Objective To compare the therapeutic effects of "three-endoscopy" and"two-endoscopy" respectively combined with traditional open surgery in the treatment of gallbladder stone complicated with common bile duct stone , and to explore the clinical value of "three-endoscopy" in the treatment of common bile duct stone complicated with gallbladder stone .Methods First, the pa-tients with upper abdominal surgical history and those patients with common bile duct diameter smaller than 0.6 cm and or those with stone diameter in common bile duct larger than 2.0 cm were screened and excluded from the study .The included patients with con-firmed gallbladder stone complicated with common bile duct stone were divided in accordance with different treatment methods into 4 groups:the traditional open surgery group (or group A), the Laparoscopy plus Bile duct endoscopy group (or group B), the Laparosco-py plus duodenal endoscopy group (or group C) and the"three-endoscopy" group (or group D), each consisting of 50 patients.Com-parisons were made in the success rate of surgery , residual stone rate , blood loss in the process of surgery , surgical time , drainage tube indwelling time , average air exhaust time after surgery , early ambulation time after surgery , cases of early complications and average hospitalization days between the 4 groups.Results There was no significant difference in the success rate of surgery between the"three-endoscopy" group and other treatment groups (P>0.05).The amount of blood loss in the process of surgery [(109.6 ±53.7) ml], surgical time [(117.3 ±53.2)h] and drainage tube indwelling time [(5.3 ±0.2)d] were significantly less than those of group A [(273.6 ±67.3)ml, (162.3 ±23.7)h, (33.6 ±5.3)d](P<0.05), Drainage tube indwelling time were significantly less than those of group A and group B (P<0.05), however, there were no significant differences, as compared with those of group C (P>0.05).In the "three-endoscopy" treatment group, residual stone rate, air exhaust time after surgery, ambulation time after surgery, cases of complications and average hospitalization days were significantly less than those of group A and group C (P >0.05). Conclusion When compared with traditional open surgery and "two-endoscopy" in the treatment of gallbladder stone combined with common bile duct stone , "three-endoscopy" therapy has the advantages of less trauma , less complications , faster recovery , shorter length of stay in hospital , with this reason , it is worth further clinical promotion .

Objective To investigate the correlation between aberrant methylation status of ras association domain family 1A (RASSF1A) , transcriptional levels of DNA methyltransferases (DNMTs) and hepatitis B virus ( HBV) infection in patients with hepatocellular carcinoma ( HCC). Methods HCC samples in 61 cases were collected. Aberrant methylation status of RASSF1A was detected using methylation specific PCR (MSP). Transcriptional levels of DNMT1, DNMT3 A and DNMT3B was measured using semi-quantitative reverse transcriptase-PCR(RT-PCR). Results RASSF1A gene with abnormal methylation in initiation zone was found in 45 cases with HCC among 61 patients (73.8%). Further analysis revealed RASSF1A methylated in 32 of 47 HBV infected cases and in 13 of 14 uninfected cases. However, there was no significant association between methylation status of RASSF1A and HBV infection (x2 =2.260, P = 0. 133). Compared with normal control, DNMTs was up-regulated in all HCC samples, HCC cell lines and HBV infected group. Analysis within each group indicated that DNMT3A and DNMT3B levels of HCC increased in MSP positive cases ( t = 3. 494, P