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Cholecystolithiasis with choledocholithiasis (CCL) is a common disease.The removal of common bile stone is a challenge for the surgery.This paper discussed the clinical application of three stone removal techniques including direct stone removal,irrigation and stone extraction by basket under cholangioscopy in order to take the stones effectively and safely,shorten the procedure time,avoid the injuries of common bile duct wall caused by the repetition of a single method such as biliary endoscopic stone extraction,reduce the difficulty of taking stone and enhance recovery of patients.
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ABSTRACT:Objective To construct a recombinant adenovirus vector harboring fusion gene NT4p53(C22)Ant and study its killing effect on HepG2 tumor cells.Methods Using molecular cloning technology,the rAVV-NT4p53(C22)Ant was produced by homologous recombination.Then we collected virus supernatant and measured its titer after it was amplified by PCR.The effect of this fusion gene on HepG2 tumor cells was evaluated by IHC, MTT assay,PI staining and flow cytometry.Results The recombinant adenovirus was successfully constructed. The p53 expression rate in rAAV-NT4p53(C22)Ant group was (44.88±2.45)%.MTT assay showed that rAAV-NT4p53(C22)Ant could strongly suppress the growth of HepG2 tumor cells.Flow cytometry showed that rAAV-NT4p53(C22)Ant could induce obvious apoptosis of HepG2 tumor cells.Conclusion The recombinant adenovirus vector encoding gene NT4p53(C22)Ant has been successfully constructed and expressed in this experiment,and it can inhibit proliferation and induce apoptosis of HepG2 tumor cells.
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Objective To study the ingenious method to suture laparoscopic puncture holes.Methods A curved needle and a hook-like needle were used in 650 patients during biliary tract surgery.Results The curved needle was used in 200 patients and the hook-like needle was used in 450 patients.All patients had good wound healing except for one patient who developed puncture hole seroma under the xiphoid.The patient was treated with drainage and improved rapidly.No other complications such as puncture hole hemorrhage,infection and puncture hole hernia occurred.Conclusion Suturing using a curved needle and a hook-like needle was easy and effective,and avoided complications.
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Objective To evaluate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound(CEUS) in calcified thyroid nodules.Methods 122 cases of calcified thyroid nodules confirmed by pathology were underwent conventional ultrasound and CEUS.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound and CEUS were evaluated.Receiver operating characteristic (ROC) curve was constructed to assess the differential diagnosis value of conventional ultrasound and CEUS in calcified thyroid nodules.Results There were 73 benign and 49 malignant nodules among 122 calcified thyroid nodules.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound were 49.98％,76.71％,58.54％,69.14％ and 65.57％,while for CEUS were 89.80％,91.78％,88.00％,93.06％ and 90.98％,respectively.There was statistical difference for each index between the two methods (all P ＜0.05).The area under ROC curve of CEUS was 0.908,which was bigger than conventional ultrasound.Conclusions Compared with conventional ultrasound,CEUS has higher value in differential diagnosis of benign and malignant calcified thyroid nodules.
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Objective To make a comparison of curative effect of 1 and 2 ureters anastomosis in modified sigma operation. Methods Modified sigma operation was used after radical cystectomy in 14 cases of bladder transitional cell carcinoma and 1 case of adenocarcinoma of the bladder.We used a folded suture of 25 cm from the sigmoid colon to make the U-shaped urinary reservoirs to anastomose with the ureters in study group.Among study group,1 ureter was anastomosed with urinary reservoir in 5 cases.In the other 10 cases,1.5-2 cm of the terminal parts of 2 ureters were sutured tI am not sure what the authors mean by big diamogether and then anastomosed with the urinary reservoir.Results 15 cases obtained good voiding control and no obvious water-electrolyte disturbance occurred.All the patients were cured and discharged within 15 to 22 days.Thirteen cases were followed-up in 8 to 24 month time period.Anastonmtic stenosis and moderate-severe hydronephrosis occurred in 4 cases with 1 ureter anastomosis.No hydronephrosis occurred in the 9 cases with 2 ureters anastomosis.Conclusions Modified sigma operation has the advantages of less injury and fewer complications.The patients can obtain self-control urination by anal sphincter without urine bags or intermittent catheterization,so the life quality of the patients is improved.Modified sigma operation with 2 ureters anastomosis has big diameter and there was a lower incidence of serious complications such as anastomotic stenosis.
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AIM: To determine puerarin and tanshinone ⅡA in Xinkeshu Capsule(Radix Puerariae Lobatae,Radix et Rhizoma Salviae Miltiorrhizae) by HPLC simultaneously. METHODS: HPLC C_(18) column was used with methanol-water(85∶15) as the mobile phase. The flow rate was 1.0 mL/min,and the wave length was at 250 nm. RESULTS: There were good liner relationships for puerarin and tanshinone ⅡA with the sample input quantity at the range of 21-63 ?g(r=0.999 8) and 20.02-60.06 ?g(r=0.999 7),respectively.The average recoveries of puerarin and tanshinone ⅡA were 97.7% and 97.0%,respectively. CONCLUSION: This method is simple,accurate,effective and suitable for the quality control of Xinkeshu Capsules.
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Objective:To study the clinical characteristics of malignant lymphomas of the head and neck.Methods:The clinical data of 139 patients with malignant lymphomas of the head and neck were retrogradely analyzed,and the long term follow up was carried out.Results:Among all the cases there were 128 non Hodgkin's lymphoma(NHL) and 11 Hodgkin's disease(HD). The average ages of patients with HD and NHL were 41.8 and 50.0 years old respectively.There were lymphadenopathy in all patients with HD and 72.7% of those with NHL. Extranodal involvement occurred in 27.3% HD patients and 75.8% NHL patients; general symptoms appeared in 45.5% HD patients and 37.5% NHL patients. Most patients received chemotherapy of CHOP and improved CHOP scheme.The average follow up time was 23.4 months. Twelve patients died and the 3 year survival rate was 55.6%.Conclusion:In our group, the patients present an older age and NHL is more common than HD.The cases with cervical lymphadenopathy are easy to be diagnosed,and the clinical stage classification is useful for the prognosis.