Objective To study the effect of percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) in treatment of acute severe cholecystitis.Method The perioperative data of patients treated with PTGBD combined with LC and patients treated with emergency LC were analyzed.Results There were no significant difference between the two groups on surgical duration (t =0.601,P =0.551) and postoperative hospital stay (t =0.979,P =0.331).Blood loss [PTGBD + LC (79.43 ± 46.27) ml,LC (125.84 ± 64.18) ml ; t =3.641,P ＜ 0.05],peritoneal drainage time [PTGDB + LC (3.29 ± 1.58) d,LC (4.63 ± 2.31) d ; t =3.131,P ＜ 0.05] and postoperative oral intake time [PTGBD +LC (2.91 ±1.58)d,LC (4.21 ±2.22)d; t =2.669,P＜0.05] were significantly different between the two groups.The rate of laparotomy,mortality and postoperative complications in the emergency LC group were higher than those in the PTGBD combined with LC group.Conclusions PTGBD combined with LC in the treatment of acute severe cholecystitis was significantly better than emergency LC.

AIM To prepare diosgenin nanosuspensions.METHODS The nanosuspensions prepared by media milling method were solidificated by freeze drying method.With particle size and polydispersity index (PDI) as evaluation indices,stabilizer kind,ratio of diosgenin to stabilizer,ratio of preliminary nanosuspension volume to grinding bead amount,milling time,lyoprotectant kind and its amount as influencing factors,single factor test was applied to screening preparation and solidification processes.The morphology of nanosuspensions was observed,then the particle sizes and polydispersity indices of nanosuspensions and freeze-dried powder were determined.RESULTS The optimal conditions were determined to be 6:1 for ratio of diosgenin to Pluronic F127 (stabilizer Ⅰ),50:1 for ratio of diogenin to sodium dodecyl sulfate (SDS,stabilizer Ⅱ),1:4 for ratio of preliminary nanosuspension volume to grinding bead amount,120 min for milling time,and 8％ PEG-6000 and 2％ mannitol as lyoprotectants.The average particle size and polydispersity index of rod-like or flaky nanosuspensions were (348.1 ±14.2) nm and 0.244 ± 0.059,respectively,which were lower than those of freeze-dried powder.At room temperature,the particle sizes of nanosuspensions and freeze-dried powder remained stable within 35 d and 3 months,respectively.CONCLUSION The physical stability of diosgenin freeze-dried powder is superior to that of its nanosuspensions,which can be used after being reconstituted.

0.05).On 1,3 and 5 days after the operation,the PHS and PVAS of Group B decreased significantly than those of Group A(P

Objective:To investigate the clinical efficacy and patient and partner's satisfaction with penile prosthesis implantation(PPI) for treating Chinese patients with severe erectile dysfunction(SED).Methods:One hundred and sixty-eight SED patients were successfully treated by PPI from July 2000 to June 2010.Of the 146(86.9%) patients who had been followed up over 6 months post-operation,36(24.7%) had been implanted with one piece malleable prosthesis(AMS650) and 110(75.3%) with three piece inflatable prosthesis(AMS700CXM).All the patients had been followed up by using international index of erectile dysfunction(IIEF5),Quality of Life Score(QOL) for evaluating clinical efficacy and using Visual Analogue Scale(VAS) for evaluating patient and partner's satisfaction and the duration of the follow-up was 6 to 119 months.Results:The mean age of patients was 35.9?12.1 years(20 to 75 years),All the operations were successful and sexual intercourse with PPI was performed post 4 to 6 weeks without severe complications like infection and erosion.The prosthesis survive rate and frequent sexual intercourse rate were 98.6% and 87.7% respectively.IIEF5 scores pre and post PPI were 6.3?1.7 and 21.3?1.6 respectively,the QOL scores pre and post PPI were 5.1?0.9 and 1.5?0.5 respectively,and both of them showed significant improvement(P

Objective To analyze of CD4+ CD25high regulatory T cells(Treg)in peripheral blood of chronic HBV patients and its correlation with multiple clinical indicators.Methods Thirty-five hepatitis B virus(HBV)infected patients in this study were divided into four different clinical types:HBsAb+group(n=5),inactive hepatitis group(n=8),chronic hepatitis group(n=12),and immune tolerance group(n=10).The number of CD4+CD25high Treg and related T cells subgroup in CD3/CD4/CD8 was thoroughly examined by flow cytometry in peripheral blood of HBV infected patients and the healthy contrast group(n=12).Serum HBV markers were determined by commercial ELISA kits.Serum HBV DNA was quantified by commercial real-time PCR kit.Statistical differences were studied to investigate the correlations between CD4+CD25high Treg and different clinical types of HBV infection and clinical indicators.Results The absolute counts of CD25high Treg and its frequency in CD4+ T cells were similar between HBV infected patients [(12.35±6.48)/μ,(1.82±0.87)%]and health controls[(8.91±3.11)/μl,(1.35±0.39)%],P＞0.05.The frequency of CD25high Treg in CD4+ T cells from the immune tolerance group was significantly higher than that of the HBsAb+ group,chronic hepatitis group,and the healthy contrast group(P＜0.05).The absolute counts of CD25high Treg from the immune tolerance group were significantly higher than the healthy control group(P＜0.05),and the frequency of CD25high Treg in CD4+ T cells is negatively correlated to the ALT level(r=-0.418,P=0.038),positively correlated to CD4/CD8 ratio(r=0.344,P=0.021),no correlation to the HBV DNA level(r=0.118,P＞0.05).The absolute counts of CD25high Treg were positively correlated to CD4/CD8 ratio(r=0.360,P=0.015),no correlation to ALT level and HBV DNA level(r=-0.211,r=0.060,P＞0.05).Conclusion CD4+ CD25high Treg may play a role in immunopathogenesis of chronic HBV infection.

Objective To study the epidemiological tendency and influencing factors for major chronic diseases in the elderly in Changsha,and to provide the scientific basis for the prevention and control strategies for the aged people.Methods Multi-stage randomized cluster sampling method was used in selecting 3135 persons aged 65 and over in Changsha.Using unified questionnaire and face to face asking method to investigate the prevalence of chronic diseases and its influencing factors.Results 95.7％ of questionnaires were valid (3000/3135).The total prevalence rate of chronic disease was 86.33％ in patients aged from 65-96 (74.83±6.63) years,with 85.49％ (1332) in males,and 87.23％ (1258) infemales(x2=1.93,P=0.164).Most of them had 1-3 kinds of chronic diseases,in 1 patient with 13 kinds of chronic diseases at the most.The most common chronic diseases among the elderly were hypertension,heart diseases,osteoarthritis,diabetes mellitus,benign prostatic hyperplasia,and fatty liver.Multivariate logistic regression suggested that age,marital status,smoking,quality of sleep were common influencing factors for hypertension,heart diseases and diabetes mellitus.Conclusions The prevalence of chronic diseases is high and the influencing factors are ubiquitous among the elderly in Changsha community.Community health education should be carried out to improve the effect of prevention and control of chronic diseases.

Objective To compare and analyze the occurrence of delayed cerebral ischemia(DCI)after coiling and clipping of intracranial aneurysms, and explore the risk factors of DCI. Methods A total of 236 patients with aneurysms diagnosed by CT angiography (CTA) or digital subtraction angiography (DSA) in Department of Neurosurgery, Tianjin Medical University General Hospital were enrolled in this study from March 2011 to May 2014. Patients were divided into clipping group(n=135) and coiling group(n=101). The clinical characteristics were compared between two groups, including gender, age, medical history, GCS score, Hunt-Hess grade, Fisher grade, WFNS grade, aneurysm location, prognosis and incidence of DCI. Risk factors for DCI were investigated by Logistic regression analysis. Results DCI was occurred in 36 patients (26.7%) underwent clipping operation while in 11 patients (10.9%) underwent coiling operation. The incidence was significantly higher in clipping group compared with that of coiling group (P <0.01). The patients were followed up for 6 months. The poor prognosis rates were 17.0%and 25.7%in clipping group and coiling group, respectively (P>0.01). The overall mortality was 11.0%, the former had a lower mortality rate (5.9% vs. 17.8%, P <0.01). According to Logistic regression analysis, Fisher Grade 3-4, postoperative pulmonary infection and surgical procedure were independent risk factors for DCI (P<0.01). Conclusion DCI is one of the most significant factors for high fatality and morbidity of postoperative aneurysm patients. There is a low occurrence of DCI after coiling compared with that of clipping. If we pay more attention to risk factors associated with the DCI, it will improve the prognosis of postoperative aneurysm patients greatly.

Objective To explore the diagnosis and treatment of bronchogenic cyst in the abdomen.Methods Clinical data of 7 cases with abdominal bronchogenic cyst in the First Affiliated Hospital of China Medical University from October 2001 to February 2016 were retrospectively analyzed.Results Of the 7 patients,5 were male and 2 were female aging from 36 to 50 years with a median age of 37 years.Two cases were complaining for upper abdominal pain,5 cases were asymptomatic.Ultrasonography revealed hypoechoic or anechoic mass.Color doppler flow imaging showed no blood flow.Contrast-enhanced CT scans showed no obvious enhancement in 6 out of 7 cases,all patients underwent cystectomy successfully.Cysts were of unilocular in 6 cases and multilocular in one.Bronchogenic cysts were diagnosed by pathology in all 7 cases.Six patients were followed up from 1 month to 6 years with no recurrence.Conclusions Abdominal bronchogenic cyst is benign and postoperative prognosis is very good.

Microbiology is one of the fundamental courses in life science and its theories and application techniques are being developed rapidly, in order to arouse the students interest and help them master better the knowledge of microbiology, we have attemped an exploration and reform in the traditional teaching methods of this subject, our study would center on multimedia teaching methods of microbiology, its content were chiefly multimedia microbiology; multimedia microbiology experiment and microbiology network teaching.

Objective To establish an animal model of dermatophytosis and to evaluate antifungal efficacy on dermatophytosis with this model. Methods Animal models of dermatophytosis were established by inoculating dermatophyte suspension onto abraded skin on the back of guinea pigs. Thirty- eight healthy guinea pigs were randomly and equally divided into 2 groups, namely, Trichophyton mentagrophytes group (infected with T. mentagrophytes), and Microsporum canis group (infected with M. canis), and each group was classified into three subgroups, i.e., itraconazole group treated with oral itraconazole of 4 mg per kilogram body weight per day from day 0 to day 14 after infection, terbinafine group treated with oral terbinafine of 5 mg per kilogram body weight per day from day 0 to day 14 after infection, and untreated group receiving no therapy. The therapeutic effect was evaluated according to skin lesion score and fungal examination results on day 8, 11 and 14 after infection. Results Obvious lesions were observed and fungal examination was positive in untreated, infected pigs on day 8 after infection. In T. mentagrophytes-infecyted pigs, the skin lesion score on day 8, 11, 14 was 9, 1 and 0 in itraconazole group, 8, 5, and 1 in terbinafine group, 48, 52, 40 in untreated group, respectively, and there was significant difference between treated and untreated groups on the three time points (all P<0.01); the mycological cure rates on the above time points were 66.7%, 83.3%, 83.3%, in itraconazole-treated pigs, 83.3%, 83.3%, 83.3%, in terbinafine-treated pigs, 0, 0, 0 in untreated pigs, respectively, with no significant difference between itraconazole and terbinafine group (all P>0.05) but statistical difference between untreated and treated groups (all P<0.01) on all time points. Meanwhile, in M. canis-infected pigs, the skin lesion score on day 8, 11, 14 reached 3, 0, 0 in itraconazole group, 9, 2, 0 in terbinafine group, 46, 47, 39 in untreated group, respectively, and mycological cure rates 83.3%, 83.3%, 83.3% in itraconazole group, 83.3%, 83.3%, 83.3% in terbinafine group, 0, 0, 0 in untreated group, respectively; significant difference was noticed in the two parameters between the treated and untreated groups (all P<0.01) but not between the two treated groups (all P>0.05). Conclusion Itraconazol and terbinafine exhibit similar excellent antifungal activity in routine model of T. mentagrophytes-and M. canis-dermatophytosis.