Objective To study the preventive effect of biliary duct injury(BDI)of three-dimensional spiral CT cholangiography(SCTC)before laparoscopic cholecystectomy(LC).Methods A retrospective analysis was carried out for 30 patients suffering from cholelithiasts concurrent with choledocholithiasis from July 2007 to June 2009.EAndoscopic sphincterotomy(EST),then three-dimensional SCTC was carried out through endoscop-ic nasobiliary drainage(ENBD)before IX,and the preventive effect of BDI was evaluated.Results The visibility of intra-hepatic bile duct,the hepatic bile duct and the common bile duct were 100% the visibility of chol-ecyst bile duct was 73% ,and three-dimensional SCTC can tell the position of cholecyst duct,BDI was not happened in all these patients.Conclusion Three-dimensional SCTC before LC can decrease the possibility of BDI.

Objective To analyze the diagnosis and treatment of intestinal obstruction patients caused by intra-abdominal hernia with no abdominal surgery history ,in order to raise awareness .Methods Clinical data of 23 intestinal obstruction patients caused by intra-abdominal hernia with no abdominal surgery history were retrospectively analyzed.The clinical manifestations ,type,and risk factors were analyzed .And its diagnosis and prevention was dis-cussed.Results 23 patients were caused by intestinal blood circulation disorders ,in which there were 11 cases small intestine mesentery hernia ,2 cases duodenal hernia ,2 cases pericecal hernia ,3 cases omentum hernia ,1 case obturator hernia,2 cases congenital dysplasia and intestinal mesenteric torsion induced small hernia ,2 cases formation of intra-abdominal pressure alone belted intestine ,8 cases of intestinal necrosis .22 patients were cured after surgery ,1 case died,12 cases had postoperative complications .The incidence rate of postoperative complications of patients with in-testinal necrosis was 59.3%( wound infection 37.1%, pneumonia 22.2%), which was significantly higher than 11.8%of patients without intestinal necrosis (wound infection 5.9%,pneumonia 5.9%)(χ2 =3.861,3.861,all P<0.05).Conclusion The intestinal obstruction caused by intra-abdominal hernia with no abdominal surgery history is closed loop obstruction , preoperative diagnosis is difficult , with the rapid progression of the disease , and intestinal strangulation ,intestinal necrosis can occur in the short term whithout timely surgical treatment .Therefore ,early diagno-sis and prompt surgical treatment is the key to the diagnosis and treatment of intestinal obstruction caused by intra -ab-dominal hernia with no abdominal surgery history .

Objective To investigate the clinical efficacy of digital gastrointestinal machine in emergency.Methods 1600 emergency patients accepted radiography with digital gastrointestinal machine.Rusults All cases were successful in examining with digital gastrointestinal machine.Conclusion Excellent digital film can be acquired by digital gastrointestinal machine.It meets the requirements in clinical emergency diagnosis.It is easy to operate and acceptable to patients.

Objective To evaluate the efficacy and safety of paclitaxel drug-coated balloons (DCB)in treating acute coronary syndrome in patients with high bleeding risk.Methods A total of 35 inpatients with acute coronary syndrome and high bleeding risk who were treated in our hospital from March 2017 to December 2017 were retrospectively analyzed.The patients were divided into the control group (n=20) treated with normal balloon dilatation and the experimental group (n =15) treated with DCB treatment.The age,major cardiac adverse events(MACE)within 3 months,fatal hemorrhage events,all-cause mortality,attributable mortality,target lesion revascularization rate(TLR),coronary artery stenosis degree before intervention,and coronary artery stenosis degree at once and 3 months after surgery,were used for comparison and for statistical analysis between the control and the experimental group.Results There were no significant differences between the two groups in the indexes as the followings:MACE within 3 months after surgery(25.0％ vs.6.7％,x2 =2.03,P =0.15),fatal hemorrhage events (10.0 ％ vs.6.7 ％,x2 =0.12,P =0.727),all-cause mortality (20.0％ vs.6.7％,x2 =1.24,P =0.27),attributable mortality(10.0％ vs.0.0％,x2 =1.59,P=0.21),TLR(14.3％ vs.0％,x2 =3.08,P =0.08).However,the incidence of fatal hemorrhage and MACE,all-cause mortality,attributable mortality and TLR were relative low in the experimental group (P＞0.05).Conclusions Drug-coated balloon treatment is safe and effective in treating acute coronary syndrome in patients with high bleeding risk.