Gallbladder stone is a common disease and frequently occurring disease in surgery.Laparoscopic cholecystectomy surgery is the main treatment for gallstones,but high complications and after cholecystectomy after biliary calculi induced colon cancer incidence,high risk factors,seriously affect the quality of life of patients.With the rapid development of endoscopy,endoscopic minimally invasive cholecystolithotomy has become a new method in the treatment of gallbladder stones,major complications of endoscopic minimally invasive cholecystolithotomy for the recurrence of cholecystolithiasis,cholecystectomy and comparison,significantly reduce the complications,and the preservation of gallbladder function,improve the the quality of life in patients.Grasp the surgical indications,regulate the operation and adjuvant drug treatment can reduce the recurrence of gallbladder stones.If it can further reduce the recurrence rate of stone,it will be expected to become a good gallbladder function in patients with gallbladder stones in the treatment of priority.

Objectives To explore the effect of the standardized residents training method on intern teaching in department of respiratory. Methods Sixty interns of Grade 2010 from the Second Military Medical School were randomly divided into 2 groups with 30 interns each. The traditional teaching method was adopted in control group, while the standardized residents training method was used in experiment group. When the rotating internship was finished in department of respiratory, the survey of satisfaction about teaching and the assessment of teaching effect were performed in two groups. The contents of examination included academic knowledge exam, clinical skills test, basic skills test and comprehensive quality assessment. Results There was no difference between two groups in academic knowledge exam (P>0.05). The total scores, clinical skills scores and basic skills scores of experiment group were higher than those of control group (P<0.05). And, higher satisfaction was ac-quired in experiment group(P<0.05). Conclusions Using the standardized residents training method can improve the effect of the intern teaching and teaching satisfaction and it can be widely applied in intern teaching.

Objective To explore the effect of curcumine on the inflammation and expression of single immunoglobin IL-1 receptor related protein in alveolar epithelial cells induced by lipopolysacharride (LPS).Methods The rat type Ⅱ alveolar epithelial cells were cultured in vitro,and cell activity was measured when stimulated with LPS and different doses of curcumin.The level of tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in supematant was detected.Cells pretreated with curcumin (20 μmol/L),were stimulated with LPS (10 μg/mL).The nuclear protein and membrane protein was extracted to detect the expression level of nuclear transcription factor kappa B (NF-κB) and single immunoglobin IL-1 receptor related protein (SIGIRR).Results The cells activities were not affected by curcumin (5 ～30 pμmol/L) and LPS (10 μg/mL) (P ＜ 0.05).Curcumin (5 ～30 μ mol/L) significantly inhibited LPS-induced overpression of TNF-α and IL-6 (P ＜ 0.05).In 20 μ mol/L and 30 μ mol/L pretreatment groups,the inhibition of curcumin was most obvious,and there were no significant differences between the two groups (P ＜ 0.05).Curcumin (20 μ mol/L) significantly inhibited the expression level of phosphorylation of NF-κB p65 in cell nucleus,while up-regulated the expression of SIGIRR (P ＜ 0.05).Conclusion Curcumin inhibits the expression of inflammatory factor such as TNF-α and IL-6 as well as activation of NF-κB in alveolar epithelial cells induced by LPS.Up-regulating the expression level of negative regulatory molecules SIGIRR is one of the possible mechanism.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on anemia and blood transfusion requirements in perioperative patients.Methods21 cases, with abdominal surgery(with anemia before operation or with expected blood loss 400～600?ml were divided into two groups (study group or control group).The patients in the study group received subcutaneously rHuEPO 300?IU?kg -1 ?w -1 starting 2 weeks before operation for 3 times.Results In the study group,RBC,Hgb,Hct significantly increased to 0 36?10 12 /L?13 3?g/L and 3 8% respectively after rHuEPO therapy,intraoperative blood transfusion reduced significantly ( P

Objective To study the relationship between the emotion disorder and cognitive function impairment relation and its influence factors with the epilepsy patients.Methods We collected 320 cases epilepsy patients in hospital and 56 cases contrast normally in People’s Hospital of the centre of Zhanjiang, and Carry on the determine of the cognitive function separately, the determine of the emotion status, and the measurement for the quality of life, then carry on statistical analysis.Results In 320 cases with epilepsy patients, 259 cases persons has intellectual Impairment (80.9) (IQ

Objective To study the effects of Xinshuai mixture on mitochondrial function of hypertrophy cardiomyocyte cell in vitro.Methods The primary neonatal rat myocardial cells were cultured to establish hypertrophic myocardial model by AngII.The levels of superoxide dismutase(SOD), methane dicarboxylic aldehyde (MDA), monoamine oxidase(MAO) and cyclooxygenase (COX) were detected by ELISA, as the mitochondrial function and oxidative stress damage.The expression level of caspase-3 mRNA was detected by Real-time PCR.Results Compared with control group, the SOD level in model group reduced markedly, MDA level increased significantly, the activities of MAO increased, the activities of COX decreased, the expression of caspase-3 level increased significantly(P<0.01).Compared with the model group, the SOD level increased and MDA level decreased in Xinshuai mixture group and blank serum group.But the SOD level and activities of MAO, COX in Xinshuai mixture group and blank serum group had significant difference(P<0.05,P<0.01).The expression of caspase-3 mRNA level in Xinshuai mixture was significantly higher than the blank serum group(P<0.01).Conclusion Xinshuai mixture could significantly improve the fuction of mitochondrial in hypertrophy cardiomyocyte cell, reduce the energy metabolism and oxidative stress injury, and protect cardiac myocyte through lower the expression of caspase-3.

Objective To investigate the clinical value of the Classification of acute pancreatitis2012.Methods Medical records and clinical data of patients with acute pancreatitis (AP) who were admitted to First Affiliated Hospital of Guangxi Medical University between October 2009 and September 2012 were retrospectively reviewed and analyzed.Patients were divided into mild acute pancreatitis (MAP),moderately severe acute pancreatitis (MSAP),and severe acute pancreatitis (SAP) groups according to the Classification of acute pancreatitis-2012.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,computed tomographic severity index (CTSI) scores among the 3 groups were compared.Results One hundred and sixty-six patients with AP (119 males and 47 females) were included,and 76 were MAP,65 MSAP and 25 SAP.The average interval between AP onset and hospital admission was (2.27 ± 1.46) d.The number of improved and cured patients,length of hospital stay,hospitalization costs,rate of ICU admission,length of ICU stay,incidence of SIRS,and length of SIRS continue,Ranson scores,APACHE Ⅱ scores,CTSI scores increased with the severity of AP.The corresponding values in SAP group were 21 cases (84.0％),(23.8 ± 13.6) d,(53900 ± 30260) Yuan,48.0％ (12/25) and (5.76 ± 13.8) d,96.0％ (24/25) and (5.00 ± 2.40) d,(3.76 ± 1.30) score,(8.52 ± 4.24) score,(5.44 ± 3.48) score.Seventy-nine patients developed local complications,among them 34 was acute peripancreatic fluid collection,45 was acute necrosis collection.The incidence of acute necrosis collection in SAP group was significantly higher than that in MSAP group (68.0％ vs 44.6％,P =0.047),but the incidence of acute peripancreatic fluid collection in SAP group was significantly lower than that in MSAP group (16.0％ vs 46.2％,P =0.016).Organ failure occurred in 42 patients,among them 35 cases were respiratory failure,2 cases were renal failure,and 5 cases were respiratary and renal failure.The incidence of organ failure in SAP and MSAP group was 100％ and 26.2％,the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Classification of acute pancreatitis-2012 is a simple and convenient system,which can predict the severity of AP and appropriate for clinical application.

Objective To evaluate the efficacy of ultrasound-guided combined C5 and superficial cervical plexus block in patients undergoing clavicle surgery.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective clavicle surgery,were randomly divided into 2 groups (n =30 each) using a random number table:injection with 10 ml local anesthetic guided by ultrasound group (group U),and injection with 10 ml local anesthetic guided by anatomical landmark group (group A).A mixture of 0.375 ％ levobupivacaine and 1.0％ lidocaine was used.The time spent performing the block onset time of analgesia,onset time of analgesia in the medial border,midpoint and lateral border of the clavicle and duration of analgesia were measured.The effectiveness of block (excellent,good,failure) was assessed.The complications were observed.Results Compared with group A,the time spent performing the block was significantly prolonged,the onset time of analgesia in the lateral border and midpoint of the clavicle was shortened,the rate of excellent anesthesia was increased,and the duration of analgesia was prolonged in group U (P ＜ 0.05).No complications occurred in group U,while vascular puncture occurred in 3 cases,and one patient developed mild toxic reaction in group A.Conclusion Ultrasound-guided combined C5 and superficial cervical plexus block provides better block,with faster onset time of analgesia in the lateral border and midpoint of the clavicle,longer duration of analgesia and fewer complications as compared with that guided by anatomical landmarks in patients undergoing clavicle surgery.

Objective To evaluate the outcome of liver transplantation (LT) or combined liver-kidney transplantation (CLKT) for acute-on-chronic liver failure (ACLF) patients with renal dysfunction.Method From January 2001 to December 2009,133 patients underwent LT for ACLF at our center.Among them,30 had both ACLF and renal dysfunction.Of the 30 patients,12 underwent CLKT for end-stage renal disease (ESRD),and the other 18 with hepatorenal syndrome type 1 (HRS1) underwent LT alone.Their clinical data were reviewed and their survival outcomes were compared.Result The median model for end-stage liver disease scores (MELD) of the patients with ACLF were 28.133 patients received deceased donor liver grafts and 12 patients also received the same deceased donor kidney grafts,The hospital mortality rate was 21.8％ for all patients with ACLF.The 5-year survival rates were 72.8％ for patients without renal dysfunction and 70％ for patients with renal dysfunction.The curative effectiveness of the patients with ESRD who underwent CLKT was better than that of the patients without renal dysfunction or the patients with HRS1 who underwent LT alone.Conclusion LT alone improved renal function in most patients with HRS1.Simultaneous liver-kidney transplantation is an excellent strategy in patients with both ACLF and ESRD.It provides protection to kidney allograft in liver-based metabolic diseases affecting the kidney.

Objective To study the effect of antivirus therapy of HBV reinfection and YMDD mutation after liver transplantation. Methods Fifteen of 317 patients with HBV-related end-stage liver diseases received lamivudine ( LAM ) monothereapy, others received combination low-dose hepatitis B immune globulin( HBIG) and LAM (or adefovir dipivoxil, ADV) therapy, as prophylaxis against HBV reinfection after OLT. Hepatitis serum markers, HBsAg, HBeAg, HBcAb-IgM, and HBcAg were detected every 2 weeks by immunohistochemistry. Serum HBV DNA was examined by PCR every 2 weeks. HBsAg and HBcAg in the liver specimens were examined by immunohistochemistry. YMDD mutation was detected by PCR in those patients with recurrence of positive HBV DNA posttransplantation. Results In LAM monotherapy group, 4 developed HBV reinfection out of 15 patients with pretreatment positve HBV DNA. Sixteen of 302 patients with combination HBIG and LAM therapy suffered from posttransplant HBV reinfection, the difference between the two groups was significant (26.7% vs. 5. 30% ,P