[Application of "modified double pocket suture" pancreatoenterostomy in laparoscopic pancreatoduodenectomy].

Objective: The purpose of this study was to explore the value of the "improved double purse-string suture method" for pancreatojejunostomy in laparoscopic pancreaticoduodene-ctomy. Methods: The clinical data of 273 patients who underwent laparoscopic pancreaticoduode-nectomy in the Department of Hepatobiliary and Pancreatic Surgery of the First Hospital of Jilin University from January 2021 to May 2022 were retrospectively analyzed. According to the method of pancreaticoenteric anastomosis, the patients were divided into two groups: the "improved double purse-string suture method" group and the "Hong's one-stitch method" group. Results: The "improved double purse-string suture method" for pancreaticoenteric anastomosis was performed in a total of 189 patients, including 107 males and 82 females, with a mean age of (59.6±10.2) years. The "Hong's one-stitch method" group" was performed in a group of 84 patients, including 52 males and 32 females, with a mean age of (60.8±9.3) years.The results showed that the "improved double purse-string suture method" group had a lower incidence of postoperative pancreatic fistula (6.88% vs 8.33% for grade B fistula, and 1.58% vs 2.38% for grade C fistula) and a shorter anastomosis time [(25.25±4.73) min vs (25.76±6.71) min] than the "Hong's one-stitch method" group. There was no statistically significant difference between the two groups in terms of postoperative biliary fistula, abdominal bleeding, delayed gastric emptying, and other complications (P>0.05). Conclusion: The "improved double purse-string suture method" for pancreatojejunostomy is safe and feasible in laparoscopic pancreaticoduodenectomy.

Topical calcineurin inhibitors in the treatment of oral lichen planus: a systematic review and meta-analysis.

BACKGROUND: TCS (topical corticosteroids) are the first-line drug in the treatment of oral lichen planus (OLP). However, the value of topical calcineurin inhibitors (TCI) including tacrolimus, pimecrolimus and ciclosporin for OLP is still controversial. OBJECTIVES: To compare the efficacy and safety of TCI vs. TCS for OLP. METHODS: The authors searched PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science and four Chinese databases from 1950 to May 2018. The randomized controlled trials comparing TCI and TCS for OLP reported at least one of the following outcomes: improvement of clinical signs and/or symptoms, relapse, blood levels of TCI and adverse events. RESULTS: Twenty-one trials involving 965 patients were included in the analysis. For the treatment of OLP (3-8 weeks), TCI including tacrolimus, pimecrolimus and ciclosporin were similar to TCS in efficacy. Tacrolimus-TCS resulted in similar outcomes, with relapse at 3 weeks to 6 months. Blood levels of TCI were usually undetectable. In addition, tacrolimus showed a statistically higher incidence of local adverse events than TCS for short-term treatment. A few systemic adverse events occurred in the tacrolimus and ciclosporin groups, but they were not serious. CONCLUSIONS: The evidence for tacrolimus (n = 12), pimecrolimus (n = 3) and ciclosporin (n = 6) demonstrated that treatment with TCI may be an alternative approach when OLP does not respond to the standard protocols. Tacrolimus 0·1% should be the first drug of choice when selecting TCI for short-term treatment in recalcitrant OLP. Further well-designed trials are warranted to evaluate the long-term efficacy and safety of TCI. What's already known about this topic? The main topical drug for oral lichen planus (OLP) is topical corticosteroids (TCS). Patients with OLP who are not responsive to TCS or are at risk of adverse events from TCS need other alternative drugs. Topical calcineurin inhibitors (TCI), including tacrolimus, pimecrolimus and ciclosporin, have become a hot topic in a variety of mucocutaneous immune-mediated diseases. What does this study add? TCI including tacrolimus, pimecrolimus and ciclosporin were similar to TCS in efficacy for the short-term treatment of OLP. The local adverse events of tacrolimus were higher than with TCS. A few systemic adverse events were reported with TCI, but they were all tolerable and not serious. The limited evidence for pimecrolimus (three trials) and ciclosporin (six trials) requires further studies to evaluate the short-term and long-term efficacy and safety of TCI compared with TCS.

[Predictive value of 3 different risk stratification models for patients after congenital heart surgeries].

Objective: To evaluate the predictive value of 3 different risk stratification models including the risk adjustment in congenital heart surgery-1 (RACHS-1), Aristotle basic complexity (ABC), and Society of Thoracic Surgeons-European Association for cardiothoracic surgery congenital heart surgery mortality score (STAT) risk scoring system for death and major complications in patients after congenital heart surgeries. Methods: A total of 3 578 patients (age<18 years old) received surgery for congenital heart diseases from January to December 2015 in Fuwai hospital were enrolled, and the clinical data were retrospectively analyzed. The congenital heart disease patients were 1.7 (0.8, 4.5) years old, and the male accounted for 54.3% (1 943 cases).Death after surgery and major complications including use of extracorporeal membrane oxygenation, bedside thoracotomy, peritoneal dialysis for renal failure, bedside hemofiltration for renal failure, tracheotomy, reoperation for mediastinum infection, reoperation for heart in hospital were observed. The area under the receiver operating characteristic (ROC) curve was calculated to evaluate the predictive value for mortality after surgery and major complications with RACHS-1, ABC, and STAT risk scoring systems. Results: The mortality after surgery was 0.4% (14/3 578) , and the rate of major complications was 3.2% (113/3 578) . For mortality after surgery, areas under the ROC curve were 0.682 (95%CI 0.570-0.795, P=0.002), 0.722 (95%CI 0.612-0.832, P<0.001), and 0.753 (95%CI 0.659-0.847, P<0.001) with RACHS-1, ABC and STAT risk scoring systems, respectively. For major complications, areas under the ROC curve were 0.709 (95%CI 0.667-0.751, P<0.001), 0.743 (95%CI 0.702-0.784, P<0.001), and 0.731 (95%CI 0.693-0.770, P<0.001) with RACHS-1, ABC and STAT risk scoring systems, respectively. Conclusion: STAT risk scoring system is superior to RACHS-1 and ABC risk scoring systems on predicting death after surgery, and ABC risk scoring system is superior to RACHS-1 and STAT risk scoring systems on predicting major complications in Chinese patients with congenital heart disease in the single center.

Efficacy evaluation of clonazepam for symptom remission in burning mouth syndrome: a meta-analysis.

OBJECTIVES: Clonazepam has been used in the treatment of burning mouth syndrome (BMS) for several decades. We conducted a meta-analysis to investigate the efficacy of clonazepam in the treatment of BMS. METHODS: We conducted a search of the PubMed, MEDLINE, EMBASE, Web of Science (TS), and the Cochrane Library databases for relevant studies that met our eligibility criteria (up to September 22, 2015). Statistical analyses were conducted using RevMan 5.2 and STATA 11.0 software. RESULTS: Three randomized controlled trials (RCTs) and two high-quality case-control studies involving 195 BMS patients were selected for this study. Our results show that clonazepam can reduce the oral pain sensation in patients with BMS (WMD: -3.72, 95% CI: -4.57, -2.86; P < 0.05; for all five studies). A positive therapeutic effect was demonstrated for both short-term (≤10 weeks) application (WMD: -1.44, 95% CI: -2.06, -0.82; P < 0.05) and long-term (>10 weeks) application (WMD: -4.50, 95% CI: -4.98, -4.03; P < 0.05). Both topical (WMD: -1.50, 95% CI: -2.14, -0.85; P < 0.05) and systemic (WMD: -3.81, 95% CI: -4.63, -2.98; P < 0.05) administration of clonazepam were confirmed to be effective. CONCLUSION: Clonazepam is effective in inducing symptom remission in patients with BMS.

Correlation between neuronal antibodies and limbic encephalitis in Chinese Han subjects.

A variety of anti-neuronal cell membrane antibodies such as voltage-gated potassium channel antibody, N-methyl-D-aspartate-2B-antibody, and glutamic acid decarboxylase antibody, are correlated with limbic encephalitis (LE). In this study on patients with LE, the clinical manifestations, psychology Wechsler Adult Intelligence Scale, cerebrospinal fluid, electrophysiology, magnetic resonance imaging, and anti-immune therapy were studied and immunological determination was conducted; it was found that patients of Chinese Han nationality showed 2 types of clinical manifestations: simple and complex. Lesions could also be divided into focal and scalable lesions, and the clinical manifestations and lesions scopes were associated with various antibodies and antibody types. The prognosis may improve if early diagnosis is conducted and early anti-immune therapy is implemented in LE patients.

Host genetic susceptibility to oral cancer: evidence from meta-analyses and pooled analyses.

BACKGROUND: A large number of meta-analyses and pooled analyses have been published on the topic of the genetic variants for oral cancer, and many positive results have been identified; however, there might be some false-positive results. The aim of this study was to identify the 'true positive' (noteworthy) results using the method of false-positive report probability (FPRP). METHODS: The PubMed database, Embase database, CNKI database, and Wanfang database were searched to retrieve the meta-analyses, pooled analyses, and genome-wide association studies (GWAS), which addressed the associations between genetic polymorphisms and the risk of oral cancer. The significant associations were further analyzed using the method of FPRP. RESULTS: A total of 14 variants were identified from meta-analyses and pooled analyses, which concern the associations between oral cancer and genetic variants. Among these 14 variants, 9 variants were reported to be significantly associated with the risk of oral cancer (CYP1A1-MspI, CYP2E1-RsaI/PstI, MTHFR-C677T, p73-G4C14-to-A4T14, XRCC1-Arg194Trp, CYP1A1-Ile462Val, GSTM1-±, and NAT2 slow vs rapid). After assessing the results of FPRP, none of the nine statistically significant associations were noteworthy (true positive). In addition, no noteworthy results were identified from GWAS. CONCLUSIONS: In summary, this study found no noteworthy associations between variants and the risk of oral cancer. Further candidate genes associations studies should be performed to explore the etiology of oral cancer.

Genome-wide identification and expression profiling of the fatty acid desaturase gene family in the silkworm, Bombyx mori.

Fatty acid desaturases exist in all living organisms and play important roles in many different biologic processes, such as fatty acid metabolism, lipid biosynthetic processes, and pheromone biosynthetic processes. Using the available silkworm genome sequence, we identified 14 candidate fatty acid desaturase genes. Eleven genes contain 3 conserved histidine cluster motifs and 4 transmembrane domains, but their N-terminal residues exhibit obvious diversity. Phylogenetic analysis revealed that there are 6 groups; Bmdesat1 and Bmdesat5-8 were clustered into group 2, which is involved in Δ11 desaturation activity, and Bmdesat3-4 were grouped in group 1, which is involved in Δ9 desaturation activity. Twelve of the 14 genes have expressed sequence tag evidence. Microarray data and reverse transcription polymerase chain reaction analysis demonstrated that Bmdesat3-4 and Bmdesat10 were expressed from the larval to moth stages and in multiple tissues on day 3 of 5th instar larvae. Bmdesat9, Bmdesat11, and Bmdesat14 were expressed during the pupal and late-embryonic stage, suggesting that they may take part in fatty acid metabolism to provide energy. These results provide some insights into the functions of individual fatty acid desaturases in silkworm.

[Regional immunity involved in the maintenance and imbalance of periodontal homeostasis].

The concept of homeostatic medicine has helped the researchers to understand the periodontal tissues in a completely new dimension. Periodontal tissues are subjected to complex external environmental stimuli and the internal tissues are continuously undergoing active remodeling. Periodontal regional immunity is continuously activated by local stimuli and interacts with the epithelial barrier, stromal tissue/extracellular matrix, and bone-coupled systems in a complex manner. Together, this complex network shapes the periodontal homeostasis. Under physiological conditions, moderate regional immunity relies on barrier function, intrinsic immune cells to control periodontal microbiota and maintain homeostasis. Under pathological conditions, pathogenic microbiota drive the periodontal homeostasis imbalance through over-activated regional immunity such as neutrophils, helper T (Th) 17 cells and B cells, causing periodontitis. Using the most basic immunological classification as a framework, this paper provides a systematic overview of the above mechanisms by which regional immunity regulates periodontal homeostasis, reviews the translational studies that have been carried out on homeostatic remodeling strategies targeting regional immunity, and proposes a series of periodontal homeostasis medicine research directions worth exploring, as well as potential new targets and strategies for homeostatic remodeling.

[Research progress in regional odontodysplasia].

Regional odontodysplasia (ROD) is a rare localized dental developmental anomaly. The typical clinical manifestations of ROD are abnormal tooth eruption, abnormal development of enamel and dentin. The radiographic characteristic is "ghost teeth". Its etiology still remains unknown. The care and treatment of a patient with ROD needs a multidisciplinary approach. And the treatment should be taken after the assessment of each individual case of ROD. This paper reviews the definition, etiology, epidemiological features, clinical manifestations, imaging features, dental microstructure and treatment strategies of ROD to provide reference for clinical diagnosis and treatment.

[Cardiovascular diseases burden attributed to low physical activity in China, 1990-2019].

Objective: To analyze the burden of cardiovascular disease (CVD) attributed to low physical activity (LPA) and its changing trends in China from 1990 to 2019. Methods: On the basis of the province results of the Study of Global Burden of Disease 2019 in China, we described the distribution of CVD death and disability-adjusted life year (DALY) attributed to LPA by sex, age and province. Joinpoint 4.9.1.0 was used to calculate the average annual percentage change. Results: In 2019, the number of CVD deaths and DALY attributed to LPA in people aged ≥25 years were 0.127 million and 1.863 million person-years in China, respectively, The age-standardized mortality rate (ASMR) and standardized DALY rate of CVD attributed to LPA were slightly higher in men than in women, and much higher in ischemic heart disease patients than in ischemic stroke patients. The ASMR (8.85/100 000) and the standardized DALY rate (112.34/100 000) of CVD attributed to LPA in China in 2019 showed no obvious change compared with 1990, while decreased in the last decade. The largest increases in the mortality rate and DALY rate were observed in people aged ≥75 years from 1990 to 2019 (26.89%, 15.61%), but the mortality rate and DALY rate in people aged 60-74 years showed a decreasing trend. The mortality rate and DALY rate in men aged 25- 44 years showed the largest increases (37.50%, 35.49%), while women aged ≥75 years had the largest increases (31.00%, 18.02%). In 2019, the highest ASMR and standardized DALY rate of CVD attributed to LPA were found in Jilin, Inner Mongolia and Hebei. The largest increases were found in Qinghai (182.41%, 154.70%), Gansu (181.29%, 152.77%), and Chongqing (132.01%, 102.79%) and the largest decreases were found in Beijing (59.11%, 62.09%), Macau (41.89%, 39.37%) and Guangdong (36.93%, 40.72%) from 1990 to 2019. Conclusion: The disease burden of CVD attributed to LPA in China was quite high and showed gender, age and area specific differences.

Promotion of peri-implant bone healing by systemically administered parathyroid hormone (1-34) and zoledronic acid adsorbed onto the implant surface.

UNLABELLED: The effect of human parathyroid hormone 1-34 (PTH) and zoledronic acid (ZA) alone or in combination on bone healing in osteoporotic settings was tested using implants inserted in tibiae of ovariectomized (OVX) rats. Combination therapy promoted bone healing more than each treatment alone 12 weeks after implant insertion. INTRODUCTION: PTH and ZA have been demonstrated to be effective on implant fixation. However, reports about the combined use of PTH and ZA for promotion of bone healing around implant in osteoporotic settings are still limited. This study aims to investigate effects of PTH+ZA on implant stabilization in OVX rats. METHODS: Twelve weeks after bilateral ovariectomy, OVX rats randomly received implants without or with ZA (by immersion in 1 mg/ml ZA solution for 24 h). Subsequently, half of the animals from each group also received subcutaneous injections of PTH (60 µg/kg, three times a week) for 12 weeks. Thus, there were four groups: control, PTH, ZA, and PTH+ZA. RESULTS: All treatments promoted bone healing around implant compared to control, but PTH+ZA treatment showed significantly stronger effects than PTH or ZA alone in histological, micro-CT, and biomechanical tests. CONCLUSION: The results indicated the additive effects of PTH and ZA on implant fixation in OVX rats; it was suggested that the anabolic effect of PTH was potent and not blunted by ZA during bone healing around implant when used concurrently.

[Research progress in the diagnosis and management of proliferative verrucous leukoplakia].

Proliferative verrucous leukoplakia (PVL) is one of the oral potentially malignant disorders (OPMD) with the highest malignant potential. PVL tends to be easily misdiagnosed owing to the resemblance in clinical manifestations between PVL and other diseases such as oral leukoplakia or oral lichen planus. PVL is considered as a special type of oral leukoplakia by some scholars, which is characterized by its tendency of recurrence and metastasis, along with its high risk of malignant transformation. So far, the accurate clinic diagnosis and management of PVL are still intractable due to the lack of definite histopathological definition, unified diagnostic criteria and effective treatment modalities. This review aims to provide the clinical practitioners with a series of advices on the clinical diagnosis and management of PVL by systematically reviewing the diagnostic logistics, therapeutic strategies, malignant transformation detection based on tremendous relevant data and evidence-based medicine.

[Interpretation and comparison of international guidelines for salivary gland malignancy in 2021].

In order to provide evidence-based recommendations on the management of salivary gland malignancy (SGM), the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) formulated and updated SGM clinical practice guidelines respectively in 2021.The two guidelines are interpreted and compared in this article from six perspectives including preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate radiotherapy techniques, the role of systemic therapy, follow-up evaluations and recurrent-metastatic diseases' management of SGM, which has guiding significance for diagnosis and treatment of SGM in China.

Retraction Note: Combination therapy with metformin and IL-12 to inhibit the growth of hepatic carcinoma by promoting apoptosis and autophagy in HepG2-bearing mice.

The article "Combination therapy with metformin and IL-12 to inhibit the growth of hepatic carcinoma by promoting apoptosis and autophagy in HepG2-bearing mice, by Z. Jin, B.-X. Jia, L.-D. Tan, Q.-M. Chen, Y.-H. Liu, published in Eur Rev Med Pharmacol Sci 2020; 24 (23): 12368-12379-DOI: 10.26355/eurrev_202012_24031-PMID: 33336757" has been retracted by the authors as they cannot ensure the reliability of the manuscript due to inaccuracies in the conclusions and in the experiment (the cell migration and invasion assay along with the cell cycle arrest assay are missing). The Publisher apologizes for any inconvenience this may cause https://www.europeanreview.org/article/24031.

The incidence of breakthrough pain associated with programmed intermittent bolus volumes for labor epidural analgesia: a randomized controlled trial.

BACKGROUND: In this randomized, blinded study, we evaluated the effects of different programmed intermittent epidural bolus (PIEB) volumes for labor analgesia on the incidence of breakthrough pain and other analgesic outcomes. METHODS: Nulliparous women with term cephalic singleton pregnancies who requested labor analgesia had epidural analgesia initiated with 10 mL 0.1% ropivacaine with sufentanil 0.3 µg/mL. The pump was programmed to deliver a 4, 6 or 8 mL bolus every 45 min (groups 4, 6 or 8, respectively). The primary outcome was the incidence of breakthrough pain, defined as inadequate analgesia after two patient-controlled epidural analgesia administrations in a 20-min period. Secondary outcomes included ropivacaine consumption, time of the first patient-controlled epidural analgesia request, duration of the second stage of labor, and incidence of motor block. RESULTS: Among 210 women randomly allocated the incidence of breakthrough pain was 34.9%, 19.7%, and 13.1%, for groups 4, 6 and 8, respectively (P=0.011). The incidence of breakthrough pain in group 8 was lower than in group 4 (P=0.006). The median (interquartile range) hourly ropivacaine consumption was 8.2 mg/h (7.1-11.3), 10.4 mg/h (9.2-13.0), and 12.0 mg/h (11.2-13.8) in groups 4, 6 and 8, respectively (P <0.001). Group 8 had a longer duration of effective analgesia and longer second stage of labor than group 4. There was no significant difference between groups in the incidence of motor block. CONCLUSION: The larger PIEB volumes were preferred for epidural labor analgesia compared with a smaller volume because of improved analgesia without clinically significant increases in adverse effects.

[Development and chinization of diagnostic criteria for oral lichen planus].

Oral lichen planus (OLP) is a common chronic inflammatory disease of oral mucosa. The diagnostic criteria of OLP is the cornerstone of clinical diagnosis and treatment and scientific research. However, there are various understandings of the diagnostic criteria in China. Thus several questions need to be answered, for example, how to combine the international diagnostic criteria with China's specific conditions, how to apply the criteria into clinical practice, and how to use the criteria guiding clinical work and scientific research in China. The authors of this article systematically introduced and discussed the development, content and difference of the international diagnostic criteria of OLP. We proposed "23 Princeples" for the selection of biopsy indications in OLP diagnosis based on authors' personal experiences in clinical and basic research and the actual conditions of Chinese clinicians. We also express our own views and suggestions about some other hot issues associated with OLP diagnosis.

Combination therapy with metformin and IL-12 to inhibit the growth of hepatic carcinoma by promoting apoptosis and autophagy in HepG2-bearing mice.

OBJECTIVE: To investigate the effects and mechanism of metformin (Met) combined the interleukin-12 (IL-12) on inhibiting hepatoma HepG2 cell proliferation via in vitro and in vivo assays. MATERIALS AND METHODS: MTT assay was used to detect inhibitory effects of Met, IL-12 alone or combination on HepG2 cells proliferation. Half inhibitory concentration (IC50) and combination index (CI) were also calculated. Anti-tumor effects of combination or monotherapy on the HepG2-bearing mice were investigated and protein expression levels of apoptosis, as well as the Akt/mTOR/STAT3 signaling pathway-related factors were detected by Western blot. RESULTS: MTT results showed that the inhibitory effect of Met combined with IL-12 on HepG2 cell proliferation was significantly enhanced (both p<0.01) compared with monomer therapy group with a significant synergistic effect (CI<1). The apoptosis rate of HepG2 cells treated with Met combined with IL-12 were 88.12±7.15% and significantly higher than the others (all p<0.01). Moreover, combination treatment significantly suppressed hepatoma growth and increased the survival rate of HepG2-bearing mice without evident body weight loss. Western blot analysis showed that Met combined with IL-12 significantly increased the expression of autophagy-related marker proteins, downregulated the protein expression levels of Bcl-2, p-Akt, p-mTOR, p-STAT3, upregulated the expression level of BAX in both HepG2 cells and tumor tissues. CONCLUSIONS: Met combined with IL-12 exhibited a synergistic antitumor effect on hepatoma HepG2 cells, and the mechanism may be related to its common inhibition of Akt/mTOR/STAT3 signaling pathway and increase of autophagy in HepG2-bearing mice.

[Analyze the national directory of rare diseases, define the diagnostic role of the stomatologists].

A rare disease, also referred to as an orphan disease, is defined as the disease with a low prevalence or that affects a small percentage of the population. It is a well model of human disease, which can facilitate the in-depth study and understanding of related diseases. Therefore, five Chinese governmental authorities, including the National Health Commission of the People's Republic of China, jointly issued the "First National Directory of Rare Diseases" (the First List) on May 11, 2018. The First List covers 121 rare indications. In the analysis of the directory, we found that among the 121 diseases, there are 51 (42.2%) with oral characterization. Oral manifestations mainly include craniofacial abnormalities, dentition (dental) abnormalities, oral soft tissue lesions, jaw bone lesions, salivary gland related diseases, etc., even some of them are the first, earliest and inevitable clinical manifestations of some patients with rare diseases. In order to strengthen the understanding of stomatological counterparts on the importance of the national directory of rare diseases and deeply understand the important and irreplaceable role of stomatologists in the diagnosis and treatment of rare diseases, the present review article is specifically written to introduce the oral characterization of the rare diseases listed in the catalogue, aiming at improving the diagnosis and treatment capabilities of these diseases by peers and benefiting the public.

Laparoscopic surgery for choledochal cyst in children: a case review of 31 patients.

INTRODUCTION: The results of the first substantial series of children suffering from choledochal cysts treated using laparoscopic surgery at the Shanghai Children's Medical Center, Shanghai, China are presented. METHODS: Data from 31 sequentially treated children (average age 45.2 months, SD 36.5, range 2 to 168 months) with choledochal cyst treated by laparoscopic surgery were collected prospectively. The chief complaints included intermittent abdominal pain, vomiting, jaundice or pancreatitis. Two cases had no clinical symptoms; their diagnoses were based on prenatal ultrasound findings and confirmed postnatally. The laparoscopic technique included excision of the gall bladder and cyst, followed by a Roux-en-Y anastomosis constructed after exteriorization of the small bowel via an infraumbilical trocar incision. After repositioning of the bowel, an end-to-side hepaticojejunostomy was carried out laparoscopically. RESULTS: The procedures were carried out successfully in 27 children and the average operating time was 5.2 hrs (4-7.5 hrs). In 4 patients, the operations were converted to open surgery because of a giant cyst (diameter 10 cm; 1 case), serious inflammation and adhesions (2 cases), and hepatic duct malformation (1 case). Complications occurring postoperatively and cured by conservative treatment included hepaticojejunostomosis leakage (1 case), bowel ileus (1 case), pancreatitis (1 case), and pneumonia (1 case). Oral food intake was started within 3-5 days and patients were discharged within 7-14 days (average 8.6 days). All patients are well with bile-stained stools after an average follow-up of 16.3 months (range 2-43 months). The average cost was RMB 19,167 ($2522, range RMB 12,600-34,538). CONCLUSIONS: Laparoscopic resection of congenital choledochal cyst and choledochojejunostomy in children is feasible and safe. The long-term results are good. There was a considerable learning curve during the development of the technique as experienced by the team.

[Application and prospect of three-dimentional printing in stomatology].

Three dimentional printing is a new rapid prototyping technology based on digital model files, which developed through a combination of multi-disciplines such as information technology, precision machinery and materials science. With rapid development in recent years, three dimentional printing technology has been widely used in the medical fields, stomatology especially. It gradually penetrates into various parts of stomatology, such as education, practice and innovation, making stomatology clinical medicine more and more efficient, accurate and minimally invasive. Combined with basic research and clinical cases, this article describes the application and developent prospects of three dimentional printing technology in stomatology.