Hem-o-lok clip migration to the common bile duct after laparoscopic common bile duct exploration:A case report

BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)has been widely used for management of gallbladder and common bile duct(CBD)stones.Post-operative clip migration is a rare complication of laparoscopic biliary surgery,which can serve as a nidus for stone formation and cause recurrent cholangitis.CASE SUMMARY A 59-year-old female was admitted to hospital because of fever and acute right upper abdominal pain.She has a history of LC and had a LCBDE surgery 2 mo ago.Physical examination revealed tenderness in the upper quadrant of right abdomen.Computed tomography scan demonstrated a high-density shadow at the distal CBD,which was considered as migrated clips.The speculation was confirmed by endoscopic retrograde cholangiopancreatography examination,and two displaced Hem-o-lok clips were removed with a stone basket.No fever or abdominal pain presented after the operation.In addition to the case report,literature regarding surgical clip migration after laparoscopic biliary surgery was reviewed and discussed.CONCLUSION Incidence of postoperative clip migration may be reduced by using clips properly and correctly;however,new methods should be explored to occlude cystic duct and vessels.If a patient with a past history of LC or LCBDE presents with features of sepsis and recurrent upper quadrant pain,clip migration must be considered as one of the differential diagnosis.

应用上唇人中区皮瓣联合下唇Abbe瓣修复双侧唇裂继发鼻唇畸形

Objective To explore an ideal method for the correction of the secondary nasolabial deformities of bilateral cleft lip. Methods From January 2013 to December 2018 ,repairing nose and lip in median of the median upper lip flap and lower lip Abbe flap in 13 patients with secondary nasolabial deformity of cleft lip, implanting artificial nose prosthesis when necessary. Results All the flaps were survived and nose appearance was greatly improved. The shape of the upper lip turned more similar to normal. Coordination between upper lip and lower lip was appropriate. Conclusion The median upper lip flap combined with lower lip Abbe flap to repair the secondary nasolabial deformities of bilateral cleft lip is effective . Goo d cosmetic results can be obtained.

Panicle Water Potential,a Physiological Trait to Identify Drought Tolerance in Rice

Two upland rice varieties （IRAT109, IAPAR9） and one lowland rice variety （Zhenshan 97B） were planted in summer and treated with both normal （full water） and drought stress in the reproductive stage. Panicle water potential （PWP） and leaf water potential （LWP） were measured every 1.0-1.5 h over 24 h on sunny days. Both PWP and LWP of upland varieties started to decrease later, maintained a higher level and recovered more quickly than that of the lowland variety. The results show that PWP can be used as an indicator of plant water status based on the parallel daily changes, and the high correlation between PWP and LWP. Similar correlations were also observed between PWP, LWP and eight traits related to plant growth and grain yield formation. PWP seemed to be more effective for distinguishing the upland rice varieties with different drought-tolerant ability. Differences in PWP and LWP between upland and lowland rice varieties were also observed at noon even under normal water conditions, implying the incorporation of the drought-tolerant mechanism to improve the photosynthesis and yield of traditional paddy rice.

Proteomic Analysis of Rice Leaves Shows the Different Regulations to Osmotic Stress and Stress Signals

Following the idea of partial root-zone drying （PRD） in crop cultivation,the morphological and physiological responses to partial root osmotic stress （PROS） and whole root osmotic stress （WROS） were investigated in rice.WROS caused stress symptoms like leaf rolling and membrane leakage.PROS stimulated stress signals,but did not cause severe leaf damage.By proteomic analysis,a total of 58 proteins showed differential expression after one or both treatments,and functional classification of these proteins suggests that stress signals regulate photosynthesis,carbohydrate and energy metabolism.Two other proteins （anthranilate synthase and submergence-induced nickel-binding protein） were upregulated only in the PROS plants,indicating their important roles in stress resistance.Additionally,more enzymes were involved in stress defense,redox homeostasis,lignin and ethylene synthesis in WROS leaves,suggesting a more comprehensive regulatory mechanism induced by osmotic stress.This study provides new insights into the complex molecular networks within plant leaves involved in the adaptation to osmotic stress and stress signals.