Cholelithiasis has still been a common and endemic disease damaging people's health in our country.Management modes and prognosis of this disease have been changed and improved greatly in the past fifty years.Based on our own clinical practice and experience in the People's Hospital of Hunan Province,we reviewed aspects concerning on diagnosis,principles and technical considerations of surgical treatment,summarized background and changes in the past almost half century,which reflected our unremitting efforts and distinctive contributions in management of cholelithiasis.Our experience demonstrated that cholelithiasis should not be considered as a gradually disappearing disease,difficulties and perplexities in dealing with such disease would still be arduous challenges for surgeons,although rates of stone residue and reoperation decreased dramatically.

Objective To describe a modified basin-forming hepatic duct-jejunum Roux-en-Y choledochojejunostomy and explore its clinical application.Methods We retrospectively reviewed clinical data on 57 patients receiving modified basin-forming hepatic duct-jejunum Roux-en-Y choledochojejunostomy in the Department of Hepatobiliary Surgery,People's Hospital of Hunan Province during the period from February 2016 to August 2016.Results Among 57 cases,38 cases previously underwent conventional basinforming hepatic duct-jejunum Roux-en-Y choledochojejunostomy for the reasons such as hepatolithiasis,iatrogenic proximal bile duct injury,congenital choledochal cyst (Todani type Ⅰ),etc.The mean number of operation was 1-4(1.8 ± 1.3).Errors during reoperation can be classified relevant to cholangiojejunostomy anastomosis,bridging jejunal loop and jejunum-bridging jejunal loop anastomosis.Among 57 cases,bile intestinal anastomotic leakage occurred in one patient,incision fat liquefaction in 3 patients,2 patients experienced stress gastritis,all postoperative complications recovered under conservative management.No postoperative mortality happened.During mean (4.07 ± 3.27) months follow-up period,only 4 patients complained of reflux cholangitis,which could be easily managed by antibiotics use.Conclusions By correcting errors in application of conventional Roux-en-Y choledochojejunostomy,a modified basin-forming hepatic duct-jejunum Roux-en-Y choledochojejunostomy proposed in this study demonstrated preliminary better results.

Chronic lymphocytic leukemia (CLL), the most frequent form of leukemia in Western countries, is characterized by the clonal proliferation and accumulation of neoplastic B lymphocytes in the blood,bone marrow,lymph nodes and spleen.During the past decades,important advances have been made in the understanding of the biology,pathology,diagnosis and treatment of CLL.In the 53rd ASH annual meeting,lots of new discoveries about the biology, prognosis, and treatment of CLL were introduced which lead us to further understand CLL and may provide more or better treatments for CLL patients.

High grade B-cell lymphoma (HGBL) has been defined as a separate entity in World Health Organization classification in 2016 and is considered to be clinically aggressive. People make continuous analysis of the subgroups and accurate treatments, such as the comparison between the prognosis of HGBL-not otherwise specified and double-hit lymphoma (DHL), transformed and primary DHL, myc partner/bcl-2/bcl-6 translocation, TP53 expression, serum albumin, chemoimmunotherapy, hematopoietic stem cell transplantation, T cells with chimeric antigen receptors therapy, etc. This report will address the progress of HGBL prognosis and therapy in the 58th American Society of Hematology Annual Meeting.

[Objective]To evaluate the reliability of proximal femoral nail anti-rotation(PFNA) in treatment of intertrochanteric fracture using K-wire apex distance(KAD) intraoperatively to control tip apex distance(TAD).[Method]From January 2007 to January 2009,44 cases of intertrochanteric fractures were treated by closed reduction internal fixation with PFNA.Intra-operative KAD and post-operative TAD were measured and analyzed for their correlation.[Result]Follow-up was given to 42 patients for 6-18 months(averaged,10 months).Bone union was achieved after 11-23 weeks(averaged,13 weeks).Intra-operative KAD were 13-31 mm,with an average of 21.75 mm.Post-operative TAD were 18-35 mm,with an average of 24.61 mm.Recurrence of cerebral infarction was found in 1 case.No infection,deep vein thrombosis,intramedullary nailing rupture,screw broken or femoral fracture was found.[Conclusion]With the help of intra-operative fluoroscopy,the distance from the end of Kirschner's wire to joint surface(KAD) plays an important role in controlling TAD,and it could prevent relative complications such as helical blade cutting-out of femoral head.

Objective To study the clinical characteristics and effects of surgical treatment of children with thalamic tumors.Methods The clinical data of 22 cases were retrospectively studied and followed-up 6 months to 9 years.Results There were 13 boys and 9 girls,their ages ranging from 3 to 13 years.The average duration of symptoms before diagnosis about 2 months.Headache and papilledem were the most symptoms and signs,respectively.Most children′s thalamic tumors were low grade tumors with clear verge.In this group,good results were obtained that total remove 9 cases,subtotal remove 8 cases,partial remove 3 cases,biopsy 2 cases and no surgical death.Conclusions Clinical character of children thalamic tumors is distinct and good surgical results in the nearly future.The long results are determined by type of pathology.

Acupuncture Therapy ; instrumentation ; methods ; standards ; China ; Humans ; Moxibustion ; instrumentation ; methods ; standards ; Needles ; standards ; Reference Standards

Objective To study clinical manifestations and imagine features (CT and MRI) on toxic encephalopathy after inhaling heroin. Methods 13 patients with toxic encephalopathy induced by inhaling heroin were observed and analyzed on its clinical and imagine features (CT and MRI).Results 13 patients all were male, and were intoxicated by way of inhaling heroin vapour. Nine cases had appearances of clinical manifestations during abrupt abstinence. The main clinical manifestations of the disease were of the sub-acute diffuse cerebral lesions, especially of early mental symptoms and cerebellum ataxia. The CT of all 13 cases showed multiple white matter lesions involving in the frontal, parietal, occipital,temporal, and cerebellum hemisphere dentate nucleus. There was no occupational mass shown in general. The MRI of 6 cases showing focus was the same as of the CT. Conclusion The diagnosis of HTE should be dependent on the definite inhaling heroin vapour and their clinical features and neuroradiological appearance. CT should be valuable for the diagnosis of HTE, and the MRI as well. Corticosteroids show less therapeutic effect on such diesease.

Objective:To prepare enteric-coated pellets of ( R)-rabeprazole sodium and investigate the drug release behavior in vitro. Methods:The pellets of ( R)-rabeprazole sodium were prepared by a fluid bed coating technology, and HPMC and Eudragit L30D-55 was used as the material of isolation layer and enteric coating, respectively. The similarity of in vitro drug release was com-pared between the reference preparation and the self-prepared preparation. Similar factor ( f2 ) was used to evaluate the similarity of re-lease curves. Results:The coating formula of ( R)-rabeprazole sodium enteric-coated pellets was as follows: the weight of HPMC E5 and Eudragit L30D-55 was 12. 0% and 45. 0%, respectively, and the plasticizer was 8. 0% of the weight of the polymers. The f2 of the reference preparation and the self-prepared preparation was more than 50, which indicated the release behavior was similar. Con-clusion:The release behavior of ( R)-rabeprazole sodium enteric-coated pellets is quite promising, and the preparation technology can be used in the industrial production.

Chronic lymphocytic leukemia (CLL) is a kind of malignant B-cell chronic lymphoproliferative disorder with highly heterogeneous clinical courses. Due to the recent advances in immunology, cellular genetics and molecular biology, several prognostic markers based on genetic, phenotypic, and molecular biology characteristics of CLL cells have emerged in the past decade. This article reviews the reports from the 57th American Society of Hematology (ASH) annual meeting on the progress of the prognosis of CLL.