Objective To discuss how to improve judgement and technique for avoiding bile duct injury during laparoscopic cholecystectomy(LC).Methods The clinical data of 39 860 patients treated by LC between October 1992 and October 2005 were analyzed retrospectively.Bile duct injury occured in 46 patients.Results Bile duct repair and T-tube drainage was performed in 26 patients and bile duct end-to-end anastomosis and T-tube drainage was performed in 4 patients,with the T-tube indwelling time for 3~12 months.The Roux-en-Y cholangiojejunostomy was conducted in 11 patients,the ligation of accessory hepatic duct was conducted in 5 pauients,the re-operation for bile duct stenosis in 4 patients,and the re-operation for stenosis after cholangiojejunostomy,in 2 patients.Conclusions Intensive anatomic knowledge and skillful surgical performance can avoid or minimize the incidence of bile duct injury.Early detection and active repair of the bile duct injury for preventing acute inflammation is the most important measure to avoid repeated operations.

Objective To explore the management of unsuspected gallbladder carcinoma (UGC) discovered during laparoscopic cholecystectomy (LC). Methods From January 2000 to May 2007, 15 560 cases of LC were performed in our hospital, UGC was discovered in 28 of the cases. Clinical data of the 28 patients were analyzed retrospectively. Results Among the 28 cases of UGC, 12 were discovered intraoperatively, and 16 were diagnosed postoperatively.Radical cholecystectomy was performed on the 12 cases who were detected during the operation,and 5 of the 16 patients who were diagnosed after the operation.LC was carried out in the remaining 11 cases. Postoperative pathological examination showed TNM stageⅠin 3 cases, stageⅡin 23, and stage Ⅲ in 2. The patients were followed up for 7-66 months with a mean of 22 months. During the period, 19 patients died. The 1-, 3-, and 5-year survival rate of the 17 patients who received radical cholecystectomy were 76.5% (13/17), 23.5% (4/17), and 11.8% (2/17), respectively. Whereas, in the 11 patients who underwent LC, the 1-year survival rate was 45.4%; moreover, none of the 11 survived for more than 2 years. Conclusions For high-risk population, attention should be paid to UGC during operation. Most of the UGCs discovered during LC are early-stage carcinomas, which should be treated with standard radical cholecystectomy, but not LC.

AIM　Bio-active constituents were expected to be obtained from Dendrobium fimbriatum Hook. METHODS　It was extracted with 95% alcohol, distributed by petrol, isolated via column chromatography on silica gel and purified by crystallization. RESULTS　Nine compounds were isolated from the stems of Dendrobium fimbriatum Hook., On the basis of spectral analyses, six compounds of them were identified as chrysophanol(3), n-dotriacodtanoic acid(5), defuscin(6), n-triacontyl cis-p-coumarate(7), β-sitosterol(8) and chrysotobibenzyl(9). CONCLUSION　Chrysophanol(3) was firstly isolated from Genus dendrobium and chrysotobibenzyl(9) was found from this species for the first time.

The Remote Medical Platform of Cloud Women and Children Health Care in Hubei Province is the key to improve the capacity building of maternal and child health care institutions,and is an important way to implement hierarchical diagnosis and treatment with the help of Internet+.After a brief analysis of the current situation and demand for maternal and child resources,it introduces the architecture and functions of the platform,and elaborates on the effectiveness of the application.In the end,putting forward relevant suggestions for future development based on the problems in application.

The Remote Medical Platform of Cloud Women and Children Health Care in Hubei Province is the key to improve the capacity building of maternal and child health care institutions,and is an important way to implement hierarchical diagnosis and treatment with the help of Internet+.After a brief analysis of the current situation and demand for maternal and child resources,it introduces the architecture and functions of the platform,and elaborates on the effectiveness of the application.In the end,putting forward relevant suggestions for future development based on the problems in application.

The Remote Medical Platform of Cloud Women and Children Health Care in Hubei Province is the key to improve the capacity building of maternal and child health care institutions,and is an important way to implement hierarchical diagnosis and treatment with the help of Internet+.After a brief analysis of the current situation and demand for maternal and child resources,it introduces the architecture and functions of the platform,and elaborates on the effectiveness of the application.In the end,putting forward relevant suggestions for future development based on the problems in application.

The Remote Medical Platform of Cloud Women and Children Health Care in Hubei Province is the key to improve the capacity building of maternal and child health care institutions,and is an important way to implement hierarchical diagnosis and treatment with the help of Internet+.After a brief analysis of the current situation and demand for maternal and child resources,it introduces the architecture and functions of the platform,and elaborates on the effectiveness of the application.In the end,putting forward relevant suggestions for future development based on the problems in application.

The Remote Medical Platform of Cloud Women and Children Health Care in Hubei Province is the key to improve the capacity building of maternal and child health care institutions,and is an important way to implement hierarchical diagnosis and treatment with the help of Internet+.After a brief analysis of the current situation and demand for maternal and child resources,it introduces the architecture and functions of the platform,and elaborates on the effectiveness of the application.In the end,putting forward relevant suggestions for future development based on the problems in application.

The Remote Medical Platform of Cloud Women and Children Health Care in Hubei Province is the key to improve the capacity building of maternal and child health care institutions,and is an important way to implement hierarchical diagnosis and treatment with the help of Internet+.After a brief analysis of the current situation and demand for maternal and child resources,it introduces the architecture and functions of the platform,and elaborates on the effectiveness of the application.In the end,putting forward relevant suggestions for future development based on the problems in application.

The Remote Medical Platform of Cloud Women and Children Health Care in Hubei Province is the key to improve the capacity building of maternal and child health care institutions,and is an important way to implement hierarchical diagnosis and treatment with the help of Internet+.After a brief analysis of the current situation and demand for maternal and child resources,it introduces the architecture and functions of the platform,and elaborates on the effectiveness of the application.In the end,putting forward relevant suggestions for future development based on the problems in application.