Objective To investigate the feasibility and techniques of laparoscopic biliary re-operations. Methods Laparoscopic surgery was performed in 13 patients with bile duct stones who already had undergone biliary tract operations. Results Laparoscopic choledochotomy was successfully completed in 12 cases, while a conversion to open surgery was required in 1 case. The success rate of laparoscopic surgery was 92.3% (12/13). The operation time was (101～300) min, with a mean of 155 min. No intra- or post- operative complications occurred. Conclusions Laparoscopic biliary re-operations are feasible and experiences are needed to ensure the success of surgery.

Aurantii Fructus is the dried and immature fruit of Citrus aurantium and its cultivars. To investigate the chemical constituents of Aurantii Fructus, the separation and purification of constituents were performed by column chromatography on silica gel LH-20, HW-40, ODS, PHPLC and PTLC. Fourteen flavonoids, including four flavone glycosides and ten polymethoxyflavones (PMFs) were isolated from the EtOAc fraction and Petroleum ether fraction of Aurantii Fructus and their structures were identified by physicochemical properties and spectral data (NMR and MS) as (2R) -and (2S)-6"-O-acetylprunin (1,2), naringenin-7-O-β-D-glucopyranside (3), 5,7,4'-trihydroxy-8,3'-dimethoxyflavone-3-O-6"-(3-hydroxyl-3-methylglutaroyl)-β-D-glucopyranoside(4), 4'-hydroxy-5,6, 7-trimethoxyflavone (5), natsudaidain (6), nobiletin (7), sinensetin (8), 5,6,7,4'-tetramethoxyflavone (9), 5,7,8,4'-tetramethoxyflavone (10), 3,5,6,7,8,3',4'-heptamethoxyflavone (11), tangeretin (12), 5-demethyl nobiletin (13), and 5-hydroxy-6,7,3', 4'-tetramethoxyflavone (14). Compound 3-5 s were isolated from this plant for the first time and compound 1 was a new one.
Citrus ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Flavonoids ; chemistry ; isolation & purification ; Fruit ; chemistry ; Mass Spectrometry ; Molecular Structure

The study was purposed to analyze DNA and allele structure of the partial D phenotypes D(Va) and D(VI) of the Rhesus blood group in Chinese. Through polymerase chain reaction (PCR) and direct genomic DNA sequencing, the RHD gene was detected in three weak D individuals identified serologically. The results showed that among the three weak D individuals, one was identified as partial D phenotype D(Va) (Hus) type and genotyped DccEe; another two were testified as D(VI) III type and genotyped DCcee. Moreover, the breakpoints of the replaced region by RHCE in D(Va) (Hus) were 5' end of the exon 5 and 3' end of the intron 5, and there were 7 novel polymorphisms in intron 5: 23-25(GCA)2, 98G>A, 168-169insG, 205-206insT, 494-495insA, 1256-1257insC, 1347G>T. In conclusion the whole exon 5 and intron 5 are replaced by RHCE in D(Va) (Hus) detected in Chinese.
China ; Exons ; genetics ; Genotype ; Humans ; Introns ; genetics ; Phenotype ; Polymerase Chain Reaction ; Rh-Hr Blood-Group System ; genetics ; Sequence Analysis, DNA

A UPLC-MS/MS method based on metabonomic skills was developed to study the serum metabolic changes of rats after acute liver injury induced by CCl4 and to evaluate the action mechanism of Si-Ni-San. The integrated data were exported for principal components analysis (PCA) by using SIMCA-P software, in order to find the potential biomarkers. It showed that clear separation of healthy control group, model group, silymarin group, Si-Ni-San group was achieved by using the PCA method. Nine significantly changed metabolites were identified as potential biomarkers of acute liver injury. Compared with the health control group, the model group rats showed higher levels of phenylalanine, tryptophan and GCDCA together with lower levels of LPC 16 : 0, LPC 18 : 0, LPC 18 : 1, LPC 16 : 1, LPC 20 : 4 and LPC 22 : 6. These changes of serum metabolites suggested that the disorders of amino acid metabolism, lipid metabolism, bile acid biosynthesis and anti-oxidative damage were related to acute liver injury induced by CCl4. Si-Ni-San might have the anti-liver injury effect on all these four metabolic pathways.

Objective To explore the clinical efficacy and safety of transcatheter absolute ethanol injection treatment on varicose veins of lower extremity.Methods twenty-there patients with 25 varicose veins of lower extremity were treated by puncture of great saphenous vein above 1—2 cm of complicated inner ankle,perforating catheter to the point below the 3—4 cm of the conjunction of great saphenous vein and Femoral vein and pressing the conjunction of these two veins.Under the monitor of DSA,inject the absolute ethenal slowly while retrieve the catheter little by little(one limb with varicose veins injected total volume 15—20 ml),in the mean time,using contrast agent to monitor the level of embolism until the formation of total embolism in the all great saphenous veins.Results All the cases were retrospectively followed up with CDFI examination after 3—12 months of the surgery,No blood flow were seen in the 25 embolismic great saphenous vein.Clinical symptom were alleviated obviously after 2—3 weeks of treatment;varicose veins were collapse after 3 to 7 days.Two eases of leg ulceration were healed after 4 to 6 weeks of operation.20 limbs were found mild swelling in the 2 day after the surgery.However,all the cases were disappeared after 1 to 2 weeks;4 treated limbs developed delayed paresthesia in the 3 day after the surgery,and recovered totally in the 2 weeks.No complications of deep vein thrombosis,lung thrombosis etc al,were found after operation.Conclusions Using transcatheter injection of absolute ethanol to treat varicose veins of lower extremity has the advantage of less invasion,more safety and low appearance of complications.The short term efficacy is solid while the long term effect needs further evaluation.

OBJECTIVEPreviously the weak D and D category allele were investigated in Caucasian and Japanese families. The current study is aimed at an RHD positive, D antigen negative allele in a Chinese family.

METHODSA pair of primers specific for RHD 270A allele were designed, and a sequence specific primer-PCR (SSP-PCR) method was then established to detect RHD 270A allele in 6 members of a family. Furthermore, RFLP method was used to determine the RHD zygosity in all family members.

RESULTSThe RHD 270A allele was detected in the proband, her father and uncle but not grandmother. Therefore this allele may be from grandfather and is inherited through 3 generations. The RHD zygosity test showed that the father and uncle possess one normal RHD gene as RHD 270A carriers, the mother is RHD(+)/RHD(-)heterozygote and the individual is RHD 270A/RHD(-)which causes an RHD positive, D antigen negative trait.

CONCLUSIONThe RHD 270A allele is an ancestral allele, but not a spontaneous.

Alleles ; Asian Continental Ancestry Group ; genetics ; Female ; Genotype ; Humans ; Male ; Pedigree ; Rh-Hr Blood-Group System ; genetics

OBJECTIVETo study the occurrence and radiograph features of the acetabular retroversion in hip dysplasia, and to evaluate the effects on the retroversion by the traditional maneuvers in the periacetabular osteotomy.

METHODSBernese periacetabular osteotomy was performed to 45 continuous dysplastic hips (43 patients) from December 2001 to November 2003. There were 37 female (39 hips) and 6 male (6 hips), average age was 28.9 (range, 15-45). The diagnosis of acetabular retroversion was based on the "cross-over" and "posterior wall" signs on the standard radiographs of the patients pre- or postoperatively.

RESULTSAmong total 45 hips, the "cross-over" sign was positive in 8 hips, whereas including the "posterior wall" sign positive in 5 hips. The occurrence of retroversion was 17.8%. And the cross-over points were located within the superior 1/3 of the acetabulums in all cases. After the osteotomy, all the cross-over points moved to the inferior 1/3 of the acetabulums, and the "posterior wall" sign was seen in all 8 cases.

CONCLUSIONSApproximately one sixth of the patients with acetabular dysplasia have retroversion in which the superior 1/3 of the acetabulum faces posterolaterally. The retroversion can be identified with the standard AP pelvic radiographs. With the traditional maneuvers in periacetabular osteotomy, the retroversion will be aggravated in these patients.

Acetabulum ; abnormalities ; diagnostic imaging ; Adolescent ; Adult ; Female ; Follow-Up Studies ; Hip Dislocation, Congenital ; surgery ; Humans ; Male ; Osteotomy ; adverse effects ; methods ; Postoperative Complications ; diagnostic imaging ; etiology ; Radiography

OBJECTIVETo establish the quantitative diagnostic criteria for cranio-orbito-zygomatic deformity (COZD).

METHODSComputer-assisted three-dimensional (3-D) CT measurement was performed in 30 cases with unilateral COZD. The differences of the measurement data between the affected and unaffected sides were analyzed. Then the patients were diagnosed and classified according to the affected bone, soft tissue and conjunctival sac. Based on the quantitative diagnosis, 8 patients underwent surgery to test the clinical practicability of the diagnostic criteria.

RESULTSThe quantitative diagnostic criteria for COZD could reflect the affected area and the corresponding severity of deformity. It helped to preoperative design and to predict movement of osteotomy segment and. the soft tissue volume needed for augmentation. Good postoperative results were achieved.

CONCLUSIONSThe quantitative diagnostic criteria for COZD can describe the affect area and severity of deformity in detail. It is very practical in the guidance of clinical treatment.

Adolescent ; Adult ; Bone Diseases, Developmental ; diagnostic imaging ; Child ; Diagnosis, Computer-Assisted ; standards ; Humans ; Imaging, Three-Dimensional ; Male ; Orbit ; abnormalities ; Tomography, X-Ray Computed ; methods ; Young Adult ; Zygoma ; abnormalities

OBJECTIVETo summarize the methods and experiences in surgical treatment of hemifacial microsomia.

METHODSFifty-eight cases of hemifacial microsomia that have been treated by plastic and reconstructive surgery and followed-up in our department during last 20 years have been reviewed. Every patient's characteristic was assessed by physical examination, photography, craniofacial cephalometry before planned the method of surgery. Different surgical treatments were chosen according to the side and the structures involved in the abnormalities and the severity of hemifacial microsomia, and the cases were followed up since 3 months after the treatments. The follow-up lean of midline of the lower 1/3 face with that before treatment is compared. The degrees of patients' and surgeons' satisfactions with the treatments were evaluated respectively.

RESULTSThe average angle of lean of midline of skeletal and soft tissue of the lower 1/3 face decreased 4.2 degrees and 2.9 degrees respectively after treatment. Fifty (82.6%) cases satisfied with the outcome of the surgical treatment and surgeons satisfied with 84.5% of the outcome of all the cases.

CONCLUSIONSIndividual surgical treatment based on the side and the structures involved in the abnormalities can effectively correct facial asymmetry of hemifacial microsomia.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Asymmetry ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Treatment Outcome

This retrospective analysis compared standard regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) with the dose-dense ABVD regimen (ABVD-21) in terms of efficacy and toxicity. Patients who had early-stage unfavorable or advanced Hodgkin's lymphoma (HL) according to German Hodgkin Study Group criteria from March 1999 to February 2011 were analyzed for treatment response, long-term survival and hematological toxicity. There were 85 patients in the ABVD-21 group and 118 patients in the ABVD group respectively. The complete remission rates after completion of treatment were 92.9% and 90.7% for ABVD-21 and ABVD, respectively. During a median follow-up period of 62 months, no significant difference was found in projected 10-year progression-free survival (PFS) and overall survival (OS) rates (84.7% and 94.1% respectively for ABVD-21; 81.4% and 91.5% for ABVD). Subgroup analyses showed that ABVD-21 was significantly better than ABVD for patients with IPS≥3 in terms of PFS and OS rates. Grade 3 to 4 leukopenia (51.8% vs. 28.8%, P=0.001) and neutropenia (57.6% vs. 39.0%, P=0.009) were more common with ABVD-21. We were led to conclude that dose-dense ABVD did not result in better tumor control and overall survival than did ABVD for early-stage unfavorable HL. However, patients at high risk, for example, with IPS≥3, may benefit from dose-dense ABVD.