Objective To compare the effects of different surgical time for the recovery of elderly patients with acute cholecystitis and provide reference for its clinical treatment. Methods Clinic data of 79 elderly patients with acute cholecystitis from January 2008 to September 2013 were analyzed retrospectively. Patients were divided into two groups according to different surgical time, 42 cases having surgery within 72 h as early surgery group, and 37 cases having surgery later than 72h as delayed surgery group then the curative effects of two groups were compared and analyzed. Results The success rate of early surgery group reached 97.6%, and that of delayed surgery group 91.9%, which showed no statistically significant difference (P > 0.05); with shorter operative time, less blood loss, shorter length of hospital stay and less medical cost, patients recovered better in early surgery group than those in delayed surgery group and there were statistically significant differences between two groups (P<0.05), while the postoperative discharge time of two groups had no significant difference (P>0.05).The complication rate of early surgery group was 2.4%, and that of delayed surgery group 18.9%, which indicated statistically significant difference (P<0.05). Conclusions Early surgical treatment for elderly patients with acute cholecystitis has a good therapeutic effect and is beneficial to the early rehabilitation of patients.

Objective To investigate whether host collateral vessels play a role in the cardiac repair induced by intracoronary injection of bone marrow mononuclear cell (BMMNCs) in a swine myocardial infarction (MI) model. Methods MI was induced in swine models by ligation of left anterior descending artery. Two weeks later, twenty animals with Rentrop score=0 (R0) or Rentrop score=1 (R1) received either intracoronary PBS or BM-MNCs (2?10~8 cells) infusion. Results At 6 weeks after MI, Rentrop score was significantly increased in the R1+BMT group. Ejection fraction and fractional shortening evaluated by echocardiography were increased in both R0+BMT and R1+BMT groups and the greatest improvements were seen in the R1+BMT group. Consistent with the changes in cardiac function and Rentrop score, the greatest degree of angiogenesis and cell count of engrafted BM-MNCs occurred in the R1+BMT group 6 weeks post MI. Conclusion The existence of intrinsic collateral vessels contributes to the beneficial effects for cardiac repair post MI by intracoronary BM-MNCs transplantation.

Objective To evaluate the expression and clinical significance of cyclin dependent kinase (CDK)-activating kinase (CAK) complex including CDK7, cyclin H and accessory protein menage a trios 1 (MAT1) in estrogen receptor-positive breast cancer.Methods A total of 40 patients with estrogen receptor-positive breast cancer from Department of Galactophore, Baoji Maternal and Child Care Service Centre of Shaanxi Province were investigated in this study.Breast cancer tissues and adjacent normal tissues were obtained from patients undergoing surgery.The mRNA expressions of CDK7, cyclin H and MAT1 in two types of tissues were measured by real-time fluorescent quantitative (qRT)-PCR, and their correlations with clinicopathologic features of patients were analyzed.Results The expressions of CDK7, cyclin H and MAT1 in cancer tissues were 2.54±0.78, 2.21±0.56 and 2.46±0.58, while those in adjacent normal tissues were 1.26±0.30, 1.16±0.42 and 1.17±0.39, and there were significantly differences between different types of tissues (t=9.654, P<0.001;t=9.433, P<0.001;t=11.741, P<0.001).The higher expressions of cyclin H and MAT1 in patients′ cancer tissues had the lower clinical stage, with significant correlations (U=3.17, P=0.01;U=2.53, P=0.01).In addition, the tumors were smaller in patients with higher expression levels of MAT1 (χ2=14.16, P=0.01).Conclusion The expressions of CAK complex CDK7, cyclin H and MAT1 are elevated in estrogen receptor-positive breast cancer patients.Cyclin H and MAT1 are closely associated with clinical grade, and MAT1 is also significantly associated with tumor size.

Objective Hepatocyte growth factor (HGF) has been proposed to be used as an endogenous cardioprotective agent. The aim of the present study was to investigate the anti-apoptosis effect of HGF on rat cardiomyocytes after being irradiated by single dose gamma ray. Methods The study was performed using primary cell cultures of cardiomyocytes isolated from hearts of new-born rats. After being cultured for 72h in vitro, cardiomyocytes were irradiated with gamma ray in a single dose of 20Gy. In the HGF treated groups, cells were incubated with HGF in the dose of 20 and 40ng/ml 3h prior to irradiation, respectively. At 48h post-irradiation, the concentration of LDH in the supernatant of cell culture was determined. Apoptosis and cell cycle were determined with flow cytometry. Results LDH concentration in the supernatant of cell culture of irradiated cardiomyocytes was increased significantly compared to that of un-irradiated cells (P

Objective To explore the clinical effect of combination of vascularized fibular head epiphysis and peroneal neurovascular reverse flap repair defects of bone and skin in lateral malleolus in children.Methods Eight children with defects of bone and skin in lateral malleolus were recruited from May,2009 to September,2014.The age of children was ranging from 4 to 12 years old.Four children were injured by wheel twist,2 children were injured by traffic accident,1 was injured by machinery,and 1 was crashed with heavy object.The size of soft-tissue defect was ranging from 3 cm × 5 cm to 7 cm × 9 cm.The flap and bone healing along with ankle joint function scoring were evaluated.Patients were reviewed every 4 to 6 weeks during one year after their surgery,and they were reviewed every 6 months one year later.Results Secondary repair were conducted in all children.The curative effect got well after follow up for 6 months to 2 years(mean,12 months).The flap and fibular head epiphysis were well developed.The ossification of fibular head epiphysis did not found.According to American Orthopaedic Foot and Ankle Society (AOFAS) ankle function evaluation criteria,the results were excellent in 5 cases,good in 2 cases and poor in 1 at 10 months after operation.The shape and function of ankle joint were good,with one exception.The average motion degree of ankle joint was (68±5.12)°.Conclusion Combination of vascularized fibular head epiphysis and peroneal neurovascular reverse flap repair defects of bone and skin in lateral malleolus in children is effective.

Objective:To evaluate the clinical value of activated carbon nanoparticles for guiding lymphadenectomy in advanc-ing rectal cancer. Methods:Eighty rectal cancer patients who underwent laparoscopic curative resection for rectal cancer were divided into two groups:control group (40 cases) and experiment group (40 cases). The experiment group received carbon nanoparticle-labeled lymph nodes in surgery. The number of lymph nodes, lymph nodes≤5 mm in size, and positive lymph nodes, as well as the side effect of the procedure, were analyzed. Results:No complications were observed in the experiment group. The experiment group showed sig-nificantly higher values (P<0.05) than the control group for average number of lymph nodes (25.5 ± 8.78 vs. 16.05 ± 4.84), lymph nodes≤5mm in size (22.6 ± 8.25 vs. 13.65 ± 4.62), and positive lymph nodes (3.13 ± 4.14 vs. 1.35 ± 2.06). During operation, two dyed lymph nodes in two cases were found at the roof of the inferior mesenteric artery and along the side of the internal iliac artery. Dissec-tion was extended for these patients and the dyed lymph nodes were confirmed to be positive. Conclusion:Local injection of activated carbon nanoparticles around the tumor during surgical exploration was an effective, secure, and easy approach for guiding lymphade-nectomy in rectal cancer patients.

Objective To establish normal reference ranges for serum cystatin C (Cys C)in relatively healthy middle-aged and elderly(＞50 years)Chinese individuals.Methods A total of 1087 candidates were consecutively selected and serum Cys-C levels were measured by transmission turbidimetry.Frequency analysis and histogram were used to establish the 95％ confidence reference range according to methods provided by CLSI (C28-A2).Results Based on the definition and verification procedures for clinical laboratory reference ranges(CLSI C28-A2,second edition),Cys-C levels of 1087 participants fell within the range of 0.30-1.55 mg/L;Male participants had higher serum Cys-C levels than female participants(Z=-10.19,P＜0.01).The serum Cys-C level increased with age,regardless of gender(R =0.600,P＜ 0.01).Differences in Cys-C levels between age groups were statistically significant (x2=411.17,P＜ 0.01).The reference ranges of normal serum Cys-C levels for different age groups (50-,55-,60-,65-,70-,75-,) were 0.42-0.98mg/L,0.45-1.04mg/L,0.47-1.34mg/L,0.46-1.38mg/L,0.61-1.33mg/L,0.61-1.28 mg/L,respectively,for males,and 0.39-0.94mg/L,0.42-1.01mg/L,0.40-0.91mg/L,0.46-1.03mg/L,0.57-1.04mg/L,0.55-1.27mg/L,respectively,for females.Conclusions This study established preliminary normal serum Cys-C reference ranges for healthy middle-aged and elderly(＞ 50 years)individuals in this region,which can serve as parameters for disease diagnosis and treatment evaluation.

BACKGROUND:Some scholars believe that for primary spontaneous pneumothorax thoracoscopic surgery and intraoperative pleurodesis can effectively reduce the recurrence rate. ＜br> OBJECTIVE:To study the reliability and validity of video-assisted thoracoscopic entoiodine pleurodesis for treatment of primary spontaneous pneumothorax. ＜br> METHODS:Videothoracoscopy procedures were performed on 64 patients with primary spontaneous pneumothorax, including 46 males and 18 females, with an age ranging from 15 to 30 years. According to the use of pleurodesis, the patients were randomly divided into two groups:experimental group and control group. In the control group, no entoiodine was used;while in the experimental group, entoiodine dipped gauze was used on the visceral pleura. The operation time, intraoperative bleeding, postoperative drainage, postoperative leakage time, postoperative extubation time, postoperative complications and the recurrence rate of pneumothorax within 1 year after operation were compared between two groups. ＜br> RESULTS AND CONCLUSION:No significance was found in the operation time, intraoperative bleeding, postoperative leakage time, postoperative extubation time and postoperative complications between the two groups (P>0.05). Although the experimental group had significantly more postoperative drainage volume than the control group (P＜0.05), there were no consequences of medical intervention. Video-assisted thoracoscopic entoiodine pleurodesis could significantly reduce the recurrence rate of pneumothorax in 1 year after operation (P＜0.05). The results show that video-assisted thoracoscopic operation with entoiodine is a reliable and effective method to reduce the recurrence of pneumothorax after operation in patients with primary spontaneous pneumothorax.

Objective:To evaluate the clinical effects of oncoplastic breast-conserving surgery on patients with early breast can-cer near the mammary areola. Methods:A total of 60 patients with early breast cancer underwent breast-conserving surgery in the Sec-ond Department of Breast Surgery, Tangshan People's Hospital from February 2011 to November 2013. These patients were random-ized into two groups, namely, the experimental Group A (n=30) and the control Group B (n=30). Oncoplastic breast-conserving surgery was performed on the patients in Group A, whereas Group B underwent standard breast-conserving surgery. The specimen weight of the locally excised breast, the nearest distance of the tumor to the surgical margins, and the postoperative cosmetic result of the affected breast were compared between the two groups. Results: The specimen weights of the locally excised breast were 71.03 ± 12.92 and 41.53±7.13 g, and the nearest distances of the tumor to the surgical margins were 13.30±2.97 and 10.63±1.65 mm in Groups A and B, respectively, with significant differences between the two groups (P<0.05). The postoperative satisfaction rates of the affected breast were 93.33%and 83.33%in Groups A and B, respectively, without any significant differences between the two groups (P>0.05). Con-clusion:A larger amount of excised breast tissue and a wider scope of surgical margins were observed in Group A patients. However, the postoperative cosmetic result of the affected breast was almost similar for both groups. Therefore, oncoplastic breast-conserving sur-gery is a feasible and effective approach for early breast cancer patients.

BACKGROUND:Although thoracoscopy with pleurodesis is regarded as a positive and effective way for the treatment of malignant pleural effusion, the merit and demerit of sclerosants are directly related to postoperative recovery and the success of pleurodesis. OBJECTIVE:To evaluate the therapeutic effect of talc pleurodesisvia thoracoscopy in the treatment of refractory malignant pleural effusions METHODS:There were 14 male and 15 female patients in this study, age ranging from 38 to 79 years. Al patients with refractory malignant pleural effusion underwent talc pleurodesis under thoracoscopy. The postoperative adverse reactions, chest CT scan 1 month after operation and the fluid drainage were observed. RESULTS AND CONCLUSION:Twenty-nine patients with chest pain were observed in this study. Eighteen patients could relieve the pain itself without medications, eight patients required oral Tramadol and three patients took Demerol or morphine oraly to ease the pain. Fever occurred in three cases at 3 days after operation. Neither pneumonedema, acute respiratory failure, nor death ocurred postoperatively. One month later, complete successful pleurodesis was achieved in 24 cases, and partial successful in 3 cases, and unsuccessful in 2 cases. The results indicate that thoracoscopy with talc pleurodesis can be regarded as a positive and effective way for the treatment of malignant pleural effusion.