Iatrogenic injury in choledocho-pancreatico-duodenal junction is usually difficult to discover in the course of operation because of its unique anatomical position. The injury can lead to postoperative chilis, fever, pain and swelling of the waist, which would easily be misdiagnosed as acute necrotizing pancreatitis. Controlling operations, such as bile and pancreatic juice separation, duodenal diverticularization, jejunal fistulation for enteral nutrition and abdominal drainage should be performed in dealing with the injury in choledocho-pancreatico-duodenal junction. Combined application of pyloric suture with absorbable thread and ligatian, gastric fistulation, ligation of the distal common bile duct and T-tube drainage is minimally invasive, and can fulfill a fully separation of bile and pancreatic juice and duodenal diverticularization. It will improve the possibility of secondary radical operation by ameliorating pyemia and general nutritional condition.

Objective To study the correlation of dominance eye and dominance hand in juvenile myopia.Methods Three hundred and twenty-seven clinical myopia eases were collected and tested the dominance eye by the simplified hole-in-the-bend method.The dominance hand was determined by medical history of every ease.The correlation between the dominance eye and the dominance hand was analyzed with the Pearson test of SPSS 15.0 software.Results The rate of right dominance eye was 64.5% in all 327 eases,and the left was 33.5%.Three hundred and nineteen in 327 eases were right dominance hand,and the other 8 cases were left dominance hand.There were 211 eases with both dominance eye and dominance hand at right side.The index of Pearson correlation between dominance eye and dominance hand was 0.214,P＜0.05.Conclusions Both dominance eye and dominance hand are at the same side in most cases.The correlation of dominance eye and dominance hand in juvenile myopia is significant.

Objective To explore the etiology,pathogenesis,diagnosis and treatment of functional evacuation disorder in gastric stump after subtotal gastrectomy. Methods 15 cases with functional evacuation disorder after sub-total gastrectomy were analyzed retrospectively. Results All 15 cases were recovered by conservational therapy. Con-dusion Functional delayed gastric emptying after subtotal gastrectomy is a functional disease and can be healed with comprehensive conservation therapy at all.

S100A7 protein has a variety of functions,concerning with multiple basic biological processes of cells such as proliferation,differentiation,apoptosis,signal transduction,lipid metabolism,adherence and migration.It is expressed mainly in the inflammatory diseases and tumors,and strongly correlated with metastasis of some tumors.

Antibody drug is a new kind of new anticancer drug with distinct superiorities in tumor thera-py developed in recent years.Antibody drugs can effectively kill the tumor cells with goodselectivity,and have good efficacy,lower toxicity and a specificity of distribution in vivo.They can specifically bind to tumor-associated target moleculars.Besides,the antibody drugs can effectively kill the tumor cells with drug-resistane.

Objective To explore the change of the serum leptin and tumor necrosis factor-α levels in children with obstructive sleep apnea-hypopnea syndrome and their relationship.Methods The level of serum leptin and TNF-α were determined in 68 children with obstructive sleep apnea-hypopnea syndrome and 30 healthy children by radio-immunity assay,and the results from patients treated with continuous positive airway pressure(CPAP)for six months were compared.The correlation between leptin and the levels of tumor necrosis factor-α,and apnea hypopnea index(AHI)or the minimum saturation of bloed oxygen were analyzed.Results The level of leptin and tumor necrosis factor-α in OSAHS patients were hisher than those in control(P＜0.05).The levels of leptin and tumor necrosis factor-αwere positive correlated with the AHI(r=0.451,r=0.460,P＜0.05)and negative correlated with the minimum saturation of blood oxygen(r=-0.489.r=-0.478,P＜0.05).The levels of leptin and tumor necrosis factor-α were decreased after treatment.Conclusion The levels of leptin and tumor necrosis factor-α are increased in OSAHS children.The increase of leptin and tumor necrosis factor-α is correlated with hypoxemia,and the levels of leptin and tumor necrosis factor-α can be improved by CPAP in OSAHS children.

Objective To study the clinical characteristics in elderly patients with colorectal carcinoma.Methods The clinical dafa of 76 cases of more than 70 years old with colorectal carcinoma were analyzed retrospectively. Results Among 76 elderly patients with colorectal carcinoma,64 cases( 84.2% ) suffered from common diseases in the elderly, such as hypertension, cardiac disease, diabetes ,lung of chronic disease et al. 27 patients had postoperative complications, and 3cases of them died from complications. The rate of postoperative complications in the elderly who had coexistent diseases was 39.1%. Conclusion The elderly patients with colorectal carcinoma frequently had blood hypertension. cardiac disease, diabetes. Strengthening the management of perioperation could improve the security of the operation and decrease the postoperative complications.

Objective To study the dinical value of serum soluble E-selectin(sE-selectin)and serum soluble P-selectin(sp-selectin)in patients with esophageal squamous cell carcinoma. MethodsThe sP-selectin and sP-selectin of the serum was measured by ELISA in 27 patients with viral encephalitis and 35 normal persons. ResultsIn patients with organ metastasissE-selectin and sP-selectin levels were significantly higher than normal(P＜0.01),In patients with organ metastasis,sE-selectin and sP-selectin levels increased more pronounced.No visceral metastasis in patients with esophageal cancer,postoperative serum sE-selectin and sP-selectin levels significantly decreased compared with the preoperative(P＜0.01),there are organ metastasis in patients with esophageal cancer sE-selectin and sP-selectin levels decreased not obvious. ConclusionsE-selectin and sP-selectin could be used as a new tumor detection of esophageal cancer targets,and has close relatimship with the incidence of esophageal cancer,development and metastasis.

Replacement therapy of stem cells transplantation represents a potential treatment for neural retinal diseases.Despite the encouraging results in laboratory,the clinical application of cells replacement therapy is still difficult because the limitation of seed cells,immunologic rejection,oncogenicity and ethical problems,etc.Recent breakthrough in somatic reprogramming provides a promising solution overcoming these obstacles.Further researches on virus-free reprogramming will make the clinical application of stem cell replacement therapy possible.

BACKGROUND: Cathepsin E, an intracellular asparUc proteinase of pepsin family, Is composed of 2 homologous domains, each containing a consensus DTG motif, in which the role of aspartic acid (Asp98) is still unknown. OBJECTIVE: To determine the role of Asp98 in the catalysis of Cathepsin E. DESIGN, TIME AND SETTING: An observation experiment was performed in the Guangdong Pharmacological College between November 2007 and December 2008.MATERIALS: Rat Cathepsin E antibody was prepared according to the references, and the purified with affinity chromatography. PcDNA3.0 was offered from Guangzhou Ganewindows Biotech Ltd. Human embryo kidney 293 cell strain was offered from Stem Cell Bank,Chinese Academy of Sciences.METHODS: The cDNA containing full-length rat Cathepsln E was inserted into pBluescdpt IISK plasmid between Smal and Xhol. Asp98 was replaced with an acidic amino acid termed glutamic acid to produce a D98E mutant by Kunkel gene site-directad mutagenesis and expressed in human embryo renal cells.MAIN OUTCOME MEASURES: Expression of wild type and mutant protein was determined, the wild type and mutant Cathepsin E was purified, the enzyme activity, folding and self-precessing were analyzed. RESULTS: Hetaroganous expression of wild type and mutant rat Cathepsin E were found in human embryo kidney 293 cells, and both were expressed in the cell culture media and cell lysate. Mutant D98E was still able to auto-activate into mature enzyme, although its activity was only 13% of that of wild type. The Km value of mutant was similar to that of wild type, but its K<,cat> value was significantly smaller than that of wild type. Both mutant and wild type were inhibited by pepstatin and Ascaris pepsin inhibitor with similar Ki values. The CD spectra of mutant and wild type were similar.CONCLUSION: The Asp98 plays an important role in catalysis, and it can be partly replaced by glutamic acid. Mutant D98E has a lowered activity since the mutation affects the catalytic efficiency.