[Summary] The article reported 107 cases of bile duct residual stones treated by plasma shock wave lithotripsy with inverse flush under fiber choledochoscope via T-tube fistula.Of the 107 patients, stones were completely removed in 98 patients, and residual stones remained in 9.Intraoperative biliary hemorrhage occurred in 5 cases, which were stopped after spraying the norepinephrine . There were 4 cases of arhythmia , 13 cases of subcostal or upper abdominal pain , and 11 cases of abdominal distention and diarrhea , all of which were cured by symptomatic treatment .Postoperative biliary infection occurred in 7 cases, which were cured by anti-infection and biliary drainage.Except for 1 patient of lost of follow-up, 106 patients were followed for 6 months.Ultrasound and CT examinations showed free of calculus in 101 cases, and intrahepatic bile duct residual stones in 5 cases.We deem that plasma shock wave lithotripsy combined with reverse flushing under fiber choledochoscope is a minimally invasive , safe, and effective treatment for difficult biliary residual stones .

objective To analyze the causes of early complications following posterior lumbar spinal operations and to find out about the way for prevention and treatment of those complications. Methods From 1998 to 2002, 903 patients underwent posterior lumbar spinal operations ,there were 587 males and 316 females , with an average age of 36.7years (range, 18 to 78 years ). The diagnosis of patients included lumbar disc prolapse in 483, lumbar stenosis in 145, lumbar spondylolisthesis in 96, lumbar fracture in 94, lumbar instability in 27, lumbar tuberculosis in 15 spinal tumors in 24 and reoperation in 19. All patients were evaluated by the medical history, clinical examination and review of the imaging data, and then the surgical plan was made respectively according to clinical evaluation. Results Early complications of 78 complications within 2 weeks post-operatively occurred in 76 cases with the incidence of 8.6%(78/903), in-cluding of 49 males and 27 females with an average age of 44.6 years. The complications consisted of 50 nerve root irritations(64.1%, 50/78), most of which relieved at 4 to 30 days after treatment, 9 gastrointesti-nal symptoms(11.5%, 9/78), all of which disappeared at 3 to 10 days but 2 cases needed enema, 4 hematomas of incisional wound(5.1%, 4/78), 4 cerebrospinal fluid leakages(5.1%, 4/78), 3 urinary reten-tions(3.9%, 3/78), 2 deep infections(2.6%, 2/78), 2 deep vein thrombosis(2.6%, 2/78), 2 pulmonary em-bolisms(2.6%, 2/78),1 infection of urinary tract(1.3%) and 1 fatty liquidization(1.3%, 1/78). The opera-tional procedure possible leading to surgical complication were laminectomy, nerve root dissection and in-strumentation. Conclusion Early complications may determine the clinical result of the posterior lumbar spinal operations. Besides the skilled technique, thorough pre-operative planning, close observation and proper management after operation, and early post-operative rehabilitations are of great benefit to the pre-vention and treatment of the complications.

Objective To evaluate the biomechanical featu res of the HOIST in the treatment of lumbar spondylolisthesis.Methods Seven fresh cadaver specimens from L 2 to sacrum was used in the study.Each specimen was tested in five states:intact state as the control,spon dylolisthesis model by Panjabi meth od without fixation,spondylolisthesis model fixed with HOIST device,fatigued test of the HOIST and fixed with DICK system.During the experiment,the flexion,extension,bilateral bending and axial rotation loading we re applied to the specimens and measure d with three dimensional analysis ap paratus.A fatigue process of HOIST device was carried out with multifunctional test system(MTS 858,American).The ranges of motion(ROM)of spinal segments were determined with two special cameras and t test was used in statistical analysis.Results The ROM in spondylolisthesis state was significantly greater than that o f the others(P0.05).The difference among two HOIST grou ps and DICK group was not significant at the0.05level except the ROM of left axia l rotation(P

Objective To observe the expansion of transverse width of post screw-implantation in the pedicle and assess the effect of the relative diameter and BMD on the expansive rate. Methods There were 48 vertebral bodies, and 96 pedicles, obtained from 4 human cadaveric T2～L1 specimens (the mean age of 41 years). The BMD(A), pedicle width (B) and height were measured respectively. According to groups of BMD(A1:0.44～0.52 g/cm2;A2:0.52～0.70 g/cm2;A3:0.70～0.92 g/cm2 and the relative diameter(screw/pedicle)(B1:40%～55%;B2:55%～70%;B3:70%～85%), the tests were classified into 9 groups (A1B1?A1B2 ?A1B3?A2B1?A2B2?A2B3?A3B1?A3B2 and A3B3). The implantation procedure was carried out under the uniform standard. Results The number of valuable date was 85, while 11 dates were excluded, including 4 burst pedicles in A3B3 group. According to the statistical analysis, the pedicle width was expanded after implantation. The expansive rate of pedicle width was influenced significantly by the relative diameter and BMD(P

Objective To observe the effects of insulin pump therapy on type 1 diabetes mellitus children with diabetic keto or diabetic ketoa-cidosis(DK/DKA).Methods Forty-three children with DK/DKA were randomly divided into treatment group(n=26)and control group(n=17).The patients in treatment group were treated with insulin pump,control group were received small amount insulin injravenous injection.The changs of blood sugar,urine ketone bodies,incidence of hypoglycemia and length of stay were observed.Results 1.The effect of decreasing sugar was the same between two groups.2.There was no hypoglycemia events in treatment group.But 2 cases in control group had hypoglycemia.3.There was significant difference of length of stay between two groups(P

Objective To explore the relationship of zearalenone (ZEA) and precocious puberty in girls.Methods The peripheral serums from 71 cases of precocious puberty girls and 50 cases of healthy girls were collected respectively and concentrations of ZEA were detected by high performance liquid chromatography.Bone age,body mass index (BMI),volume of uterus and ovaries,concentrations of estradiol (E2),luteinizing hormone (LH) and folliclestimulating hormone (FSH) were detected,and the residence of each subject was recorded as well.Results (1) In 71 patients,52 patients were diagnosed as idiopathic central precocious puberty,others were diagnosed as premature thelarche.(2) In 71 patients,serum ZEA was detected from 51 patients,and undetected in 20 patients.(3)Concentration of ZEA in precocious puberty girls [(318 ±34) ng/L]was significantly increased than that in healthy girls [(143 ± 35) ng/L,P =0.002],but no distinct difference existed between ICPP group and PT group(P =0.326).(4)Compared with uterus volume of ZEA in the undetected patients (1.975 ±0.150) cm3,the uterus volume of ZEA detected patients (2.972 ±0.180) cm3,which was significantly enlarged,there was significant difference (P =0.01) ; Percentage of overweight girls in ZEA detected patients (31.4％,16/51 cases) was lower than which in ZEA undetected patients (65.0％,13/20 cases,P =0.01) ; Although there was no statistical differences in the breast diameter,bone age,value of E2,LH and FSH between ZEA detected patients and undetected patients (all P ＞ 0.05),but the increased tendency in ZEA detected patients existed.(5) ZEA in serum was detected in 53.3％ (16/30 cases) patients living in the cities,and the rate was obviously lower than 82.9％ of the patients (34/41 cases) living in the countryside,there was significant difference (P =0.007).Conclusions ZEA is correlated with precocious puberty in girls.ZEA pollution might be one of reasons for precocious puberty occurrence.

Objective To analyze the characteristics, surgical timing and treatment of middle super thoracic fractures. Methods 35 cases of middle super thoracic fractures (T1 10) were retrospectively reviewed. Among them, 25 cases were complete injury of the spinal cord and 10 cases were neurologically incomplete injury. The bleeding in operations at different times, the ASIA grades and the sensorimotor scores were analyzed. Results The follow up showed that the ASIA grade increased by 1 to 2 degrees in 10 cases of incomplete spinal cord injury, while in complete spinal cord injury the ASIA grades hardly increased but the sense and motion scores could be improved by about 20. Conclusions Middle super thoracic fractures often involve multi vertebra body, and the spinal cord is injured severely. Decompression, fusion, internal fixation from posterior approach can obtain a satisfactory result. Neurologically incomplete injury should be treated as soon as possible, while complete injury of the spinal cord should be treated around 2 weeks after the injury.

Objective To study the MR imaging technology and 3D reconstruction of the articular cartilage of knee.MethodsConventional,2D,3D and multiparameter MR imaging scans of knee were performed in ninety patients with trauma(n=34)andosteoarthritis(n=56) of knee and 10 healthy volunteers.The articular cartilages on 3D images were reconstructed using maximum intensity projection(MIP).The mean thickness of articular cartilage was measured and analysed statistically.Results Articular cartilages of knee were clearly depicted by MR imaging technique and 3D.On 2D FSE sequence,about 50% of articular cartilage appeared as three laminar apearance.On 3D imaging,the three-dimensional morphology of articular cartilage was showed clearly.Conclusion MR imaging and 3D reconstruction of the articular cartilages of knee is helpful in early diagnosis and treatment of disordered cartilages.

AIM: To analyze the change of serum inflammatory factors in glaucoma patients at different stages and its clinical significance. ·METHODS:Totally 70 cases of 128 eyes with primary open-angle glaucoma in our hospital from January 2014 to August 2016 were selected. According to the mean defect of visual field, they were divided into light ( observation Group 1 ) , moderate ( observation Group 2 ) and heavy group(observation Group 3). Another 65 cases of 130 eyes with cataract were taken as the control group in our hospital. The observation and expression of serum cytokines in these patients with glaucoma were taken. ·RESULTS:There was no significant difference in serum IL-2 and IFN- γlevels between the two groups (P>0. 05). The sIL-2R and IL-4 levels in the glaucoma group were higher than those in the control group, and the levels of IL-6 and IL-12 were lower than those of the control group (P<0. 05). The IOP and proportion of myopia in the glaucoma group was higher than that in the control group, the difference was not statistically significant ( P<0. 05) . The ratio of moderate myopia to severe myopia in each group was not statistically significant (P>0. 05). To observe the low myopia ratio in Group 3 of patients, it was less than observation Group 1 and observation Group2 ( P > 0. 05 ). There was no statistically significant difference between observation Group 1 and 2 of patients on IL-2, sIL-2R, IL-4, IL-6 and IFN-γlevels (P>0. 05). The level of sIL-2R in the Group 3 was higher than that in the Group 1, and the level of IL-12 was lower than that in the Group 1 and in the Group 2 (P<0. 05). There was no significant difference in IL-2, IL-4, IL-6 and IFN-γlevels between the glaucoma patients (P>0. 05). The IOP level and the proportion of myopia in the Group 3 were higher than those in the Group 1 and the Group 2 were observed, the difference was statistically significant (P<0. 05). The intraocular pressure was higher in Group 2 than in group 1 (P<0. 05). There was no statistically significant difference on proportion of myopia between observation Group 1 and observation Group 2 (P>0. 05). ·CONCLUSION: The levels of serum IL-12, sIL-2R and intraocular pressure in patients with primary open-angle glaucoma fluctuated significantly at different stages of the nerve injury, indicating that the immune response and intraocular pressure were involved in the process of optic nerve damage.

Objective To further understand the cellular events of myocarditis,we have examined the myocardial mitochondria structure and activity of ATPase in mice with myocarditis,and observe the interventional effect of different doses of carptopril.Methods Sixty male Balb/c mice were randomly divided into 5 groups:infected coxsackie B3 virus(CVB3)group,infected CVB3 and treated with carptopril(in a dose of 10,30,or 100 mg/kg,twice a day)groups and control group.Captopril was administered after infection.The activity of Na+-K+-adenosine triphosphatase(Na+-K+-ATPase)and Ca2+-adenosine triphosphatase(Ca2+-ATPase)of myocardial mitochondrial as well as the morphological of myocardial mitochondrial were investigated on day 14.Results The activity of mitochondrial Na+-K+-ATPase and Ca2+-ATPase were significantly higher(Pa0.05).Conclusions The favorable effects of captopril exerts on myocyte mitochondria were shown in a dose-dependent manner.Thirty and 100 mg/kg,twice a day captopril protecs the membrane integrity and thus plays a role at the recovery of depressed mitochondrial Na+-K+-ATPase and Ca2+-ATPase activity and also in myocytes injury.