Objective To study the feasibility of laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair.Methods Twenty-four adult patients received laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair in our hospital from November 2003 to April 2008.An incision was made in navel defect and entered the abdominal cavity under a direct vision.LC was performed by 3-trocar technique.Umbilical hernia was repaired by Mayo' style.Results The operation was successfully completed in all the cases.The operation time ranged from 35 to 65 minutes (mean,48 minutes),the blood loss was 5-30 ml(mean,16 ml),and hospital stay after the operation was 3 -4 days.No patient dereloped wound infection or skin necrosis.No recurreme was found during a 1-to 54-month follow-up(mean,28.6 months).Conclusions Laparoscopie cholecystectomy accompanied by simultaneous umbilical hernia repair is a safe and effective procedure.Mayo repair is simple and effective for umbilical hernia with less fascial defects.

Objective To investigate the diagnosis value of laparosco-pie examination in ascites.Methods The data of twenty-three cases with ascites of unknown origin undergoing laparescopie examination and pathologic examination were retrospectively analyzed from May 2004 to August 2008.Results Twenty-two eases were definitely diagnosed by laparoscopie exploration,the positive rate was 95.6%.One ease re-mained unknown.Among them,18 eases were tuberculous peritonitis; 3 eases were metastatic adenocarcino-ma; one ease was peritoneal mesothelioma.No obvious postoperative complications occurred.Conclusion Laparoscopie examination is a safe method with hige definite diagnostic rate,which has important values in diagnosis of ascites of unknown origin.

Adult ; Cryptococcosis ; physiopathology ; Cryptococcus neoformans ; Duodenal Diseases ; microbiology ; physiopathology ; Humans ; Male

To study the changes in every part of the beta-adrenergic signal transduction pathway and their effects on ischemic preconditioning of rat myocardium in vivo. SD rats were divided into three groups: IP group, I/R group and CON group. The IP group was further divided into PC1-, 2-, 3-, and PC1+, 2+, 3+ groups according to preconditioning procedure. The rats received surgical procedure and underwent left coronary artery occlusion and reperfusion. We analyzed the infarct size by TTC staining, measured serum myocardial enzymes, studied the beta-AR Bmax and Kd by radioligand binding assay of receptors, checked the activity of AC and PKA by the method of biochemistry and examined the content of cAMP by radioimmunoassay. The infarct area was much smaller in the IP group than in the I/R group (P < 0.001), while the enzymes were significantly higher in I/R (P < 0.001). The Bmax of beta-AR in IP was much higher than that in I/R (P < 0. 001), but no difference in Kd could be seen between IP and I/R groups. In IP, the activity of AC and PKA and the content of cAMP were higher than those in I/R (P < 0.05, 0.002 and 0.001, respectively). In the procedure of preconditioning, the content of cAMP and the activity of PKA showed the characteristic of cyclic fluctuation. Ischemic preconditioning can protect the heart from necrosis and reduce endo-enzyme leakage. The system of beta-adrenergic signal transduction pathway probably takes part in the protection effect of the IP, which might be elicited by the PKA.
Ischemic Preconditioning, Myocardial ; Myocardium/*metabolism ; Rats, Sprague-Dawley ; Receptors, Adrenergic, beta/*physiology ; Signal Transduction

Objective To investigate the feasibility and safety of laparoscopic cholecystectomy(LC) in patients with chronic renal dysfunction at azotaemic stage.Methods Clinical data of 7 patients accompanying chronic renal dysfunction at azotaemic stage treated with LC between May 2004 and September 2006 were analyzed retrospectively.The operation was performed under general anesthesia and endotracheal intubation.The CO2 pressure was maintained at 9～12 mm Hg.The LC was conducted with 3-port technique in 5 patients and 4-port technique in 2.Results The LC was completed smoothly in all the 7 patients.Patients' renal dysfunction was not aggravated.There was no significant difference between pre-and post-operative time in levels of blood urea nitrogen(11.92?4.06 mmol/L vs 12.16?3.76 mmol/L;t=0.50,P=0.633) and blood creatinine(208.62?134.37 ?mol/L vs 204.20?125.53 ?mol/L;t= 0.51,P=0.626).As compared with preoperative levels,the creatinine clearance rates were not significantly changed at 2 weeks after operation in 3 patients(40.03 ml/min vs 45.61 ml/min;32.28 ml/min vs 38.93 ml/min;56.72 ml/min vs 51.60 ml/min).Follow-up checkups for 4～20 months(mean,10 months) showed no aggravation of renal dysfunction.Conclusions Laparoscopic cholecystectomy is a feasible and safe procedure for patients with chronic renal dysfunction at azotaemic stage.

Objective To explore the correlation of single nucleotide polymorphism ( SNP ) in Nrf2 gene with acute mountain sickness ( AMS) among Han populations in China .Methods As a nested case-control study , 603 Chinese Han young men who had been quickly exposed to 3700 m were adopted and divided into case group and control group ( 369 vs 234,respectively) by Lake Louise Self-assessment Scoring System(LLSS).The Sequenom Mass Array system was used to detect the SNPs of rs10497511 and rs2364722 in Nrf2 gene.Results Alleles of rs10497511 and rs2364722 were respec-tively detected in both case and control groups , which were T-C and A-G.Statistically significant difference was not found in allele frequencies ( P>0.05 ) .Further analysis showed that there was still no significant difference between the codomi -nant, dominant and recessive genotype models (P>0.05).Conclusion rs10497511 and rs2364722 of Nrf2 gene may not be related to susceptibility to AMS in Chinese Han populations .

Objective To investigate the spherical diopter and astigmatism change of humans at sitting and supine position.De- sign Prospective case series.Participants 96 eyes of 52 patients (spherical diopter from-2.50 D to-10.00 D,astigmatism diopter from -0.75 D to-4.50 D) were selected.Methods The subjects were examined with NIKON portable retinomax at sitting and supine posi- tion,respectively.Main Outcome Measures The spherical diopter,cylinder diopter and axis change were analyzed statistically.Re- sults Spherical diopter at supine position (-5.31?3.43 D) was a little higher than that at sitting position (-5.27?3.24 D) statistically(P= 0.25),and cylinder diopter at sitting position (-2.27?1.24 D) and at supine position (-2.35?1.19 D) was no statistically difference (P= 0.20).The axis of astigmatism changed from-16?to +18?.Axis change was within 2?in 52.1% eyes,6?-10?in 5.2%,over 10?in 3.1%. The change of axis rotation tended to counter-clockwise in the right eye and clockwise in the left eye.Conclusions Eye rotation at sit- ting and supine position may cause the astigmatism axis change.It may be one of the main factors affecting the results of LASIK.

ObjectiveTo discuss the myocardial integrated backscatter (IB) characterization in old myocardial infarction (OMI) patients during the low dose dobutamine stress echocardiography (DSE). Methods Twenty eight OMI patients underwent 4 stages low dose DSE (0, 5, 10 and 20 ?g?kg -1 ?min -1 dobutamine infusion).The cardiac variation of IB (CVIB) and calibrated CVIB (CVIB%) were measured according to different segments (anterior septum, anterior wall, inferior wall and post wall of left ventricle) in different stages.ResultsIn the viable segments (Group C), CVIB and CVIB% increased from low level in early stage (5～10 ?g?kg -1 ?min -1 ) then maintaining in high level to the endpoint (20 ?g?kg -1 ?min -1 ), while maintained high level in control segments (Group A). Both CVIB and CVIB% were lower in non viable segments(Group D) than in Group A without changing during all stages. ConclusionsThe indexes of IB under dobutamine infusion were valuable for the quantitative evaluating the contractility of myocardium in OMI patients, especially for the viable myocardium.

Objective To explore the risk factors of cognitive function in out-patients with depression in order to direct clinical therapy.Methods The clinical data of 180 cases of epileptic patients with depression from September 2005 to March 2009 were analyzed retrospectively.Results In 180 cases of epileptic patients with depression,82 cases(45.6%) of cognitive function were found,the occurrence with sex,marital status,the site of epileptic foci,the types of epileptic seizures were no significant correlation(P＞0.05),but related with onset age,educational level,disease course,the frequency of epileptic seizures and duration of attack (P＜0.05).Conclusion The risk factors of cognitive function in epileptic patients with depression were onset age,educational level,disease course,seizure frequency and duration of attack,it should avoid the occurrence of these risk factors and improve the quality of life of patients in clinical practice.

Objective To explore the risk factors of cognitive function in out-patients with depression in order to direct clinical therapy.Methods The clinical data of 180 cases of epileptic patients with depression from September 2005 to March 2009 were analyzed retrospectively.Results In 180 cases of epileptic patients with depression,82 cases(45.6%)of cognitive function were found,the occurrence with sex,marital status,the site of epileptic foci,the types of epileptic seizures was no significant correlation(P＞0.05),but related with onset age.educational levd,disease course,the frequency of epileptic seizures and duration of attack(P＜0.05).Conclusion The risk factors of cognitive function in epileptic patients with depression were onset age,educational level,disease course,seizure frequency and duration of attack,it should avoid the occurrence of these risk factors and improve the quality of life of patients in clinical practice.