Objective To explore the value of application of choledochofiberscopy in the diagnosis and treatment of the extrahepatic bile duct disease, and the effect on reducing the incidence of the postoperative residual stone in biliary ducts. Methods According to the case history and ultrasonography,if the common bile duct(CBD) diseases suspected,the CBD was explored by intraoperative choledochofiberscope(IOCF). During the procedure,a biliary passage mirror inducer apparatus and biliary tract probe which were manufactured by ourselves were used. Results During LC,IOCF was performed on 385 cases of the 10 396 LC cases,and possitive findings were dicovered in 102 cases(26.49%). Among those positive patients, 67 cases belonged to stricture of the lower biliary tract; 5 cases were Mirizzi syndrome; 2 cases were carcinoma of the periampulla; 1 case was primarily carcinoma of the bile duct; 1case was ascarisis of the biliary system. Conclusions IOCF is a good inspect technique with high success rate and clear image of bile duct, it can discover the common duct diseases which are difficult to be diagnosed through the routine examination.At the same time, it can provide the locative and qualitive diagnosis, determine reasonable methods of operation,and effectively provent postoperative complications.

To identify the isolated suspicious strain of Campylobacter jejuni from the blood of bacteremia patient in Guizhou Province ,China ,conventional and molecular techniques (specific mPCR and NAP-mPCR) were used to identify suspi-cious bacteria strains .Results showed that Campylobacter jejuni suspicious colonies were cultured in bacteremia patient blood samples .The strain was identified as Campylobacter jejuni ssp . jejuni by conventional tests and was identified as Campy-lobacter jejuni by genus specific mPCR .Then the strain was classified as Campylobacter jejuni ssp . jejuni by subspecies NAP-mPCR .The strain was identified as Campylobacter jejuni ssp .jejuni isolated from the blood of bacteremia patient and Campylobacter jejuni can be identified subspecies by NAP-mPCR .

Thirty-seven cases of brain glioma,confirmed by light microscopy and immuno-'histochemistry were studied with transmission electron microscopy.It was found that there were certain ultrastructural features for each type and each grade of glioma.In astrocytoma,there was certain amount of glial filaments in the tumor cells; Rosenthal fibers consisted of irregular osmiophilic masses surrounded with glial filaments,occasionally cytoplasmic annulate lamellae and intranuclear filaments could be seen,and the interstitial capillaries were characteristic.In typical oligodendroglioma,astrocytic processes containing glial filaments were quite present in different amounts.These findings suggest that observation on the ultrastructure of gliomas is of significance to establish the diagnosis,to assess the degree of differentiation,and to identify some rare structures which can reveal the essence of the tumor.In addition,ultrastructural observation is helpful for prognosis.

Objective To observe the effect of laparoscopic surgery for patients with acute gallstone pancreatitis(AGP). Methods The clinical data of 134 patients suffered from AGP treated with laparoscopy surgery since 2000 in our hospital were analyzed retrospectively.Results All the patients were treated with laparoscopic surgery successfully. Among them, 21 cases were treated with laparoscopic cholecystectomy (LC);113 cases with LC and exploration of common bile duct,induding 75 cases received opening the pancreatic capsule and placement of irregation tubes for postoperative washing the abdominal cavity during the same operation. One hundred and tweent-six cases(94.0%) cured, 6 cases(4.5%) died, 2 cases( 1.5%) discharged themself. Conclusions Laparoscopic surgery in the treatment of early stage of AGP can get good results and improve the prognosis remarkably.It is worth to be used widely.

Objective To probe into the variation of CT values of surface enhanced layers of nasopharynx wall,intensified regularity and choosing the best scanning time.Methods 138 patients received conventional plus enhanced CT scan and 58 cases of them received delayed and repeated scans.Results 83% of the cases were correspondent to the surface of nasopharynx and had manifest linear enhancement.After giving contrast injection,it reached 97% at the 74 second.All CT values of the cases were enhanced in the phase of 92～344 second.Conclusion The ratio of linear enhancement is manifestly high,which is very helpful to the CT diangosis of NPC restricted to or under the mucosa.The best acquisition time should be just before or after the 74 second,correspondent to the surface of nasopharynx.The enhancement lasted long.

Extra-luminal flow hollow fiber membrane oxygenator (ELFHFMO) has been widely applied in cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) because of its advantages over other types of MO. But its low hemocompatibility and durability are the major problems in clinical application that even have limited its wide application. In this paper, we reviewed the recent researches on how to improve the hemocompatibility and durability of ELFHFMO.
Coated Materials, Biocompatible ; Extracorporeal Membrane Oxygenation ; instrumentation ; Heparin ; administration & dosage ; Humans ; Oxygenators, Membrane ; trends

Objective To explore the application value of the lower leg perforator flaps in repairing soft tissue defect on ankle.Methods From January 2007 to December 2012,62 cases of soft tissue defect on ankles have been repaired.The defects were combined with tendon and/or bone exposure for all the cases,among them 7 cases were exposure or sinus tract after achilles tendon rupture surgery,8 cases with ankle or intertarsal joint defect and exposure,24 cases with distal tibia fracture,or medial malleolus fracture,or lateral malleolus fracture,or calcaneus fracture,11 cases with different level of infection.Fifteen cases were primarily repair,and 47 cases were secondly repair or extended phase.The cases were repaired by applying different types retrograde transferred perforator pedicle flaps of lower legs,with 10 cases of posterior tibial artery perforator flaps on the medial malleolus,12 cases of front top flaps of com peroneal artery on external ankle,40 cases of back top flaps of peroneal artery on external ankle.The sizes of the flap ranged from 4.0 cm ×5.5 cm to 9.0 cm × 15.0 cm.Ten cases were applied direct suturing in donor site,and other cases were applied skin grafts to repair the defect.Results Flaps in 56 cases completely survived.Partial necrosis appeared in 3 cases of front top flaps of peroneal artery on external ankle,one perforator flap of posterior tibial artery on the medial malleolus and 2 cases of back top flaps of peroneal artery on external ankle.All these cases recovered after careful dressing changes.Sixty two cases were followed up for 3-12 months.Texture of flaps was soft with good elasticity.All of the donor skin grafts in patients survived.Conclusion Perforator flaps have the advantage of easy operation,little damage to the main blood vessels,high reliability in flap survival,less destroy to donor site.It is important that individualized flap is selected given different position of defect.

Eight patients with suspected cases of C .jejuni were etiologically diagnosed and analyzed in this study to pro-vide scientific basis for the confirmation of the cases of human campylobacteriosis in Guizhou Province ,China .Blood or feces of 8 suspected patients were employed to isolate bacteria strains .Conventional and multi-PCR techniques were applied to identify suspicious bacteria strains .The C .jejuni strains were analyzed by using Pulsed Field Gel Electrophoresis (PFGE) .Suspicious strains of C .jejuni were isolated from all the 8 suspected patients of campylobacteriosis and anticipated genes fragment were detected with multi-PCR .With the digestion of restriction enzyme SmaI ,the 8 C .jejuni strains were divided into 7 PFGE pat-terns with 7-10 DNA bands .Cluster analysis showed that the gross similarity of 8 strains of C . jejuni was more than 50% . The similarity of PFGE patterns between strain GZ201004 and GZ201005 from diarrhea patients was as high as 100% ,while the similarity of strain GZ201201 and GZ201007 was 66 .7% .Moreover ,C . jejuni were detected from all the suspected pa-tients of campylobacteriosis .PFGE results indicated that strains GZ201004 and GZ201005 were from the same source ,while all the 8 isolates showed PFGE polymorphism .

Objective To study the composition of variant and point mutations of Norovirus GⅡ.4 in Guiyang regions.Methods From June to November 2010,cases information and fecal specimens were collected from guard-hospitals in Guiyang regions,who had caught the acute-gastroenteritis.Noroviruses in specimens were detected by a real-time reverse transcription polymerase chain reaction(real-time RT-PCR),and then partial genotyped norovirus-positive clinical samples (in random) were cloned and sequenced in VP1 gene code.Furthermore,the gene sequences were compared with the published variants at home and abroad of norovirus(GⅡ.4),including the phylogenetic analyses of genomes and variation of amino acids within individual sites.Results Those 267 specimens were GⅡ-norovirus-positive(62.68％) in 426 clinical samples.There were nine GⅡ.4-norovirus-positive VP1 gene-sequences available,and two subtype-norovirus variants (GⅡ.4 2008a and G Ⅱ.4 2008b variant) were epidemic in 2010,Guizhou province.The homology between and in subgroups were 95.90％-96.72％ and 99.45％-100％.Two amino acids within individual sites were apt to mutate.Conclusion Norovirus GⅡ genotype were predominant in summer and fall acute gastroenteritis in 2010 for Guiyang regions,and the variants were diversity.

Objective To investigate the efficacy of laparoscopic percutaneous common bile duct exploration (LPCBDE) with internal draining tube placement for the treatment of cholelithiasis. Methods The clinical data of 962 patients with choledocholithiasis who were admitted to the No. 451 Hospital of PLA were retrospectively analyzed. A self-made internal draining tube was placed in the common bile duct and duodenum to drain bile internally. The correct position of the internal draining tube was comfirmed by injecting water into and draining water from duodenum. The internal draining tube was pulled out with the help of duodenoscope at 30 days after the operation. Results LPCBDE with internal draining tube placement was successfully performed on 864 patients. Forty-two patients were transferred to open surgery, and 56 patients were transferred to receive LPCBDE with T-tube drainage. The mean operation time was (36 ± 18) minutes (range, 20-72 minutes), and the length of postoperative hospital stay was (6.6 ±2.1)days. Two patients were complicated with retroperitoneal abscess and they were cured by puncture and drainage, 32 patients were complicated with bile leakage and they were cured by conservative treatment. A total of 862 patients were followed up by B ultrasound at 30 days after the operation. The internal draining tube which was confirmed in the common bile duct was extracted with duodenoscope in 603 patients; the internal draining tube which was drawn back in 1 patient was removed with endoscopic sphincterotomy ( EST); the internal draining tube was removed naturally in 258 patients. The follow-up period ranged from 1 to 3 years, 26 patients had recurrent cholelithiasis and they were treated by EST. Conclusions LPCBDE with internal draining tube placement is a safe and minimally invasive method for the treatment of cholelithiasis.