Objective To evaluate the value of endoscopy in etiological diagnosis and treatment of post - cholecystectomy syndrome. Methods Three hundred and twenty - six patients with post -cholecystectomy syndrome received ERCP. To reveral the etiology of post - cholecystectomy syndrome. For those with choledocholithiasis and those with papillary inflammatory stricture EST or EPBD were given those with papillary diverticulum and SOD EPBD were given, those with papillary tumor and hepatobiliary carcinoma EMBE were given and for those with bililary stricture in middle part of bile duct, purulent cholangitis, chloedocholithiasis(stones not excluded in one time)and bile leakage ENBD were used. Results ERCP was succeeded in 315 cases(96. 6%), 24 cases had no abnormal endoscopic findings view. 191 cases of choledocholithiasis 186 were totally get rid of stone after one to three times of opretion EST or EPBD was successfully given to 39 cases of 39 had papillary inflammatory stricture. Nine had papillary diverticulum which oppressed the papillary orifice, 7 had SOD, all of them were dealt with EPBD. Sixteen had stricture in the middle portion of bile duct, 11 of which were treated with ENBD. In 6 cases of papillary tumor and 5 hepatobiliary carcinoma patients jaundice improved significantly after received EMBE. Residual stones in cholecystic duct were seen in 4 cases. In 2 cases of bile leakage after cholecystectomy, ENBD was successfully carried out to avoid another operation. Complications were noted in 15 cases(4. 8%) of them. pancreatitis 11 cases, cholangitis 3 eases and hemorrhage of upper gastrointestinal tract one ease. Conclusion ERCP can find out the defenite cause of post - cholecystectomy syndrome at early stage and take corresponding endoscopic therapeutic measures. The complications of ERCP can be avoided by skillful operator.

Objective To improve the successful rate of endoscopic biliary drainage. Methods The experience of biliary drainage with duodenoscope for biliary obstruction from January 1998 to September 2001 was reviewed retrospectively. Endoscopic naso -biliary drainage (ENBD) , endoscopic retrograde biliary drainage (ERBD) and endoscopic metal biliary endoprothesis (EMBE) were performed in 242 cases, 43 cases and 35 cases respectively. Results Of 320 cases with biliary obstruction, 305 received successful drainage under endoscopy and 15 cases failed. Ten cases with ENBD failed but got successful drainage after modulating the site of naso-biliary tube or reinserting another tube. For 3 cases failed with ERBD, we chose plastic stents with appropriate length for 2 cases to achieve fluent drainage and percutaneous transhepatic biliary drainage (PTBD) was managed for another case after endoscopic management failed. For 2 cases with EMBE failed, one stent couldn' t exceed the tumor stricture site and one was obstructed by tumor implantion at one month after EMBE. Either a metal stent or a plastic stent was replaced through previous prothesis in these two failed cases. Conclusions The effect of endoscopic biliary drainage for biliary obstruction is definite. Mostly the drainage failure can be avoided as early as possible by analyzing the causes and taking some corresponding measures to correct it.

OBJECTIVE To explore the genotype and distribution of humam papilloma viruses(HPV) among rural women with cervical lesion.METHODS The cervical exfoliated cell specimens were collected and divided into two groups,the experimental group with 340 rural women finally diagnosed as cervical intra-epithelial neoplasm(CIN) or higher grade pathological changes in healthy examination,and the health control group with 230 rural women randomly selected from the crowd taken healthy examination.DNA was extracted and the genotypes of HPV-DNA were monitored by traditional nested PCR,flow-through hybridization and gene chip technique.RESULTS One-hundred and ninety-five cases(57.4%) in experimental group and the 58 cases(25.2%) in control group were confirmed to be HPV-DNA positive.There was significant difference between the two groups(P

Objective To explore the relationship between S100β, neuron-specific enolase (NSE) and postoperative cognitive dysfunction(POCD) in the elderly. Methods Cognitive function was evaluated using a battery of nine neuro-psychological tests before operation,at one week after operation. The old people were divided into POCD group(n=121) and normal group(n=439). Their S100β and NSE levels in all group were detected by enzyme linked immunesorbent assay(ELISA) before anesthesia,at the end of surgery and 6h,24h after opera-tion. Meanwhile relativity between S100βand NSE levels and factors of postoperative cognitive dysfunction were an-alyzed. Results S100βand NSE levels increased significantly at the end of surgery in both groups, but the levels in normal group were significantly lower than those in POCD group at the same stage(P<0.05). S100β and NSE levels were obviously relative to POCD. Conclusion S100β and NSE levels have close correlation with POCD in the elderly.

Objective To investigate the effect of α-lipoic acid on cerebral injury induced by cardiopulmonary bypass (CPB) in dogs. Methods Twelve adult healthy mengrel dogs of both sexes weighing 13.5-17.5 kg were randomly divided into control group (group C) and α-lopoic acid group (group L) (n = 6each). In group L α-lipoic acid 50 mg/kg was injected iv immediately before CPB. The animals were anesthetized with intraperitoneal 2.5% pentobarbital 25 mg/kg, intubated and mechanically ventilated. PaCO2 was maintained at 35-40 mm Hg. Femoral artery and vein were cannulated and Swan-Ganz catheter was inserted into pulmonary artery for MAP, CVP and CO monitoring and blood sampling. Blood samples were obtained immediately before aortic cross-clamping (T0, baseline), at 30 and 60 min after aortic cross-clamping (T1,2) and 30 and 60 min after aortic unclamping (T3,4) for measurement of plasma concentrations of TNF-α, S100β protein and neuron-specific enolase (NSE). Results In group C CPB significantly increased plasma TNF-α, S100β protein and NSE concentrations as compared with the baseline values at T0. Pretreatment with α-lipoic acid significantly attenuated CPB-induced increase in plasma TNF-α, S100β protein and NSE concentrations in group L. Plasma S100β protein and NSE levels were positively correlated with plasma TNF-α level. Conclusion Pretreatment with α-lipoic acid is effective in attenuating CPB-induced inflammatory response and cerebral injury.

BACKGROUND:There is controversial in choosing the treatment method for the treatment of traumatic subaxial cervical fracture-dislocation and spinal cord injury.
OBJECTIVE:To evaluate the clinical effect of implant internal fixation and Halo-vest external fixation on the stability after treatment of subaxial cervical fracture-dislocation.
METHODS:A retrospective analysis was conducted on 17 patients with subaxial cervical fracture-dislocation in the Department of Orthopedics, the Second Affiliated Hospital of Shantou University Medical Col ege between January 2009 to December 2011, including 13 male patients and 4 female patients, the age was ranged from 21-65 years, average 41.6 years. There were six cases of high fal ing injury, three cases of crush injury and eight cases of traffic accident injury. The hospitalization time after injury was 2 hours to 5 days, average 2.5 days. Al the patients received Halo-vest external fixation under local anesthesia, then distraction gradual y, and received anterior decompression graft and titanium screw fixation under reduction. The treatment effect was evaluated
through Frankel classification and imaging examination.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-24 months, average 15.4 months. Normal anteraposterior X-ray film showed fracture reduction, the cervical vertebra restored to the normal
sequence and physiological curvature;CT showed graft fusion without internal fixation fracture and loosing;
according to Frankel classification, marked effect (decreased for 2 grade) in five cases, effective (decreased for 1
grade) in 10 cases, and ineffective in two cases. Implant internal fixation combined with Halo-vest external fixation is safe and reliable in the instability fixation of subaxial cervical fracture-dislocation, and can better restore the spinal sagittal alignment.

ObjectiveTo investigate the correlation of Skp2,p27kiP1 and p21WAF1 expression with the clinicopathological features of ovarian serous cystadenocarcinomas.Methods Expressions of Skp2 ,p27kiP1 and p21WAF1 were examined by immunohistochemical staining in 124 epithelial ovarian tumors (25 serous cystadenomas, 19 borderline serous cystadenomas, and 80 serous cystadenocarcinomas) Results(1) The expression of Skp2 in serous cystadenocarcinomas (47.5％)was significantly higher than that in borderline serous cystadenomas (0％)and serous cystadenomas (0％)(P ＜ 0.001) .The p27kiP1 expression in serous cystadenocarcinomas (35.0％) was significantly lower than that in borderline serous cystadenomas(73.7％)and serous cystadenomas (80.0％) .The p21WAF1 staining frequency in serous cystadenocarcinomas (38.8％)was significantly lower than in borderline serous cystadenomas (73.7％)and serous cystadenomas (80.0％) .(2) The Skp2 protein expression in serous cystadenocarcinomas was positively correlated with clinicopathological stage,histological differentiation degree and lymph node metastasis of the tumors.The p27kiP1, p21WAF1 protein expression in serous cystadenocarcinomas was reversely correlated with clinicopathological stage and histological differentiation degree of the tumors(Ps ＜ 0.05) .(3) The Skp2 protein expression in serous cystadenocarcinomas was reversely correlated with that of p27kiP1 , p21WAF1.Conclusion The Skp2 protein expression in serous cystadenocarcinomas was increased and positively correlated with the clinicopathological features of ovarian serous cystadenocarcinomas.Skp2 protein expression was reversely correlated with p27kip1 ,p21WAF1.Skp2 protein expression may play an important role in the development and progression of serous cystadenocarcinomas.

Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P ＜ 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.

AIM:To establish a HPLC fingerprint of Stellera chamaejasme L. from Inner Mongolia Region. METHODS: The RP-HPLC method was used with Akzonobel Kromasil C_ 18 (250 mm?4.6 mm, 5 ?m) the acetonitrile-0.5% phosphoric acid (gradient elution) was used as mobile phase, analytic time was 60 min, and detective wavelength was at 297 nm, the column temperature of 15℃ were adopted. RESULTS: The HPLC fingerprint of Stellera chamaejasme L. set up showed that 14 peaks were co-possessing in different sources. The results of method validation met technical standard of fingerprint, the similarities of Stellera chamaejasme L. were 0.9 to 1.0. CONCLUSION: The method is stable and reliable with a good reproducibility and provides a reference standard for the quality control of Stellera chamaejasme L. from Inner Mongolia Region.

Objective To evaluate the value of hyomental distance (HMD) measured when the byoid was located using ultrasound in predicting the difficult airway.Methods Two hundred and thirteen patients of both sexes,aged 18-64 yr,with body mass index of 14-34 kg/m2,with interincisor distance ＞3 cm,with atlanto-axial joint mobility ＞ 90°,of Mallampati class Ⅰ-Ⅳ,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective surgery requiring endotracheal intubation under general anesthesia,were enrolled in the study.The HMD was measured by fingers (finger breaths in width,HMDf) and by rulers (HMDr) when the hyoid was located artificially and when the hyoid was viewed on ultrasound (HMDu) before anesthesia induction.After anesthesia induction,the difficult airway was defined as Cormack-Lehane grade 3 or 4 assessed under direct laryngoscope during intubation.The hyoid viewed on ultrasound was considered as the criterion,and the error rate was calculated when the hyoid was located artificially.Youden Index was used to determine the optimal value in predicting difficult airway,and the specificity and sensitivity of HMDf,HMDr and HMDu in predicting difficult airway were calculated based on this criterion.Results The error rate was 18.8％ when the hyoid was located artificially.The specificity and sensitivity of HMDu in predicting difficult airway were 64.6％ and 91.5％,respectively.The specificity and sensitivity of HMDr in predicting difficult airway were 62.5％ and 84.8％,respectively.The specificity and sensitivity of HMDf in predicting difficult airway was 29.2％ and 98.2％,respectively.Conclusion The HMD measured when the hyoid is located using ultrasound can accurately predict the difficult airway.