Objective To evaluate the safety of laparoscopic cholecystectomy (LC) for patients with hepatic cirrhosis. Methods We retrospectively analyzed the clinical data of 72 patients with hepatic cirrhosis (Child-Pugh’s grads A or B). The patients received LC between July 2002 and March 2007. Under general anesthesia, the operation was preformed with four trocars and an intra-abdominal pressure of 8 to 12 mm Hg. Results LC was completed in 71 of the patients (antegrade in 67 and retrograde in 4), 6 of them received subtotal cholecystectomy. One patient was converted to open procedure because of dense adhesion at the Calot triangle. The operation time was 35 to 105 minutes (mean, 51 minutes); blood loss ranged from 5 to 60 ml with a mean of 12 ml. The patients were discharged 3 to 11 days (mean, 5.6 days) after the operation and were followed up for 3 to 18 months (mean, 12 months). After the operation, 7 patients developed ascites, and 1 had hemorrhage at the puncture site. During the follow-up, all patients were free of biliary symptoms, no residual or recurrent liver stone was found. Conclusions LC is safe for patients with liver cirrhosis, and should be the first choice for Child-Pugh’s grads A or B patients. Proper preoperative preparation and intra-and postoperative treatments are critical for the surgical outcomes.

0 05).The size of PEI group was larger than that of PAI group 2 months after treatment (P

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.

Use of the existing data to analyse the situation for Military progress prizes in science and technology,medical achievement prizes,Army logistics major science and technology achievement award of Nanjing Military Commands health system from the eighth five-year plan period to the eleventh five-year plan.It shows that the medical research is overall increase during the ninth five-year plan period and downturn during the tenth five-year plan period,then the lever picks up again during the eleventh five-year plan period.This suggests that the improve the quality and quantity of the achievement in science and technology is effected by subject scale and scientific research innovation factors.Then put forward some countermeasures and suggestions for guiding the project direction of subject research,expanding the scale of subject,introducing high quality talents actively,using the incentive mechanism to strengthen the innovation of science and technology and expressing the special advantage to speed up the transformation of scientific and technological achievements.

Objective To evaluate the effects of ambroxol on prevention of bronchopulmonary complications after thoracotomy in patients with chronic obstructive pulmonary disease(COPD).MethodsTotal 161 elderly patients aged ≥70 years with COPD undergoing thoracotomy were randomly allocated to two groups:ambroxol group (300 mg/d,6 d) and placebo group as control.Pulmonary complications were evaluated by clinical symptoms,radiographic changes,and blood gas analysis. Results The incidence rates of atelectasis were 8.6％ in ambroxol group and 28.8％ in placebo group,respectively.The PaO2 values after surgery in ambroxol group decreased more than in placebo group (P＜0.05) compared with the preoperative values.Side effects were not found in all patients.Conclusions Ambroxol should be considered as an alternative pharmacologic approach for the prevention of post-thoracotomy pulmonary complications in the elderly patients with COPD.

In order to understand the patients' physique accurately,and formulate individualized conditioning scheme for patients with biased physique,our hospital established a new clinic called physique nursing clinic of Traditional Chinese Medicine (TCM) in August 2017,formed a series of corresponding rules and management regulations,and made clear the focus of the clinic and the work content of outpatient nurses.After implementation,the physique nursing clinic of TCM has achieved various goals:a total of 526 cases of TCM physique identification were carried out,324 patients with biased physique were given health guidance,and 148 cases of referral treatment.Hospital organized clinic members to go out to study for 10 times,and the voluntary community clinic were developed for 4 times.The physique nursing clinic of TCM has been appreciated by outpatients,doctors and nurses,who believed it could meet patients' individualized health needs and promote the development of TCM nursing.