Objective:To observe the change of blood endotoxin level after external biliary drainage with bile extracorporeal bypass in patients with malignant obstructive jaundice.Methods:The external biliary drainages with bile extracorporeal bypass were undergone in 14 patients with malignant obstructive jaundice,peripheral blood endotoxin levels were measured in perioperative period, other 15 cases internal biliary drainage and 20 cases external biliary drainage as contrast.Results:The changes of endotoxin level were not significant in external biliary drainage group,however,the endotoxin level was decreased signficantly in internal biliary drainage or external biliary drainage with bile extracorporeal bypass at postoperation.Conclusion:The external biliary drainage with bile extracorporeal bypass can decrease postoperative blood endotoxin level in patients with malignant obstructive jaundice.

Objective:To evaluate the influence of atorvastatin and rosuvastatin on the lipid level and liver function in the patients with coronary heart disease (CHD). Methods:The CHD patients in our hospital were selected from January 2011 to December 2012. According to statin types, the patients were divided into atorvastatin group (n=102) and rosuvastatin group (n=98), and the lipid level and liver function in the first week, and the first, third, 6th and 12th month after the statin treatment were evaluated. Results:TC and LDL-c levels of the two groups had no statistical differences in the same period (P>0. 05). AST and ALT levels were signifi-cantly increased after the statin treatment (P<0. 05), while no statistically significant difference was shown between the two groups (P>0. 05). Conclusion:Atorvastatin and rosuvastatin have the similar lipid-lowering effect, and both can increase liver enzymes.

0.05) while the level was significantly higher in the former 4 groups than in the control (P

Objective To study the relationship of plasma endotoxin (ET) level and renal function damage in patients with obstructive jaundice(OJ). Method The level of plasma ET、creatinine (Cr) or blood urea nitrogen ( BUN ) and endogenous creatinine clearance rate (Ccr ) were determined before and after operation in 30 patients with OJ(OJ group), and 21 cases of chronic cholelithiasis without jaundice (control group). Results The plasma ET level of peripheral blood was increased more significantly (P

Objective To summarize the experiences and lessons drawn from iatrogenic bile duct injury. Methods The clinical records of 52 patients with iatrogenic bile duct injuries were studied retrospectively. Results The injuries of 48 cases were resulted from extrahepatic bile duct operation,2 cases from partial gastrectomy and 2 cases from hepatectomy.The locations of injuries were at the juncture of common hepatic duct and common bile duct in 34 cases, the common hepatic duct in 6 cases ,the common bile duct in 6 cases ,the juncture of left and right hepatic duct in 4 cases,and the left and right hepatic duct each in 1 case respectively.Complete bile duct injuries were seen in 30 cases,and partial injuries in 22 cases .All patients were treated by operation. 8 cases were immediately discovered at the time of the initial operation and direct repair or end to end anastomosis with T tube stent was done in 5 of the cases,direct insertion of T tube drain in 1 case and Roux en Y hepaticojejunostomy in 1 case, all with good results;and in the another, a choledo choduodenostomy was performed,but re operation by Roux en Y hepaticojejunostomy was done 3 years later,due to stricture of the anastomosis.For the 44 cases in which the bile duct injury was detected after the initial operation, Roux en Y hepaticojunostomy was done in 31 cases,hepaticoduodenostomy in 8 cases, drainage of common bile duct in 2 cases,plastic repair of common bile duct defect with jejunal flap in 1 case, hepaticojejunostomy (Longmire) in 1 case,and removal of stitches between the anterior and posterior wall of the common bile duct in 1 case.In the whole series,4 patients died,and 41 of 48 surviving patients were followed up.The excellent result rate was 82.9%,and 7 cases with poor results were cured by reoperation with Roux en Y cholangiojejunal anastomosis 2 months to 5 years after operation. Conclusions The key to improvenment of treatment results of iatrogenic bile duct injury is awareness of its acurrence,early diagnosis , and eraly repair of the bile duct.The method of surgical therapy depends on the location and type of injury,and the time of detection after the injury.Roux en Y cholangiojejunal anastomosis gives the best results.

Objective To observe the change of perioperati ve endotoxin (ET) level and renal function in obstructive jaundice (OJ) patient and the effect of sodium cholate,lactulose, and anisodamine.Methods Forty-eight OJ patients were randomly divided in to control group(n=15), sodium cholate treatment group(n=11), lactul ose treatment group (n=10) and a anisodamine treatment group(n=12), 21 patients with cholecystolithiasis served as non-jaundiced control group. The levels of plasma ET and endogenous creatinine clearance rate (Ccr) were determi ned in all the cases.Results Compar ed with non-jaundiced control group, plasma ET level increased significantly an d Ccr significantly decreased in OJ group (P

Objective The efficacies of four cholangiogrphies were compaired with each other in preventing bile duct injury during the procedure of LC. Methods Four cholangiogrphies were used in LC:1. Cold light cholangiography (CLCP); 2. Methylenum coeruleum cholangioguaphy (MCCP); 3. Intraoperative cholangiography (IOCP); 4. Intraoperative endoscopic retrogarde cholangiopancreatography (IERCP). Results The images of CLCP and MCCP were direct and could help operator to identify bile duct structure in LC. The images of IPCP and IERCP were indirect and could not be so helpful. Conclusions CLCP is the only technique that clearly and directly shows the location of the extra hepatic biliary system and may be useful in selected cases with abnormal or uncertain anatomy for the prevention of bile duct injury.

Objective:To study the role of rennin and angiotension Ⅱ in the developement of acute pancreatitis in rats.Methods:Forth-two Sprague-Dawley rats were divided into two groups randomly-control group,and acute pancreatitis group.Acute pancreatitis model was reproduced by closed duodenal loop technique.Plasma amylase.Plasma renin activity and angiotesion Ⅱ level were measured,pancreatic histopathology was examined with light microscopy. Results:In acute pancreatitis group,pancreatitis histopathology developed from edematous to bleeding and necrotizing pancreatitis,plasma amylase,plasma renin activity,and angiotesion Ⅱ level were increased as acute pancreatitis developed,but after 10h,the angiotesion Ⅱ level was increased sequentially and plasma renin activity was increased unsignificantly.Conclusion:Renin and angiotension Ⅱ played the important role in the developement of experimental acute pancreatitis.

Objective: To explore the acute effect of air pollution on mortality for patients with cardio cerebral vascular disease and to provide the basis for disease prevention and control.
Methods: The Mortality for patients with cardio cerebral vascular disease from 2001-01 to 2009-12 was from Tianjin Centers for Disease Control and Prevention, the meteorological and air pollution data were from Tianjin meteorological bureau and Tianjin environmental monitoring station respectively. The Single and multiple generalized additive model (GAM) extended poisson regression analysis was performed to calculate the relationship between air pollution and cardio-cerebral vascular disease mortality by controlling the time trends, weather, the day of week and air population.
Results: Results: Single GAM analysis indicated that when the effect of SO2, NO2 and PM10 in the air reached the maximum in the day, the RR values for the mortality in patients with cardio-cerebral vascular disease increased 1.13%[95%CI (0.76-1.51)%], 0.78% [95%CI ( 0.41-1.15)%] and 0.61% [95%CI ( 0.51-0.71)%] respectively; when the average concentration of SO2, NO2 and PM10 increasing 10μg/m3 per day, after 0-5 days, the RR values for the mortality elevated 0.70% [95%CI (0.47-0.94)%], 0.51% [95%CI (0.27-0.74)%] and 0.16% [95%CI (0.06-0.27)%] respectively. Multiple GAM analysis presented that when SO2, NO2 and PM10 increasing 10 μg/m3 per day, the RR values for the mortality elevated 0.77% [95%CI (0.58-0.97)%], 0.41% [95%CI (0.05-0.78) %] and 0.38% [95%CI (0.12-0.64%)%] respectively.
Conclusion: The air pollution could increase the mortality risk in patients with cardio-cerebral vascular disease, it is necessary to establish the prevention system in order to decrease the mortality risk in those patients.

OBJECTIVETo analyze the mortality attributable to smoking in different work environments among male citizens in Tianjin, China, and to provide scientific evidence for banning smoking in workplaces and public places.

METHODSThe data of 38 312 male deaths 18-69 years of age in Tianjin from 2010 to 2012 were collected. The risk of death due to lung cancer and cardiovascular diseases attributed to smoking in different work environments was analyzed.

RESULTSAmong the male deaths 18-69 years of age in Tianjin, 22.57% were caused by smoking, and the life scan of smokers was shortened by 5 years on average. The smokers who started smoking at an early age and had high dialy cigarette consumption were at high risk of death.The risk of death due to cardiovascular and cerebrovascular diseases among workers in indoor workshop(OR=1.82,95%CI: 1.55 2.15), indoor office personnel (OR=1.59, 95%CI: 1.39-1.81) Indoor public places (OR=1 .55, 95%U: 1.19 2.01) were higher than outdoor workers (OR=1.23,95%CI: 1.12-1.35). The risk of death due to lung cancer among workers in indoor workshop (OR =3.80,95% CI: 3.03-4.76), indoor office personnel (OR =3.04,95% CI: 2.48-3.73) Indoor public places (OR =4.63,95% CI:3.08-6.96)were higher than outdoor workers (OR 2.57,95% CI:2.22-2.97). The risk of death due to lung cancer and cardiovascular diseases among indoor workers was higher than that among outdoor workers. The risk of death due to lung cancer among indoor workers in public places who started smoking when they were younger than 18 years of age was higher than those among outdoor workers and other indoor workers.

CONCLUSIONSmoking is a major risk factor for mortality among male citizens in Tianjin, and also a key factor for the loss of labor productivity. Indoor workers have a higher risk of mortality than outdoor workers. In order to reduce the mortality attributable to smoking, effective actions should be taken as soon as possible to ban smoking in indoor workplaces.

Adolescent ; Adult ; Aged ; Cardiovascular Diseases ; mortality ; China ; epidemiology ; Humans ; Lung Neoplasms ; mortality ; Male ; Middle Aged ; Occupations ; Risk Factors ; Smoking ; mortality ; Workplace ; Young Adult