Postoperative pancreatic fistula (POPF) is the most common complication after pancreaticoduodenectomy (PD) and remains a challenge to pancreatic surgeons.In pancreaticojejunostomy,the methods of reconstruction,experience and operational techniques of surgeons are closely related to POPF.Based on a literature review and on personal experience,the author presented the basic requirements and principle in reconstructing a safe pancreaticojejunostomy (PJ).The traditional methods of pancreaticojejunostomy and their recent developments were evaluated,with their advantages and disadvantages compared.The indications of various types of PJ and the special skills required were summarized.According to his own experience,the author described in detail his recommended method of anastomosis.

Objective To explore the ways to strengthen the mode and effect of the standard community management of the diabetes,and the management model of diabetic mellitus that adopt to current situation of China.Methods 80 diabetics patients were divided into intensive group and common group,and the period of the treatment is three consecutive months.We observed the levels of FBG,2hPG,HbA1c and the cost of drugs.Results The levels of FBG(6.82 ± 1.23),2hPG[(9.51 ± 2.18)mmol/L]and HbA1c(7.52 ± 1.31)％ in intensive group were significantly lower than common group[(8.65 ± 2.31)mmol/L、(12.22 ± 3.11)mtmol/L,(10.32 ± 3.51)％](t =3.12,3.25,3.56,3.69,all P ＜ 0.05).The cost of drugs in intensive group[(621.5 ± 204.5)yuan]was significantly lower than common group[(796.5 ± 240.6)yuan](t =3.69,P ＜ 0.05).Conclusion The ways to strengthen the mode could spend less but control disease well,and improving the existing community diabetes management should be truly effective in reducing medical costs.

Objective To investigate the feasibility,technique and clinical significance of preserving the great auricular nerve in parotid benign tumors surgery during the first postoperative year.Methods Fifty-two patients with parotid benign tumors were randomly divded into 2 groups.24 patients (group sacrificed) underwent classic parotidectomy with sacrifice of the great auricular nerve.The surgeons spare the nerve in the 32 patients with FOCUS ultrasonic harmonic scalpel (group preserved).Results After surgery,both groups showed lower levels of subjective sensation and sensory function test at auricle.These alterations were less pronounced in group preserved.Both groups showed improvement over time.In group preserved the sensory function reached normal level by 12 months after surgery.The recuperation in group sacrificed was partial at 12 months after operation.Conclusion The great auricular nerve preservation during parotidectomy is feasible,It can decrease sensory disturbance in the early postoperative period and avoid the permanent sequelae that occur when the nerve is sacrificed.The FOCUS ultrasonic harmonic scalpel technique can reduce the operation time.

The quantitative determination of octanoate content in albumin product was performed by acid base titration directly after the water phase was mixed up with the ether phase using the mixture solvent solution. The three factor optimum seeking principle was used to seek the optimum concentrations and volumes of components in mixture solvent solution and the optimum conditions of extraction. The method had its recovery rate of 99. 8+0. 89%(n=6) and variation coeff-cient (CV)of 0. 89%(n= 16),indicating that the method was a precise and reliable one.

In order to provide highly purified preparation of human ieukoregulin (LR) for the exploration of its anticancer mschatiism, crude preparations of LR and lymphotoxin(LT) derived from human spleen cell cultures induced with phytohem-agglutinin and diterp;ne ester l2-O-tetradecanoylphorbol-i3-acetate were purified by using four purification nmhois : (a) Con A-Sepharose 48 affinity chromatography, by which crude human LR or LT was purified to maximum specific activity of 85 333 U/mg protein or 13333 U/mg protein with a recovery of 28.1% or 31.9%, respectively 5 (b) DEAE-Sjphadex A-50 ion-exchange chromatography, by which partially purified LR or LT obtained after Con A-Sepharose 4B affinity chromatography was further purified 2.44-fold or 3.8o-fold with a recovery of 96% or 92%, respectively ; (c) DEAE-22-celluiose ion-exchange chromatography, by which crude human LR or LT was purified to maximum specific activity of 11 294 U/mg protein or 13 176 U/mg protein with a recovery of 87.5% or 89.6%.respectively ; (d) Blue-Sepharose CL-6B affinity chromatography, by which crude human LR or LT was purified to maximum specific activity of 51.89 U/mg protein or 2594 U/mg protein with a recovery of 53.75% or 5t3.G7%, respectively.Our data indicate that Con A-Sepharose 4B affinity chromatography, DEAE-Sephadex A-50 ion-exchange chromatography.DEAE-22-cellulose ion-exchange chromatography and Blue-Sepharose CL-6B affinity chromatography may be useful in the purification of LR or LT.

Objective: To investigate the effects of devascularization procedure on portal hemodynamics and recent and long-term hepatic function of portal hypertensive patients. Methods: A retrospective clinical analysis about portal hemodynamics and recent and long-term hepatic function was made in 367 cases of portal hypertensive patients, who admitted to our hospital and subjected to double devascularization from January 1989 to January 2008. Results: It was found that FPP was decreased from (36.2?4.2)cmH2O preoperatively to (31.4?3.3)cmH2O postoperatively (P0.05), but if was improved significantly after 6 and 12 month (P

The cellular sources of leukoregulin (LR) and lymphotoxin (LT) from human peripheral blood leukocytes or spleen cells were examined The ratios of LT activity to LR activity in lymphokine preparations from different individuals were not constant but varied over 640-fold, suggesting that LR and LT activities were mediated by distinctly different entities.Purified LR was used to examine the relative susceptibilities of human or mice cells to LR.Most human tumor cells were very sensitive to LR while human normal cells and mice normal or tumor cells were less sensitive or resistant.Crude preparations of human interferon (Hu IFN)-? or Hu IFN-? were more cytotoxic to human tumor cells than partially purified natural Hu IFN-? or highly purified rHu IFN-?D, and crude or purified LR were more cytotoxic to human tumor cells than Hu IFN-? Hu IFN-?.Hu IFN-? activity but not cytotoxic activity could be removed from preparatons containing Hu IFN-?,LR and LT activities with the aid of monoclonal antibody to Hu IFN-?. Natural killer cytotoxic factor (NKCF) supernatants from the co-culture of human spleen cells and NK susceptible cell line K562 or Molt-4 were strongly cytotoxic to various tumor cell lines.The NKCF activity was completely adsorbed after incubation with Molt-4 cells and completely inactivated by incubating at pH2 for 24 h.The putative receptor for LR or LT was studied using adsorption assay.The present study reveals that human LR activity can be adsorbed from crude LR supernatants by incubation with native or formalin-treated K562 or SMMC-7721 cells at 37℃ or 4℃; LT activity can be adsorbed with L929 cells.Therefore, LR appears to be a cytotoxic/cytostatic factor that is distinct from LT, 1FN and NKCF.

The rank order for the spectrum of death causes of non-war wounds had changed significantly among troops at a certain area in China from 1950 to 1986. In 1980s, the chief death causes were malignant tumors,accidents and acute infectious diseases, respectively. When the rank order among the troops was compared with that among the citizens at the same area during this period, we have found that the former was similar to the latter for malignant tumors,but the former was higher for accidents and acute infectious diseases, and lower for cerebrovascular diseases, heart diseases and tuberculosis of lungs than the latter. Hepatitis and leukemia made up a high proportion of death cases in≤29 years age group, and lung cancer, stomach cancer, liver cancer, cirrhosis and coronary heart disease in ≥40 years age group. So it indicates that the focal point of surveillance for diseases should be different between these two age groups in the medical work and health examination in future. The mean age of death for accidents was 24.92 years, and 83.30% of the subjects belonged to≤29 years age group, which shows that special attention shouldbe given to the prevention of accidents in this age group.

Thirty seven cases after myocardial infarction, in which 15 cases previously had ST reciprocal changes (ST-RC) and 22 cases without that changes (without ST-RC) in acute phase. Bicycle ergometer exercise test was used to osbserve the clinical significance about ST-RC patients. The results are as follows. 1 ) ST-RC group have induced angina pectoris, ST segments depression in reciprocal region of infarcted areas and positive results with exercise test all are significantly higher than that of non-ST-RC group(P