Iatrogenic bile duct injury (IBDI) is a severe complication in general surgery, especially during laparos-eopic cholecystectomy. Many factors may cause IBDi, in which the conscientiousness, skill and experience of the surgeons play a more important role than the abnormal anatomy and patholo-gical changes of the patient. The Bismuth's classification, which originated from the era of open surgery, does not cover the whole spectrum of bile duct injuries. Strasberg's classification made a supplement by including other types of extrahepatie bile duct injuries. The variation of opportunities leads to different thera-peutic strategies. When the injuries are diagnosed intraopera-tively, a conversion to open surgery is the option of choice, and the prosthesis should be performed by a more experienced surgeon. If the bile duct injury is diagnosed in the early stage after operation, therapeutic principles are as follows: biliary peritonitis often required an emergency reoperation, while extra-peritoneal drainage is taken for patients with simple biliary leak. The most serious postoperative complication after IBDI is steno-sis, sometimes followed by fistula. Sufficient preoperative prepa-ration is essential, which includes controlling the biliary tract infection, improving the liver and renal function and nutritional state of the patient.

Excellent teaching team is basic guarantee of top-quality course construction. In order to improve the teaching team construction in dermatology,a lot of work has been done on the team construction,professional degree of medicine,quality construction,etc. As a results,the quality of dermatology teaching team has been greatly improved in the Department of Dermatology of West China Hospital,Sichuan University,which is the basis for the following top-quality course construction.

Objectives:To study the effect of triptolide(Tri) on fibroblast cells in vitro culture, morphologically and kinetically. Methods:Light microscope(LM)and electron microscope(EM)were employed to detect the morphological changes in Tri group. Cell DNA content and apoptosis were assayed by flow cytometry (FCM). Results:In Tri group, fibroblast cells showed less density, slimmer body, abnormally and typical apoptosis under LM, while rarefaction and content of rough endoplasmic reticulum(RER) decrease, and apoptosis in different stages could be seen under EM. In FCM,AI elevated remarkably in Tri groups, and the effect is dose dependent, with cell cycle uninfluenced at all. Conclusions:The mechanism of triptolide on hypertrophic scars is related to its promotion on fibroblast apoptosis and inhibition of collagen excretion.

The patient complained of finding on the right side of the neck fistula with discharge nine years. In recently, fistula spills significantly increased compared with the previous. Special physical examination: Right sternocleidomastoid middle 1/3 front border is seen here in a small fistula, translucence jelly secretion were spilling out when squeezeing the fistula, no smell. Ultrasound: On the right side of the upper cervical skin to submandibular gland rear could see tubular low echo area. MRI: Visible on the right side of the neck tube signal, after the submandibular gland rear. Three-dimensional CT: Visible on the right side of the neck by skin sinus crossings as deep as the tonsillar fossa lumen containing contrast agent. Clinical diagnosis: The second branchial cleft cyst and fistula.
Branchial Region ; pathology ; Branchioma ; diagnosis ; Contrast Media ; Cutaneous Fistula ; diagnosis ; Head and Neck Neoplasms ; diagnosis ; Humans ; Magnetic Resonance Imaging ; Neck Muscles ; pathology ; Tomography, X-Ray Computed

Chronic Disease ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Heart ; drug effects ; physiopathology ; Heart Failure ; drug therapy ; physiopathology ; Humans ; Kidney ; drug effects ; physiopathology

Humans ; Spleen ; injuries ; physiology ; surgery ; Splenectomy

To explore the value and attentive problems of the innovative practical teaching reform of dermatology staff room,the author constructed a new practical teaching system by carrying out advanced teaching methods,gradually establishing the on-line test system and setting up the evaluation and feedback system. The result showed that the innovative practical teaching reform of dermatology staff room had strong applicability and operability.

Objective To report the medium-term follow-up results for deep venous thrombosis(DVT) after total knee arthroplasty(TKA).Methods Between July 2003 and March 2004,55 patients(63 knees)who had had TKA were followed up for DVT.In follow-ups 1 to 2 weeks after TKA,their clinic symptoms,Doppler ultrasonograms and venograms were analyzed.In the following out-patient follow-ups done at every six months,we observed their clinic symptoms and Doppler uhrasonograms for the operated lower extremity.Venography was done only for those who had severe DVT symptoms.Results The venography one week after TKA conformed that DVT occurred in 34 patients(41 knees,61.8%).Two weeks after operation,DVT vanished in 12 cases,but deterio- rated to the proximal part in two cases.The follow-ups averaged 36.6 months(range,32 to 40 months).The results at five time points showed that the incidence of DVT did no decrease with lapse of time(P＞0.05).Conclusion No matter whether DVT occurs in the perioperative period,incidence of DVT in the medium term varies little.

Recombinant PCR applies to fulfill gene recombination by PCR thermal reaction.Over the twenty years,it has branched into three characteristic strategies:splicing by overlapping extension(SOE),jumping polymerase chain reaction(JPCR)and DNA shuffling.Recently,the technique aimed with exploiting natural source of different allele genes is developing up on simplification of experimental procedure,on trap for mutation and variation,and on highthroughput screening with technology of surface display and fluorescent probe.The recombinant PCR is increasesing value in broad range from biological basic research to bioengineering study.

In order to explore more reasonable and scientific accounting method of community health service costs, to improve the accounting method system of community health service cost. In the current existing community health services costing methods, based on the analysis of hospital cost accounting methods system, analyze and imitate the accounting method of hospital costs, establish a more scientific and implemented accounting method system of community health service costs: divide parts of clinics scientifically, redesign the center acollation method of indirect cost, confirm different cost accounting methods for different cost accounting objective and provide suggestion for the improvement of project cost accounting.