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OBJECTIVE To identify the possible risk factors for the development of surgical site infection (SSI). METHODS A total of 218 consecutive patients who received open cholecystectomy due to gallbladder disease and stone of common bile duct during from the Jun to Dec in 2007 were included in the study. The potential risk factors including clinical features,biochemical data,operative types and incision types were analyzed by univariate analysis. RESULTS The overall incidence of SSI was 5.04%.The incidence of SSI in cholecystectomy alone group was lower than in cholecystectomy with exploration of common bile duct group (10.9% vs 3.1%,P=0.022).The incidence of SSI in emergency group was higher than that in selective operation group (12.5% vs 3.8%,P=0.037). The incidence of SSI among patients with white blood cell count more than 10.0?109 befove surgery was higher (12.2% vs 3.0%,P=0.025). The incidence was 1.5%,6.1% and 26.3%,respectively,for patients with Ⅱ,Ⅲ and Ⅳ types incision (P=0.000). CONCLUSIONS These findings indicate that risk factors for the development of SSI after open cholecystectomy include operation manner,operation type,incision type and preoperative leucocyte count.

Objective To analyze the rules of acupoint selection in treating knee osteoarthritis with acupuncture and moxibustion therapy based on data mining; To provide references for clinical treatment.MethodsArticles about treating knee osteoarthritis with acupuncture and moxibustion were retrived from China National Knowledge Infrastructure (CNKI), Wanfang academic periodical full-text database, Chinese Journal Full-text Database (VIP) and SinoMed in China from Jan. 1st 2006 to Jan. 1st 2016. The database of acupuncture and moxibustion prescription was set up. The Apriori association rules, system cluster analysis and factor analysis were adopted in order to analyze the rules of acupoint selection for knee osteoarthritis.ResultsTotally 190 articles were included, covering 228 acupuncture- moxibustion prescriptions, 65 acupoints and the total frequency for 1736 times. The usual acupoints in the lower limbs were Dubi (ST35), Neixiyan (EX-LE 4), and Yanglingquan (GB34). The main maridians were Stomach Meridian of Foot-Yangming, Spleen Meridian of Foot-Taiyin, and Gallbladder Meridian of Foot-Shaoyang, accounting to for 1626 times (93.66%). Cluster analysis achieved other four groups of acupoint selection based on syndrome differentiation.ConclusionLocal acupoints and dialectical point selection were important principle in treating knee osteoarthritis combined with acupoint selection based on syndrome differentiation.

Objective To investigate a new method for the reconstruction of the urethra using peritoneal free grafts in phalloplasty in a rabbit model. Methods Animal models were established in 24 adult male New Zealand white rabbits, which were randomly divided into the peritoneal graft group (n=12) and peritoneum-skin graft group (n=12). In the former group the peritoneal tube grafts with the mesothelial surface inward were used as the urethral substitutes. And a circumferential 1 cm rim of scrotal skin was inserted at the tip of the tubularized peritoneal graft for urethroplasty in the latter group. Subsequently, a superficial epigastric fasciovascular pedicle flap for phalloplasty was harvested and tubed over the reconstructed urethra. The process of growth was observed grossly. Results The reconstructed penis survived well without urethral stricture, and the peritoneal-lined grafts survived in all rabbits with a smooth, moist quality and without ulceration and fibrosis. Gross examination showed 8 meatal occlusions with fistulas simultaneously in the peritoneal graft group, and 3 fistulas in the peritoneum-skin graft group. Conclusion The authors have successfully designed the rabbit model of the urethroplasty using the tubularized peritoneal free grafts in the penile reconstruction and demonstrated the possibility of the new method for phalloplasty brings a light to clinical study.

Objective To investigate the clinico-pathological characteristics of nodular goiter (NG) with lymphocytes infiltration and its relationship with Hashimoto′s disease. Methods Clinical and histologic data were collected and reviewed for 1121 cases of nodular goiter and 55 cases of thyroid adenoma, among which 83 cases had lymphocytes infiltration. These 83 cases of NG with lymphocytes infiltration were observed histologically in detail, followed up and assessed for the correlation of thyroid function to histologic findings. Results The overall incidence of lymphocytic infiltration in non-toxic nodular goiter was 7.4% (83/1121). Most of them were women of middle age. All had lymphocytes infiltration, follicule atrophy and oxiphilic epithelia in the background of nodular goiter. Seventy-six percent underwent cystic degeneration or had fibrous scar. Nineteen percent with lymphocytes infiltration in NG developed post-operative hypothyroidism. Six cases (7%) had high levels of thyroid auto-antibodies. None of the 55 cases of thyroid adenoma had overt lymphocytes infiltration. Conclusion Nodular goiter with lymphocytes infiltration and Hashimoto′s disease shares similar morphology and clinical presentation in some degree. It seems that NG with lymphocytes infiltration is a kind of inflammatory hyperplasia relating to autoimmunity and perhaps the beginning of some cases of Hashimoto′s disease.

Objective To use estimation of physiologic ability and surgical stress (E-PASS) to assay operative risks in patients with hip fracture and to discuss its application value.Methods Sixtyfour patients with hip fractures were subjected to the retrospective review.There were 38 males and 26 females,at mean age of 54.3 years (range,19-84 years).The operative risk was assayed by E-PASS and postoperative complications as well as case fatality were detected and compared.Results Postoperative complications developed in 16 patients (25％).E-PASS score was significantly higher for the patients with postoperative complications than in those without [(0.64 ± 0.31) points vs (0.22 ± 0.31) points,P ＜ 0.05].Incidence of complications was significantly lower for patients with a E-PASS score ＜ 0.6 than for those with a E-PASS score ＞ 0.6 (19％ vs 50％,P ＜ 0.01).There were 2 deaths among 16 patients with a E-PASS score ＞ 0.6.The remaining 48 patients with a E-PASS score ＜ 0.6 obtained satisfactory recovery.Conclusion E-PASS is effective for predicting operative risk and is instructive for surgery decision in treatment of hip fractures.

Objective To study a new clinicopathological subtype of primary cutaneous T-cell lym phoma (PCTCL). Methods A case of T-cell lymphoma was systematically evaluated clinically and by using H-E staining, special staining,immunohistochemical staining,gene rearrangement and PCR.Results The skin lesion presented as tender nodules with mucocele. Skin biopsies showed that in the dermis and subcutaneous tissue,most of the angiotropic tumor cells were small T cells; no obvious epidermotropic phenomenon was detected.A few vessels were observed with obvious fibromucinous matrix formation. Immunohislochemical studies showed the following:CD3(+),CD43(+),CD45RO(+),CD56(a few),CD68(-), CD79?(-),CD20 (-), CD30(-), CD117(-), ALK(-), S-100(-),CD45R(-),EMA(-),SMA(-).The mucoid matrix was positive for Alcian blue staining.The rearrangement of T-cell ? receptor gene was detected.EBV was not detected with PCR.Conclusion Fibromucinous T-cell lymphoma rich in blood vessels is a new and distinct variant of PCTCL; it is not a subtype of mycosis fungoides.

Objective To investigate the clinicopathologic features of GIST. Method Fifty-five GIST cases were collected. Immunohistochemical assays of vimentin, CD117, CD34, S-100, SMA, desmin, NF were used to study the specimen. Results 69% (38/55) of the tumors located in the stomach, 18% (10/55) in the small intestine. Tumors varied greatly in size, ranging from 0.4 to 40 cm (average 6.7 cm). Morphologic criteria of malignancy are tumor size≥5 cm, mitotic rates≥5/50 HPF and ulcer formation and there were significant differences between the benign and the malignant. Immunohistochemical staining results: CD117 positive in 39 cases(71%), CD34 in 45 cases (82%), S-100 in 19 cases (35%), SMA in 12 cases (22%), vimentin in 32 cases (58%), desmin in 6 cases(11%),and NF in 2/4 (50%). All 13 benign cases were alive on the latest follow-up. In 42 cases of malignancy and potential malignancy, 4 developed metastasis, 13 died. Conclusion (1) GIST occur predominantly in middle-aged and older persons.(2) The main criteria of malignancy of GIST are tumor size≥5 cm, mitotic rates≥5/50 HPF and ulcer formation. (3)Whereas it is difficult to identify true leiomyomas/leiomyosarcomars and neuogenic tumors from GIST, immunohistochemical staining is capable of doing this.

The aim of this study was to investigate the effect of Compound Yihe Tea on improving insulin resistance in obesity mice. Thirty-two male C57BL/6J mice were randomly divided into 4 groups: the normal fat diet group(NFD group), high fat diet group(HFD group), Compound Yihe Tea low dosage group［20 mg/(kg ·d), YH-L group］ and high dosage group［40 mg/(kg ·d), YH-H group］. NFD group was given standard feed, and the remaining mice were administered with high fat diet. After 6 weeks, YH-H and YH-L groups were given Compound Yihe Tea for 6 weeks. Blood glucose was measured at week 11 and serum levels of total cholesterol(TC), serum triglyceride(TG), low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were measured at week 12. Liver tissues were prepared for oil red O and HE staining. Immunohistochemical analysis was used to test the protein expression of GLUT4 in liver. Protein expressions of PI3K, Akt and GLUT4 in epididymis white adipose tissue(WAT)were tested by Western blot. The results showed that Compound Yihe Tea could effectively reduce body weights and the serum levels of TC, TG and LDL-C. Furthermore Compound Yihe Tea could improve the histopathological changes of liver, up-regulate the protein expression of PI3K, Akt and GLUT4 in epididymis WAT and the protein expression of GLUT4 in liver. Compound Yihe Tea can reduce the fat accumulation in liver tissue, improve the indexes of blood glucose and lipid levels, and improve insulin resistance via PI3K-AKT-GLUT4 pathway.