for treatment of TNBC.