ObjectiveTo investigate the risk factors of early postoperative complications after pancreaticoduodenectomy.MethodsThe clinical data of 159 patients undergoing pancreaticoduodenectomy from March 2005 to October 2010 was analyzed retrospectively.The related factors of early postoperative complications were analyzed.ResultsThe incidence rate of early postoperative complications was 30.8％ (49/159).Univariate analysis showed that preoperative fasting blood glucose level,total serum bilirubin level,serum albumin level,high density lipoproteins level and intraoperative bleeding were closely correlated with early postoperative complications in patients undergoing pancreaticoduodenectomy (P ＜ 0.05),but gender,age,preoperative jaundice,history of diabetes mellitus,operation time and whether portal vein reconstruction were no significantly associated with early postoperative complications in patients undergoing pancreaticoduodenectomy (P ＞ 0.05).Multivariate analysis showed that preoperative fasting blood glucose level( ≥6.1 mmol/L),total serum bilirubin level ( ≥ 171 μ mol/L) and serum albumin level( ＜ 35 g/L) were the important independent risk factors of early postoperative complications in patients undergoing pancreaticoduodenectomy.ConclusionThe risk factors of pancreaticoduodenectomy should be fully recognized and dealt with promptly.

Objective To investigate the efficacy of flupentixol and melitracen(Deanxit) in treatment of non-erosive reflux disease(NERD) and non-responding to proton pump inhibitor. Methods Fifty eight NERD pa-tients were randomly divided into two groups, the treatment group (n = 29) and control group (n = 29). Patients in control group were given esomeprazole 40 mg qd. Patients in the treatment group were given the same drug plus Deanxit 1 Tab qd. The clinical effect was evaluated and scored by Hemihon Anxiety Rating Scale (HAMA) after 4 weeks. Results The total efficacy rate of the treatment group was higher than control group (P < 0.01),and HAMA was lower in the treatment group than in control group (P < 0.01). Conclusions Adjuvant treatment of Deanxit combined with esomeprazole is effective to NERD patients who did not respond to proton pump inhibitor, can greatly improve anxious disorders.

Objective To study the mechanism of male infertility. Methods Forty sperms from 8 normal males as control and 60 sperms from 12 males with infertility were observed by SEM.The ultrastructure of acrosomes was analyzed and compared. Results Spermatozoa with obscure ringed rips in infertile group acounted for 66.7%(40/60),serrate 65.0%(39/60);but in control group,the proportions were 10.0 % (4/40) and 5.0%(2/40),respectively.The ratios of acrosome to head in infertile group were ( 70.0 ?8.0)%,greater than controls (57.7?6.4)%.The ratios of acrosome membrane which was not intact were 70.0%(42/60) in infertile group and 22.5%(9/40) in control group.Acrosomes with rough surface were 68.3%(41/60) and 20.0%(8/40) respectively in the 2 groups;Acrosomes with particles adhesive to the surface were 65.0%(39/60) and 27.5%(11/40) respectively. Conclusions Abnormal acrosome structure is one of the causes of male infertility.

Objective To explore a practicable method of serial sections of whole CNS in the rat, in which both neurons and nerve fibers were showed at the same section. Methods After perfused fixation and quick freezing, the tissues of whole CNS were cut into serial sections with cryostat followed by hematoxylin stain. Results The nerve fibers were stained in blue color while the neurons were showed black-blue and the background was light-yellow.Conclusion Our method was feasible to show both neurons and nerve fibers at the same section with quick freezing, freezing serial sectioning and improved hematoxylin staining.

The treatments for ankylosing spondylitis (AS) are still not effective, which partially due to its unclear patho?genesis. Interleukin (IL)-23/IL-17 axis is a significant immunologic pathway which has attracted much attention in the past few years. This article reviewed the role of IL-23/IL-17 axis in genetic and immunological pathogenesis of AS, and intro?duced the recent progresses in treatments of AS using anti-IL-23 or anti-IL-17 antibody. The important role of IL-23/IL-17 axis in the pathogenesis and treatment of AS indicates its potential use as a new therapeutic target.

Objective To study the metabolic characteristics of temporal lobe injury during the radiotherapy in the elderly with nasopharyngeal carcinoma through 1H- magnetic resonance spectroscopy (MRS). Methods The 15 aged and 23 young cases among 80 cases with nasopharyngeal carcinoma confirmed clinically and receiving radiotherapy for the first time were involved in the same period of July 2006 to May 2009. Conventional MRI scanning and bilateral temporal MRS were performed before and during radiotherapy at radiation dosages of 20 Gy, 40 Gy, and 60 Gy respectively. The spectroscopy morphology and the ratios of the three main metabolites were compared and analyzed. Results The values of N-acetylasparate (NAA)/creatine (Cr) was lower and choline-containing compound (Cho)/Cr ratio was higher in aged group than in young group before radiotherapy (P＞0.05). The spectroscopy morphology stepped down, NAA, Cho, NAA/Cr, Cho/Cr and NAA/Cho decreased to some extent along with the adding of radiation dosages in the course of radiotherapy. At the end of radiotherapy, the decreased amplitude of NAA/Cr value was larger in aged group than in control group (P＜0.01), and the amplitude of Cho/Cr value was lower than other group. Conclusions The neurons of aged patients with nasopharyngeal carcinoma have a weak tolerance to the radiation, brain injury occurs earlier and heavier in aged patients than in young patients. It is necessary to prevent neuron injury early.

Objective To study the iatrogenic risk factors of post-ERCP pancreatitis (PEP).Method A meta-analysis was carried out on 15 clinical studies which included more than 100 patients published in the medical literature in the last twenty years.Result When the risk factors were analysed,OR for endoscopic sphincterotomy (EST) was 3.75 (95％CI 3.01-4.68),OR for papillae precut was 2.17 (95％CI 1.76-2.67),OR for biliary sphincter balloon dilation was 1.66 (95％CI 1.16-2.39),OR for pancreatic contrast injection was 2.79 (2.31-3.37),OR for sphincter of Oddi manome try was 5.86 (95％CI 5.04-6.80),OR for pancreatic stenting was 2.57 (95％CI 2.09-3.17).Conclusion The analysis indicated EST,papillae precut,balloon dilation,pancreatic contrast injection,Oddi manometry,non-prophylactic pancreatic duct stenting were the risk factors of post-ERCP pancreatitis.

OBJECTIVE To discuss the common problems and their management in the endoscopic nasal dacryocystorhinostomy(DCR) for recurrent dacryocystitis.METHODS A total of 44 patients with recurrent dacryocystitis were performed in our hospital from July,2003 to July,2008.The clinical data of all the cases were studied.All the cases were followed up for over 6 months.RESULTS The common problems met in the operation according to the occurrence frequency were bleeding,difficult for localizing the lacrimal sac,the size and the location of the bony ostium,the size of lacrimal ostium and sinonasal diseases.The cure rate was 93.18%(41/44). CONCLUSION Special instruments,skillful handling and familiar with intranasal anatomy of the lacrimal sac area are the keys to improve the successful rate of endoscopic nasal dacryocystorhinostomy.

Objective To evaluate the value of high-frequency ultrasound for diagnosing Duchenne muscular dystrophy.Methods Eighty-one cases with Duchenne muscualr dystrophy were divided into four groups according to their age,age 3-7(13 cases),age 7-10 (30 cases), age 10-13 (30 cases),age 13-14 (8 cases). Twenty cases of healthy children, aged from 1 to 11 were chosed as controls. In all groups' buttock muscle,thigh and leg muscle were observed by high-frequency ultrasound longitudinally and horizontally.Results Gluteus atrophy and subcutaneous fat thickening were seen in age 3 patients,progressive subcutaneous fat thickening and progressive muscular atrophy of buttock,thigh and leg with age were proved.There were significantly differences among groups ( P

Objective To introduce the clinical application and method of endoscopic harvesting the sural nerve in the carbon dioxide gas cavity. Methods 7 cases with peripheral nerve defect were involved, including 5 men and 2 women. The length of nerve defects ranged from 5 to 8 cm, all the nerve defects were repaired by autogenous sural nerve grafting. The sural nerve were removed from 9 calves in 7 cases. Along the course of the sural nerve in the proximal calf, a transverse 1.0 to 1.5 cm incision was done for endoscope approach, another transverse 0.5 to 1.0 cm incision was done lateral to the sural nerve for operation approach. Using abdominoscope system, the sural nerves were cut and removed smoothly in the cavities which were maintained the gas pressure 10 to 15 mm Hg with carbon dioxide insufflation. All the peripheral nerve defects of 7 cases were repaired as cable graft with harvested sural nerve. Results The length of nerve graft harvested from 30 to 42 cm in 9 calves. It took about 30 minutes to harvest the nerve in each side. There was no abvious injuries found by pathologic inspection. No carbonemia and air embolism occurred on patients during operating time, no complications of hypodermic pneumatosis and hematoma occurred on all cases. All patients followed up from 6 to 10 months, the function recovery of the nerves was good. The muscle power was obtained 2 to 4 grade, the sensation was obtained S3 to S4 grade. The function recovered as fast as the traditional operation of sural nerve transfer. Conclusion The method of endoscopic harvesting the sural nerve in the carbon dioxide gas cavity with minimal incision is easy to perform. Compared with the long longitudinal incision and multiple stair-step incision, the method can get less invasive and traumatic, and good aesthetic results. This technique deserves the doctor application in clinical work.