Objective To summarize our experience in the prevention and treatment of right accessory hepatic duct and right hepatic duct injury during laparoscopic cholecystectomy. Methods The clinical data of 21 cases with right accessory hepatic duct or right hepatic duct during laparoscopic cholecystectomy were reviewed retrospectively. Result According to anatomy identified by preoperative work-up and selective cholangiography during the operation, 18 cases had the right accessory hepatic duct,eleven of them were confirmed intraoperatively. The accessory hepatic ducts were conserved in 3 cases and clipped without biliary leaks postoperativly in 7 cases; One case had biliary leaks postoperatively with the duct sutured intraoperatively, and recovered well conservative therapy. Accessory hepatic ducts were accidentally injuried in 7 cases, two patients were transferred to open surgery; three cases were confirmed to be injuried and clipped by second laparoscopic exploration because of biliary leaks postoperatively. Three cases had a low confluence of the right and left hepatic duct with the gallbladder duct joining the right bile duct, the ducts were conserved in 2 cases and injuried in one. Postoperatively all these 21 cases were followed up for 2 years, without jaundice or liver dysfunction. Conclusions To prevent injury of right accessory hepatic duct and right hepatic duct. High vigilance and familiarity with the anatomic variants of the biliary tree and intraoperative cholangiography in selective cases are fundmental.

Objective To evaluate the feasibility and efficacy of laparoscopic splenectomy(LS). Methods In this study 41 cases were enrolled including 10 cirrhotic splenomegaly cases and 17 idiopathic thrombocytopenic purpura cases. The clinical data of 41 cases undergoing LS was retrospectively reviewed. KG2Result Two cases were shifted to open surgery, LS was successful in 39 cases with average operating time of 238 min, the average spleen weight was 389 g, blood loss 318 ml, postoperative GI movement started from 12 to 24 hrs. The average postoperative hospital stay was 4 days. Postoperative complications occurred in 3 cases including intraabdominal bleeding, subcutaneous emphysema, and stabbing-caused abdominal wall bleeding in one each. Conclusion LS is safe and less traumatic in selected patients indicated for splenectomy, especially for those suffering from haemotologic diseases.

ObjectiveTo evaluate the effect of laparoscopic cholecystectomy (LC) combined with intraoperative cholangiography (IOC) and intraoperative endoscopic sphincterotomy (IOEST) for the diagnosis and treatment of choledocolithiasis. Methods Statistical analysis was carried out for 106 patients with cholecystocholedocolithiasis diagnosed and treated by LC-IOC-IOEST. Results Sixty-four (60.4%, 64/106 ) patients with preoperative diagnosis of simple gall stone were found with complicated choledocholithisis; LC-IOC -IOEST was successfully performed in 99(93.4%, 99/106) cases. Six cases (6.1%) suffered from mild postoperative acute pancreatitis. Duodenal perforation, bile leakage, peumothorax (0.9%) developed in one each. Duodenal adenocarcinoma was overlooked in one case, and 2 cases (1.8%) suffered from gastric paralysis. Conclusion LC combined with IOC and IOEST was a safe, effective approach to the diagnosis and minimally invasive treatment of choledocholithiasis.

Objective To analyze risk factor of bile duct injury (BDI) during laparoscopic cholecystectomy (LC). Methods A retrospective population-based cohort study was carried out on 13878 patients undergoing LC from Apr 1994 to Dec 2003. Patients were divided into BDI group and non-BDI group. Factors with statistically significant differences between groups in anivariable analysis were selected to construct a multivariate logistic regression mode. Result Among 13878 LC procedures 38 BDI (0.27%) were identified. Factors which were of significant differences between groups in anivariable analysis includ diameter of common bile duct(?~2=5.92, P

Objective To analyze the diagnosis and treatment of pancreatic pseudocyst. Method This study included 46 pancreatic pseudocyst cases, 7 received conservative therapy, 12 received internal drainage, 9 received external drainage, 5 received sequential internal and external drainage and 13 received partial pancreatectomy. Result Cases receiving conservative therapy recovered well without recurrence, one case receiving internal drainage suffered from postoperative pancreatic fistula, one receiving external drainage was complicated with pancreatic fistula and recurrence developed in another 2 cases, one case undergoing partial pancreatectomy was complicated with postoperative pancreatic fistula. Conclusion Pancreatic pseudocyst should be managed individually according the course and patients' clinical condition.

Objective To evaluate the maneuvre of curettage and aspiration(LTCA) in laparoscopic hepatectomy. MethodsWe used Peng′s multifunctional operative dissector(PMOD) to perform laparoscopic liver transection by maneuvre of curettage and aspiration in 20 cases undergoing laparoscopic hepatectomy. Results Procedures were all successful. The recovery was uneventful without any complications. Mean operative time was 105 minutes, the average bleeding volume was 420 ml, the largest excised sample size was 10 cm?9 cm?7 cm. All patients were discharged within one week. ConclusionsThe new technique-LTCA can be used in laparoscopic hepatectomy, it has the advantages of clear anatomy, good exposure of canal construction, rapid liver transection, satisfactory hemostasis and clear operative field.

With its high dimensionalities, small samples and great noise, feature reduction of gene expression profile becomes quite necessary. The most common form of gene expression profile is nonlinear, and traditional dimensionality reduction methods can not project high dimensional data, whose initial dimensionalities are low, into low dimensional space. In this work, an improved distance locally linear embedding (LLE ) algorism was proposed to reduce the dimensionalities. LLE method is very sensitive to the closely-neighboring parameters. In order to enhance the robustness to the number of neighbors, in the paper we presented a novel distance to measure the distance between the samples for the purpose of reducing-the influence of distribution of samples. Experimental results demonstrated that the improved distance LLE can effectively extract information of classification features and greatly reduce the dimensionalities of data while maintaining a higher classification accuracy.
Algorithms ; Discriminant Analysis ; Gene Expression Profiling ; classification ; methods ; Humans ; Linear Models ; Neoplasms ; genetics

Objective To assess the association between early adiposity rebound (AR) and indices of obesity and metabolic risk in 5-year-old children. Methods Based on Ma’anshan Birth Cohort Study (MABC), single live births born in Ma'anshan of Anhui province from October 2013 to April 2015 were followed for up to 5 years consecutively. As of August 2019, 720 children with continuous measurements (≥8 times) and metabolic indicators were obtained. Physical examination and laboratory tests were used to obtain information on the birth status, length/height, weight, waist circumference, body composition and metabolic indicators of children. The 2 test, F test, t-test, non-parametric test, general linear model and logistic regression model were used for statistical analysis. Results 43.5% of the children had AR≤4 years. After controlling for gender, it was found that earlier AR was associated with overweight/obesity (OR=2.71, 95%CI: 1.81~4.05), larger waist circumference (OR=1.88, 95%CI: 1.25~2.82), and body fat percentage ≥90th percentile (OR=2.09, 95%CI: 1.26~3.48). In the earlier AR group, the insulin resistance and metabolic score were higher, but the difference was not statistically significant. At 5 years of age, the prevalence of obesity and overweight was 6.0% and 12.8%, respectively. Children with overweight/obesity, larger waist circumference, higher waist-to-weight ratio and body fat percentage ≥ 90th percentile were associated with higher insulin resistance and metabolic score, and all the differences were statistically significant (all P<0.001). Conclusion Earlier AR increased the risk of overweight/obesity, larger waist circumference, and body fat percentage ≥90th percentile at age of 5 years. Each index of the commonly used measures of childhood obesity was closely related with insulin resistance and metabolic risk factors at 5 years old.