Objective To explore the clinicopathologic features and surgicalResultsof paraaortic node-positive periampullary adenocarcinoma. Methods101 patients underwent pancreatectomy with regional and paraaortic lymphadenectomy.Fifteen(15%)patients had histologically proven paraaortic lymph node disease. ResultsThe 15 patients included 9(26%)of 34 patients with pancreatic head carcinoma and 6(17%)of 36 patients with bile duct adenocarcinoma.All 15 patients had locally advanced tumor invading adjacent structures.The 1-,2-,and 3-year survival rates were 33%,27%,and 0%,with median survival of 12 months(range from 3 to 33months).In patients with pancreatic head carcinoma or bile duct adenocarcinoma,survival curve for those without paranortic lymph node metastasis was significantly better than those with involved paraaortic lymph nodes(P＜0.01). ConclusionWhen the paraaortic lymph nodes obtained from sampling biopsy were histologically positive,radical pancreatectomy with extended lymphatic and soft tissue clearance should be abandoned owing to poor outcome.

The influence of shock in varied degrees on pial-microcirculation in rats and the dynamic change of pial-microcirculation in hypotension were observed. It was shown that severe disturbance occurred in pial-microcirculation when blood ressure was lowered to 3.20 kPa.In early stage after severe bleeding the main manifestation of pial-microcirculatory disturbance was hyperemia, i. e., dilatation of arteriole or segmental dilatation-contraction of arteriole, hyperemia of capillary net, increased number of opened capillaries and appearance of 0-I degree of blood flow status (according to the classification of Tia Niu).Ninety minutes after bleeding arterioles and venules became gradually constricted,red blood cells aggregation was increased, ischemia of pial-microcirculation became more severe and blood flow status changed from 1st to 2nd, even 3rd degree.The results demonstrate that autoregulation of cerebral microcirculation is much stronger than that of other organs. Microcirculatory disturbance does not appear until blood pressure drops to the degree beyond the ability of autoregulation.

Objective To observe the effect of early enteral nutrition on the recovery and stress reaction after the operation of colon carcinoma.Methods 93 patients with colon carcinoma were divided into enteral nutrition group and parenteral nutrition group.Patients of EN group were given nutrition preparation through the jejunal nutrient canal beginning in the first day after operation and reduced the venous support gradually.Those of PN group were given parenteral nutritional supports from the the first day after operation until oral feeding.Results There were no significant differences between the EN group and PN group in the nutritional status.Both the first postoperative anoretum exhaust time and defecation time(52.9 ± 17.6;67.2 ± 9.3) h in group EN were less than that(71.4 ± 13.8;83.6 ± 10.1) h in group PN,there were significant differences between two groups(t = 2.58,3.56,all P＜0.05).The CRP in EN group after operation was obviously lower than preoperation(P＜0.05).Conclusion The early enteral nutrition could lower the stress reaction and promote the recovery of gastrointestinal tract function.

Objective To properly choose and employ an air disinfect-purifying machine in ICU. Method This paper analyses the principle of air disinfect-purifying machine and put forward some attention-deserved problems such as the value of CADR in clinical application. Conclusion. The disinfect-purifying machine with different CADR value should be chosen according to the area of air disinfect-purifying district, thus can really bring the machine into full play.

[Objective]To observe the growth pattern of oligodendrocyte precursor cells(OPCs) in the primary culture from neonatal rat cerebral cortices and study the methods of cell culture and isolation in order to obtain purified OPCs for the experiments of cell transplantation.[Method]The mixed glial cells from the cerebral cortices of 48-hour-old Sprague-Dawley(SD) rats were cultured in vitro.Until 9-10 days in vitro OPCs were isolated and purified by the shaking process and differential adhesion,and then continued OPCs culture in the defined medium.The growth pattern of OPCs in vitro was investigated by contrast phase microscopy and OPC s were further identified with the immunocytochemical techniques.[Result]The distinct stratification of OPCs and astrocytes developed around 9-10 days in primary culture.At this point,the OPCs scattered on the top of the monolayer astroctyes and the soma of most OPCs typically appeared oval or round with two or three processes.The purity of the isolated OPCs reached 95% and these OPCs further developed into the mature oligdendrocytes which were immunoreactive to the specific antigen of oligodendrocyte lineage cells,Oligo2.[Conclusion]OPCs separated from the cerebral cortices of neonatal SD rats can be maintained as immature precursor cells in culture,and OPCs are able to be purified by shaking and differential adhesion under the condition of appropriate cell stratification.

Ductus Arteriosus, Patent ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; Platelet-Rich Plasma

Objective:To investigate the rational use of antiplatelet drugs and provide references for clinical utilization. Method:The sales amount,defined daily dose(DDDS) and daily expense(DDDc) of antiplatelet drugs in senile wards of our hospital were collected and analyzed,and other kinds of drugs which had drug interaction with aspirin were monitored by the Prescription Automatic Screening System(PASS) during 2007-2008.Result:Clopidogrel Hydrogen Sulphate Tablet was No.1 of all DDDs and Alprostadil Fat Emulsiom Injection was the most expensive of all the antiplatelet drugs,and the DDDs of aspirin was lower only than that of Clopidogrel Hydrogen;moreover,there were some problems in the clinical use of aspirin.Conclusion:The antiplatelet drug utilization in the senile wards almost meets with the guidelines and develops towards the direction to use new drugs with good action and few side-effects,but needs further standardization.

OBJECTIVE:To observe the safety and therapeutic efficacy of low molecular weight heparin calcium in the preven-tion of venous thromboembolism (VTE) of ICU patients. METHODS:572 VTE patients were randomly divided into trial group and control group,with 286 cases in each group. Trial group was given Low molecular weight heparin calcium injection 0.3-0.6 ml, im,qd;control group was given Rivaroxaban tablet 10 mg,po,qd. The incidence of VTE,platelet count,coagulation function, quality score of life and the occurrence of ADR were compared between 2 groups. RESULTS:The incidence of VTE in trial group (0.3%)was significantly lower than control group(2.1%),with statistical significance(P<0.05). There was no statistical signifi-cance in platelet count,prothrombin time,APPT, fibrinogen and other indexes between 2 groups before and after treatment(P>0.05). The physical health,body function and role,general health,emotional role function,mental health and other aspects of trial group were improved significantly,compared to control group,with statistical significance(P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Low molecular weight heparin calcium can effectively prevent VTE and improve the quality of life, while doesn’t influence platelet count and coagulation function with good safety.

?Ocular trauma related glaucoma is one of secondary glaucoma, which can lead to serious visual loss. According to the complex clinical findings and pathogenesis of ocular trauma related glaucoma, we divide traumatic secondary glaucoma into hyphema related glaucoma, angle recession related, lens injury related, adhesion and proliferation related. The treatment of secondary traumatic glaucoma with ocular trauma were different, specific treatment measures should be given according to the specific case to protect visual function.

Objective To investigate the effects of transplantation of oligodendrocyte precursor cells (OPCs) on axonal myelination after spinal cord injury in a rat model. Methods A rat model of spinal cord injury at the tenth thoracic vertebral level (T10) was produced by Allen weight-drop impact method. OPCs implantation was performed at the subacute stage of spinal cord injury. Effects of OPCs transplantation on axonal myelination after spinal cord injury were evaluated by HE staining, immunohistochemistry, myelin staining and transmission electron microscopy. Results The implanted cells were still observed in lesioned segments of spinal cord eight weeks after transplantation. The results of HE staining clearly showed better structure of spinal cord in OPCs-transplanted group than that of control group.Myelin staining also demonstrated that the amount of myelin in white matter of lesioned cord in the OPCs-transplanted group (7 802.42 ± 1085.58) was higher than that of the control group (5 055.98 ± 916.74)(P ＜0.01 ). Expression of myelin basic protein (MBP) was significantly increased in the OPCs-trans-planted group (8 544.44 ±812.78) as compared with that of the control group (5 243.83 ±808.27)(P＜0.01). Moreover, transmission electron microscopy further confirmed the improvement of micro-structure of myelination in OPCs-treated rats. Conclusion OPCs transplantation can improve axonal myelination in rat with spinal cord injury.