ObjectiveTo review the management and prevention of stenosis after hepaticojejunostomy. MethodsWe retrospectively analyzed 133 patients who developed stenosis after hepaticojejunostomy carried out for iatrogenic bile duct injuries. ResultThrough our active reoperative protocol, we were able to achieve satisfactory results in 131 patients, although the results were still unsatisfactory in 2 patients. ConclusionsStenosis after hepaticojejunostomy is a severe complication which should actively be prevented. Once it happens, doctors should apply active, appropriate and effective measures to correct the stenosis.

Objective To pay close attention to and reverse the increasing trend about missed diagnosis and misdiagnosis of carcinoma of gallbladder and bile duct in laparoscopic cholecystectomy(LC). Methods By using retrospective analysis of 17 cases of missed diagnosis and misdiagnosis of carcinoma of gallbladder and bile duct in LC, their Clinical features and proposing protective measures were summarized. Results Seventeen patients including 14 with carcinoma of gallbladder and 3 with carcinoma of bile duct received various therapeutic measures according to their own conditions or aspirations. Conclusion Rapid intraoperative frozen section diagnosis is required for the cases with suspected carcinoma in LC and second operation is performed for those who are pathologically diagnosed with malignant tumor after the first one. No pathological diagnosis is strictly prohibited.

Objective To explore the emergency management and prevention of iatrogenic injury of in-ferior vena cava. Methods A retrospective study was undertaken to investigate the operative procedure and post-operative outcome of 7 patients suffering from iatrogenic injury of inferior vena cava in the course of three nephrectomy, one fight adrenal gland tumor resection, one fight surgical kidney, one right upper retro-peritoneal tumor and one pancreaticoduodenectomy. The gross hemorrhage was controlled by local pressure. Then, abdominal incision was done. Firm pressure on the inferior vena cava was performed to right side for temporary control of hemorrhage. The bleeding part could be found when the hematocele was cleaned. And continuous suture should be done with 3-0 silk or absorbable suture after the crevasse was clamped. Results In these 7 cases, 1 died of hemorrhagic shock and the other 6 had significant effect postoperatively. The asso-ciated injuries were healed well except 1 case of slight edema of lower extremity. Conclusion Iatrogenic inju-ry of inferior vena cava can be treated successfully with correct procedure. Furthermore, the injury could be avoided with exactitude intraoperative procedure.

Objective To analyze the risk factors for thrombosis by investigating the incidence of central venous catheter‐related thrombosis in elderly patients .Methods Four hundred and five elderly patients who underwent central venous catheterization were divided into femoral vein group(n=46) ,internal jugular vein group (n=40) and subclavian vein group (n=319) according to their catheter position ,or into thrombosis group (n=31) and non‐thrombosis group (n=374) according to the incidence of central venous catheter‐related thrombosis .T heir gender ,age ,basic diseases ,catheter position ,retention time of catheter ,and complications of central venous catheter‐related thrombosis were retrospectively analyzed .Results The incidence of central venous cathe‐ter‐related thrombosis was significantly lower in subclavian vein group than in internal jugular vein group and femoral vein group (5 .0% vs 15 .0% ,5 .0% vs 19 .6% ,P<0 .05 ,P<0 .01) .The percentage of past venous thrombosis history was significantly higher in thrombosis group than in non‐thrombosis group (19 .4% vs 6 .4% ,P<0 .05) .Conclusions Subclavian vein catheterization can significantly reduce the incidence of central venous catheter‐related thrombosis and past ve‐nous thrombosis history can predict the incidence of central venous catheter‐related thrombosis in elderly patients .

Objective To explore the diagnostic and therapeutic methods for male breast cancer. Methods Clinical data of 11 cases of male breast cancer treated in our hospital from 1992 were analyzed (retrospectively). Results 2 patients were diagnosed at advanced stage and survived 6 and 8 months (respectively) after biopsy. The other 9 patients received radical mastectomy. 3 were lost to follow-up, 1 was found to have pulmonary metastasis after 5 years and combined treatment of traditional Chinese medicine and western medicine was given. Nodules were found under the axillary fossa in another patient at five years after surgery and the nodules were recurrent carcinoma as confirmed by biopsy. The patient has survived for 7 years with radiotherapy and chemotherapy. The other 4 cases have survived 0.5 to 7 years respectively, and are undergoing treatment. Conclusions Early diagnosis of male breast cancer should be emphasized. Aggressive surgery combined with other auxiliary treatments are effective.

Objective To explore methods for the treatment and prevention of residual gallbladder.Methods Clinical data of 56 patients with residual gallbladder were retrospectively analyzed.Results All 56 cases were diagnosed through clinical imaging examination and cured by selective operation of residual gallbladder resection.Conclusion The residual gallbladder can be diagnosed by repeated biliary symptoms in patients with a history of cholecystectomy and imaging examination.Residual gallbladder resection is an effective therapy for the treatment of residual gallbladder.

Objective To explore the effect of sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) overexpression on neuroendocrine system in chronic heart failure beagles. Methods The cardiac contraction function of chronic heart failure beagles were assessed by echocardiography before and after SERCA2a gene transduction. Radiation immune method was used to test the serum level of neuroendocrine factors such as Angiotensin Ⅱ, atrial natriuretic peptide, endothelin-1 and TNF-α, IL-6. Results The cardiac contraction function of chronic heart failure beagles improved greatly (P<0.05), and the serum levels of neuroendocrine factors significantly reduced after SERCA2a overexpression (P<0.05). Conclusion The vicious circle of neuroendocrine system may be blocked partially by SERCA2a overexpression.

Objective To investigate the expression of glutathione S-transferase π (Glutathione S-transferase π, GST-π) protein in peripheral blood and brain of patients with drug-resistant epilepsy and refractory epilepsy rats. Meth?ods From January 2010 to March 2014, the expression of GST-πin the blood and brain of 32 cases of drug-resistant epi?lepsy underwent neurosurgery and 10 cases of cerebral vascular malformation underwent surgery were studied and com?pared. The expression of GST-πin the blood and brain in refractory epilepsy rats and normal rats were studied and com?pared. Results The specimen from 20 temporal, 6 frontal and 6 occipital lobes were obtained from drug-resistant epilep?sy patients. The expression levels of GST-πin the blood and brain in refractory epilepsy rats and normal rats were higher than those of the control groups (P<0.05). Conclusion GST-πmay be involved in the process of drug-resistant epilepsy. The GST-πexpression in blood may be used as a marker for resistance to anti-epileptic agents.

Objective To establish a method for the determination of forsy thin in Baohe Oral Liquid by HPLC.Methods The determination was carried out on a Diamonsil C18 column,with mobile phase of acetonitrile-water(29∶71) at room temperature.The flow rate was 1.0mL?min-1 and the detective wavelength at 277 nm.Results The calibration curves was linear in the range of 0.068～ 0.340 ? g(r=0.9996).The average recovery rate of tested sample was 99.7 %(RSD=2.1 %).Conclusion The method was specific,accurate and precise.It can be used for the quality control of Baohe Oral Liquid.

Objective To investigate the therapeutic effects of recombinant adeno-associated virual gene serotype 1(rAAV1) mediated transfer of sarcoplasmic reticulum Ca2+ ATPase(SERCA2a) on beagle dogs with heart failure(HF).Methods The chronic HF model was reproduced in beagle dogs by giving rapid right ventricular pacing(230 beats/min) for 30 days.A reduced rate(180 beats/min)was continued for another 30 days.Sixteen beagle dogs were divided into four groups(4 each): control group,HF group,HF+EGFP group and HF+SERCA2a group.After rapid pacing for 30 days,rAAV1-EGFP(1?1012vg/ml) and rAAV1-SERCA2a(1?1012vg/ml) were respectively delivered via intramyocardial routes,while no treatment was given to the animals in both control and HF groups.At the end of the study,haemodynamics,echocardiography and the protein expression of SRCA2a were measured respectively.The apoptosis index of cardiac myocyte was evaluated by TUNEL.Bax expression was assessed by immunohistochemistry.Results After gene transfer of SERCA2a in HF beagle dogs for 30 days,the heart function was improved along with an increase in SERCA2a expression.Left ventricular systolic function was significantly increased,including the left ventricular systolic pressure(LVSP),left ventricular maximal rate of pressure rise(LV+dp/dtmax),left ventricular maximal rate of pressure decline(LV-dp/dtmax,P