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.

We investigated the students of a seven-year medical master in the bilingual teaching program in Neurology with a questionnaire.We found that the bilingual teaching program has the following problems:the students don't have a solid foundation of medical English terminology and the content of the English teaching was higher than the ability of the students.So we think that we need to impress upon the students the importance of the program.We can also raise the overall quality of this program through an improvement of teaching methods,regulation of the proportion of English content in all courses and suitable midterm and final examinations.These alterations will effectively improve the bilingual teaching program.

We changed the form of literature reading from simple reading and translation to comprehensive lecture,analysis,discussion and exchange under the guidance of teachers in order to promote postgraduates' capability of learning professional English and to enhance their overall quality.The new form not only improves students' English proficiency but also enhances their overall quality,such as literature quality,teaching ability,competitive consciousness,psychological quality,etc.At the same time,it is also beneficial for teachers.

OBJECTIVE: To evaluate therapeutic effect and safety of poly DL-lactic bio-absorbable screws in the treatment of Pipkin fractures.METHODS: A total of 13 Patients of Pipkin fractures received treatment at the Department of Orthopaedics, Third People's Hospital of Wujiang City and Department of Orthopaedics, First Affiliated Hospital of Soochow University from March 2003 to October 2007 were selected, including 10 males and 3 females, mean aged 30.5 years. Six of them had a Pipkin type Ⅰ fracture,4 had a Pipkin type Ⅱ fracture, and 3 patients had a Pipkin type Ⅳ fracture. In all the operative procedures, a dorsolateral Kocher-Langenbeck approach was used.RESULTS: After an average duration of 47.9 months follow-up, all fractures achieved complete bony healing. One patient had femoral head avascular necrosis and 1 had persistent hip pain, but no heterotopic ossification was observed. According to Harris hip score: Pipkin type I 85 points, type Ⅱ 90 points and type Ⅳ 77 points. According to the Thompson-Epstein hip scale, 3 patients were rated as excellent, 8 good, 1 fair, and 1 poor; the excellent and good rate was 84.6%.CONCLUSION: Poly DL-lactic bio-absorbable screw fixations are safe and effective in treating Pipkin fractures.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.