Objective To investigate causes and the treatment of jaundice following laparoscopic cholecystectomy (LC). Methods A retrospective analysis of records of 11 cases of jaundice following LC out of 2047 cases between October 1995 and December 2001 was made. Results The incidence of postoperative jaundice was 0.54% (11 of 2047). Jaundice was due to bile leakage (45.4%, 5 of 11), residual choledocholithiasis (18.2%, 2 of 11), acute pancreatitis (18.2%, 2 of 11), biliary stricture (9.1%, 1 of 11) and acute liver infraction (9.1%, 1 of 11). Three kinds of procedures-endoscopic operation, open operation and conservative treatment-were executed respectively and had obtained satisfactory results. Conclusions Bile leakage and residual choledocholithiasis were the leading causes of jaundice following LC. Prompt etiologic therapy may effectively relieve the symptoms.

Objective To explore the clinical effect of laparoscopic exploration on incarcerated inguinal hernia.Methods 38 patients with incarcerated inguinal hernia were randomly divided into open operation group (19 cases) and laparoscopic group(19 cases) by using the digital table method.The open operation group used Lichtenstein tension-free repair method.The laparoscopic group used the transabdominal preperitoneal(TAPP) repair method.The hospitalization days,operation time,degree of pain,bleeding loss,postoperative time return to normal activities,postoperative complications and the postoperation recurrence of two groups were compared.Results The hospitalization days,operation time,degree of pain,bleeding loss,postoperative time return to normal activities,incidence rate of complications in the laparoscopic group were (5.11±1.29)d,(43.05±8.10)min,(2.79±1.08)points,(20.42±9.69)mL,(14.11±3.81)d,15.79% respectively,which of the open operation group were (6.79±1.80)d,(48.32±6.82)min,(4.21±1.13)points,(28.42±7.99)mL,(18.26±3.77)d,47.37% respectively,there were significant differences between the two groups in terms of above indicators(t=-3.31,-2.17,-3.95,-2.78,-3.38,x2=4.38,all P<0.05).Conclusion TAPP is a safe and effective operation for incarcerated inguinal hernia treatment,with the advantages of minimal invasion and less complications.

Objective To explore and evaluate the advantages of anchor nail in the treatment of achilles tendon rupture.Methods The clinical data of 27 patients with fresh achilles tendon rupture who received the treatment of thread anchor nail from January 2007 to August 2010 was retrospectively analyzed.Among them,14 patients received Krackow method,7 patients received Lindholm method to repair achilles tendon,6 patients received anchor nail combined with Krackow suture technique repair of achilles tendon.Arner-Lindholm clinical evaluation criterion was used for objective evaluation.Results Twenty-seven patients got 1-36 ( 17.35 ± 5.70) months follow-up.According to the corresponding standard in the 14 cases using Krackow method,8 cases were excellent,2 cases were good,4 cases were bad,the excellent and good rate was 71.4％( 10/14);in the 7 cases using Lindholm method,5 cases were excellent,1 case was good,1 case was bad,the excellent and good rate was 85.7 (6/7) ; all of the 6 cases using anchor nail combined with Krackow suture technique repair of achilles tendon were excellent,the excellent and good rate was 100.0％(6/6).Postoperative incisions were primarily healing,joint range of motion were all right,without rigidity,gait were almost normal,without the secondary fracture of ligament.Conclusion Anchor nail combined with Krackow suture technique in the treatment of achilles tendon rupture has significant effect,it is worth to be popularized because of its preonunced effect.

Objective To investigate the effects of high-fat diets and rosiglitazone treatment on the expressions of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) and mitofusin-2 (Mfn2) in skeletal muscle of aged rats. Methods Male wistar rats aged 21-23 months were randomly divided into old control group (OC; n=20), high-fat diets group (HF; n=20) and high-fat diets plus rosiglitazone treatment group (RSG; n=20). Male wistar rats aged 4-5 months were selected as young control group (YC; n=20). Insulin sensitivity was evaluated by hyperinsulinemic-euglycemic clamp technique at the end of the 4th and 8th week. The expressions at mRNA and protein levels of PGC-1α and Mfn2 in skeletal muscle were determined by polymerase chain reaction and Western blotting technique. Results (1)After 8 weeks, the levels of free fatty acid [(0. 68±0. 18)mmol/L, (0.82±0. 23) mmol/L and (1. 53±0.40) mmol/L], triglyceride [(0.53±0.13) mmol/L,(0. 63±0. 17) mmol/L and (1.08±0.30) mmol/L]and muscle triglyceride [(1.09±0.17) mmol/L,(1.34±0. 20) mmol/L and (2.07±0. 30) mmol/L]in YC group, OC group and HF group were significantly increased and glucose infusion rate [(30.4±4. 2) mg·kg~(-1)·min~(-1), (20.9±2.2) mg·kg~(-1)·min~(-1) and (12. 0±1.9) mg·kg~(-1)·min~(-1)]was significantly decreased as compared with pre-high fat diet, respectively. The levels of fasting free fatty acid [(0.93±0.29) mmol/L], triglyceride [(0.62±0.12) mmol/L]and music triglyceride [(1.68±0.28) mmol/L]in RSG group were significantly decreased and glucose infusion rate [(16.7±1.7) mg·kg~(-1)·min~(-1)]was significantly higher than in HF group. (2)In skeletal muscle, the expressions at mRNA and protein levels of PGC-1α and Mfn2 decreased in OC group compared with YC group (all P<0.01). The expressions of PGC-1α and Mfn2 were lower significantly in HF group than in OC group, and were higher significantly in RSG group than in HF group (all P<0.01). Conclusions The aged rats fed the high-fat diets develop insulin resistance with decreased expressions of PGC-1α and Mfn2 in skeletal muscle. Insulin sensitivity is improved with rosiglitazone treatment by increasing expressions of PGC-1α and Mfn2 in skeletal muscle.

Objective To explore the clinicopathological significance of the presence of lymphovascular invasion (LVI) in the high-grade stage pT1 bladder cancer (BC) after first transurethral resection of bladder tumor (TURBT).Methods The retrospective study was performed with 27 patients of high-grade stage pT1 BC after first TURBT from January 2006 to December 2011,and another 54 patients were matched as negative control in terms of gender,age,pathological pattern,grading and staging.All the data were calculated by using SPSS17.0 software.Qualitative variables were compared by using chi-square test.The Kaplan-Meier method was used to calculate total survival and cancer-specific survival and differences were assessed with the Log-rank statistic.Results Twenty-four patients (89％) experienced cancer recurrence in LVI group,while 19 cases (35％) experienced recurrence in control group.Progress developed in 56％ (15/27) and 24％ (13/54) in the 2 groups respectively.LVI was detected to be a prognostic factor for overall recurrence (x2 =20.845,P＜0.001) and progress (x2 =7.887,P =0.005) in patients with high-grade T1 stage BC.Furthermore,overall survival and recurrence-free survival according to the presence or absence of LVI was 54±6 months and 84±3 months,17±5 months and 67±5 months,respectively.LVI was proved to be associated with worse overall survival (x2=13.443,P＜0.001) and recurrence free survival (x2=33.094,P＜0.001).Conclusion In patients with high-grade T1 stage BC,LVI in first TURBT specimens predicts disease recurrence,progression and overall recurrence and recurrence free survival.

Objective To study the inhibitory effect of fluorouracil combined with DDP on the growth of human osteosarcoma cell line MG-63,and to explore its influence on the expressions of transient receptor potential vanilloid 5 (TRPV5 )and transient receptor potential vanilloid 6 (TRPV6 )proteins.Methods The MG-63 cells were cultured by the density of 5 × 104 mL-1 .Fluorouracil group,DDP group,fluorouracil+ DDP group and control group containing 10% FBS were set up.The inhibitory rates of growth of MG-63 cells at different time were detected by CCK-8 assay.The apoptosis of MG-63 cells after treated with different drugs was determined by Hoechst staining Kit.The immunocytochemical staining was used to treatent to detect the expressions of TRPV5 and TRPV6 before and after treatment.Results Fluorouracil and DDP both inhibited the growth of MG-63 cells in a time-and dose- dependent manner.There were a lot of black particles in the MG-63 cells and the cells were smaller,aging or death when they were exposed to fluorouracil or DDP.Compared with 24 h group,the inhibitory rates of proliferation of MG-63 cells after treated with the sigle drug of fluorouracil or DDP for 48 and 72 h were increased significantly (P <0.05).Compared with control group,the apoptotic rates of MG-63 cells in fluorouracil group and DDP group 24,48,and 72 h after treatment were increased (P < 0.01)in a time-dependent manner. The expression levels of TRPV5 and TRPV6 in MG-63 cells 72 h after treatment of fluorouracil and DDP were decreased significantly compared with before treatment (P < 0.05 ). Conclusion Fluorouracil, DDP and fluorouracil combined with DDP could significantly inhibit the proliferation of MG-63 cells,induce the apoptosis, and decrease the expression levels of TRPV5 and TRPV6.

Objective To explore the clinical value of renal dynamic imaging and urinary N-acetyl-?-D-glucosaminidase(NAG),apoptosis DNA fragment(ADF) in evaluating the damage degree of hydronephrotic kidneys(HnK) in children with hydronephrosis.Methods Level of glomerular filtration rate(GFR) was detected in 41 children with congenital hydronephrosis by renal dynamic imaging,and urine NAG,ADF in pelvis in HnK and healthy kidneys (as controls) were detected by enzyme-linked immuno-sorbent assay(ELISA).Patholo-gic changes of HnK in 41 children were graded intoⅠ~Ⅴ according to Elder standard. And GFR,urinary NAG and ADF of HnK were divi-ded into subgroup according to pathologic changes ,at the same time statistical analysis was performed within each groups. And the correlations of pathologic grades with GFR,urinary NAG and ADF of HnK were analyzed.Results 1.Kindneys GFR in healthy kidneys and Hnk were (174.33?20.43)?10-3 L/min,(143.86?17.51)?10-3 L/min respectinely,and there was significant difference between healthy kidneys and Hnk (P0.05).3.There was significant negative correlation between GFR levels of HnK and pathologic grades(r=-0.814 P0.05).Conclusions For hydronephrotic kidneys,urinary NAG can eva-luate impaired nephric tubule whereas renal dynamic imaging may evaluate the damage level of glomeruli;urine ADF may not indicate the damage level of diseased kidneys in children with congenital hydronephrosis.

Objective　To find out if an unique blood mode-vasculogenic mimicry (VM) exist in prostate cancer and analyze its relationship with prognosis.　Methods　The age of the patients was 59 to 72 years,with a mean age of (66.7 ± 11.0) years.All had been confirmed as prostate cancer by biopsy.The level of serum PSA was 15.6 to 76.7 μg/L,with a mean level of (34.6 ± 1.7 ) μg/L.A histochemical and immunohistochemical dual staining method for PAS-CD31 and MMP-2 in 96 prostatic adenocarcinomas were conducted to explore if VM exist in prostate cancer,describe its morphology and distribution.The different expression of MMP-2 in VM positive and VM negative tissue were.The clinical data were collected and analyzed to explore the relationship between disease progression and VM.　Results　Among 96 cases,24 cases were found VM positive,the others were negative.The boundary membrane of VM was PAS positive,which was continuous or incontinuous. A positive correlation between VM density and high Gleason score were found.The tPSA were higher in the VM positive cases than that in VM negatives.The VM positive patients had poorer prognosis than that of the negatives.The MMP-2 expression was found correlated with VM positive (rs =0.60,P ＜ 0.01 ).　Conclusions　VM exists in the prostate cancer as an independent structure,and it is more common in the high-grade cancer.The progression-free survival of VM positive patients could be worse than the negative.MMP-2 and VM could be the indicators of poor prognosis.

Objective To find out the status of drinking-water-borne endemic fluorosis and the effect of preventive measures in Hebei Province,so as to provide a basis to prevent and cure fluorosis.Methods One affected county (city,district) with drinking-water-borne endemic fluorosis was sampled in every city and 10 water improvement projects were investigated in that county.Three villages were taken out in every county.The operating state of the projects,the water fluoride content,and the dental fluorosis of children aged 8-12 and skeletal fluorosis of adults were investigated in these villages.Results A total of 93 projects were investigated,among which 94.6％(88/93) were operating properly and the qualified rate(fluoride content ≤ 1.2 mg/L) of the projects was 54.84％(51/93).Among the 9 large projects,the water fluoride content of 7 projects exceeded 1.2 mg/L.A total of 23 villages with water improvement projects were investigated and only 43.4％ (10/23) of them water fluoride content were lower than 1.2 mg/L.The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.2％ (532/1601),0.74 and 5.7％ (66/1155),respectively.In the 7 villages without water improvement projects,2 of them exceeded 2.0 mg/L,but lower than and equal to 4.0 mg/L of water fluorosis and 5 of them were normal(＜ 1.2 mg/L).The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.4％ (111/332),0.72 and 2.9％ (10/350),respectively.Conclutions The qualified rate of water improvement projects of fluoride content ≤ 1.2 mg/L is low and the endemic fluorosis is still comparatively serious in Hebei Province.The progress of water improvement projects in the areas with endemic fluorosis should be accelerated and the quality of water improvement projects should be increased.

Objective To evaluate the long-term effect of hepatic arterial embolization with pingyangmycin-lipiodol emulsion (PLE) in patients with cavernous hemangiomas of the liver (CHL)and its influence factors.Methods One hundred and fifty-six hemangiomas that were diagnosed by imaging examinations or confirmed pathologically by surgery in 105 patients with integral follow-up data were analyzed retrospectively in this paper.All hemangiomas were divided into 4 groups according to their size (the largest size of hemangioma)by the authors as follows; A group(≤3 cm, n=25); B group(>3 cm and<5 cm, n =32) ;C group(≥5 cm and<10 cm, n=58); and D group(> 10 cm, n=41) .According to the number of abnormal sinusoids filled with the contrast medium in the angiography, 156 hemangiomas of this series were further classified as three types: abundant type (n=90) ; sparse type (n=9) and the middle type (n=57) .Hepatic arterial embolization with PLE was performed in the 105 patients with total 135 procedures (including single procedure in 75 patients, twice procedures in 30 patients).All of the 105 patients were followed up 3 to 8 years(mean 4 years) using US, CT or MRI or DSA.The criteria for the evaluation of curative effect were classified as best, good, recovery and no change in this series, and the sum of best and good effects were defined as the total effective rate.Then, the total effective rate of single procedure between the A, B groups and C, D groups; and the total effective rate of single procedure and twice procedures in the D groups, were compared statistically by X~2 test respectively.And the influence factors, included of the variant size of hemangiomas, abundant or sparse of abnormal sinusoids and the number of treatment procedures, were also analyzed and evaluated respectively.Results The total effective rate of the 156 hemangiomas in 105 patients was 92.95% (145/156).After single procedure of hepatic arterial embolization with PLE, the total effective rate of A and B groups were 100% (57/57), that of C and D groups were 85.86% (85/99), and the difference reach significant (X ~2=8.8553, P<0.01).In the D group, the total effective rate in group with twice procedures (100.00%,30/30) was significant higher (X~2 =5.2642,P<0.05) than those of group with single procedure (72.73%,8/11).Of this series, during the period of following-up, no recurrent or severe complications were observed.Conclusions A best long-term curative effect (complete cure) is usually obtained in the small hemangiomas with abundant abnormal sinusoids, and a satisfactory long-term curative effect can also be achieved in the larger or multiple hemangiomas, particularly in those hemangiomas with abundant abnormal sinusoids by using the repeat procedures of hepatic arterial embolization with PLE.