With advances in surgical techniques,laparoseopic surgical instruments and constant equipment innovation,minimally invasive surgery has become the main stream of this century.Wide range of applications of endoscopy and laparoscopy as the representative of the revolutionary changes in diagnosis and treatment of digestive diseases since the second half of last century is the main symbol.Patients obtained benefits from the minimally invasive technique to reduce the trauma and pain,shorten the course of treatment,and gain rapid recovery.Singleincision laparoscopic surgery (SILS) is proposed in recent years.It differs from conventional multiports laparoscopic surgery,with only a small 2-3 cm incision at the body's natural scar-umbilicus as the approach to assist laparoscope and surgical instruments into the abdomen cavity.In this paper,the surgical experiences of SILS based on 800 cases and understanding of the SILS at home and abroad were presented to talk about the application of SILS technique in digestive surgery.

Abnormality of sphincter of Oddi is divided into the anatomical and functional ones. Anatomical abnormality includes stenosis and insufficiency, and the dyskinesia of sphincter of Oddi is composed of hypermotility and hypomotility. Many biliopancreatic diseases are associated with the abnormality of sphincter of Oddi, which include congenital pancreaticobiliary maljunction, gallstones, primary choledocholithiasis and hepatolithiasis, post-cholecystectomy syndrome, and pancreatitis. The proper acknowledgement of abnormality of sphincter of Oddi is of importance to improve the diagnosis and therapy of corresponding biliopancreatic diseases.

This article introduces the explorations in improving minimally invasive therapies and techniques for intra-and extrahepatic bile duct stones in this center,including laparoscopic choledocholithotomy without the placement of T tube,laparoscopic partial hepatectomy for the treatment of intrahepatic bile duct stones using an anastomosis stapler for liver partition,and modification of percutaneous transhepatic cholangioscopy.The improved therapies and techniques above have achieved good clinical effects,and a scientific judgment of their clinical effects still depends on a large number of cases and randomized controlled clinical trials.

Objective To evaluate the application status of China Disease Prevention and Control Information System of Hy?datid Disease,in which questions existed are summarized in order to promote the system update. Methods A questionnaire was designed and distributed to Inner Mongolia,Sichuan,Tibet,Gansu,Qinghai,Ningxia,Xinjiang and Xinjiang Production and Construction Corps to evaluate the application status of China Disease Prevention and Control Information System of Hydatid Disease assistant with telephone. Results The recovery rate of questionnaires was 87.5%. The statistics of closed questions showed that national application rate of the China Disease Prevention and Control Information System of Hydatid Disease was 100%,of which 15.3%were low frequency users,57.1%believed the system was necessary,28.6%considered it was dispens?able,and 14.3%believed that it was totally unnecessary. The statistics of open?ended questions indicated that 6 endemic regions suggested to increase the guidance and training,while 4 endemic regions had opinions on sharing the information of the national infectious disease reporting systems and hydatid disease prevention and control information system,and the opinions on turning monthly report to quarterly report,and increasing statistics and analysis module,and 3 endemic regions deemed that the system had logic errors and defects. Conclusion The problems of the system are mainly focused on the existence of systemic deficien?cies and logic errors,lacking of statistical parameters and corresponding analysis function module,and lacking of the guidance and training,which limits the use of the system. Therefore,these problems should be resolved.

Purpose: To analyze the treatment effects by radiotherapy alone and radiotherapy plus chemotherapy of carotid artery intubation after operation for malignant astrocytoma. Materials and Methods: 135 patients with malignant astrocytoma were treated from August, 1987 to November, 1992. Patients were divided into two groups after operation: 71 patients received radiotherapy alone and 64 patients,combination therapy of chemotherapy (BCNU) plus radiotherapy. All patients received DT 55～70Gy. In combination therapy group, BCNU(250mg) was given daily by carotid artery intubation for 4～15 days.Radiotherapy was given 10～15 days after chemotherapy, then followed by 1～3 intubation. Results: The median survival were 17.5 months in radiotherapy alone group and 31.9 months in combination one.Patients with glioblastoma gave the better results with the 2-,3-,and 5- year survivals of 70%, 36% and 15%, respectively. Conclusion: Chemotherapy (BCNU) of intubation plus radiotherapy is preferable in treating malignant astrocytoma after operation.

Objective To study the occurrence of the extraintestinal manifestations of inflammatory bowal disease.Methods By the retrospective study,the data of 201 IBD patients was analysed.Results A total of 21.43%of patients with ulcerative colitis(UC) and 15.79% of patients with Crohn's disease(CD) showed at least one kind of EMIs.In UC patients with EIM,the activity of disease was active phase in 89.74% and remassion phase in 10.26%.Tree CD patients were all in active phase. Musculoskeletal manifestation was the most frequent EIM,the second was dermatological manifestation,EIMs involving the genitourinary、thyroid、hepatobiliary were rarely. EN and/or PG and arthritis were more frequent coexisting other EIMs.Conclusion The prevalence of EIM was not rarely.EIM was most common among female and young patients.Arthritis and dermatological manifestations were most frequent of all assessed.The patient could have multiple EIMs and there was a tendency that EIM was more likely among patients in active phase、severe severity and with pancolitis.

BACKGROUND: Thawed allografts are usually discarded for various reasons. Whether these discarded allografts can be refrozen for later use and their histological changes in vivo have not been reported. OBJECTIVE: To investigate the histological characteristics of anterior cruciate ligament (ACL) reconstructed with the repetitive freeze-thawing allogenic Achilles tendon in New Zealand white rabbits. METHODS: Allogenic Achilles tendons were harvested from adult male New Zealand white rabbits, and were stored at -8 ℃ and thawed at 20 ℃ for 1, 2, 3 and 10 times, respectively, after sealed package and 60Co irradiation. Twenty-four adult male New Zealand white rabbits were enrolled: the left and right knees of 12 rabbits were respectively reconstructed with 1 (control group) and 2 times of freeze-thawing allogenic Achilles tendon, and another 12 rabbits underwent reconstruction with 3 and 10 times of freeze-thawing allogenic Achilles tendon, respectively. Three specimens from each group were evaluated with modified histology grading scores at 6, 12 and 24 weeks to assess the cell morphology, cell quantity, matrix staining intensity, fibrocartilage formation, new bone formation, tendon healing and cartilage injury. RESULTS AND CONCLUSION: The cell morphology, matrix staining intensity and total scores of the 10 times group were significantly higher than those of the other groups at 6 weeks (P < 0.05), but other parameters showed no significant differences among groups (P > 0.05). ACL reconstructed with 10 times of repetitive freeze-thawing allogenic Achilles tendons had higher histological scores at 6 weeks after modeling, but no significant differences were shown at 12 and 24 weeks after modeling. To conclude, our study only testifies better histological scores on the multiple times of freezethawing Achilles tendon than the less times of freeze-thawing Achilles tendon at the early period after operation.

Bronchogenic Cyst ; Humans ; Laryngeal Diseases ; Male ; Middle Aged

Objective To evaluate spiral CT features and differential diagnosis of cystadenocarcinoma in the hepatic biliary duct.Methods CT findings of cystadenocarcinoma in the hepatic biliary duct proved by pathology in 4 cases were retrospectively analysed with review literatures.Results Biliary cystadenocarcinoma appeared as unilocular or multilocular cystic tumor,the cystic wall was irregular with mural nodules and satellite leisons,and the distal biliary duct was dilated.Conclusion Spiral CT is efficient method in diagnosis of cystadenocarcinoma in the hepatic biliary duct.

BACKGROUND: Advanced oxidation protein products (AOPPs) are a crucial pathogenic link to such long-term uremic complications in hemodialysis patients as immune system dysregulation, accelerated atherosclerosis, dialysis-related amyloldosis and so on. However, basic studies on AOPPs are relatively few, and one of the main reasons is the fact that it is difficult to obtain AOPPs with high pudty and biological activity.OBJECTIVE: To prepare, pudfy and indentify AOPPs, with the hope of searching for a method of preparing AOPPs with high purity and biological activity.DESIGN, TIME AND SETTING: A single sample observation was completed in the Clinical Biochemistry Section of Ecsomatics Department, Third Military Medical University of Chinese PLA from September to November in 2008. MATERIALS: Human serum albumin (HSA) was provided by Chengdu Rongsheng Company Ltd. Hitrap 26/60 sephacryl S-300 was purchased from GE Healthcare.METHODS: Hypochloric acid was used in the oxidation of purified HSA to prepare in vitro the AOPPs-modified HSA (AOPPs-HSA), which was then isolated by Hitrap 26/60 sephacryl S-300. Relative molecular mass was determined by sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE), native polyacrylamide gel electrophoresis (PAGE) and molecular weight standards. Structural features and biological activities were identified in the experiment of tumor necrosis factor α (TNF-α) release from monocytes.MAIN OUTCOME MEASURES: ①The purification and gel electrophoresis results of HSA. ②The purification and gel electrophoresis results of AOPPs. ③The dose-effect relationship between AOPPs-HSA and TNF-α release from monocytes. RESULTS: The relative molecular mass of AOPPs-HSA was 670 000 according to SDS-PAGE, native PAGE and molecular weight standards. Moreover, AOPPs-HSA could encourage the release of TNF-α from monocytes. The time effects showed that TNF-α release volume significantly increased after 6 hours of stimulation by AOPPs-HSA (1 g/L) and reached a peak at hour 12. CONCLUSION: Highly purified and bioactive AOPPs can be successfully prepared by the above-mentioned method, which builds a basis for further study on AOPPs.