Objective To explore the causes and surgical management of acute gangrenous cholecvstitis(AGC)after endoscopic sphincterotomy(EST).Methods Clinical and pathological data of 1066 patients who underwent EST from June 2003 to January 2007 were analyzed retrospectively.ResultsAGC was complicated in 16 patients(16/1066,1.5%),who underwent emergency operations and no death occurred.During the follow-up period of 4 to 36 months,no infection or obstruction was found.Conclusion Difficuitv in EST manipulation and biliary obstrucion might play a leading role in AGC after EST,and early surgical intervention is effective.

Objective To investigate the diagnostic value of electrophysiological examination for tarsal tunnel syndrome (TTS).Methods Motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),F wave and electromyographic measurements were carried out with 26 clinically suspected TTS patients.Results Of the 26,22 patients were unilaterally affected and 4 were bilaterally affected,so 30 tarsal tunnels in total were affected.All received electrophysiological examination.Of the 30 affected tarsal tunnels,abnormal MCV was detected in 28 of the posterior tibial nerves (93.3％),while abnormal SCV was detected in 27 medial plantar nerves (90％) and 24 lateral plantar nerves (80％).Needle electromyography of 156 targeted foot muscles detected abnormal spontaneous potentials in 90 of them (57.7％),giant potential in 12 muscles (7.7％) and decreased recruitment in 76 (48.7％).Conclusions The distal posterior tibial nerve is impaired in TTS,presenting axonal damage in an electrophysiological examination.Such examinations should have an important role in the diagnosis and differential diagnosis of TTS.

Objective To explore the protective effect of Salvia miltiorrhiza on small intestinal ischemia reperfusion injury during intestinal transplantation induced by cytokines in rats.Methods Sixty Sprague Dawley rats were randomly divided into sham operation group,model group and low,mid,high doze treatment group,the superior mesenteric artery was occluded and then released to simulate the model of small intestinal ischemia reperfusion during intestinal transplantation.Tumor necrosis factor-?,interleukin-1?,interleukin-8 both in the plasm and small intestinal tissue were evaluated by ELISA 2 hours after reperfusion,changes of pathology in intestinal mucosa were observed.Results TNF-?,IL-1?,IL-8 were significantly higer(P

Objective To explore the diagnosis and treatment of gastroparasis syndrome after abdominal operation. Methods Clinical data of 25 cases with gastroparasis syndrome after abdominal operation from Jan 1995 to June 2006 were analysed retrospectively. Results Gastrectomy and nongastrectomy amounted to 16 and 9 cases( portal-azygous vein disconnection in 4 cases, panceaticoduodenectomy in 1 case, partial small intestinectomy and adhesions lysis in 1 case, radical excision of colon carcinoma in 2 cases, choledocholithotomy in 1 case). Gastroparasis syndrome characterized by upper abdominal distension, nausea, vomiting after clipping the pipe or large quantity of gastric drainage after operations. Gastrointestinal series and gastroscopy confirmed functional delayed gastric emptying. All cases recoverd through non-operative therapy including fasting, continuous gastrointestinal decompression, total parenteral nutrition or enteral nutrition, adn administration of gastro-intestinal dynamic medicine. Conclusions Gastroparasis syndrome is the common complication after abdomianl operation, gastrointestinal series, gastroscopy are main diagnostic methods, conservative medication obtains good effect.

Objective To explore the effect on nutrient and immune function of glutamine-enriched enteral nutrition on patients after total gastrectomy. Methods 36 patients after total gastriecomy were randomly divided into EN(n=18) and GLN(n=18) group. Compared the index after total gastrectomy including nutrient status, immune function and lassitude degree in the 1st, 3rd, 7th day. Results GLN group showed more effective process than EN group in improving postoperative nutrient status, immune function, nitrogen balance and lassitude degree. All the indexes in GLN group changed significantly on the 7th day than that in EN group(P

Objective To study effect of eleetromyograghie(EMG) biofeedback training on three kinds of u- rinary ineontifienee.Methods Nineteen patients with urinary incontinence were treated by means of EMG biofeed- back training twice a day for six weeks.The treatment was performed with a device,which can detect the EMG ampli- tude of the pelvic muscle and deliver electric stimulation accordingly.Results After 6 weeks of treatment,the inci- dence of uretbrorrhea was reduced by 41%,and the frequency of micturition was decreased by 38% ,while the fre- quency of urination in one day reduced to 9 to 13.The general subjectively rated improvement rate of patients was 53% ,while the general objectively one was 58%.Conclusion Biofeedback training has significant therapeutic: eftects on patients with urinary incontinence.

Objective To determine the expression spectrum of microRNA(miRNA)in the lung homogenate of rats with chronic obstructive pulmonary disease(COPD)or healthy rats,to look for differentially expressed miRNA, and to explore their potential role in pathogenesis of COPD. Methods Twenty male Sprague-Dawley(SD)rats were randomly divided into normal control group and COPD model group,with 10 rats in each group. COPD rat models were reproduced by smoke inhalation as well as intratracheal instillation of lipopolysaccharide(LPS). The samples of the lung were harvested,and the histopathological examination of the right lung was carried out to evaluate the degree of lung injury. Total RNAs were isolated from the left lung. The miRNA expressions in lung tissue of rats with COPD or normal rats were determined by miRNA chip eichnology to screen the miRNA with differential expression, and hierarchical clustering analysis was made. The data were analyzed to study the expression difference of miRNAs between the two groups,and to construct the miRNA-Target network. Results Compared with normal control group, 20 miRNA with increased expression were found in COPD model group,the top 10 were miR-30c-2,miR-199a-5p, miR-30a, miR-145, miR-151, miR-674-5p, miR-214, miR-423, miR-28 and miR-181b, and only miR-376b-3p showed down-regulation. Hierarchical clustering analysis showed that significant differences in individual miRNA in lung tissue between rats of two groups were found. However,similar samples could not be gathered well,thus it may give rise to inconsistency during the sample preparation. Many miRNAs had multiple target genes in miRNA-Target network, such as miR-30c-2, miR-145, miR-181b, miR-181a, miR-181d, miR-199. Conclusions The study reveals that there is a variance of miRNAs expression profile in lung homogenates between COPD group and the normal control group of rats,and many miRNAs have multiple target genes,such as miR-30c-2,miR-145,miR-181b,miR-181a,miR-181d,and miR-199. Therefore,the results may be valuable to centain extent for the interpretation of COPD pathogenesis.

Objective To explore the clinical value of expression of CEA and CK-20 detected by flow cytometry (FCM) in peritoneal washes on predicting peritoneal metastasis and prognosis of gastric carcinama.Methods Clinicopathological characteristics and follow up data of 105 patients with gastric carcinoma who were underwent D2 radical resection (R0) were collected.Peritoneal washes was collected.Peritoneal lavage cytology examination (PLC) was used to find intraperitoneal free cancer cells (IFCC).FCM was used to determine the CEA and CK-20 expressions.Meanwhile,13 patients with benign lesion on the stomach and the gastric carcinama cell line SGC-7901 were served as the negative and positive control,respectively.Results Positive expression of CEA was in 48 (45.7 ％) patients,of CK-20 was found in 67 (63.8 ％) patients,and of CEA and CK-20 was in 85 (81.0 ％) patients by FCM.However,positive expression of IFCCs was found in 31 patients(29.5 ％) by PLC.The expression of CEA and CK-20 were related to serosa invasion,lymphnode metastasis and pTNM stage (P ＜ 0.05).The median survival of patients with negative expression of both CEA and CK-20 (n =20) was significantly longer those with positive expression (n =30)(52 vs 18 months,P ＜ 0.05).Conclusions Combined Detection of CEA and CK-20 in peritoneal washes by FCM can be used to predict peritoneal micrometastasis and may predict the prognosis of gastric carcinoma.

Professional features,which include taking students as its main body and improving the students' practical and operational ability as its aim are embodied in microbiology experimental teaching to improve the teaching quality and train high medical talents with different majors.Meanwhile,the design is intended to make medical graduates with different majors to quickly combine the microbiology knowledge with the practical situation in work thus to better serve the society.

ObjectiveTo investigate the influence of timing of definitive operation on prognosis of patients with iatrogenic bile duct injury (IBDI). MethodsThe clinical data of 38 patients with IBDI were retrospectively analyzed. Of the 38 patients, the injury happened in 7 patients in our hospital while 31 patients were transferred in from other hospitals. We analyzed the previous operative records, the clinical manifestations of the patients, the radiological images and our operative findings in the definitive operations. According to the timing of the definitive operation, the patients were divided into the intraoperative repair group (n=26), the early repair group (n=15) and the delayed repair group (n=17). ResultsPatients in the intraoperative repair group had the best short-and long-term results, the shortest length of hospital stay and the lowest total cost. The early repair group, though having worse Results than the intraoperative repair group was still better than the delayed repair group. However, early detection of injuries and the ability to carry out timely corrective procedures depended on the availability of surgical expertise in the hospital. ConclusionsThe timing of definitive operation to provide corrective surgery to IBDI was a vitally important factor which affected prognosis.It is best to repair the injury within the same operation. The repair should be carried out by a doctor with ample experience in bile duct surgery.