Objective To summarize the experience in prevention and treatment of bile duct injury during laparoscopic cholecysteclomy(LC). Methods Retrospective analysis on the clinical data of 31 cases of LC was carried out. Of them, 27 underwent one stage operative repair and 4 underwent palliative external drainage of the bile duct first. Results 16 cases succeeded and 11 failed in the one stage operative repairing.There were 15 cases underwent 2～4 operations in this series,and the re-operation rate was 48.4%. 29 patients was cured while 2 died. Conclusions During LC, the operative rule should always be strictly observed, and the key to preventing bile duct injury is to avoid clipping, cutting and coagulation blindly.

Objective To analyze and compare the advantages and disadvantages in high-field MRI scan and LAVA enhanced in the display of hepatic carcinoma capsule,in order to improve the early diagnosis and differential diagnosis level of primary hepatic carcinoma by MRI.Methods MRI data of 233 patients of primary hepatic carcinoma were retrospective analysed by two radiologists. Results 233 cases of primary hepatic carcinoma,except for 18 cases of diffuse hepatocellular carcinoma,a total of 239 lesions (54 small hepatocellular carcinoma,76 nodular hepatocellular carcinoma,109 massive hepatocellular carcinoma )were found .Hepato-cellular carcinoma capsule display rate was 139/239(58.16%).119 T1 WI,87 cases were found in T2 WI,and 139 cases were found in LAVA enhanced scan.25 lisions showed complete capsule on T1 WI,12 lisions showed complete capsule on T2 WI,59 lisions showed complete capsule on LAVA enhanced scan.Small hepatocellular carcinoma displayed capsule 21/54 (38.9%),nodular hepa-tocellular carcinoma 53/76 (69.7%),massive hepatocellular carcinoma 65/109 (59.6%).Conclusion High-field MRI conventional scan and LAVA enhenced scan can display PHC capsule better,LAVA enhanced (portal phase + delay phase)showed PHC capsule better than T1 WI and T2 WI.

Objective To evaluate the therapeutic effect of combination of sandostatin and growth hormone (GH) in the treatment of severe acute pancreatitis (SAP ). Methods Sixty patients with SAP were divided randomly into 3 groups:(1)Sandostatin treatment(ST) group (n=15);(2)combination of sandostatin with GH treatment(CT) group (n=30) ;(3)control group (n=15). The changes in serum IL-1, IL-6,TNF-? and albumin levels after treatment, and the incidence of complications, the duration of hospital stay and cost were compared among the 3 groups. Results The complications, mortality, duration of hospital stay in the CT group were significantly shorter than those in ST group and control group (all P

Objective To investigate the risk factors leading to complications in patients undergoing laparoscopic cholecystectomy (LC). Methods Clinical data of 11?974 patients undergoing LC from Mar. 1991 to June 2003 were collected and analyzed retrospectively. Fifteen clinical factors were recruited for the study in relation to surgical complications. Data were analyzed by ?2 test and Logistic regression. Results The overall operative complication rate was 1.896%. The procedure was shifted to open surgery in 2.389% of all cases, Logistic regression analysis revealed that Calot triangle adhesion, stage, expertise of the team, gallbladder wall thickness, gallbladder and vicinity adhesion were important risk factors for complications. Conclusion LC complications can be prevented by good training, strictly following protocol, and timely shifting to open surgery.

Objective To explore the application of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) value in the diagnosis and differential diagnosis of prostatic cancer. Methods Diffusion-weighted echo-planar imaging (EPI) sequences were performed in 46 patients, including 21 cases of benign prostatic hyperplasia (BPH), 9 cases of chronic prostatitis and 16 cases of prostate cancer. DWI were obtained with a b-factor of 800 s/mm2. According to the pathological results obtained by ultrasound guided biopsy, the peripheral zone of prostate was divided into six parts by orientations and they were divided into noncancerous, hyperplasia, prostatitis and cancerous groups. The ADC value of each region was measured and analyzed with one-way ANOVA and ROC analysis. Results Acceptable images for ADC measurement were obtained in all cases.The mean ADC values of prostatic peripheral zone, prostatic central gland, inflammatory area and cancerous area were (2.20±0. 29)×10-3 mm2/s, (1.66±0.14)×10-3 mm2/s, (1.95±0.34)×10-3 mm2/s and ( 1.24 ± 0.32) × 10-3 mm2/s, respectively. There were statistically significant differences in ADC values between the inter-groups (P＜0. 01 ). With ROC cut point setting to 1.49 ×10-3 mm2/s, the diagnostic sensitivity and specificity for prostate cancer were 86. 8% and 94. 0%, the area under the ROC curve (AUC) was 0. 945±0. 010. Conclusions ADC value might be useful to evaluate prostate cancer. DWI has an important clinical application value in the diagnosis and differentiation of prostate cancer.

ObjectiveTo investigate the central nervous system mechanisms of active of movement switch in the patients with Tourette' s syndrome( TS),and to explore the possible underlying distinct neural networks for tic trigger and generation. Methods Participants were 14 patients with TS and 14 age- and gender-matched healthy volunteers with no history of physical,psychiatric or neurological disease: All patients were assessed with functional magnetic resonances imaging (fMRI)of the brain during the intermittent performance of finger-tapping switch tasks,Blood-oxygen-level dependent-fMRI was performed using a 3.0 Tesla MR.The area over which the activation was distributed was calculated,and the activation volumes were also compared between the patients with TS and the control subjects.ResultsThe regions activated in the patients with TS and in the volunteers were similar in several brain regions,including contralateral precentral and postcentral gyrus,contralateral mesia pre-front gyrus,contralateral cingulate gyrus,contralateral insula and ipsilataral cerebellum. There were also many different activation areas between the patients and the control subjects. The patients with TS demonstrated more significant and extended activation in the contralateral pre- and postcentral gyrus than the healthy volunteers.The volume of the left pre- and postcentral gyrus of the TS patients was (8.024 ±0.071 ) cm3,while the volume of the left pre-and postcentral gyrus of the control subjects was ( 6.480 ± 0.026) cm3 ( t =3.026,P ＜ 0.01 ) ; The volume of the right pre- and postcentral gyrus was (6.192 ± 0.019) cm3 in the TS cases,while there was (5.608 ±0.037) cm3 in the control subjects (t =2.752,P ＜0.05).There were significant differences in the volumes of bilateral pre- and postcetral gyrus between the TS and control subjects. The activations of conralateral thalamus without contralateral insula were found in the patients with TS. Conversely, the contralateral insula activation without thalamus activation could be found in the healthy volunteers.ConclusionThe thalamus might play an important role in the aetiological and physiopathologic mechanisms of the TS. The thalamus along with the parietal cortex,cingulate cortex and insular cortex appear to constitute a distinct neural network for tic trigger and generation.

Oxidation stress is a key factor in the progression of various diseases.Hydrogen,as a reducing inert gas,can effectively inhibit the reactive oxygen produced by oxidative stress.With the daily use of dissociated water in recent years,the health care and treatment effects of hydrogen rich water are gradually reflected and valued.In this paper,the current status of hydrogen in medical research is briefly reviewed,which provides a reference for reducing the damage caused by the increase of reactive oxygen species in the treatment process and the wide application of hydrogen as a safe oxidant in the future.

Objective To investigate the effects of nutritional treatment in patients with AIDS.Methods A total of 104 HIV/AIDS patients with a total score of nutritional risk screening≥3 were divided into two groups:observation group (n =50) who were treated with nutritional therapy,control group(n =54) who refused nutritional treatment.The changes of parameters in two groups were observed before(I0) and 1 month after (I1)treatment and 3 months after treatment (I2).Results Compare with thecontrol group,the weight,BMI and ALB in observation group were higher at the time of I1 and I2 (P＜0.05);Except for Hb and ALB,the other indexes had significant difference between the time of I0,I1,I2 in control group.While all the indexes had significant differencebetween the time of I0,I1,I2 in observation group.Conclusion Long-term comprehensive nutritional therapy can improve the nutritional status of AIDS patients,which provides patients with a good basis for anti-viral treatment.

OBJECTIVETo compare the applicative effect of four diagnostic criteria of metabolic syndrome (MS) among the urban adult population of Zhejiang Province.

METHODSAccording to multi-stage stratified and proportional to size, cluster, random sampling principle, 3 417 adults population at urban areas were extracted by random number method from 320 families of Shangcheng and Jianggan community in Hangzhou,Jiangdong community in Ningbo and Wucheng community in Jinhua in 2009 and 2010 respectively, which excluded pregnant, wet nurse, children, and those who were at least 18 years of age. Height, weight, waist, blood pressure, fasting plasma glucose (FBG) , 2-hour postprandial blood glucose (2h-PBG), TG and HDL-C of all the subjects were measured by standard method. MS was diagnosed and compared according to four diagnostic criteria:Chinese Medical Association Diabetic Society (CDS), Joint Committee for Developing Chinese Guidelines (JCDCG), American National Cholesterol Education Program Adult Treatment PaneI II in 2005 (ATPIII) and International Diabetes Federation (IDF), respectively.

RESULTSThe high prevalence of MS diagnosed by the criteria of ATPIII was 21.6% (737/3 417) , while the lowest prevalence diagnosed by CDS was 9.8% (335/3 417), the result of consistency check demonstrated the MS diagnostic criteria of ATPIII and IDF, ATPIII and JCDCG were in strong and the same accordance with the concordance rate, Kappa value was 0.75, while the consistency of the criteria of ATP III and CDS were in relatively weak agreement, Kappa value was 0.53; the detection result of MS abnormal components showed the highest proportion of having ≥ 3 risk factors was presented by ATPIII among subjects diagnosed as MS (100.0%) , meanwhile, the lowest proportion of having ≥ 3 risk factors was also found by ATPIII among those MS-free (0.8%) .

CONCLUSIONSThe criteria of ATPIII may have more sensitivity when screening MS and its abnormal components.However, it's limited to extrapolate the results from the cross-sectional survey to the total population.

Adult ; Blood Glucose ; Body Weight ; Body Weights and Measures ; Cholesterol ; Cross-Sectional Studies ; Diabetes Mellitus ; Diagnostic Techniques and Procedures ; Humans ; Metabolic Syndrome ; Prevalence ; Risk Factors ; Urban Population

AIM: To evaluate the safety and efficacy of ultrasonic cycloplasty(UCP)combined with anti-vascular endothelial growth factor(VEGF)+ panretinal photocoagulation(PRP)in the treatment of advanced neovascular glaucoma(NVG).METHODS: Retrospective study. A total of 45 patients(45 eyes)with advanced NVG who received surgery in our hospital from August 2020 to September 2022 were collected and divided into UCP+ anti-VEGF +PRP group(16 patients, 16 eyes), transscleral cyclophotocoagulation(TCP)+anti-VEGF+PRP group(20 patients, 20 eyes), UCP alone group(9 patients, 9 eyes). The intraocular pressure, pain scores, postoperative medication, effective rate, total success rate and the incidence of complications of the patients in the three groups were compared before surgery and at 1 d, 1 wk, 1 and 3 mo after surgery.RESULTS: There was no significant difference in preoperative intraocular pressure, pain scores and preoperative medication of patients in the three groups(all P>0.05). While there were statistical significance in the intraocular pressure and pain scores at 1 d, 1 wk, 1 and 3 mo after surgery(all P<0.01). The intraocular pressure of the UCP alone group(31.78±10.23 mmHg)was found to be higher than that of both the UCP+ anti-VEGF +PRP group(19.44±8.23 mmHg)and the TCP+ anti-VEGF +PRP group(20.80±10.27 mmHg)at 1 mo postoperatively(all P<0.017). The pain score of the TCP+ anti-VEGF +PRP group at 1 d and 1 wk postoperatively was higher than both the UCP+ anti-VEGF +PRP group and the UCP alone group(all P<0.017). The effective rates of UCP+ anti-VEGF +PRP group, TCP+ anti-VEGF +PRP group and UCP alone group were 81%(13/16), 75%(15/20)and 67%(6/9), respectively,(P=0.675), and the success rates were 69%(11/16), 50%(10/20), and 0(0/9), respectively(P=0.003). There was no significant difference in complications of patients in the three groups(P>0.05).CONCLUSION: UCP combined with anti-VEGF +PRP and TCP combined with anti-VEGF +PRP showed comparable efficacy in reducing intraocular pressure in advanced NVG. UCP combined with anti-VEGF+PRP was more effective in relieving pain and with no serious complications in advanced NVG. UCP alone can effectively control intraocular pressure and alleviate the pain of patients in the early postoperative period, but long-term control still requires anti-VEGF+PRP.