[Objective] To discuss the reasonable treatment and skil of gal bladder calculus.[Method] Select 81 cases of such patients, take their clinical data as examples for analysis foundation;and choose relative documents for evidence of theoretic analysis.[Result] 77 cases were successively operated of laparo-scope, 3 transferred for laparotomy owing to difficult anatomy of Colot triangle, 1 made probe of choledoch because of choledocholithiasis;compared with documents results, the incision length, bleeding, operaiotn time, in-hospital time and complications of laparoscope operation, transferred laparotomy in the study were similar to relative documentary reports, the differences had no statistical meaning;the intranperative bleeding, operation period, in-hopital time, complications were better than documents, the differences had statistical meaning. [Conclusion] The correct pre-operation evaluation of disease condition, operation chance and methods selection, 3 operation points were the key of successful operaiton.

Objective To evaluate the value of mini-thoracotomy for open heart surgery.Methods From December 1995 to January 2008,810 patients including 660 cases of congenital heart diseases,129 cases of valvular heart diseases and 21 cases of heart myxoma,underwent open heart surgery by mini-thoracotomy through cardiopulmonary bypass in our hospital.Among the cases,superior median sternotomy was performed on 36 patients,inferior median sternotomy was made on 59,right parasternal mini-thoracotomy was carried out in 3,right anterolateral thoracotomy was done on 658,and right axillary mini-thoracotomy was used in 54.A total of 382 patients received beating-heart surgery.Results The postoperative mortality in our patients was 1.5%(12 cases).In this series,the mean postoperative mechanical ventilation time,drainage volume,and hospital stay were(6.7?4.2) hours,(210?165) ml,and(7.4?4.9) days respectively.421 of the patients received no blood transfusion.None of the patients developed sternal dehiscence or mediastinal infection.Follow-up was available in 690(85%) of the patients up to a mean of(48.2?25.3) months,none of them died during the period.The cardiac function of the patients was significantly improved after the operation(preparation vs postoperation: 310 cases vs 478 cases for grade Ⅰ,438 vs 212 for grades Ⅱ-Ⅲ,and 62 vs 0 for grade Ⅳ,Z=-13.21,P=0.000).The mean cardiothoracic ratio was decreased significantly after the operation(0.51?0.11 vs 0.53?0.08,t=4.065,P=0.000),while the left ventricular ejection fraction was increased markedly(0.63?0.11 vs 0.57?0.11,t=-10.529,P=0.000).Conclusions The mini-thoracotomy is superior in cosmetic results and the postoperative morbidity rates of sternal malformation and infection.Proper selection of patients,good exposure of the surgical field,and skillful surgical procedures are crucial for the outcomes of the operation.

Cells, Cultured ; DNA Damage ; drug effects ; Dimethylformamide ; administration & dosage ; toxicity ; Dose-Response Relationship, Drug ; Hepatocytes ; drug effects ; pathology ; Humans

AIM: To compare the clinical results of suture method and partial eyelash resection treating for pediatric eyelid trichiasis, and screen an effective method for the treatment of pediatric lower eyelid trichiasis.
METHODS: Fifty-six cases of pediatric patients with lower eyelid trichiasis were randomly divided into a control group and an observation group in accordance with the method of drawing lots, and each group was 28 cases. The control group was treated with suture method, and the observation group was treated with partial eyelash resection. The clinical efficacy, patient satisfaction before and after treatment, and the incidence of complications were compared.
RESULTS:(1) The clinically total effective rate was 74%of the control group, which was 89% of the observation group, and there were statistical differences of the clinical efficacy between the two groups ( P<0. 05 ); ( 2 ) the satisfaction scores were (3. 89±1. 22) points and (6. 27±1-86) points of the the control group before and after treatment, which were ( 4. 00±1. 34 ) points and ( 8-95±2-34) points of the observation group, and there were statistical differences of the two groups before and after treatment (P<0. 05), and the scores of the observation group were higher than that of the control group ( P<0-05);(3) complications such as swelling and stitches off appeared in both groups, and the rate was 21% in the control group, which was 11% in the observation group, and there were statistical differences between the two groups (P<0. 05).
CONCLUSION: The treatment of children with lower eyelid trichiasis, suture method is simple and can be performed under local anesthesia in collaboration with children, but with a higher relapse rate, some patients required reoperation;partial resection of eyelashes can be more thoroughly solve the problem of pediatric eyelid trichiasis with low recurrence rate, but children need to be under general anesthesia with some of big risk. So partial resection of eyelashes is unsuitable for using in clinical practice widely and can be used in special cases.

Objective To study feasibility in extraction of calcific sign within pulmonary nodules with pattern classification.Meth-ods 49 cases with pulmonary nodules (benign in 16 and malignant in 33)confirmed by pathology or clinical follow-up were included in this study and all cases underwent chest CT examinations.CT images were interpreted double-blind by two associate chief radiolo-gists to draw a conclusion that there were any calcification within pulmonary nodules.Meanwhile,the calcifications in the regions of interest(ROI)on CT images were estimated with extraction of the sign of gray value,geometric and lung markings in ROI,and based on pattern classification algorithm at supporting vector machine(SVM).Results According to the results assessed by senior radiologists for classification within pulmonary nodules,the area under ROC curve was 0.95 which was extracted by automatic pat-tern classification algorithm,the extraction performance was stable(k=1),and was goodness fit with visual observation by doctors (k=0.939).Conclusion The ability of automatic pattern classification in detecting calcification within pulmonary nodules is about the same as that of visual assessment by senior doctors.

0 05). SLPP determation is helpful in the assessment of the type of genuine female stress urinary incontinence and is therefore valuable in its management.

Objective To investigate the clinical application value of the laparoscopic intraoperative cholan-giography in laparoscopic cholecystectomy,and summarize the experience.Methods The clinical data of 169 cases of laparoscopic cholecystectomy intraoperative cholangiography were analyzed retrospectively.Results 169 patients were successfully completed,131 cases recovered well and no complications occurred after operation.29 patients showed hyperamylasemia,of which 3 patients had intractable hyperamylasemia,8 patients complicated with secondary acute pancreatitis,with fasting,gastrointestinal decompression,enzyme inhibition(plus somatostatin)and acid,analgesic, anti infection,rehydration treatment after remission.Conclusion Laparoscopic cholecystectomy intraoperative cholan-giography is a safe and reliable diagnostic technique,on the occurrence of biliary residual stones in prevention of post-operative prevention and timely detection of bile duct injury during operation and improves the success rate of repair of bile duct injury has important clinical value;control adaptation of intraoperative cholangiography has important clinical significance of reasonable application license.

Objective To investigate the preventive effects of anti-viral therapy in combination with transcatheter arteria chemoembolization (TACE) on recurrence of HBV-related hepatocellular carcinoma (HCC) after operation. Methods According to selection standards, 49 patients treated in this hospital from January 2003 to June 2009 were enrolled in this study and divided into a control group and combined group.The cumulative tumor-free survival rate, cumulative survival rate, the 1-, 2- and 3-year recurrence rates and cumulative recurrence rates were determined in all the patients and compared between the 2 groups. Results The cumulative tumor-free survival rate and cumulative survival rate were significantly higher in the combined group than in the control group (P=0. 019, 0. 008). The 1-, 2-, and 3-recurrence rates were 24% vs. 38.9%, 28% vs. 33.3%, and 28% vs. 22.2% in the combined group and control group, respectively. The 1-, 2-, and 3-year cumulative recurrence rates were 24% vs. 38. 9%, 52% vs. 72. 2%, and 80% vs.94. 4% in the combined group and control group, respectively. Conclusion Anti-viral therapy in combination with TACE can exert significant preventive effects on recurrence of HBV-related HCC after operation.

Objective To summarize surgical results of secondary tunnel-like subaortic stenosis( STSS) after congenital heart disease( CHD) operations, analyze the pathogenesis of STSS, evaluate the operative effect and prognosis.Methods We analyzed clinical data of 25 patients who underwent surgical repair for STSS in Fuwai Hospital from January 2009 to December 2015.There were 17 males and 8 females.CHD types included double outlet right ventricle, ventricular septal defect and par-tial atrioventricular septal defect, et al.The median age of the patients when they received their first CHD operations was 1 year (1 month to 42 years).The median age of the patients when they received TSS repair was 5 years and 8 months(2 years and 10 months to 48 years) .The surgical types contained modified Konno procedure , Konno procedure, resection of the conal sep-tum, resection of fibromuscular ridge and myectomy, removal and reconstruction of the intraventricular baffle.Results All the patients successfully received their TSS repair .There was no surgical death in this study .The preoperative gradient of aortic valve pressure was 81(43 to 159)mmHg(1 mmHg=0.133 kPa), and the postoperative gradient was 8.2(4.0 to 46.2) mm-Hg.Ⅲ degree atrioventricular block was occurred in 2 patients after operation and both 2 patients needed to set permanent pacemaker.All the patients were followed up after discharge for a median duration of 2 years( 4 months to 6 years) .During follow-up, none of the patients had any clinical symptom or subaortic restenosis , and there was no late death .Conclusion The pathogenesis of STSS is perhaps related to turbulent flow and shear stress to the left ventricular outflow tract , resulting in the proliferation of fibromuscular marterials and stenosis in the left ventricular outflow tract .The modified Konno procedure and resection of the conal septum are safe and effective.

Objective To investigate the impacts of the left ventricular size for infants with total anomalous pulmonary venous connection(TAPVC) on the early results of anatomical correction.Methods From Jan 2010 to Jun 2013,103 cases of TAPVC children under 1 year of age received biventricular correction in our hospital,including 65 males and 38 females with the mean body weight of(5.3 ± 1.3) kg.Taking left ventricular end-diastolic volume index(LVEDVI) of 20 ml/m2 as a boundary,all the children were divided into two groups:Small LV group and the Near normal LVgroup.Various factors including age,body weight,pathological type,pulmonary venous obstruction and restricted atrial septal defect were compared between the two groups.The Z value were introduced to demonstrate the small extent of the left atrium and left ventricle of TAPVC patients in comparison with the normal children.TAPVC correction surgery were performed with conventional median sternotomy,moderate hypothermic cardiopulmonary bypass and combined malformations were treated simultaneously.Results 45 patients were classified to Small LV group and 58 patients were classified toNear normal LV group.71.1％ of all Small LV patients was diagnosed as the obstruction type of TAPVC,the ratio was significantly higher than that of theNear normal LV group.The Z value of left ventricular end-diastolic diameter in theSmall LV group was significantly lower than that of the Near normal LV group.The mean CPB and aortic clamping time of all patients were (96.6 ± 34.4) min and (58.0 ±21.1) min respectively.There were 4 early postoperative death and the overall mortality was 3.9％.No patient was dead of low cardiac output.The duration of postoperative mechanical ventilation,ICU stay and vasoactive drugs application in Small LV group was significantly longer than that of Near normal LV group.Conclusion TheSmall LV,which should be viewed as relative dysplasia of left ventricle ,is more common in obstructive type of TAPVC.As long as the sizes of mitral valve and aortic valve were not significantly reduced,anatomic correction can be implemented and need not to concern the reducing degree of left ventricle.Nevertheless,the prevention and treatment of low cardiac output in the operation and early postoperative period were still key points for small LV patients to achieve good surgical results.