ObjectiveTo evaluate the effect of health education to women of childbearing age on knowledge of birthdefents.MethodsRandomly selected 200 case of maternal pre-pregnancy check-up in the hospital outpatient department were divided into two groups,The observation group of 100 cases,100 cases of the control group.the control group received rule progestation knowledge education,the observation group enforce health education intervention,apply the way of questionnaire survey,and the results were statistically analyzed.ResultsThe observation group answer correct rate is obviously higher than the control group ( all P ＜ 0.05 ).ConclusionTaking a variety of measures of health education for pregnant women during the physical examination for effective interventions,could significantly improve the population birth defects knowledge rate had positive significance to the prevention of birth defects.

OBJECTIVEThe study investigated the epidemiology of Filifactor alocis (F. alocis) in subgingival plaque samples from subjects with different periodontal statuses. The relationship between the prevalence of F. alocis and clinical periodontal parameters was also analyzed.

METHODSSubgingival plaque samples and periodontal data were collected from 68 healthy sites (H groups) in 17 healthy subjects, 64 healthy (G-H group) and 76 diseased sites (G-D group) in 19 patients with chronic gingivitis, and 36 healthy (P-H group) and 56 diseased sites (P-D group) in 14 patients with chronic periodontitis. The plaque samples were analyzed by polymerase chain reaction, and possible correlations between the F. alocis detection rate and the bleeding index, probing depth, or clinical attachment level were determined.

RESULTSThe detection levels of F. alocis increased in both healthy and diseased groups. The lowest level at 30.88% (21/68) was noted in the H group, whereas the highest level at 91.07% (51/56) was obtained from the P-D group. A significant correlation was found between the F. alocis detection levels and periodontal disease condition (P < 0.000 1). Further analyses showed that a significant correlation also existed between the detection level of F. alocis and the abnormal clinical periodontal parameters, namely, bleeding index, probing depth, and clinical attachment loss. The odds ratios were 5.26, 8.85, and 11.65, respectively.

CONCLUSIONF. alocis was found at increased-levels in subjects with periodontal disease. The presence of F. alocis increases the risk of sites with abnormal clinical periodontal parameters.

Objective To evaluate the preoperative diagnosis and treatment of primary duodenal adenocarcinoma ( PDA). Methods Clinical data of 89 PDA cases undergoing laparotomy from 1985 to 2009 in three hospital in Beijing and Zhengzhou were analyzed retrospectively. Results The prevalence rate of PDA is comparatively low and its clinical manifestations are not specific. The correct diagnostic rate of auxiliary examination were 93% by endoscopy,90% by gastrointestinal X-ray air barium double radiography,82% by MRCP,42% by BUS,70% by CT/MRI. The most common location of the adenocarcinoma(65% ) was at the second portion of the duodenum. Among 67 PDA cases 48 cases underwent pancreatoduodenectomy, 19 cases received segmental deodenectomy. The 5 year's survival rate was 47% and 50% respectively. Conclusions Endoscope and X-ray radiography are mainstays for the diagnosis of PDA. Early diagnosis and radical operation are the key to improve the resection rate and the long term survival.

Objective To evaluate the treatment experience on primary retroperitoneal neoplasms involving large blood vessels.Methods In this study 82 patients with primary retropetropeal neoplasms were treated surgically from 1990 to 2010 and the clinical data of these patients including preoperative radiological examinations and surgery were retrospectively analyzed.Result The sensitivity and specificity of preoperative imaging examination for identifing large blood vessel involvement was 70％ and 73％respectively.Compared with those of no large blood vessel involvement,patients with large blood vessels involvement had a lower rate of tumor complete removal,more intraoperative blood loss and longer operation time( P ＜ 0.05).In group of large vascular involvement,patients undergoing complete tumor resection were all alive after 12 months,and none of those undergoing palliative resection survived more than 9 months.Conclusions Preoperative imaging allows precise evaluation on the status of large blood vessel involvement in patients of retroperitoneal tumors.Involving large vessels often predicts inability in total resection of retroperitoneal tumors.

The animal models of hypoxic-ischemic brain injury have been established inmany animals, such as monkeys, dogs, rats, mice, rabbits, and pigs. These models have provideda great deal of important information for neonatal hypoxic-ischemic brain injury. Howerver, thedifferent species vary in their susceptibility to the various types of ischemic insults. This articlereviews the animal models of hypoxic-ischemic brain injury in different species.

Objective To summary the experience of living donor liver transplantation (LDLT) in order to improve therapeutic effect of LDLT. Methods We retrospectively analyzed the clinical data of donors and recipients of 22 LDLT cases, evaluating patients' and donors' preoperative assessment, surgical strategies and postoperative complications. Results Donor's grafts harvested included 2 left lateral lobes, 6 left half livers, 1 extended left half liver, 5 right half livers and 8 extended right half livers. Postoperatively all donors recovered without severe post-transplantation complications. Among 13 adult and 9 child receipients, there were 8 recipients suffering from posttransplantation complications, including intra-abdominal severe infection in one case, delayed liver function recovery complicating incisional infection in one case, intra-abdominal hemorrage complicating thrombogenesis of the hepatic artery in one case. All these 3 patients died. One child recipient of hepatic failure died of heart and respiratory failure after operation. Other non-lethal complications were bile leakage in 2 cases, refractory ascites in one and deep venous thrombosis of the lower limb in one. These complications were cured without laparotomy. Finally 18 recipients were fully recovered and discharged. Late post-operative complications included strictures of biliary tract in 3 cases which were treated with PTCD and indwelling stent, the obstructive jaundice due to achalasia of sphincter of Oddi was treated with endoscopic sphincterotomy. These 4 patients' are on stable condition and the liver function is normal. Conclusions Select proper donor and optimal surgical strategy are extremely helpful to secure donors and recipients during the procedure of LDLT.

Objective To evaluate the application of helix hydro-jet in laparoscopic hepatectomy (LH).Methods Clinical data of 18 patients who underwent laparoscopic hepatectomy by helix hydro-jet were analyzed retrospectively.Results There were 18 cases including 9 cases of hepatic cavernous hemangioma,5 cases of primary hepatocellular carcinoma,2 cases of hepatic focal nodular hyperplasia,1 case of hepatic metastasis from colon carcinoma and 1 case of biliary cystadenoma in left liver.In 17 out of 18 patients laparoscopic hepatectomy was successfully completed by using helix hydro-jet.Only 1 patient was converted to open hepatectomy during operation due to uncontrollable hemorrhage from the branch of left hepatic vein.Partial hepatectomy was performed in 14 cases and hepatic left lateral hepatectomy was performed in 3 cases.Average intraoperative blood loss was 230 ml and average operation time was 170 minutes.No postoperative hemorrhage and hepatic function failure was observed.Postoperative bile leakage was observed in 1 patient,which was cured by drainage.Asymptomatic pleural effusions was found in 2 patients,necessitating no special intervention.The average hospital stay after the surgery was 5.6 days.5 patients with hepatocellular carcinoma were followed up for an average of 17 months and the patient converted to open hepatectomy suffered from tumor recurrence 13 month postoperatively.No implantation metastasis was observed on the trocar sites.Conclusions Laparoscopic hepatectomy by helix hydro-jet device can provide excellent visualization of vessels and bile ducts,which can assure the safe margin of hepatic neoplasm.No severe complications were observed.Laparoscopic hepatectomy by helix hydro-jet is a safe and feasible technique.

Objective To discuss the clinical presentation and management of pancreatic arteriovenous malformation.Methods The data pool for the analysis was collected from pancreatic arteriovenous malformation cases encountered by our hospital and sporadic case reports in the literature.Results A total of 95 cases were collected,including 83 males (87.37％) and 12 females (12.63％).The most common presenting symptom was epigastric pain (45.26％),followed by melena (17.89％),epigastric pain accompanied melena (14.74％) and haematemesis (8.42％).The most commonly associated complications were gastrointestinal bleeding (48.42％),pancreatitis (23.16％),duodenal ulcer (16.84％),portal hypertension (11.58％),pseudocyst (4.21％) and hemobilia (3.16％).Most cases were of singular lesion,located in the pancreatic head (61.05 ％) in 58 cases and in the pancreatic body-tail (20％) in 19 cases.Surgery (51.58％) was the most common treatment for pancreatic arteriovenous malformation cases,followed by transarterial embolization (17.89％),a combination of surgery and transarterial embolization (7.37％) and radiotherapy (4.21％).Watchful conservation was adopted in 20％ cases.Conclusions Pancreatic arteriovenous malformation occurs most commonly in males.Epigastric pain and gastrointestinal bleeding are the main clinical presentations.Surgical resection is indicated in symptomatic patients.

Objective To explore the efficacy and side effect of inductive chemotherapy with lowdose,cytarabine,homoharringtonine and granulocyte colony-stimulating factor(CHG) in elderly acute myeloid leukemia(AML). Methods Thirty-five elderly patients (age＞60 years) with AML were enrolled for the initial treatment with CHG regimen,The CHG regimen consisted of cytarabine 10 mg/m2 per 12 h by subcutaneous injection,days 1-14,homoharringtonine 1 mg/m2 per day by intravenous continuous infusion,days 1-14,and G-CSF 200 μg/m2 per day by subcutaneous injection 12 h before chemotherapy,days 0-14. G-CSF only was used when white blood cell count(WBC) was less than 20×109/L during the whole course. Results After the first course,12 patients achieved complete response (CR),15 patients achieved partial response(PR),and 8 patients had no response(NR). After the second course,5 of 15 PR patients achieved CR,2 of 8 NR patients achieved PR. The total effective rate was 82 % (29/35). Of those 17 CR patients,eleven patients continued maintenance therapy and remained in remission for 12-34 months with a median CR duration of 18 months,the other 6 patients relapsed and were treated with original regimen,including one achieved CR again,4 achieved PR,and 1 achieved NR. The CHG regimen had mild hematologic toxicities and no severe nonhematologic toxicities. Conclusion CHG regimen is effective and well tolerated in remission for elderly AML.

Objective To investigate the differential diagnosis and management of IgG4 associated biliary pancreatic diseases.Methods A total of 18 patients with jaundice and abdominal pain were retrospectively studied.The final diagnosis was 7 cases of type Ⅰ autoimmune pancreatitis (Ⅰ-ALP),4 cases of IgG4-associated sclerosing cholangitis (IgG4-SC),and 7 cases of I-AIP combined IgG4-SC.Results (1)Imaging features:I-AIP patients showed pancreatic head mass,with relatively poor blood supply when under dynamic contrast-enhanced scan,in delay image,enhanced amplitude more than the normal pancreas.IgG4-SC can be seen in patients with symmetrical bile duct wall stenosis and (or) soft tissue mass,the thickened bile duct wall and intraluminal soft tissue mass can be enhanced with bile duct wall thickening.(2) Serological characteristics:Serum IgG4 fluctuated between 59.3 and 1 120.0 mg/dl,CA19-9 fluctuated between 12.2 and 230.8 U/ml.(3) Histopathology:Plasma cells lymphocyte infiltration and fibrosis,immunohistochemical staining showed IgG4 positive cells ＞ 10/hpf,and obliterative phlebitis.(4) Combined with other organ lesions in 6 cases including renal injury,retroperitoneal fibrosis,mesenteric inflammatory nodules,omental inflammatory nodules,submandibular gland enlargementin,and pituitary inflammation.(5)Response to hormone therapy:4 out of 6 operated patients were none resected and we re given hormonotherapy.In twelve non-surgical patients,2 cases abandoned therapy,10 cases were treated with hormone therapy,and improved.Conclusion IgG4 associated biliary pancreatic disease characterized by localized pancreatic or bile duct disease,can be distinguished from malignancy by special imaging,IgG4 elevation,histopathology and positive response to experimental hormonotherapy.