The causes of iatrogenic injury in choledo-cho-pancreatico-duodenai junction include iatrogenic factors, anatomic factors and pathological factors. T-tube, methylthionine chloride and fiber choledochoscopy are useful methods for early diagnosis. Accurate exploration of the injury site and reasonable choice of management were significant in dealing with the iatrogenie injury and can lead to a satisfactory result. Choledo-chojejunostomy and Oddi sphincteroplasty are not recommended unless the patients had distal bile duet stricture or the stones can not be removed. Accurate detection of the injury site, evaluation of the severity, and proper choice of the surgical method are important for the prognosis of the patients.

Lactate is considered a dead-end product of glycolysis.Its generation and accumulation promotes tumor growth and metastasis,and it is related to the poor prognosis of tumor.But recent studies have found,tumor cells can also uptake and utilize lactate.With the recent advances in tumor metabolism and gene therapy,lactate is a potential therapeutic target in tumors.

Objective To compare clinical outcomes of minimally invasive plating osteosynthesis (MIPO) and intramedullary nail stabilization in treatment of acute humeral shaft fractures. Methods From March 2007 to January 2009, 52 patients were treated in our department for acute fractures of middle and lower humeral shaft. Twenty-seven were treated with MIPO technique (group A) and 25 with intramedullary nail (group B) . In group A, there were 15 men and 12 women, aged from 18 to 65 years (average, 36. 7 years); in group B, there were 16 men and 9 women, aged from 25 to 63 years (average,39. 4 years). Operation time, amount of blood transfusion, hospital stay, time for union, complications, Mayo scores of the elbow and Constant scores of the shoulder were recorded in both groups and compared statistically. Results The mean follow-up time was 17. 8 months (range, 16 to 36 months) . There were no significant differences between the 2 groups in operation time, amount of blood transfusion, hospital stay, time for union, and Mayo scores of the elbow ( P > 0. 05) . There was no case of postoperative iatrogenic radial nerve palsy or non-union in group A, but there were 4 cases of non-union, 2 cases of iatrogenic radial nerve palsy and one case of varus malunion in group B. Compared with group B, group A showed significant advantages in rate of postoperative non-union and Constant scores of the shoulder functional recovery ( P < 0. 05) . Conclusion In treatment of humeral shaft fractures, MIPO technique has advantages of less operative invasion, quick bone union, satisfactory shoulder functional recovery and low risk of postoperative palsy of the iatrogenic radial nerve.

As a tool, cholelithiasis animal models have become an important platform for pathogenetic, preventative, diagnostic and therapeutic research. As biliary calculus formation has a close relationship with dysfunction of hepatic and biliary systems, inability of lipid metabolism homeostasis and impairment of immunologic barriers, increasing studies have been carried out with the use of animal models in these fields. Animal genetic susceptibility to cholelithiasis has greatly attracted people's attention in recent years and cholelithiasis animal models have been used in Chinese traditional medicine development and authentication. Furthermore, reports on invasive and traumatic research have been published in which large animal models were used. It is supposed that technical progress and scientists' demands would result in wide application of more kinds of cholelithiasis animal models.

Objective:To observe the roles of p50 protein in pathologic responses of cerulein(CR)pancreatitis in mice deficient in p50 protein of NF-?B.Methods:Pancreatitis was induced by i.p.injection of 50?g/kg CR.The express and compensation of p65,p50 and cRel proteins of NF-?B,NF-?B activity were measured using electromobility shift assay;parameters of pancreatitis,eg,amylase,lipase and trypsin were evaluated.The apoptosis,necrosis and caspase-3 activity were observed.Results:p50 knockout(KO)mice had no p50 protein expression and increased p65 and cRel proteins expression.p50 KO mice's NF-?B activity decreased and apoptosis increased in pancreatitis compared with wild type(WT)mice.There was no caspase-3 activition in both mice before and after pancreatitis.All KO mice had an increased necrosis and amylase,lipase,trypsin activity compared with WT mice in pancreatitis.Conclusions:The results indicated that NF-?B p50 genetic deletion might attenuate cerulean induced pancreatitis.

OBJECTIVE:To study the pharmacokinetic features of Fagopyrum tataricum total flavonoids. METHODS:6 Beagle dogs were intragastrically given single dose of 80 mg F.tataricum total flavonoids (with content of quercetin at 1.2% and the content of eldrin at 24.7%). HPLC-UV spectrophotometry was adopted to determine the content of total quercetin in the hydrolyzed plasma samples. RESULTS:Taking the total quercetin as the index of the pharmacokinetic features of the F. tataricum total flavonoids in the Beagle dogs,the main pharmacokinetic parameters were as follows:AUC0→t:(9.92?1.49)?g?h?mL-1;AUC0→∞:(10.81?1.86)?g?h?mL-1;Cmax:(1.07?0.19)?g?mL-1. CONCLUSION:The pharmacokinetics of the F.tataricum total flavonoids in the Beagle dogs conforms to two-compartment model,and the concentration-time curves are characterized by multiple peak pharmacokinetics.

AIM: To study the changes of hippocampal ne uronal microenvironment and alterations of excitatory amino (EAA) and inhibitory amino acid (IAA) in extracellular fluid (ECF) in different time after t hrombotic cerebral ischemia in tree shrews. METHODS: The model of focal thrombotic cerebral ischemia was ind uced by photochemistry-technology in tree shrews. Hippocampal ECF was collected b y microperfusion. pH, PCO 2, PO 2 and HCO 3- were analyzed by blood gas ana lyzer, and Asp, Glu, Gly and GABA were measured by high-performance liquid chrom atography (HPLC)-PITC technology after occlusion. RESULTS: The contents of Asp, Glu, Gly and GABA in hippocampal E CF increased, and pH, PO 2 and HCO 3- decreased after photochemical induced cerebral ischemia in tree shrews. There were significant differences between ish emic group and sham group (P

Single incision laparoscopic surgery (SILS) has many advantages than standard multiport laparoscopic cholecystectomy (MLC),such as small trauma,less postoperative pain,shorter hospital stay,good cosmetic effect,and so on.Especially the satisfying cosmetic result of no abdominal scar is more important.But the SILS is also faced with many difficulties.The operation time of SILS were significantly longer in duration than MLC.The safety and the technical feasibility were lower for the SILS whose operation complications are more than the MLC.The main reason is that the operation field don't exposureis sufficient and the formation of surgical operation triangle is not easy.In order to overcome these difficulties,scholars have used the auxiliary methods of exposing the operative field in various operation,including the penetration of abdomen wall retraction and intraperitonealretractionand abdomen wall retraction.This paper with review the advantages and disadvantages of the above methods aiming to affer more values for clinical doctors in opperating SILS who get more knonledge abont it.

Objective To investigate the etiology of the nosocomial infection and immune function changes anus and anal after operation.Methods 130 patients who needed anus and anal canal surgery were recruited in the study.The clinical data were recor-ded and postoperative nosocomial infection data were observed,including infection type,distribution,pathogenic analysis and im-mune function.Results A total of 67 cases of nosocomial infection occured,the infection rate was 51.5% (67/130),the main types of infection were perineal wound infection,abdominal infections and pelvic infections,urinary tract and vaginal infections were rare. 93 isolates were collected,of which gram-negative bacilli accounted for 67.7% (63/93 ),including bacteroides fragilis (21.5%), Escherichia coli (18.3%),Pseudomonas aeruginosa (10.8%);Gram-positive bacteria accounted for 23.7% (30/93 ),including Staphylococcus aureus(17.2%),Staphylococcus epidermidis(6.5%);5 fungi were isolated accounting for 5.4%,other strains ac-counted for 3.2%.All the immune parameters detected in patients with postoperative nosocomial infection were statistically differ-ent from those before infection(P <0.05)except for IgM(P >0.05).Conclusion The incidence of nosocomial infection was rela-tively high in patients who had anus and anal canal surgery,which could serious affect the patients'outcomes,preventive and control measures should be taken in clinical practice.

Objective To establish a HPLC method for the content determination of hesperidin in Shuhouyin. Methods Chromatographic assay was performed on CenturySIL C18-AQ (250 mm?4.6 mm, 5 ?m) column at room temperature. The mobile phase was acetonitrile-0.2% phosphoric acid solution (21∶79). The flow rate was 0.8 mL/min. The detection wavelength was at 284 nm. The sample size was 20 ?L. Results Good linear relationship of hesperidin achieved in the range of 1.004～10.04 ?g. The average recovery rate was 98.59% with RSD=0.72%. Conclusion The method is simple, accurate and stable with good reproducibility. This method can be used for determination of hesperidin in Shuhouyin.