Objective To investigate the clinical characteristics and treatments of early-stage acute pancreatitis following laparoscopic cholecystectomy (LC). Methods From April 1998 to June 2006,totally 18 470 cases of LC were performed in our hospital,16 (0.09%) of them developed early-stage acute pancreatitis (

Objective To explore the clinical value of serum procalcitonin(PCT)and C-reactive protein(CRP)combination detec-tion in early diagnosis of liver cirrhosis complicating spontaneous bacterial peritonitis(SBP).Methods The peripheral blood sam-ples were collected from 30 cases of liver cirrhosis complicating SBP,30 cases of simple ascites liver cirrhosis (non-SBP)and 45 healthy subjects as control group.The serum PCT level was detected by the dry immunofluorescence quantitation method and the serum CRP level was detected by the immunoturbidimetry.The sensitivity and specificity of PCT,CRP and PCT combined with CRP in diagnosing liver cirrhosis complicating SBP were compared and the relationship between PCT levels and prognosis was ana-lyzed.Results Compare with the healthy control group and the non-SBP group,the serum PCT and CRP levels in the SBP group were markedly increased(P <0.05).The sensitivity of PCT,CRP and PCT combined with CRP in diagnosing liver cirrhosis compli-cating SBP was 93.3%,90.0% and 96.6% respectively,and the specificity was 90.0%,75.0% and 95.0% respectively.Conclusion The combination detection of serum PCT and CRP can increase the sensitivity and specificity of the diagnosis and has more clini-cal value in early diagnosing liver cirrhosis complicating SBP.

BACKGROUND: Compared with the metal screws, absorbable screws have more obvious advantages, such as does not have to conduct internal fixation removal, non-metal ic components, no influence on the magnetic resonance imaging of patients after implantation, relatively simple operations, namely dril ing-tapping-screws fixation, more in line with the principles of minimal y invasive in orthopedics. OBJECTIVE: To investigate the biomechanical characteristics of absorbable screw fixation in repair of simple lateral mal eolus fractures by means of finite element technology. METHODS: The three-dimensional model of simple lateral mal eolus fractures and absorbable screw model were established, and then fixed according to standard orthopedic surgical techniques. The reference load when the load bearing of fibulotalar joint reaching the peak value in a normal adult gait cycle was loaded. The stress distribution and displacement of fibula and absorbable screws were analyzed. RESULTS AND CONCLUSION: There were total y 38 542 units, 8 790 nodes in the single screw fixation model. When the articular facet of lateral mal eolus loading 300 N, the maximum stress of screws was 89.35 MPa, the maximum displacement was 0.5 mm, the maximum displacement of the distal fracture was 0.5 mm. When the articular facet of lateral mal eolus loading 450 N, the maximum stress of screws was 152.58 MPa, the maximum displacement was 0.59 mm, the maximum displacement of the distal fracture was 0.77 mm. There were total y 43 115 units, 9 496 nodes in the double screws fixation model. When the articular facet of lateral mal eolus loading 300 N, the maximum stress of screws was 38 MPa, the maximum displacement was 0.44 mm, the maximum displacement of the distal fracture was 0.44 mm. When the articular facet of lateral mal eolus loading 450 N, the maximum stress of screws was 66.68 MPa, the maximum displacement was 0.48 mm, the maximum displacement of the distal fracture was 0.49 mm. The experiment verified the biomechanical feasibility of absorbable screw fixation in repair of simple lateral mal eolus fractures. For simple involving only the lower lateral fibular fracture, absorbable screw fixation is entirely feasible, and usual y requires at least two screws to maintain the stability of the articular surface of the reset.

Objective To assess the efficacy,side effects and perinatal outcome of nifedipine compared with other antihypertensives for treating severe preeclampsia in pregnant women. Methods Randomized controlled trials (RCTs) that comparing nifedipine with other antihypertensives for severe preeclampsia were searched in PubMed,EMBase,Cochrane library,CNKI and VIP database etc( till January 2012).The quality of the included RCTs was evaluated,and Meta-analvsis was performed with Rev Man 5.1software.Results Nine trials were included,involving 386 women in the nifedipine group,and 378 women in other antihypertensives group.Compared with other antihypertensives,nifidepine was associated with greater effective control of blood pressure ( OR =2.65,95％ CI:1.65 -4.25,P ＜0.01 ).There was no clear difference in the time needed to control blood pressure ( W.M D =- 3.64,95％ CI:- 10.90 - 3.61,P =0.32 ).Nifedipine could prolong gestation better than other antihypertensives ( WMD =5.14,95％ CI:3.29-6.99,P ＜0.01 ).There were no clear differences in maternal side effects headache (P =0.28),palpitation ( P =0.06 ),and nausea vomiting ( P =0.28 ).No noticeable difference was found between the two groups in the Apgar score at five minutes ( WMD =- 0.21,95％ CI:- 0.32 - 0.91,P =0.72),neonatal respiratory distress syndrome ( OR =1.24,95％ CI:0.57 - 2.67,P =0.59 ),or perinatal deaths ( OR =0.49,95％ CI:0.22 - 1.11,P =0.09 ).Conclusion Nifedipine is associated with greater effective control of blood pressure and prolongation of gestation,with no additional neonatal respiratory distress syndrome or perinatal deaths,compared with other antihypertensives for women with severe preeclampsia.

Objective To discuss with micro-tympanoplastic operation with osteo retention on treating cholesteatomatous otitismedis. Methods Choose 33 cases cholesteatomatous otitis medis patients who toke the tympanoplastic with osteo retention operation,then analyze the postulate and method of the operation, curative effect and complication after operation. Results Follow up with those patients by 12-72 months, and when 3-4 months after operation we endoscopiced the ears, could see that 43 cases of patients ear mastoid process and tympanic sinus were covered with epithelium, those mastoid cavity were well epithelial metaplasia;and the middle ear was separate from mastoid cavity; 39 cases patient of transplant eardrums are heal up (39/43, 90.7%). 2 cases have perforation of the tympanic membrane toke place after 4 months and 6 months with the operation, and it will heal up by anti-inflammatory drug and laser burning, 1 case had tympanic sinus hyperplasia with granulation tissue, and also had grassery juice; after taken anti-inflammatory drug and change bandage for 15 weeks, the symptom disappear. 1 case had grassery juice of operation cavity, after taking anti-inflammatory drug and physiotherapy, the symptom disappear in 24 weeks. After operation the pure tone audiometry shows that air conduction raise (16.8±6.8) dB HL, hearing raise up to:79.1%(34/43). Conclusion Base on right indication of operation choose, taken combined therapy of ambi-operation period, focus of infection are thoroughly cleaning up. Tympanoplastic with osteo retention are treating well with patients of cholesteatomatous otitismedis.

A total of 120 patients with Ⅲ/Ⅳ degree hemorrhoids were randomly divided into 3 groups.Self-made drainage(A group),traditional device(B group)and stuffing(C group) were used at the end of operation.The patient postoperative complications and satisfaction were observed and compared.The results showed that postoperative abdominal distension,pain,medical dressing dampness and satisfaction were better in A group than those in B and C groups(all P ＜0.01).Postoperative abdominal distention in B group was lighter than that in C group and medical dressing dampness less in C group than that in B group (all P ＜ 0.01).Thus the self-made drainage device may reduce the levels of postoperative abdominal distension,pain and medical dressing dampness and increase postoperative patient satisfaction.

Objective To establish a guinea pig model for diagnostic reagent of tuberculosis.Methods By single or multiple subcutaneous injection of heat-killed H37 Rv in different doses in the groin of guinea pigs to establish a model of positive response to 0.1 mL (5 IU) standard tuberculin ( TB-PPD) skin test.Results Three doses of heat-killed H37 Rv ( 0.2 mg/mL, 0.3 mg/mL and 0.5 mg/mL ) could be used to generate the model of biological diagnosis of tuberculosis.After 24 and 48 hours, the diameter of red spot by TB-PPD skin test was 15.4 ±2.3 mm when a dose of 0.2 mg/mL heat-killed H37 Rv was administered for immunizing and allergizing the guinea pigs.The biggest red spot was induced at doses of 0.3 mg/mL and 0.5 mg/mL.The test results showed that the immune response induced by multiple njection to immunizing and allergizing guinea pigs was not significantly different than that induced by single immunizing injection, and the first skin test was better than the second, third and fourth skin test (P≤0.05).In addition, the body weight of the guinea pigs was still increasing after infection with heat-killed H37 Rv, and ulcers occurred in the injection sites in some guinea pigs.Conclusions A single subcutaneous injection of 0.2 mg/mL heat-killed H37 Rv in guinea pigs can be used well to establish a reliable model for biological diagnostic reagent of tuberculosis.Increasing the sensitizing dose and multiple sensitization can not increase the intensity of the delayed-type hypersensitivity ( DTH) response.

Objective To investigate the resident performance on preoperative anesthetist visit in Beijing hospitals,thereby providing introduction for further training.Methods A self-designed questionnaire was distributed among the anesthesia residents who were receiving anesthesia residency training in Beijing through WeChat.The questionnaire covers geographic data of the residents,information on preoperative visit and existing training program.Results160 questionnaires were reclaimed.History-taking and physical examination were not comprehensive in many residents,the nature of surgery was not evaluated by most residents.The capacity of risk assessment and risk informing were not competent in many residents.The most desired training methods for preoperative visit were scenario simulation and bedside observation.Conclusions Scenario simulation with standard patient may have a promising prospect in preoperative anesthetist visit training.

Objective To investigate the expression characteristic of metastasis associated 1(MTA1) protein in laryngocarcino-ma tissue and to analyze its relationship with matrix metalloproteinase-9(MMP-9) and vascular endothelial growth factor C(VEGF-C) proteinin .Methods The Western blot method was adopt to detect the expression levels of MTA1 ,MMP-9 and VEGF-C protein in the specimens of normal laryngeal mucosal tissue ,paracarcinoma tissue and tumor tissue from 40 cases of laryngocarcinoma .Re-sults Compared with the groups of laryngocarcinoma without lymph node metastasis ,paracarcinoma and normal tissue ,the expres-sion level of MTA1 protein in the laryngocarcinoma with lymph node metastasis group was significantly increased (P<0 .05) .The expression of MTA1 protein in the laryngocarcinoma tissue was significantly correlated with the lymph nodes metastasis ,tumor staging and differentiation degree of laryngocarcinoma (P<0 .05) and was positively correlated with the expression of VEGF-C and MMP-9 (P<0 .05) .Conclusion MTA1 may participate in the development ,progress and metastasis of laryngocarcinoma .Moreo-ver the regulating effect may exist among MTA1 ,MMP-9 and VEGF-C .

Objective To discuss the treatment method and opportunity for patients with gallbladder stones and extrahepatic bile duct stones who failed endoscopic removal of common bile duct stones by endoscopic retrograde cholangiopancreaticography (ERCP). Methods 12 patients, with gallbladder stones and extrahepatic bile duct stones, failed endoscopic stone extraction (ESE), underwent emergency one-stage laparoscopic cholecystectomy (LC) and Laparoscopic common bile duct exploration (LCBDE). Results All of the patients were successfully completed LC +LCBDE and stones were completely removed. Hyperamylasemia occurred in 3 cases and there was no bile leakage, intestinal leakage, cholangitis, pancreatitis, biliary bleeding and other complications. Conclusions Emergency LCBDE has been shown to be a safe and effective salvage procedure for failed ESE.