Objective To study the feasibility and timing of early laparoscopic cholecystectomy (LC) for the patients with mild-to-moderate acute pancreatitis with gallbladder stone.Methods 26 patients with mild-to-moderate acute pancreatitis with gallbladder stone underwent early laparoscopic cholecystectomy.The patients were initially treated with conservative treatment.When the diagnosis was confirmed and the patients were stable,LC was carried out within 48 hours of hospitalization.The results were compared with a delayed group of patients who received delayed LC for acute pancreatitis.Results All the LC operations were successfully carried out.There were no significant differences between the two groups in alkaline phosphatase,alanine aminotransferase,aspartate aminotransferase,blood amylase and urine armylase on postoperative day 1,3,5,7.Patients who received early laparoscopic cholecystectomy had a shorter hospital stay.There were no significant differences between the two groups in the operation time,intraoperative blood loss,postoperative complication rates and recurrence of acute pancreatifis.Conclusion After CBD stones have been ruled out,it is safe and feasible to carry out early laparoscopic cholecystectomy within 48 hours of hospital admission for patients with mild-to-moderate acute pancreatitis with gallbladder stone.

Objective:To study the changes of platelet and blood coagulating function during endovascular graft exclusion(EVGE), providing reference for reasonable use of heparin and platelet. Methods:Using sonoclot analysis (SCT), 20 patients accepted EVGE were measured for ACT, clot rate, platelet function and hematocrit (HCT) and platelet count (PLT) after anesthesia induction(T 1), heparination(0.3 0.5 mg/kg)(T 2) and EVGE(T 3), respectively. The reasons for variability were analyzed. Results:ACT, clot rate and blood platelet function were normal at T 1. At T 2 ACT was prolonged [(289? 61.1) s,] clot rate and platelet function were decreased ( P

Objective To assess the efficacy of 6-month uniform multidrug therapy in various types of leprosy. Methods A field trial was conducted among 166 patients with different types of leprosy. All patients were treated with uniform multidrug therapy for 6 months, then followed up for 2 years. Clinical and bacterio-logical improvements were evaluated. Results Among the 166 patients, 31 dropped out due to various reasons,and 135 completed the 6-month treatment and 2-year follow-up. Among the 135 patients, 45 (33.3%) were skin smear negative, and the other smear-positive 90 had an average bacterial index (BI) of 2.91±1.45 (range: 0.1-6.0) before treatment. At the end of the 2-year follow-up, the 45 skin smear-negative patients showed 93.3% improvement in skin lesions and 80.0% improvement in nerve impairments, and the smear-posi-tive 90 patients showed 95.6% improvements in skin lesions and 77.8% improvement in nerve impairments.Skin smear turned negative in 49 (54.4%) out of the smear-positive 90 patients with the average BI declining to 0.66±0.99. The annual decrease in BI reached 0.9 during the first 2.5 years after the beginning of treat-ment. Twenty-five patients developed leprosy reaction during the follow-up, including 13 cases of type Ⅰ leprosy reaction and 12 cases of type Ⅱ leprosy reaction. Relapse was noted in 1 patient with muhibacillary leprosy 13 months after the termination of treatment. Conclusions The short-term efficacy of uniform multidrug therapy is similar to that of 2-year treatment with routine multidrug therapy. However, further studies are required to survey the incidence of leprosy reaction and relapse in patients treated with uniform multidrug therapy.

Objective:To compare the short-term clinical effect of gastrointestinal or enterointestinal dominant channels after radical proximal gastrectomy combined with dual-channel anastomosis for upper gastric cancer.Methods:A total of 72 patients in Hefei Second People's Hospital from Jan 2017 to Jul 2021 were retrospectively analyzed, including 29 patients in the total gastrectomy group, and 43 patients in the group of radical proximal gastrectomy+dual-channel anastomosis, and by imaging results it was futher stratified into gastrointestinal dominant channel sub-group (26 cases) and intestinal dominant channel sub-group (17 cases).Results:The number of lymph node dissection in the total gastrectomy group was more than that in the proximal stomach group (27.9±3.2 vs. 25.4±2.9, t=3.441, P<0.05). While the 12 months post operation albumin [(36.1±2.4) g/L vs. (34.1 ± 2.3) g/L, t=3.526, P=0.001], hemoglobin [(122.9 ± 6.9) g/L vs. (115.9 ± 6.0) g/L, t=4.444, P=0.000], vitamin B12 [(349.0±21.7) pmol/ml vs. (77.9±8.5) pmol/ml, t=63.931, P=0.000] level, and the body mass index [(23.01±0.78) kg/m 2vs. (21.95±0.67) kg/m 2, t=5.978, P=0.000] decline level was unfavored ( P<0.05). The 12 months post operation vitamin B12 level, body mass index, albumin and hemoglobin level had no statistical difference in the two subgroups of proximal gastrectomy (all P>0.05). Conclusions:Laparoscopic proximal gastrectomy with double tract reconstruction for proximal gastric cancer is safe and reliable, which can effectively improve the postoperative nutritional status, prevent postoperative anemia.

Objective:To investigate the effects of preoperative oral high glucose solution on postoperative recovery, homeostasis model assessment-insulinresistance and high sensitivity C-reactive protein level in patients with gastric cancer.Methods:A total of 83 patients with gastric cancer diagnosed and treated in Hefei Hospital of Anhui Medical University from Jan. 2018 to Jun. 2020 were selected and divided into study group (42 cases) and control group (41 cases) according to whether or not they were given oral glucose solution before operation. In the first 4 hours, 500 ml of 10% glucose solution (glucose solution, GS) was taken orally, and the control group did not take it before surgery. The postoperative recovery (time of first exhaust after operation, time of first defecation, length of hospitalization after operation) , postoperative complications, HOMA-IR and serum hsCRP levels between the two groups were observed and compared.Results:The two groups had very small differences in general information such as gender, age, BMI, TNM staging, and surgical methods ( P>0.05) . In comparison of HOMA-IR index, before treatment, the difference of HOMA-IR index between the two groups was small ( P>0.05) ; after treatment, the difference of HOMA-IR index between the two groups increased (1.80±0.45 vs 5.65±1.46 for the study group before and after treatment, 1.92±0.43 vs 11.70±3.05 for the control group before and after treatment) , and the HOMA-IR index of the control group was higher than that of the study group ( P<0.05) . In comparison of hsCRP levels, before treatment, there was little difference in hsCRP levels between the two groups ( P>0.05) ; after treatment, hsCRP levels in the two groups increased (1.23±0.90 vs 40.40±27.05 for the study group before and after treatment, and 1.40±1.15 vs 80.05±38.85 for the control group before and after treatment) , and the hsCRP level of the control group was higher than that of the study group ( P<0.05) . In terms of postoperative recovery, the study group’s first exhaust time, first defecation time, and postoperative hospital stay were significantly shorter than those of the control group [ (3.35±0.50, 4.05±0.50, 14.65±1.90) vs (4.30±0.90, 5.70±1.15, 16.15±2.05) , P<0.05]. In comparison with postoperative complications, the total incidence of postoperative gastric bleeding, anastomotic leakage, intestinal obstruction, and other complications was 11.9% for the study group and the total incidence of complications was 14.63% in the control group ( P>0.05) . Conclusions:After operation, oral GS can reduce insulin resistance and inflammation in patients with gastric cancer. It has positive significance to promote postoperative rehabilitation.

Objective To evaluate the intraoperative identification of ectopic parathyroid tissue in the central neck region using autofluorescence point-spectral analysis(AFPSA)combined with immune colloidal gold technique(ICGT),for guiding total parathyroidectomy(TPTX)or clean parathyroidectomy(CPTX)in the management of secondary hyperparathyroidism(SHPT).Methods Retrospectively collected and compared the clinical data of 64 patients with SHPT from October 2019 to June 2023.In the observation group,TPTX was performed as the initial procedure in 36 cases,followed by sampling of suspicious targets using AFPSA in the central neck area and subsequent detection through ICGT.CPTX was then conducted if a positive result was obtained.On the other hand,the control group consisted of 28 cases where only TPTX was performed without any additional tests during surgery.The surgical data,parathyroid hormone(PTH)levels,blood calcium levels,blood phosphorus levels,alkaline phosphatase(ALP)levels,regression of clinical symptoms,changes in parathyroid function and occurrence of hypocalcemia were compared between these two groups.Results In the observation group,there were 9 cases of AFPSA-ICGT positivity,including 2 left-sided cases,4 right-sided cases,and 3 thymic cases;among these posi-tive cases,there were a total of 10 locations with mildly hyperplastic or nonhyperplastic microscopic parathyroid tissue.The difference in the number of total parathyroid glands removed(including ectopic)between the two groups was statistically significant(P<0.05).At both 3 and 6 months postoperatively,ALP levels in the observation group were significantly lower than those in the control group(P<0.01 and P<0.001 respectively);at 6 months postoperatively,differences in PTH and blood phosphorus levels between the two groups were also statistically significant(P<0.05 and P<0.001 respectively).Joint bone pain and skin itching recurred in some patients within the control group at six months after surgery(P<0.05),whereas recurrence of SHPT was less frequent within the observation group compared to controls(P<0.05);however,no statistically significant differences were observed regarding postoperative hypoparathyroidism or hyperparathyroidism as well as hypocalcemia between either groups.Conclusion The AFPSA-ICGT intraoperative test can be utilized to guide surgery for SHPT,enabling accurate and efficient identification as well as safe targeting of parathyroid tissues that may not exhibit obvious hyperplasia in the central cervical region.