Objective To study the treatment of postoperative pancreatic fistula. Methods The study (retrospectively) reviewed the management of 20 patients with pancreatic fistula. Fifteen patients were treated (conservatively), and 5 patients were treated surgically. Results All of the patients treated conservatively or by (surgery) were cured,and the results were satisfactory. Conclusions The majority of pancreatic fistulas can be cured with conservative management. If the fistula communicates with the main pancreatic duct or fails to heal after 5 months of conservative therapy, operation is necessary.Pancreatic fistulojejunostomy is a simple, safe and effective method.

Objective:To study the expression of P27kipl and mutant P53 protein in thyroid tumors, and to understand the relationship between the biological behavior and prognosis of benign and malignant thyroid tumors. Methods: We used S-P immunohistochemical technique to study the expression of P27kipl and mutant P53 protein in 60 cases of thyroid tumors, including 40 cases of malignant tumors and 20 cases of benign tumors. Categorical data were analyzed by using X2 tests. All reported significance levels were two-tails. The software system used for statistical analysis was SPSS10. 0. Results: In benign and malignant tumors, P27kipl protein positive expression was detected in 18 of 20 benign cases (90. 0%) and 24 of 40 malignant cases (60. 0% ) respectively(P P

Objective To study the influence of ultralow‐frequency transcranial magnetic stimulus(TMS) on the cognitive a‐bility of rats with cerebral ischemia and its mechanism .Methods 60 healthy rats were divided into 4 groups(15 cases each):A (sham‐operation) ,B(model) ,C(TMS) and D(TMS+ H89) .The escape latency time ,times of passing through platform ,expression level of VEGF ,BDNF and nestin protein were compared among 4 groups .Results In the group A ,the escape latency time was (16 .31 ± 2 .33)s ,times passing through platform were (8 .02 ± 1 .76) times ;in group B ,which were (57 .14 ± 2 .89)s and (3 .15 ± 0 .88) times;in group C ,which were (29 .18 ± 1 .95)s and (5 .44 ± 0 .75) times ;in group D ,which were (45 .87 ± 2 .06)s and (4 .16 ± 1 .02) times .Compared with the group A ,the escape latency time in the group B ,C and D was significantly extended ,more‐over that in the group B was longer than that in the group D and C ,the differences were statistically significant (P<0 .05);the times of passing through platform decreased ,which in the group B was less than that in the group D and C ,the differences had sta‐tistical significance(P<0 .05) .The expression levels of VEGF ,BDNF and nestin had statistical differences among various groups (P<0 .05) .Conclusion Low‐frequency TMS can significantly improve the cognitive ability of rats with cerebral ischemia ,its effect is related to the expression of cAMP‐response element binding protein and its following genes(VEGF and BDNF) .

AIM: To investigate the involvement of calcineruin (CaN) signal pathway mediated by angiotension Ⅱ (Ang Ⅱ) in the myocardial remodeling mechanism in patients with congestive heart failure (CHF). METHODS: 39 patients of mitral valve disease with CHF were randomly selected and 30 cases of healthy persons were included as controls. Cardiac function parameters were measured by echocardiography. Concentration of Ang Ⅱ in plasma and myocardial tissues were determined by radioimmunoassay. Immunoprecitipation was used to assay the protein expression and phosphorylation CaN, nuclear factor of activated T cells (NFAT_3),zinc finger transcription factor (GATA_4) in myocardial tissues. The mRNA expression of ?-myosin heavy chain (?-MHC) was measured by RT-PCR. RESULTS: The Ang Ⅱ concentrations in patients with CHF were positively correlated with the parameters of the cardiac dialtion respectively, but negatively correlated with the paremeters of cardiac function. Compared to the control group, protein of CaN and GATA_4, phosphorylation of CaN, and ?-MHC mRNA expression in myocardial tissues in CHF groups were highly expressed and their expression were positively correlated to the levels of CHF, but the phosphorylation of NFAT_3 was negatively correlated with the levels of CHF. CONCLUSION: CaN signal pathway may play important roles in the myocardial remodeling in CHF.

Objective To explore the methods of surgical treatment of patients with tumors in the body and tail of pancreas. Methods We analyzed the clinical data from 45 patients with tumors in the body and tail of pancreas who underwent surgical excision between 1984 and 2002 in our hospital. The 45 cases consisted of malignant tumors(n=33) and benign tumors(n=12). Operations performed included resection of the body and tail of pancreas(17 cases), combined-organ excision (24 cases) and local tumor resection(4 cases ). Results Pathological classification:carcinoma (33 cases), islet cell tumors (8 cases ), cystic adenoma (8 cases), epithelioid fibroma (1 case) and cystic teratoma (1 case). The average diameter-size of excised tumor was determined as follows: carcinoma in the body or tail of pancreas was(8.0?2.6)cm, and that of islet cell tumors was(6.5?2.4)cm. There were no operative deaths, but operation resulted in the following complications: pancreatic fistula (2 cases), subdiaphragmatic abscess (2 cases), pancreatic pseudocyst (1 case ), upper gastrointestinal bleeding(1 case) and infection or poor healing of incisional wound (3 cases). All of the complications were cured with conservative therapy. Conclusions Excision of the body and tail of pancreas is an effective method for the treatment of patients with tumors in the distal half of pancreas.Before operation, it is necessary to be routinely prepared to perform combined organ excision. Regarding the surgical handling of pancreatic stump, we select the use of ligation of main pancreatic duct plus mattress suture, which we believe could effectively prevent pancreatic fistula.

BACKGROUND:The safety and efficacy of simultaneous bilateral total knee replacement or selective unilateral total knee arthroplasty in patients with severe osteoarthritis of the knees are stil controversial. OBJECTIVE:To compare safety and clinical efficacy of patients with osteoarthritis knees after simultaneous bilateral total knee replacement or selective unilateral total knee replacement. METHODS:Total y 60 cases with severe osteoarthritis of the knees (90 knees) undergoing total knee replacement were divided into unilateral total knee replacement group (n=30, 30 knees), and the simultaneous bilateral total knee replacement group (n=30, 60 knees). RESULTS AND CONCLUSION:There was no significant difference in the incidence of other complications such as infection, mortality, pulmonary embolism in patients of both groups (P>0.05). The incidence of cardiovascular complications, postoperative blood loss and blood transfusion were higher in the bilateral knee group than in the unilateral knee group (P<0.05). During fol ow-up at 1 year after replacement, no significant differences in range of motion, muscle strength of quadriceps and hospital for special surgery knee score were detected in patients of both groups (P>0.05). However, Visual Analogue Scale scores were significantly lower in the bilateral knee group than in the unilateral group (P<0.05). These data indicated that the risk of cardiovascular complications was high in patients receiving bilateral total knee replacement. Patients with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty.