Objective To study the outcome of lost gallstones in peritoneal cavity. Methods Gallstones and bile collected from 51 patients undergoing laparoscopic cholecystectomy were analysed and cultured.One to three gallstones from each patient were placed into the peritoneal cavity of a corresponding Wistar rat on sterile condition. Results 8 rats died of peritoneal infection, intestinal fistula and ileus within one month. Abdominal wall abscess occured to one rat. All survival rats were sacrificed three months later. Pathologic results showed that the nidus of abscess appeared in tissue around the stone. Conclusions Lost gallstone is harmful to body. We should avoid gallstone lost in peritoneal cavity.

Objective: To explore the effect of CO 2 pneumoperitoneum in laparoscopic surgery on the cardiovascular function of the geriatric cholelithiasis.Methods:Sixty aged patients undergone laparoscopic surgery were selected.During various stage of CO 2 insufflation,the heart rate(HR),blood pressure,oxygen saturation ,electrocardiogram(ECG),and myocardial enzymes were dected,and the clinical values of these changes were analyzed.Results: when CO 2 pneumoperitoneum established ,the HR and blood pressure were increased obviously .The incidence of arrhythmia was 36% and the incidence of changes of ST segment was 30%,10 minutes after pneumoperitoneum eliminated,these changes were restored. The myocardial enzymes and the oxygon saturation of blood had no distinct changes. Conclusion: The procedure of CO 2 pneumoperitoneum caused temporany changes of the HR ,SBP/DSP and ECG.The laparoscopic surgery is effective and safe for geriatric cholelithiasis.It suggests that the dynamic monitoring of electrocardiogram is necessary,especially for those with abnormal heart function.

Objective To investigate the effect and the mechanism of intragastric administration of gentamicin and lactulose on stress ulcer in rats with obstructive jaundice.Methods Forty male Wistar rats were divided into 4 groups: Jaundice(Ligation of the bile duct) and intragastric administration of gentamicin and lactulose(group A),jaundice with intragastric glucose(group B),sham operation with intragastris gentamicin and lactulose(group C);and sham operation with intragastric glucose(group D).Two weeks after the operation,the respective intragastric administration was given for 7 days,and then the water immersion and restraint stress induction procedures were performed in the 4 groups.Endotoxemia levels in portal vein were measured by the Limulus test and the ulcer index was calculated.Results Group A showed significantly lower ulcer index and lower level of endotoxemia compared to group B,while the levels of endotoxemia and ulcer index in group B were increased,and group C and D also showed lower ulcer index and lower level of endotoxemia.Conclusions Endotoxemia is an important aggravating factor for stress ulcer in obstructive jaundice.Intragastric administration of lactulose and gentamicin can decrease the level of endotoxemia which is beneficial to reduce the incidence of stress ulcer in rats with obstructive jaundice.

OBJECTIVE:To establish the quality standard for Compound huaihua granules.METHODS:Sophora japonica,salvia miltiorrhiza,and Lonicera joponica in the formulation were identified qualitatively by TLC,and the content of rutin in Sophora japonica was determined by UV spectrophotometry.RESULTS: The TLC spots were clear and well-separated.The linear range of rutin was 2.904～14.52 ?g?mL-1(r=0.997 7) and its average recovery was 98.43%(RSD=0.55%,n=6).CONCLUSION: The established standard is suitable for the quality control of Compound huaihua granules.

Objective To evaluate the specificity of CD105 labeled microvessel density (MVD)and its clinical significance.Methods Formalin fixed,paraffin wax embedded specimens from 63 patients with hepatocellular carcinoma (HCC) were stained with anti-CD105 monoclonal antibody.A correlation was analyzed between the expression and distribution of MVD-CD105 in HCC/adjacent non-tumorous tissues and clinicopathological features.Results CD105 immunoreactivity was seen in all the specimens of HCC and adjacent non-tumorous tissues.Immunoreactivity intensity was higher in adjacent non-tumorous tissues than in HCC (χ2=9.184,P＜0.01).The mean scores of M VD-CD105 were also higher in adjacent non-tumorous tissues than in HCC.The levels of expression and distribution of MVD-CD105 in HCC were associated with tumor metastasis and TNM staging (P＜0.01).The levels of expression and distribution of MVD-CD105 in adjacent non-tumorous tissues were associated with TNM staging and 2-year survival rate (P＜0.01).Conclusions CD105 showed no specificity in labeling MVD of HCC specimens.The higher level of expression and distribution of MVD-CD105 in HCC was associated with local tumor metastasis and progression.CD105 cannot be used as a target for anti-angiogenesis therapy for HCC.

Objective To explore the clinical value of laparoscopy in the treatment of pancreatic diseases.Methods Twelve patients with pancreatic diseases received laparoscopic surgery.Among which 9 patients with cystic diseases,4 cases underwent laparoscopic spleen-preserving distal pancreatectomy,2 cases received distal pancreatectomy and splenectomy,and 3 cases underwent pancreatic cystectomy.Laparoscopic insulinoma enucleation was performed for 2 patients who suffered from insulinoma.Besides,a patient suffered from pancreatic carcinoma recurrence received left thoracoscopic splanchnicectomy.Results All the operations were accomplished successfully,including 8 total laparoscopic surgery and 4 laparoscopic assisted surgery.The average operative time was 225 min(range 100-420 min),and the average volume of blood loss was 80 ml(range 2-150 ml).Pancreatic fistula was observed in 1 patient which was cured by conservative therapy.The postoperative average hospital stay was 7.2 d(range 5-13 d).The patient with recurrent pancreatic carcinoma survived for 6 months after operation and the pain-killing effect was satisfactory.With a follow-up of 10-36 months for other patients,the surgical effects were ideal and no recurrence occurred.Conclusion With the advantages of less trauma,less pain,fast recovery,and low morbidity rate,laparoscopic surgery is an effective and safe method for the treatment of pancreatic diseases,and thus may be widely used in the clinical settings in the future.

Objective:To study the expression of tenascin in hepatocellular carcinoma(HCC)and to investigate the roles of tenascin expression in microvessel angiogenesis,invasion,metastasis and prognosis of HCC.Methods:Formalin fixed,paraffin wax embedded specimens from 63 HCC patients were stained with an anti-tenascin monoclonal antibody,and the measurements were also done for paracancerous specimens from the same patients and specimens from 15 patients with liver cirrhosis and 10 normal liver.The correlation was analyzed between expression of tenascin and clinicopathological features as well as microvessel angiogenesis.Results:Tenascin immunoreactivity was observed in 65.1% samples of HCC,69.8% of paracarcinoma,20.0% of liver cirrhosis and negative of normal liver samples.Positivity and intensity of tenascin expressions in samples of HCC and paracarcinoma were higher than those in samples of cirrhotic and normal liver.Tenascin expression was correlated with Edmondson-Steiner grades,tumour numbers,capsule invasion,tumour metastasis and microvessel angiogenesis.Conclusion:The up-regulation of tenascin expression may play an important role in invasion and metastasis of HCC.

Objective To evaluate the significance of hemihepatic vascular occlusion with extrahepatic control of major hepatic veins for hepatectomy in cirrhotic carcinoma. Methods A retrospective comparative study for hepatectomy in patients with hepatocellular carcinoma(HCC) using Pringle maneuver (groupA,n=44),hemihepatic vascular occlusion(group B,n=76) and hemihepatic vascular occlusion plus extrahepatic control of major hepatic veins(group C,n=85)were made from March 2006 to September 2008.The amount of intraoperative bleeding,time of operation,postoperative liver function,liver function recovering and complications were compared.Results There was significant difference in the amount of intraoperative blood loss between the three groups(543.7 ml、415.8 ml、324.5 ml,respectively,F=98.96,P<0.001).There was no difference in the time of operation.The level of serum alanine transaminase(ALT) and that of serum bilirubin on the 3rd and 6th day postoperatively in group B,and C was significantly lower than that in group A.Conclusions Hemihepatic vascular occlusion with control of major hepatic veins results in selective liver isolation from the systemic circulation,which is more effective than Pringle maneuver for controlling intraoperative bleeding without interruption of hemodynamic stability in liver cancer patients.

Objective To study the effect of ribozyme mediated inhibition on telomerase activity and cell(proliferation) of GBC-SD cells.Methods According to the hTR template two wings region sequence,the hammerhead ribozyme gene sequence was synthesized in vitro.Then,it was engineered into the eukaryon(expression) vector pTriEx-4.Lipofectamine was used to transfect the carcinoma of gallbladder.The inhibition of telomerase activity and cell proliferation in GBC-SD cell was observed,and compared with control group.(Results) Compared to control group,ribozyme can significantly inhibit telomerase activity and cell proliferation of GBC-SD cell.After ribozyme action,the cell ratio of G_0/G_1 markedly increased,and the cell ratio of S phase markedly decreased.Cellular cleavage and proliferation was markedly inhibited.The apoptosis rate was 17.10% and 31.01% on day10 and day13 after ribozyme action.Conclusions Ribozyme can inhibit(telomerase) activity of GBC-SD cells effectively and induce cell apoptosis.

Objective To investigate complications and mortality of primary reamed intramedullary nailing for femoral shaft fractures in patients a ssociated with thoracic injuries. Methods A retrospective a nalysis of trauma data was performed and the case selection based on the followi ng criteria: (1) patient age of 17-65 years, (2) patients with multiple injury ( ISS≥16) as well as complicated thoracic trauma (AIS≥2), (3) hospitalization stay ≥48 hours, (4)no serious pre-existing medical diseases in history, (5) as sociated femoral shaft fractures treated with reamed intramedullary nailing, ext ernal fixation, plate, cast, traction and unreamed intramedullary nailing. The s elected patients were divided into two groups according to the interval from inj ury to operation, ie, those within 24 hours as Group A and beyond 24 hours as Gr oup B. Results During the study period, 96 patients met the criteria for the investigation. There were 57 patients in the Group A and 39 pa tients in the Group B. In two groups, there was significant difference in incide nce of open femoral shaft fractures (53% in the Group A and 31% in the Group B, ? 2=4.496, P