Objective To summarize clinical experience of laparoscopic cholecystectomy (LC) for acute cholecystitis.Methods Two hundred and eighty patients with acute cholecystitis underwent LC in our hospita1.Results The LC was successfully completed in 268 cases,the other 12 patients were converted to open surgery because of massive adhesion at the Calot triangle (5 cases),severe hemorrhage (2 cases),Mirizzi syndrome (3 cases),Common bile duct injury (2 cases) were exectuted by bile duct repair and T tube drainage' and were Roux-en-Y chole-enterostomy).None of the patients had intra-abdominal hemorrhage,biliary leakage,or subphrenic abscess after the operation.Conclusions LC is safe and feasible in the treatment of acute cholecystitis,and successful surgery should be based on the skilled techniques and the knowledge of key points in the operation.Conversion to open surgery is necessary when LC is difficult.

Objective To discuss the blood substitutes during the perioperative period for hemophilic children with surgical disease as well as the coping strategies to its postoperative complications.Methods A retrospective study between 2003 and 2013 from one our centre identified a total of 41 perations performed in haemophiliac patients.33 patients were diagnosed with haemophilia A,among whom 10 were severe cases,13 moderate cases and 8 mild cases.8 patients were diagnosed with haemophilia B,among whom 2 were severe cases and 6 were mild cases.Different kinds of operation were required for each case.Results According to the monitoring of the coagulation tests PT and APTT before and after the operation respectively,after the use of the blood substitutes such as FV Ⅲ,PPSB and fresh frozen plasma,38 patients underwent surgical treatment successfully and had full recovery without any surgical complications,1 patient was dead,1 suffered intraperitoneal hemorrhage and 1 had delayed wound healing.Conclusion Full preparation and thorough plan before the operations,combined with appropriate blood substitutes can effectively reduce postoperative bleeding for hemophilic children.

OBJECTIVEThis study aimed to evaluate the effort of applying frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater in the treatment of sagittal synostosis.

METHODSFrom April 2008 to June 2013, sixty-three children with sagittal synostosis, aged 5 months to 3 years, were included in the study. The frontal bone flap was removed using an air drill. The occipital and bilateral temporal bone flaps were cut open but not detached from the dura mater or fixed to produce floating bone flaps. The skull bone was cut into palisade-like structures. Brain compression from both sides and the base of the skull was released and the brain expanded bilaterally through the enlarged space. Only a long strip-shaped bone bridge remained in the central parietal bone. Subsequently, the frontal bone flaps and occipital bone flap were pushed towards the midline and fixed with the parietal bone bridge to shorten the anteroposterior diameter of the cranial cavity and allow the brain to expand bilaterally to correct scaphocephaly. The CT images showed that both sides of the parietal bone of artificial sagittal groove gradually merged postoperative 1 year, and skull almost completely normal healing after operation 2 or 3 years, without deformity recurrence within 5 years. Among them all, 61 children's intelligence is normal and 2 children's lagged behind normal level, no further improvement.

RESULTSPatients were followed up 1 - 5 years (an average of 43 months). Skull growth was excellent in all patients, the anteroposterior diameter was shortened by 14.6 mm averagely, the transverse diameter was increased by 12.3 mm averagely, the prominent forehead was corrected, and scaphocephaly improved significantly. There were no complications such as death and skull necrosis.

CONCLUSIONSThe application of frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater can be used in the treatment of sagittal synostosis. Surgery without removing bone flaps is less traumatic and results in no massive bleeding. It can effectively relieve brain compression and promotes transversal expansion of the brain during surgery and subsequent normal brain development.

Bone and Bones ; Brain ; growth & development ; Child, Preschool ; Craniosynostoses ; surgery ; Dura Mater ; Frontal Bone ; surgery ; Humans ; Infant ; Parietal Bone ; surgery ; Recurrence ; Surgical Flaps ; Temporal Bone ; surgery

OBJECTIVE：To establish the fingerprint of Adiantum capillusveneris from different producing areas ，and to conduct chemometric analysis and content determination of differential components ，so as to provide reference for quality control of A. capillusveneris . METHODS ：HPLC-DAD combined with Similarity Evaluation System of TCM Chromatogramtic Fingerprint （2004 A edition ）were used to establish fingerprint of 19 batches of A. capillusveneris from different producing areas （S1-S19）. Common peaks were confirmed and their similarities were evaluated. Chemometric analysis methods such as cluster analysis ， principle component analysis （PCA），orthogonal partial least squares discriminant analysis （OPLS-DA）were used to evaluate the quality of 19 batches of A. capillusveneris from different producing areas ，screen the differential components ，and determine the contents of some differential components. RESULTS ：Among 19 batches of A. capillusveneris from different producing areas ，22 common peaks were confirmed ；peak 9 was chlorogenic acid ，peak 17 was quercetin- 3-O-β-D-glucopyranoside，peak 20 was kaempferol-3-O-rutoside；the similarity of 19 batches of sample were 0.677-0.962. Through cluster analysis ，it was found that S 7 and S 10 were clustered into one category ；S15 and S 18 were clustered into one category ；and S 1-S6，S8，S9，S11-S14，S16，S17 and S 19 were clustered into one category. PCA and OPLS-DA found that S 7 and S 10 were clustered into one category ；S15 were clustered into one category ；S18 were clustered into one category ；S1-S6，S8，S9，S11-S14，S16，S17 and S 19 were clustered into one category. Chlorogenic acid ，quercetin-3-O-β-D-glucopyranoside，kaempferol-3-O-rutoside and chemical composition represented by peak 14 were the differential components of the〔2017〕2841）； medicinal material. Among 19 batches of A. capillusveneris ， average contents of chlorogenic acid and quercetin- 3-O-β-D- glucopyranoside and kaempferol- 3-O-rutoside were 0.10-4.25， 0.31-7.11，0.61-12.00 mg/g，respectively. CONCLUSIONS ： 电话：0851-86614212。 HPLC-DAD fingerprints of A. capillusveneris from different producing areas are establishe d in the study ，and three common peaks are identified. Four differential components affecting the quality of A. capillusveneris are screened ， and the contents of chlorogenic acid ， quercetin-3-O-β-D-glucopyranoside and kaempferol-3-O-rutoside in A. capillusveneris from different producing areas were significantly different.