The sphincter of Oddi is a valve that controls the biliopancreatic duct and plays an irreplaceable role in maintaining normal physiological functions of the biliopancreatic duct.However,sphincteroplasty and sphincterotomy may cause varying degrees of damage to the function of the sphincter of Oddi,which may further result in postoperative reflux of duodenal fluids and bacterial contamination in bile and increase the risks of recurrent common bile duct stones,reflux cholangitis,and even cholangiocarcinoma.Therefore,clinical physicians should protect the structure and function of the sphincter of Oddi.Based on our experience,under the premise that the extrahepatic bile duct can be preserved,patients with iatrogenic injury of the sphincter of Oddi can be treated with transduodenal sphincteroplasty to restore the structural integrity of the sphincter of Oddi and reduce biliopancreatic duct complications secondary to loss of function.

Objective To analyse the current situation and advance in perioperative therapy of liver transplantation for primary hepatocellular carcinoma(HCC).Methods The published papers on current situation and advance in the perioperative therapy of liver transplantation for HCC were reviewed.Results The survival rate of liver transplantation for HCC in early stage has been the same as that for benign liver diseases up to now. However, it is still a difficult problem to improve the survival rate of liver transplantation for advanced HCC. The ideal perioperative therapies of liver transplantation for HCC should be helpful to suppress the growth of tumor while the HCC patients are waiting for donated livers, to diminish or eliminate the intraoperative spread or implantation of tumor cells and to repress the micrometastasis postoperatively. The current perioperative therapies of liver transplantation for HCC include hepatic arterial chemoembolization, systemic chemotherapy, radiotherapy, percutaneous ethanol injection into HCC and radiofrequency ablation etc. Conclusion The perioperative assistant therapy of HCC can not only save time for patients before liver transplantation but also improve the survival rate after operation.

ObjectiveTo evaluate effect of music electrical stimulation on functional headache . Method78 patients were selected randomly from the patients who were cured after two years. Result46 patients are cured completely, 18 patients get better than before, accounting for 82.05%. Conclusion Music electrical stimulation is effective for functional headache.

Objective To observe the clinical efficacy and safety of ultrapulse CO 2 laser-assisted au-tologous epidermal grafting for the treatment of vitiligo.Methods1605patients with30660skin grafts were treated by CO 2 laser-assisted autologous epidermal grafting.Among them,782patients had localized vi-tiligo,319segmental,226general and278scattered.Epidermal grafts were harvested with negative pressure blistering method from normally pigmented skin,and recipient areas were prepared with a ultrapulse CO 2 laser.The curative effect was evaluated8weeks later.Results79.04%of the lesions were cured complete-ly,and total response rate was92.21%,with better effect in localized and scattered lesions than in other le-sions.The best results were shown in face,while the worst results shown in brow and hairline lesions.Con-clusions The advantage of combined therapy of CO 2 laser with autologous epidermal grafting in vitiligo is of easy performance,convenience,high response rate,which is worthy of large scale application.

Background Many studies showed that attenuation of retinal nerve fiber layer(RNFL)in early glaucoma is one of the important signs.How to accurately and quantitatively measure RNFL thickness is very important for the early diagnosis and monitoring of glaucoma.0bjective This study was to evaluate the clinical value of Optovue RTVue OCT and Heidelberg Retina Tomograph Ⅲ(HRT-Ⅲ)confocal scanning laser ophthalmoscopy in glaucomatous eyes. Methods This cross-sectional study included 40 eyes of 26 patients with suspected open-angle glaucoma(SOAG),48 eyes of 29 patients with open-angle glaucoma and 48 eyes of 27 healthy subjects.Optical nerve head(ONH) parameters and peripapillary RNFL thickness were measured in all the subjects with Optovue RTVue OCT and HRT-Ⅲ,meanwhile all the eyes received perimetry with Humphrey 750-I.Glaucoma variables obtained from Optovue RTVue OCT and HRT-Ⅲ were analyzed among the groups.Topographic Optovue RTVue OCT and HRT-Ⅲ parameters,including disc area(DA),cup area(CA),rim area(RA),rim volume(RV),cup volume(CV),cup/disc area ratio(C/DAR)as well as superior,temporal,inferior and nasal average RNFL thickness,were analyzed.The relationship of ONH parameters and RNFL thickness was analyzed using a linear correlation.The correlation between the mean defect(MD)of the visual field and the tomography parameters in glaucomatous eyes was described by bivariate Pearson correlation coefficients.Resuits The ONH parameters and RNFL thickness obtained by HRT-Ⅲ and OCT showed significant difference(P<0.05).ONH parameters such as RA,C/DAR,CA and RV were statistically changed in SOAG and the POAG patients compared with the normal subjects(q=6.47,q=7.67,P<0.05).The superior and inferior RNFL thickness parameters in three groups were positively correlated between HRT-Ⅲand OCT(r=0.362,r=0.441,r=0.395,P<0.05),Topographic Optovue RTVue OCT and HRT-Ⅲ parameters including CV,CA,RA and C/DAR fitted Pearson analysis(all P<0.05).In POAG group。The RA,RV,CV,C/DAR from Optovue RTVue OCT were correlated with MD with the significant coefficient 0.284,0.286,0.340,0.371 respectively(P<0.05),and evidently correlations also were found between RA,RV,C/DAR with MD respectively with the coefficient 0.339,0.859,0.422(P<0.05)by HRT-Ⅲ. Conclusion Both Optovue RTVue OCT and HRT-Ⅲ can difierentiate ONH analysis with a similar outcome in glaucomatous eye.The C/D value.RA,superior and inferior RNFL thickness based on Optovue RTVue OCT and HRT-Ⅲare distinguishing indexes in the diagnosis of early glaucomatous damage.

Objective To summarize the clinical experience of living relative donor kidney transplantation.Methods A retrospective analysis on 19 cases of living relative donor kidney transplantation from February 2002 to May 2006 was carried out.Results No blood transfusion was needed and no serious postoperative complications occurred in donors.The 19 donors were discharged from hospital at 7～10 days postoperatively.Follow-up examinations for 1～51 months(mean,28 months)in the 19 donors revealed normal liver and renal functions.Among the 19 recipients,follow-up examinations for 1～51 months(mean,28 months)showed that the renal functions recovered in 3～5 postoperative days in 16 recipients and within 3 weeks after transplantation in 3.Acute rejection occurred in 2 recipients postoperatively,and was reversed by steroid pulse therapy in 1 recipient and by ALG treatment for 10 days in 1 recipient,in whom the hormone pulse therapy was invalid.The hormone treatment was needed for only 3 weeks in a renal transplantation between monozygotic twins,without using other immunosuppressors,and no acute rejection occurred.Two patients with an uneventful recovery developed an acute rejection because of voluntary decrement and even stopping of immunosuppressor after 6 months,and then was treated with hormone pulse treatment until a reversion.The 1-year survival rate for patient/kidney was 100%.Conclusions Living relative donor renal transplantation is safe and feasible,offering a high survival rate for patient/kidney.

Optimization of surgical treatment of biliary dilatation (BD) depends on reasonable clinical classification and standardized classification-based treatment strategy.Due to increasing limits and defects of classic Todani classification,a new classification named Dong-classification has been proposed,which was based on a large series analysis from a single referral center.Some important parameters including anatomical location and range of BD,pathogenic factors,and different surgical managements were main considerations in the new classification.After practical application and evaluation,Dong-classification has been improved step by step.It is believed that Dong-classification may contribute to improving surgical treatment decision and selecting reasonable operative plan.

Aim To study the effects of sodium magnesium fructose diphosphate (SMFD) on free calcium concentration and nitric oxide synthase activity of ischemic synaptosome, so as to explore the protective mechanisms of SMFD on cerebral ischemia. Methods The synaptosomes from normal rat brain were prepared by phase partition and cultured with oxygen-glucose deprivation to establish ischemic synaptosome model. The intrasynaptosomal free calcium concentration and nitric oxide synthase activity were detected separtately after the synaptosomes were co-incubated with SMFD (1.3 mmol*L-1) or fructose-1,6-diphosphate (FDP, 4.0 mmol*L-1) for 60 min. Results SMFD decreased the free calcium concentration and reduced the activity of nitric oxide synthase (NOS) of ischemic synaptosomes. Its effects were more powerful than those of FDP. Conclusion SMFD may protect neurons from ischemic injury by preventing intracellular Ca2+ overload and inhibiting the activity of nitric oxide synthase.

Objective To investigate treatment method for existing and impending benign pathological femoral neck and trochanteric lesions.Methods A retrospective study wad done on 25 patients with benign proximal femur lesions treated between 2002 and 2004.All patients were treated with lesion curettage,cauterization,autografting and/or allografting.Then,dynamic condylar screw (DCS) or hip joint-span external fixator were selected according to the involved area of the lesion of the proximal femur.The duration of follow-up was mean 2.3 years (2-4 years).Results Sound bony union was seen on the radiographs of all patients by 3-6 months after surgery.There found no local recurrence or avascular necrosis of the femoral head,or complications like necrosis,infections or fractures.Function of the patients in the current series was graded excellent,assessed by the validated outcome measures MSTS-87,MSTS-93 and TESS lower extremity.Conclusion DCS or hip joint-span external fixator may be better alternative treatment of benign pathological femoral neck and trochanteric lesions,compared with conventional surgical methods such as simple bone grafting,traction and hip spica cast.

In this paper we analyzed examination results of the Beijing Community Dentistry Professional Post Assessment and related factors, also discussed the measures for improving the quality of the post assessment. In 325 examinees 244 passed with a pass rate of 75.1%. There significant differences among examinees, educational background and academic training were most influential