Type I Mirizzi syndrome treated by electrohydraulic lithotripsy under the direct view of SpyGlass:A case report

BACKGROUND Mirizzi syndrome is an uncommon clinical complication for which the available treatment options mainly include open surgery,laparoscopic surgery,endoscopic retrograde cholangiopancreatography(ERCP),electrohydraulic lithotripsy,and laser lithotripsy.Here,a patient diagnosed with type I Mirizzi syndrome was treated with electrohydraulic lithotripsy under SpyGlass direct visualization,which may provide a reference to explore new treatments for Mirizzi syndrome.CASE SUMMARY This paper describes a middle-aged female patient with suspected choledocholithiasis who complained for over 1 mo of intermittent abdominal pain,dark yellow urine,jaundice,and was proposed to undergo ERCP lithotomy.Mirizzi syndrome was found during the operation and confirmed by SpyGlass.Electrohydraulic lithotripsy was performed under the direct vision of SpyGlass.After the lithotripsy,the stones were extracted using the stone extraction basket and balloon.After the operation,the patient developed transient hyperamylasemia.Through a series of symptomatic treatments(such as fasting,fluids and antiinflammation medications),the symptoms of the patient improved.Finally,laparoscopic cholecystectomy or open cholecystectomy was performed after a half-year post-operatively.CONCLUSION Direct visualization-guided laser or electrohydraulic lithotripsy with SpyGlass is feasible and minimally invasive for type I Mirizzi syndrome without apparent unsafe outcomes.

Status of reproductive health knowledge for junior high school students in Guangzhou city

Objective To understand the status of reproductive health knowledge for junior high school students in Guangzhou city and provide the base data for reproductive health education. Methods A total of l 210 students including 657 boys and 553 girls aged 12 ~15 years were surveyed with anonymous self-administrated questionnaire. The students were from a middle school in suburb of Guangzhou city. The questionnaire contained basic concepts of reproduction, love, sex, contraceptives, abortion and sexually transmitted diseases （STDs）. Analysis consisted of descriptive statistics and Chi square tests for differences between boys and girls. Results The students mostly had experienced menarche （94%） or first spermatorrhea （83.6%）. About 58. 4% of students just knew little about process of puberty, fertilization, and contraception. Far more boys than girls considered that the effect of abortion on physical injury was harmless （30.4% and 9.6%, P〈O.O01）. More than 60% of respon- dents knew the route of transmission of STDs well but were poor understanding of adverse impact of STDs. The majority of the students did not consider sexual relation- ship acceptable at their age, a viewpoint that was more strongly held by girls （61.6%） than boys （45.1%） （P〈0.001）. Just 35.5% of boys would refuse when the lovers required to have a sex activity, far less than girls （76.1%） （P〈0.001）. The rate of sex intercourses among students was 5%, and a slightly higher proportion （46%） had never used contraception among those who had sexual activity. The demands of students on reproductive health were mainly on how to deal with the relationship with lovers （56. 0%）, knowledge on sexual health and menses （41.7%）, sex moral knowledge （48.3%）, contraception （45.0%）, and preventive measures of STDs/acquired immune deficiency syndrome （AIDS） （47. 0%）. Conclusion The reproductive health knowledge for the students was at very low level There were some differences on the knowledge mastered by boys and girls while the sexual opinion of boys was more open than girls. It was urgent to carry out education among junior high school students to promote their reproductive health.

Ring-opening Copolymerization of Cyclohexene Oxide and Maleic Anhydride Catalyzed by Mononuclear [Zn(L)(H_2O)] or Binuclear [Zn_2(L)(OAc)_2(H_2O)] Complex Based on the Salen-type Schiff-base Ligand

From the self-assembly of the typical Salen-type Schiff-base ligand H2L and Zn（OAc）2.2H20 in the molar ratio of 1：1 or 1：2, the mononuclear [Zn（L）（H2O）] （1） or binuclear [Zn2（L）（OAc）2（H2O）] （2） are obtained, respectively. For both complexes 1 and 2, the unsaturated five-coordinate coordination environment to the catalytic active centers （Zn2＋ ions） permits the monomer insertion for the effective solution copolymerization of cyclohexene oxide and maleic anhydride. All the solution copolymerizations afford poly（ester-co-ether）s, while lower catalyst and co-catalyst concentrations are helpful for the formation of alternating polyester. Of the three co-catalysts, 4-（dimethylamino）pyridine is found to be the most efficient, while an excess thereof is detrimental for chain growth of the copolymers.