The intraportal islet transplantation is the most hopeful method for the treatment of type 1 dia-betes mellitus. However about 70% of transplanted islets would be destroyed in the early two weeks after transplantation, only a few parts of them could engraft in liver and become functional. This results in the lower efficiency of islet transplantation. Here we review the reasons of this early islet loss and its preventive strategies.

Objective To investigate the value of combined use of laparoscopic cholecystectomy (LC) and duodenoscopic procedures in the treatment of selective common bile duct stones. Methods We retrospectively analyzed clinical data of 32 cases of selective common bile duct diseases treated with laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography (ERCP) from January 2002 to December 2003. Results Of 24 cases receiving ERCP before LC, 19 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 2 cases normal. These cases underwent ERCP and endoscopic sphincterotomy (EST) following by LC. Of 8 cases receiving ERCP after LC, 4 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 1 case normal. Except for 1 case of conversion to open surgery because of a failed stone removal, all the cases were cured with EST. Conclusions combined use of LC and ERCP is a highly useful approach in the treatment of selective common bile duct stones, which has broadened the utilization of minimally invasive treatment for bile duct diseases.

Objective:To assess the relationship between Insulin-like growth factor-I(IGF-I) and TCM syndrome of acute cerebral infarction by measuring IGF-I levels in patients of acute cerebral infarction.Methods:100 patients of acute cerebral infarction with 48 hours after onset were divided into three groups by TCM syndrome.The IGF-I levels in plasma were measured by saturation analysis of radioimmunoassay.Results:The IGF-I levels in plasma was(10.39?1.56)ng/ml in the group of wind-phlegm syndrome and stasis,(12.96?2.27)ng/ml in the group of wind-phlegm syndrome and exuberance of re,(13.54?3.22)ng/ml in the group of stirring of wind due to de ciency of yin.These values showed statistically signi cant di erence between groups.Conclusion:Acute cerebral infarction occured most frequently in the group of wind-phlegm syndrome and stasis,the IGF-I levels showed signi cant decrease in this group.

Objective To eliminate the interference of CEA-related substances in CEA measurement and increase the specificity of CEA in the detection of malignant digestive diseases.Methods CEA level of peripheral blood and digestive juice(bile,gastric juice) from patients with benign or malignant digestive diseases was measured by ELISA,and semi-dry electrophoretic transfer method of Western blot technique to distinguish CEA and CEA-related substances.Results In malignant diseases,the CEA level of digestive juice was significantly higher than that in the blood,and there was no difference of CEA level in digestive juice and blood in benign diseases.Meanwhile,the CEA level of digestive juice and blood in malignant diseases were significantly higher than that in benign diseases.A specific band(molecular weight about 210?10~3) was detected in all malignant diseases except four cases whose CEA level was too low(less than 5 ?g/L),whereas no one of benign diseases had this specific band no matter how high or low the CEA level was.Conclusion The specificity of CEA detection in malignant digestive diseases can be improved by using digestive juice as sample and combining with Western blot technique.

The hemodynamics of 49 scheduled patients during anesthesia and opration for mitral and aortic valve replacement were studied with the insertion of SwanGanz catheter and by the method of thermodilution technics.Pre-anesthesia CI and LVWI were in the nor mal range with abnormal MPAP, PCWP, PTRI and RVWI.Increase of RAP and decrease in MPA,PCWP, MAP, CI, LVWI and RVWI were observed during induction of anesthesia. The hemodynamic parameters returned to or exceded the pre-anesthesia values after trachcal intubation and sternotomy. The CI, MAP, MPAP, PCWP, LVWI and RVWI decreased signifi- cantly after insertion of aorta and vena cava catheter. The reduction of MPAP, P(IWP,PTRI and RVWI post-cardiopulmonary bypass (CPB) were significant and persistent with no change of PVRI.The lower MAP,SVRI and deterioration of cardiac performance post-CPB indicate that the administeration of positive inotropir agents and restoration of hematocrit are nec essary as early as possible.

The effects of normothermic or hypothermic cardiopulmonary bypass(CPB)on hemodynamics, plasma levels of endothelin(ET)and atrial natriuetic peptide(ANP)were comparatively studied in dogs with Swan-Ganz catheter technique and radioimmunoassay. The results showed the total peripheral resistance(TPR)during hypothermic CPB was significantly higher than that of the normothermic. Plasm ET levels increased significantly during hypothermic CPB but remained stable during normothermic CPB. Plasma ANP levels almost unchanged during either CPB. Plasma ET level was positively correlated to TPR but ANT level was not. The results suggest that the increased ET levels may be one of the causes of higher TPR during hypothermic CPB;the stable ET levels contributes to the maintenance of cardiovascular function during and after normothermic CPB and the ANP amount secreted beyond the heart has little effect on the plasma level and hemodynamics during CPB.

Objective: To evaluate the effects of isoflurane-nitrous oxide on hemodynamics in patients undergoing cardiac valve replacement. Method:Hemodynamics values were measured with Swan-Ganz technique. Thirty-nine patients were divided into two groups according to their cardiac function before surgery. The patients with cardiac function Ⅱ degree were belong to group Ⅰ and those with cardiac function Ⅲ-Ⅳ degree to group Ⅱ. Result:CI,LVWI, RVWI,HR and MAP decreased significantly in both groups after induction of anesthesia without change in SI. During tracheal intubation and sternotomy,CI and LVWI decreased,PTRI and SVRI increased,particularly in group Ⅱ. During aorta and vena cava intubation the changes of hemodynamics were relatively complicated with CI and SI improved in group Ⅱ and further decreased in group Ⅰ. After CPB,MPAP,PAWP,PTRI and SVRI were decreasad in different degree in both groups with significant increased in CI and SI in group Ⅱ. Conclusion:Induction and maintenance anes thesia with 1.0%-1.5% isoflurane and 40%-50% N_2O are suitable in patients with impaired cardiac function.

Objective: To observe the changes of the pulmonary ventilatory function during cardiac valve operation under cardiopulmonary bypass(CPB). Method: Thirty-four patients undergoing cardiac valve operation were selected. The pulmonary function was measured with side stream spirometer. Result: P_(peak) and P_(plat) did not have any significant changes within 60 min after CPB, but increased significantly at the end of surgery and after closure of sternum(P

Objective:To observe the hemodynamic effects of sevoflurane or sevoflurane-N_2O inhalation during induction and maintenance of anesthesia in patients undergoing cardiac valve replacement Method:Forty-four patients were randomly divided into two groups. Group I with 1.0 MAC sevoflurane and groupⅡwith 1.2 MAC sevoflurane-N_2O inhalation. Hemodynamic monitoring was performed with Swan-Ganz catheter technique. Result:The incidence of breath holding, coughing and movement could he hardly observed during the induction. There were no significant changes in HR,PTRI,PVRI and SVRI during the induction,but MAP,CI,LVWI,LVSWI,RVWI and RVSWI decreased significantly (P

Objective To evaluate the effect of local arterial infusion (LAI) of medicine on the treatment of servere acute pancreatitis(SAP). Methods The clinical data of 85 cases of SAP were retrospectively analyzed, and divided into three groups according to the admitted time:Group A. 42 cases admitted from February 1982 to December 1993,treated mainly by operation. Group B. 23 cases, admitted January 1994 to Auguest 1996, treated mainly by non operation. Group C. 20 cases, from September 1996 to Auguest 2000. treated mainly by LAI. Results The secondary infection rate in group A, B and C were 47%(20/42),26%(6/23) and 10%(2/20) respectively. The mortality in group A ,B and C were 36%(15/42),22%(5/23) and 5%(1/20),respectively. The difference in the secondary infection rate and mortality between group A , B and group C showed obvious significance (P