Unexpected gallbladder cancer (UGC) is a sort of gallbladder cancer discovered during or after laparoscopic cholecystectomy (LC) which was diagnosed as benign gallbladder disease before surgery. With the high incidence of gallstones in China, the number of patients with UGC increases as well.However, due to the lack of randomized controlled trials on UGC, unified treatment has not been established, and argues on how LC will influence the prognosis of UGC still exist. Surgery for gallbladder cancer is technically challenging. The extent of resection varies based on a number of factors, and controversy exists regarding what constitutes an acceptable resection. We believe that satisfying treatment results are based on the surgical techniques, acute evaluation of different cases and wisely-chosen surgical procedures. This paper summarized therapeutic strategies for UGC based on our clinical experiences.

Firstly, this paper analyzed the significance of strengthening medical students’ ecological moral ed-ucation under the view of Beautiful China. Secondly, it discussed the present situation of ecological moral and the reasons of lacking of ecological moral in medical students. At last, the authors pointed out the countermeasures to strengthen the moral cultivation of medical students’ ecological countermeasures under the view of Beautiful China. Therefore, we must strengthen the top-level design to ensure the ecological moral education enter into the national education system, enhance to maintain power to build the full-area coverage ecological moral teaching system, and strengthen institutional construction to establish long-term mechanism of ecologic moral education.

Objective:To observe the effect of acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) on gastrointestinal function of patients after laparoscopic cholecystectomy. Methods:Totally 120 patients undergone laparoscopic cholecystectomy were randomized into an acupoint injection group, a muscular injection group, and a blank control group at 1:1:1 by random number table, 40 cases in each group. The blank control group was intervened by conventional post-operation treatment, the acupoint injection group was by acupoint injection with Neostigmine Methylsulfate 2 mL at bilateral Zusanli (ST 36) in addition to the treatment given to the blank control group, and the muscular injection group was by muscular injection with Neostigmine Methylsulfate 2 mL in addition to the treatment given to the blank control group. The two injection groups both received injection twice a day, totally for 3 d at most. The restored time of bowel sounds, initial flatulence time, defecation time and clinical efficacy were observed. Results:After treatment, there were significant differences in comparing the restored time of bowel sounds among the three groups (F=17.30,P<0.05), the acupoint injection group and muscular injection group were significantly different from the blank control group (P<0.05), and there was a significant difference between the acupoint injection group and muscular injection group (P<0.05); there were significant differences in comparing the initial flatulence time among the three groups (F=19.12,P<0.05), and the acupoint injection group was significantly different from the muscular injection group and the blank control group (P<0.05); there were significant differences in comparing the initial defecation time among the three groups (χ2=21.23,P<0.05), while the difference between the acupoint injection group and muscular injection group was statistically insignificant (P>0.05). The total effective rate was 87.5% in the acupoint injection group, versus 72.5% in the muscular injection group and 60.0% in the blank control group, and there were significant differences among the three groups (P<0.05). Conclusion:Acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) can shorten the restored time of bowel sounds and flatulence time in patients undergone laparoscopic cholecystectomy, and the efficacy is more significant compared to muscular injection with Neostigmine Methylsulfate.

Objective To evaluate the effect of the four-port bimanual vitrectomy illuminated by assistants in severe vitreo-retinopathy. Design Retrospective case series. Participants 39 eyes of 39 patients of severve vitreoretinopathy. Methods Four-port bimanual vitrectomy illuminated by assistants were applied. All the patients were followed up for 6 to 18 months. The best corrected visual acuity and reattachment of retina were observed. Main Outcome Measures Operation duration,effect,and complications. Results All the 39 eyes were successfully operated. Time of membrane stripping of membrane ranged from 4 to 50 min (mean 16 min). No complications were found in operation. Retinal redetachment occurred in 4 case and vitreous rebleeding in 2 cases. No sclerotomy was found. Best corrected visual acuity improved in 35 eyes defined as 2-line increase in visual acuity chart or visual acuity from light perception to finger count post-operation. Conclusion Four-port bimanual vitrectomy has more advantages in the operation procedure. It is a promising method in treating patients with severve vitreoretinopathy.

Objective To make the detection results of the different automated hematology analyzers in laboratory to be reliable and comparable.Methods With the Beckman Coulter LH750 after calibration as the reference instrument,the fresh whole blood was extracted from the patient and divided into 3 equal parts after mixing evenly.The first part was determined the target value in the LH750 instrument;the second part was used to calibrate the HMX and ABX PENTRA 60 instruments and the third part served as a calibration validation.After calibration,the fresh whole blood of patient was performed the detection for conducting the accuracy evaluation.Results After calibration,the detection results of RBC,HGB,WBC,HCT,MCV and PLT by each instrument were largely improved and the error of the results was less than 1/3 of CLIA′88 requirements.Conclusion Adopting fresh whole blood for calibrating the hematology analyzer is feasible.

Objective To analyze the clinic and imaging characteristics as well as development of intervertebral disc calcification in children.Methods 6 cases underwent intervertebral disc calcification.X-ray films and CT scan of cervical spine had been taken in all cases,two cases had MRI examination.All cases were followed-up for 2 to 3 years by radiograph and CT.Results Only one intervertebral disc involved in all cases.X-ray and CT findings included disc calcification,disc herniation and change of vertebral boy in form.The clinical symptoms disappeared after conservative therapy 2 to 4 weeks.But the disc calcification disappeared until 6 months to 3 years.Conclusion Intervertebral disc calcification in children is a self-limiting disease with excellent prognosis,its diagnosis depends on imageology.

The present situation of medical equipment department was introduced from the aspects of function, management and personnel. The influencing factors were explored for medical equipment department. Some suggestions were put forward including the national progress in medical equipment management, technician qualification certification, training and examination, title promotion and etc. Medical equipment department may stride forward with the development of all conditions.

A worm-like specimen recovered from a patient previously identified as Armillifer sp. in the city of Yulin,Guangxi Autonomous Region. After comparative analysis of habitat (serpents as final hosts and human being as accidental intermediate host) and body size of the 4 known pathogenic pentastomid species of Armillifer (A.agkistrodontis, A.armillatus, A.grandis and A.moniliformis) with the recovered specimen, the present authors consider that the recovered specimen has been misidentified as Armillifer sp. The recovered specimen probably belongs to a nasal leech.

ObjectiveTo explore the expression of EZH2 and p53 protein in primary prostate cancer (Pca) and its clinical significance.Methods High-throughput tissue microarray technique and immunohistochemistry was used to detect the expression of EZH2 and p53 protein in 48 human prostate cancer specimens without a history of chemo-radiation therapy and 15 cases of benign prostate hyperplasic (BPH) tissues. The pathological characteristics and the relationship of the expression of EZH2 and p53 protein in primary prostate cancer was analyzed. ResultsImmunohistochemical results showed that the positive rates of EZH2 and p53 protein in prostate cancer were 87.50 ％ (42/48) and 33.33 ％ (16/48), respectively, which were significantly higher than that in BPH tissues[13.33 ％ (2/15) and 0 (0/15)](x2=26.429, x2=5.058,P ＜0.05). The expression of EZH2 and p53 protein was significantly related to Gleason score, TNM stage (P ＜0.05), but not to age and serum prostate-specific antigen (PSA) level (P ＞0.05). The positive expression in patients with Gleason＞6 was higher than that with Gleason≤6(P ＜0.05).The positive expression in patients with T3-T4 stage was higher than that with T1-T2 stage(P ＜0.05).Spearman rank correlation showed a significantly positive correlation between EZH2 and p53 protein (r=0.294, P ＜0.05). ConclusionEZH2 and p53 protein may participate in the pathogenesis of prostate cancer.The overexpression of EZH2 and p53 protein could become an index for the evaluation of the level of malignancy and progression of prostate cancer.Furthermore,combining detection of EZH2 and p53 protein may provide a new theoretical basis for the treatment of prostate cancer.

Objective To evaluate the usefulness of combined three-dimensional (3D) and two-dimensional (2D) contrast enhanced magnetic resonance angiography (CE-MRA) for checking the thrombus embolism of different positions within single examination on the pulmonary artery and pelvic-lower limb deep veins. Methods Fifteen patients with suspected pulmonary embolism and pelvic-lower limb deep venous thrombosis (DVT)were evaluated with combined 3D MRA and 2D CE-MRA. 3D spoiled gradient-recalled-echo bolus chase MR angiograms were obtained in four stations from the pulmonary artery to the ankle. Thereafter,3D CE MRA was reversely scanned from the ankle to the pelvic. 2D contrast-enhanced MRI was obtained in pelvis, thigh, and calf. Pulmonary CT angiography (CTA) and/or DSA were performed in 15 patients,and duplex ultrasonography of lower-limb vein was performed in 12 patients. Results Of the 15 cases, acceptable imaging of pulmonary vessel was acquired with 3D CE-MRA in 12 cases. The signal intensity was lower in the deep iliac vein and lower extremities than that in the artery, but vein frame was distinct after post processing. The artery and deep vein were clearly revealed with contrast enhanced FSPGR sequence in 15 cases. 3D CE-MRA imaging disclosed pulmonary embolism in fourteen patients and pelvis-lower limb DVT with multi-place involvement in nine patients. 2D contrast-enhanced MR imaging proved DVT in pelvis-lower limb. 2D contrast-enhanced FSPGR sequence was a complementation of 3D CE-MRA and it had larger scan field. Thrombus presented as low signals and eccentral or intraluminal filling defect. Local caliber of vein thrombus in 6 cases was evidently broadened. Conclusion Within only one MR examination procedure, it is capable of examining the pulmonary embolism and DVT of pelvis-lower limb with combined 3D MRA and 2D contrast enhanced MR. The results are promising as a non-invasion "one-stop shopping" tool in the evaluation of thromboembolic disease.