0.05). Peak force test maximal displacement evaluation and failure energy absorption measurement showed that hamstring tendon knot or bone bolt press fit implant fixation were significantly better than B-PT-B (P0.05). Conclusion Reconstruction of ACL by hamstring tendon knot or bone bolt press fit implant fixation and tibia side tendons by weaving suture to tie a knot on the bone bridge can meet daily physiological demand.

Objective To review the diagnosis and causes of iatrogenic injury to the distal choledochus at operation. Method The case notes of the patients with bile duct injuries that were treated in my Department from 1990.2-2005.2 were reviewed. Results To detect distal bile duct injuries, a sound in the bile duct had an accuracy rate of 95 % while injection of water into the bile duct to detect leakage had an accuracy rate of 100%. Using a long arm T tube in the common bile duct was an effective method to treat the injury. In 18 patients with an average follow-up time of 20. 8 months, the results were satisfactory. Conclusions Injecting water into the bile duct to diagnose distal common bile duct injury at operation was an effective way to detect distal bile duct injury. Adequate exposure of the opeative field is the best method to prevent bile duct injury.

The antibacterial peptide CM4 having potent antifungal activity on inhibitiong the cell wall regeneration of Saccharomyces cerevisiae protoplasts.When the peptide increased,the ratio of the regenerated colonies drop obviously.To study the antifungal mechanism of the antibacterial peptide,fluorescence\|labeled peptide mixted with the protoplast of yeast,then confocal laser scanning microscopy were performed.The results indicated that the peptides interactted with the protoplast membrane and damaged the structure of the membrane,then the permeation of protoplast changed.Finally the protoplasts with the peptide failed to regenerate the cell walls leading to killing the cell.

Objective To study the values of serum CA19-9,CA242,CEA,alone or in combination in the diagnosis and prognosis of combined hepatobiliary calculus and cholangiocarcinoma (HCWC).Method Serum CA19-9,CA242,CEA in 100 patients with HCWC,70 patients with hepatobiliary calculus combined with cholangitis and 30 patients with hepatic hemangioma (normal bile duct group) were preoperatively studied.Results When the serum levels of CA19-9,CA242,CEA were separately used in the diagnosis of HCWC,the sensitivity of CA19 9 was highest,but its specificity was significantly lower than that of CA242 and CEA (P＜0.01).Patients with all the three tumor markers raised had significantly lower survival than those of patients with only one or two raised markers (P＜0.05).Conclusions The diagnostic rate for CA19 9 in HCWC was better than that of CEA and CA242.A joint detection improved the diagnostic specificity.Raised tumor markers were associated with progression of HCWC.Survival was worse in patients with 3 raised markers than those with 2 or 1 raised markers.

Objective To assess the causes and methods of surgical treatment of hepatolithiasis reoperation Methods The clinical data of 81 cases of hepatolith reoperation were analyzed retrospectively. Results The main causes of hepatolith reoperation include biliary stricture,biliary tract variation,cholangiocarcinoma, etc. The chief reoperation patterns were hepatic lobectomy, Roux-en-Y hepaticojejunostomy, and lobectomy combined with Roux-en-Y hepaticojejunostomy.A follow-up of 2 months to 12 months showed excellent (outcome) of 93.8% of cases. According to postoperative cholangiograph,the retained stone rate was 6.2%. Conclusions When treating cholelithiasis ,we should follow the following principles: remove stones, relieve biliary stricture, correct biliary variation, resect abnormal liver, and establish adeguate biliary drainage.

Sepharose 6B was activated by epichlorohydrin in the strong base condition, and then reacted with solution of iminodiacetic sodium. The arms of IDA were conjuncted to the activated Sepharose 6B. Then the products were reacted with the solution of NiSO4. The arms of IDA were chelated with Ni2+,and the chelating resin―Ni2+-IDA could be prepared. The physicochemical indexes and performance in purifying protein of the expressing product were assayed with atomic absorption method and purifying aimed protein-human B lymphocyte stimulator(hBLyS) from the expressing products in E.coli. The results indicated that the performance of made gel is very good, and its price is less than 1/10 of that of commodity gel.

Objective　To study the experience in prevention and treatment of iatrogenic bile duct trauma(IBDT). Methods　A retrospective study was made on the clinical data of 118 patients with iatrogenic bile　 duct trauma admitted to the Hunan Provincial People's Hospital from March 1990 to September 2000. Results　50.8%　(60/118) of patients with IBDT resulted from the wrong identification of the anatomy of the Calot' Triangle during cholecystectomy. The clinical diagnosis of IBDT depended on the clinical findings, diagnostic abdominocentesis and image examination. The diagnostic rate of ultrasonography for IBDT was 93.2%(110/118). According to the injury site of bile duct, IBDT could be divided into 6 types, the most common type of　 IBDT was resection of partical hepatic duct and part common bile duct(type Ⅲ) which occurred in 83.9%　(99/118) of the patients. The cure rate of IBCT was 100%(118/118) in this series due to the choice of operation according to the trauma type. Conclusions　The key of prevention to IBDT lies in abiding by the princible of “identifying-cut-recognazing” during cholecystectomy. The choice for surgical operative procedure should agree with the trauma type.

Objective To investigate the character of real-time gray-scale contrast-enhanced ultrasonography (CEUS) and its clinical value in diagnosing hepatic focal lesion. Methods One hundred and three patients with 142 focal hepatic lesions were examined by CEUS after an intravenous administration of the contrast agent, then the characters of the images were analyzed. Results The initial contrast-enhanced signal patterns were classified into 5 modes, peak contrast-enhanced signal patterns into 4 modes, and contrast agent perfusion patterns into 7 modes. Different lesions had different characters of contrast-enhanced phases. The accuracy rate of the CEUS in diagnosing focal hepatic lesion was 93.0%. which was significantly higher than that of conventional ultrasound and contrast-enhanced CT (X2=47.430, P<0.05). Conclusions The characteristic initial contrast-enhanced pattern and contrast agent perfusion pattern are helpful in the differential diagnosis of hepatic focal lesion, while peak contrast-enhanced signal pattern is relatively unreliable. Compared with conventional ultrasound and contrast-enhanced CT, CEUS can dramatically improve the accuracy of qualitative diagnosis of hepatic focal lesion.

Post-stroke cognitive impairment (PSCI) is a series of syndromes caused by stroke, involving impairment of one or more cognitive functions, such as attention, language function, executive function, visuospatial cognition, episodic memory and working memory, etc. The traditional treatment methods of PSCI include drug therapy and cognitive training. The treatment modalities are limited and the maintenance effect is not good. Therefore, an auxiliary treatment method is urgently needed to improve its therapeutic effect. Transcranial direct current stimulation (tDCS) is a safe and mature non-invasive brain stimulation technique, which generates weak direct current (1-2 mA) through electrodes placed on the scalp to change the resting membrane potential of neurons, regulate the excitability of the cerebral cortex, so as to achieve the purpose of treatment. This article reviews the effect of tDCS on PSCI, and hopes to provide reference and guidance for its rehabilitation treatment.

Objective To explore the expressions of cyclooxygenase-2 (COX-2), phosphatase and tensin homolog deleted on chromosome ten (PTEN) in hepatobiliary calculus associated with cholangiocarcinoma (HCWC) and their clinical significance. The relationship between the expressions of COX-2, PTEN and the onset and progression of HCWC was investigated to form an experimental base for the prevention and treatment of HCWC. Methods Thirty seven patients with tumor tissues of HCWC (group C), thirty patients with tissues of bile duct surrounding intrahepatic calculus (group B), and ten patients with normal tissues of bile duct from operations of hemangiomas of liver or liver trauma as the control (group A) were sampled and collected. A two-step immunohistochemistry (SP method) was employed to detect and statistically analyze the expressions of COX-2 and PTEN in each of the 3 groups. Results In groups A, B, C, the positive rate of the expression of COX-2 was 10%,33.3%, and 70.3%, respectively. The positive rates of expression of COX-2 in the carcinoma tissues of HCWC was significantly higher compared with the control group (P＜0. 01). In groups A, B, C the positive rates of the expression of PTEN was 90. 0%, 80. 0%, and 35.0%, respectively. The positive rate of expression of PTEN in the carcinoma tissues of HCWC was significantly lower than the control group (P＜0. 01). The expression of COX-2 was followed by a low expression of PTEN in the tissues of HCWC. Kendall's related analysis showed a strong negative correlation between the expression of COX-2 and PTEN in HCWC (r=-0. 323, P＜0. 05). Conclusions A high expression of COX-2 was related to HCWC. There was a negative correlation between the expressions of COX-2 and PTEN in HCWC. A high expression of COX-2 and a low expression of PTEN suggested a high chance of HCWC in extrahepatic or lymphatic metastasis.