Objective To investigate the value of emergent endoscopy in the acute nonvariceal gastrointestinal bleeding.Methods Retrospective analysis was done in patients with melena or haematemesis in the ward from Jan 1st 2003 to Dec 31st 2007.For emergent group,the patients took endoscopy in 48 h after bleeding.For selective group,the patients took endoscopy after 48 h.Medical outcomes and resource utilization were compared between two groups.Results The average age of 332 patients(246 males and 86 females)was(45.9?18.8)years old.In the median and low risk patients,the length and the cost of hospitalization,blood transfution and the use of PPI were lower in the emergent group than in the selective group.In the high risk patients,the above variables had no statistical difference.Conclusion For the patients whose Rockall Score were less than 5,emergent endoscopy could decrease the length and the costs of hospitalization,the transfusion volumes and the use of PPI.However,for the patients whose Rockall Score were more than 5,the advantage of emergent endoscopy need further discussion.

Objective To investigate the changes of IL-6, IL-10 and TNF-αafter cholecystectomy.Methods 46 cases with cholecystolithiasis were selected and divided into 2 groups.23 in control group were treated with open cholecystectomy, experimental group were treated with laparoscopic cholecystectomy.The levels of IL-6, TNF-α, IL-10 and CD4 +/CD8 +T were compared in the two groups pre-and post-treatment.ResuIts Compared with pre-treatment, two groups of patients with IL-10, TNF-α, IL-6 and CD4 +T and CD4 +/CD8 +T increased (P<0.05), compared with control group, experimental group IL-10, TNF-α, IL-6, CD4 +/CD8 +T levels were higher (P<0.05).ConcIusion Laparoscopic cholecystectomy can significantly reduce the IL-6, TNF-αand IL-10 levels, reduce the body′s stress response to surgery, and reduce blood flow, shorten the operation time.

Objective To retrospectively analyze whether the kyphosis exists after removal of the internal fixators for thoracolumabar vertebrae fractures. Methods A total of 18 patients (35-68 years old) with thoracolumabar vertebrae fractures (T11-L2 ) were fixed with short segment pedical screw. The fixators were removed one year postoperatively to observe the changes of the Cobb' s angle and trauma vertebra'height. Results All the patients were followed up for 6-24 months ( average 18.7 months),which showed no intraoperative or postoperative complication, breakage or loosening of the screws. Compared to the Cobb angle and the vertebra height before removal of the internal fixators, the average loss of the Cobb angle was 0.7° and that of the vertebra height was 0.8 mm six months after removal of the fixators, 1.9° and 1.1 mm respectively one year after removal of the fixators, and 2.4° and 1.3 mm respectively two years after removal of the fixators in 16 patients without osteoporosis (P ＞0. 05). Among two patients with osteoporosis, the average loss of the Cobb angle and the vertebra height was 6° and 8°respectively and 3 mm and 5 mm respectively six months after removal of the fixators; 13° and 17° respectively and 5 mm and 7 mm respectively one year after removal of the fixators; 15° and 19° respectively and 6 mm and 7.5 mm two years after removal of the fixators. Conclusions After the internal fixation for thoracolumbar vertebrae burst fractures, kyphosis develops mildly, with insignificant change of the vertebral height. While the kyphosis becomes worse after removal of the fixators for thoracolumbar vertebrae burst fractures in patients with osteoporosis.