Objective To study the mechanism and prevention for complications associated with postoperative T-Tube cholangiography.Method The study reviewed the data of six patients with complications following postoperative T-Tube cholangiography.Results Minor adverse reactions occurred in 4 cases, severe in 2.The severe reactions were related to cholangiovenous reflux resulted from the increase in intrabiliary pressure during postoperative T-Tube cholangiography.Conclusion Limitation of high intrabiliary pressure during the perfor mance of postoperative T-Tube cholangiography is the most important measure to prevent such reactions.

Objective To investigate the clinical efficacy of the titanium clip in endoscopic treatment of the transverse colon pol‐yps and discuss the incidence of postoperative complications .Methods A retrospective analysis of 47 patients with the diameter of the transverse colon polyps with the diameter of 1 .0 cm above for EMR treatment .47 patients divided into titanium clip group (EMR preoperative using the titanium clip in the tumor periphery 1 .0 cm extension and vascular anatomy distribution ,n=21) and no titanium clip group (EMR preoperative no using the titanium clip ,n=26) .Analysis one‐time complete resection ,intraoperative blood loss and the hemorrhage after 7 days of two groups .Results There were one‐time removal of the tumor in the titanium clip group ,and no one‐time removal of the tumor in the no titanium clip group due to the large blood loss with poor visibility ,three cases can not be a one‐time complete resection ,the two groups were significantly different (P< 0 .05);the average amount of bleeding (20 .0 ± 5 .6)mL in titanium clip group ,that was (80 .0 ± 8 .2)mL in the on titanium clip group ;compared with the two groups , there was statistically significant (P<0 .01) .There was not complication of hemorrhage after 7 days ,but three cases were that in no titanium clip group ,the difference was significant (P<0 .05) .Conclusion EMR preoperative use the titanium clip in the tumor periphery 1 .0 cm extension and vascular anatomy distribution in trement of benign tumor of the transverse colon ,which can signifi‐cantly improve the clinical efficacy of EM R technique ,and significantly reduced the intraoperative and postoperative bleeding occur‐rence ,thus it's worthy of promotion .

Objective To evaluate surgical performance of reconstruction of the cistern magna for the treatment of Chiari Ⅰ malformation associated with syringomyelia.Methods Suboccipital craniotomy and laminectomy of C1 segment were performed.The superior edge of bone window was limited to the inferior nuchal line.The dura mater and arachnoid were opened Y-shaped.The cerebellar tonsils were removed by electrocoagulation or subpially.A communication of cerebrospinal fluid between the fourth ventricle and subarachnoid space was achieved.The pseduomembrane,which is a very thin membrane over the opening of the central canal,should be cut away,with fascia grafting.Then a new enlarged cistern magna was established.Results The procedure was successfully completed in all the 36 patients with Chiari Ⅰ malformation and syringomyelia.The pseduomembrane was found in 30 patients.Postoperative follow-up checkups for 3 months ~ 5 years showed various degrees of recovery of sensation and muscle strength.Re-examinations with MRI revealed that the spinal cord cavity disappeared in 6 patients and decreased in size in 30 patients.Conclusions The decompression of the posterior cranial fossa,the communication of cerebrospinal fluid between the fourth ventricle and subarachnoid space,and the removal of pseduomembrane are key processes for treating Chiari Ⅰ malformation associated with syringomyelia.

OBJECTIVE To explore the source resulting in nosocomial infection and main component elements managing and controlling nosocomial infection in order to enhance the administration of nosocomial infection and to raise proposition on standardized administration.METHODS Main component elements resulting in nosocomial infection were investigated by reviewing literature and clinical data,and analyzing hierarchy process of administration.RESULTS Emphasis on the administrative measures of main component elements resulting in nosocomial infection might achieve the aim of preventing and reducing nosocomial infection.CONCLUSIONS Reconstruction of administrative links on nosocomial infection can reduce medical risk and cost.

Objective To retrospectively review the mortality and morbidity after orthopedic surgery for aged patients with reference to orthopedic version physiological and operative severity score for the enumeration of mortality and morbidity (O-POSSUM) and Portsmouth POSSUM (P-POSSUM) and validate the score' s accuracy in operative risk prediction.Methods O-POSSUM and P-POSSUM for mortality and morbidity were applied to 839 aged patients who had undergone orthopedic surgery between January 2008 and December 2011.Observed mortality and morbidity were compared with the expected values.Results O-POSSUM predicted 230 morbidities,but the observed value was 182 (x2 =2.718,P ＞ 0.05).O-POSSUM predicted 46 deaths,higher than the observed 3 deaths (x2 =38.870,P＜0.01).P-POSSUM predicted 16 deaths,higher than the observed 3 deaths (x2 =8.997,P ＜ 0.01).Conclusions O-POSSUM accurately predicts postoperative morbidity in aged orthopedic patients.However,O-POSSUM and P-POSSUM overpredicts the mortality and should be used with caution.

Objective To investigate the effect of pronuciferine on apoptosis of cultured human umbilical vein endothelium cells(HUVECs) induced by angiotensin Ⅱ(AngⅡ).Methods HUVECs cell line ECV304 was cultured in vitro,pretreated with Captopril(10 ?mol/L) or pronuciferine 10,1,0.1,0.01 ?mol/L for 30 min,respectively,then treated with AngⅡ(1 ?mol/L).Cell-morphosis was observed by light microscope.Cells viability was assessed by MTT assay.Production of nitric oxide(NO),activities of total nitric oxide synthase(tNOS),and inducible nitric oxide synthase(iNOS) were measured by colorimetry.Apoptosis rate was measured by Flow Cytometer(FCM).Results AngⅡ induced typical endothelial cell apoptosis and the apoptosis rates were significantly higher than those of the control group((P

Objective To determine the radiographic feasibility of oblique lumbar interbody fusion (OLIF) corridor to treat lumbar disease at each lumbar disc level,including the corridor's numerical value and the influence of diaphragmatic crura and aorta abdominalis.Methods A retrospective CT study was conducted on 110 patients (including 69 males and 41 females,average age 47.95 years,range 16-83 years) that continuously collected and analyzed in the PACS system.The oblique corridor was defined as the area between the left lateral border of the aorta abdominalis(or iliac artery) and the right lateral border of the left psoas.The distances and angles of L1-2,L2-3,L3-4 and L4-5 levels were measured.Whether the change of diaphragmatic crura and aorta abdominalis affected the building of the corridor was also observed.Results The mean distances of oblique corridor to the levels of L1-L5 discs were:L1-2 15.90 mm,L2-3 14.82 mm,L3-4 17.57 mm,L4-5 11.16 mm.At the levels of L1-2 and L3-4,all of the images could build the corridor.But there were only 97.27％ images allowing operation at both L2-3 and L4-5,and the other 3 cases couldn't build the corridor since the aorta abdominalis was very close to psoas,and the distance was almost 0 mm.The max mean distance was 36.79 mm at L3-4 level.The mean angles were:L1-2 36.98°;L2-3 37.76°;L3-4 40.96°;L4-5 37.85°.The significant difference was at L3-4,ranged from 13.09 to 61.93°.The level of the aortic bifurcation was from the lower third of the L3 vertebral body to the middle third of the L5 vertebral body.The levels of left diaphragmatic crura's ending point in the lumbar was divided into four groups:1) Group L1 vertebral body level:the level at L1 vertebral body and above,5 cases (4.55％);Group L1-2 disc to L2 vertebral body level:at L1-2 disc and L2 vertebral body,67 cases (60.91％);Group L2-3 disc to L3 vertebral body level:at L2-3 disc and L3 vertebral body,36 cases (32.72％);Group L3-4 disc to L4 vertebral body level:at L3-4 disc and L4 vertebral body,2 case (1.81％).Conclusion The OLIF corridor can be built successfully at L1-2 and L3-4.However,it may be difficult at L2-3 and L4-5 for some patients due to the aorta abdominalis which is too close to psoas.The angles of L1-L5 levels were similar.While the left diaphragmatic crura was mainly impact the corridor insertion at L1-2 and L2-3.And the level of the aortic bifurcation was mainly located at the upper endplate of L4 to the L4-5 disc (87％).

The wild type cells of human stomach glandular carcinoma, cell line BGC 823, were treated firstly by a chemical carcinogen (MNNG) for the induction of mutagenesis, then the cells were selected in medium with gradually increasing amount of 8-AG (8-azaguanine) from 1-20?g/ml. It was found that the mutant cells could grow vigorously in the medium containing 20?g/ml of 8-AG but not in HAT medium. The HGPRT assay showed an obvious quantitative difference between the wild type and HGPRT mutant cells of BGC 823.

Aim To study the mechanisms of N-demethyl-clarithromycin-induced apoptosis in human cervical cancer cell line HeLa. Methods MTT, photomicroscopical observation, DNA agarose gel electrophoresis, LDH release and Western blot were used for apoptosis assay. Results N-demethyl-clarithromycin inhibited growth of HeLa in a time-dependent manner. Apoptotic bodies were found with Hoechst 33258 staining after treatment with 60 ?mol?L-1 N-demethyl-clarithromycin. DNA fragmentation was observed in N-demethyl-clarithromycin treated HeLa cells. The Akt inhibitor and the ERK inhibitor (PD98059) increased cell death. The expression of anti-apoptotic protein Akt, phosphorylated-Akt, ERK and phosphorylated-ERK decreased. Conclusion N-demethyl-clarithromycin induces HeLa apoptosis through Akt and ERK expression and phosphorylation.

[Objective] To discuss the effect of intestine-dredging and Qi-benefiting method and its corresponding prescription in managing systemic inflammatory response and preventing multiple organ dysfunction syndrome (MODS). [Methods] Eighty. SD rats were randomized to control, model, low-dosage (LD) and high-dosage (HD) groups. One day before modeling, HD and LD groups were administered the preparation based on intestine-dredging and Qi-benefiting method by 60g/kg and 30 g/kg for 2 times, and control and model groups were given equal amounts of normal saline. On the 2nd day after the administration, 3 groups except the control group were modeled on the given reference. Twelve hours after modeling, the content of TNF-? and NO in serum was examined and histopathological examination of the main organs was conducted. [Results] Compared with the control group, the level of TNF-? and NO significantly increased (P