ObjectiveTo explore the clinical effects of laparoscopic common bile duct exploration and primary suture combined with choledochoscopy (LBEPS) and laparoscopic common bile and duct exploration T-tube drainage(LCHTD) on cholelithiasis.Methods101 cholelithiasis patients were selected and,grouped by the operation methods.56 cases were treated with LCHTD,while 45 cases were treated with LBEPS.The operation time,blood lose,and postoperative digest function recovery time were ampared betreen two groups.ResultsThe operation time betreen the two groups has no significant difference(P ＞ 0.05 ),while the blood lose,postoperative digest function recovery time in LBEPS group were better than the LCHTD group( all P ＜ 0.05 ),the differences were statistically significant.Meanwhile the LBEPS group had a less complication and re-treatment rate than those of the LCHTD group ( P＜0.05).ConclusionCompared with LCHTD,LBEPS had smaller trauma,less operation complications and faster postoperative digest recovery time,worthy of clinical promotion.

Objective To observe the activation effect of histamine on mast cells in the acupoint area and its analgesic effects similar to acupuncture stimulation,so as to reveal the underlying mechanism of acupoint injection therapy.Methods A total of 60 SD rats were divided into control,model,normal saline(NS),histamine-injection and acupuncture groups(12 rats/group).Acute adjuvant-induced-arthritis(AIA) model was duplicated by injection of complete Freunds' Adjuvant(0.05 mL) into the left ankle articular cavity.For rats of saline and histamine groups,normal saline(50 ?L) and histamine(50 ?L,100 ?g/mL) were injected into the left "Zusanli"(ST 36) acupoint area.For rats of acupuncture group,manual acupuncture(lifting-thrusting and twisting needle intermittently) was applied to ST 36 for 20 min.Paw withdrawal(pain threshold,PT) was detected by radiant heat irradiation of the hindpaw.Skin and muscle tissues of ST 36 area were sampled to be fixed in formalin,then,sliced(5 ?m),and stained with Toluidine Blue,separately,followed by counting the degranulation rate of mast cells under microscope.Results Compared with normal control group and pre-modeling,PT of model,NS,acupuncture and histamine groups decreased significantly(P

Objective To estimate the effect of itermittent subglottic secretions drainage(ISSD)on management of artificial airway to prevent tube-related pulmonary pneumonia.Methods One hundred ICU patients with intubation for artificial airway were divided equally into control and experiment group by random digits table.Both were managed with construction of artificial airway and besides the experiment group received ISSD. The two groups were compared in terms of incidence and occurrence time of catheter-related pneumonia, time for airway opening and ICU stay.Result The incidence and the occurrence time of pneumonia, time for airway opening and ICU stay time in the experiment group were significantly lower or shorter than those in the control group with statistical difference(all P<0.05).Conclusion ISSD is effective in decreasing the incidence of catheter related pneumonia, shortening the occurrence time of catheter related pneumonia and ICU stay time for the patients with artificial airway.

Objective To summarize the minimally invasive transthoracic ventricular septal defect (VSD) occlusion operation experience in the clinical application. Methods 142 VSD patients (admitted from August, 2013 to October, 2014) were chosen. All patients were treated with minimally invasive transthoracic device closure under the monitoring of transoesophageal echocardiogram. Results 136 cases received successful closure, and 6 cases still need CPB conventional extracorporeal circulation operation. After follow-up for 3 ~ 12 months for 102 patients, 16 cases remain residual shunt. Conclusion The short-term therapeutic effect of minimally invasive transthoracic device closure of VSD is satisfying. However , the long-term follow-up remains to be studied.

Objective To analyze the changes of serum fatty acid synthase (FAS),carcinoembryonic antigen (CEA) and carbohydrate antigen 72-4 (CA72-4) in patients with gastric cancer and its clinical diagnostic value.Methods Forty five patients with gastric cancer and 45 patients with benign gastric cancer treated in our hospital from January 2016 to December 2016 were enrolled in this study.Forty five healthy subjects were enrolled in this study.The levels of FAS,CEA,and CA72-4 in three groups were analyzed.Results The levels of FAS,CEA,and CA72-4 in patients with gasttric cancer [(12.73 ± 5.48) mg/L,(31.36 ± 14.51) ng/ml,and (39.32 ± 18.76) U/ml] were significantly higher than those in benign gastric cancer group [(2.26 ± 1.15) ng/L,(3.24 ± 1.47) ng/ml,and (3.75 ± 1.69) U/ml],and normal control group [(1.83 ± 0.92) mg/L,(2.71 ± 1.54) ng/ml,and (3.13 ± 1.82) U/ml] (P ＜ 0.05).FAS,CEA,and CA72-4 levels in patients with lymph node metastasis of gastric cancer [(13.58 ± 6.09) mg/L,(6.25 ± 11.54) ng/ml,and (41.31 ± 13.67) U/ml] were significantly higher than those without lymph node metastasis [(9.21 ± 5.42) mg/L,(28.38 ± 9.72) ng/ml,and (26.75 ± 11.86) U/ml] (P ＜ 0.05).The sensitivity of FAS,CEA,and CA72-4 in patients with gastric cancer was significantly lower than that in combined detection,the specificity of FAS,CEA,and CA72-4 in patients with gastric cancer was significantly higher than that in combination test (P ＜ 0.05).The sensitivity of FAS,CEA,and CA72-4 in patients with lymph node metastasis was significantly lower than that in combination test,and the specificity of FAS,CEA and CA72-4 was significantly higher than that of combined detection (P ＜ 0.05).Conclusions FAS,CEA,and CA72-4 can be used as indicators of gastric cancer and diagnosis of lymph node metastasis.Combined detection of three indexes can improve the diagnostic sensitivity and have good clinical significance.

Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .