Objective To evaluate the repot of common hepatic duct defect caused by Type Ⅱ or Type Ⅲ Mirizzi syndrome laparoscopically.Methods Eight cases of Type Ⅱ or Type Ⅲ Mirizzi syndrome treated under laparoscopy were analyzed retrospectively.Among them six cases were identified as Mirizzi Ⅱ and a defect on the lateral wall of common hepatic duct was found and repmred by suturing the stubble of cystic duct.The two Mirizzi Ⅲ cases had a defect on front and lateral wall or back and lateral wall of common hepatic duct respectively.Both defects were repaired by a patch from the infundibulum of galllbladder. Results All the 8 cases underwent laparoscopic subtotal cholecystectomy followed by repair of common hepatic duct defect.The operation lasted for 80～150 min(mean 110 min).There was no recurrence of the symptoms after 6～24 months follow up.Conclusion The familiarity of the anatomical characters of Mirizzi syndrome and the skillful suture technique under laparoscopy are both necessary.

Objective To comparing the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia(BPH) between doctors in general hospitals and community hospitals,and to provide scientific clues for the standardization in medical practice.Methods General and community hospitals in urban China were selected via the stratified sampling.127,325 outpatients in these hospitals from December 2011 to December 2012 were randomly recruited.Results The average age of patients was(67.82±8.62) years.There were significant differences in I-PSS,prostate volume,urinary flow rate(UFR) and result of digital rectal examination(DRE) between patients in general and community hospitals.The rates of diagnostic applications were different between doctors in the two kinds of hospitals except I-PSS.Compared with community hospitals,DRE was more frequently applied while ultrasonic inspection and UFR test were less used in general hospitals in North China.A totally opposite situation was observed in East China as compared with the north.The application rates of DRE and UFR test were lower and ultrasonic inspection rate was higher in community hospitals than in general hospitals in South China.Pharmacotherapy was the most common treatment for BPH patients in both types of hospitals(97.53 ％).The rates of drug combinations were statistically different but both were close to 75％ in the two types of hospitals.In community hospitals,the percentage of patients receiving watchful waiting with severe symptoms and signs were lower than that of patients receiving watchful waiting with moderate symptoms and signs,but the percentage of patients receiving operation was not significantly increased.On the contrary,the percentage of patients receiving operation with severe symptoms and signs was higher than that of patients receiving operation with moderate symptoms and signs in general hospitals,but the percentage of patients receiving watchful waiting was not decreased.Conclusions Applications of diagnostic methods are significantly different between doctors in general hospitals and community hospitals and vary among regions.Therapeutic strategies are correlated with the severity of obstructive symptoms or signs.The medication strategy is similar between the two types of doctors.

Objective To ssarch for the relationship between hemoglobulin (Hb),erythrocyte protoporphyrin (EP) and the altitude.Methods The altitudes of Guinan and Maduo county in Qinghai province are respectively 3200m and 4300m. The 122 healthy students aged from 7 to 14 years old were selected, Hb and EP of them were respectively determined by the methods of ferric cyanation and fluorospectrophotometry. The statistical treatment was carry out by t test and matched-pair t test.Results The Hb levels of the healthy children aged from 7 to 14 years old in Guinan and Maduo county are respectively 133 .6?10.1 and 152.8?14.0 g/L (t = 12.31, p＜0.001), the EP levels of them are respectively 320.7 ? 114.9 and 347.8 ? 123.6 ?g/L (t = 1.77, P＞0.05), the value of EP/Hh of them are respectively 2.4 ?0 .9 and 2 .3?0.8 (t = 1.12, p＞0.05). The result of matched-pair t test shows that there are not sexural difFerence for Hb, EP and EP/Hb (P＞0.05).Conclusion Along with the increasing of altitude, the Hb and EP levels of the healthy Children aged from 7 to 14 years old are obviously increased and on sexural difference.

OBJECTIVETo study the prevalence of internet use and internet addiction in adolescents of Shanghai.

METHODFrom September to October 2007, a total of 5135 adolescents from 16 middle schools of 6 districts of Shanghai took part in the epidemiological study by a cross-sectional survey and 5123 adolescents finally enrolled in the study. A questionnaire of "DRM Adolescent Internet Use 52 Scale" was administrated to investigate the prevalence of internet use and internet addiction in adolescents of Shanghai. On this scale of 5-point rating, the scale includes seven parts of contents as tolerance, abstinence reaction, planning ability, self-control ability, whenness, sociability and hazard.

RESULTSThe rate of internet use among the surveyed adolescents was 94.32% (4673/5123), among which the incidence rate of internet addiction was 8.78% (450/5123). Boys, senior middle-school students were more susceptible to internet addiction than girls and junior middle-school students (male scores 122.42+/-43.46, female scores 116.92+/-38.10, F=23.22, P=0.00; senior middle-school students 125.24+/-39.02, junior middle-school students 110.30+/-42.35, F=164.68, P=0.00). Students from vocational senior middle-school were most susceptible (junior middle-school students 110.30+/-42.35, ordinary senior middle-school students 122.83+/-40.99, key senior middle-school students 120.05+/-37.87, vocational senior middle-school students 133.37+/-36.84, F=34.44, P=0.00). The 2nd grade students of senior middle-school have the highest risk for internet-addiction.

CONCLUSIONThe prevalence of internet use and internet addiction in adolescents of Shanghai should be comparatively high in China, which indicates that great attention should be paid to the prevention and control.

Adolescent ; Behavior, Addictive ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Students ; Surveys and Questionnaires

OBJECTIVETo investigate the clinical efficacy, adverse reaction and safety of Jieyu pill (JYP) in treating depression.

METHODSThe randomized controlled trial was conducted in 28 patients in the treated group and 29 patients in the control group treated with maprotiline (Map). The efficacy of treatment was evaluated before treatment and 14, 28 and 42 days after treatment, with Hamilton depression rating scale (HAMD), self-rating scale for depression (SDS), self-rating scale for anxiety (SAS) and clinical global impression (CGI), the adverse reaction was assessed by Asberg Rating Scale (ARS).

RESULTSJYP was effective in treating depression, the markedly effective rate being 78.8%, corresponded to that of Map (82.8%, P > 0.05). After treatment, the scores assessed by HAMD, SDS and SAS were all lower than those before treatment (P < 0.01) respectively, but comparison between the two groups showed insignificant difference (P > 0.05). However, scores of ARS were significantly lower in the treated group than that in the control group, and the efficacy index of JYP was significantly higher than that of Map (P < 0.01).

CONCLUSIONJYP in treating depression shows the efficacy corresponded to that of Map and with less adverse reaction.

Adolescent ; Adult ; Aged ; Antidepressive Agents ; therapeutic use ; Antidepressive Agents, Second-Generation ; therapeutic use ; Depressive Disorder ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Maprotiline ; therapeutic use ; Middle Aged ; Phytotherapy ; Psychiatric Status Rating Scales

Fifty-six patients with Graves' ophthalmopathy(GO)were treated with antithyroid drug and oral prednisone for three months,TSH receptor antibody(TRAb)level was reduced,GO activity and severity of some patients were ameliorated but still positively associated with TRAb.It suggests that TRAb not only triggers off GO but also plays a possible role in the maintenance of the autoimmune process in GO.

To compare the short-and long-term effect of two minimal invasive surgical therapies including keyhole approach endoscopic surgery(KAES)and stereotactic aspiration plus urokinase(SAU)in treating basal ganglia hypertensive intracerebral hemorrhage(hICH). The clinical data of 117 hICH patients(63 received KAES and 54 received SAU)were retrospectively analyzed.The operation time,blood loss during surgery,and drainage time were compared between two groups.The residual hematoma volume,hematoma clearance rate(HCR),Glasgow coma scale(GCS)score,and National Institute of Health Stroke Scale(NIHSS)score were recorded at baseline and in the ultra-early stage,early stage,and sub-early stage after surgery.The 30-day mortality and serious adverse events were assessed and the 6-month modified Rankin scale(mRS)score was rated. Baseline data showed no significant difference between these two groups.Compared with the SAU group,the KAES group had significantly longer operation time,more intraoperative blood loss,and shorter drainage time(all <0.001).In the ultra-early stage after surgery,HCR was significantly higher in the KAES group(<0.001),whereas in the early and sub-early stage,HCR showed no significant differences(all >0.05).In the ultra-early and early stage,the GCS and NIHSS scores showed no significant differences between two groups(all >0.05),whereas in the sub-early stage,the NIHSS score was better in the SAU group(=0.034).The 30-day mortality and incidences of serious adverse events showed no significant difference(all >0.05).The good recovery(mRS≤3)at 6-months follow-up showed no significant difference between the two groups(=0.413). Both KAES and SAU are safe and effective in treating basal ganglia hICH.In the ultra-early stage after surgery,KAES achieves better residual hematoma volume and HCR,and patients undergoing SAU quickly catch up.The short-and long-term effectiveness of SAU is comparable or even superior to KAES.
Basal Ganglia ; Humans ; Intracranial Hemorrhage, Hypertensive ; Retrospective Studies ; Treatment Outcome ; Urokinase-Type Plasminogen Activator

Biopsy, Fine-Needle ; Carcinoma ; pathology ; Endosonography ; Giant Cells ; pathology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Osteoclasts ; pathology ; Pancreas ; diagnostic imaging ; pathology ; Pancreatic Neoplasms ; pathology

The present study aimed to examine the value of ultrasonic soft markers in prenatal screening by analyzing the clinical outcome of fetuses with ultrasonic soft markers during the second trimester of pregnancy.A retrospective analysis was performed to evaluate the outcome of 591 fetuses with ultrasonic soft markers from January 2015 to August 2016 in Zhongnan Hospital of Wuhan University,China.It was found that 591 fetuses showed ultrasonic soft markers in 4927 cases with the occurrence rate being 12.0％.Among them,564 fetuses (95.4％) were delivered and the remaining 27 cases (4.6％) were aborted.Five hundred and sixty-seven cases had single ultrasonic soft marker,including echogenic intracardiac focus (n=343),mild renal pelvis dilatation (n=116),short long bones (n=72),single umbilical artery (n=31),mild lateral ventriculomegaly (n=21),choroid plexus cysts (n=19),and echogenic bowel (n=13),with the disappearing rates in pregnancy being 97.1％ (333/343),77.6％ (90/116),0％ (0/72),0％ (0/31),57.1％ (12/21),89.5％ (17/19) and 61.5％ (8/13) respectively.The rate of pregnancy termination due to single ultrasonic soft marker was 3.4％ (19/567),and that was 33.3％ (8/24) due to two ultrasonic soft markers with the difference being statistically significant (P＜0.05).The reasons of pregnancy termination included malformations (polycystic kidney,cleft lip and palate,congenital heart diseases,pcromphalus,hypospadias,hydrocephalus),chromosome abnormality,and stillbirth.It was concluded that single ultrasonic soft marker is usually transient manifestation in pregnancy.Without the other structural defects,single ultrasonic soft marker usually disappears spontaneously with favorable prognosis in a low-risk population.It is suggested that ultrasonic soft markers should be appropriately interpreted to avoid unnecessary invasive examination.

OBJECTIVETo evaluate three biopsy methods which are currently used in stereotactic breast biopsy.

METHODSA total of 361 cases of stereotactic breast biopsies were carried out since 2000, including 73 cases of true cut core needle biopsies (ST-CNB), 74 cases of vacuum assisted biopsies (ST-VAB) and 214 cases of excisional biopsies. After medium follow-up time of 18 months (6 to 66 months), the accuracy as well as the clinical benefits of the three stereotactic biopsy procedures were analyzed retrospectively.

RESULTSThe cancer miss rate of stereotactic wire localized excisional biopsy, ST-CNB and ST-VAB is 0, 2.7% and 0 respectively. Under-estimate rate of minimal invasive biopsy was 33% in atypical ductal hyperplasia (ADH) and 53% in ductal carcinoma in situ (DCIS). The minimal invasive procedure is superior to surgical procedure in terms of operation time, breast cosmetic outcome and complications, etc. Furthermore, 69% of the surgeries for suspicious lesion were waived.

CONCLUSIONSStereotactic minimal invasive breast biopsy, especially ST-VAB, is an accurate, safty and convenient diagnosis technique and could be considered as the first line choice for mammographic moderate suspicious breast lesions (BIRADS-4). However, further excisional biopsy is recommended for atypical hyperplasia. Stereotactic excisional biopsy could be directly used for diagnosis of mammographic highly suspicious breast lesions (BIRADS-5).

Biopsy ; methods ; Biopsy, Needle ; instrumentation ; Breast ; pathology ; Breast Diseases ; diagnostic imaging ; pathology ; Female ; Follow-Up Studies ; Humans ; Mammography ; Sensitivity and Specificity