0.05).The blood gas analysis(BGA) and pulmonary function test(PFT) were performed in patients with stable COPD.The cognitive function was evaluated by ESD in both patients with stable COPD and healthy persons as control.The patients were divided into different groups by BGA and PFT(FEV1/Pred).Results:The total score of ESD and the subtest scores of ESD in leaning,memory,calculation,constructive function were obviously lower in the patient group than those in the control group(The mean difference of the total score was 16,with the two groups' total scores as 208.1?17.6/224.3?10.6,t=5.19,P

Objective To study how to reduce the complication rate of laparoscopic cholecystectomy (LC) for acute cholecystitis. Methods A retrospective analysis was made on clinical data of 158 cases of acute cholecystitis treated by LC from September 2001 to December 2003. Results Operations were accomplished laparoscopically in 151 cases, while conversions to open surgery were required in 7 cases (1 case of Mirizzi’s syndrome, 2 cases of gallbladder carcinoma, 1 case of cholecystoduodenal fistula, 2 cases of "ice-like" adhesions in the Calot triangle, and 1 case of common bile duct stones). Open re-exploration was performed in 1 case because of biliary leakage. Intraoperative cholangiography (IOC) was successfully conducted in 10 cases, 3 of which were found common bile duct stones. Out of the 3 cases, 2 cases underwent an intraoperative endoscopic sphincterotomy and 1 received a conversion to open choledochotomy with T-tube drainage. Conclusions When utilizing LC for acute cholecystitis, the rate of conversion and the incidence of complication may be reduced as long as the patients were properly selected, the principles of safety were abided by, and the intraoperative cholangiography was performed routinely.

10.3969/j.issn.2095-4344.2013.26.005

OBJECTIVE: To explore the effects of Shenfu Injection on prostacyclin, thromboxane A2 and the activities of ATPases in rats exposed to hepatic ischemia-reperfusion injury. METHODS: Twenty-four male Wistar rats weighing 200-250 g were randomly divided into two groups: Shenfu Injection (SF)-treated group (rats were treated with Shenfu Injection of 10 ml/kg through intraperitoneal injection) and untreated group (rats were administered with normal saline at the same dose and served as a control group). Hepatic ischemia was caused by Pringle's maneuver and lasted for fifteen minutes, and then one-hour or three-hour reperfusion was performed. Venous blood samples for the measurement of thromboxane B(2) (TXB(2)) and 6-keto-prostaglandin F(1 alpha)(6-keto-PGF(1 alpha)) were collected three hours after reperfusion. Liver tissue samples were collected one hour or three hours after reperfusion for the measurement of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)-ATPase and for morphological studies. RESULTS: Plasma TXB(2) was lower in the SF-treated group than that in the untreated group after three-hour reperfusion (P>0.05), while 6-keto-PGF(1 alpha) was higher in the SF-treated group than that in the untreated group (P>0.05). The ratio of TXB(2) and 6-keto-PGF(1 alpha) was significantly lower in the SF-treated group than that in the untreated group (P<0.05). The activities of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)-ATPase in the SF-treated group were improved obviously. A three-hour reperfusion after fifteen-minute ischemia caused important hepatic histological alterations. Marked structural abnormalities were observed in the untreated group, such as massive hepatocyte swelling, necrosis, mitochondria edema and vacuolar changes. In the SF-treated group, hepatic tissue injury was reduced significantly. CONCLUSION: Shenfu Injection protects hepatic tissue from ischemia-reperfusion injury, and such protective effects are achieved by decreasing the ratio of thromboxane A(2) and prostacyclin, and increasing the activities of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)- ATPase.

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 investigate the consistency of M RI detecting posterior ligamentous complex (PLC) injury associated with thoracolumbar factures.Methods MRI data of 170 cases of thoracolumbar fractures were reviewed retrospectively.Each case underwent MRI around one week postinjury.MRI data were analyzed and compared by three physicians respectively to discuss the consistency in MRI detection of PLC injury and the severity of PLC injury.Results Kappa coefficient was 0.846 between observer 1 and 2,0.768 between observer 1 and 3,and 0.793 between observer 2 and 3.Interobserver reliability was high and overall Kappa coefficient was 0.803.Severity of PLC injury was interrelated with spinal cord nerve injury (P ＜ 0.05).Conclusions Accurate detection of PLC injury in thoracolumbar fractures is beneficial to clear the mechanical stability of the spine.MRI detection of PLC injury is of high consistency and hence deserves wide use.

ObjectiveTo investigate the expression of estrogen receptor(ER)and progesterone receptor(PR)in intrahepatic cholangiocarcinoma(ICCA)and extrahepatic cholangiocarcinoma(ECCA)comparatively.MethodsThe expression of ER and PR was detected in 24 specimens of ICCA and 34specimens of ECCA by immunohistochemistry assay.ResultsThe positive rates for ER and PR expression were 29 ％(7/24)and 46 ％(11/24)in ICCA specimens,respectively.3 cases among 9 cases of high histological grade,3 cases among 11 cases of middle histological grade and 1 case among 4 cases of low histological grade expressed ER positively,while 2 cases,7 cases and 2 cases expressed PR positively,respectively.The expression of ER and PR expressions showed no statistically significant differences between different histological grades of ICCA.ER and PR were all negative in 34 specimens of ECCA.Conclusion ER and PR show significant different expression between ICCA and ECCA,with exclusive positive expression in ICCA.ER and PR might be involved in the pathogeuesis of ICCA.

Objective To evaluate the incidence of postoperative epididymitis by laparoscopic cluster ligation and laparoscopic internal spermatic vein high ligation in the treatment of varicocele. Methods Forty-four cases of bilateral varicocele were retrospectively analyzed , who had undergone laparoscopic spermatic vein ligation. The 22 cases were treated with laparoscopic cluster ligation, and the other 22 cases with laparoscopic internal spermatic vein high ligation. The effects and the reasons of two kinds of surgical procedures on postoperative epididymitis were investigated. Results A total of seven patients were affected with postoperative epididymitis. The incidence of laparoscopic cluster ligation was 27.27%. The incidence of laparoscopic internal spermatic vein high ligation was 4.55%. All cases were affected within 4 weeks after surgery. Conclusion It is important to reserve the spermatic artery for decreasing the incidence of postoperative epididymitis.

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