Pancreaticoduodenectomy (PD) is the procedure for treating adenocarcinoma in periampullary region.This involves resection of multiple organs and complex reconstructions.The modern surgery has witnessed the dramatic improvement in outcomes after PD.Mortality has dropped to less than 4％,however,the complication rate remains high,making this procedure still a big challenge for most surgeons. PD is so complicated that even small mistakes could jeopardize the whole procedure and outcomes.With experiences of over 1000 PDs,we discuss the challenges of this procedure and strategies to deal with them.

ObjectiveTo observe the effect of Chinese medicinal application at Yongquan (KI1) on hot flush and sweating brought by using GnRH-ain patients with endometriosis.MethodTotally 120 patients diagnosed with endometriosis of stageⅢ~Ⅳ were randomized into a treatment group and a control group. The control group started to receive GnRH-a(Goserelinum) at 3.6 mg/28 d since post-operational day 3, 4 times in total; the treatment group started to receive GnRH-a(Goserelinum) at 3.6 mg/28 d since post-operational day 3, 4 times in total; at the night of taking GnRH-a, the treatment group was also given Chinese medicinal application at Yongquan, a month as a treatment course, successively for 4 courses.ResultThe side effects of using GnRH-a, including hot flush and sweating, were significantly less in the treatment group than that in the control group (P<0.05).Conclusion Medicinal application at Yongquan can significantly reduce the side effects including hot flush and sweating brought by using GnRH-ain patients with endometriosis.

Objective To review the correlation between self-discrepancy and body image based on the papers published before 2014 at home and abroad,with an attempt to provide an new idea for body image disorder.Methods Major online database including Sciencedirect,Springer,CNKI,and Wan Fang datebase were searched in January 2014.The key words we used are body image, body dissatisfaction, body self-discrepancy and so on.Results Totally 40 studies enrolled,the analysis show self-discrepancy is an important mechanism to affect body image,and body self-discrepancies has been found to be associated with body-related behaviors,emotional experience and eating disorder.Conclusion self-discrepancies are cognitive structures,which can influence ongoing information processing without individual' s awareness,resulting in Cognitive biases and body image disorder.Further research is needed exploring the discriminate validity of the body self,the method of measurement an so on.

The article discusses the problems and challenges that will be met in the pathology teaching pratice in English for international students as well as the way to solve the problems.

Position analysis is a basic task in human resources management. The paper introduces the concept and implication of position analysis, discusses its necessity in light of the current situation of position analysis in domestic and foreign hospitals, and puts forward some measures for doing a good job of it.

OBJECTIVE:To evaluate the postoperative analgesic effects and side effects of buprenorphine versus ketamine for patients with patient-controlled epidural analgesia(PCEA).METHODS:60 patients withⅠ～Ⅱ grade in physical status evaluated by American society of anesthesiologists(ASA)scheduled for lower abdomen surgery by lumbar anesthesia combined epidural anesthesia were divided into three groups by a randomized double blind method to be treated with Buprenorphine + Droperidol(Group A),Buprenorphine + Droperidol + Bupivacaine(Group B),or Ketamine + Droperidol+ Bupivacaine(Group C).The visual analogous scale(VAS),Ramsay scale,frequency to press the analgesia pump was recorded at 0～48 h after operation,the time spent for the recovery of intestinal functions;score for nausea vomiting and other adverse drug reactions were observed.RESULTS:Frequency to press the analgesia pump,VAS score and Ramsay score in Group A in different period of time were all significantly different from those in Group B and Group C(P

Aim To investigate the effects of berberine on epithelial-mesenchymal transition (EMT) of human liver cancer HepG2 cells induced by transforming growth factor-pi ( TGF-pl ) and its mechanism. Methods MTT assay was used to detect the proliferation activity of berberine on HepG2 cells. After 10 ng • L"1 TGF-pl was used to induce EMT model process of HepG2 cells, berberine was added to treat HepG2 cells. Colony formation, cell scratch and Transwell assays were used to detect the clonogenic, migratory and invasive capabilities of HepG2 cells. Immunofluorescence assay was used to detect the expression of EMT mesenchymal marker Vimentin. Western blot assay was used to detect the proteins expression of EMT marker (E-cadherin, N-cadherin, Snail), matrix metallopro-teinase ( MMP-2), TGF-p/Smad pathway (Smad2, p-Smad2, Smad3, p-Smad3) in HepG2 cells. Results Berberine inhibited the proliferation of HepG2 cells in a concentration-time dependent manner. Compared with TGF-pl group, berberine could significantly inhibit the abilities of colony formation, migration and invasion of HepG2 cells. Berberine could significandy inhibit the expression of E-cadherin protein up-regula-ted by TGF-pl, and N-cadherin, Vimentin;, Snail, MMP-2, p-Smad2, p-Smad2 proteins expression down-regulated by TGF-pl. Conclusions Berberine may interfere with the EMT process of HepG2 cells induced by TGF-pl by inhibiting the TGF-p/Smad 'signaling pathway to inhibit the HepG2 cell migration and invasion.

Objective: To study the optimized technology of inclusion for the volatile oil of Caryophylli Flos with β-cyclodextrin polymer (β-CDP) microsphere. Methods β-CDP Microsphere was prepared by saturated peroxide solution. The study was carried out with uniform design to optimize the best inclusion processing conditions and inclusion compound was to characterize its structure. Results The best condition of the optimized technology of inclusion for the volatile oil of Caryophylli Flos with β-CDP microsphene was as follow: the volatile oil of Caryophylli Flos (mL)-β-CDP microsphere (g) was 1:1; inclusion temperature was 35°C; clathration time was 1 h; ethyl alcohol could be ignored. The package method is successful by characterizing structure. Conclusion: The inclusion compound of β-CDP has high rate and the inclusion process is reasonable and feasible.

Diterpenes, Abietane ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Genital Neoplasms, Female ; drug therapy ; Humans

Objective To summarize the experience of laparoscopic purse-string transfixion of the internal ring combined with intraperitoneal onlay mesh(IPOM) laparoscopic herniorrhaphy in the treatment of adult indirect inguinal hernia.Methods The modified IPOM laparoscopic herniorrhaphy(laparoscopic purse-string transfixion of the internal ring combined with IPOM laparoscopic herniorrhaphy) was performed in 15 adult patients with indirect inguinal hernia in this hospital from September 2004 to February 2005.Results The time of operation was 30~60 min(mean,35 min). The patients were discharged from hospital 2~3 days after operation.Two patients complained of tractive discomfort after operation and were cured with postoperative physical therapy for 2 weeks.Follow-up observations in 15 patients for 2~6 months(mean,4.8 months) revealed no recurrence.Conclusions The modified IPOM laparoscopic herniorrhaphy is a safe and feasible option for adult indirect inguinal hernia,with advantages of simplicity of performance, few complications,mild postoperative pain,quick recovery,low recurrence,and good cosmetic results.