Objective To evaluate the effect of laparoscopic cholecystectomy(LC) combined with bile duct exploration and stone removal(BDE) and LC with endoscopic sphincterotomy(EST) in treating cholecystolithiasis with choledocholithiasis.Methods Among 256 cases of cholecystolithiasis and choledocholithlasis,132 patients were treated by LC+LCBDE,and 124 cases by EST combined with LC.The operation success rate,operation time and cost,complication rate,and length of hospital stay of the two groups were compared.Results There was no statistical difference in the operation success rate,complication rate,stone clearance rate,and average hospital stay between the two groups,but EST+LC group had significantly longer operation time and higher cost.Conclusions There are respective indications,advantages and disadvantages in the two groups.EST+LC is the better choice for patients with diameter of CBD1.0cm and with multiple choledocholithiasis,especially for middle-aged patients,the better way is LC+LCBDE.

Objective To evaluate the effect of LC+LCBDE and EST+LC in treating the cho-leeystolithiasis with choledocholithiasis. Methods The clinical data of 256 patients treated in our hos-pital were retrospectively analyzed. Of the 256 patients, 132 were treated by LC+LCBDE and 124 by EST combined with LC. The clinical data of the two groups was compared in operation success rate, operation time and cost, complication rate and operative hospital stay. Results There was no statisti-cal difference in the operation success rate, complication rate, operative hospital stay between 2 groups. However, there were significant differences in the operation time and cost between the 2 gruops. Conclusion There are respective indications, advantages and disadvantages in the two groups. EST+LC is the better choice for patients with a CBD<1.0 cm in diameter, stones impacted in the distal CBD, or old age. Otherwise, the better way is LC+LCBDE for patients with a CBD>1. 0 cm in diameter and multiple choledocholithiasis, especially in young and middle-aged people.

Hepatocellular carcinoma (HCC) is a common malignant tumor that threatens the health of all mankind, and its incidence and mortality rates keep increasing in recent years. Most patients are in the advanced stage at the time of confirmed diagnosis and are unable to undergo potential therapeutic surgery. Transcatheter arterial chemoembolization (TACE) and the anti-angiogenic drug apatinib are two palliative treatments for HCC. At present, apatinib combined with TACE is still a new treatment method for HCC in clinical practice, and there are still controversies over its efficacy and safety, which needs further studies. This article reviews the research advances in apatinib combined with TACE in the treatment of HCC.

Severe acute pancreatitis is a common clinical acute abdominal disease, characterized by acute onset, rapid progression, high risk, poor prognosis and so on. Due to the high mortality of this disease, it has been the focus and difficulty of clinical research. The traditional treatment of severe acute pancreatitis mainly include fasting and parenteral nutrition. However, recently, international and national consensus suggest that early enteral nutrition is fit for severe acute pancreatitis, although the timing of early enteral nutrition has been controversial. The article summarizes the optimal timing of early enteral nutrition for severe acute pancreatitis.

MicroRNA-223 (miR-223) is located on chromosome X, and is highly conserved in the process of evolution. In recent years, many studies have shown that miR-223 is abnormally expressed in a variety of digestive system tumors, such as esophageal cancer, gastric cancer, liver cancer, pancreatic cancer and colorectal cancer. MiR-223 can participate in the proliferation, apoptosis and invasion of tumor cells through a variety of signal pathways, which is expected to become a marker for the diagnosis and prognosis of digestive system tumors.

Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.