Objective To explore the operative timing and cause of death in the patients with acute cholangitis of severe type(ACST). Methods The clinical data on the treatment and the prognosis of 116 patients with ACST were analyzed retrospectively. Results 10 cases died during perioperative period.The patients who received operation within 6 hours after toxic shock all survived.Of 8 cases who received operation after 24 hours,7cases died from toxic shock and multiple organ deficiency of function (MODF) within 4 days of post-operation. Conclusion Operation should be performed before toxic shock or mental symptom occurred in the patients with ACST. The earlier the operation was performed, and the better the prognosis was. The main causes of death were delayed operative time,severe complications and senility.

Objective To study the cause of mis-diagnosis on carcinoma of large intestine in young people. Methods We retrospectively reviewed and analyzed the diagnosis and treatment of 62 young people with carcinoma of large intestine from 1990 to 2002. Results Among 36 cases of rectal carcinomas, 7 were diagnosed as colonitis,5 as hemorrhoid,3 as dysentery and 2 as perianal abscess with anal fistula. Among 26 cases of colon carcinomas, 3 were diagnosed as periappendic abscess,2 as colonitis and 1 as iron deficiency anemia.The rate of mis-diagnosis was 37 1%. Conclusions Carcinoma of large intestine in young people was a high malignant tumor with bad prognosis and little symptom in early stage. Surgeons should pay a great attention to the characteristic of this carcinoma to diagnose and treat early

Objective To explore the effect of surgical management of left colon cancer with acute obstruction.Methods A retrospective analysis was made on the clinical data of 85 cases with acute obstructive colorectal carcinoma treated by one-stage resection.Among the 85 cases,there were 48 cases of left colon obstruction (treatment group),and the control group included 37 cases of right colon cancer.To compare the occurrence of postoperative complications.Results 20 cases had postoperative complication in the treatment group,among which,2 cases had anastomosis fistula,4 cases of pulmonary infection,5 cases of abdominal abscess,6 cases of incision infection and 3 cases of intestinal adhesion.In control group,there were 15 cases had complication,among which,1 case had anastomosis fistula,3 cases of pulmonary infection,3 cases of abdominal abscess,5 cases of incision infection and 3 cases of intestinal adhesion.There was no significant difference in incidence rate of complication between two groups (P ＞ 0.05).Conclusion One stage resection in the treatment of left colon cancer with acute obstruction is safe and feasible.

Objective To investigate the different influencing on the healing of anastomotic stoma between two kinds of alimentary canal reconstruction after laparoscopic radical resection of low rectal cance.Methods The clinical data of July 2013 -January 2016 suffering from stage Ⅱ -Ⅲ low rectal cancer and in our hospital underwent laparoscopic colorectal cancer radical surgery patients was retrospectively analyzed.Through accessing to medical records,the patients of diabetes,hypoproteinemia,malnutrition,preoperative uncorrectable cases and received neoadjuvant therapy were excluded.More than a total of 59 cases were enrolled,34 cases of them received traditional alimentary canal reconstruction(traditional group,including 26 cases of low rectal cancer,8 cases of super low rectal cancer,also 21 cases of them in stageⅡand 13 cases in stage Ⅲ),25 cases of them received anal anastomosis resection (including 18 cases of low rectal cancer,7 cases of super low rectal cancer,also 20 cases of them in stage Ⅱ and 5 cases in stageⅢ).Results In the traditional group,1case of 34 patients with anastomotic leakage,3 cases of anastomotic bleeding, while in the improved group,2cases of 25 patients with anastomotic leakage,2 cases of anastomotic bleeding.There was no significant difference in the incidence of anastomotic leakage and anastomotic bleeding between the two groups (3cases vs.2cases,1case vs.2cases,χ2 =0.13,0.75,all P >0.05).All cases did not occur in patients with anastomotic stenosis,and all patients were cured and discharged.Conclusion Each of the two methods have their advantages and disadvantages.Through preoperative,intraoperative evaluation of tumor status,reasonable choice of tumor treatment and anastomosis,is more conducive to postoperative recovery.

Objective To explore the efficacy of surgery in the treatment of hepatolithiasis .Methods The clinical data of 98 patients with hepatolithiasis treated with different surgical procedures were retrospectively anan -lyzed,there were 91 cases transhepatic cholangiolithotomy treatment and 7 cases hepatolobectomy .Results 25 cases were found residual stone after operation .Recurrence calculus(10 cases),liver abscess(2 cases),and complicated by bile duct carcinoma(4cases) were found in following -up.2 cases were dead.The total effective rate was 97.96%. Conclusion Correct operation methods of calculus of intrahepatic duct was the key of reduction residual stone after operation.Resection extra-lateral lobe and choledchoscope are main means of reduction residual stone after opera -tion.

Objective To investigate the correlation between expression of Panton-Valentine leukocidin gene and accessory gene regulator among different clinical isolates of Staphylococcus aureus.Methods All non-duplicate Staphylococcus aureus clinical isolates were isolated from various clinical specimens of the patients at 4 hospitals from January 2003 to December 2010.Panton-Valentine leukocidin genes among Staphylococcus aureus clinical isolates were detected by PCR and DNA sequencing.The expressions of lukS-PV and agrA were determined by real-time PCR.Results Ninty-six S.aureus isolates including 58 hospital-acquired and 28 community-acquired isolates were positive for PVL genes,among which 54 from blood,33 from pus and 9 from sputum.Ten isolates cannot be classified due to lack of information.Sixty-seven and 29 PVL-positive isolates were isolated from the specimens of adults and children.The median relative quantities of lukSmRNA of the isolates from pus and blood were 1.500 and 0.818.The quantity of lukSmRNA among the isolates from pus was significantly higher than that from blood (U =634,P =0.025).The median relative quantities of lukSmRNA of the isolates from children and adults were 1.292 and 0.540,respectively.The quantity of lukSmRNA among the isolates from children was significantly higher than that from adults (U =660,P =0.013).The median relative quantities of lukSmRNA among community-acquired and hospital-acquired isolates were 1.034 and 0.536,respectively.The quantity of lukSmRNA among community-acquired isolates was significantly higher than that from hospital-acquired isolates (U =338,P =0.012).The correlation coefficients between lukSmRNA and agrAmRNA of total isolates,pus isolates and blood isolates were 0.592 (P ＜ 0.01),0.810 (P ＜ 0.0l) and 0.543 (P ＜0.01),respectively.While the correlation coefficients of those among the isolates from children and adults were 0.804 (P ＜ 0.01) and 0.476 (P ＜ 0.01).The correlation coefficients of those among the isolates from community-acquired and hospital-acquired isolates were 0.767 (P ＜ 0.01) and 0.556 (P＜0.01).Conclusions The quantity of lukSmRNA of Staphylococcus aureus isolates from pus was significantly higher than that from blood.The agr may have positive regulation effect on the expression of lukS/F-PV,especially among the isolates from pus and children.(Chin J Lab Med,2013,36:313-317)

Objective To explore the levels of leptin(LEP) and soluble leptin receptor (sOB‐R) in breast cancer patients′ser‐um ,and to discuss the relationship between LEP ,sOB‐R ,free leptin index(FLI) and the patients′clinical pathologic features .Meth‐ods 70 serum specimens of breast cancer patients who confirmed by pathological diagnosis were collected before the surgery ,the serum of benign breast disease group(n=50) and normal group(n=50) were also collected as control .The levels of LEP and sOB‐Rinserumweredetected,andtheresultafterbodymassindex(BMI)correctionwereanalyzed.Finally,therelationshipbetweenthe expression of LEP ,sOB‐R and clinical pathologic features were analyzed .Results The serum level of LEP in breast cancer group was highly increased than the other two groups (P<0 .05) ,and sOB‐R was reduced(P<0 .05) .After BMI correction ,LEP was still highly increased(P<0 .05) ,but sOB‐R was no significant difference (P>0 .05) .The level of LEP in the postmenopausal breast cancer patients were highly increased than menopause patients (P>0 .05) ,and the expression of LEP in cancer group were signifi‐cant higher than two control groups by both postmenopausal and menopause (P>0 .05) .The result suggested the serum level of LEP and FLI are associated with pTNM stages and lymph node metastases (P<0 .05) ,and elevated level of LEP in postmenopausal patients had differences in pTNM stages and lymph node metastases (P< 0 .05) .Conclusion The serum LEP level and the FLI may be potential indicators to evaluate the prognosis of the patient with breast cancer .The serum LEP may promoted the process of the postmenopausal patients of breast cancer .

Objective To compare the influence of laparoscopic inguinal hernia repair ( TAPP) and open inguinal hernia repair(Lichtenstein) on clinical serum swelling and the prevention and treatment strategy.Methods From September 2015 to September 2016,117 patients with inguinal hernia in the Second People's Hospital of Shantou were selected.The patients were divided into TAPP group and Lichtenstein group according to the operation mode .The incidence of seroma,occurrence,characteristics and diagnosis and treatment of the two groups were compared.Results There were 64 cases in the TAPP group,aged 25-73 years old,the median age was 57 years,58 cases of indirect inguinal hernia,4 cases of direct hernia ,2 cases of femoral hernia ,3 cases of refractory hernia.There were 53 cases in the Lichtenstein group,aged 24-84 years old,the median age was 63 years,41 cases of indirect inguinal hernia , 10 cases of direct hernia,2 cases of femoral hernia ,7 cases of refractory hernia.There was no statistically significant difference in the incidence rate of seroma between the two groups (P＝0.875).There were no statistically significant differences in the incidence rate of different types of seroma (all P＞0.05).There was no need for treatment of 0-II type seroma.The type III -IVa clinical seroma could be given local puncture parallel compression treatment , improved after treatment.After drainage and anti -inflammatory treatment, type IVb seroma was improved. Conclusion There is no difference in the incidence of seroma and the treatment between the two surgical procedures after inguinal hernia repair.