Objective To introduce a surgical technique for the cases with the papilla of Vater located in the diverticula. Methods When diverticula was opened, there was a cuff shape edge left in the bottom, which reduced tensility of oversew, and the probability of postoperative leakage was reduced. Fistula Oddi sphincteroplasty was adopted oversewwing when it was splitted,and the length of each time was not more than 3mm,and the total length was not more than 2cm. ResultsNone of 11 cases died in postoperation, 3 of them occured biliary fistula,duodenal fistula,and pancreatic fistula, the rate of fistula was 27.27%. They were all followed-up, and the result was satisfactory.ConclusionAlthough the operation technique is ifficult,and there are many complications,it is a good technique.

The purpose of this study was to determine the total Bolton index (TBI) and anterior Bolton index (ABI), evaluate the clinical significance of tooth size discrepancies and the influence of gender variation of mesiodistal tooth width on Bolton Index and estimate which tooth has the greatest influence on Bolton Index. A total of 110 pairs of pretreatment dental study casts (41 male and 69 female) were selected from patients treated in Department of Orthodontics of Union Hospital in Wuhan, China. A sliding dental Vernier caliper was used for the measurement of the mesiodistal tooth width. Descriptive statistical mean values, standard deviation, standard error of the mean values, coefficient of variance and the t-test were used for the statistical analysis of the data. The study found that TBI, ABI and the total sum of teeth width had no significant difference between male and female. Male group indicated that Bolton Index (BI) was mostly influenced by the width of lower right second premolar, whereas female group showed that BI was mostly influenced by the width of both the right and left maxillary lateral incisor.

A method was developed for the determination of four sulfa antibiotics in groundwater, soil and excreta using solid phase micro extraction disks coupled with high performance liquid chromatography. The influence of eluent, different solid phase micro extraction membranes on the recovery of sulfa antibiotics in groundwater was investigated and it was found that when using the mixture of methyl alcohol and 1 . 0% formic acid as eluent, HLB ( divinyl benzene-N-vinyl pyrrolidone polymer ) as extraction membranes, an optimal enrichment effect was obtained. Different pretreatment methods for the 3 kinds of samples abovementioned were also examined. It was found that the signal response values obtained by using mixture of methyl alcohol and 1 . 0% formic acid as base solution of standard or sample solution was higher 8-10 times than that by using methyl alcohol only. Under the optimal conditions, good linear relationships were obtained in the sulfa antibiotics concentrations of 0 . 005-10 . 0 mg/L with the correlation coefficients>0 . 9999;The detection limits of sulfathiazole ( ST ) , sulfadiazine ( SM ) , sulfamethazine ( SM2 ) , sulfamethoxazole ( SMX ) were 1 . 08 , 3. 56, 4. 63 and 1. 84 ng/L(S/N=3), respectively. The enrichment factors for four sulfa antibiotics were 4000 times with solid phase micro extraction disks. The RSD of matrix spiked samples were 0. 1%-0. 4%(n=7). The proposed method was applied to the determination of the four sulfa antibiotics in groundwater, soil and excreta with spiked recoveries of the four sulfa antibiotics in the range of 69 . 80%-117 . 60%.

Objective To explorethe clinical features of adenosquamous carcinoma,squamous cell carcinoma and adenocarcinoma of the gallbladder. Methods A retrospective analysis of 112 patients with gallbladder carcinoma was performed.The clinical features and outcomes of 11 patients with either adenosquamous or squamous cell carcinoma were compared with the other 101 patients of adenocarcinoma.Results The rate of tumor with T3 or T4 stage in adenosquamous/squamous cell carcinoma group and adenocarcinoma groupwere 100%and 53%(X2=7.013,P=0.008).The rate of distant metastasis in adenosquamous/squamous cell carcinoma group and edenocarcinoma at advanced stage(T3 or T4 stage)group were 0 and 35%(X2=3.900,P=0.048).The rate of lymph node invasion were 82% and 87%(X2=0.000,P=1.000).The rate of gastrointestinal tract invasion in adenosquamous/squamous cell carcinoma group and adenocarcinoma at advanced stage(T3 or T4 stage)group were 45% and 15%(X2=3.618,P=0.054).The median survival time for the two groups were 5 months and 4 months respectively(X2=0.359,P=0.549).Condusiom Adenosquamous/squamous cell carcinoma of the gallbladder had high local invasion capacity and usually were diagnosed at an advanced stage.The distant metastasis rate of adenosquamous/squamous cell carcinoma of the gallbladder was lower compared with adenocarcinoma.The lymph node invasion mte of adenosquamous/squamoua cell carcinoma was similar to adenocarcinoma.

Objective To enhance therapeutic effects of hepatolithiasis by improving surgical procedures. Methods Forty eight patients suffering from hepatolithiasis with bile duct stricture were treated in this study, in whom 27% (13/48) of the stone was located in the left lobe, 19% (9/48) in the right, and 54% (26/48) in bilateral lobe. Stone coexisted with stricture in 71% (34/48). Hepatic duct and stricture were opened, making a basin at the porta, and repaired by one end of a segment of jejunum. The other end was set subcutaneously. At the same time, a portion of the liver habouring stone was resected. Results Forty four out of 48 patients were followed up (92%) with an average of 5 years. The rate of recurrent stone was 20% (9/44), the rate of cholangitis was 16% (7/44), and 84% of cases fared very well. Postoperatively, 7 cases underwent lithotomy by choledochoscope through the subcutaneous blind loop. Conclusion This procedure decreases the relapsing cholangitis effectively.

Objective To investigate the different exposure and treatment methods for the chorda tympanic nerve in middle ear surgery, and discuss the surgery techniques and the feasibility of the chorda tympanic nerve protection.Methods From September 2013 to March 2016, 155 cases of middle ear surgeries at Zhujiang hospital were included in this study, including 24 cases of type I tympanoplasty, 6 cases of atticotomy and type I tympanoplasty, 22 cases of atticotomy and type II tympanoplasty, 23 cases of canal-wall-up mastoidectomy and tympanoplasty,74 cases of canal-wall-down mastoidectomy and tympanoplasty, 6 cases of stapedotomy.The conditions of exposure and protection of the chorda tympanic nerve in the operation were compared, and their taste function at 3 days to 1 months postoperatively through questionnaires were evaluated.Results The preservation rate of the chorda tympanic nerve was up to 89.03%(138/155).There were 17 cases of chorda tympanic nerve injuries, of which 15 cases suffered hypogeusia with the rate being 88.2%(15/17).In 126 cases of the complete protection of the chorda tympanic nerve, 13 of them appeared hypogeusia at 10.3% (13/126), but they recovered within 1 months postoperatively.One case of delayed facial paralysis occurred in 16 days postoperatively, and recovered completely after 2 weeks of treatment with glucocorticoids.There was a significant difference in the incidence of postoperative abnormal taste between the complete protection of the chorda tympanic nerve and fracture during operation.Conclusion According to the different position and exposure of chorda tympanic nerve, the individual measures should be taken in middle ear surgery to protect the chorda tympanic nerve.

Objective To explore the relationship between surgical procedure and prognosis of gallbladder carcinama invading the whole layer without extension beyond serosa. Methods A retrospective analysis on 24 patients with pathologic stage T2 gallbladder carcinoma invading the whole layer without extension beyond serosa was performed. Kaplan-Meier method was used to analyze the survival rate and disease-free survival rate between the patients undergoing radical resection ( n = 14) and the patients undergoing simple cholecystectomy (re = 10). Results The 1,3 and 5-year survival rates for patients undergoing radical resection were 100%、71% and 54% respectively, whereas the rates that for patients undergoing simple cholecystectomy were 70%、30% and 20% respectively. There was significant difference between the survival time of these two groups ( X2 =4. 659, P = 0. 031). The median clinical tumor-free survival time in radical resection group and simple cholecystectomy group were 45 months and 13.5 months respectively. There was significant difference between the clinical tumor-free survival time of these two groups ( X2 = 3. 854, P = 0. 049 ). Conclusions A radical resection is indicated for patients with pathologic stage T2 gallbladder carcinoma. Radical resection is an effective method to improve the survival rate for pathologic stage T2 gallbladder carcinoma.

Objective To study the vancomycin-resistant genes and the virulence factors genes in vancomycin-resistant Enterococci (VRE),and to analyze the drug-resistance character and epidemic characteristics of VRE strains and provide the basis for clincal selection of drugs and infection control.Methods VRE were screened by agar dilution sieving plate (ADSP) containing 6 μg/ml of vancomycin,drug resistance of VRE to other common antibiotics were detected by VITEK-60 automatic microbial analyzer.The gene types and virulence factor genes of VRE were determined by PCR.And the genetic relationships among VRE were determined by multilocus sequence typing.Results Seven vancomycin-resistant Enterococcus faecium strains were found in 360 enterococcus strains.All the VRE strains exhibited high-level vancomycin resistance ; some of them were medium or senstive to teicoplanin.They all carried vanA gene and esp gene and one of them carried 4 kinds of virulence factor genes.The ST type of the 7 VRE strains were diffused distribution.Conclusion We found vanB phenotype vanA genotype vancomycin-resistant Enterococcus faecium isolates in Wenzhou; these VRE strains were multidrug resistance and carried various virulence factor genes.Linezolid could be used as a recommend drug for treatment of VRE infection.The protection of antibiotics sensitivity should be strengthened.

Objective This study aims to investigate the moral disgust cognitive processing of patients with obses?sive-compulsive disorder (OCD) and its relationship with OCD symptoms. Methods Twenty-eight OCD and 30 healthy controls matched for gender, age and education completed lexical decision task, recording reaction time and accuracy of words and assessing the degree of disgust. Yale-Brown obsessive-compulsive scale (Y-BOCS) and Padua Invento?ry-Washington State University Revision (PI-WUSR) were used to assess the symptoms. Results OCD group showed significantly longer reaction time to core disgust-related words [(762.69 ± 128.25) ms vs. (648.69 ± 162.66) ms] and moral disgust-related words [(798.73 ± 115.26) ms vs. (727.00 ± 106.06) ms] than the healthy controls (P<0.05). OCD group showed significantly higher aversion degree to core disgust-related words [(6.38 ± 1.78) vs. (5.03 ± 1.64)] and moral dis?gust-related words [(7.08 ± 1.23) vs. (5.77 ± 1.44)] than control group (P<0.05). Y-BOCS total score, Y-BOCS obsessive thoughts score, Y-BOCS compulsive behavior score, total score of PI-WUSR, cleaning/pollution force factor score, hurt?ing themselves and others force factor were positively correlated with two types of disgust-related words in patients group (P<0.05). Multiple stepwise regression analysis between disgust words and Y-BOCS/PI-WUSR scores pointed that only CWCF influenced disgust degree of core disgust-related words (β=0.61, P<0.01) and moral disgust-related words (β=0.54, P<0.01), respectively. Conclusion The core disgust and moral disgust of OCD are stronger compared to controls.

The purpose of this study was to determine the total Bolton index (TBI) and anterior Bolton index (ABI), evaluate the clinical significance of tooth size discrepancies and the influence of gender variation of mesiodistal tooth width on Bolton Index and estimate which tooth has the greatest influence on Bolton Index. A total of 110 pairs of pretreatment dental study casts (41 male and 69female) were selected from patients treated in Department of Orthodontics of Union Hospital in Wuhan, China. A sliding dental Vernier caliper was used for the measurement of the mesiodistal tooth width. Descriptive statistical mean values, standard deviation, standard error of the mean values, coefficient of variance and the t-test were used for the statistical analysis of the data. The study found that TBI, ABI and the total sum of teeth width had no significant difference between male and female.Male group indicated that Bolton Index (BI) was mostly influenced by the width of lower right second premolar, whereas female group showed that BI was mostly influenced by the width of both the right and left maxillary lateral incisor.