Objective To explore the prevention and management of biliary tract injury during laparoscopic cholecystectomy(LC) in patients with acute cholecystitis.Methods Between October 1999 and October 2008,368 patients with acute cholecystitis received LC in our hospital,7 of them developed biliary tract injury during the operation,and therefore underwent the biliary repair or Roux-en-Y anastomosis between the common bile duct and jejunum as well as T-tube drainage.Results Among these 7 cases,5 cases was converted to open abdominal operation during the procedure of LC,of which 2 cases(1 with total bile duct transection and 1 with electric burn of bile duct) showed stenosis of the bile duct in 12 and 3 months respectively after the T tube was removed,and then was cured by a second Roux-en-Y anastomosis.Two of the 7 patients received biliary repair because of electric burn;cholangiography showed no stenosis after 3-month T-tube drainage.In one patient who had severe injury to the common bile duct,Roux-en-Y anastomosis was performed,and then the patient was discharged from the hospital in 2 weeks with the T tube;one month later,re-examination by cholangiography showed that the case was cured.In the 7 patients,jaundice was observed in 2 cases in 3 to 5 days after the surgery;ERCP showed biliary stenosis in one of them,and complete biliary atresia in another.Subsequent abdominal exploration on the two cases revealed complete common bile duct occlusion in one and partially occluded common hepatic duct in the other.Roux-en-Y anastomosis between the bile duct and jejunum combined with T-tube drainage was therefore made on the patients.The 7 cases were followed up for 0.5 to 6 years,during the period,none of them showed biliary stenosis,residual stones or other complications.No patient died during the follow-up.Conclusion Biliary tract injury during LC in patients with acute cholecystitis can be avoided as long as we choose the right time for LC as well as for conversion to an open surgery.

OBJECTIVE:To prepare oxymatrine pellets and study the pellets' properties.METHODS:Oxymatrine pellets were prepared using an experimental low-temperature extrusion-spheronization granulator.L9(34)orthogonal design was used to obtain optimal formulation.The micromeritic properties and in vitro dissolution of the pellets at different dosage were determined.RESULTS:Oxymatrine pellets prepared by extrusion-spheronization were round and smooth and well-distributed.The optimal technical conditions were as follows:water∶MCC=0.90∶1;spheronization velocity=35 Hz;spheroniza-tion time=5 min;extrusion velocity=40 Hz.The in vitro dissolution was more than 75% within 30 minutes.CONCLUSION:The process of preparing pellets by extrusion-spheronization was simple and feasible and the quality of pellets was excellent.

Objective To evaluate the effect of endoprostheses for short and long term management of common bile duct stones in elderly patients(70 89 years). Methods Fifty two patients over 70 years with common bile duct stones undergone endoscopic biliary stenting(Group S, 28 cases) or common bile duct exploration (Group D, 24 cases) were followed up for 14 85 months. The two groups were similar to each other in clinical manifestations. Results One patient (4 2%) died because of breath and circulation exhausting on the 3rd day postoperation in Group D. Early complications were 14 4% and 33 3% respectively ( P

Objective To study features and causes of biliary duct re-operations and evaluate their therapeutic efficacy for avoiding its occurrence and decreasing its number.Methods 32cases of the clinical data of all de patients receiving bile duct re-operations in our hospital from 1996 were retrospectively analyed.Results 32 cases have no surgical operation complications,with 23 cases visit 5 years and only 2 cases are poor.Conclusions The main cause for re-operations is bile ston.The purpose of re-operations is to clean up stones,correct strictures and build pathway for bile flow.

Objective　The covered tracheal stent in shape of a straight tube or a fork-like tube was placed clinically to treat tracheal stricture and tracheal fistula caused by malignant tumour in order to maintain the normal function respiration and to keep the fistula closed.Methods　The stent was made of stainless steel in shape of "Z"covered with membrane partially or entirely.An instrument with tube in three sheathes was used to place the stent in position.Results　The tracheal stents were placed successfully in 9 cases at first time and the esophageal stents were placed for 6 cases among them in the meantime.Dyspnea of patiants was remarkably alleviated.The tracheal fistula of them was closed effectivelly.Follow-up for 4～12 monthes all cases demonstrated no adverse effects.Conclusion　The application of the covered stent is a safe effective method to treat the tracheal stricture and tracheal fistula.

OBJECTIVE To study the distribution of drug-resistant gene of meticillin-resistant coagulase negative Staphylococcus(MRCNS) in children septicemia.METHODS The total MRCNS isolates were 40,and whether in there harbored genes mec,erm and qac was studied.RESULTS Among 40 CNS strains,in there harbored genes mec,erm,and qac were 38(95.0%),30(75.0%) and 18(45.0%),respectively.CONCLUSIONS MRCNS in children septicemia where harbor drug resistance genes is very serious,so we should pay great heed to its effective control.

Objective T o establish a gas chrom atography-m ass spectrom etry (G C-M S ) m ethod for the determ ination of sulfide ion in blood and apply it to the practical cases. Methods T he 1, 3, 5-tribro-m obenzene w as selected as an internal standard, and 0.2 m L blood sam ple w as collected and analyzed using G C-M S after α-B rom o-2, 3, 4, 5, 6-pentafluorobenzyl brom ide derivatization. Results T he m ass concentration of sulfide ion in blood had good linearity in the range of 0.2-40μg/m L w ith a lim it of detection (L O D ) of 0.05μg/m L . T he m ass concentration of sulfide ion w as less than 0.05μg/m L in blank blood from different sources such as healthy subjects and dead cases. In 3 sulfide poisoning cases, sul-fide ion w as detected in the blood sam ples of 6 victim s, and the m ass concentration range w as 1.02-3.13μg/m L . Conclusion T his study establishes a m ethod for investigation of sulfide ion in blood w hich has been applied successfully to the cases of fatal sulfide poisonings.

Objective: To study the expression of negative costimulatroy molecule B7-H4 in non-small cell lung cancer (NSCLC) tissues and its relationship with the clinical features of NSCLC. Methods: Fifty-two NSCLC specimens from pa-tients who were pathologically diagnosed in our hospital during January 2008 to April 2009 were included in the present study. B7-H4 expression and infiltration of CD3~+ T cells in NSCLC tissues were detected by immunohistochemistry. The correlation between B7-H4 expression, CD3~+ T infiltration, and the clinical features of NSCLC was studied. Results: The positive rate of B7-H4 in 52 NSCLC tissues was 48.08% (25/52), and B7-H4 expression in normal lung tissues was neg-ative or low (P <0.05). B7-H4 expression was positively correlated with the clinical tumor stages and lymph node metas-tasis of NSCLC (P < 0.05), and negatively correlated with tumor infiltration of CD3~+ T cells (P < 0.05), but had no re-lationship with clinicopathologie parameters of NSCLC (P > 0.05). Conclusion: Negative costimulatroy molecule B7-H4 may play important roles in the development of NSCLC. Positive expression of BT-H4 is correlated with the clinical tumor stages and lymph node metastasis of NSCLC, which provides a foundation for diagnosis and therapy of NSCLC.

Objective To investigate the distribution of occupations and traditional Chinese medical syndromes of the patients with hypokalemic periodic paralysis in Foshan area. Methods A multicenter retrospective investigation was carried out to analyze the characteristics of occupations and syndrome types of hypokalemic periodic paralysis in Foshan area, and the correlation of occupations with syndrome types was also explored. Results (1) The workers engaged in agriculture, forestry, animal-breeding and fishing, and the workers engaged in production & transportation were most likely to suffering from hypokalemic periodic paralysis, with the incidence being 36.8%, 34.7% respectively. (2) The damp-heat syndrome was the most commonly-seen syndrome type, accounting for 53.1%, and then followed by Qi deficiency syndrome (20.3%) and Qi-Yin deficiency syndrome(15.7%).(3) The syndromes of heavy manual labor workers such as agriculture, forestry, animal-breeding and fishing workers, production & transportation workers, and soldiers were characterized by damp-heat type, accounting for 62.5%, 69.4%, 47.0% respectively. Professionals & technicians were most likely to suffering from Qi-Yin deficiency syndrome, accounting for 44.4%; business service personnel were most likely to suffering from Qi-Yin deficiency syndrome (32.5%) and Qi deficiency syndrome (31.3%). The syndrome distribution of heavy manual labor workers differed from that of light manual labor workers and brain workers(P < 0.001). Conclusion The high-risk groups of hypokalemic periodic paralysis in Foshan area are the heavy manual labor workers who are manifested with the damp-heat syndrome. The dominated syndrome types of light manual labor workers and brain workers are Qi deficiency and Qi-Yin deficiency.

AIM: To investigate the effects of antisense oligonucleotides (asODN) of PKC-? and PKA-Ⅰon growth and proliferation of the CNE-2Z cells. METHODS: The expression of PKC-? and PKA-Ⅰ was observed with immunohistochemistry method. The asODNs of (1)PKC-?, (2)PKA-Ⅰ, (3)PKC-? and PKA-Ⅰ, were transfected into CNE-2Z cells by lipofectin (LP), and a random sequence as a control was used. The cell growth index (GI) and the clone formation rate of CNE-2Z were detected by MTT colorimetric assay and soft agar assy, respectively. RESULTS: The expression of PKC-? or PKA-Ⅰin CNE-2Z in experimental group were both significantly lower than that of control group(P