The reoperation for biliary diseases is usually unplanned, and the major reasons leading to this situation include:(1) The initial operation was performed under emergency situation and radical procedure could not be carried out.(2) The surgical procedure was inadequate.( 3 ) The operator was unqualified for the operation. In order to avoid repeated operations,the following principles must be obeyed strictly.Firstly,once the initial operation was failed,the patients must be transferred to large medical center and the reoperation must be performed by hepatobiliary specialists.Secondly,the operator must realize that most of the patients were in poor condition because of the previous operation,and they needed careful evaluation of organ function and adequate supportive treatment before reoperation.Thirdly,various measures must be taken to avoid unplanned operation and ensure the successful implement of radical operation at a time:( 1 ) Operator must learn all the details of previous operation,which include operation procedure,findings during operation and postoperative complications.( 2 ) Cholangiogram of the whole biliary tree is important for surgical planning,ultrasonography,computed tomography (CT),endoscopic retrograde cholangiopancreatography,magnetic resonance cholangiopancreatography, percutaneous transhepatic cholangiography (PTC),or PTC-CT should be performed solely or comprehensively to determine the nature and location of lesions.For bile duct injury,additional examination including CT angiography,magnetic resonance angiography or digital subtraction angiography is necessary to ascertain the accompanied vessel injury.(3) Making individual surgical procedure according to patien's condition and distribution of lesions.

Objective To observe the therapeutic efficacy and postoperative complications of combined surgery and sequential surgery in treating proliferative diabetic retinopathy (PDR) and cataract.Methods The cilinical data of 59 patients (66 eyes) with PDR were retrospectively analyzed.The patients were divided into combined-surgery group and sequential-surgery group.Combined surgery was performed on patients with obvious lens opacity which was an obstacle to the ocular fundus surgery,while sequential surgery was performed on the patients with transparent lens or lens with light opacity on which ocular fundus surgery could be performed.Lens excision in cataractopoiesis could only be performed when the state of ocular fundus was stable and cataractopoiesis was the main cause of vision damage.A total of 28 patients (32 eyes) in combined-surgery group underwent vitrectomy combined with phacoemulsification and IOL implantation;31 patients (34 eyes) in sequential-surgery group underwent vitrectomy,lens excision and IOL implantation.Corrected visual acuity (BCVA) and complications were observed.The mean follow-up period was (25±8.5) months.The measurement data were analyzed with t test and enumeration data with 2 test.Results In combined-surgery group,visual acuity improvement was achieved in 27 eyes (84.4%),remained unchanged in 2 eyes (6.3%) and decreased in 3 eyes (9.4 %).In sequential-surgery group,visual acuity improved in 26 eyes (76.5%),remained unchanged in 2 eyes(5.8%)and decreased in 6 eyes (17.7%.).However,anterior chamber fibrin exudation occurred in 4 eyes in the combined-surgery group and no eyes in the sequential-surgery group;compared with each other,the difference is statistically significant (χ2=4.524,P=0.033).Conclusion Combined surgery and sequential surgery are all safe and effective on treating PDR and postoperative complications have no obvious correlation with the surgery procedure.

Cancelling drug price addition is one of public hospital reform content, under the condition of insufficient financial input, public hospitals should enhance the drug cost management, taking measures to reduce drug proportion, to deal with all kinds of hospital operation problems produced by hospital income decline due to the cancellation of drug addition. Through years of exploration and practice, Affiliated Hospital of Jining Medical University has controlled the rising of drug cost effectively and received better effect, which built a good foundation of public hospital reform.

Objective To investigate the health status of university faculty.Methods The healthy physical examination results of teaching staff in Beijing University of Technology in 2012 were statistically analyzed.Results Among 4 191people,3 678 were examined abnormal.The prevalence rate was 87.97％.A total of 36 kinds of diseases were detected,and mainly in chronic diseases such as pharyngitis,fatty liver,hyperlipidemia,hypertension,breast hyperplasi a,diabetes or fasting glucose ≥7.00mmol/L and others.The prevalence rate in the male staff was significantly higher than that in female staff(all P ＜ 0.05).Condusion College teachers' health condition is not optimistic.Necessary preventive measures such as regularly medical examinations,strengthening health care and education should be taken and implemented.

AIM: To investigate the influence of tumor necrosis factor-α (TNF-α) induced apoptosis through knocking down Bax gene by RNA interference (RNAi) in human alveolar type II epithelial cells (A549). METHODS: A549 cells were cultured in vitro and divided into 4 groups according to RNAi treatment: control group, TNF-α treated group, Bax siRNA group and control siRNA group. Chemically synthesized small interfering RNA (siRNA) directed against human Bax gene was transfected into A549 cells by cationic liposome. The effect of RNAi was investigated by reverse transcription PCR, Western blotting and immunohistochemisty, and the rate of apoptosis was investigated by flow cytometry. RESULTS: Bax gene was knocked down effectively in Bax siRNA group (P<0.05). Apoptosis was induced by TNF-α in TNF-α treated group and control siRNA group. However, it was abolished in Bax siRNA group by the downregulation of Bax gene compared to TNF-α treated group and control siRNA group (P<0.05). CONCLUSION: This result suggests that Bax gene has a significant role of pro-apoptosis in A549 cells and knocking down Bax gene by RNAi can effectively inhibit TNF-α-induced apoptosis in A549 cells.

AIM:To investigate the influence of tumor necrosis factor-? (TNF-?) induced apoptosis through knocking down Bax gene by RNA interference (RNAi) in human alveolar type II epithelial cells (A549). METHODS: A549 cells were cultured in vitro and divided into 4 groups according to RNAi treatment: control group,TNF-? treated group,Bax siRNA group and control siRNA group. Chemically synthesized small interfering RNA (siRNA) directed against human Bax gene was transfected into A549 cells by cationic liposome. The effect of RNAi was investigated by reverse transcription PCR,Western blotting and immunohistochemisty,and the rate of apoptosis was investigated by flow cytometry. RESULTS: Bax gene was knocked down effectively in Bax siRNA group (P

Objective: To investigate whether periodontitis might adversely affect the outcome of eradication of gastric Helicobacter pylori(Hp) . Methods: Ninety one patients with gastric Helicobacter pylori and periodontitis were enrolled. The patients were treated by medicine therapy, meanwhile 33 of them were treated by initial periodontal therapy. After treatment, the effect of initial periodontal therapy on the eradication of gastric( Hp ) was examined with 13 C urea breath test. The correlation between the gastric eradication rate and periodontitis was analyzed. Results: Four weeks and one year after medicine therapy, the eradication rate was singnificantly lower in the patients with PD≥4 mm than in those with PD

Objective:To construct the finite element models of maxillary central incisor and the simu-lations with crown lengthening surgery and post-core restoration in management of different crown-root fracture types, to investigate the stress intensity and distributions of these models mentioned above, and to analyze the indications of crown lengthening from the point of view of mechanics. Methods:An extrac-ted maxillary central incisor and alveolar bone plaster model were scanned by Micro-CT and dental impression scanner ( 3shape D700 ) respectively. Then the 3D finite element models of the maxillary central incisor and 9 simulations with crown lengthening surgery and post-core restoration were construc-ted by Mimics 10. 0, Geomagic studio 9. 0 and ANSYS 14. 0 software. The oblique static force (100 N) was applied to the palatal surface ( the junctional area of the incisal 1/3 and middle 1/3 ) , at 45 degrees to the longitudinal axis, then the von Mises stress of dentin, periodontal ligament, alveolar bone, post and core, as well as the periodontal ligament area, were calculated. Results:A total of 10 high-precision three-dimensional finite element models of maxillary central incisor were established. The von Mises stress of models: post >dentin >alveolar bone >core >periodontal ligament, and the von Mises stress increased linearly with the augmentation of fracture degree ( besides the core) . The periodontal ligament area of the crown lengthening was reduced by 12% to 33%. The von Mises stress of periodontal ligament of the B2L2c, B2L3c, B3L1c, B3L2c, B3L3c models exceeded their threshold limit value, respective-ly. Conclusion: The maxillary central incisors with the labial fracture greater than three-quarter crown length and the palatal fracture deeper than 1 mm below the alveolar crest are not the ideal indications of the crown lengthening surgery.

Objective To evaluate the clinical effects of the interlocking intramedullary nails in treatment of the floating knee. Methods Internal fixation with the interlocking nail in unilateral femur and tibia was performed on 6 patients with the floating knee, and the treatments of complications were analyzed and summarized. Results After operation the 6 patients were followed up and their X ray films were reviewed after 3, 6, and 12 months respectively. Fractures in unilateral femur and tibia healed at once in 4 patients, the union of one femur fracture delayed in one case and the union of tibia fracture delayed in one case. The knee joint could flex to 80～90 degrees in 5 of the 6 patients, and the other one could flex to 60 degrees. No shortening of the limb occurred in all the patients who healed after 6～18 months. Conclusion As the “floating knee”is a kind of high energy injury, often complicated with injury of important organs, the complication should be treated while the internal fixation be conducted as soon as possible. The interlocking intramedullary nail is a good device with which the function of the limb can recover fast with the postoperative dysfunction of the knee and ankle joints greatly reduced.

Objective To investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. Methods Thirty rats were randomly divided into normal control group ( n =6), liver cirrhosis group (LC group, n =6), liver cirrhosis and hepatectomy group (LCH group, n =6), PN (parenteral nutrition) group ( n =6, given PN after hepatectomy) and rhGH+PN group ( n =6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RT PCR. Liver Ki67 immunohistochemistry was studied. Results Compared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. Conclusion rhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.