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.

OBJECTIVE:To discuss the general regularity and characteristics of the drug-induced edema so as to provide reference for clinical safe medication.METHODS:173 drug-induced edema cases publicly reported in domestic journal from 2001 to 2006 were analyzed statistically.RESULTS:The drug-induced edema was more often seen in males than in females,but not linked to age.It was characterized by early onset,with 76(43.9%)showing edema within 1h.It was chiefly induced vial oral and intravenous routes.The drug-induced edema was caused by 17 drug categories(or 115 kinds),with antibacterials showing the highest percentage(31.2%,54 cases).Laryngeal edema,which occurred in 57 cases,was the chief type among all the edema cases.CONCLUSION:Drug-induced edema is a common adverse drug reaction,which should be given great attention in the clinic,much as in the case of acute laryngeal edema.Clinicians should give close monitoring on patients after medication to guard against possible events.

Objective To explore the fibrosis mechanism of patients with fibrosing cholestatic hepatitis(FCH) in the way of degradation of collagen.Methods The expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of metalloproteinase 1(TIMP1),and contents of type I,III collagen proteins were detected by immunohistochemical staining in the liver tissues of 9 cases with FCH associated with HBV developed following renal transplantation and 5 cases without liver disease as controls.Results The expressions of MMP1 and TIMP1,and type I,III collagen proteins in the patients with FCH were significantly higher than those in the control group.There was a positive correlation between the expressions of type I,III collagen proteins and TIMP1/ MMP1 ratio.Conclusion Hepatic fibrosis in the patients with FCH associated with HBV developed following renal transplantation may be relative to the increase of TIMP1 expression which inhibit the degradation of collagen.

Objective To observe the expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of matrix metalloproteinase1(TIMP1) and the collagen type Ⅰ,Ⅲ deposition in the liver tissues,and evaluate the possible fibrosis mechanism of patients with chronic hepatitis B(CHB) in the way of degradation of collagen. Methods The specimens of the biopsy liver in 50 cases with CHB were detected for the expressions of type Ⅰ,Ⅲ collagen proteins,MMP1 and TIMP1 by immunohistochemical staining. Results The expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1,were significantly increased along with the advancing of hepatic fibrosis.There was a positive correlation between the expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1. Conclusions Hepatic fibrosis in the patients with CHB may be related to increase of TIMP1 expression that inhibit the degradation of collagen.

Objective To observe expressions of ?-smooth muscle actin(?-SMA) and collagen type Ⅰ,Ⅲ deposition in the liver tissues, and to evaluate potential mechanism of fibrosis in patients with fibrosing cholestatic hepatitis (FCH) by collagen synthesis. Method Immunohistochemical staining was used to detect the expressions of ?-SMA and contents of type Ⅰ,Ⅲ collagen proteins, which were from the specimens of the biopsy liver in 9 cases with FCH associated with hepatitis virus B (HBV) developed following renal transplantation and in 5 cases without liver disease(control group), respectively. Results The expressions of ?-SMA and type Ⅰ,Ⅲ collagen proteins in the patients with FCH were significantly higher than those in the control group. The expression and distribution pattern of ?-SMA and type Ⅰ,Ⅲ collagen proteins were almost identical, and quantitative analysis showed a positive correlation (P

Insulin as high-risk medication , its clinical application is increasing widely .In order to decrease adverse events and ensure the safety of medication application , our department design improved insulin labeling affix to both reasonable and scientific preservation of high-risk medication, and ic convenient for nurses check and application , improve the clinical medication safety , and reduce medical disputes .

Objective To investigate the CT and MRI features of intraosseous myofibroma/myofibromatosis in pediatric patients.Methods The retrospective analysis involved the examination of clinical data and imaging findings from 15 children who were diagnosed with myofibroma/myofibromatosis of bone invasion through pathological means.Subsequently,the imaging characteristics were summarized.Results CT examinations were conducted on a total of 15 patients,with 2 of them also received enhanced scans.Additionally,MRI examinations were conducted on 5 patients,with 3 of them also underwent enhanced scans.Eleven patients were diagnosed with solitary type myofibroma,with 7 cases localized in the skull and the remaining lesions observed in the maxillofacial bone.Three patients exhibited the multicentric type without any involvement of visceral organs,while one patient presented with the multicentric type accompanied by visceral involvement.The lesions exhibited a uniform soft-tissue density on plain CT scan,predominantly located between the inner and outer layers of the bone.Additionally,they displayed swelling changes and osteolytic bone destruction,with some lesions showed residual bone shell.On MRI,the lesions exhibited a uniform signal,demonstrated an isointense or slightly hypointense signal on T1WI and an isointense or slightly hyperintense signal on T2WI.The lesions displayed significantly heterogeneous enhancement on CT and MRI.Conclusion The imaging manifestations of intraosseous myofibroma/myofibromatosis in pediatric patients exhibit certain characteristics,and the residual bone shell in the lesion is helpful for diagnosis,however,distinguishing it from Langerhans cell histiocytosis of the bone remains challenging,necessitating the reliance on pathological diagnosis.

Objective: To analyze the Oxford classification (MESTC) and the International Study of Kidney Disease in Children (ISKDC) classification for evaluating the clinical manifestations, histological lesion and short-term prognosis of children with Henoch-Schönlein purpura nephritis (HSPN). Methods: According to the Oxford classification and ISKDC classification, the histological lesions of children with HSPN diagnosed by renal biopsy from Beijing Children's Hospital affiliated to Capital Medical University from January 2018 to December 2018 were re-evaluated. The renal biopsy specimens of the selected subjects were scored according to the Oxford classification and the ISKDC classification. According to whether the first symptom was combined with renal performance, MESTC score and ISKDC classification, children were grouped. The differences in clinicopathological manifestations between the groups were compared. Correlation between MESTC and ISKDC grades was analyzed by nonparametric test rank correlation. Kaplan-Meier survival curve and Log-rank test were used to compare the difference of proteinuria remission rate between the two groups. Univariate and multivariate Cox regression equations were used to analyze the influencing factors of the proteinuria remission rate. Results: A total of 78 children with HSPN were enrolled. There were 37 male patients (47.4%) with age of (10.4±2.9) years. When the patients were divided according to MESTC scores and ISKDC classification, the results showed that the proportion of children with nephrotic-range proteinuria in the group of endocapillary hypercellularity (E1, P=0.008), segmental glomerulosclerosis (S1, P=0.015) and ISKDCⅢ(P=0.041) was higher than that of E0, S0 and ISKDCⅡ groups. The proportion of children with E1 (P=0.015), crescents (C1&C2, P=0.025) or ISKDCⅢ(P=0.017) that had been treated with high-dose methylprednisolone was higher. The result of Kaplan-Meier survival curve showed more difficult for proteinuria remission in children with C2 are than C0&C1 group (P=0.026), while no difference were found when children were grouped by M, E, S, T and ISKDC. Multivariate Cox regression analysis showed that the C2 (HR=0.143, 95%CI 0.020-1.046, P=0.055) might be a risk factor for proteinuria remission, while the P value was close to 0.05. Conclusions Children with HSPN scored as ISKDCⅢ, E1 and S1 are more likely to show nephrotic-range proteinuria. C2 may indicate that patients are more difficult to achieve proteinuria remission.