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With the continuous development of laparoscopic technology, the treatment of common bile duct stones has changed from the traditional open surgery to the current laparoscopic common bile duct exploration (LCBDE), which has the advantages of small trauma, fast recovery, less complications, short hospital stay and so on. LCBDE has two ways: through the common bile duct (LCD) and through the cystic duct (LTCBDE). LCD + T-tube drainage has a wide range of applications while the LCD + primary suture of bile duct eliminates T-tube and improves the quality of life of patients. LTCBDE has a certain range of applications, but has little trauma. The improvement of endoscopic technology and the application of new equipment also improve the efficiency and safety of operation. This article reviews the application progress of laparoscopic common bile duct exploration and lithotomy in the treatment of common bile duct stones.
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Intrahepatic cholangiocarcinoma (ICC) is a rare primary liver cancers.The pathogenesis is obscure and usually,it is asymptomatic in early stage,the diagnosis is made with difficulty.Most patients are in advanced stage upon diagnosis and have unresectable tumors.Strategies and indications for surgery are variable by different doctors.Standard,effective and individualized treatment strategies are lacking,with high malignancy,the tumor often shows unfavorable prognosis.In this review,we elucidate the cancer staging system,diagnostic algorithm,choice of surgical approaches and progress of nonsurgical treatment in conjunction with domestic and foreign literatures,so as to enhance the awareness of ICC and avoid misdiagnosis or underdiagnosis,eccessive or inadequate treatment in clinical work and confer benefit to patients.
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Intrahepatic cholangiocarcinoma (ICC) is a rare primary liver cancers. The pathogenesis is obscure and usually, it is asymptomatic in early stage, the diagnosis is made with difficulty. Most patients are in advanced stage upon diagnosis and have unresectable tumors.Strategies and indications for surgery are variable by different doctors. Standard, effective and individualized treatment strategies are lacking, with high malignancy, the tumor often shows unfavorable prognosis. In this review, we elucidate the cancer staging system, diagnostic algorithm, choice of surgical approaches and progress of nonsurgical treatment in conjunction with domestic and foreign literatures, so as to enhance the awareness of ICC and avoid misdiagnosis or underdiagnosis, eccessive or inadequate treatment in clinical work and confer benefit to patients.
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Objective@#To understand the awareness and influencing factors of medical healthcare APP among female college students in Weifang, and to provide references for healthy lifestyle and health literacy improvement.@*Methods@#A total of 891 female college students were selected by stratified random sampling method, and were investigated regrading awareness on medical and health care APP and associated factors. Data were statistically analyzed by composition ratio, CHI-square test and binary Logistic regression.@*Results@#There were 54.6% of the female college students who reported not aware of medical healthcare APP. The overall awareness rates of medical and health care APP for freshmen,sophomores, juniors, seniurs and above were 39.75%,45.59%,55.78% and 52.56%, respectively, and the difference was statistically significant(χ2=16.43，P<0.05). Logistic regression analysis showed that medical costs, medical healthcare information attention, medical health care information recognition, consulting the treatment scheme were positively associated with awareness of health care APP(OR=1.40,1.51,1.27,1.33,P<0.05).@*Conclusion@#The awareness rate of medical health care APP of female college students in Weifang is relatively low,and the difference between different groups is obvious. It is necessary to improve the scientific knowledge rate of the female college students to the APP, so as to influence the life style of the female college students.
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Gallstone is a common and frequently-occurring disease in surgery,and its formation is a process of many factors,many links and many steps,often accompanied by a variety of metabolic diseases.The treatment of cholecystolithiasis,operation time and operation mode are influenced by many factors.Clinicians are often confused because of their different strategies in diagnosis and treatment.Based on the domestic and foreign research progress of diagnosis and treatment of gallbladder calculi,combined with clinical practice,this article discusses the existing problems in the diagnosis and treatment of gallstone problems,treatment principles,individualized treatment strategy to make a discussion,aimed at strengthening grassroots doctors and general practitioners awareness of gallstones,individual treatment protocol.Therefore we could avoid excessive and inadequate treatment,and make the treatment of "standardization"" individualization",the benefit of the "maximum".
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Objective To evaluate the function of Rouviere's sulcus with posterior cystohepatic triangle in prevention of bile duct injury in laparoscopic cholecystectomy.Methods The clinical data of 170 patients undergoing laparoscopic cholecystectomy through Rouviere's sulcus approach with posterior cystohepatic triangle from May 2016 to June 2017 in the Department of General Surgery,the Second People's Hospital of Wuhu were retrospectively analyzed.The incidences and types of Rouviere's sulcus were documented.Results The open type of Rouviere's sulcus was visualized in 108 patients(63.53％),the fused type in 44 patients(25.88％),and the deficient type in 18 patients (10.59％).Hence in a total of 152 (89.41％) patients had Rouviere's sulcus.All patients underwent laparoscopic cholecystectomy safely.There was no bile duct injury or mortality.Four patients (2.35％) were converted to open operation,all were deficient type of Rouviere's sulcus for chronic inflammation of the gallbladder triangle.Conclusion Rouviere's sulcus are present and visible in most patients.Guided by Rouviere's sulcus with posterior cystohepatic triangle it could be safely and effectively to expose the anatomical structure of Calot's triangle and prevent bile duct injury in laparoscopic cholecystectomy.
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Objective To investigate the effect of alpha-lipoic acid on oxidative stress and cerebral edema after hypoxic-ischemic brain damage (HIBD)in neonatal rats.Methods A total of 108 neonatal 7-day-old Wistar rats were randomly divided into 3 groups:sham-operated group(sham, n=36), HIBD group(HIBD, n=36) and alpha-lipoic acid-treated group (treated group, n=36).Each group was divided into 3 sub-groups (n=12, per sub-group) based on different time points after HIBD (1 d, 3 d, 7 d).HIBD rat models were established by ligating the left common carotid artery, The sham-operated group and the HIBD group were treated with normal sodium injection intraperitoneally; treated group were treated with alpha-lipoic acid 100 mg/kg every 12 hours in 5 days.Animals were sacrificed at different time points.Changes of brain water content were determined by dry-wet weight method.And the levels of SOD,MDA,GSH-PX were measured.Results HIBD group showed an upward trend in brain water content and the level of MDA after HIBD, were higher than that of sham-operated group at each time point (P<0.05).Meanwhile, the levels of SOD and GSH-PX showed the downward trend in HIBD group.The levels of brain water content and the level of MDA in treated group were significantly lower than HIBD group at each time point ( P<0.05 ) .And the levels of SOD and GSH-PX in treated group were significantly higher than HIBD group at 3 d and 7 d.on the contrary , the level of MDA in treated group was significantly lower than HIBD group at 3 d and 7 d.Conclusion Alpha-lipoic acid can amiliorate cerebral edema, so it can prevent HIBD.The neuronal protective mechanism might be reverse oxidative imbalance in the brain of neonatal rats with HIBD.
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Objective To analyze the early mortality and morbidity of early postoperative complications of gastric cancer patients submitted to D1 or D2 gastrectomy for improving the surgical effect.Methods All consecutive patients who underwent D1 or D2 radical gastric resection between January 2006 and December 2007 were evaluated.Clinicopathologic features of the tumor,the extent of lymphadenectomy,the postoperative mortality and the early morbidity of complication were analysed.Results There were 130 patients admitted for the treatment of gastric cancer.34 underwent D1 dissection and 96 underwent D2 dissection.The early morbidity of D2 dissection was higher than that of D1 dissection (20.6% vs.39.6%,P<0.05).When complications were analyzed individually,there was no significant difference.Although the postoperative mortality was higher in the D2 group,no significant difference was observed(4.2% vs.0,P>0.05).4 patients underwent D2 dissection died.Considering the causes of the 4 died patients,respiratory complication related to anaatomotic and pancreatic leakage was the most important.Conclusion This study indicates that D2 dissection is a safe and effective procedure and the extent of lymphadenectomy may be related with high postoperative complication morbidity and mortality.Improving the surgical dissection skill and standardizing the gastric lymphadenectomy are the key ways to decrease the morbidity and mortality.
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OBJECTIVE: To discuss the correlation between the consumption of antibacterials and the antibiotic resistance of Pseudomonas aeruginosa(PA) in our hospital.METHODS: The total antibacterial consumption expressed as defined daily doses(DDDs/day/100 persons) as well as the synchronous antibiotic resistance rate of PA were computed and the correlation beween the them was analyzed.RESULTS: The resistance rates of PA to cefepime,gentamycin and ciprofloxacin were positively correlated with the consumption of ciprofloxacin.A significant positive correlation was noted between the resistance rates of PA to gentamycin and imipenem cilastatin and the consumption of imipenem.The resistance rates of PA to ceftazidime and ceftriaxone were positively correlated with the consumption of piperacillin/tazobactam.The resistance rates of PA to amikacin and gentamycin were positively correlated with the consumption of amikacin and gentamycin respectively.CONCLUSION: A positive correlation was noted between antimicrobial consumption and antibiotic resistance of PA.
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OBJECTIVE:To evaluate the efficacy and safety of Redunin injection in treating pharyngoconjunctial fever in children.METHODS:81 children with pharyngoconjunctial fever were randomly divided into two groups:42 cases in treatment group were treated with Redunin injection(0.6～0.8 mL?kg-1?d-1) that diluted in 5% Glucose injection iv gtt q.d for 3～5 days,and 39 cases in control group with Ribavirin injection(10 mg?kg-1?d-1) that diluted in 10% Glucose iv gtt q.d for 3～5 days.Both group received routine fluid therapy plus symptomatic treatment.The duration of fever,and the time for the extinction of pharyngalgia and conjunctival congestion as well as the side effects in two groups were evaluated.RESULTS:The duration of fever and the time for the extinction of pharyngalgia and conjunctival congestion in the treatment group were significantly shorter than in the control group(P
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OBJECTIVE:To evaluate the permeation enhancing effect of Flos Caryophylli volatile oil versus azone on diclofenac sodium.METHODS:Percutaneous absorption experiment was performed on the apparatus of isolated skin,and the penetrated amounts of diclofenac sodium at different time were measured,then the steady-state flux and enhancing rate were calculated,and the deposit effect of diclofenac sodium was investigated.RESULTS:Flos Caryophylli volatile oil and azone all had promotion effect on percutaneous absorption of diclofenac sodium,especially when they used in combination.Used either in combination or alone,they all had remarkable enhancement property on deposit effect of diclofenac sodium(P
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Purpose:To investigate the expression of tumor suppressor genes P16 and P15 in human primary gastric carcinoma(PGC) and metastatic lymph node(MLN) in order to explore their roles in carcinoma metastasis and the prognosis of PGC.Methods:The expresion of P16 and P15 was detected by SP immunohistochemical method in 92 cases of PGC and 138 MLN. All samples were obtained fresh, fixed with 10% buffered formalin immediately, embedded with paraffin and then sectioned serially. Results:The positive expression rates of P16 and P15 were 17.45% and 28.3% in PGC, and 15.95% and 28.3% in MLN respectively. The positive expression rates of P16 and P15 in PGC with lymph node metastasis was lower than that without lymph node metastasis ( P