Laparoscopic surgery in hepatobiliary,splenic and pancreatic diseases is being widely used.However,the incidence of postoperative complications is relatively higher due to the complexity of the operative procedures.Surgeons are expected to have familiarity with normal and variant anatomy,as well as a good command of prevention and management of bleeding.Different separation techniques should be used based on the different characteristics of tissues.Moreover,digestive tract reconstruction is the technical bottleneck in laparoscopic hepatobiliary,splenic and pancreatic surgeries,and depending on the team work.Different anastomotic methods should be applied according to patients' condition.Three-dimensional laparoscopy and Da Vinci robot surgical system have greatly promoted the development of complex laparoscopic surgery in hepatobiliary,splenic and pancreatic surgeries.Comprehensive perioperative management and enhanced recovery after surgery are the guarantee of safe and quick postoperative recovery,which also fully embody the advantages of minimally invasive surgery.

Pancreatic cancer is highly malignant with a poor prognosis. The resectability and prognosis of early pancreatic cancer are much better than the advanced, so early diagnosis is crucial for saving patients' lives. Because the symptoms of pancreatic cancer are non-specific, most of the patients are misdiagnosed as gastrointestinal or hepatobiliary diseases. Early diagnosis rate of pancreatic cancer can be greatly improved by combined application of tumor marker detection, endoscopic ultrasound, computed tomography, positron emission tomo-graphy, and etc. Early screening of high-risk population has been advocated by the experts, and its value in early diagnosis of pancreatic cancer has been confirmed by relevant studies. The colaboration of multiple pancreatic surgery centers in conducting prospective studies and setting gnidlines for the pancreatic cancer diagnosis, and relevant fundamental reseaches should also be emphasized.

Objective To investigate the pollution status of main indoors air pollution factor, CO and CO2, in Guangzhou City, and to study the feasibility of using same standards in pollution monitoring. Methods 822 sampling points of various public places were monitored. Public places were classified into 1 group (≤5 mg/m3)?2 group(≤10 mg/m3)?3 group(CO level was not require to monitor)by CO level and were classified into Ⅰgroup(≤0.07%)?Ⅱgroup(≤0.10%)?Ⅲgroup(≤0.15%) by CO2 level. The 822 statistics of various public places were analyzed according to the standard value of hygienic Standard for Public Place. Results The results of the monitoring value of CO and CO2 showed as positive bias distribution. Average of CO was (2.76?1.41)mg/m3, the 95% percentile was 6.2 mg/m3; CO2 average value was (0.060?0.020)%, the 95% percentile was 0.099%. There was no significant difference among CO concentrations in 3 public places classified according to the standard (?2=3.70, P=0.157), but significant difference had been seen among CO2 (?2=35.266, P

Objective To investigate the relationship between the eosinophil (Eos) percentage and levels of eosinophil cationic protein (ECP) in induced sputum and the severity of late onset asthma(LOA) and differential diagnosis. Methods Fifty-four patients with LOA were selected. The percentage of eosinophil and levels of ECP were measured by Wrigbt′s stain and immuno-CAP system respectively. The lung function was also evaluated. The same indexes were measured in 25 elderly patients with chronic obstructive pulmonary disease (COPD) and 10 healthy elderly subjects as control. Results The percentage of Eos and levels of ECP in induced sputum in patients with LOA were significantly and negatively correlated with FEV_1/FVC (r=-0.68,-0.61, respectively, P

Objective To investigate the relationship between the number of eosinophil(Eos)and level of eosinophil cationic protein(ECP)in induced sputum and asthma severity and their value of differential diagnosis.Methods From July 2002 to June 2004,59 asthmatic patients were selected in the People Hospital of Wuhan University.The number of eosinophil and level of ECP were measured by Wrights' stain and Immuno-CAP System.The lung function was also evaluated.The same index was measured in 20 patients with COPD and 10 healthy subjects as control.Results The number of eosinophil in induced sputum in asthmatic patients negatively correlated with FEV_1%(r=-0.65,P

AIM: To investigate the effects of low-dose theophylline on differentiation of the naive T lymphocyte. METHODS: Naive T lymphocytes and monocytes were isolated from cord blood in neonate. Theophylline (10 mg?L-1 ) was added in naive T lymphocytes and monocytes which stimulated by PHA (200 mg?L-1 ) for 3 days, and the differentiation of T cells was analyzed by flow cytometry. Cytokines were measured by enzyme linked immune-sorbent assay ( ELISA ). RESULTS: Theophylline significantly promoted differentiation fromTh1 cells to naive T cells ( P

An inductively coupled plasma mass spectrometry ( ICP-MS) was developed for the direct determination of Be, Na, Mg, Al, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, Zr, Mo, Sr, Cd, Ba, Pd, Ag, Sn, Au and Pb in lithium hexafluorophosphate. The sample was dissolved with absolute ethyl alcohol to analyze the above 26 impurity elements in the solution by ICP-MS. The condensation and deposition of high concentrations of carbon in mass cone interface and ion lens, which will decrease the sensitivity of element analysis, can be avoided effectively by introducing O2 to plasma. The mass spectral interferences of polyatomic ions to analytes were corrected by collision reaction cell (CRC). The matrix matching method was used to corrected matrix effect. Satisfactory linearity of each working curve of 26 impurity elements was obtained. The correlation coefficients being over 0. 9995, the detection limits for the investigated elements were in the range of 0. 6-32 ng / L, the relative standard deviation of each element within 2. 5% -7. 3% , and the recovery of each element at 90. 6% -108. 6% . The method had been applied to the determination of trace elements in lithium hexafluorophosphate with satisfactory results.

Pancreatic adenocarcinoma is a highly malignant tumor and its prognosis is poor. The key factors for cure and prolonged survival are early detection, adequate evaluation of resectability and surgical resection with microscopic tumor clearance. Surgeons should pay attention to standardize operative procedures to increase the R0 resection rate. Whipple specimens should be inked and examined carefully. Postoperative adjuvant radiotherapy and chemotherapy are beneficial in the prevention of local tumor recurrence and distant metastasis. Inter-disciplinary cooperation and multimodality treatment are helpful to improve the prognosis and quality of life of patients with pancreatic cancer.

Objective:To investigate the effects of enteral nutrition support in inoperable advanced gastric cancer patients during chemotherapy.Methods:This was a prospective randomized study.A total of 62 patients with advanced gastric cancer were firsted evaluated according to the Nutritional Risk Screening 2002 (NRS 2002) scale,and were randomly divided into two groups.All patients received oxaliplatin combined with tegefur gimeracil oteraci.Patients in the control group (n =30) received chemotherapy along with nutrition consultation,and patients in the treatment group (n =32) were provided enteral nutrition-additionally.NRS 2002 assessment was conducted before and after chemotherapy,The body weight,BMI,serum albumin,and the efficacy and toxicity were collected during the study.Results:Patients in the treatment group had significantly higher serum albumin levels,body weight and BMI than those of the control group (P ＜ 0.05).No differences were found as for the efficacy and toxicity of chemotherapy between two groups.Conclusion:Enteral nutrition support therapy can improve the nutrition status of gastric cancer patients who received chemotherapy and reduce the risk of malnutrition.

Objective To explore the clinicopathological and immunohistochemical features of wolffian adnexal tumour ( WAT) . Meth-ods The clinical and pathological features analysis and immunohistochemistry methods were utilized to study the histopathology features of a case Wolffian adnexal tumor. Results One case of unilateral WAT which located in broad ligament display a solid-cystic mass with pedicled and enveloped,its histology showed large and small tubulars,screen structure and solid zone. Its immunohistochemistry staining was positive for pan-cytokeratin,vimentin,CK18 and CD99,positive staining for α-inhibin in a little tumor cell,and negative for calretinin,CD10,EMA, ER,PR,Syn,CA15-3,CA19-9,Ki-67 index is less than 5%. PAS positive staining for the basement membrane around Gland like structure. Conclusion Wolffian adnexal tumour is diagnosised by its histopathological,immunohistochemical and it’ s distinctive location where Wolffi-an duct remnants are found.