Development of laparoscopic technology in biliary surgery in the past 23 years: a single-center experience / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point.</p><p><b>RESULTS</b>The 11419 patients receiving laparoscopic surgery accounted for 56.3% of the total patients undergoing biliary surgeries during the 23 years, including 4701 male and 6718 female patients with a mean age of 50.9∓13.2 years (6-93 years). Most (80.83%) of the patients received laparoscopic surgery for gallbladder stones, and 12.53% patients had the operation for gallbladder polyps. The laparoscopic operation rate was 84.81% in patients with gallbladder stones and 34.91% in patients with extrahepatic bile duct stones, but remained low in patients with biliary carcinoma. In laparoscopic operations, laparoscopic cholecystectomy was the most frequent (96.18%) followed by operations for extrahepatic bile duct stones, in which primary suture accounted for 1.38%, traditional T tube drainage for 0.90% and laparoscopic transcystic duct exploration for 0.72%. For malignant tumors, laparoscopic technique was used mainly for the purpose of exploration (0.34%). The application of laparoscopic technique in biliary surgery tended to increase after the year 2004, especially for benign gallbladder diseases and extrahepatic bile duct stones (P<0.05).</p><p><b>CONCLUSION</b>Laparoscopic technique in biliary surgery is gradually replacing the traditional open operation and becomes the gold standard for the treatment of benign biliary diseases.</p>

Study on relationship between serum cccDNA and liver damage in the patients with chronic HBV infection / 中国基层医药

Objective To explore the relationship between serum cccDNA and liver damage in the patients with chronic HBV infection.Methods Serum cccDNA,ALT of 156 patients with chronic HBV infection were measured,and pathology of liver tissue in 85 patients was detected.Results The positive rate of Serum cccDNA and ALT had no significant difference(P＞0.05).Between pathology light,medium and severe group,S0_(～1) and S_(2～4) group,G_(0～1) and G_(2～4) group the serum cccDNA mean was significantly different(P＜0.01).The positive rate of serum cccDNA was significantly different between the group of NAASC and ASC,CH,LC,HCC,and the group of ALT ≤40u/Land 40～80,80～400,≥400u/L(P＜0.01).Conclusion Serum cccDNA and liver inflammation,fibrosis and ALT had no relevance,serum cccDNA with at a low level may be non-active,but should be excluded from serious liver diseases.

Study on treatment of climacteric depression with bushen tiaogan qingxin recipe / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of bushen tiaogan qingxin recipe (BTQR) on Hamilton rating scale for depression (HAMD), monoamine meurotransmitter and endocrinal function in patients with climacteric depression, and to explore its mechanism.</p><p><b>METHODS</b>Patients were randomly divided into two groups, the 25 patients in the treated group treated with BTQR and 15 patients in the control group treated with hormone replacement therapy (HRT). The HAMD scoring, levels of 5-HT, NE in plasma, serum estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH) were determined before and after treatment, and the thickness of endometrium was measured by B-Doppler ultrasonographic technique.</p><p><b>RESULTS</b>The total effective rate, evaluated by the HAMD score reducing rate, in the treated group was 87.2%, and in the control group was 67.3%, showing significant difference (P<0.05). After treatment, 5-HT decreased (P<0.01), NE increased (P<0.05) and 5-HT/NE ratio lowered (P<0.01) in the treated group; E2 increased in both groups; FSH, LH and FSH/LH ratio decreased in the treated group (P<0.05 or P<0.01), FSH/LH ratio decreased in the control group (P<0.05). The thickness of endometrium increased in the control group after treatment (P<0.05).</p><p><b>CONCLUSION</b>The mechanism of BTQR in treating climacteric depression might be related with its actions in: (1) To regulate the synthesis and release of monoamine neurotransmitter; (2) To adjust reproductive endocrine function; (3) To coordinate the neuroendocrinal function.</p>