Objective To investigate the application of laparoscope,duodenoscope and choledochoscope in the treatment of intra-and extrahepatic bile duct stone.Methods The clinical data of 3 16 patients with intraand extrahepatic bile duct stone who were admitted to the Bethune First Hospital from April 2007 to August 2010were retrospectively analyzed.There were 269 patients with cholecystolithiasis and choledocholithiasis,10 patients with cholesystolithiasis,choledocholithiasis and hepatolithiagis,and 37 patients with choledocholithiasis.Laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)+choledochoscopy was applied to patients with hepatolithiasis or with the diameter of common bile duct≥10 mm;endoscopic sphincterotomy (EST)+LC or LC+EST was applied to patients with the diameter of common bile duct between 10 mm and 5 mm and the diameter of cystic duct<5 mm;LC+laparoscopic transcystic common bile duct exploration(TC-CBDE)+choledochoscopy wag applied to patients with the diameter of common bile duct≤5 mm and the diameter of cystic duct≥5 mm.Results The success rate of operation was 96.8%(306/316).A total of 163 patients received LC +LCBDE+T-tube drainage+choledochoscopy,and the mean operation time,expense,duration of hospital stay were 93.6 minutes,2.8×104 yuan and 9.8 days,respectively,and 5 patients had complications postoperatively.Fifty-four patients received EST+LC,and the mean operation time,expense,duration of hospital stay were 45.0minutes,6.6 days,2.3×104yuan,respectively,and 1 patient had complication postoperatively.Sixty-seven patients received LC+EST,and the mean operation time,expense and duration of hospital stay were 40.0minutes,6.1 days,2.4×104 yuan,respectively,and 2 patients had complication postoperatively.Thirty-two patients received one-stage repair of common bile duct and LC+TC-CBDE+choledochoscopy,and the mean operation time,expense and duration of hospital stay were 97.3 minutes,7.3 days and 2.5×104yuan,respectively,and 1 patient had complication postoperatively.A total of 272 patients were followed up for 12 months,except for 6 patients with recurrence of common bile duct stone,no residual stone or biliary stricture was etected.Conclusion Combined application of laparoscope,duodenoscope and choledochoscope has advantages of less trauma,quick ecovery and fewer complications in the treatment of intra-and extrahepatic bile duct stone.

Objective To investigate the effect of hypoxia adaptation on cerebral ischemai hypoxic injury Methods Hypoxia pretreatment mouse was placed in a tightly closed 150 ml bottle with large opening Once the mouse developed dyspnea, it was taken out and placed in another tightly closed 150ml bottle filled with fresh air When the mouse was short of breath it was again taken out This process was repeated 4 times Ischemia hypoxia model the left common carotid artery was ligated under ether anethesia and 1h later the mouse was placed in a hypoxia chamber in which the oxygen concentration was maintained at 8% Twenty four Kunmin mice weighting 18 25g were divided into six groups of four animals each:(1) control group; (2) hypoxia pretreatment group; (3) ischemia hypoxia group I (group I H1): the mice stayed in hypoxia chamber for 1 h; (4) ischemia hypoxia group 2 (group I H2): the mice stayed in hypoxia chamber for 2h; (5) hypoxia pretreatment +I H1; (6) Hypoxia pretreatment +I H2 The animals were sacrificed immediately at the end of the experiment Neural apoptosis was identified by terminal deoxynucleotidyl transferase mediated dUPT biotin nick end labelling (TUNEL).Results Apoptosis cells could be seen scattered in the cerebral cortex in hypoxia adaptation group and group I H1 No apoptosis cells were found in control group and group I H2 But hypoxia adaptation increased the number of apoptosis cells in severe hypoxia ischemia group (group I H2) Conclusions Hypoxia adaptation protects brain against hypoxia ischemia injury Hypoxia adaptation induces apoptosis Hypoxia adaptation can have neurons end up in apoptosis instead of nacrosis during cerebral ischemia hypoxia

Objective To develop an advanced two-cuff technique orthotopic liver transplantation model in rats. Methods On the basis of the previous two-cuff-technique, some hypercoagulable blood was released from the recipient's PV and IVC before the cuffed donor PV and IVC were inserted into the lumen of the recipient's PV and IVC. The anastomosis of recipient's SVC was between the donor's diaphragm venaccaval hiatus and recipient's SVC. Results Every anastomosis was effective. The operative successful rate and one-week survival rate were 96.7?% and 90.0?% respectively. Conclusion This model could be used as an effective measure for the study of liver transplantation in rats.

Objective To investigate the protective effects of transection of the cervical sympathetic trunk (TCST) on the gastric mucosal lesions in rats fastened to a board and immersed vertically in water, up to the level of xiphoid with the animals' heads up water for 6 hours. Methods Thirty male SD rats weighing 200-250 g were randomly divided into 3 groups ( n = 10 each): group A sham operation; group B sham operation + water immersion and group C TCST + water immersion. The animals were anesthetized with intraperitoneal 2.5% pentobarbital 40 mg?kg-1. Cervical sympathetic trunk was exposed at right common carotid artery bifurcation and cut. The gastric mucosal blood flow (GMBF) was measured with Doppler blood flow monitor after 6 h water immersion. Blood samples were taken from abdominal aorta for determination of plasma concentration of ET-1 and serum concentration of NO. Gastric mucosal ulcer index was determined according to Guth criteria.Results There was gastric mucosa bleeding and erosion in group B and C and the degree of injury was severer in group B than in group C. Plasma concentration of ET-1 and serum concentration of NO were significantly higher in group B than in group C and A.Conclusion TCST has protective effect on gastric mucosal blood flow in rats under stress by reducing blood ET and NO concentrations.

Objective To compare the preemptive analgesia effect of flurbiprofen axetil with tramadol in patients undergoing laparoscopic hysterectomy. Methods Ninety patients undergoing laparoscopic hysterectomy were divided randomly into group A (n=30), group B (n=30) and group C (n=30). The patients in group A were administrated 1mg/kg flurbiprofen axetil intravenously before tracheal intubation, and in group B 2mg/kg tramadol intravenously before tracheal intubation, while in group C 1mg/kg flurbiprofen axetil were administrated intravenously at the end of operation. The postoperative analgesic effects (1, 2, 4, 8, 12, 24 hours) were evaluated by VAS score and BCS score, while the times of pain-killer boosting and the side effects were recorded. Results VAS scores of group C were significantly higher than those of group A and B at all time points (P<0.05), except for 12 hours and 24 hours after the surgery, while BCS scores of group C Were lower than those of group A and B at the same time points (P<0.05).The side effects of group A and group C were significantly lower than those of group B (P<0.05). Conclusion Preemptive analgesia with flurbiprofen axetil and tramadol in patients undergoing laparoscopic hysterectomy is effective and convenient, while flurbiprofen axetil has less side effects.

Objective: To optimize semi-bionic extraction(SBE)of rhubard. Methods: The best extraction conditions of semi-bionic extraction for rhubard were optimized by uniform design with the total content of loeemodin, rhein, emodin, chrysophanol, and anthraquinone and the dried extract weight as the indices. Results:According to the optimization and the industrial production condi-tion, the pH values of water in three times of extraction were 2. 0,6. 5 and 9. 0,and the extraction time was 2, 1, 1 h, respectively. Conclusion:This method provides a theoretical basis for the optimization of rhubard extraction.

Objective:To optimize semi-bionic extraction(SBE)of Forsythia suspensa. Methods: The best conditions of semi-bionic extraction of Forsythia suspense were screened by uniform design with the total content of forsythoside A,and forsythin and dried extract weight as the indices. Results:The results of the uniform design were analyzed by DPS data, and combined with the industrial production conditions, the optimal extraction technology was as follows:the pH value of water in the three-time extraction was 2. 0,7. 0 and 10. 0 with the extraction time of 1. 0h,0. 5h and 0. 5h, respectively. Conclusion: The technology provides a theoretical basis for the extraction optimization of Forsythia suspensa.

ObjectiveThis study was to evaluate the effects of different pneumoperitoneum used in laparoscopy on in vitro tumor cells growth. Methods 3H-TdR incorporation was used to compare the DNA synthesis (CPM value) of tumor cells after exposure to simulated laparoscopic environments, composed of carbon dioxide, helium and room air, respectively. Results At 24 hours after pneumoperitoneum, compared with group of helium, air and control, CPM increased in group of carbon dioxide (F=47.576 5,P0.05). At 48,72 and 96 hours, pneumoperitoneum, compared with helium group, air group and control group, CPM increased significantly in carbon dioxide group (F=116.183,1082.92 and 5116.75, P0.05). Conclusion Carbon dioxide promotes tumor cells growth, while helium restrains the growth of tumor cells. [

OBJECTIVE:To investigate the characteristics and regularity of pediatric adverse drug reactions(ADR)in our hos-pital in order to promote rational drug use of children. METHODS:In retrospective study,378 pediatric ADR cases collected from our hospital during 2010-2014 were analyzed statistically. RESULTS:Among 378 pediatric ADR cases,255 cases were male (67.46%),and 123 cases were female (32.54%);the incidence of ADR in patients aged from one year to three years were the highest (27.51%);most of the cases were induced by intravenous injection,accounting for 87.57%(331 cases);sterile powder for injection was main dosage form (236 cases,62.43%) anti-infective agents were the major cause of ADR in respect of drug types (50.26%),among which cephalothin ranked the first place(43.68%);the lesion of skin and its appendants were the most common clinical manifestation of ADR(56.35%),such as erythra and pruritus. And most of the cases were cured(64.29%)or im-proved(34.66%)after treatment. CONCLUSIONS:The occurrence of ADR are related to multiple factors,such as administration route and drug varieties. Great importance should be attached to indication,route of adiminstration,method,speed and so on,in order to promote rational drug use and reduce the occurrence of ADR.

Objective To analyze the significant impact factors of postoperative hemorrhage after pancreaticoduodenectomy.Method The clinical data of 154 patients who underwent pancreatieoduodeneetomy from Jan.2009 to Jun.2012 were retrospectively analyzed.Results The incidence of postoperative hemorrhage was 10.4％ (16/154).The mortality caused by this complication was 12.5％ (2/16).Among these patients,intra-abdominal hemorrhage occurred in seven patients,and gastrointestinal hemorrhage occurred in nine patients.One patient suffered from both these complications.There were five and two patients presenting with early or delayed intra-abdominal hemorrhage,respectively.Early and delayed gastrointestinal hemorrhage occurred in three and six patients,respec tively.Statistical analysis showed that infection (P=0.002,P＜ 0.01) and pancreatic fistula (P=0.048,P＜0.05) are significantly associated with postoperative hemorrhage.Conclusions Postoperative hemorrhage after pancreaticoduodenectomy is a severe complication.Adequate hemostasis and prevention of pancreatic fistula and infection are the key points in reducing postoperative hemorrhage.Proper treatments should be used according to the site,type of onset and severity of hemorrhage.