Objective To understand the relationship between Hp infection and treatment role in perioperative period patients with liver cirrhosis.Methods Hp in gastric juice and ammonia concentration in blood were examined in 32 patients with liver cirrhosis.Results ⑴The rate of Hp infection was 62 1% in 32 patients with liver cirrhosis.⑵There was no obviously difference in the blood ammonia concentration between both patients with Hp positive and negative.⑶The blood ammonia concentration after Hp eradication was significantly lower than that before eradication.Conclusions Hp infection could partly contribute to occur the hyperammoniaemia in patients with liver cirrhosis.Hp should be checked routinely in perioperative period patients with liver cirrhosis.The eradication of Hp is necessary to prevent and treat the hyperammoniaemia in operative patients with liver cirrhosis.

Objective To evaluate the effect of LC+LCBDE and EST+LC in treating the cho-leeystolithiasis with choledocholithiasis. Methods The clinical data of 256 patients treated in our hos-pital were retrospectively analyzed. Of the 256 patients, 132 were treated by LC+LCBDE and 124 by EST combined with LC. The clinical data of the two groups was compared in operation success rate, operation time and cost, complication rate and operative hospital stay. Results There was no statisti-cal difference in the operation success rate, complication rate, operative hospital stay between 2 groups. However, there were significant differences in the operation time and cost between the 2 gruops. Conclusion There are respective indications, advantages and disadvantages in the two groups. EST+LC is the better choice for patients with a CBD<1.0 cm in diameter, stones impacted in the distal CBD, or old age. Otherwise, the better way is LC+LCBDE for patients with a CBD>1. 0 cm in diameter and multiple choledocholithiasis, especially in young and middle-aged people.

Objective To evaluate the effect of laparoscopic cholecystectomy(LC) combined with bile duct exploration and stone removal(BDE) and LC with endoscopic sphincterotomy(EST) in treating cholecystolithiasis with choledocholithiasis.Methods Among 256 cases of cholecystolithiasis and choledocholithlasis,132 patients were treated by LC+LCBDE,and 124 cases by EST combined with LC.The operation success rate,operation time and cost,complication rate,and length of hospital stay of the two groups were compared.Results There was no statistical difference in the operation success rate,complication rate,stone clearance rate,and average hospital stay between the two groups,but EST+LC group had significantly longer operation time and higher cost.Conclusions There are respective indications,advantages and disadvantages in the two groups.EST+LC is the better choice for patients with diameter of CBD1.0cm and with multiple choledocholithiasis,especially for middle-aged patients,the better way is LC+LCBDE.

Objective To evaluate the effect of combined laparoscopic and endoscopic treatment for cholelith of gallbladder and common bile duct(CBD).Methods Diagnosis was established in 44 patients by ERCP , and endoscopic Oddi′s sphincteromy (EST) was performed in all patients, then choledocholith was removed by endoscopic netbasket and balloon. 3～5 days after laparoscopic cholecystectomy(LC) was carried out. Results The success rate of combined treatment in this study was 98%(43/44), and stones were removed in 100%(44/44). There was no conversion to open surgery in our series, and no severe complications. All patients were discharged in 5～15 days postoperatively. Conclusions Combined laparoscopic and endoscopic procedure is a safe and effctive method to treat patients suffering from cholelith of the gallbladder and CBD.

Objectives:B type ultrasonic diagnosis instrument is used to measure the sebum thickness and the relevance vs evaluated with sebum thickness calipers in sebum thickness determination. Methods:The study included 219 healthy adult persons and 11 cases of corpse dead of non disease reason for less than 10 hours.The measurements of sebum thickness were made by B type ultrasonic diagnosis instrument and sebum thickness calipers respectively. Results:The measurement results of two different methods were not significantly different. Conclusions:It is feasible to use B type ultrasonic diagnosis instrument for the measurement of the sebum thickness in clinic.

Objective To assess the safety and efficiency of systematic transperineal ultrasound guided template positioning biopsy for the high-risk population of prostate cancer.Methods From January 2010 to January 2012 a total of 42 high-risk men of prostate cancer underwent systematic ultrasound guided biopsy using the transperineal template positioning technique.All patients got at least one previous biopsy,and all the patients showed negative results,including prostatic intraepithelial neoplasia,and/or atypical small cell acinar proliferation.During the follow-up,all the patients still had high prostate specific antigen (PSA) velocity (＞ 0.75 μg/L) or high PSA level (＞ 10 μg/L).Results A mean of 18.7 biopsy cores had been obtained.Cancer was identified in 19 of the 42 men (44％).The mean Gleason score was 6 (from 4 to 9).Mean prostate volume in the positive and negative biopsy groups was 44 and 71 ml.The only significant independent influence factor for positive biopsy was prostate volume (P ＜ 0.05).The positive rate showed no statistic difference in term of presence of PIN,AHH,the number of biopsy sites,or PSA value (P ＞0.05).Adenocarcinoma was found in transition zone in 14 of 19 cases (74％),and 5 (36％) was positive only in the transition zone.Complications were rare and self-limiting,including hematuria (29％)and urinary retention (0.9％).Conclusions Systematic transperineal template positioning biopsy of the prostate is a safe and precise biopsy technique in patients who remain at high-risk for prostate adenocarcinoma.

Objective To investigate the value of MRCP in conjunction with CT or MRI contrast-enhanced scan in locating and qualitative diagnosis of biliary obstruction.Methods 954 patients with biliary obstruction confirmed by surgical pathology and clini-cal follow up underwent MRCP scans in our hospital.Contrast-enhanced CT scans in 87 patients,contrast-enhanced MRI scans in 52 and both CT and MRI enhancement in 37 were performed.Results The accuracy of location of biliary obstruction with MRCP was 100%,the accuracy of quality of biliary obstruction with MRCP combined with CT or MRI dynamic contrast-enhanced scan was 96%.Conclusion MRCP combined with CT or MRI dynamic contrast-enhanced scans has an important clinical value for the locali-zation and qualitative diagnosis of biliary obstruction.

Objective Few reports are seen on the methods of establishing the rabbit model of pancreatic cancer .This study was to compare the effect of Panc-1 cell suspension orthotopic implantation with that of VX-2 tissue orthotopic implantation in construc-ting the rabbit model of pancreatic cancer . Methods Using the random number table method , we divided 30 healthy rabbits into a tissue suspension group ( n=15) and a cell suspension group ( n=15) , VX-2 tissue suspension employed for in-situ implanting in the former group and panc-1 cell suspension utilized in the latter .Then we evaluated the two modeling methods by B-ultrasonography , 3.0T MRI, and CT. Results In the third week after modeling , transpla-ntive metastasis of lots of tumor tissues was observed in the duode-num, colon, appendix, and peritoneal wall in 5 rabbits of the tissue suspension group , but only in the greater omentum of 3 rabbits in the cell suspension group , with high signals of MR T 2 in the posterior gastric body .One case of duodenal metastasis was seen in the cell suspension group , with slightly high signals of MR LAVA in the posterior gastric body .The model of pancreatic cancer was successfully established in all the 15 rabbits of the tissue suspension group , but only in 3 of the cell suspension group .The success rate of tumor im-planting at 3 and 4 weeks was significantly higher in the former ( 46.66%and 100%) than in the latter group ( 6.67%and 20.00%) (P<0.05). Conclusion VX-2 tissue orthotopic implantation is a more feasible and convenient method than Panc -1 cell suspension orthotopic implantation for establishing the rabbit model of pancreatic cancer .

AIM:To screen the miRNA related to blood stasis syndrome and to explore the genetic mechanism of blood stasis syndrome in hypertension.METHODS:Human umbilical vein endothelial cell line CRL-1730 was co-cul-tured with the human sera from healthy normal controls and hypertension patients to establish a blood stasis-hypertension cell modela.The hypertension patients showed qi deficiency and blood stasis, qi stagnation and blood stasis, cold retaining and blood stasis, heat retaining and blood stasis and non-blood stasis syndromes.The endothelial cell models of blood stasis in hypertension were established.Target cells were collected for total RNA extraction.The techniques of Solexa ( high-throughput sequencing method) and digital gene expression profiling were applied for screening the target miRNA, and miRWalk software was used for online prediction the mRNA which might be the relevant target.qRT-PCR was conducted to confirm the prediction.RESULTS:SAT1-Hsa-miR-199a-5p and ATF4-Hsa-miR-1283 were found to be highly expressed in these cell models.The expression of miR-1283 and miR-199a-5p was confirmed by qRT-PCR.CONCLUSION:miR-199a-5p and miR-1283 may be the relevant miRNA for the prediction of blood stasis syndrome in hypertension.

Objective To evaluate the risk factors of massive blood loss in resection of giant liver hemangioma.Method The clinical data of 141 patients who underwent giant liver hemangioma resection were retrospectively studied.These data included general physical condition,laboratory tests,radiologic findings,and various surgical parameters.The patients were divided into the massive blood loss group (＞ 1 000 ml,n =27) and the minor blood loss group (≤1 000 ml,n =114).Logistic regression was performed to determine the risk factors of intraoperative massive blood loss.Results The average diameter of the liver hemangioma was significantly greater in the massive blood loss group than that in the minor blood loss group [(21.7 ± 8.5) cm vs.(14.1 ± 5.3) cm,P ＜ 0.05].The incidences of preoperative leukopenia,anemia,thrombocytopenia and prolonged prothrombin time were higher in the massive blood loss group than that in the minor blood loss group (48.1％ vs.16.7％,37.0％ vs.11.4％,25.9％ vs.3.5％,22.2％ vs.3.5％,respectively,all P ＜ 0.05).Hepatic hemangioma with compressed hepatic veins,inferior vena cava and porta hepatis were more frequently found in the massive blood loss group than in the minor blood group (55.6％ vs.14.9％,44.4％ vs.14.0％,55.6％ vs.12.3％,respectively,all P＜0.05).Logistic regression analysis demonstrated a diameter of hemangioma greater than 15 cm was a risk factor of intraoperative massive blood loss during surgical resection.Conclusions Giant hepatic hemangioma may cause disorders in the hematological and coagulation systems.Compression of major hepatic vessels raised technical difficulty and risks in surgery.Hemangioma with a diameter greater than 15 cm was recognized as a high-risk factor of intraoperative massive blood loss.