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@#The increasing number of pulmonary nodules being detected by computed tomography scans significantly increase the workload of the radiologists for scan interpretation. Limitations of traditional methods for differential diagnosis of pulmonary nodules have been increasingly prominent. Artificial intelligence (AI) has the potential to increase the efficiency of discrimination and invasiveness classification for pulmonary nodules and lead to effective nodule management. Chinese Experts Consensus on Artificial Intelligence Assisted Management for Pulmonary Nodule (2022 Version) has been officially released recently. This article closely follows the context, significance, core implications, and the impact of future AI-assisted management on the diagnosis and treatment of pulmonary nodules. It is hoped that through our joint efforts, we can promote the standardization of management for pulmonary nodules and strive to improve the long-term survival and postoperative life quality of patients with lung cancer.
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γ-synuclein (SNCG) has been extensively studied for its specific overexpression in various malignant neoplasms. Recently, SNCG has been found to be involved in multiple signaling pathways, including estrogen, AKT-mTOR, mitogen-activated protein kinase (MAPK) and microtubule regulation. SNCG has also been found to be related to the proliferation, invasion, migration and chemotherapy drug resistance of neoplasms. Therefore, SNCG is expected to be the key target of anti-tumor and improving the sensitivity of tumor cells to chemotherapeutic drugs.
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Even patients after standard surgery and adjuvant chemotherapy still have a high risk of recurrence and metastasis. With the success of immunotherapy in advanced non-small cell lung cancer (NSCLC), the application of immunotherapy in locally advanced NSCLC has being investigated to reduce the recurrence and metastasis. Pre-clinical studies and several phase II clinical studies had provided theoretical support and clinical evidence for neoadjuvant immunotherapy for NSCLC. This review describes the mechanism of neoadjuvant immuno-chemotherapy, summarizes up-to-date clinical studies, and analyzes efficiency and feasibility of neoadjuvant immune monotherapy or immuno-chemotherapy. Results from four studies (NCT02259621, NEOSTAR, LCMC3 and ChiCTR-OIC-17013726) showed efficiency and feasibility of neoadjuvant anti-programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) monotherapy. Neoadjuvant nivolumab plus ipilimumab achieved higher major pathological response rate than nivolumab monotherapy. However, the combination of nivolumab plus ipilimumab led to more severe adverse events as is seen in the NEOSTAR trial. Results from NCT02716038, SAKK 16/14 and NADIM studies suggest that the pathological response rate of neoadjuvant immune-chemotherapy is higher than neoadjuvant immune checkpoint inhibitor monotherapy. This review also elaborates the mechanism of chemotherapy combined with immunotherapy, and discusses the efficacy evaluation after neoadjuvant immunotherapy. .
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Hepatic ischemia-reperfusion injury is the most common complication after liver transplantation. Oxidative stress, autophagy, and inflammatory response caused by excessive reactive oxygen species production are significant steps that cause liver ischemia-reperfusion injury. What′s more, nuclear factor erythroid 2-related factor 2 is considered to be a major regulator of the antioxidant response, the PI3K-Akt-mTOR signaling pathway is considered to be an important pathway of autophagy, and the HMGB1-TLR4-NF-κB signaling pathway is considered to be a key signaling pathway which leads to inflammation. Based on the above signaling pathways and regulatory factor, this article shows that the antioxidant, anti-inflammatory and autophagy regulation effects of genes, molecules and drugs on hepatic ischemia-reperfusion cells, to explore the protective effects on hepatic ischemia-reperfusion cells.
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The metabolites were detected in feces and urine of rats orally administrated alkaloids of Piper longum by using high performance liquid chromatography coupled with a Fourier Transform ion cyclotron resonance mass spectrometer (HPLC-FT-MS). According to the mass spectrometric data and reported literature, the structures of metabolites were identified. Several metabolites were analyzed and belonged to piperine, piperanine, piperlonguminine, Δα,β-dihydropiperlonguminine and pellitorine, respectively. The metabolites of alkaloids from P. longum alkaloids were produced through Ⅰ phase and Ⅱ phase metabolism reaction, and were excreted with urination and defecation. The approach provided a rapid method for characterizing the metabolites of P. longum alkaloids and gave the truly active structures and the action mechanism of their neuroprotective effects.
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<p><b>OBJECTIVE</b>To study the clinical efficacy of cellular immunotherapy combined with bortezomib for treatment of patients with multiple myeloma.</p><p><b>METHODS</b>A total of 76 patients with multiple myeloma in our hospital from October 2012 to October 2013 were selected and randomly divided into 2 groups: the patients in 1 group (38 cases) were treated with cellular immunotherapy combined with chemotherapy including bortezomib (combined therapy group), the patients in other group(38 cases) were treated with only chemotherapy including bortezomib(single chemotherapy as control group). The treatment remission rate, the expression changes of immunophenotype, progression-free survival(PFS) and adverse reactions were compared in the 2 groups.</p><p><b>RESULTS</b>The total remission rate of combined therapy group was significantly higher than that in the control group (P<0.05); the positive rates of CD38, CD56and CD138in combined therapy group were all significantly lower than those in control group, and the CD19was significantly higher (P<0.05). The PFS rates of 1, 2 and 3 years in the combined therapy group were all significantly higher than those in the control group (P<0.05). The incidence of fatigue, rash, peripheral neuropathy, anemia and granulocyte deficiency in the combined therapy group was all significantly lower than that in the control group (P<0.05).</p><p><b>CONCLUSION</b>Cellular immunotherapy combined with bortezomib can significantly improve the remission rate, prolong survival, and significantly decrease adverse event rate of multiple myeloma patients.</p>
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BACKGROUND:Monoaxial pedicle screws are not conducive to the instal ation during percutaneous pedicle screw technique, but it has better mechanical conductivity and stability than polyaxial pedicle screws. How to select and use these two kinds of screws in the clinic to exert their advantages and to further elevate efficacy has become a subject worthy of reflection. OBJECTIVE:To compare the clinical efficacy of percutaneous pedicle screw placement for thoracolumbar fracture using monoaxial and polyaxial pedicle screws at different placement selections. METHODS:A total of 46 cases of thoracolumbar fracture without neurological symptoms underwent minimal y invasive percutaneous pedicle screw fixation. 25 patients (monoaxial screw group) were treated with monoaxial pedicle screws and the other 21 ones (polyaxial screw group) with polyaxial pedicle screws. Kyphotic angle, correction rate, correction loss rate and height of injury vertebrae were compared before and after fixation in both groups. The therapeutic effects of monoaxial and polyaxial percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures were evaluated. RESULTS AND CONCLUSION:(1) Fixation time, blood loss, complication and hospital stay were not significantly different in both groups (P>0.05). (2) Kyphotic angle and height of the fractured vertebra body were significantly different between the two groups (P0.05). (4) These findings indicate that compared with the polyaxial percutaneous pedicle screw fixation, the monoaxial pedicle screw may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures, has more satisfactory fracture distraction reduction, and has less postoperative correction loss rate.
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Objective To explore the accuracy of endoscopic ultrasonography (EUS) for evaluating T3 esophageal squamous cell carcinoma (ESCC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 733 patients diagnosed with T3 ESCC by preoperative EUS who were admitted to the Sun Yat-sen University Cancer Center from January 2003 to December 2015 were collected.All the patients underwent radical resection of ESCC.The postoperative pathological stage as a gold standard,the accuracy,overstaged and understaged rates of clinical staging by preoperative EUS were assessed.Observation indicators:(1) comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' diseases and postoperative survival up to December 30,2016.Overall survival time was from operation time to death or last effective follow-up.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Count data were represented as cases and percentage.The survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results (1) Comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging:all the 733 patients were confirmed as T3 ESCC by preoperative EUS.Postoperative pathological diagnosis showed that 9 patients were detected in pT1b,87 in pT2,630 in pT3 and 7 in pT4a.The accuracy,overstaged and understaged rates of preoperative EUS in evaluating T3 ESCC were 85.95％(630/733),13.10％(96/733) and 0.95％(7/733),respectively.N0,N1,N2 and N3 of postoperative pathological N stage were respectively detected in 329,247,110 and 47 patients.Twenty-seven,323 and 383 patients were in stage Ⅰ,Ⅱ and Ⅲ of TNM stage,respectively.The high-,moderate-and lowdifferentiated tumors were respectively detected in 125,403 and 205 patients.(2) Follow-up and survival situations:among 733 patients,639 were followed up for 1.0-153.0 months,with a median time of 29.0 months.The median survival time,1-,3-,5-year overall survival rates were 53.0 months (range,37.7-68.3 months),85.3％,58.1％ and 48.2％ in 733 patients,respectively.The 5-year overall survival rate was 75.2％ in 9 patients with pT1b,63.0％ in 87 patients with pT2,46.3％ in 630 patients with pT3 and 0 in 7 patients with pT4a,respectively,with a statistically significant difference (x2=24.089,P＜0.05).Conclusion There is a higher accuracy of EUS for evaluating T3 ESCC,however,the stage migration should be noted.
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Objective To evaluate the clinical results of self-designed double-pivot extracorporeal reduction device in internal fixation with percutaneous pedicle screws for thoracolumbar fractures.Methods From January 2014 to May 2015,a total of 41 patients with thoracolumbar fracture without neurological symptoms underwent minimally invasive fixation with percutaneous pedicle screws.Of them,22 were treated with our self-designed double-pivot extracorporeal reduction device and the other 20 with common single-pivot extracorporeal reduction device.The 2 groups were compared in terms of pre-and postoperative kyphotic angles,correction rates and anterior,middle and posterior heights of injured vertebrae to evaluate the therapeutic effects of the self-designed double-pivot extracorporeal reduction device.Results The patients were followed up for 6 to 18 months (average,12.3 months).No iatrogenic impairment of nerve root,postoperative infection,or implant failure happened.Compared with preoperation,significant improvements were observed in all the patients regarding cobb's angle,anterior,middle and posterior heights of the fractured vertebral body (P ＜ 0.05).Compared with the single-pivot group,the double-pivot group were significantly superior in the kyphotic angle,correction rate,and anterior and middle heights of the injured vertebrae(P ＜ 0.05),but there was no significant difference between the 2 groups in the recovery of posterior height of the fractured vertebral body (P ＞ 0.05).Conclusion Compared with the single-pivot reduction device,the self-designed double-pivot reduction device may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures.
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Platelets, small pieces of cytoplasm with biological activity, split and fall off the megakaryocytes and mature from the bone marrow. After stimulated, platelets produce nitric oxide to inhibit their own activation and aggregation. Pathologically, the injury of endothelial cells activates platelets and changes their functions. The release of inflammatory mediators and cytokines induces and enhances the development and progression of atherosclerosis, and thereby promotes the occurrence of erectile dysfunction. Besides, platelets and their related functional parameters may serve as important indicators in the diagnosis and treatment of erectile dysfunction.
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Humans , Male , Atherosclerosis , Blood Platelets , Physiology , Cytokines , Metabolism , Endothelial Cells , Erectile Dysfunction , Nitric Oxide , Platelet ActivationABSTRACT
<p><b>OBJECTIVE</b>To discuss the protective effect of alkaloids from Piper longum (PLA) in rat dopaminergic neuron injury of 6-OHDA-induced Parkinson's disease and its possible mechanism.</p><p><b>METHOD</b>The rat PD model was established by injecting 6-OHDA into the unilateral striatum with a brain solid positioner. The PD rats were divided into the PLA group (50 mg x kg(-1) x d(-1)), the madorpa group (50 mg x kg(-1) x d(-1)) and the model group, with 15 rats in each group. All of the rats were orally given drugs once a day for 6 weeks. Meanwhile, other 15 rats were randomly selected as the sham operation group, and only injected with normal saline in the unilateral striatum. The behavioral changes were observed with the apomorphine (APO)-induced rotation and rotary rod tests. The number of tyrosine hydroxylase (TH)-positive cells in rat substantia nigra and the density of TH-positive fibers in striatum were detected by tyrosine hydroxylase immunohistochemistry. The content of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione (GSH), catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and nitric oxide synthase (NOS) in rat substantia nigra and striatum were measured by the spectrophotometric method.</p><p><b>RESULT</b>After being induced by APO, PD rats showed obvious rotation behaviors, with decreased time stay on rotary rod and significant reduction in the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. The activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity significantly decreased, whereas the activities of NOS and the content of MDA, NO significantly increased. PLA could significantly improve the behavioral abnormality of PD rats and increase the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. It could up-regulate the activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity, and decrease the content of NOS and the content of MDA, NO.</p><p><b>CONCLUSION</b>Alkaloids from P. longum shows the protective effect in substantia nigra cells of 6-OHDA-induced PD model rats. Its mechanism may be related with their antioxidant activity.</p>
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Animals , Male , Rats , Administration, Oral , Alkaloids , Pharmacology , Apomorphine , Pharmacology , Catalase , Metabolism , Dopamine Agonists , Pharmacology , Dopaminergic Neurons , Metabolism , Pathology , Glutathione , Metabolism , Glutathione Peroxidase , Metabolism , Malondialdehyde , Metabolism , Motor Activity , Neostriatum , Metabolism , Nitric Oxide , Metabolism , Nitric Oxide Synthase , Metabolism , Oxidopamine , Parkinson Disease, Secondary , Piper , Chemistry , Random Allocation , Rats, Sprague-Dawley , Substantia Nigra , Metabolism , Superoxide Dismutase , Metabolism , Tyrosine 3-Monooxygenase , MetabolismABSTRACT
Objective The study was designed to investigate the serum levels of HE4 in patients with lung cancer,and explore its prognostic value.Methods Blood samples of 106 healthy adults and 191 patients with lung cancer before treatment were measured by means of ELISA for HE4 levels in different stages and pathological types,for analyzing prognostic effect of HE4.Results The serum levels of HE4 in patients with lung cancer (median level 91.63 pmol/L) were significantly higher than control group (median level 56.42 pmol/L) (U =3 081.00,P ＜ 0.05).AUC of serum HE4 was 0.85,with a cut-off value of 82.70 pmol/L (specificity =95.31％,sensitivity =62.32％).HE4 expression was not statistically related to clinical stage and pathological types of lung cancer.The median overall survival (mOS) was 36.87 months in the HE4-low group and 30.43 months in the HE4-high group (P ＜0.05),respectively.HE4 level was an independent prognostic factor for overall survival (HR =2.15,95％ CI 1.49-3.12,P ＜ 0.05).Conclusions The prognosis of patients with high HE4 expression is poor.Therefore,it might be necessary for patients with high level of HE4 to receive more aggressive adjuvant therapy.
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The chance of craniocerebral injury in children is high.Severe craniocerebral injury is still the difficult point in current clinical treatment.Children severe head trauma is different from adults.It is characteristic of severe primary injury,rapid progressing secondary injury,confusing vital signs,less contrecoup injury,high incidence of epilepsy,cerebral ischemia in familiar,and good prognosis.This article focused on 2 hot issues in recent therapeutic strategy of severe craniocerebral injury in children——intracranial pressure monitoring and hypothermia therapy.The former is simple,convenient,safe and practical,is worth popularizing widely.
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Objective To discusses the clinical application value and safety of endoscopic minimally invasive cholecystolithotomy in gallstones treatment .Methods To retrospectively analyzes the clinical data of 94 patients with gallbladder stone from Feb .2010 to Feb .2013 ,and divided into endoscopic minimally invasive cholecystolithotomy (EMIC) group (46 cases) and laparoscopic chole-cystectomy (LC) group (48 cases) .Observed two groups of operation time ,intraoperative blood loss ,intraoperative bile duct inju-ry ,anal exhaust time ,postoperative hospitalization time ,bile reflux gastritis ,abdominal distention ,diarrhea ,common bile duct calculi and hospitalization expenses ,etc .Results Two groups of operation time ,hospitalization expenses ,length of hospital stay ,and intra-operative blood loss have no obvious difference(P>0 .05) ,in EMIC set ,the exhaust time ,postoperative bile duct calculi incidence , intraoperative bile duct injury ,bile reflux gastritis incidence and the incidence of abdominal distension ,diarrhea are significantly less than LC group (P<0 .05) .Conclusion The endoscopic minimally invasive cholecystolithotomy compared with laparoscopic chole-cystectomy had high security ,light pain ,quicker recovery ,less complications advantages .It has already achieved the purpose of min-imally invasive treatment ,while maintaining the integrity of bile duct and gallbladder function ,thus it is worthy of promoting .
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The extraction parameters for Pleurotus eryngii SI-02 exopolysaccharide (EPS) produced during submerged culture were optimized using response surface methodology (RSM). The optimum conditions for EPS extraction were predicted to be, precipitation time 20.24 h, ethanol concentration 89.62% and pH 8.17, and EPS production was estimated at 7.27 g/L. The actual yield of EPS under these conditions was 7.21 g/L. The in vitro antioxidant results of the EPS showed that the inhibition effects of EPS at a dosage of 400 mg/L on hydroxyl, superoxide anion and 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals were 59.63 ± 3.72%, 38.69 ± 2.59%, and 66.36 ± 4.42%, respectively, which were 12.74 ± 1.03%, 8.01 ± 0.56%, and 12.19 ± 1.05% higher than that of butylated hydroxytoluene (BHT), respectively. The reducing power of EPS of P. eryngii SI-02 was 0.98 ± 0.05, 60.66 ± 5.14% higher than that of BHT. The results provide a reference for large-scale production of EPS by P. eryngii SI-02 in industrial fermentation and the EPS can be used as a potential antioxidant which enhances adaptive immune responses.
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Antioxidants/isolation & purification , Antioxidants/metabolism , Pleurotus/chemistry , Polysaccharides/isolation & purification , Polysaccharides/metabolism , Data Interpretation, Statistical , Ethanol/metabolism , Hydrogen-Ion Concentration , Solvents/metabolism , Time FactorsABSTRACT
To investigate the surgical approach and outcomes, as well as prognostic factors for pulmonary metastasectomy. Clinical data of 201 patients treated by pulmonary metastasectomy between January 1990 and December 2009 were retrospectively reviewed. One hundred thirty three patients were received an approach of thoracotomy while 68 with video-assisted thoracoscopic surgery [VATS]. There were 54 lobectomies, 139 wedge resections and 8 pneumonectomies. Hilar or mediastinal lymph nodes dissection or sampling was carried out in 38 patients with lobectomy. The Kaplan-Meier method was used for the survival analysis. Cox proportional hazards model was used for multivariate analysis. The 5 years survival rate of patients after metastasectomy was 50.5%, and the median survival time was 65.9 months. The median survival time of patients with hilar or mediastinal lymph nodes metastasis was 23 months. By univariate analysis, significant prognostic factors included disease-free interval [DFI], number of metastases, number of affected lobe, surgical approach [open vs. VATS] and pathology types. DFI, number of metastases, and pathology types were revealed by Cox multivariate analysis as independent prognostic factors. Surgical resection of pulmonary metastases is safe and effective. Palpation of the lung is still seen as necessary to detect the occult nodule. More accurate and sensitive pre-operative mediastinal staging are required
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Humans , Female , Male , Neoplasm Metastasis , Prognosis , Thoracotomy , Lung Neoplasms/surgery , Thoracic Surgery, Video-Assisted , Treatment OutcomeABSTRACT
Objective To explore the experience of operative cooperation of trans-sternocostal triangle hand-assisted double lung metastatic tumor resection.Method The clinical data of 54 patients undergoing trans-sternocostal triangle hand-assisted double lung metastatic tumor resection were retrospectively analyzed from January 2005 to December 2005.Results The operations were all successful,with blood loss of 10~700 mL,operation time of 40~300 min,averaged(130.3+43.0)mins.One hundred and seventy eight malignant tumor lesions were removed.No serious complications occurred.Conclusion The key points to ensure thesuccessful operation were as follows:preoperation of special equipment,reasonable position,intraoperative strict aseptic operation,fixing of endoscopic incision suturing instrument,and accurate cooperation at all procedures.
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Objective To discusses the feasibility of selective mini-cholecystolithotomy in treatment of gallstones .Methods To retrospectively analyzes the clinical data of the function good gallstones patients who treatmented by mini-cholecystolithotomy .Re-sults 4 cases treatmented by Laparoscopic cholecystectomy because of the severe cholecystitis ,1 case treatmented by laparoscopic cholecystectomy because of the severe adhesion around the gallbladder .51 cases treatmented by mini-cholecystolithotomy .In the fol-low-up of 1-3 years ,1 case of recurrence ,and the recurrence rate was 1 .96% .Conclusion The mini-cholecystolithotomy is a safe , effective ,feasible ,minimally invasive treatment method in treatmented gallstones ,but should be strictly grasp the surgical indica-tions .
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<p><b>OBJECTIVES</b>To prove the protective effect of Edaravone to neurons and to study the particular mechanism.</p><p><b>METHODS</b>Neurons were collected from 18-day fetal rat brains and a culture of almost pure neurons was obtained after 14-day culture, then the cells were randomly assigned to one of the three groups: control group, hydrogen peroxide (H₂O₂)-treated group, and Edaravone-treated group. In H₂O₂-treated group, 300 µmol/L H₂O₂ was added to the medium, followed by returning to the normal culture for the presupposition of time. In Edaravone-treated group, 500 µmol/L Edaravone was prophylactically added to the medium for 30 minutes before the insult. Morphology of mitochondria was visualized by transmission electron microscopy. The rate of apoptotic cells was detected by flow cytometry analysis. The relationships between the proteins and the key proteins expressions were observed by immunoprecipitation and immunoblotting.</p><p><b>RESULTS</b>Compared to the Edaravone-treated group, mitochondria in H₂O₂-treated group displayed more vesicular matrix compartments at the same time. Percentage of apoptotic cells in H₂O₂-treated group after 0.5, 2, 6 and 12 h were 14.40% ± 1.23%, 45.50% ± 2.81%, 56.40% ± 3.53%, 62.50% ± 4.23%, which were higher than control group (F = 274.8, P < 0.01). Edaravone-treated group were 0.90% ± 0.07%, 1.10% ± 0.08%, 3.50% ± 1.90%, 12.60% ± 1.10%, which were lower than H₂O₂-treated group (F = 362.7, P < 0.01). After H₂O₂ stimulation for 0.5 h in H₂O₂-treated group, the levels of p-JNK (Thr183/Tyr185) and cytochrome c in cytosol and BAX in heavy membrane were increased significantly at 0.5 h, reaching a peak at 12 h after stimulation, In addition, the expressions of p-BAD, BAX, BAD and 14-3-3 of cytoplasm decreased, however, these changes were inhibited in the Edaravone-treated group.</p><p><b>CONCLUSIONS</b>As a free radical scavenger, the Edaravone could protect neurons by inhibiting the activity of JNK, the disassociation of BAD from 14-3-3 and the translocation of BAX from the cytosol to mitochondria.</p>
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Animals , Rats , 14-3-3 Proteins , Metabolism , Antipyrine , Pharmacology , Apoptosis , Cells, Cultured , Free Radical Scavengers , Pharmacology , Hydrogen Peroxide , Metabolism , MAP Kinase Signaling System , Mitochondria , Neurons , Neuroprotective Agents , Pharmacology , Primary Cell Culture , Rats, Sprague-Dawley , bcl-2-Associated X Protein , Metabolism , bcl-Associated Death Protein , MetabolismABSTRACT
Objective To investigate the clinical value of intraoperative cholangiography( IOC) by cystic duct during laparoscopic chol-ecystectomy( LC) . Methods The clinical data of 58 patients with LC received intraoperative cholangiography by cystic duct were analyzed retrospectively. Results In this group,Successful treatment of 55 cases(94. 83%),failed in 3 cases(5. 17%),no common bile duct calculi in 50 cases(90. 91%),small common bile duct calculi(0. 4 cm) in 5 cases(9. 09%). Among them 4 cases were received common bile duct exploration via laparotomy,1 case treated by laparoscopic transcystic biliary calculus extraction with Dormia basket. The cystic duct drained into the right hepatic duct in 1 patient. In all the cases,no bile duct injury,residual choledocholith,bile leakage,intra-abdominal infection and IOC related complications. Conclusion IOC during LC is simple and easy,with high success rate and good development effect,which can promptly discover the anatomical variations of biliary tract. It has important clinical application value to reduce biliary negative exploration,in-traoperative injury of biliary tract and postoperative common bile duct residual stone in basic hospital.