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 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.

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.

BACKGROUND:The repairing of bone defect near joint in long bone resulting from complicated comminuted fracture or excision of bone tumor is very difficult. It is a much studied issue to find a feasible solution to this problem.OBJECTIVE: To explore a feasible treatment to bone defect near joint in long bone through comparative observation of 3 reconstruction methods.DESIGN: A completely randomized experiment with self-control and mutual control.SETTING: Laboratory for Experimental Animals, First Hospital of Jilin University.MATERIALS: Twelve healthy adult hybrid dogs, 5 males and 7 females weighing 12 to 18 kg, were recruited.METHODS: The bone defects near joints were established in upper femoral condyle in the 12 dogs, which were reconstructed by 3 operation styles: only filling with bone cement, filling with bone cement + autogenous ilium bone graft, and filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate. There was one dog in each method. The specimens were harvested at the end of weeks 3, 6, 12and 24, respectively, after operation. One week before specimens were harvested the fluorescent labeling was prepared; we conducted vascular perfusion of disulphine blue before the animals were executed.MAIN OUTCOME MEASURES: A series of examinations were carried out, including X-ray film, biomechanical test, intravascular perfusion and tetracycline fluorescent labeling. The bone healing, blood supply recovery and biomechanics were observed in the three groups.RESULTS: The 12 dogs all entered the result analysis. ① Results of Xray examination: Two cases of fracture occurred in experimental side at 6and 12 weeks in group Ⅰ; one case of fracture occurred in experimental side at 6 weeks in group Ⅱ. No fracture happened in group Ⅲ. ② Bone stiffness assayed with biomechanics: It decreased in experimental side as compared to control side by 67% and 70% in group Ⅰ; 66%, 76% and 46% in group Ⅱ; and 8% in group Ⅲ. ③ Specimen observation after operation: Bone formation, callus, and blood supply recovery were significantly better in group Ⅲ than in groups Ⅰ and Ⅱ at all stages.CONCLUSION: The third operation, filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate, is an ideal method of bone reconstruction. It can recover bone function, and prevent complications such as refracture and bone nonunion.

A cross-sectional study was conducted on 1619 youngsters aged 13-15.They were divided into two groups:one with family history of diabetes (FHD~+) and another without a family history of diabetes (FHD~-).Measurements included height,weight,waist circumference (WC) and hip.FHD~+ group had significantly higher WC measurement,waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) when compared with FHD~-group (P ＜0.01).The abdominal obesity rate defined by WC measurement in FHD+ group was higher than that in FHD~-group (P＜0.01).The rate of overweight and obesity defined by body mass index (BMI) were no significant difference between two groups.After adjusting the gender and age,logistic regression analysis showed that the odds ratios of WC alone and BMI+WC for FHD~+ were 2.029 and 1.364 (95% CI:1.211-3.400,1.043-1.784,P＜0.05) respectively.Our data suggest that teenage with a family history of type 2 diabetes has a tendency of overweight characterized by the abdominal obesity.

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.

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.

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.