Objective To evaluate the feasibility and clinical efficacy of laparoscopic biliary reoperation. Methods From May 2000 to May 2007, 105 patients received laparoscopic biliary reoperation, including choledocholithotomy and T-tube drainage in 96 cases, Roux-en-Y anastomosis of the gallstone/hepatic-duct in 5, and liver resection in 4. Results The operations were completed in all the 105 patients without severe complications. The operation time was 60-185 min [mean, (125.3?23.2) min]. Intraoperative blood loss was 15-310 ml [mean, (21.1?8.6) ml]. The patients stayed at hospital for 5-9 days after the operation. The 5 patients, who underwent Roux-en-Y anastomosis of the gallstone/hepatic-duct, were followed up for 6 to 65 months [mean, (13.2?8.6)months]. Partial liver resection was performed in 2 cases (resection of the left hepatic lobe in 2, and the right lobe in 2); they were followed up for 8-25 months [mean, (10.2?3.6)months]. In the 96 patients, who received laparoscopic choledocholithotomy and T-tube drainage, the follow-up were lasted for 3-72 months [mean, (13.2?9.6)months]. None of the patients who were followed up had recurrence of gallbladder stone. Conclusions Laparoscopic biliary reoperation is feasible and safe with minimal trauma to patients.

Objective To summarize our experience in the management of stones impacted at cystic duct during laparoscopic cholecystectomy(LC). Methods There were 58 patients with stones impacted at cystic duct during LC from July 1997 to June 2001.Cystic duct was incised to remove stones first,then intraoperative cholangiography was performed.If stones were found in common bile duct,they would be taken out by intraoperative endoscopic sphincterotomy or open operation. Results All the impacted stones in 58 patients were removed successfully.51 coses underwent LC.Intraoperative cholangiography showed there were common bile duct stones in 7 cases.For these 7 coses,5 cases were treated by LC combined with intraoperative endoscopic sphincterotomy and other 2 cases were converted into open operation.No Severe complication occurred. Conclusions Nearly all cases with stones impacted at cystic duct can receive LC by removing impacted stones through incising the cystic duct and intraoperative cholangiography.If there are any stones in common bile duct,they can be removed by endoscopic sphincterotomy.

Objective To study the feasibility of the ultrasonic scalpel in the management of cystic blood vessels during laparoscopic cholecystectomy(LC). Methods Abdominal blood vessels of two dogs were managed by ultrasonic scalpel under the conditions of two step output power,low tension,low holding force and blunt scalpel head.The blood vessels were sealed and arteries and veins of (1～11)mm were cut.On this basis,the technique was applied to the management of cystic vessels during laparoscopic cystic and biliary operation. Results The sealing and cutting effect was good for the blood vessels of less than 9mm 140/150(93 3%).No blood oozing was found at the cutting ends of blood vessels during and after operation.In all 706 cases of laparoscopic gallbladder and biliary duct operations,no bleeding was found at the cutting ends of blood vessels during and after operation. Conclusions Ultrasonic scalpel can be directly used to seal and cut cystic artery during laparoscopic cholecystectomy.

Objective To summarize the experience on the prevention of severe complications of endoscopic thyroidectomy.Methods Twelve cases of bilateral lesions underwent endoscopic thyroidectomy via precordial approach and 41 cases of unilateral lesions, via subaxillary approach. A subcutaneous channel, with a width of about 5 cm from the incision site to the thyroid, was made by using self-made instruments. The CO 2 pressure was set at 4 mm Hg. By ultrasonic scalpel the lesions were divided and removed. Results There were 41 cases of thyroid adenoma (unilateral, 34 cases; bilateral, 7 cases) and 12 cases of nodular goiter (unilateral, 7 cases; bilateral, 5 cases). Postoperative subcutaneous hematoma occurred in 1 case and was cured by conservative management. No nerve damage or parathyroid complications were observed. Conclusions Application of ultrasonic scalpel and continued low cavity pressure are effective means for preventing complications in endoscopic thyroidectomy.

AIM: To observe the role of free radicals in the inhibitory effect of chemotherapy on glioma cells. METHODS: C6 glioma cells were cultured in vitro , and treated with carmustine (B), teniposide (V), or/and nimodipine (N). Furthermore, the glioma-bearing rats were treated with B plus N, B+V+lisplatin (D)+N, or B+V+D+N+angiotensin Ⅱ. The MDA content and superoxide dismutase (SOD) activity in the culture supernatant and cortical brain tissue were assayed. RESULTS: B, V and N significantly decreased MDA content and SOD activity in the supernatant of glioma cell culture and C6 glioma cells. Chemotherapy reduced MDA content and increased SOD activity in the cortical brain tissue of tumor-bearing rats, with highest efficiency in B+V+D+N+angiotensin Ⅱ group. The survival time of tumor-bearing rats in B+V+D+N+angiotensin Ⅱ group was longer than that in other chemotherapy group. CONCLUSION: The antitumor effects of combined chemotherapy may be involved in the free radical metabolism. [

Objective To discuss the specific role of association rules in the compatibility of herbs and the relationship between herbs and symptoms by analyzing ancient analogous prescriptions Zhizichi Decoction with SQL Server software.Methods The prescriptions which contain Gardenia and Semen Sojae Preparatum were searched in the database of “Ancient Prescriptions for Epidemic Disease”, and they were imported to software with the standardized data of their symptoms and ingredients, then the proper association rules were found. The laws between parameter setting and rule generation were searched through parameter adjustment.Results Many laws of the drug compatibility and relationship between herbs and symptoms were obtained effectively in data mining by adjusting the parameters:The support setting was good for finding common used drug compatibility, and the confidence was good for finding specific drug compatibility and relationship between herbs and symptoms;the item set which had high frequency, sometimes made the rule’s importance low.Conclusion The laws of compatibility of herbs and the relationship between herbs and symptoms for data mining of analogous prescriptions are discovered by analyzing the support, confidence and importance of the association-rules and the clinical magnificence between symptoms and herbs.

Objective To observe the anesthesia and recovery results of sevoflrane and remifentanil combined anesthesia in open or laparoscopic surgeries. Methods 60 cases of ordinary surgeries from the department of gynecology and general surgeries were included in this study with 30 cases in each group. (1)recording total sevoflurane inhalation time, muscular relaxant amount, end tidal sevoflurane concentration;(2)recording BP,HR at 10 min after induction,operation staring and ending,ventilation recovery, opening eye and extubation period;also sevoflurane concentration 5 min after stopping medicine and ventilation recovery;recording time period between surgery ending and autonomous respiration recovery , eye opening and extubation. Results No any adverse events happen in each patient.the sevoflurane inhalation time in open surgery group was (157.20 ± 47.28) min, longer than that of laparoscopic surgeries group (73.50 ± 11.23)min(P<0.05), we had seen no statistical significance in all other index observed (P>0.05). Conclusion Sevoflurane combined remifentanil anesthesia can achieve stable intra-operative maintenance and rapid postoperative recovery quality , we suggest the widespread usage of it in clinic.

Objective To investigate the current situation of radiation protection in nuclear medicine diagnosis workplace.Methods The study was performed in 3 hospitals in northeast,north and central of China from February to December in 2013.The γ dose rate instrument was used to detect the workplace ambient dose equivalent rate of medicine preparation,leaching,packing,injection and imaging.Individual effective dose and equivalent dose were evaluated by photoluminescent dosimeter.Results The ambient dose equivalent rate was up to 1.92 mSv/h at repacking place and 1.2 mSv/h at injection place.The ambient dose equivalent rate of patients after injection was 5.36-240 μ,Sv/h.The hand equivalent dose was 0.01-0.02 mGy.Moreover,there were problems of staff route intersection,as well as the patients after injection staying in the public area.Conclusions Radiation workers should pay more attention to individual protection,and improve the operation proficiency to shorten the operation time.Furthermore,in order to protect public from unnecessary irradiation,there should be some changes in staff route and patients administration.

Objective To use Monte Carlo method to build a shielding calculation model for the proton and heavy ion treatment room,and to provide a reliable calculation method for shielding design.Methods A Monte Carlo-based FLUKA code was adopted to build the shielding calculation model for the proton and heavy ion treatment room,and to simulate the radiation field distribution in the proton and heavy ion treatment room.The calculation model was verified through the radiation detection around the proton and heavy ions treatment room.Results The FLUKA code-based simulation results were consistent with the radiation detection.Conclusions The shielding calculation model based on FLUKA code can simulate the radiation field from proton and heavy ions.Among the secondary particles,secondary neutrons are the dominant component and the main concern of accelerator shielding design.In shielding calculation,the emphasis should be put on both beam intensity and energy.

Objective To measure the circuit time constants of 4 kinds of radiation survey meters (451P ionization chamber dosimeter,6150AD6 + 6150AD-b dose meter,FH40G + FHZ672E-10 dose meter and AT1123 dose meter) and,to discuss the formula of time response correction and its application.Methods In the condition of continuous exposure of X-ray machine,the ambient dose equivalent rates shown by survey meters were recorded.In order to get the circuits time constant,the least squares fittingmethod was used to fit the data using the time response formula of circuit having a capacitance C and a resistance R in series.Results The relative uncertainty of fitted circuit time constants was higher than 20％ except for 6150AD6 + 6150AD-b dose meter.The relative uncertainty of fitted r was 8％ for 6150AD6 + 6150AD-b dose meter.Conclusions The time required to stabilize the dosimeter readings was 8,5,3 and 2 s,respectively,for the 451P ionization chamber dosimeter,6150AD6 +6150AD-b dose meter,FH40G + FHZ672E-10 dose meter and AT1123 dose meter.The rising trend of their measured values was not fully accordance with the RC circuit time response correction formula.