Objective To study the use of early bile duct to bile duct end-to-end(side) anastomosis for extrahepatic bile duct injuries.Methods The clinical data of 25 patients with extrahepatic bile duct injuries with early bile duct to bile duct end-to-end(side) anastomosis were retrospectively analyzed.Results Bile duct injuries happened in laparoscopic cholecystectomy (n=17),laparoscopic exploration of common bile duct (n=1),laparotomy (n=5),and knife wound (n=2).All of the repairs were successfully carried out.Except for one patient who was lost to follow-up,the other patients were followed for over 2 years.There was no bile duct stenosis.One patient died after 5 months of repair in other hospital because of a recurrent bile duct calculus.Conclusions Early bile duct to bile duct end-to-end(side) anastomosis had a good long-term results.The operation needs to be done by a good surgeon or supervised by an experienced specialist in biliary surgery.A prolonged period of T tube stenting is a prerequisite for success.

Objective:To observe the relationship between lymphocyte phenotype and clinical presentation in cancer patient receiving immunotherapy combined with chemoradiotherapy.Methods:42 patients were enrolled into the study.Among these patients,22 received stimulated normal peripheral blood lymphocytes(PBLs) as well as chemoradiotherapy,and 20 patients received chemoradiotherapy only as control group.Immunotherapy was administrated biweekly,totally 8 times.Results:22 patients receiving immunotherapy had lymphocyte phenotype change which was also in accordance with symptom improvement,but didn't reach statistical significance.Among 22 patients receiving immunotherapy had 15(68.18%) had lymphocyte phenotype change which was in accordance with symptom improvement,including elevation of CD3 + 3,CD + 4(P

Objective To analysis the constituents of urinary stones in southeast Chongqing district,and provide the percep-tion and treatment of urinary stones.Methods Retrospective analysis of 1 628 random urinary stones samples in southeast Chongqing district from 2008 to 2014.The chemical constituents of stones were analysis with the clinical data.Results Urinary stones were more often found in those 30 to 70 years old,especially in males.The upper system stones were frequently founded.The percentage of mixed stones and pure stones were similar,The constituents of stones were similar to male and female,the most com-mon component of the urinary stones are calcium oxalate,which were found in 82.9% of the stones,infection stones were found 1 9.2%,but only found in renal and ureteral stones,and also increase gradually.The most common component of urinary stones in Qianjiang and Pengshui district were calcium oxalate,the infection stones were frequently found in Youyang and Xiushan district. Conclusion Chemical composition analysis of urinary stones is simple,quick and accurate,it is very important in providing infor-mation to the etiology,treatment and prevention of urinary stones.

Objective To investigate the effects of sevoflurane on ca2+ transsarcolemmal influx and ca2+ release function of endoplasmic reticulum in isolated outer hair cells (OHCs) of guinea pigs and the possible mechanism by which sevofhlrane acts on cochleas.Methods The experiment was performed in 2 parts.In experiment I:twelve adult guinea pigs(8 male,4 female)weighing 180-230 g were used.OHCs were mechanically sparated after enzymatic incubation.Thirty OHCs with favorable activity were divided into 3 groups (n=10 each):group I control(C);group Ⅱ low concentration sevoflurane (1.7%,group S1) and group Ⅲ high concentration sevoflurane(3.4%,group S2).The OHCs were stained with 6 umol/L Fluo-3AM in estefified form for 40 min.Group S1 and S2 were pretreated with 1.7% and 3.4% sevoflugsne respectively for 20 min.KCI 40 mmol/L was then added.The intracellular ionized Ca2+ concentration ([C2+]I) was determined byintracelhlar Ca2+ fluorescent intensity using laser scanning confocal microscope.The protocol of the experimentⅡ was the same as the experimentI.The only difference was that caffeine 20 mmol/L was added instead of KCI 40 mmol/L.Results In experiment I:there was no significant difference in baseline[ca2+]I and[ca2+]I after being exposed to sevoflurane among the 3 groups.[Ca2+]I was significanfly increased after addition of KCI as compared with the baseline[Ca2+]I and was significantly lower in group Sl and S2 than in group C and was the lowest in group S2.In experimentⅡ:the[ca2+]I was significantly increased after addition of caffeine but there was no significant difference in[Ca2+]I among the 3 groups.Conclusion Sevoflurane can inhibit voltage-dependent Ca2+ channel opening in a concentration-dependent manner but can not affect ryanodine-sensitive Ca2+ release function of endoplasmic reticuhm in isolated outer hair cells of guinea pigs.

Objective To investigate the influencing factors for post-discharge treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB).Methods MDR-TB patients who were hospitalized in a tubercu-losis hospital between November 2011 and January 2013 were chosen,post-discharge follow-up was conducted regu-larly through telephone call.Medicine-taking and re-examination of patients was inquired,factors influencing pa-tients’treatment compliance were analyzed.Results 299 patients were included in the study,the total treatment compliance rate was 81 .94% (n=245);249(83.28%)patients regularly took medicine,50(16.72%)didn’t regu-larly take medicine;254 (84.95%)were re-examined on time,45 (15.05%)were not re-examined on time;37 (12.37%)discontinued treatment,260 (86.96%)continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate,timely re-examination rate,interrupted treat-ment rate,and total compliance rate)was significantly different among MDR-TB patients of different ages,education levels,treatment time,and with or without adverse reactions(all P <0.05 ).Logistic regression analysis revealed that treatment compliance of MDR-TB patients was negatively correlated with treatment time(β=-1 .47,Wald χ2=24.28,P <0.05)and adverse reactions(β=-2.02,Waldχ2 =24.24,P <0.05 ),while positively correlated with education levels(β=0.79,Wald χ2 =6.50,p <0.05 ).Conclusion Prolonged treatment time and adverse reactions can reduce the treatment compliance of MDR-TB patients,the higher education levels of MDR-TB patients have, the better treatment compliance they implement.

AIM: To establish methods for identifying the antetype of Compound Qingkailing(Calculus bovis,Concha margaritifera,Radix isatidis,Cornu bubali) in rat serum by HPLC-MS~n and HPLC-TOF-MS. METHODS: Addition of methanol to serum after Qingkailing given intravenously to rats was used to precipitate protein.The HPLC-TOF-MS provided the exact molecular weight and the HPLC-ESI-MS~n provided the m/z of multilevel fragment.The medicine antetypes were identified by combining the two methods. RESULTS: Four main medicine antetypes in rat serum,such as geniposide,baicalein,wogonoside and cholic acid,were identified. CONCLUSION: It is a rapid and exact method that can be used to identify other complicated traditional Chinese medicine in vivo.

Allotransplantation of peripheral blood-derived hemopoietic stem cells is the best therapy for acute leukemia. With increases of only-child families, sibling donors are decreasing. Moreover, the probability is low and time consuming is long to search a matched hemopoietic stem cell donor from the Chinese Marrow Donor Program. Haploidentical stem cell transplantation would bring a hope for donor resource. However, difficult transplantation and high incidence of graft versus host disease are two risks. Based on modified regimen and cyclosporine A+short-term amethopterin, mycophenolic acid, interleukin-11, anti-lymphocyte immunoglobulin and hemopoietic stem cells mobilized by recombinant human granulocyte colony-stimulating factor can prevent graft versus host disease. This therapy succeeded in two cases with no severe graft versus host disease.

Objective To analyse the effect of mobilization and collection's time of peripheral blood stem cells(PBSC) from 8 cases of healthy donors. Methods The 10 donors were studied by self-control design.The number of aphereses was two times every donors. Healthy donors received rhG-CSF according to two different PBSC collection starting time: group 1:PBSC collection was starts 2 hours(2 h) after the fourth day or the fifth day of rhG-CSF. group 2:PBSC collection was starts 4 hours(4 h) after the fourth day or the fifth day of rhG-CSF.(The first dose of rhG-CSF was given on day 1, considering day 0 as the day before starting mobilization). In this study we have compared with two groups of apheresis product. Results The MNC count was significantly higher for donors 4 h collection (groups 2) then 2 h. ( groups 1)(P

OBJECTIVE:To study curative effect of the combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate as acute graft-versus-host disease(aGVHD) prophylaxis on HLA-matched unrelated donor or HLA-mismatched related donor allogenic peripheral blood stem cell transplantation(Allo-PBSCT).METHODS:Thirteen patients with haematological malignancies who underwent HLA-matched unrelated donor or HLA-mismatched related donor Allo-PBSCT with the combination of cyclosporine A as aGVHD prophylaxis at Haikou Municipal People's Hospital from September to November 2008 were selected,including 7 of unrelated donor,3 of haplotype transplantation,and 3 of 1-locus mismatched.The conditioning regimen was performed at 7 days prior to transplantation,with cyclosporine A 5-10 mg/(kg?d),12 hours per time with twice per day.From day 7 prior to transplantation,mycophenolic acid was intravenous drip once per day,then 2.5 mg/(kg?d) antithymocyte globulin at days 5-2 prior to transplantation,1.5 mg/d interleukin 11 was subcutaneous injected at day 2 prior to and 10 days after transplantation,followed by intravenous drip 15 mg/m2 amethopterin at day 1 and 10 mg/m2 at days 3,6,11 after transplantation.The drug doge was reduced and stopped gradually after 3-6 months,which could be prolonged for haplotype grafter.Recombinant human granulocyte colony-stimulating factor was injected subcutaneously at day 3 prior to transplantation,and PBSCT was collected at days 4 and 5 after medication,which was infused to patients with subclavian vein at the same day.In total(7.82-9.11)?108/kg mononuclearcell and(2.9-7.7)?106/kg CD34+ cells were infused.RESULTS:Hematopoiesis was rebuilt in all patients with 46.15%(6/13) aGVHD incidence rate,including 8 %(1/13) of Ⅲ-Ⅳ aGVHD.Up to April of 2009,all patients live and work as normal except one patient who can not visit public places.CONCLUSION:The combination of cyclosporine A,mycophenolate mofetil,anti-thymocyte globulin,interleukin-11 and short-term methotrexate is effective in the prevention of aGVHD.

Objective To investigate the clinical value of serum activin A,endoglin combined with uterine artery pulsatility index in predicting preeclampsia.Methods One hundred cases pregnant women who were admitted to the obstetrics clinic of Longhua New District People′s Hospital in Shenzhen from December 2016 to July 2017 were selected ,50 cases of preeclampsia were in the observation group,and another 50 cases of healthy pregnant women were in the control group.Serum activin A,endoglin and uterine artery pulsatility index ( UAPI ) were measured at 11 ～ 13 weeks respectively.Receiver operating characteristic curve was used to analyze the diagnostic value of activin A,endoglin and UAPI in different gestational weeks separately and jointly in predicting preeclampsia.Results At 11～13 weeks of pregnancy, the serum activin A((379.98±153.80)ng／L],endoglin((9.87 g±1.62)μg／L) and UAPI (0.97±0.09) in the observation group were significantly higher than in the control group ((205.45±93.29)ng／L,(6.61 ±1.54)μg／L, ( 0.82 ± 0.15 )), and the difference was statistically significant ( all P＜ 0.05 ).The multivariate Logistic regression analysis showed that serum activin A, endoglin level and UAPI in early pregnancy were the risk factors for preeclampsia ( all P＜0.05).ROC curve analysis showed that the joint prediction of activin A, endoglin and UAPI in different gestational weeks was better than that in single detection.The maximum area (AUC) of the joint prediction of activin A,endoglin and UAPI at pregnant 11～13 weeks was 0.969, the sensitivity was 82.0%, and the specificity was 100.0%.Conclusion The combined detection of serum activin A, endothelial factor and uterine artery pulsation index in early pregnancy can be used to predict preeclampsia with high sensitivity and specificity,and can be used as a clinical index to predict preeclampsia.