Objective To explore the methods of decreasing pancreatic fistula rates after pancreaticoduodenectomy. Methods This paper was made on the review of recent literatures about preventing pancreatic fistula after pancreaticoduodenectomy. Results Pancreatic fistula is still one of the main common complications of pancreaticoduodenectomy. Pancreatic stamp is managed mostly by pancreato enteric or pancreato gastric anastomosis. Ligation of the pancreatic duct and total pancreatectomy have reduced gradully. It is still undertermined that perioperative somatostatin can prevent pancreatic fistula. Conclusions The key point of deteasing pancreatic fistula rate of pancreaticoduodenectomy is to master all sorts of ways in managing the pancreatic stump.

ObjectiveTo study the effect of age on the perioperative and long-term outcome of hepatic resection for hepatocellular carcinoma. MethodsFifty two cases of elderly patients with hepatic resection for hepatocellular carcinoma were analysised retrospectively. ResultsThe morbidity rate and in-hospital duration in elderly group were 32.7% and (29.94.3)d respectively, higher than 18.6% and (24.76.1)d in non-elderly group (P

Objective To investigate the protective effect and the mechanisms of triptolide on antibody-mediated rejection (AMR) in kidney transplantation.Method A rat model of AMR in kidney transplantation was constructed by sensitizing major histocompability complex (MHC) completely incompatible species of rats via blood transfusion before kidney transplantation.The protective effect of Triptolide on the renal function and pathologic injury was studied in this rat model.The levels of donor specific antibodies were measured by flow cytometry.C4d expression and macrophage infiltration were examined by immunohistochemistry and immunofluorescence.Result Triptolide could improve the function of transplanted kidney significantly (P＜0.05) and alleviate the pathologic injury.Triptolide can also reduce the levels of IgM,IgG2b and IgG2c in the serum of the recipient rats and inhibit the macrophage infiltration as well (P＜0.05).Conclusion Triptolide plays protective and therapeutic roles in AMR of kidney transplantation,which may be contributed to the inhibition of the production of donor specific antibody and the macrophage infiltration.

Objective To study the expression of integrin ?v subunit(?v) in hepatocellular carcinoma(HCC )and its effect. Methods With the method of immunohistochemistry, specimens from 43 HCC patients and 6 control patients were studied. The relationship between the ?v expression and pathological features,microvessel density(MVD) was evaluated.Results The difference of the expression of ?v in tumor cells between HCC with satellite lesions and without it was significant(H=9 008, P =0 003).The MVD of HCC with positive and negative expression of ?v in endothelia was 151?54 and 115?39 respectively,difference of which was significant( t =2 503, P =0 016).Conclusions Integrin ?v subunit may play an important role in the angiogenesis, invasiveness and metastasis of hepatocellular carcinoma.

ObjectiveTo investigate the relationship between metabolic abnormalies of thyroid hormone and intestinal barrier disfunction and the potential protective effects of exogenous thyroid hormone in sepsis. MethodsMurine septic model was established through cecal ligation puncture. Triiodothyronine (15??g/kg) was given to the septic rats to correct the low T 3 syndrome. ResultsThere was significant negative correlation between the seral concentration of free T 3 or free T 4 and MDA concentration in the tissues of small intestines. The insulting degree of the intestinal barrier in the treatment group were much milder than that of the sepsis group. ConclusionsThere were significant correlation between the metabolic abnormalies of thyroid hormone and the oxic insults of the intestinal barriers in sepsis. Providing the thyroid hormone for the septic rats could protect the intestinal barriers and improve the prognosis of sepsis.

Objective To investigate prognosis and related factors of infectious pancreatic necrosis(IPN) caused by multidrug-resistant organisms(MDROs).Methods Clinical data of 53 IPN patients admitted to a hospital between October 2010 and March 2016 were analyzed retrospectively,patients were divided into MDRO infection group and common bacterial infection group according to antimicrobial resistance of pathogens isolated from peripancreatic drainge fluid,prognosis and related factors of two groups were compared.Results Among 53 IPN patients with confirmed evidence for pathogenicity,33(62.3％)were in MDRO infection group,and 20(37.7％)were in common bacterial infection group,the most common MDROs isolated from peripancreatic drainage was multidrug-resistant Acinetobacter baumannii (MDRO-AB) (37.5％,18/48).The mortality of IPN patients was 30.2％ (16/53),mortality of MDRO infection group was higher than common bacterial infection group(39.4％ [13/33] vs 15.0％ [3/ 20],P＜0.05);the severity score,length of intensive care unit (ICU) stay,and hospitalization expenses in MDRO infection group were all higher than common bacterial infection group(all P＜0.05).The mortality of IPN patients were closely associated with MDRO infection and severity score of acute pancreatitis (all P ＜ 0.05).Conclusion Prognosis of patients with MDRO infection is poor,treatment is difficult,MDRO infection has become one of the most important challenge to the treatment of severe acute pancreatitis.

Objective To study the effect of age on the recurrence-free survival rate after hepatic resection for hepatocellular carcinoma(HCC)and the relationship between microvessel density (MVD)and recurrence of HCC in the elderly. Methods　Severty one cases of elderly patients with HCC were analyzed retrospectively with 352 cases of non-elderly HCC patients as control,and the effect of age on the recurrence-free survival rate was studied.The expressions of CD34 and endocan in HCC tissues were detected by immunohistochemistry in 30 elderly and 30 non-elderly patients.Results　The 1-,3- and 5-year recurrence free survival rates were 75.7%,43.0% and 43.0% in the elderly group respectively,which were higher than those in the non-elderly group(53.6%,38.5% and 33.4%,respectively,Log Rank value=10.25,P＜0.05).The positive rate of alpha fetoprotein (AFP)in the elderly group was 47.9%,which was lower than that in the non-elderly group(62.2%)(X2=23.68,P＜0.05).The median survival times in the high CD34-MVD group and high endocan MVD group were shorter than those in the low CD34-MVD group and low endocan-MVD group(260 d vs.850 d,360 d vs.800 d,Log Rank value was 22.18 and 20.56 respectively,both P＜0.05).Conclusions　The long-term prognosis of hepatic resection for HCC is better in elderly patients than in non-elderly patients.The recurrence of HCC in the elderly is closely related with angiogenesis.

ObjectiveTo investigate the expression of RhoC gene in primary hepatocellular carcinoma and to evaluate the relationship between RhoC gene expression and invasion and metastasis of primary hepatocellular carcinoma.MethodsThe mRNA expression of RhoC gene was examined by polymerase chain reation after reverse transcription (RT-PCR) in 25 cases of primary hepatocellular carcinoma (HCC) and adjacent non-cancerous tissuse. In addition, the mutation of RhoC gene was examined by polymerase chain reaction-single strand conformational polymorphism(PCR-SSCP)ResultsThe mRNA expression of RhoC in tumor tissue were higher than that in adjacent liver tissue,1.8?1.1 vs. 1.0?0.7( P

Objective To investigate the protective role of Ulinastatin UTI on gut barrier of septic rats. Methods Twenty-two SD rats were divided into three groups: sham laparatomy(S), cecal ligation and punture(CLP), and CLP plus UTI. Septic rat model was estabilished through CLP method. Fluorescence spectrometry was used to measure FITC-dextran concentration from bowel lumen to portal vein. Ultrastructure of intestinal mucosa was observed under transmission eletron microscope (TEM). Results Twenty-one hrs after CLP septic symptoms in CLP plus UTI group were milder than those in CLP group. Portal concentration of FITC-dextran in CLP group was higher than that of S group[S (1.22?0.21) ?g/ml vs. CLP (2.51?0.56) ?g/ml, P

Objective To investigate the expressions of vascular endothelial growth factor (VEGF) , hypoxia inducible factor 1 alpha (HIF 1?) and epidermal growth factor (EGF) in hepatocellular carcinoma (HCC) and their clinical significance. Methods The expressions of VEGF, HIF 1? and EGF in 36 cases of HCC and corresponding paraneoplastic tissues and normal liver tissues (6 cases) were studied by immunohistochemistry assay. ResultsThe expression rate of VEGF, HIF 1? and EGF in HCC tissue was 89%, 67% and 75% respectively, higher than those in paraneoplastic tissues and normal liver tissues ( P