Objective To discuss the pathogeny,treatment and prophylactic measures of postcholecystectomy syndrome (PCS).Methods The clinical data of 150 patients with laparoscopic PCS in our department from October 2000 to March 2009 were analyzed.Results Etiological factors were found in 131 patients:one hundred and twelve cases were due to the reasons of biliary system,including bile duct residual stones after cystic resection,the injury bile duct stenosis,a long residual cystic canal,nipple benign stricture,bile duct tumor etc;Nineteen examples were due to other reasons,including gallbladder stone merger reflux gastritis,gastroduodenal ulcer,diverticulum beside duodenal nipple,and so on,which resulted in the symptoms un-release after cystic resection.Nineteen cases were not found organic lesion.In ones whose etiological factors were definite,117 cases were treated with different surgeries according to different etiological factors;another 33 cases were treated with conservative treatment.Total 145 cases were followed up,and 139 cases in them were cured or relieved at different degrees.Conclusion Careful preoperative examination,normalized operation avoiding damaging bile duct and leaving behind bile duct stones can effectively prevent laparoscopic PCS.

HRP was injected into the cervical (3 cases) or lumbar (2 cases) spinal cord unilaterally in 5 adult cats. Labeled cells were discovered in the hypoth alamus and nearby areas. There was no obvious difference in labeling between cervical and lumbar injection cases. Labeled cells were found bilaterally with ipsilateral preponderance.he paraventricular nucleus was most heavily labeled; the posterior and lateral hypothalamic areas were less. A few labeled cells were found in the dorsal hypothalamic area and the supramamillary nucleus. Forel's area was also weakly labeled and occasional cells were found in the subthalamic nucleus and zona incerta.We were unable to find labeled cells in the dorsomedial nucleus. Labeling of the supramamillary nucleus, which was found in this sutdy, has not been mentioned in the literature available to us.

The projection from the lower brain stem to the spinal cord was studied with HRP method by injecting HRP into the cervical and lumbar enlargements of the spinal cord of 10 cats.The follwing nuclei were found to have spinal projections:1) The reticular formation: Numerous retrogradely labeled cells were seen in the nuclei of gigantocellularis and medullae oblongatae centralis subnucleus ventralis, fewer in the nuclei pontis centralis caudalis and oralis. A few labeled neurons were also found in the nuclei of medullae oblongatae centralis subnucleus dorsalis, parvocellularis, paragigantocellularis laterlaris, paramedium reticularis subnucleus ventralis and cuneiformis. Most of them projected to the spinal gray matter ventral to the dorsal horn except the nuclei of medullae oblongatae centralis subnucleus dorsalis and parvocellularis which projected mainly to the dorsal horn.2) The raphe nuclei: Nuclei of raphe pallidus, magnus and obscurus projected to both the cervical and lumbar enlargements, while nucleus raphe dorsalis only to the gray matter ventral to the dorsal horn of the cervical enlargement.3) The gracile and medial cuneatus nuclei projected somatotopically to ipsilateral spinal cord.4) The cranial nuclei: The Edinger-Westphal nucleus, nuclei of nervi oculomotor principalis, tractus spinalis nervi trigemini and tractus solitarii and the nuclei vestibularis lateralis, medialis, superior and spinalis were found to project to spinal cord. There was somatotopic arrangement in the nucleus vestibularis lateralis.5) The nuclei of locus coeruleus, subcoeruleus, parabrachialis lateralis and medialis, neucleus retroambigualis and the Kolliker-Fuse nucleus projected bilaterally to the spinal cord.6) The red nucleus: Large amount of labeled cells were seen in the controlateral red nucleus. The ventrolateral part of the red nucleus projected to the cervical enlargement while the dorsornedial part to the lumbar enlargement.7) The superior colliculus and the griseum centrale mesencephali projected to the gray matter ventral to the dorsal horn of the cervical enlargement.

HRP was injected into C_6, C_7, L_5, L_6 or T_(5～7) spinal gray. The retrogradely labeled cells and anterogradly labeled terminal arborizations were traced in L_5 and T_5 in cervical injection cases, C_5 and T_5 in lumbar cases, and C_5, L_5 in thoracic cases.Large amount of labeled cell were consistently found in laminae Ⅶ (including the lateral horn of the thoracic cord) and Ⅷ, next numerous in lamina Ⅴ and Ⅹ region. Lamina Ⅰ was found labeled in the cervical and lumbar cord, but virtually not found in the thoracic cord. Labeled cells were few and inconsistent in laminae Ⅳ and Ⅵ. A few labeled lamina Ⅸ cells could be found in the thoracic cord, only occasionally in the lumbar cord, but could not be found in the cervical cord. Laminae Ⅱ and Ⅲ were free from labeled cells in all cases. The labeled terminal arborizations were more widespread and could be found in practically every lamina, being densest in region Ⅹ, laminae Ⅶ (including the lateral horn of the thoracic cord) and Ⅷ. In lumbar injection cases a prominent plexus of labeled terminal arborization could be seen in the ventrolateral part of the C_5 ventral horn. Corresponding plexus was not found in the lumbar cord in cervical injection cases.Some labeled terminal arborizations were found in close approximation to or overlapping with labeled cells or unlabeled motor neurons.These results imply that: (1) The occurance of labeled cells and labeled terminal arborizations in the lateral part of lamina Ⅶ (lateral horn) suggests that intersegmental connection is related to visceral activities as well as somatic ones. (2) Labeled cells were consistently found in region Ⅹ which was also the area of dense labeling of terminal arborization, suggesting that this region plays a remarkable role in intersegmental connection. (3) Long ascending bundle connects the lumbar enlargement with the ventrolateral part of the motor neurons directly. (4) The close approximation of labeled terminal arborization and labeled cells signifies direct intersegmental feedback circuit.

The cervical, thoracic, or lumbar spinal gray was injected with HRP or WGAHRP unilaterally in 18 adult rabbits and the anterograde labeling was traced in the pontine nucleus and the caudal pontine ventrolateral tegmentum.In the pontine nucleus labeled terminal arborizations were found in its caudal 1/3, distributing in the paramedian nucleus, the dorsal part of peduncular nucleus and the dorsolateral nucleus. In the ventrolateral tegmentum four small cell groups were found labeled which were temporarily denominated as VLPT_(1～4) groups. In all locations labelings were found bilaterally and no apparent somatotopical localization could be identified.The cytoarchitecture of VLPT_(1～4) was studied on Nissl sections and their relationship with Meessen and Olszewski's (M-O's) "k" and "m" groups and with pontobulbar body was discussed. VLPT_2 (corresponding to the ventral part of M-O's "k") and VLPT_3 (corresponding to a part of M-O's "m") join each other to form one group which then merges into the dorsolateral nucleus of the pontine gray. They apparently form a part of the pontobulbar body.

The somatotopical pattern of the spinal projection to the lateral reticular nucleus (LRN) was examined in 16 rabbits. The anterograde transport of HRP method were used.1. Cervical, thoracic and lumbar segments all gave rise to small numbers of fibers projecting to bilateral lateral reticular subtrigeminal subnucleus (Lrs).2. Cervical, thoracic and lumbar projections to the LRN were bilateral but the cervical ascending fibers terminated predominately on the ipsilateral side. The lumbar ascending fibers projected chiefly to the contralateral side. The thoracic cord gave fibers to bilateral LRN. No significant difference could be seen between the two sides. There were certain overlapping among the distribution areas of the terminal branches from different parts of the cord.3. The spinal projections of the rabbit were predominately terminated in the caudal half of the LRN. It showed a somatotopical pattern. The cervical cord projected to the lateral 3/5 of the lateral reticular magnocellular subnucleus (Lrm) and its neighbouring part of the lateral reticular parvocellular subnucleus (Lrp). The thoracic cord projected to the medial 3/5 of the Lrm and its neighbouring part of Lrp. The lumbar cord gave afferents to the Lrp and its neighbouring part of Lrm.

HRP or WGA-HRP was injected into the rabbit cervical, thoracic, or lumbar spinal gray unilaterally and the retrograde labeled ceils and anterograde labeled terminal branches in the nucleus of the solitary tract were studied. The labeled cells were found in the caudal part of the nucleus. The amount of the labeled cells in the cervical and thoracic injection cases out numbered that of the lumbar cases. In all the cases labeled ceils were most concentrated near the obex level, mainly located ventromedial to the tract. Some could be found ventral, ven- trolateral, lateral and medial to and in the vicinity of the tract. In the medial part of the nucleus labeled cells were limited in its ventral part dorsal to the dorsal motor nucleus of the vagus nerve. No labeling could be ascertained in the subnucleus parvocellularis. In the thoracic injection cases a group of labeled cells were discovered dorsolateral to the tract where only a few labeled ceils could be found in the cervical and lumbar cases. Labeled terminal branches largely accompanied the labeledcells. Thus the chance of establishing direct synaptic contact between spino-solitary fibers and the spinal projection cells of the nucleus of the solitary tract is great. At the level of obex a narrow band of terminal labeling along the dorsolateral border of the nucleus was identified. Except occasionally no labeled cells were found in this zone, an area probably related to cardiac function.

Aim To investigate the effects of chloride channel blockers on the apoptosis of RIN-m? cells of pancreatic islet induced by H2O2.Methods The apoptotic model was made by H2O2 exposed for six hours with a concentration of 500 ?mol?L-1.The chloride channel blockers:DIDS,NPPB and NFA were administered to pretreat the samples respectively.The cell viability,morphological changes,and apoptosis rate were observed.Results Chloride channel blockers alone have no marked effects on the cell viability of RIN-m? cell.However,they elevated the cell viability of RIN-m?cell disposed of by H2O2.Compared to H2O2 group,the groups of DIDS +H2O2,NPPB+ H2O2 and NFA+H2O2 have significant difference in cell viability and apoptosis rate(P

In recent years, the medical graduates who take part in postgraduate examination have been increasing each year. The preparation for postgraduate examination affects the clinical practice, but not yet has a quantitative report. This article studied the students in general surgery, which were divided into postgraduate examination group and clinical practice group. By comparing the theoretical knowledge results and the clinical practice skills between the two groups we found that there was no difference between the two groups in the theoretical and operating skill when they were just in the department, and the operating results in the clinical practice group were better than the postgraduate examination group when they were out of the department.

ObjectiveTo discuss the effect of surgical treatment of varicose vein on primary chronic venous insufficiency(PCVI) in the lower extremities.MethodsBetween August 2007 and August 2008,128PCVIpatients underwenthighligationof the greatsaphenousveinandendovenous electrocoagulation of the varix superficial vein. Spectrum Doppler ultrasound was used to measure the superficial femoral vein blood flow hemodynamic information beneath the first pair of valve including quiet breathing condition and the Valsalva action (reflux time、caliber、reflux velocity). Reflux index (RI) was used as guide line.ResultsClinical sympotoms improved in 54 out of 60 mild PCVI cases, in 29 of 45 moderate PCVI patients, while only in 6 out 23 cases in whom severe preoperative clinical symptom with PCVI was present.The effective rate respectively was 90％, 64％, and 30％.The mild reflux index significantly improved than that before operation ( t = 21. 484, P = 0. 000 ), the moderate reflux index improved than that before operation ( t = 2. 173, P = 0. 035 ), while the serious reflux index were not statistically improved than that before operation( t = 1. 888, P = 0. 078 ). In all cases reflux index improved after the surgery ( x2 = 8. 266,P = 0. 004).ConclusionsMinimally invasive surgical treatment of varicose veins can improve the reflux of the deep vein in PCVI cases with mild to moderate clinical symptom.