Objective To investigate the application value of transcystic choledochoscopy combined with holmium laser for common bile duct stones . Methods Clinical data of 16 patients with common bile duct stones who underwent transcystic choledochoscopy and holmium laser cholelithotripsy between March 2012 and December 2013 in this hospital were retrospectively analyzed.During holmium laser cholelithotripsy (1.0 J/10 Hz, 400 μm fiber), the stones were fragmented under direct vision of choledochoscopy and were extracted by using water flushing or a stone basket . Results The stones were successfully removed in 15 patients, including 6 cases of laparoscopic operation and 9 cases of open operation .The operation time was (132 ±27) min for open surgery and (156 ±33) min for laparoscopic surgery .The stone fragment and removal time was (30.2 ±8.5) min for open surgery and (45.6 ±10.4) min for laparoscopic surgery .The hospital stay was (9.7 ±1.4) d.There was 1 case of failed cholelithotripsy due to obstructed water flow and blurry vision .Follow-up examinations in 14 cases for 2-24 months found no recurrence of stones or biliary strictures. Conclusion Transcystic choledochoscopy and holmium laser cholelithotripsy is intuitive , accurate, and effective, being a safe and reliable alternative for choledocholithiasis .

Objective To study the effect of an angiogenesis inhibitor TNP-470 (TNP )used alone and in combination with cytoxan(CTX) in the treatment of human ovarian cancer transplanted s.c. in nude mice. Methods Human ovarian cancer transplanted s.c. in nude mice model was established, then divided into 5 groups: control group, vehicle group, TNP group,CTX group and TNP+CTX group, different treatments were served from day 8 after transplantation and all mice were sacrificed after 28 days. The weights of the mice and the volumes of the tumors were measured respectively during the therapy time. Moreover, microscopy was done after H&E staining. Results The growth inhibiting rates in the TNP and CTX group were 26.1% and 33.9% respectively; After combined, the rate was increased to 70.5%. There were no obvious decrease in the weight of all treated mice. Conclusions Treatment with TNP is an potentially useful method of antitumor therapy in ovarian cancer, although the inhibition effects were not obvious in small doses. Moreover,TNP could enhance the effectiveness of antitumor drug.

Objective To study the clinical pathological features, treatment and prognosis of umbilical metastases of colorectal carcinoma. Methods From January 2000 to September 2010, 10 umbilical metastases of colorectal carcinoma cases were admitted. The clinical features were reviewed. Results Four radical resection of colon cancer and resection of the umbilical plexus metastases cases with chemotherapeutic intraperitoneal perfusion lived 9,11,14 and 18 months respectively, 1 ileum-transverse colon anastomosis case with chemotherapeutic intraperitoneal perfusion lived six months, 2 patients with systemic widely transfer and umbilical transfer with pure venous chemotherapy lived 3, 3.5 months respectively, 3 colon intra-operative cases with venous chemotherapy lived 5 ,5. 5 and 7 months respectively. Conclusion Surgical resection of the primary focal and periumbilical metastases can prolong survival time with adjunctive therapy.

Objective To compare sinus tarsi approach(STA) and extensile L shape approach (ELA) in the surgical treatment of calcaneal fractures. Methods A total of 51 cases of calcaneal fractures treated from May 2014 to December 2016 were enrolled. Twenty of them were performed ORIF via the sinus tarsi approach, while the other 31 cases were performed ORIF via lateral extensile L shape approach. X-ray films were taken postoperatively to record the changes of B?hler angle and Gissane angle. The AOFAS, VAS and SF-36 scores were adopted to assess the therapeutic effect. Results The average follow-up period of STA group was 15.5 months. And patients in ELA group were followed up for an average period of 18.4 months. All the fractures in the series had a boney union at or before the final follow-up. The final correction of B?hler angle (34.60 ± 2.91)° , and Gissane angle (114.45 ± 2.91)° was significantly increased in the STA group; and the final correction of B?hler angle (33.55 ± 2.73)° , and Gissane angle (112.81 ± 4.15)° was also significantly increased in the ELA group; while there was no significant difference between the two groups. The final AOFAS scores , VAS scores and SF-36 scores of the STA were (83.56 ± 7.13), (1.78 ± 0.89), (88.95 ± 4.31) scores, while those in ELA group were (81.91 ± 9.89), (2.01 ± 1.33) and (86.65 ± 4.95) scores. There was no significant difference between the two groups (P>0.05). No wound problem happened in STA group, but there were 2 cases who had wound complications in ELA group. Conclusions No significant difference is found between the two groups in the short-term efficacy of the treatment for calaneal fracture. However, STA has the advantages of lower soft tissue complication rate.

AIM:To investigate the kinetics of tumor necrosis factor alpha(TNF-?)in an animal model of chronic P.aeruginosa biomembrane associated with lung infection.METHODS:Rats were challenged with 0.1 mL of PAO579(1012 CFU/L)in alginate beads or 0.1 mL of planktonic PAO579(1012 CFU/L).After challenging for 3,7 and 14 d,bacteriological and pathological features,and TNF-? expression in lung tissue were observed.RESULTS:(1)CFU/lung in alginate beads group was significantly higher than that in planktonic bacteria group(P

OBJECTIVE To understand the effects of meropenem on the biofilms of Pseudomonas aeruginosa lasR/rhlR mutations in vitro.METHODS The biofilms of PAEO1 and its lasR,rhlR,and lasR rhlR mutants were incubated in a polyvinyl chloride tube in 0.9% saline for three days,then were immersed in meropenem solution of 26 ?g/ml for 24 hours,and examined by scanning electron microscopy(SEM).RESULTS After three days incubation,PAEO1 biofilms showed a well-developed structure,however,the biofilms of PAEO1 lasR,rhlR,and lasR rhlR mutants were thin and poor developed;after 24 hours in meropenem solution,PAEO1 biofilm become rareness,whereas PAEO1 lasR,rhlR,and lasR rhlR mutants biofilms were almost destructed and only small pieces left.CONCLUSIONS lasR/rhlR Genes play probably an important role in the formation of P.aeruginosa biofilm and in the resistance to meropenem.

OBJECTIVE To understand the effects of lasR/rhlR mutations on the biofilm formation of Pseudomonas aeruginosa in vitro.METHODS The biofilms of PAEO1 and lasR,rhlR,and lasR rhlR mutants were incubated in a polyvinyl chloride tube in 0.9% saline and studied by means of scanning electronic microscopy(SEM) after three days′ incubation.RESULTS After 3 day′s incubation,PAEO1 biofilm showed a well-developed structure,whereas thin and poor developed biofilms were seen in lasR/rhlR mutant groups.CONCLUSIONS lasR/rhlR Genes play probably an important role in the formation of P.aeruginosa biofilm in vitro.

OBJECTIVE To understand the importance of quorum sensing(QS)system in Pseudomonas aeruginosa(PAE)biofilm infection in lungs,the pathogenic effects of the wild-type P.aeruginosa PAEO1 were compared with QS double mutants PAEO1 lasR rhlR and PAEO1 lasⅠ rhⅡ in vivo.METHODS Rats were challenged intratracheally with alginate embedded PAE strain PAEO1 and the mutants of QS in the concentration of 1?109 colony-forming units per milliliter(CFU/ml).Two weeks post intratracheal challenge with P.aeruginosa,parameters were evaluated.RESULTS Two weeks after challenge,significantly milder microscopic and macroscopic lung pathology(P

Objective To explore the treatment experience and surgical strategy in papillary thyroid carcinoma (PTC) patients with parapharyngeal lymph node metastasis. Methods A retrospective review was performed on ten patients with PTC metastasis to parapharyngeal lymph node from January 2005 to August 2014. The treatment experience and surgical strategy were analyzed. Results Three patients accepted initial treatment and 7 patients had a history of surgical treatment prior to PTC. Parapharyngeal lymph node metastasis was diagnosed by imaging examination or fine needle aspiration cytology. Resection of lymph node metastasis was performed via transcervical approach and transmandibular approach. Total thyroidectomy and neck dissection were performed synchronously. All patients received 131I therapy after surgery and did not have recurrence in neck or parapharyngeal space. During follow-up, 3 patients died in 5 years because of lung metastasis, 3 patients survived with tumor , and 4 patients survived without recurrence. The 5-year overall survival rate was 7/10 and the 5-year disease-free was 4/10. Conclusions Parapharyngeal lymph node metastasis from PTC may occur in patients with previous neck dissection or widespread cervical metastases. CT and MRI is helpful for establishing the diagnosis. Surgical resection remains the mainstay of treatment for this disease. PTC patients with parapharyngeal lymph node metastasis have a poor prognosis.

Objective To compare the clinical efficacy of the nerve bow (digital nerve and cutaneous antebrachii later-als) with end-to-side neuroanastomosis and traditional end-to-end neuroanastomosis for repairing bilateral proper digital nerve inju-ries while replanting injured fingers. Methods A total of 57 patients with bilateral proper digital nerve injuries from March 2009 to September 2012 were retrospectively analyzed. The patients were divided into three groups according to different treatments:19 patients underwent nerve graft bow end-to-side neuroanastomosis. During operation, a cutaneous antebrachii laterals nerve was freed and obtained from the homolateral forearm, which were sutured with bilateral distal digital nerve end to end, then nerve bow was formed. The bilateral proximal ends of digital nerve were sutured end-to-side bow, respectively. 22 patients underwent digital nerve bow end-to-side neuroanastomosis. During operation, bilateral distal ends and proximal ends were sutured respectively;con-sequently, the distal and proximal nerve bows were formed. A cutaneous antebrachii laterals nerve was obtained from the homolat-eral forearm, then divided equally to 2 parts which were used to bridge the 2 nerve digital nerve bow end-to-side neuroanastomosis bows. 16 patients underwent nerve graft with end-to-end neuroanastomosis. The sensation of finger plup, two point discrimination and motion of joints were evaluated. Results All patients achieved primary healing of wound after operation, with 57 fingers re-covered uneventfully. In nerve graft bow end-to-side neuroanastomosis group, 18 patients were followed up for 3-15 months;the average result of sensation measurement was S3+;the average result of two point discrimination was 5.1±0.8 mm. In digital nerve bow end-to-side neuroanastomosis group, 19 patients were followed up for 4-15 months;the average result of sensation measure-ment was S3; the average result of two point discrimination was 6.3 ± 0.9 mm. In nerve graft with end-to-end neuroanastomosis group, 12 patients were followed up for 3-14 months;the average result of sensation measurement was S2, the average result of two point discrimination was 7.2±1.4 mm. According to total active motion scales, there had no difference in results of motion of joints in the 3 groups. Conclusion The nerve bow end-to-side neuroanastomosis is valuable method for repairing bilateral proper digi-tal nerve injuries at the same time, which can restore sensation of fingers.