Objective To investigate the technique and instrument improvement of laparoscopic choledocholithotomy with T-tube drainage. Methods A total of 42 cases of gall stones complicated with common bile duct stones entered the study. During the operation, we exposed the common bile duct before the removal of the gall bladder, opened the common bile duct by a self-made bile duct scalpel, removed the stones by open instruments laparoscopically, and performed choledochofiberscopic examinations and T-tube drainages. Results All the 42 operations were successfully accomplished without the conversion to open surgery. The operation time (exclusive of that of LC) was 80～180 min (mean, 96 min). All the patients got out of bed and received liquids within 24 hours after the surgery. The postoperative hospital stay was 5～9 days (mean, 6 days). The T-tube was removed 3 weeks after the operation in the absence of residual stones or stenosis of bile duct under T-tube choledochography. Follow-up for 6～48 months (mean, 23 months) in 38 cases found no recurrence of stones or biliary tract symptoms. Conclusions The modified laparoscopic choledocholithotomy with T-tube drainage, which shortens the operation time, is an effective and safe method for the treatment of common bile duct stones.

Behavior Therapy ; Body Mass Index ; Body Weight ; China ; epidemiology ; Chronic Disease ; Diet ; Exercise ; Humans ; Obesity ; complications ; epidemiology ; prevention & control ; Prevalence ; Preventive Medicine ; Weight Loss

Objective To analyze the risk factors of aortic valve calcification,and discuss its correlation with coronary artery disease.Methods A total of 188 patients who underwent coronary angiography (CAG) and transthoracic echocardiography (TTE) were divided into two groups:101cases with aortic valve calcification (AVC) and 87 cases without AVC (NAVC).General data such as sex,age,height,weight and hypertension history,results of blood test such as glucose,lipid and homocysteine(HCY)level were recorded.Results In AVC versus NAVC group,age were (67.0±9.0) years vs.(59.4 ± 6.9) years (t =6.74,P =0.000),men were 36 cases (35.6％) vs.44 cases (50.6％) (t=4.26,P=0.039),hypertension patients were 72 cases (71.3％) vs.50 cases (57.5％)(x2=3.92,P=0.048),total cholesterol were (5.4 ± 1.0) mmol/L vs.(4.5 ± 1.0)mmol/L (t =5.70,P=0.000),triglyceride were (2.2 ± 1.1 ) mmol/L vs.( 1.6 ± 0.8) mmol/L (t =4.04,P =0.000),HCY were (17.6±8.8) μmol/L vs.(14.9±6.6) μmol/L (t=2.86,P=0.028),respectively.One-way analysis showed that age,sex,hypertension,total cholesterol,triglyceride had relationship with aortic valve calcification.When we divided the cases into two groups (with and without coronary disease),there is no significant difference in HCY(t=0.88,P=0.382) between the two groups.Logistic regression indicated that age,total cholesterol,triglycerides,HCY were independent risk factors of aortic valve calcification,the incidence of aortic valve calcification was related with the severity of coronary artery lesion (x2 =9.48,P =0.024 ).Conclusions The independent risk factors of aortic valve calcification are age,cholesterol,triglyceride,HCY.Higher incidence of aortic valve calcification may result in greater severity coronary artery lesion.

Objective To explore the effects of liraglutide on cardiovascular in obese men without diabetes mellitus.Methods Ten obese men without diabetes mellitus (body mass index (BMI) ＞ 25 kg/m2)were enrolled in this study.All subjects received 6 months treatments of liraglutide.Cardiovascular risk factors were measured at 0 and 6 months after treatment.Results Compared to the baseline,BMI and blood pressure didn't change(P＞0.05).The waist-hip ratio and hemoglobin A1c (HbA1c) in base line were 0.98±0.04,(5.96± 0.4) 6％,significant different from those after treatment (0.94 ± 0.04,(5.45 ± 0.25) ％;t =2.391,4.115;P＜0.05).The high density lipoprotein cholesterol and superoxide dismutase after treatment were (1.24 ±0.15) mmol/L and (92.6±6.1) U/ml,higher than those before treatment ((1.08±0.16) mmol/L,(83.2 ± ±9.2) U/ml;t =2.843,2.490;P ＜ 0.05).Conclusion Liraglutide improve body fat distribution and cardiovascular risk factors in obese men.

Seventy-four men aged 20-50 years with normal glucose tolerance were divided into abdominal obese group(n=36),simple obese group(n=16),and normal body weight group(n=22).One-hour postload plasma glucose(1hPG)and carotid intima-media thickness(IMT)were higher in abdominal obese group than those in simple obese group and control group(all P<0.01).IMT was positively correlated with 1hPG(P<0.05).In multiple regression analysis,waist circumference and triglycerides were independent predictors for IMT.

Objeetive To evaluate the relationship between aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) and metabolic syndrome in college students.Methods Anthropometric and metabolic measurements including fasting plasma glucose (FPG),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),true insulin (TI),(AST and ALT) were assessed in a crosssectional study of 425 college students aged 19 to 24 years old (male 216,female 209) in 2009.The participants were then assigned to the AST/ALT ratio ＜ 1 group or the AST/ALT ratio ≥ 1 group.Metabolic syndrome was defined as Adult Treatment Panel Ⅲ criteria.Results AST/ALT ratio ＜ 1 was found in 146 subjects (34.4％).After adjustment for age and sex,AST/ALT ratio showed a positive correlation with HDLC (r=0.125) and negative correlations with body mass index (BMI,r=-0.281),waist circumtance (WC,r =-0.264),TG (r =-0.134),TI (r =-0.118) and HOMA-insulin resistance (HOMA-IR,r =-0.121) (all P ＜0.05).The prevalence of metabolic syndrome was 2.1％ and was similar in males and females (2.3％ vs.1.9％,P =0.774).Those with AST/ALT ratio ＜ 1 had a significantly higher prevalence of metabolic syndrome (4.8％ vs.0.7％,P =0.016).After adjustment for age,gender and BMI,the prevalence of metabolic syndrome of subjects with AST/ALT ratio ＜ 1 was nearly 7 (95％ CI:1.430 to 34.019,P =0.016) times of those with AST/ALT ratio ≥ 1.Conclusion AST/ALT ratio may be related with metabolic syndrome in college students.

A total of 1507 children aged 7 ～ 12 years in Qinhuangdao were incruited to evaluate the diagnostic accuracy of different obesity indices in screening hypertension.Blood pressure and obesity indices were positively correlated(P＜0.01).Area under the receiver operating characteristic (ROC) curve were 0.744 ～ 0.835 in boys and 0.704 ～ 0.796 in girls (P＜0.01).Obesity indices could be used as parameters for detecting hypertension in children.

Forty-eight men with normal glucose tolerance were divided into fatty liver disease ( NAFLD, n =23 ) and non-NAFLD (n =25 ) groups. The blood glucose excursion was evaluated by continuous glucose monitoring system. The results showed that the mean amplitude of glucose excursion[MAGE, (2. 17± 1.13 vs 1.45±0. 42 )mmol/L]and standard deviation of blood glucose[SDBG, (0. 88 ±0. 45 vs 0. 61 ±0. 21 ) mmol/L]were significantly higher in NAFLD group than in non-NAFLD group( both P＜0. 05 ). MAGE and SDBG were positively correlated with body mass index, waist circumference, and the increased value of plasma glucose 0. 5 h after glucose loading( △G30,all P＜0. 05 ). In multiple regression analysis, △G30, waist circumference, and age were significant independent predictors for MAGE( P＜0. 05 or P＜0. 01 ). △G30 and waist circumference were significant independent predictors for SDBG( P＜0. 05 or P＜0. 01 ).

OBJECTIVE:To demonstrate challenges of pharmacy automation reconstruction so as to set solutions. METHODS:Based on literature review,analysis of pharmacy automation setting and features,this paper gave the suggestions and solutions on construction cost,management model change,equipment maintenance and emergency response,etc. according to the practice of the hospital. RESULTS&CONCLUSIONS:Pharmacy automation construction should be stick to the requirements of new health re-form to lower the cost by using the out resources and interior optimal allocation,to improve efficiency by unified planning and proper design,and to ensure the system running efficiently by sufficient maintenance and contingency plan.

ObjectiveTo investigate the relation of obesity parameters,including body mass index (BMI),waist-to-height ratio(WHR),waist circumference,and waist-to-hip ratio(WHR),with hypertension in adolescents.MethodsA cross-section study was conducted among 3953 adolescents aged 12 to 18 years old,who were assigned to the normal blood pressure group (3724) or hypertension group(229).Measurements were height,weight,waist circumference,systolic blood pressure (SBP),and diastolic blood pressure (DBP).ResultsThe data showed that mean BMI,WHR,waist circumference,WHR,SBP,and DBP in the hypertension group Was significantly higher than those in the normal blood pressure group(all P<0.05).In partial correlation analysis,BMI,WHR,waist circumference,and WHR were positively correlated with both SBP and DBP after gender or age were adjusted(r'=0.3228 and 0.2358,both P<0.05).For alias under the receiver operating curve(ROC),the BMI was obserred to strongly predict hypertension in male (0.715;95%CI0.659-0.771)and female (0.702;95%CI0.646-0.757).BMI was also entered into the multiple linear regression modeL ConclusionBMI could be an effective predictive factor of hypertension in adolescents.