As a variance of the experience and the behavior of emotion, emotional masking has been obtained in society and will be developed during all one's life. The emotional masking, which has been influenced by many facts, such as social surroundings, the family, the received education, accompanier and so on, will produce different results for the multiplicity of cognition/emotion and acts and will work on the people's physiology, psychology and social relation.

Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS) guided fine needle aspiration (FNA) in patients with suspected chronic pancreatitis. Methods Forty seven patients including 28 males and 19 females (mean age 52.3 years, range 47～69 years) were enrolled into study. The diagnosis of chronic pancreatitis or pancreatic malignancy was based on results of BT PABA test, Sudan Ⅲ staining of stool and abdominal CT scanning, the mean course of disease was 6.3 year (range 3 21 year). Pancreatic tissue specimens were harvested by EUS guided FNA and investigated by histopathological study. Results Totally 31 cases (31/47, 69%) were diagnosed as chronic pancreatitis based on histopathological examination of the specimens taken by EUS FNA. Conclusion EUS FNA had the potential clinical value in diagnosis of chronic pancreatitis.

Hepatocyte transplantation may be a viable alternative treatment to liver transplantation for acute/chronic liver failure and metabolic liver disorders. Hepatocyte transplantation is an effective treatment to support liver function around liver transplantation due to its relatively easy manipulation and mild wound. In recent two decades, hepatocyte transplantation have been applied in clinical treatment and showed some effect in acute/chronic liver failure and metabolic liver disorders. Here, we sum up the status of clinical hepatocyte transplantation, discuss its value in clinical application and some challenges need to resolve.

BACKGROUND: Membrane materials of bioreactor have exchange of substance and good physiochemical characteristics as well as good biocompatibility.OBJECTIVE: To evaluate the biocompatibility of interface of human hepatocyte/microporous polypropylene, i.e. graft modified microporous polypropylene semipermeable ultrafiltration membrane (MPP).DESIGN, TIME AND SETTING: Animal observation was performed at the Organ Transplantation Center, Ruijin Hospital of Shanghai Jiao Tong University Medical School and Polymers Institute of Zhejiang University between September 2005 and October 2007.MATERIALS: The microporous polypropylene ultrafiltration plane thin membranes, 0.2 μm diameter, M<,r> 50 000-100 000 molecular blockage, were used. Photochemical graft polymerization modification technique was adopted to graft hydrophilic acrylamide group through chemical bonds on MPP surface and succeeded in constructing an interface of human hepatocyte/microporous polypropylene, i.e. bioreactor membrane of bioartificial liver, graft modified MPP.METHODS: The biocompatibility of modified MPP was evaluated by hemolysis test, cytotoxicity test, acute systemic toxicity test, pyrogen test, skin sensitization and percutaneous stimulation test according to the requirements and biological evaluation criteria of medical device of ISO10993-1:1992.MAIN OUTCOME MEAURES: The experimental results of hemolysis, cytotoxicity, general acute toxicity, pyrogen, skin sensitization and percutaneous stimulation of modified MPP.RESULTS: The hemolytic rate of modified MPP was 1.90% (<5%), which showed that modified MPP did not lead to hemolysis. The extract solution of modified MPP exhibited no significant inhibition on the proliferative activity of L929 cells. At 24, 48 and 72 hours after MPP injection, no mice death, significant changes in body mass, or acute systemic toxicity were observed, such as ptosis, dyspnea, eyanosis, abdominal stimulation, diarrhea, decreased movement or tremor. In rabbit pyrogen test, the body temperature changed in a range from -0.2 to 0.4, which was consistent with the evaluation criteria of biomedical materials without pyrogen. Only one case was found with very slight erythema in skin sensitization test; its integral was 1 and primary stimulation index was 0.25 (<0.4), and the primary stimulation index of percutaneous stimulation test was 0.2; the average primary stimulation index was 0.068, indicating that modified MPP had no skin irritation.CONCLUSION: Modified MPP has no haemolytieus, cytotoxicity, pyrogenicity or skin sensitization, suggesting good biocompatibility by photochemical graft acrylamide on the surface of MPP.

With the development of cell separation technique, hepatocyte transplantation becomes a hot topic; however, the application is limited by donor deficiency and immunological rejection. Microencapsulated hepatocytes contribute to the promotion and application for liver cell transplantation, for which provide a large amount of high activity and good function of liver cells, in this paper, liver cell microencapsulation technology and its progress in applications were reviewed, providing prospective way for large-scale and high-active culture in vitro and long-term cryopreservation.

OBJECTIVE: To analyze the research literatures related to bioartificial liver, and to make a conclusion concerning the development of bio-artificial liver.DATA SOURCES: Using bioartificial liver, liver cell, hepatocyte culture and bioreactor as search terms, searching Ovid, Springer Link database, and China National Knowledge Infrastructure, Vip Information database and Wanfang Date (1990.09-2008.09). Literatures search was limited to English and Chinese languages.DATA SELECTION: Researches regarding liver cells of bioartificial liver, reactors and auxiliary equipment was included, and the studies about immune and animal infection studies of bioartificial liver were excluded.MAIN OUTCOME MEASURES: ①The source, quantity and culturing of bio-artificial liver hepatocytes. ②Bioreactor type, nature and type of films. ③Composition of oxygen and temperature control devices of bioartificial liver.RESULTS: Totally 3898 documents seized initially in the searching by computer, according to inclusion and exclusion criteria, 29 were analyzed. Bioartificial liver was a hybrid device in which can culture hepatocytes in vitro, when the patient's blood flows through the device, material exchange with the cultured hepatocytes through semi-permeable membrane or direct contacting can take place, which can perform the same roles of detoxification, synthesis, biological transformation and other functions as real liver cells, so as to achieve the purpose of support and treatment. Bioartificial liver can also be involved in metabolism of the three major nutritive substances, as well as secretion of hepatocyte growth promo ting substances. So it is an effective alternative to the real liver as the function of detoxification and synthesis, and can fills the essential gap between the transplantation and acute liver failure.CONCLUSION: Although the bioartificial liver research has made significant progress, it still faces the problems such as limited liver cells sources, long-term maintenance of liver cell activity and function, and further optimization of the reactor design.

Objective To investigate morbidity, mortality and survival of patients with adenocarcinoma of the pancreas who underwent pancreaticoduodenectomy with en bloc portal vein resection, and to evaluate its effect on radical resection of pancreatic carcinoma. Methods Between 1999 and 2003, 32 patients with ductal adenocarcinoma of the head of the pancreas who underwent pancreaticoduodenectomy with SMPV resection were retrospectively analyzed. Patients were divided into two groups with group A(n = 12) in which the wall of portal vein was surrounded by carcinoma without true invasion,and group B(n = 20) , by tumor transmural invasion. Results The overall morbidity was 31% , there was no operative mortality, the 1,3-year survival rate was 59% and 22% respectively. The mean survival time of patients with microscopically positive margin was 5. 6 months as compared with 20 months with microscopically negative margin. There was no difference in tumor size, margin positivity, nodal positivity, and 1,3-year survival rate between the two groups. Conclusions Pancreaticoduodenectomy combined with SMPV resection can be performed safely, without increasing the morbidity and mortality. SMPV resection should be performed only when a margin-negative resection is expected. SMPV invasion is not associated with histologic parameters suggesting a poor prognosis.

Objective To evaluate the surgical treatment of Nevin′s stage Ⅳ and Ⅴ gallbladder carcinoma. Methods A retrospective analysis was made on 62 cases of Nevin′s stage Ⅳ and Ⅴ gallbladder carcinoma patients undergoing surgical treatment from Jan. 1993 to Dec. 2002. Results There were 17 cases of stage Ⅳ and 45 of stage Ⅴ. Cholecystectomy was performed in 32 cases with a resection rate of 52%, 7 cases received radical resection, 10 extended radical resection and 15 palliative resection. The total surgical morbidity rate was 35.3%. Postoperative 1-, 3-, 5-year survival rate of radical and palliative resection were 61%, 31%, 11% and 27%, 13%, 0 respectively (P

AIM: To evaluate the blood compatibility of a new bioartificial reactor membranous material (propylene-acidamide grafted poly propylene membrane, PP-g-AAm) in vitro. METHODS: Contacted PP-g-AAm membrane and PP (polypropylene) memb rane with platelet-rich plasma in a swing bed, 37 ℃, to simulate the conditions in vivo, and another group of PRP without any membranes was set as control group. ELISA was used to study the expression of ?-thromboglobulin, and flow cy tometry was used to study CD62P and CD63 expressio n of the activated blood platelets after contacting the two kinds of membranes w ith PRP. Scanning electrical microscopy was used to study the configuration and numbers of platelet cells adhered on the membranes. RESULTS: After contacting with PRP 30 min, ?-TG expression show ed marked difference between the two kinds of material groups and the control gr oup (P

Objective To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 310 patients who received pancreaticoduodenectomy at the Ruijin Hospital of Shanghai Jiaotong University from January 2005 to May 2013 were retrospectively analyzed.The risk factors associated with the interoperative pancreatic fistula were analyzed.The univariate and multivariate analysis were done using the Pearson chi-square test and non-conditional Logistic regression model.Results A total of 134 patients had postoperative complications,including 103 (33.23％) with pancreatic fistula,among them 40 patients developed additional complications.The results of univariate analysis showed that preoperative levels of hemoglobin,total bilirubin,diameter of the pancreatic duct and postoperative level of albumin were risk factors of pancreatic fistula after pancreaticoduodenectomy (x2 ＝ 4.543,6.087,6.265,5.311,P ＜ 0.05).The results of multivariate analysis showed that preoperative level of total bilirubin equal to or above 34.2 μmol/L,the diameter of the pancreatic duct under 3 mm and the level of postoperative albumin under 28 g/L were the independent risk factors of pancreatic fistula (OR =1.806,1.936,1.780; 95％ confidence interval:1.107-2.948,1.170-3.206,1.002-3.165,P ＜ 0.05).Conclusion Preoperative jaundice (the level of total bilirubin ≥ 34.2 umol/L),pancreatic duct diameter ＜ 3 mm and postoperative malnutrition (albumin ＜ 28 g/L) indicate a higher incidence of postoperative pancreatic fistula.