Objective To investigate the application effect of fast secure multipath exposure of portal vein ( PV) and superior mesenter-ic vein ( SMV) in pancreaticoduodenectomy. Methods Retrospective analyzed the clinical data of 80 cases of pancreatic head cancer pa-tients who underwent pancreatoduodenectomy in our hospital from October 2005 to October 2013. According to the different PV/SMV expo-sure methods, they were divided into 2 groups with 40 cases in each group. The observation group used fast secure multipath exposure meth-od while the control group were given traditional method of exposure, and curative effect of the 2 groups were compared. Results In the ob-servation group, the success rate of operation was 90. 0%(36/40) which is significantly higher than 72. 5% (29/40) in the control group;in the observation group , operation time was ( 3 6 0 . 6 ± 5 8 . 7 ) min and intraoperative bleeding was ( 6 0 0 . 4 ± 3 6 . 8 ) mL which were significantly lower than that(414. 2 ± 81. 3)min and (788. 8 ± 57. 9) mL in the control group;3 year mortality rate in observation group was 65.0%(26/40) which was significantly lower than 86. 1% (31/36) in control group, these differences were statistically significant (P<0. 05). Conclusion Fast and secure multipath PV/SMV applied in pancreatoduodenectomy could improve the operation success rate, shorten the operation time, reduce the intraoperatve blood soss and postoperative adverse reactions, and improve the long-term survival rate.

Telemedicine is a combination of modern computer technology, communication technology and medical technology. It has a promising application potential. This paper mainly overviews the history of telemedicine, especially the development of wireless telemedicine. With the classification and comparison, the opinion on the future of wireless telemedicine is given according to the author's research work. Portable telemedicine system is the trend of telemedicine.

Objective: To explore the imported medicine price’s pass-through effect on domestic western medicine’s price. Methods: Based on the time-series data from January 2003 to March 2013, the empirical research studied the effect of imported medicine’s price and other variables on domestic western medicine price. Results: The imported medicine’ price has short significant effect on domestic medicine. Conclusion: To reduce the effect of imported medicine price’s fluctuation, the government should intervene the medicine price moderately; the drug company and the hospital should pay attention to the efficacy and the promotion of the domestic western medicine.

Objective To explore the risk factors of the chronic subdural hematoma(CSDH) drilling drainage recurrence.Methods The clinical data of 252 CSDH patients were retrospectively analyzed.All patients underwent trephination and drainage treatment,there were 40 cases with postoperative recurrence of hematoma.Multivariate logistic analysis of linear regression was used to analyze the risk factors for postoperative hematoma recurrence.Results In this study,of 252 CSDH patients received trepanation and hematoma,the probability of recurrence was 15.9 ％ (40/252).Single factor analysis showed that the size of hematoma,CT shows the density of hematoma,postoperative drainage volume,operation time,review the CT intracranial pneumatosis,age,hematoma midline shift could increase the recurrence possibility.Logistic multivariate analysis showed that he size of hematoma,CT shows the density of hematoma,postoperative drainage volume,age were independent risk factors of recurrence of hematoma drainage in patients with CSDH after drilling.Conclusion The influence factor of recurrence of hematoma in CSDH patients received trepanation and drainage is complex,we should strengthen the intraoperative,postoperative nursing and operation to reduce postoperative recurrence of CSDH.

Objective To explore the clinical application of lesser saphenous-sural nerve adipofascial flap accompanied with a full-thickness skin graft taken from the groin area for reconstruction of the distal one third of anterior tibia,.around the ankle. Methods A distally based lesser saphenous.sural nerve adipofag.cial flap accompanied with a full-thickness skin graft which was taken from the groin area was studied and used to treat 12 patients with soft tissue defects in the distal one third of anterior tibia,3 cases with soft tissue defects and tibia osteomyelitis,2 cases with soft tissue defects and tibia osteomyelitis.The size of the soft tissue defects ranged from 3 cm×5 cm to 9 cm×13 cm,and the biggest donor flap was 13 cm×18 cm.The donor sites at the posterior aspect of the leg and at the groin area were closed primarily. Results All 17 patients were followed up for 6-12 months(average 9 months).All 17 flaps had good perfusion and survived completely,which successfully treated all 17 patients with soft tissue defects or with both soft tissue defects and osteomyelitis.The donor and recipient sites of adipofascial flaps and the groin area healed primarily,and satisfactory appearance and function were achieved.Conclusion Distally based lesser saphenous-sural nerve adipofascial flap accompanied with a full-thickness skin graft which was taken from the groin area can reconstruct the distal one third of anterior tibia,around the ankle,and even treat osetomyelitis successfully,in the same time,which can preserve the function and appearance of the involved limb to the utmost.

Some traditional Chinese medicine technologies,with strong safety, quick and significant effect, standerdized manipulation, simple operation and good prospect for promotion and application are selected in the research project for application and demonstration of rural health appropriate technology. Through the application of the project, we have new experience in medical teaching.

Objective To study the effect of UHRF1 expression inhibition by RNA interference on the radiosensitivity of esophageal cancer cell line TE-1 and its mechanism.Methods Short hairpin RNA (shRNA) targeting UHRF1 gene was introduced into TE-1 cells by lentivector-mediated transfer.The cells were divided into three groups:non-transfected group,negative control (NC)-shRNA-transfected group,and UHRF1-shRNA-transfected group.The mRNA and protein expression levels of UHRF1 in TE-1 cells were measured by RT-PCR and Western blot before and after transfection.After transfection and X-ray radiation,the radiosensitivity of TE-1 cells was evaluated by colony formation assay; the cell cycle and cell apoptosis were determined by flow cytometry; the γ-H2AX (as a marker of DNA damage) level was measured by Western blot.Results After transfection with UHRF1-shRNA,the mRNA and protein expression levels of UHRF1 were significantly decreased in TE-1 cells,as compared with those in the NC-shRNA-transfected group and non-transfected group (0.11 vs 0.96 and 0.98,F =124.21,P =0.000;0.10 vs 0.89 and 0.94,F =125.25,P =0.000).The UHRF1-shRNA-transfected group had sensitization enhancement ratios of 1.53 (D0 ratio) and 1.95 (Dq ratio).X-ray radiation could cause G2/M arrest and increase apoptotic rate and γ-H2AX expression in TE-1 cells.Compared with the two control groups,the UHRF1-shRNA-transfected group showed significantly less G2/M arrest (F =500.15,P =0.000),a significantly higher apoptotic rate (F =100.10,P =0.000),and significantly higher residual γ-H2AX expression (F =61.00,P =0.000) at 24 hours after X-ray radiation.Conclusions RNA interference can effectively inhibit the UHRF1 expression and enhance the radiosensitivity of TE-1 cells.The mechanism may be related to cell cycle regulation,cell apoptosis,and DNA damage repair.

Objective To investigate the animal model of acute lung injury (ALI) induced by caudal vein injection of trypsin in rats and to evaluate the model.Methods The model of lung injury was established by caudal vein injection of trypsin in rats.The rats were killed at the time point of 3 h,6 h,12 h,24 h,and 24 h and then the pathological changes of structure of lungs,peripheral blood neutrophil count,arterial blood gas analysis and lung wet/dry (W/D) weight ratio in rats were measured and observed.Results The results of hematoxylin eosin (HE) staining showed that there was no obvious pathological changes in lung tissues of the control group,while alveolar and pulmonary septal edema,thickening,and a large number of inflammatory cells infiltration in the lung tissues of the model group.Compared to the control group,the peripheral blood neutrophil counts,W/D and PaCO2 were significantly increased,PaO2 was significantly decreased (P ＜0.01).There was significant differences in the number of peripheral blood neutrophils,PaCO2,W/D and PaO2 between the model groups (P ＜ 0.01).Conclusions The rat model of ALI induced by trypsin can successfully simulate the lung damage caused by the release of a large number of trypsin when severe acute pancreatitis occurred.

Objective To describe the changes of thrombosed venous sinus on MRI after administration of contrast material and evaluate the sensitivity and specificity of thread-like enhancement around sinus to diagnose thrombosis in the corresponding sinus.Methods Patients with cerebral venous sinus thrombosis (CVST) admitted to our department from January 2005 to December 2014 and undergone a MRI scan with administration of contrast material were included in this study.The enhancement features of venous sinus were studied in the plane parallel to the interested sinus.The features of enhancement were classified as peripheral thread-like enhancement, partial enhancement and complete enhancement.The proportion of these three type of enhancement in thrombosed sinuses and normal sinuses were described and compared.The sensitivity and specificity of peripheral thread-like enhancement to diagnose thrombosis in corresponding sinus were calculated.The proportion of each type of enhancement was also described and compared in acute (≤ 7 d), subacute (8-30 d) and chronic (≥ 31 d) stage after onset of symptoms.Results Peripheral thread-like enhancement, partial enhancement and complete enhancement were all found in both thrombosed and normal sinuses.There was a significant difference of enhancement features between normal and thrombosed sinus in superior sagittal sinus (100％ (30/30) vs 60％ (27/45), x2 =13.789, P =0.001), left trans verse sinus, and right sigrnoid sinus.The sensitivity and specificity of peripheral thread-like enhancement to diagnose thrombosis in the corresponding sinus were 10.5％-44.4％ and 53.3％-76.7％ respectively.There was no significant difference of contrast features at different stage after onset.Conclusion The value of peripheral thread-like enhancement to diagnose CVST is limited because of low sensitivity and specificity.