Objective To evaluate the effect of surgical treatment for cholecystolithiasis with billiary-cardiac syndrome(BCS). Methods The clinical data of 149 cholecystolithiasis patients with BCS were retrospectively analysed. Results The incidence of BCS in cholecystolithiasis was 39.4%(149/378).All the 149 patients underwent cholecystectomy.No severe complications or death occurred in this series. Three months after operation, 123(82.6%) cases of BCS were followed up. Of them, ECG returned to normal and the symptoms disappeared in 102 cases(82.9%);ECG had no obvious change,but the symptoms improved in 15 cases(12.2%). Conclusions Cholecystectomy is the only effective method for treating cholecystolithiasis with BCS. For patients with asymtomatic cholecystolithiasis,if the patients cardiac function can tolerate operation,a cholecystectomy should also be done.

Objective To analyze the etiology,diagnosis and therapy of benign biliary strictures and im-prove curative and preventive effects. Methods 212 patients suffering from benign biliary strictures in Nankai Hos-pital from January 2004 to December 2006 were retrospectively analyzed. Results Inflammatory strictures (65.12%,140/215) and strictures caused by operations (20.46%,44/215) were the most two causes. Strictures parts were mainly located in the latter segment of common bile duct 52.09% (112/215). In our group,the stent of strictures parts took 31.37% (64/204), bilioendodraignage 18.13% (37/204), and the modification of strictures parts 43.63% (89/204) as well as resection of stricture parts 1.96% (4/204). Conclusions Inflammatory stricture is the main cause in benign biliary strictures and the main locus is the hinder segment of common bile duct. The di-agnesis of benign biliary strictures before operation is important because it can help to decide the approach way and prognosis. The strategies of curing benign biliary strictures could include operations and endoscopy. The stent of stric-tures parts, bilioendodraignage and the modification of strictures parts are the main treaments for benign biliary stric-tures.

Objective:To evaluate the correlation between the prognosis of patients with hilar cholangiocarcinoma and the degree of bile duct dilatation in MRCP .Methods:The clinical data of 89 patients with hilar cholangiocarcinoma undergoing radical operation at Tianjin Nankai Hospital from Jan 2009 to Dec 2013 were analyzed retrospectively.Results:Tumor size ( P=0.024), Bismuth-Corlette classification ( P=0.048) and tumor stage ( P=0.013) were related factors of biliary dilatation. Tumor differentiation ( P=0.002), R 0 resection ( P=0.002) and biliary dilatation ( P<0.001) were independent predictors of disease-free survival (DFS). Conclusion:The imaging evaluation of the degree of biliary dilatation has a certain predictive value for the prognosis of patients with hilar cholangio-carcinoma.

Objective: To investigate the characteristics and prevalence of HIV infection among AIDS volunteer counseling and testing ( VCT ) clients in Shangcheng District, Hangzhou City from 2016 to 2019, so as to provide insights into local AIDS control. Methods: The demographic features, reasons for counseling and detection of anti-HIV antibody were captured from the VCT clinic of Shangcheng Center for Disease Control and Prevention from 2016 to 2019, and the reasons for counseling and prevalence of HIV infections were analyzed. Results: A total of 2 205 clients were included, among whom 1 920 participants ( 87.07% ) were male, 1 094 ( 49.61% ) were at ages of < 30 years, 1 293 ( 58.64% ) were single, and 1 165 ( 52.83% ) had an education level of diploma and above. The common reasons for counseling included a history of homosexual behaviors with men (887 clients, 40.23%), non-commercial irregular heterosexual behaviors ( 661 clients, 29.98% ), commercial heterosexual behaviors ( 308 clients, 13.97% ), HIV-positive spouse/regular sex partners ( 123 clients, 5.58% ), and no high-risk behaviors ( 47 clients, 2.13% ). The positive rate of anti-HIV antibody was 2.95% among the 2 205 clients, and a high positive rate was observed among clients at ages of 50 years and below ( 6.15% ), single clients ( 3.71% ), clients with an education level of primary school and below ( 6.04% ) and clients with HIV-positive spouse/regular sex partners ( 11.38% ). Conclusions Single men at ages of less than 30 years and with a high education level are predominant among VCT clients in Shangcheng District, and a history of homosexual behaviors with men is the predominant reason for counseling. There is a relative low prevalence rate of HIV infection among VCT clients in Shangcheng District; however, a high prevalence rate is found among single visitors at ages of 50 years and older, with an education level of primary school and below and HIV-positive spouse/regular sex partners.

Objective To explore the preventive effects of different extracts from Aspidopterys obcordata on renal tubu-lar epithelial cells injury induced by sodium oxalate in vitro, and initially identify the effective part for treating urolithiasis. Methods The injury model of HK-2 cells induced by sodium oxalate was established to screen the active parts of Aspidopterys obcordata by testing the protective effects of different polarity extracts on HK-2 injury cells through MTT method. Results Dif-ferent extracts from Aspidopterys obcordata improved the activity of HK-2 injury cells, which were elevated to 86.17% and 95.42%by 0. 5 mg?mL-1 and 1 mg?mL-1 aqueous extract, respectively. And the activity reached to 93. 59% and 84. 77% by 0.5 mg?mL-1 and 1 mg?mL-1 50% alcohol extracts, reached above 81.56% by 95% alcohol extracts,all of which showed sig-nificant difference compared with the model group. The HK-2 cells viability were elevated to 82. 53% and 91. 58% by 0.5 mg?mL-1 and 1 mg?mL-1 95% alcohol extracted ethyl acetate parts,and increased to 77.24% and 87.22% by 0.5 mg?mL-1and 1 mg?mL-1 of 95% alcohol isolated n-butanol extracts, approached to 95.46% and 81.36% by 0.5 mg?mL-1 and 1 mg?mL-1 water extracts, all of which showed significant difference compared with the model control group. Conclusion The aqueous extracts and alcohol extracts from Aspidopterys obcordata have obvious preventive effects on HK-2 cells injury, among which the ethyl acetate extracts, n-butanol extracts and water extracts present the remarkable effects, which are supposed to be the active parts for inhibiting calcium oxalate stone formation in vitro.

Objective To study the film￣forming property of film￣forming materials in dragon blood ethanol solution, and provide the reference for screening of film￣forming materials for dragon blood plastics. Methods PVA124,PVA1788, PVP￣K30, EC, MC, PVB were chosen to study the film￣forming property of film￣forming materials based on solubility, formation time, and adhesion. Results PVA1788 and PVP￣K30 mixed in dragon blood ethanol solution in proportion of 4:1 showed good film￣forming property, and the membrane was smooth, uniform and easy to tear off.However, PVA124 and PVP￣K30 mixed in proportion of 4:1 precipitated in dragon blood ethanol solution.EC, MC and PVB were not easy to tear off the membrane. Conclusion PVA1788 and PVP￣K30 mixed in proportion of 4:1 and added with propylene glycol is the optimal choice of film￣forming material for dragon blood spray film.

Objective To study the causes of reoperation after biliary duct operation, in order to decreasing the rate of biliary tract reoperation. Methods The clinical data of 828 patients who underwent reoperation of biliary duct diseases in Nankai hospital between 1990-1999 were evalated, and the causes of biliary duct reoperation were classified and analysed.Results The most common cause for reoperation was recurrent or retained bile stone(65.10% ), bile stone companied by stenosis of the sphincter of oddi (33.82%), simple stenosis of sphincter of Oddi ( 9.54%), traumatic stricture of bile duct and stricture of bilioenteric anastomosis( 10.39%), bile duct obstruction due to tumor (6.52%), and other less important factors. Conclusions Recurrent or retained bile duct stone was the main cause for biliary reoperation,and stenosis of the sphincter of Oddi was the next important factor for reoperations.Thoroughness of the initial operation and rationality of operative procedure are the chief factors to decrease bile duct reoperations.

Objective To analyze risk factors in order to predict the in-hospital mortality of patients with se-vere acute pancreatitis (SAP), especially the factor of total cholesterol. Method Factors for predicting in-hospi-tal mortality were evaluated retrospectively from the clinical data collected from 338 SAP patients of Tianjin Nankai Hospital between January 1999 and December 2008 according to the Guidelines for for clinical diagnosis and classi-fication of Acute Panereatitis set by the Society of Chinese Medical Association in 2003. The patients were treated with intensive care, blood routine examination, blood biochemical test and even computed tomography within 24 hours after admission. The patients were divided as per outcome into deceased and survivor group. All patients were admitted within 72 hours after the onset of symptoms. The Off-square test was used for univariate analysis and multivariate test was performed by logistic regression. Results Compared with TC≤3.67 mmol/L, when the TC was between 3.67 -4.37 mmol/L, OR was 0.664 (P = 0.412), while TC was between 4.37 mmol/L and 5.23 mmol/L, OR was 0.144 (P =0.021).The OR was 1.013 (P =0.018) when TC was ≥5.23 mmol/L. The variation of serum TC levels was accompanied with the changes of C-reactive protein (CRP). When the CRP was ≥170 mg/L, OR was 7.074 (P =0.031). When the serum ALB≤30 g/L, OR was 7.224 (P =0.029).Conclusions The CRP, ALB, TC can be used for early predicting the in-hospital mortality of SAP patients. TC is a protective factor when it was between 4.37 mmol/L and 5.23 mmol/L, while it is a risk factor when ≥5.23 mmol/L or≤3.67 mmol/L. CRP> 170 mg/L or ALB < 30 g/L increases the probability of fatal outcome. Low level of albumin is a stronger predictor than the high level of CRP. Moderate elevation of TC level seems to in-crease the resistance to inflammation and hence improving the survival rate of patients with SAP and reducing the in-hospital mortality.

Infection rate and in-hospital treatment were two prognostic factors for SAP recurrence.

Objective To analyze the value of early evaluation in predicting the onset of multiple organ dysfunction syndrome (MODS) in patients with severe acute pancreatitis (SAP). Methods The clinical data of 338 patients with SAP who had been admitted to Tianjin Nankai Hospital from January 1998 to September 2008 were retrospectively analyzed. The patients were divided into MODS group (n = 163) and control group (n = 175) according to whether they did or did not have MODS. Risk factors causing MODS were analyzed by t test and Logistic regression analysis. Results The factors leading to the MODS included white blood cells count≥ 16 ×109/L, serum creatinine≥ 180 μmol/L, serum calcium≥2.5 mmol/L, c-reactive protein≥ 120 mg/L and pH value of blood≥7.35 (χ2 = 51.720, 21.421, 12.393, P < 0.05). The total cholesterol was a protective factor when it was 3.67-5.23 mmol/L. Conclusions Infection, renal insufficiency and hypercalcinemia are early predictive factors for MODS, and infection is the strongest predictive factor. Appropriate elevated total cholesterol can reduce the incidence of MODS.