Objective To explore rational and effective treatment strategies by comparing long-term effects of different treatment methods for hepatolithiasis. Methods One hundred and fifty-nine cases of hepatolithiasis treated in this hospital from January 1993 to December 2002 were analyzed retrospectively.Five treatment methods: conservative treatment,choledocholithotomy followed by choledochostomy,hepatolobectomy,hepaticojejunostomy,and hepaticoplasty with the conservation of the Oddi's sphincter,were compared in respect of postoperative complications and long-term outcomes.Results Out of the 159 cases,follow-up was completed in 146 cases(91.8%,146/159) for 2~12 years(median,7 years).Of 16 cases of conservative treatment,15 were followed.Cholangitis occurred in all the 15 cases,with 1 fatal case.Of 47 cases of extrahepatic surgical exploration,the incidence of residual stones was 100%.Follow-up in 43 cases found 32 cases of cholangitis(74.4%) with 7 fatal cases.Of 16 cases of hepatolobectomy,residual stones were noted in 3 cases(12.5%).Follow-up in 15 cases found 4 cases of cholangitis(26.7%) with 1 fatal case.Of 32 cases of hepaticojejunostomy,residual stones were found in 11 cases(34.4%).Follow-up in 29 cases found 14 cases of cholangitis(48.3%) with 3 fatal cases.Of 48 cases of sphincter-sparing operation,residual stones were found in 8 cases(16.7%).Follow-up in 44 cases found 7 cases of cholangitis(15.9%).The incidence of residual stones was significantly higher in cases of extrahepatic surgical exploration than in cases of other treatment(P=0.000).The recurrence rate of cholangitis was significantly higher in cases of conservative treatment and extrahepatic surgical exploration than in cases of other treatment(P

0.05). Conclusions The upstream lesions of biliary tract must be dealt with thoroughly in the treatment of hepatolithiasis. EST should not be the first choice for hepatolithiasis preparatory to determining whether or not lesions like stricture are present in intrahepatic ducts.

Adult ; Body Mass Index ; Child ; Humans ; Insulin Resistance ; Obesity ; complications ; Sleep Apnea, Obstructive ; etiology ; physiopathology

Humans ; Pediatrics ; manpower ; Personnel Administration, Hospital ; Respiratory Therapy Department, Hospital ; manpower

Drugs, Chinese Herbal ; Medicine, Chinese Traditional ; Terminology as Topic ; Translations

Objective To observe endoplagmic reticulum stress in bone tissue of fluomsis rats and further explore the pathogenesis of skeletal fluorosis.Methods 48 Wistar rats were divided into 4 groups according to their body mass.The control and low.calcium group were fed with normal diet(0.79%calcium)and low-calcium diet(0.79%calcium)respectively,and both drank tap water(sodium fluoride concentrations＜1 mg/L).High fluoride and low.calcium plus high-fluoride groups were fed with normal diet(0.79%calcium)and low-calcium diet (0.79%calcium)respectively,and both drank tap water containing sodium fluoride(sodium fluoride concentrations 221 mg/L).During experimental period,rats were measured body mass once a week with a stand diet and water available ad libiturn.The experimental period was 3 months.The biochemical techniques were used to test the indicators of oxidative stress and ALP in seFum of fluorosis rats.The total RNA was extracted from the one side of the femur,and the transcription level of Bip,Xbp1,CHOP and PDI were investigated by reverse transcription polymerase chain reaction(RT-PCR).Results The level of MDA in serum of low-calcium plus high-fluoride group wag higher than that of the control[(14.74±3.11)μmol/L vs(10.15±1.96)μmol/L,P＜0.05];the activity of GPx was ma~edly higher in hish-fluoride group compared with the control[(3.87±0.41)×103 U/L vs(2.85± 0.55)×103 U/L,P＜0.05];the level of uric acid in sel'um was significantly lower both in high-fluoride group and low-calcium plus high-fluoride group compared with the respective control and the low-calcium group[(73.95± 9.52)μmol/L vs(110.43±25.48)μmol/L,(54.32±22.09)μmol/L vs(101.71±17.01)μmol/L,P＜0.05]. The activity of ALP wag obviously higher in low-calcium plus high-fluoride group compared with the control [(24.77±4.57)×103U/L vs (12.91±3.97)×103U/L,P＜0.01)].The mRNA expression of Bip/GAPDH in bone tissue was markedly higher in bone of high-fluoride group and low-calcium plus high-fluoride group compared with the control(1.38±0.24,1.35±0.12 vs 1.14±0.06,P ＜ 0.05). The expression of Xbp1/GAPDH in bone tissue significantly increased in low-calcium plus high-fluoride groups compared with the control and the low-calcium group (1.48±0.20 vs 1.02±0.25,1.07±0.25,P ＜ 0.05 or ＜ 0.01);and CHOP/GAPDH in bone tissue significantly increased in low-calcium plus high-fluoride groups compared with the control(0.84±0.18 vs 0.52±0.07,P ＜ 0.05 ). Conclusions Accelerated osteogenetic action is seen in fluorosis rats,accompanied by oxidative stress and bone endoplasmic reticulum stress,which is likely involved in the pathogenesis of skeletal fluorosis.

Objective To summarize the clinical features,diagnosis,treatment and prognosis of hepatolithiasis complicating cholangiocarcinoma. Methods From June 1958 to March 2011,709 cases of hepatolithiasis were admitted to Department of General Surgery,Peking University Third Hospital.The cases concomitant with cholangiocarcinoma were reviewed. Results 20 of 709 (2.8％ ) hepatolithiasis cases developed cholangiocarcinoma.17 cases (85％,17/20) were followed-up for 2 years (0 - 15 years).The hepatolithiasis course before the malignant diagnosis was 15 ± 1 1 years (3 -38 years).14 cases had frequent episodes of cholangitis,15 cases had liver cirrhosis.Preoperative diagnosis was established by CT,MRCP,B-ultrasound and tumor markers in 55％ (11/20) cases.4 cases underwent radical resection,7 received palliative resection,9 cases received conservative treatment.In radical resection,one lost to follow-up,one survived one year,two for 5 years.In palliative resection,2 lost to follow-up,two survived one year,one survived 3 years, one for 5 years. None in conservative group survived more than one year.Conclusions Cholangiocarcinoma developed from hepatolithiasis with a long history,frequent cholangitis,liver cirrhosis,especially in cases with imige showing thickness of bile duct or mass and rising tumor markers (CA19-9,CA125,CEA).The cases undergoing radical resection may have a favorable prognosis.

Objective To study CD64 expression in neutrophilic granulocyte and its clinical effect in neonatal infection disease. Methods CD64 was detected among 59 neonatal patients(septicemia group 34 patients, local infection group 25 patients)hospitalized in our neonatal department diagnosed as neonatal infection disease in 48 h after hospitalized,2 weeks after therapy, then the results were compared with 27 patients as non - infection disease during the same period. Results CD64 in septicemia group was (6156. 21?3643. 32) molecula per cell,in local infection group was (2176.19 ? 946. 32)molecula per cell, in non- infection group was (2176. 19 ? 946. 32) molecula per cell.There were significant differences among three groups (all P0.05). Conclusions CD64 expression increases in bacterium infection disease. It is more obvious in widespread infection desease.and it can be the mark in early diagnosis of neonatal infection disease.

Objective To study the relationship of urine RBC morphology between UF-100 urine sediment analytic instrument andphase contrast microscope.Methods The UF-100 urine sediment analytic instrument to analyze 500 urine specimens and study the relation-ship of urine RBC morphology between urine sediment analytic instrument and phase contrast microscope.Results The according perceptionof Normocytic,Microcytic and Non-classified RBC between phase contrast microscope and UF-100 urine sediment analytic instrument RBC-info are 91.4%,94.4%,83.3% respectively,the according perception between phase contrast microscope and RBC-P70Fsc are 94.9%,95.7%,94.7% respectively,and the according perception between phase contrast microscope and RBC Fsc-DW are 84.4%,86.8%,90.5% respectively,the specificity of UF-100 and phase contrast microscope in glomerular hematuria and non-glomerular hematuria are84.3%,88.1% and 83.3%,87.9% respectively.Conclusion The results show that the UF-100 urine sediment analytic instrument issimply operating,fast and high accurate,and which can instruct clinical dignose,therapy and prognosis judgement.

ABSTRACTOBJECTIVE Proteomic technique was applied to analyze ankylosing spondylitis AS patients with damp?heat arthralgia spasm syndrome.METHODS Serum proteins of AS patients with damp?heat arthralgia spasm syndrome groupn=30 was compared with that of normal control group n = 30 and AS patients with cold?dampness arthralgia spasm syn-drome groupn =30 respectively by two?dimensional gel electrophoresisthe common differential protein spots of damp?heat arthralgia spasm syndrome were analyzed by the second order MS.The validation of the differential protein was performed u-sing Western blot.RESULTS Seven kinds of common differential protein spots were selected and five kinds of proteins were i-dentified by mass spectrometry.They were fibulin 1dipeptidy lpeptidase 1kininogen 1mutant IL 17Fmannose?binding protein C and related to extracellular matrix proteinproteasecoagulation factorcytokinetransport proteinand so on.Re-sults of Western blot were consistent with the proteomic results.CONCLUSION These proteins are implicated in the patho-genesis and pathological processes of AS with damp?heat arthralgia spasm syndromeand provide a basis for further studies of the essence of the syndrome in traditional Chinese medicine.