Objective To study the indication and the feasibility of laparoscopic cholecystectomy (LC) combined with laparoscopic appendectomy (LA). Methods Following routine LC under general anasthesia,a dissecting forceps was introduced from the 10 mm trocar on the right McBurney point.The appendix was excised outside the abdomen,or removed by using an electrotome after the mesoappendix and the appendix root were dipped. Results The operation time was 29～76 min (mean, 48 min) and the length of hospital stay was 2～7 days(mean,3 days).Complications occurred in 3 cases: 1 case of transection of the common bile duct, 1 case of appendicular artery bleeding, and 1 case of right lower abdominal pain with unknown causes. Conclusions LC combined with LA is feasible and applicable to cholecystic benign diseases accompanying simple or suppurative appendicitis.

Objective:To explore the correlation among serum uric acid (UA) level and severity of coronary heart disease (CHD) ,adverse cardiovascular events .Methods :Clinical data of 403 patients undergoing coronary angiog-raphy in our hospital were retrospectively analyzed .They were divided into CHD group [n=308 ,including 137 cases with stable angina pectoris (SAP) and 171 cases with acute coronary syndrome (ACS)] and normal control group (n=95 ,non-CHD patients) .UA level was compared among all groups and its correlation with CHD severity was fur-ther analyzed .According to UA level ,CHD patients were divided into low UA group (n=147) and high UA group (n=161) ,after 12-month follow-up ,incidence rate of major adverse cardiovascular events (MACE) uring follow-up was compared between two groups .Results:Serum UA level of ACS group was significantly higher than that of nor-mal control group [ (318.44 ± 69.07)μmol/L vs .(295.38 ± 80.08)μmol/L ,P=0.003];along with number of dis-eased coronary vessels increased and CHD severity aggravated (Gensini score rose ) ,serum UA level showed an in-creasing trend [single-branch (316.58 ± 95.27 ) μmol/L vs . double-branch (335.26 ± 43.26 ) μmol/L vs . multi-branch (346.53 ± 86.74) μmol/L ;low score group (312.42 ± 48.26) μmol/L vs .middle score group (346.58 ± 47.36)μmol/L vs .high score group (363.84 ± 54.68)μmol/L , P<0.05 or <0.01] .Pearson correlation analysis indicated that serum UA level was positively correlated with Gensini score (r=0.583 ,P<0.05);MACE incidence rate in high UA group was significantly higher than that of low UA group (58.38% vs .36.24% , P=0.012) .Con-clusion:Serum uric acid level is positively correlated with severity of coronary heart disease ,which may be an inde-pendent risk factor for coronary heart disease .

Objective This study was designed to study the effect of Diltiazem on patency rate of arteriovenous anastomosis in rat and how it works.Methods 24 SD rats were divided into control group and experimental group,12 rats in each group.Experimental group rats were gavaged with Diltiazem after vascular anastomosis.Control group rats were gavaged with water.By comparing the patency rate and the thickness of artery to make sure whether Diltiazem will affect the patency rate.;By comparing the clotting time,prothrombin time,artial thromboplastin time,and serum thromboxane B2 levels to explore the pathway of diltiazem.Results The patency rate was 75％ in the experimental group and 25％ in control group.Compared with the control group,experimental group venous blood vessels in the film segment was significantly thicker,clotting time was prolonged,TXB2 levels in blood was decreased,the differences were statistically significant(P ＜ 0.05).There were no significant difference in prothrombin time and partial thromboplastin between two groups (P ＞ 0.05).Conclusion Diltiazem can inhibit the secretion of TXB2,antagonize the effct of antiplatelet,and increase the patency rate of vascular anastomosis in rats.

Tumor necrosis factor-like weak inducer of apoptosis ( TWEAK ) is a member of the superfamily .TWEAK binds to its receptor [ fibroblast growth factor-inducible 14 ( Fnl4 ) and the serum level of soluble CD 163 ( sCD163 ) ] and regulates many cellular activities via associated signal pathways ,including proliferation,migration,differentiation,apoptosis, angiogenesis and inflammation ,which play a significant role in the formation and development of cardiovascular diseases , such as atherosclerosis , heart failure , cardiomyopathy , and peripheral vascular disease .This review summarizes functions of TWEAK and its receptor in cardiovascular diseases .

Objective To analyze and study the implication of dynamic changes in plasma CD62P among patients with obstructive jaundice and cholecystolithiasis.Methods A total of 58 patients diagnosed with choledocholithiasis and jaundice were included in the obstructive jaundice group,and 50 patients were in the cholecystolithiasis group.Peripheral venous blood was collected on preoperative day 3,on opera-tive day,and on postoperative days 3,6,9,12,15,18,and 21 in two groups,and the concentrations of plasma CD62P were measured by ELISA.Comparison of continuous data between the two groups was made by t test.Results The concentrations of plasma CD62P from preop-erative day 3 to postoperative day 18 were significantly higher in the obstructive jaundice group than in the cholecystolithiasis group (P<0.01 across all time points).In the cholecystolithiasis group,the concentrations of plasma CD62P significantly increased on operative day, and the increase continued and reached the peak on postoperative day 3,then followed by a decrease down to the preoperative level on post-operative day 9.In the obstructive jaundice group,the concentrations of plasma CD62P reached the peak on postoperative day 9,followed by a gradual decrease down to the preoperative level on postoperative day 18 and to an even lower level (preoperative level of patients with cho-lecystolithiasis)on postoperative day 21.Conclusion Extrahepatic biliary obstruction may lead to endothelial cell injury and platelet acti-vation,the condition of which is improved with the relief of obstruction.The surgery for obstructive jaundice may lead to much more endothe-lial cell injury and higher platelet activation than that for cholecystolithiasis.

Objective To study treatment effect of qingre shugan tuihuang tang in the treatment of newly diagnosed hepatitis B with jaundice.Methods88 patients newly diagnosed hepatitis B with jaundice in our hospital from August 2015 to December 2016 were randomly divided into control group and treatment group according to different modes of treatment, control group was given protecting liver and reducing enzyme, antivirus and other conventional therapy, treatment group added qingre shugan tuihuang tang on the basis of control group, changes of liver function indexes, changes of bilirubin, changes of clinical syndromes and treatment effect in the two groups were compared.ResultsSerum total bilirubin (TBIL), direct bilirubin (DBIL), Alanine transaminase (ALT) and prothrombin time (PT) in the two groups were significantly decreased (P<0.05), albumin was significantly increased (P<0.05), and rangeability of TBIL, DBIL, ALT and albumin in treatment group after the treatment were significantly higher than control group, the difference was statistically significant (P<0.05);hepatitis B virus DNA copy numbers in the two groups were significantly decreased (P<0.05), treatment group was significantly lower than control group, the difference was statistically significant (P<0.05);yellow tint of sclera and skin, gastric distention, rib-side pain, anorexia, drowsiness and fatigue symptom scores in the two groups were significantly decreased (P<0.05), decrease of treatment group was significantly higher than control group, the difference was statistically significant (P<0.05);total effective rate of treatment group was 97.73%, while the control group was 81.82%, the two groups had significant difference (P<0.05).ConclusionQingre shugan tuihuang tang in the treatment of newly diagnosed hepatitis B with jaundice can improve symptoms of jaundice significantly, improve liver function injury, effect is remarkable, its clinical application is very important.

Objective To investigate the MRI findings of recurrent supurative colangitis complicated by intrahepatic cholangiocarcinoma and clinical diagnostic value.Methods 264 patients with recurrent suppurative cholangitis who were admitted into the hospital during June 2010 to July 2014 were selected as the research objects.All of the patients were given magnetic resonance imaging(MRI)and surgical pathological examination or biopsy.The Resultsof surgical pathological examination certified that there 43 patients(52 lesions)complicated by intrahepatic cholangiocarcinoma.The results of pathological examination were taken as the golden standard to evaluate the accuracy, specificity and sensitivity of MRI in the clinical diagnosis of recurrent supurative colangitis complicated by intrahepatic cholangiocarcinoma.The MRI findings were analuzed.ResultsAmong the 264 patients with recurrent supurative cholangitis in this group, there were 43 patients(52 lesions)with complicated intrahepatic cholangiocarcinoma confirmed by surgical pathological examination or biopsy, accounting for 16.3% of total number of subjects;MRI results showed that 218 cases were true negative, 41 cases true positive, 2 cases false negative and 3 cases false positive.The diagnostic sensitivity was 95.3%(41/43), specificity 98.6%(218/221)and the accuracy 98.1%(259/264).Conclusion MRI in the diagnosis of recurrent supurative cholangitis complicated by intrahepatic cholangiocarcinoma is of higher accuracy, sensitivity and specificity.MRI findings are obvious.It is worthy of clinical promotion.

Objective To assess the diagnostic value of glycosylated hemoglobin A1c (HbA1c) ≥6.5％ for diabetes in Chinese adults with oral glucose tolerance test(OGTT) as the reference standard.Methods Major databases were searched to get all diagnostic tests with HbA1c ≥ 6.5％ for diabetes in Chinese adults.QUADAS items were used to evaluate the quality of the eligible studies.Meta-disc software was used to perform comprehensive quantitative assessment for all included studies and summary ROC (SROC) curve were drawn.Results A total of 11 studies were included.The outcomes of the diagnostic value with HbA1c ≥6.5％ were as the following:pooled sensitivity 0.62 (95％ CI:0.60-0.64),pooled specificity 0.96 (95％ CI:0.95-0.96),diagnostic odds ratio (DOR) 40.25 (95％ CI:20.79-77.95) and AUCSROC 0.7702 (sx =0.0636).Conclusions The diagnostic specificity is pretty high for the diagnostic test with HbA1c ≥6.5％,while sensitivity is low.Combination of HbA1c and glucose tests is needed to reduce the missed diagnosis rate.

Objective To study a functional variable fragment of heavy chain(VH)antibody against the terminal protein(TP)region of hepatitis B virus(HBV)polymerase introduced by human immunodeficiency virus Tat protein transduction domain(TAT)and the inhibitive activity of TAT-VH on the replication of HBV in vitro.Methods The gene encoding TAT-VH was cloned into prokaryotic expression vector pET28a(+).Recombinant plasmid was transduced into E coli BL21(DE3)LysS,then the protein was expressed and purified.The purified TAT-VH fusion protein was added into HepG2.2.15 cell culture.The transduction efficiency was evaluated by indirect fluorescence assay(IFA).The cytotoxicity of TAT-VH was detected by Methabenzthiazuron(MTT)assay.HBV DNA level in HepG2.2.15 cell culture was measured using quantitative polymerase chain reaction(PCR).The data were analyzed by one-factor analysis of variance and t test.Results TAT-VH fusion protein was successfully expressed and purified.It was confirmed by IFA and MTT assay that TAT-VH was introduced into HepG2.2.15 cells and the cell growth was not affected.The level of HBV DNA in supernatant of HeDG2.2.15 cell culture with 5 000 nmol/L TAT-VH was(1.211±0.132)lg copy/mL,which was significantly lower than control group[(5.325±0.041)lg copy/mL,t=72.91,P＜0.05].Meanwhile,the level of intracellular HBV DNA was(3.521±0.411)lg copy/mL,which was significantly lower than control group[(8.532±0.132)lg copy/mL.t=28.41,P＜0.05].Conclusion The HBV replication is inhibited by anti-TP TAT-VH antibodies in vitro,which provides valuable experimemal basis for developing therapy of HBV infection with intracellular antibody.

Objective To detect the genetic association between schizophrenia and polymorphism of phosphodiesterase 4B (PDE4B) gene. Methods Observed in a sample of 98 parent/offspring trios where the proband net the Amerecan Classification and diagnostic Criteria for Mental Disorders The Forth Revised Edition,criteria for schizophrenia using correlation analysis and haplotype relative risk analysis. The polymorphism of phosphodiesterase 4B gene was detected with PCR methods and SNP typing in all nucleus families. Results The rs2180335 al-lele was connected with schizophrenia (P = 0.02131). Allele A was protective factor (Z = -2. 184) and allele G was the hazard factor (Z = 2.184). The frequency of rs2180335 allele A was 0.452 and the allele G was 0.548. The rs1040716, rs 3767311 and rs472952 allele was independence with schizophrenia. Five kinds haplotypes of A/A in the rs2180335-rs3767311, A/A in the rs 3767311-rs472952, A/A/A in the rs2180335-rs3767311-rs472952,A/G/G/A and T/A/A/A in the rs1040716-rs2180335-rs3767311-rs472952 associated with schizophrenia (P values were 0. 028715,0. 034845,0. 024177,0. 023967,0. 010839,genotype frequencies were 0. 223, 0.223,0.127,0.081,0.073). Conclusion It shows an association between schizophrenia and the rs2180335 polymorphism at nucleotide of phosphodiesterase 4B gene in Chinese.