Objective To explore the value of the combination of endoscopic sphincterotomy (EST) and laparoscopic cholecystestomy (LC) in the treatment of Cholecystolithiasis with extraheptatic bile duct stones. Methods 62 cases with cholecystolithiasis combined with extraheptatic bile duct stones were underwent LC following EST. Results Two cases were treated with common bile duct exploration after the failure of EST. 60 cases were executed sucessfully by EST and LC. No case occured serious complications. 8 patients with transient hyperamylasemia and 4 cases with intestinal bleeding after operation were cured by means of conservative therapy. Conclusion Combination of EST and LC is a safe and effective method in the treatment of cholecystolithiasis with extraheptatic bile duct stones.

BACKGROUND:In China there is no norm to assess anxiety disorders in children.The Chinese urban norm for screening child anxiety related emotional disorders is applicable to assessing anxiety problem in Chinese children and assisting clinical diagnosis,research and epidemiological investigation. OBJECTIVE:To develop the norm for screening child anxiety related emotional disorders(SCARED) in Chinese cities,and test the reliability and validity of this scale. DESIGN:A sampling survey taking the students of Grade 2 and up in elementary schools and junior middle schools in 14 big and medium sized cities in China and children with anxiety disorders who visited children's mental clinics in Changsha,Jinan and Shenzhen cities from October 2001 to April 2002,as the subjects. SETTING:The psychiatric department of a provincial specialized mental hospital. PARTICIPANTS:A total of 2 019 subjects(1 012 males and 1 007 females) with the mean age of(11± 2) years old were selected from 14 cities in China(Beijing,Tianjin,Taiyuan,Siping,Wuhan, Changsha,Xi'an,Shenzhen,Mianyang,Jinan,Fuzhou and Yichun) from October 2001 to April 2002.The students and their parents(norm group) filled in SCARED,and meanwhile,90 children with anxiety disorders who visited children's mental clinics in Changsha, Jinan and Shenzhen were taken as anxiety group. INTERVENTIONS:The children completed one copy of SCARED in the classroom during regular classes after informed consent was obtained, and then the questionnaires were collected on the spot. Another copy of SCARED was taken home by the children to be completed by the parents.Meanwhile,in Changsha,the parents filled in the child behavior checklist(CBCL) while their children completed the Piers Harris children's self concept scale(PHCSS).The reliability and validity of SCARED were determined. MAIN OUTCOME MEASURES:Reliability and validity of SCARED. RESULTS:The test retest coefficients of SCARED ranged from 0.567 to 0.608,split reliability of SCARED was 0.88,and Cronbach alpha(α ) coefficients were 0.43 to 0.89,with good reliability. Significant correlations were found between the total scores and anxiety indexes of SCARED and Achenbach CBCL(r=0.564,0.603,P< 0.05).The children in anxiety group scored higher in SCARED than those in norm group(t=8.06 to 12.89,P=0.000). Sensitivity and specificity of diagnosis of anxiety disorder were 0.74 and 0.79,respectively. CONCLUSION:The reliability and validity of SCARED are good, suggesting that the norm is applicable to assessing anxiety disorders in Chinese children.

OBJECTIVE:To observe the adjunctive efficacy of allicin for restenosis of geriatric myocardial infarction (MI) after percutaneous coronary intervention (PCI). METHODS:From Jan.to Dec.2007,150 geriatric MI patients after PCI were divided into 2 groups (n=75 each),i.e. conventional therapy group and allicin group (allicin 40 mg tid plus conventional therapy). After treatment for 1 year,plasma levels of restenosis markers including endothelin-1,CRP,NO were tested; Coronary arteriography was carried out to reveal the restenosis situation; Angina attack frequencies were also recorded. RESULTS:66 cases in allicin group vs.57 in conventional therapy group had no recurrence of angina,with the effective rate being 88% in allicin group vs.76% in conventional therapy group,showing significant differences between the two groups (P

Objective:To investigate the relationship between body mass index (BMI) and invasive mechanical ventilation time in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:Medical records of 72 patients with AECOPD admitted to Zhejiang Xin′an International Hospital from June 2018 to December 2019 were retrospectively analyzed. According to BMI, they were divided into the low body mass group (BMI<18.5 kg/m 2), the normal body mass group (18.5 kg/ m 2 ≤ BMI < 24.0 kg/m 2), and the obesity and overweight group (BMI ≥ 24.0 kg/m 2). According to the time of invasive mechanical ventilation of patients, they were divided into invasive mechanical ventilation time>7 d group and ≤ 7 d group. The changes of baseline data in each group were compared, and the risk factors of invasive mechanical ventilation time of patients with AECOPD were analyzed. Results:The incidence of hypertension and diabetes in the obesity and overweight group were higher than those in the low body mass group: 11/15 vs. 31.8(7/22), 8/15 vs. 13.6%(3/22), P<0.05. Before intubation, the level of ALB in the obesity and overweight group was higher than that in the normal body mass group and the low body mass group: (34.77 ± 5.11) g/L vs.(33.02 ± 4.86), (29.13 ± 3.64) g/L, the level of ALB in the normal body mass group was higher than those in the low body mass group , and there were significant differences ( P<0.05). The time of invasive mechanical ventilation in the obesity and overweight group was shorter than that in the normal body mass group and the low body mass group:(9.51 ± 1.38) d vs. (11.03 ± 1.91), (14.11 ± 2.36) d, the time of invasive mechanical ventilation in the normal body mass group was shorter than that in the in the low body mass group, and there were significant differences ( P<0.05). But there were no statistically significant differences in gender, age, smoking, complicated gastrointestinal bleeding, abdominal distension, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, exudation, ventilator modes, pH values, arterial partial pressure of carbon dioxide (PaCO 2) before intubation and arterial partial pressure of oxygen (PaO 2) before intubation of patients in the three groups ( P>0.05). Complicated diabetes mellitus, gastrointestinal bleeding, abdominal distension, BMI<18.5 kg/m 2, the rate of exudation and APACHEⅡscore in the invasive mechanical ventilation time ≤ 7 d group were lower than those in the invasive mechanical ventilation time>7 d group. Before intubation, ALB levels in the invasive mechanical ventilation time ≤ 7 d group were higher than those in the invasive mechanical ventilation time >7 d group ( P<0.05). The Logistic regression analysis results showed that complicated gastrointestinal bleeding, abdominal distension, BMI<18.5 kg/m 2, APACHEⅡscore > 10 points, before intubation, ALB< 30 g/L were independent risk factors of invasive mechanical ventilation time of patients with AECOPD ( P<0.05). Conclusions:In addition to the mechanical ventilation related complications and high APACHEⅡscore, malnutrition is an important risk factor affecting invasive mechanical ventilation time of patients with AECOPD before intubation.

[Objective]To discuss the effects of DHS and compression screw application on femoral intertrochanteric fracture.[Method]Internal fixation was performed with DHS,DHS and compression screw,Ender nail and proximal femoral anatomical plate in 185 patients with femoral intertrochanteric fracture.The main outcome measures were operation duration,coxa adducta rates and postoperative Sanders scoring.[Result]All patients were followed up for 9-48 months.Operation duration was similar in the four groups.There were significant differences in coxa adducta rates and postoperative Sander's scores.According to the Sander's scores,the excellent to good rates in DHS and compression screw,DHS,Ender nail and proximal femoral anatomical plate groups were 94.6%,85.3%,75.4% and 80.6%,respectively.The coax adducta rates were 2.4%,9.5%,22.2% and 19.2%,respectively.[Conclusion]All the four kinds of internal fixation can be used for femoral intertrochanteric fracture,but DHS and compression screw is the best one for its good restoration of joint function and has no or little complication.

Objective To develop a quick, simple and sensitive method for determination of sulfuric acid mist in the air by ion chromatography. Methods The samples were collected by Nillipore filter, Na2CO3-NaHCO3 solution was used and the samples were analyzed by using ion-chromatography as well as external standard curve. Results The linear range of the method was 0.5-10.0 ?g/ml and the correlation coefficient was 0.999 8. The RSD for the test accuracy and variation of repeat tests within one day or between the different days was

The morbidity of pancreatic duct calculus is increasing every year in China. Currently the main therapeutic methods include non-surgical treatment and surgical treatment. Non-surgical treatments contain endoscopic calculus extracting and / or extracorporeal shock wave lithotripsy. Surgical treatment has two categories: drainage of the pancreatic duct decompression and pancreatectomy. Concrete treatment or surgical options should follow the strategy of individual.

Objective To explore the incidence, etiological and protective factors, and preventive countermeasures of deep venous thrombosis (DVT) in patients undergoing hip surgery. Methods Four hundred and forty-one patients who had hip fracture surgery in our department from January, 2005 to May, 2010were analyzed retrospectively. They were 223 males and 218 females, aged 65.7 years. (range, 22 to 87). A binary logistic regression was performed, using gender, age, duration of surgery, surgery type, anesthesia type, blood transfusion, physical therapy, thrombo-prophylaxis and complication as covariates, taking DVT incidence as the dependant variable. Results The patients obtained a median follow-up of 17.2 months (range, 3 months to 4 years and 7 months). Sixty-nine patients developed DVT (incidence, 15.6%).Analysis of multiple variables showed that duration of surgery, anesthesia type, blood transfusion, hypertension and diabetes were risk factors to DVT. Physical therapy and thrombo-prophylaxis were protective factors.Age, gender and surgery type had no statistically significant influence on DVT (P ＞ 0.05). Conclusions The DVT incidence after hip fracture surgery is high. In order to decrease the DVT incidence, surgeons should try their best to estimate risk factors for every patient perioperatively, avoid general anesthesia or blood transfusion, shorten operating duration, effectively control complications, actively perform physical therapy or thrombo-prophylaxis, and prolong the anticoagulant therapy for patients with higher risk factors.

How the hosts recognize and clear invading viruses is one of the key issues in molecular immunology. Previous studies uncovered that many early antiviral proteins, such as Type Ⅰ interferons and PKR, are strongly induced upon virus infection. These proteins not only limit virus replication and spread or cause infected cells to undergo apoptosis, but also induce consequently expression of cytokines and chemokines to initiate acquired immunity. However, the immediate-early signaling events among host and virus interaction were largely unknown. In the past few years, there are great breakthroughs in this rapidly evolving field. TLR3 and RIG-I/MDA5 signaling pathways were shown to play a crucial regulatory role in antiviral processes. These pathways are essential for the vertebrate immune system to recognize and clear RNA virus with different strategies, which are integral parts of innate immune response and directly affect later-stage acquired immunity. The recent know-how on TLR3 and RIG-I/MDA5 signal transduction pathways and their roles in antiviral immunity were summarized.

As hepatic fibrosis and cirrhosis have chronic progressive process,the assessment of fibrosis is of great significance for making appropriate treatment.It is divided into two categories,which includes invasive and noninvasive assessing methods.As a noninvasive method,magnetic resonance shows prospect in many aspects.This article is a review of magnetic resonance imaging in the assessment of hepatic fibrosis and cirrhosis.