Objective To promote the recognition and effect of treatment of the iatrogenic injury in the end of common bile.Methods The clinical data of 12 cases of the iatrogenic injury in the end of common bile duct were retrospectively analyzed.Of the 12 patients with an age ranging from 45-65,6were mate and 6 female.All the 12 patients had the bile leakage after choledocholithotomy in combination with exploration.The injury was found during operation and managed immediately in 6 cases.In other 6 cases,there were fever and right upper local retroperitonitits and delayed diagnosis of the injury.Results Nine cases were cured and 3 died(mortality=25%).Conclusion Timely finding and management of the injury during operation are important.Meanwhile,postoperative finding and early management can promote the survival of patients.The delayed treatment will result in high mortality.

ObjectiveTo evaluate the effect of different operative methods for treating rebleeding in patients with portal hypertension(PHT). MethodsThe clinical data of 66 patients with postoperative ebleeding out of 373 PHT cases during the last 30 years was retrospectively analyzed. Their first operations were splenectomy, portoazygous devascularization, various non-selective shunt and combined operation(devascularization combined with shunt), of which, the rebleeding rate were 26.67 %, 17.86 %, 14.58 % and 4.35 %, respectively. Among 55 cases receiving re-operation, there were 42 with distal esophago-fundusectomy, 11 mesocaval shunt(MCS)and 2 re-devascularization. The other 11 cases received nonoperative therapy. ResultsThe mortality, mean follow-up time, rebleeding rate and encephalopathy rate were 9.52% (4/42), 11 years,9.52% (4/42)and 14.29% (6/42)in distal esophago-fundusectomy group;0,7.5 years,0 and 9.09% (1/11)in MCS group. All 2 cases in re-devascularization group died within one postoperative month. All 11 cases in non-operative group were with portal hypertension gastropathy(PHG). ConelusionCombined operation may effectively reduce postoperative rebleeding rate in PHT cases and MCS is a relatively ideal method for treating rebleeding.

Objectives:To evaluate the effect of early enteral nutrition(EEN) on the structure and function of the gut, the bacterial and endotoxin translocation. Methods:SAP model was induced by injecting 1 ml/kg of combined solution of 5% sodium taurocholate and trypsin into the pancreas via pancreatic duct.15 dogs were divided into PN group and EEN group.Systemic plasma endotoxin levels was quantified.Both portal and systemic blood sample were obtained before and 1?4?7 d following SAP,and cultured for aerobic as well as anaerobic bacterial growth.Specimens of tissue from mesentery lymph nodes,lung and pulmonary portal nodes and pancreas were removed,weighed and homogenized at the 7th day. Results:The levels of systemic plasma endotoxin and the magnitude of bacterial translocation to the portal and cycle blood and distant organs were significantly reduced the protein and DNA content of the small intestine and colon increased,and the height of the villi and the thickness of mucosa and whole bowel wall of the intestinel and colon improved in EEN group as compared with those in PN group. Conclusions:We conclude that EEN can improve gut metabolism,decrease the extent of mucosal atrophy,and assist in the maintenance of the mucosal barrier function.It is effective touse EEN in severe acute pancreatitis.

Objective: To investigate the early clinical effects of tantalum augment assisted with 3D technology in treating acetabular bone defects of Paprosky type III in revision total hip arthroplasty (THA). Methods: From May 2013 to July 2017, a total of 16 patients (18 hips) undergoing revision THA were retrospectively analyzed, including 11 males and 5 females aged 58.06±8.29 years (range 44-69 years). There were 3 cases with infective loosening and 15 cases with aseptic loosening, 13 cases with Paprosky IIIA type bone defects and 5 cases with IIIB type bone defects. 3D technology was used for precise planning before operation. The tantalum augment and cup were used to repair acetabular bone defects during operation. Cup anteversion, abduction angle, ratio of the lateral and contralateral vertical distance of the center of rotation, ratio of the lateral and contralateral horizontal distance of the center of rotation and femoral offset were measured preoperatively and postoperatively. The percentages of hips located in Lewinnek safe zone were calculated preoperatively and postoperatively. Postoperative radiographic evidence of loosening and Harris score were collected at the end of the follow-up. Results: The percentage of the hips located in Lewinnek safe zone increased from 22% (4/18) preoperatively to 61% (11/18) postoperatively. The mean anteversion of the operative side was 11.99°±6.91° (range 1.71°-26.36°) postoperatively. The mean abduction angle of the operative side was 44.91°±5.93° (range 35.6°-56.0°). The mean ratio of the lateral and contralateral vertical distance of the center of rotation was 1.10±0.20 (range 0.87-1.62). The mean ratio of the lateral and contralateral horizontal distance of the center of rotation was 1.00±0.18 (range 0.69-1.46) and the mean ratio of the lateral and contralateral femoral offset was 1.01±0.66 (range 0.51-3.56). All the patients were followed-up for an average of 27.72±12.18 months (range 14-53 months). No complications, such as periprosthetic joint infection, dislocation or aseptic loosening, were observed in all patients. The mean Harris score was 77.28±4.80 (range 65-85) at 6 months postoperatively and 80.9±5.2 (range 69-89) at the end of the follow-up. Conclusion Using tantalum augmentassisted with 3D technology to re construct Paprosky type III severe bone defects of the hip can increase the accuracy of the acetabular cup positioning. The short-term outcomes are satisfying and no early prosthetic loosening was observed.

Schizophrenia is a serious mental disease. The diagnosis of schizophrenia so far relies heavily on subjective evidence, including self-reported experiences by patients, manifestations described by relatives, and abnormal behaviors assessed by psychiatrists. The diagnosis, monitoring of the disease progression and therapy efficacy assessment are challenging due to the lack of established laboratory biomarkers. Based on the current literature, clinical consensus, guidelines, and expert recommendations, this review highlighted evidence-based potential laboratory biomarkers for the diagnosis of schizophrenia, including genetic biomarkers, neurotransmitters, neurodevelopmental-related proteins, and intestinal flora, and discussed the potential future directions for the application of these biomarkers in this field, aiming to provide an objective basis for the use of these biomarkers in the early and accurate diagnosis, treatment, and prognosis and rehabilitation assessment of schizophrenia.