Objective To investigate the clinical relevance of hepatic artery variation during the procedure of duodenopancreatectomy. Methods Data of 100 patients who underwent duodenopancreatectomy were retrospectively reviewed, and the anatomy of hepatic artery variation was evaluated, then the types of variation and specific intra-operative managements were recorded. Results Through pre-operative celiac artery and superior mesenteric artery DSA and duodenohepatic ligament skeletonization during operation, 16 cases were found to have hepatic artery variation, and 14 (14%) patients had alternative hepatic artery, among them there were 10 cases of alternative right hepatic artery (10%) , 8 cases originated from superior mesenteric artery, 2 cases originated from gastroduodenal artery. 4(4%) patients had alternative left hepatic artery, 3 of them originated from left gastric artery, 1 originated from right hepatic artery. The diameter of variant artery was 0.3 -0.6 cm with a mean of 0. 47 cm. All the variant arteries were reserved in operation. 1 patient had a variant hepatic artery located in the posterior of hepatoduodenal ligament parallel with portal vein, and the diameter of this variant artery was 0. 4 cm, the variant artery was reserved. 1 patient had a variant hepatic artery towards right hepatic lobe which originated from the direction of pancreatic head, and the diameter of this variant artery was 0.2 cm, the artery was dissected 1 h after artery occlusion. Conclusions Whether variant blood vessel need to be reserved shall be judged according to blood vessel diameter, the changes of liver in the course of variant artery occlusion and suggestions from blood vessel surgeon.

Objective To investigate the feasibility and safety of spleen-preserving distal pancreatetomy outside abdominal cavity. Methods We used the method of spleen-preserving distal pancreatetomy outside abdominal cavity for 6 patients of benign diseases of distal pancreas who were admitted in Gulou Hospital from December 2005 to December 2008. Results All patients underwent the operation successfully. The mean operation time was 180 minutes, the blood loss was 100～300 ml with a mean of 200ml. No patients needed blood transfusion. The mean post-operative hospital stay time was (14±5 ) days. One patient developed pancreatic fistula and was cured with non-operative management, there was no other complications. All patients were followed up from 3 to 24 months, and the results were excellent. Conclusions Spleen-preserving distal pancreatetomy outside abdominal cavity is safe and feasible, which may avoid the unnecessary splenectomy.

Objective To evaluate the significance of intraoperative laparoscopic ultrasonography (IOUS) during hepatobiliary surgery. Methods Sixty-eight cases of hepatobiliary lithiasis (liver disease 23 and cholecystopathy with difficulty in management by preoperative estimation, 45 ) were examined by intraoperative laparoscopic ultrasonography. Results Two CBD stones and one Mirrizi syndrome were found in IOUS. The laparoscopic procedures were successful fulfilled in 68 cases under the guidance of sonography including fenestration on liver cyst, incision and drainage on liver abscess, resection and biopsy on space occupied liver lesion with unknown cause, resection of solitary space occupied mass in liver, destruction of unre-sectable liver cancer by microwave and injection of absolute alcohol and chemotherapy through portal vein catheterization, cholecystectomy in acute cholecystitis, chronic cholecystitis with chiledolithiasis, and broad pedicle polyps in gallbladder etc. Conclusion IOUS has the advantages of non-invasive, fast, repeatable, high accuracy and has important clinical significance in laparoscopic diagnosis and treatment.

Congenital Abnormalities ; Encephalocele ; Humans ; Nose Diseases ; congenital

Adrenal Cortex Hormones ; therapeutic use ; Adrenergic beta-Agonists ; therapeutic use ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; drug therapy ; Humans ; Medication Adherence

Objective To study the relationship of the collection efficiency and physical parameters,such as the height of exhaust hood,baffle,ventilation conditions of these parameters on the effect of control.Methods The computational fluid dynamics software FLUENT was used to form the model,and to maximize production in line with the actual operating conditions for physics experiments,to take air numerical simulation and physical model of re-testing the method of combining.Results Without the lagging conditions,the air flow system should be chosen 1 320 m~3/h,with the lagging conditions,the air flow system should be chosen 1 078 m~3/h.The system in a certain air volume,lower installation height could increase the average wind speed of breathing zone.At a certain suction cover installation height and air flow,the baffle could improve the collection efficiency.Without the baffle,the collection efficiency and control distance(dimensionless)showed a relation of cubic polynomial.Conclusion The physical parameters of suction on the hood may impact the collection efficiency at breathing zone measuring point.

Objective To explore the expressions of hypoxia-inducible factor-1 alpha (HIF- lα)and nestin in the hippocampus of developing rats after pentylenetetrazol (PTZ)-induced starus epilepticus (SE),and the correlation between HIF-1α level and proliferation of neural stem cells (NSCs). Methods A total of 768 SD rats,including rats of postnatal 7 days (P7,n-192),rats of postnatal 14 days (P14,n=192),rats of postnatal 21 days (P21,n=192) and rats of postnatal 28 days (P28,n=192),were equally randomized into vehicle group (n=96) and control group (n-96),respectively; SE rat models of the vehicle group were induced by intraperitoneal injection of 1％ PTZ (80 mg/kg); and rats of the control group were received injection of normal saline (NS); 6 and 12 h,and 1,2,3 and 7 d after the inducement,the mRNA and protein expressions of HIF-1α in the hippocampus of rats in these 8 groups were examined by RT-PCR and immunohistochemistry, respectively. Another 48 21-d- old SD rats were equally randomized into vehicle I group (n=24) and intervention group (n=24); and rats in the intervention group received injection of HIF-lα antisense oligodeoxynucleotides (ASODN) into the right hippocampus and NS into the left hippocampus; 6 h after the injection,these 48 rats were induced into SE models by intraperitoneal injection of 1％ PTZ (80 mg/kg); 2 d after the inducement, the mRNA expression of HIF-1α in the hippocampus was examined by RT-PCR; and 7 and 14 d after theinducement, the protein expressions of HIF-1α and nestin in the hippocampus were examined by immunohistochemistry. Results The mRNA expression of HIF-1 α in the hippocampus of all the rats in the vehicle group after SE increased significantly with similar trend.Six h after SE,the HIF-1α mRNA expression significantly decreased with time prolongation (P＜0.05). Major HIF-1α positive cells were located in different areas at different time after SE. In intervention experiment, the HIF-1α mRNA expression 2 d after SE and the number ofnestin positive cells 7 and 14 d after SE in the vehicle I group and the left hippocampus of intervention group(being intervented with ASODN) obviously decreased as compared with those in the right hippocampus (being intervented with NS,P＜0.05). Conclusion The mRNA and protein expressions of HIF-1α in the hippocampus of developing rats are enhanced after SE with a correlation of age-in-days; correlativity between HIF-1α and proliferation of NSCs might exist after SE.

Objective:To evaluate the role of using the double body position CT(DBP-CT)in the staging of advanced gastric cancer.Methods:We performed CT examination in 85 patients with advanced gastric cancer which were divided into the double postion group(55 cases)and the single position group(30 cases),after oral intake water agent.The preoperative CT findings of each group was compared with surgical findings respectively and the accuracy in the CT staging of advanced gastric cancer of each group was estimated.Results:The accuracy in the preoperative CT staging of double position group was 89.09%,and in single postition group was 60%.There was a significant difference(P＜0.05).Conclusion:Our findings show that the DBP-CT is surperior to the single position group in finding lesion,confineing the range of the tumour,and determing the degree of adjacent invasion.It can improve the diagnostic accuracy in the preoperative staging of advanced gastric cancers significantly.

OBJECTIVE:To evaluate the economic effectiveness of different pharmacotherapeutic schemes for peptic ulcer and chronic gastritis with infection of Helicobacteria pylori(Hp) METHODS:To perform cost-effectiveness analysis of three ther_apeutic schemes for Hp infection RESULTS:The cost-effectiveness ratios of three therapeutic schemes were 8 71,10 12 and 13 99 CONCLUSION:Scheme A(omeprazole+amoxicillin+clarithomycin) is the best one