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.

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

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.

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.

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

OBJECTIVE: To discuss blood collection tubes with different additives and their effects on the testing results of alcohol concentration in blood samples. METHODS: Blood samples from 10 volunteers were collected 2 hours after drinking with seven different types of disposable vacuum blood collection tubes, including ordinary tube without anticoagulant, coagulant tube, separating gel-coagulant tube, sodium citrate (1:4) tube, sodium citrate (1:9) tube, sodium citrate (9:1) tube and EDTA-K2 tube. The alcohol concentrations in these blood samples were analyzed by headspace gas chromatography. RESULTS: The concentration testing results of the same blood samples in different types of tubes were different from one to another. The sequence was as follows: separating gel-coagulant tube > coagulant tube > ordi- nary tube without anticoagulant > EDTA-K2 tube> sodium citrate (1:9) tube> sodium citrate (1:4) tube, whereas the results of the same blood sample in sodium citrate (1:9) tube and sodium citrate (9:1) tube showed no obvious difference. CONCLUSION It is better to collect a suspicious drunk driver's blood sam- ple using a disposable vacuum blood collection tube, with the EDTA-K2 tube being preferred.
Anticoagulants ; Blood Specimen Collection/methods* ; Citrates ; Ethanol/blood* ; Humans ; Sodium Citrate

UNLABELLED: Patients with cervical painless mass for 3 months with swallowing not feeling a week for the chief complaint. PHYSICAL EXAMINATION top right sternocleidomastoid before hitting a 7.0 by 3.0 cm size, lower limb reached 2.0 cm x 1.8 cm, the size of the mass on the left side of the supraclavicular reached 3.0 cm x 2.5 cm of the size of the mass, the three homogeneous medium hard, focally border and clear, the activity can be puncture cytological examination in return for: left supraclavicular see more protein and blood samples and a small amount of sample are arranged heap of fiber cells. Nuclear magnetic resonance (NMR): on the right side of the neck, with three at the left supraclavicular neoplasm, between 2.5-5.5 cm in size, high in T2, T1 low mixed signals, lesion boundaries clear.
Clavicle ; Deglutition Disorders ; etiology ; Head and Neck Neoplasms ; complications ; pathology ; Humans ; Magnetic Resonance Imaging ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology ; Neck ; Neurilemmoma ; complications ; pathology ; Sensation Disorders ; etiology ; Tumor Burden

Chemotherapy is one of main treatments for nasopharyngeal carcinoma (NPC) except radiation therapy. Improving and optimizing chemotherapeutic regimen are helpful to improve the therapeutic effects and reduce side effects. At present, concurrent chemoradiotherapy still is the standard treatment for advanced nasopharyngeal carcinoma. Induced chemotherapy has been shown superiority, but the effect of adjuvant chemotherapy needs further study. This paper analyzed the superior and inferior, effect and side effect of all kinds of chemotherapeutic methods or scheme including induced chemotherapy, concurrent chemotherapy, adjuvant chemotherapy and palliative chemotherapy and introduced simply the mechanism and clinical effect of new drugs of anticancer. It was hoped to offer some reference for the selection of chemotherapy for NPC.
Antineoplastic Combined Chemotherapy Protocols ; Carcinoma ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy

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.