ObjectiveTo investigate the risk factors of early postoperative complications after pancreaticoduodenectomy.MethodsThe clinical data of 159 patients undergoing pancreaticoduodenectomy from March 2005 to October 2010 was analyzed retrospectively.The related factors of early postoperative complications were analyzed.ResultsThe incidence rate of early postoperative complications was 30.8％ (49/159).Univariate analysis showed that preoperative fasting blood glucose level,total serum bilirubin level,serum albumin level,high density lipoproteins level and intraoperative bleeding were closely correlated with early postoperative complications in patients undergoing pancreaticoduodenectomy (P ＜ 0.05),but gender,age,preoperative jaundice,history of diabetes mellitus,operation time and whether portal vein reconstruction were no significantly associated with early postoperative complications in patients undergoing pancreaticoduodenectomy (P ＞ 0.05).Multivariate analysis showed that preoperative fasting blood glucose level( ≥6.1 mmol/L),total serum bilirubin level ( ≥ 171 μ mol/L) and serum albumin level( ＜ 35 g/L) were the important independent risk factors of early postoperative complications in patients undergoing pancreaticoduodenectomy.ConclusionThe risk factors of pancreaticoduodenectomy should be fully recognized and dealt with promptly.

Objective To explore a practicable method of serial sections of whole CNS in the rat, in which both neurons and nerve fibers were showed at the same section. Methods After perfused fixation and quick freezing, the tissues of whole CNS were cut into serial sections with cryostat followed by hematoxylin stain. Results The nerve fibers were stained in blue color while the neurons were showed black-blue and the background was light-yellow.Conclusion Our method was feasible to show both neurons and nerve fibers at the same section with quick freezing, freezing serial sectioning and improved hematoxylin staining.

Objective To investigate the efficacy of flupentixol and melitracen(Deanxit) in treatment of non-erosive reflux disease(NERD) and non-responding to proton pump inhibitor. Methods Fifty eight NERD pa-tients were randomly divided into two groups, the treatment group (n = 29) and control group (n = 29). Patients in control group were given esomeprazole 40 mg qd. Patients in the treatment group were given the same drug plus Deanxit 1 Tab qd. The clinical effect was evaluated and scored by Hemihon Anxiety Rating Scale (HAMA) after 4 weeks. Results The total efficacy rate of the treatment group was higher than control group (P < 0.01),and HAMA was lower in the treatment group than in control group (P < 0.01). Conclusions Adjuvant treatment of Deanxit combined with esomeprazole is effective to NERD patients who did not respond to proton pump inhibitor, can greatly improve anxious disorders.

The treatments for ankylosing spondylitis (AS) are still not effective, which partially due to its unclear patho?genesis. Interleukin (IL)-23/IL-17 axis is a significant immunologic pathway which has attracted much attention in the past few years. This article reviewed the role of IL-23/IL-17 axis in genetic and immunological pathogenesis of AS, and intro?duced the recent progresses in treatments of AS using anti-IL-23 or anti-IL-17 antibody. The important role of IL-23/IL-17 axis in the pathogenesis and treatment of AS indicates its potential use as a new therapeutic target.

Objective To study the mechanism of male infertility. Methods Forty sperms from 8 normal males as control and 60 sperms from 12 males with infertility were observed by SEM.The ultrastructure of acrosomes was analyzed and compared. Results Spermatozoa with obscure ringed rips in infertile group acounted for 66.7%(40/60),serrate 65.0%(39/60);but in control group,the proportions were 10.0 % (4/40) and 5.0%(2/40),respectively.The ratios of acrosome to head in infertile group were ( 70.0 ?8.0)%,greater than controls (57.7?6.4)%.The ratios of acrosome membrane which was not intact were 70.0%(42/60) in infertile group and 22.5%(9/40) in control group.Acrosomes with rough surface were 68.3%(41/60) and 20.0%(8/40) respectively in the 2 groups;Acrosomes with particles adhesive to the surface were 65.0%(39/60) and 27.5%(11/40) respectively. Conclusions Abnormal acrosome structure is one of the causes of male infertility.

Objective To study the metabolic characteristics of temporal lobe injury during the radiotherapy in the elderly with nasopharyngeal carcinoma through 1H- magnetic resonance spectroscopy (MRS). Methods The 15 aged and 23 young cases among 80 cases with nasopharyngeal carcinoma confirmed clinically and receiving radiotherapy for the first time were involved in the same period of July 2006 to May 2009. Conventional MRI scanning and bilateral temporal MRS were performed before and during radiotherapy at radiation dosages of 20 Gy, 40 Gy, and 60 Gy respectively. The spectroscopy morphology and the ratios of the three main metabolites were compared and analyzed. Results The values of N-acetylasparate (NAA)/creatine (Cr) was lower and choline-containing compound (Cho)/Cr ratio was higher in aged group than in young group before radiotherapy (P＞0.05). The spectroscopy morphology stepped down, NAA, Cho, NAA/Cr, Cho/Cr and NAA/Cho decreased to some extent along with the adding of radiation dosages in the course of radiotherapy. At the end of radiotherapy, the decreased amplitude of NAA/Cr value was larger in aged group than in control group (P＜0.01), and the amplitude of Cho/Cr value was lower than other group. Conclusions The neurons of aged patients with nasopharyngeal carcinoma have a weak tolerance to the radiation, brain injury occurs earlier and heavier in aged patients than in young patients. It is necessary to prevent neuron injury early.

Objective To observe the clinical efficacy of acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles in treating postpartum sacroiliac malposition.Method Forty patients with postpartum sacroiliac malposition were randomized into group A, group B, group C and group D, 10 cases in each group. Group A was intervened by acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles, group B by acupuncture plus chiropractic, group C by acupuncture plus functional exercise of lumbar and gluteal muscles, and group D by chiropractic plus functional exercise of lumbar and gluteal muscles. The four groups were intervened once every other day. The modified Oswestry Disability Index (ODI) score was observed before and after 5 treatment sessions, and the clinical efficacies in the four groups were compared.Result The total effective rates were 100.0% in the four groups, and the inter-group differences were statistically insignificant (P>0.05). The ODI scores in the four groups were significantly changed after treatment and in the 3-month follow-up study compared with those before the treatment (P<0.05). After the treatment, the ODI score in group B was significantly different from that in the other groups (P<0.05). The ODI scores in group A and B in the 3-month follow-up study were significantly different from those after the treatment in the same group (P<0.05). The ODI score in group A was significantly different from that in the other groups in the 3-month follow-up study (P<0.05). The ODI score in group B in the 3-month follow-up study was significantly different from that in group C and D (P<0.05).Conclusion Acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles is definitely effective in treating postpartum sacroiliac malposition, acupuncture plus chiropractic can produce a significant short-term efficacy and alleviate the symptoms, and functional exercise of lumbar and gluteal muscle can produce an obvious long-term efficacy.

Objective To investigate the mechanism involved in the brain protection afforded by prenatal hypoxic adaptation by determining the quantitative variation in bcl-2 and bax mRNA expression.Methods Twenty-four Wistar pregnant (22d pregnant) rat were randomly divided into two groups: group I (hypoxia group) and group *** ( control group) . In group Ⅰ the pregnant rats were placed in an airtight cabin specially designed for hypoxic adaptation. When O2 % in the cabin decreased to 15%, the animals were taken out breathing fresh air for 5min and then placed back in the cabin and underwent another episode of hypoxia. In group Ⅱ the animals were placed in the cabin which was not tightly closed and underwent no hypoxia. 7 fetal or newborn rats were taken at 1st, 3rd, 24th, 48th, 72nd, 120th, and 168th h after prenatal hypoxic adaptation from each group and their brains removed for determination of bcl-2 mRNA and bax mRNA. Results In control group the expression of bcl-2 and bax were observed in the brain tissue of normal fetal or newborn rats from the 22nd day in the uterus to the 7th day postpartum during which there were no significant changes in bcl-2 gene expression while bax gene expression gradually decreased with time ( the decrease was of no statistical significance) . In hypoxia group bax gene expression decreased at 8th h after hypoxic adaptation and reached the bottom at 24th h which persisted until 120th h; while bcl-2 gene expression started increasing at 24th h after hypoxic adaptation and persisted until 72nd h. The bcl-2/bax ratio also started increasing at 8th h after hypoxic adaptation and peaked at 24th h and persisted until 72nd h. Conclusions In the brain tissue of fetal and newborn rats which have undergone prenatal hypoxic adaptation, bcl-2 gene expression is elevated, bax gene expression decreases and bcl-2/bax ratio increases. These changes are time -dependent.

The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sustain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to reconstruct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.

Objective To identify the influencing factors for pediatric nursese' reporting of adverse events at 3A hospitals in Beijing. Methods Adopting the random sampling of ten 3A hospitals with pediatric wards in Beijing and conducting an questionnaire survey of some nurses in those hospitals. Results The possibility of adverse events reporting increased with the awareness of adverse events which was related with their severity. Except for title, educational background, length of service, position and past experiences were not associated with the barriers. The major perceived barrier was fear of colleague relationship brokenup and some other undesirable consequence. Conclusions Better training of awareness of adverse events and changes of the punitive culture by the roots as well as some regulation or policy were the major solutions to improve incident reporting.