Objective To explore the protective measure and the complication of laparoscopic common bile duct primary closure surgery with self-releasing single-J tube. Methods The clinical data of 35 choledocholithiasis patients having underwent selective operation were retrospectively analyzed from January 2009 to November 2014. The operation was laparoscopic choledocholithotomy, a self-releasing single J-tube was placed in the common bile duct, and the common bile duct was primary closure. The postoperative complication was observed. Results All the patients were operated under laparoscope. The operative time was (120 ± 15) min, and the intraoperative bleeding was (50 ± 15) ml. The levels of diastase was normal or increased slightly 1 d after operation. There were no postoperative bile leakage, bleeding and incision infection. The diet was recovered 2-4 d after operation. Postoperative abdominal X-ray result showed that single-J tube position was good. Two-three weeks after operation, the single-J tube was discharged from the intestinal tract, without intestinal obstruction. The length of stay was (9.3 ± 1.8) d. Open operation with T tube drainage was performed in one case with the complication of stone residue and stenosis of common bile duct. Conclusions In laparoscopic common bile duct primary closure surgery, self-releasing single-J tube can provide security guarantees in patients with choledocholithiasis. Although there are some complications, it has less trauma and quicker recovery, and deserves further popularization and application.

Objective To observe the clinical therapeutic effect of danshenfenzhen and nutritional support in treating congestive heart failure accompanied with malnutrition on the basis of common treatment.Methods 42 cas- es of congestive heart failure accompanied with malnutrition were randomly divided into 2 groups:test group 21 cases (danshenfenzhen and nutritional support) and control group 21 cases(free diet),in the test group intravenous drip danshenfenzhen and vein nutrition were given if the internal nutrition can not provide enough energy on the basis of count of energy consumption,the serum albumin,total blood lymph cells and body weight were measured.Results After 14 days' treatment in the test group,the serum albumin,body weight and the total lymph cell increased signifi- cantly while in the control group,the serum albumin,body weight and the total lymph cells decreased significantly. Conclusion Intravenous drip danshenfenzhen and nutritional support can improve nutritional status and cardiac function of patients with congestive heart failure accompanied with malnutrition.

BACKGROUND:The development of spinal non-fusion technology promoted movement function protection of adjacent segment and operating segment. In the treatment of cervical spondylosis surgery, non-fusion technology has been widely carried out. For middle-aged patients with cervical spondylosis, the demand for spinal joint movement function is high. Non-fusion technology can improve the postoperative quality of life and slow down the risk of adjacent segment degeneration. OBJECTIVE:To evaluate the clinical efficacy of anterior cervical different implant materials (fusion or non-fusion) in the treatment of single segment of the intervertebral disc degeneration of cervical spondylosis in middle-aged patients. METHODS:This study enrol ed 10 cases of single segmental radiculopathy and cervical myelopathy after cervical intervertebral disc replacement from June 2011 to June 2013. Simultaneously, 10 cases were randomly selected from patients with anterior interbody fusion as the control group. Before treatment, at 1 and 3 months, and 1 year after treatment, changes in range of motion of cervical vertebra were observed using imaging results. Therapeutic effects were assessed using Japanese Orthopaedic Association Scores, Visual Analog Scale and The Neek Disability Index in both groups. RESULTS AND CONCLUSION:Al patients did not suffer from incision fat liquefaction, infection and delayed healing, and had finished fol ow-up for more than 1 year. Results revealed that Japanese Orthopaedic Association Scores and Visual Analog Scale scores were improved at 1 and 3 months, and 1 year after treatment (P<0.05), and no significant difference was detected between the two groups (P>0.05). In the analysis of range of motion of cervical vertebra and The Neek Disability Index, there were significant advantages in non-fusion treatment group (P<0.05). For middle-aged patients with cervical spondylosis, due to its life demand for neck mobility, the repair program of non-fusion cervical intervertebral disc replacement has a clear advantage.

Inspection of the complexion is one of the characteristics of traditional Chinese medical diagnosis. Traditional Chinese medicine puts high emphasis on inspection of the complexion and there exists detailed discussion on inspection of facial expression in Neijing. The so-called inspection of facial expression is a method to diagnose diseases according to the theory of five Zang-organs matching five elements and five colors by distinguishing various changes of facial color, such as green, red, yellow, white and black based on yin and yang doctrine and five elements theory. Nowadays, more and more experts have introduced color optical theory and modern devices into the modern research field of traditional Chinese medical diagnosis with the development of color optical theory and the renewal of determining devices, such as digital camera, color differentiation meter and spectrophotometer, to make the research more scientific and objective and avoid the deviations caused by human factors. The modern study of traditional Chinese medicine diagnosis has made fare progress, consequently enriching the contents of its facial color observation and giving a more scientific explanation of it. However, the devices being used now are still disunited; the data may be unilateral and cannot contain the whole information. So the most important task is to invent and use scientific devices conforming better with the theory of five colors observation in traditional Chinese medicine.

Objective To investigate colloidal gold immune chromatography (GICA ) and enzyme linked immunosorbent assay (ELISA) detection pepsinogen (PG) consistency of results ,so as to provide experimental evidence for the use of colloidal gold im‐munochromatography assay PG and briefly analysis of its clinical utility .Methods Totally 40 cases in our hospital digested samples and medical centers 60 healthy population sample in Endoscopy Center by endoscopy diagnosed with inflammation of the stomach disease ,respectively ,with colloidal gold immune chromatography and enzyme‐linked immunosorbent assay PG ,colloidal gold immu‐noassay chromatography method to be evaluated ,as the reference ELISA method .The results were compared to the method and bias analysis .Results GICA method with a correlation coefficient ELISA test results were greater than 0 .95 ,indicating a good correla‐tion between the two methods and there is no overall bias;sensitivity and specificity of the two methods were (0 .775 ,0 .85) and (0 .782 ,0 .823) .Conclusion Both GICA and ELISA can be used for screening or diagnosis of stomach illnesses .

Objective To use the colloidal gold immunochromatography (GICA ) method to conduct the methodological prelimi-nary evaluation on pepsinogen Ⅰ (PGI) reagent kit .Methods The method provide by the Preliminary Evaluation of Clinical Quan-titative Experimental Methods :Approval Guide Second Edition (EP10-A2) formulated according to the Clinical Laboratory Stand-ards Institute (CLSI) was used to continuously detect the low ,moderate and high concentrations of serum for 5 d ,Then the related data were collected for analyzing the dispersion degree ,linearity ,offset ,precision and so on .Results The PGⅠ quality control ser-um (concentration 25 ,50 ,100 μg/L) was detected at low ,medium and high concentration levels ,the linear regression equation ob-tained by analysis was Y=0 .9939X+0 .7433 ,correlation coefficient (R2 )=0 .9992 ;the offsets were 0 .37 ,0 .77 ,0 .78 μg/L re-spectively ,total imprecision was 3 .04% ,1 .17% and 1 .08% respectively .Conclusion The GICA related technical indicators of PGⅠreagent kit reach the standards of EP10-A2 document ,the detection results are accurate with high sensitivity and good stability , and conform to the requirements of clinical applications .

Objective To analyse the effects of serum estradiol levels during controlled ovarian hyperstimulation (COH) on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods The clinical data of 472 patients undergoing IVF-ET with GnRH analogues recombinant FSH long protocol were retrospectively analysed. The area under the curve (AUC) of estradiol (E2) level was calculated during COH, and patients were categorized into groups according to the percentile of AUC of E2(AUCE2) during COH. The general characteristics and parameters related to the outcomes of IVF-ET were compared among groups. Results The 10th percentile and 90th percentile of AUCE2 were 3 347.0 pmoL/L and 14 414.3 pmol/L, respectively. Four hundred and seventy-two patients were divided into lower reaction group (AUCE2 3 347.0 pmol/L, n=48), normal reaction group (14 414.3 pmol/L>AUCE2 > 3 347.0 pmol/L, n=376) and higher reaction group (AUCE2≥14 413.3 pmol/L, n=48). There was no significant difference in age, body mass index, baseline follicle stimulating hormone level, time of treatment with gonadotropin, endometrium thickness on day of transfer and embryos transferred(P>0.05). Compared with lower reaction group and normal reaction group, the number of oocytes per retrieval and number of embryos frozen were significantly larger(P<0.01) and the mild/severe ovarian hyperstimulation syndrome rate was significantly higher in higher reaction group(P<0.05). There was no significant difference in fertilization rate, cumulative embryo score, high-grade embryo rate, clinical pregnancy rate and implantation rate among groups (P> 0.05). Conclusion Sustained snpraphysiological serum E2 levels during the COH process do not adversely affect the quality of oocytes and embryos, clinical pregnancy rate and implantation rate to some extent in IVF-ET.

Animals ; Central Nervous System ; radiation effects ; Humans ; Mice ; Microwaves ; Rats

BACKGROUND:There is lack of an objective and standardized animal model for assessing the therapeutic effect of physical and medication treatment on bone defoct, the effectiveness of operation, as well as the role of bone substitute in the repairing of bone defects.DESIGN:Verified study on the experimental model of bone nonunion in rabbitsSETTING: Department of Orthopaedics in Shenzhen people' s Hospital MATERIALS:Twenty common grade pure New Zealand rabbits of either gender were selected with body mass of (2.5±0.5)kg,aged 6 to 8 months.METHODS :This experiment was carried out at the experimental animal center of Shenzhen people's Hospital between May and August 1999. 1.5cm bone segment (including periosteum)was cut off in the middle of forearm radius in 20 common grade pure NewZealand rabbits,the broken ends were covered with bone wax, 10 weeks later, the bone nonunion status was assessed by macropathological observation, pathohistological and X-ray examination.MAIN OUTCOME MEASURES:Observations on rabbit forearm radius defects by macropathological observation, pathohistological and X-ray examination.RESULTS :Twenty rabbits(40 side radius)were enrolled in this study and weeks later, bone defect region was found filled with fibrous cicatricial tissue without osseous connection ,bone wax was not absorbed, capitulum was ossified with medullary cavity blocked,a small amount of callus formed at both broken ends of fractural bone ,length of bone defect ranged from 0.8 to blocked under optical microscope,chondrocyte and osteocyte could be observed arranging disorderly and covered with fibrous membrane,defect reosseous connection could be detected at defect region at week 10,broken end was ossified and medullary cavity was blocked ,there was small amount of callus appeared at both broken ends displaying irregular shape.CONCLUSION:Bone nonunion experimental animal was successfully established on rabbits in this study, with pathological changes meeting the need of bone nonunion and displaying typical properties,which can be used as reliable and feasible experimental animal model.

Objective To analyze the clinical and pathological characteristics of breast carcinoma in elderly female patients and to offer the standard clinical diagnosis and treatment for breast carcinoma.Methods A total of 178 patients admitted to Breast Center of Beijing Hospital from January to December 2011 were enrolled in this retrospective study.Patients were divided into non-elderly group and elderly group.Clinical features,imaging diagnosis,operation patterns and pathological diagnosis were recorded.The data were analyzed by using SAS 9.1 software.Results The patients diagnosed as breast carcinomas in BI-RAD 4-5 categories by mammography were much more in the elderly group than in the non-elderly group (82.1％ vs.63.0％,P＜0.05).The diagnostic accuracy rates of ultrasonography and mammography in the elderly group were comparable(P＞ 0.05),while in the non-elderly group,the diagnostic accuracy rate of ultrasonography was higher than that of mammography (P＜0.05).The incidence of concurrent diseases was higher in the elderly group than in the non-elderly group (P＜0.05).The patients undergoing breast resection operation were much more in the elderly group than in the non-elderly group (14 cases vs.3 cases,P＜0.05).The pathological diagnosis analysis showed that there were no significant differences in the number of ER-positive cells and PR-positive cells,tumor size,histological grade,pathological stage between the two groups (all P＞0.05).The incidence of lymph node metastasis was lower in the elderly group than in the non-elderly group (P＜0.05).The percentage of Ki-67 positive cells was lower in the elderly group than in the non-elderly group (P＜0.05).The percentage of CerbB-2 strongly positive (+++) cells was lower in the elderly group than in the non-elderly group (5.1 ％ vs.24％,P＜0.05).The invasive ductal carcinoma was the major histological type of breast cancer in both two groups,but there were more mixed type and other type carcinomas in the elderly group than in the non-elderly group (P＜0.05).Conclusions Ultrasonograpy and mammography have better sensitivity for breast cancer in elderly female patients.The surgical protocols are often influenced because more concurrent diseases have occurred in the elderly.There are significant differences in some prognostic factors between the two groups,which may imply a better prognosis in elderly patients.