Objective To evaluate the efficacy and clinical application value of endoscopic transpapillary cyst drainage(ETCD)on huge pancreatic pseudocysts(HPP)and pancreatic abscess.Methods According to unification standard from 2003 Jun to 2006 Jun,to select 10 disquisitive cases,in which patients with uninfected HPP were 8 cases and that with infected HPP was 1 case,and pancreatic abscess was 1 case.ETCD was adopted in all cases.The clinical treatment process and the change of relative investigation subjects were retrospectively studied.Results Endoscopic transpapillary treatment failed in 1 case,postoperative infection of HPP occurred in 2 cases and acute pancreatitis was found in 1 case.Mean follow-up was 16.5 months in 8 cases.Finally,four patients had complete resolution of HPP,3 cases had partial resolution,and the remains cavity of HPP was formed in 1 caes.Acute grave pancreatitis were cured in 2 cases and Chronic pancreatitis had resolution in 6 cases.Conclusion ETCD was safe and efficient in HPP and pancreatic abscess.Postoperative infection of HPP was the familiar complication,and obstruction of drainage path of HPP was major cause.So the crux of complications precaution and treatment was that the drainage path of HPP was unhindered.

Objective To evaluate the clinical curative effects of pancreatic stents on chronic pancreatitis.Methods 18 cases of chronic pancreatitis were diagnosed by clinical symptoms,by lab tests and by relative examinations.All cases had received pancreatic stents endoscopic treatment,and were followed up postoperatively about the change of the clinical symptoms and the lab tests.Results All cases were placed successfully pancreatic stents.Abdominal pain relieved completely within one month.The remissive rate of abdominal pain was a hundred percent.The clinical symptoms such as marasmus and fatty diarrhea were markedly improved.The serum amylase level recovered to the normal range within 1 to 14 days,except one case in which the serum amylase level recovered slowly for the dysfunction of pancreatic external secretion.The stent was replaced in 1 case after 10 days because of obstruction.Conclusion Pancreatic stents endoscopic treatment of chronic pancreatitis is a preferred method which is secure,low-traumatic,low-expenditure,convenient and effectual,and it is of prominent clinical application value.

Objective To evaluate the effects of endoscopic treatment on chronic pancreatitis. Methods 33 cases with chronic pancreatitis having received endoscopic treatment in a 2 years' period were retrospectively analyzed. The diagnosis was confirmed in all the patients by clinical examination, lab tests, CT, ultrasonography and endoscopic retrograde cholangiopancreatography (ERCP). According to the patients' condition, various treatment measures including endoscopic pancreatic sphincterotomy (EPS), endoscopic papillo-sphincterotomy (EST), pancreatic stenting (PS), pancreatic stone extraction, naso-pancreatic drainage (ENPD), pancreatic duct stricture dilation, etc, were used individually or jointly. Results 18 cases received EPS and 27 underwent EST. Pancreatic duct stone extraction by basket or balloon was performed in 6 cases, PS in 13, ENPD in 5, and pancreatic duct dilatation in 9 cases. The endoscopic drainage by transgastric placement of a stent was done in a patient with a huge pseudocyst. Abdominal pain disappeared or markedly relieved in 29 cases after treatment. Marked improvement after treatment was shown by lab examination and imaging. Conclusion The combined application of various treatment measures for chronic pancreatitis through endoscopic approach is a safe, minimal-invasive and effective procedure.

Objective To evaluate the clinical value of endoscopy for the treatment of acute obstructive suppurative cholangitis. Methods Data of 182 patients suffering from acute obstructive suppurative cholangitis, in whom endoscopic treatment was undertaken, were retrospectively analysed. Results All patients received endoscopic sphincterotomy (EST). Among them, 25 patients underwent endoscopic retractor-biliary drainage (ERBD), 140 patients received endoscopic naso-biliary drainage (ENBD), and in 17 cases endoscopic metal retractor-biliary drainage (EMBD) was done. The treatment was successfully in all patients. The clinical findings were markedly improved after treatment in all of them. Conclusion Endoscopic treatment was a fast, safe, effective and economic method for the treatment of acute obstructive suppurative cholangitis.

Objective To explore the correlation between pathologic findings of pancreatic ductal adenocarcinoma accompanied with cystic lesion and their radiological images .Methods The pathological and radiological data of 97 cases with cystic lesion of 560 patients who were diagnosed as pancreatic ductal adenocarcinoma based on postoperative pathology were retrospectively analyzed .All the patients underwent CT and MRI examinations .Results Postoperative pathological report showed that solid masses and cysts coexisted in all the lesions .Solid masses had compact structures and consisted of innumerable fibrous collagen mixed with tumorous tubular or acinar gland tissue but lack of vessels and inflammatory cells were infiltrated in tissues surrounding the tumors .As for the accompanied cystic lesions , 54 cases ( 56%) were pseudocysts , 22 cases (23%) were retention cysts, 12 cases (12%) were pancreatic intraductal papillary mucinous neoplasms ( IPMN) , and 9 cases (9%) were the necrosis and cystic changes of the tumors .Solid masses were hypodense or iso-hypodense in CT, and hypodense on T1 WI and isodense or iso-hyperdense on T2 WI in MR.The focal calcification was detected in only one mass .Seventy-eight cases displayed slight enhancement and 19 cases displayed no enhancement after enhancement .The tumor′s boundary were unclear in all cases .The cystic lesions which were located in masses were only observed in patients with tumors′necrosis and cystic degeneration, and other cystic lesions were adjacent to the solid masses .Single cyst was found in 70 cases (49 with pseudocysts , 12 with retention cysts , 9 tumors′necrosis and cystic degeneration ,) and multiple cysts were in 27 cases (5 with pseudocysts, 10 with retention cysts ,12 with IPMN).Exudation appeared surrounding the tumors in all cases accompanied with pseudocysts , and the cystic wall was attached to the spleen in 10 cases and the kidney in 5 cases.Hemorrhage appeared in 16 cases with pseudocysts .Pancreatic ducts were blocked by tumor masses and the proximal duct was dilated in 80 cases.Common bile ducts were obstructed with the proximal duct dilated in 18 patients.Splenic veins were infiltrated in 11 cases.Wall nodular lesions were seen in 5 cases with cystic degeneration .Conclusions Pancreatic ductal adenocarcinoma is a highly invasive tumor with compact structures , and the tumors′cystic degeneration is uncommon in such patients .Most of the cystic lesions accompanied with the tumors are pseudocysts or retention cysts , which are secondary changes caused by the obstruction in pancreatic ducts , and these pathological features are correlated the imaging findings .

BACKGROUND:Cel membrane microparticles CD31 and CD54 lead to microvascular injury in the femoral head by mediating vascular inflammatory response, promoting blood clotting, affecting vasomotion and promoting vascular endothelial injury. Studies have verified that membrane particles play an important role in steroid-induced necrosis of the femoral head, but there is no studies concerning relationship between microparticles and alcohol-induced avascular necrosis of femoral head. METHODS/DESIGN:This is a randomized control ed animal study. Healthy male Wistar rats wil be randomly assigned to two groups. In the model group, rats wil be intragastrical y administered hard liquor for 6 consecutive months to prepare models of alcohol-induced avascular necrosis of the femoral head. Blank controls wil be intragastrical y given an equal volume of physiological saline. In 1-6 months of intervention, six rats wil be randomly selected from each group every month. Blood wil be col ected separately. Flow cytometry wil be used to detect serum cel membrane particles CD31, CD54 levels. Bilateral femoral head wil be fixed, decalcified, embedded in wax, and then sections. After hematoxylin-eosin staining, empty bone lacuna wil be quantified under a light microscope to identify femoral head necrosis. Verhoff’s staining and MSB microthrombosis staining wil be used to observe microvascular injury and microvascular thrombosis in the femoral head, and to analyze the correlation of CD31 and CD54 levels with femoral head necrosis, vascular endothelial injury and microvascular thrombosis. DISCUSSION:This study wil investigate the effects of CD31 and CD54 on alcohol-induced avascular necrosis of the femoral head, explore the pathogenesis of alcohol-induced avascular necrosis of the femoral head, provide a new theoretical basis for early diagnosis and early treatment, and may provide a new target for its treatment. ETHICS APPROVAL:The protocol has been approved by the Animal Experimental Ethics Committee of Inner Mongolia Medical University (approval number YKD2016154). Experimental procedures and materials of rats wil be in accordance with the Guide for the Care and Use of Laboratory Animals, which is consistent with the guide of National Institutes of Health. Subject headings:Femur Head Necrosis;Membrane Proteins;Tissue Engineering

BACKGROUND:The relationship between long-term heavy drinking and alcohol-induced necrosis of the femoral head has long been clear, but thepathogenesis of alcohol-induced necrosis of the femoral head is currently not fuly understood.
OBJECTIVE:To establish a rat model of alcohol-induced avascular necrosis of femoral head and to study its pathogenesis.
METHODS: Eighty Wistar rats were randomly divided into experimental and control groups (40 rats per group). Rats in the experimental group were intragastricaly administered strong wine 10 mL/kg, once a day, for 6 consecutive days. Rats in the control group were given physiological saline 10mL/kg, once a day, for 6 consecutive days. Bilateral femoral heads were randomly colected from six rats every month for histomorphological observation.
RESULTS AND CONCLUSION:(1) Osteonecrosis: in the experimental group, at 3 months, trabecular bone became thin, arranged disorderly, and the number of empty lacuna began to increase. At 6 months, typical osteonecrosis appeared, and vacant lacunaes increased significantly. In the control group, trabecular bone was complete and neatly arranged. Osteocytes were visible in bone lacuna, and normal morphology of cels was seen. (2) Injury of blood vessels: in the experimental group, at 3 months, micro-intimal hyperplasia was observed. Elastic fibers of partial vascular endothelium were reduced. Elastic fiber andmiddle-layer smooth muscle breakage and proliferation were found. At 6 months, above manifestations were more remarkable. In the control group, arteriole film was not thickened, and vessel wal was normal. (3) Formation of microthrombus, in the experimental group, the number of microthrombus was increased at 3 months, and became significant at 6 months. In the control group, the number of microthrombus was not altered. (4) Results indicated that chronic alcohol intake can lead to microvascular endothelial injury in the rat femoral head. Abnormal blood microcirculation was detected in local region, and resulted in avascular necrosis of the femoral head. The degree of necrosis was associated with alcohol intake.

Objective To evaluate the measurement uncertainty for the determination of ethanol in human blood by auto-headspace GC/MS.Methods Each source of uncertainty,arising from the procedure of testing,was analyzed and confirmed according to the guidelines of the uncertainty in measurement.After each uncertainty component was evaluated,the combined standard uncertainty and the expanded uncertainty of the result were calculated.Results The expanded uncertainty was 0.084mg/mL when the concentration of ethanol in blood sample was 0.738 mg/mL.Conclusion The measurement uncertainty of the concentration of ethanol was came primarily from the sample determination,standard solution of the ethanol and the calibration curve.

Objective To evaluate the clinical results from different endoscopic treatments of patients with chronic pancreatitis. Methods Thirty-seven cases of chronic pancreatitis had accepted endoscop-ie treatments were analvzed retrospectively. Results All cases were diagnosed clearly by ERCP showing different degree of pancreatic duct dilatation. Among them 21 cases had pancreatic duct stricture, 9 cases pancreatie duet ealeification. EPS in 18 cases and EST in 37 cases, basket extraction pancreatic duct stones in 6 eases, PDSD in 17 cases, NPD in 5 cases were conducted. The abdominal pain in 34 cases disappeared or markedly relieved alter treatment. Conclusion Endoseopie treatments have the advantages of safe, less-trauma and effectiveness. The combination of different endoscopic treatments improved evidently the current state of chronic pancreatitis treatment, thereby the therapeutic results.

Objective:To summarize the oblique branches found in the transfer of anterolateral thigh flap (ALTF) and to handle the issues of oblique branch.Methods:Thirty patients who require surgery of ALTF transfer from May, 2017 to October, 2019 were enrolled. CTA examination was perfected prior surgery and the origin of ALTF vessels was preliminarily determined. During the surgery, Three-longitudinal-and-five-transverse methods were used to locate and design the flap. The ALTF was taken according to the flap design. Attention should be paid to the location of the oblique branch and the separation of the vessels of oblique branch to avoid a damage as much as possible. The vessels of oblique branch should be completely explored and separated. One or 2 vascular pedicles were cut according to whether the oblique branch vessels and the descending branch vessels were joined together during surgery. Clamping tests were carried out on the 2 vascular pedicles to determine an arterial blood supply. Super drainage of vascular pedicle veins according to the situation of blood circulation. After the surgery, routine treatment was carried out. Blood supply, skin temperature, swelling degree, exudation and survival of the flap were closely observed and regular follow-up was carried out.Results:Among the 30 ALTF examined by CTA, 13 patients were identified with oblique branch vessels before operation. During operation, 11 oblique branch vessels (The occurrencce rate was 36.6%)were found to enter the flap, and were completely preserved. Of the 11 identified oblique branch vessels, 8 had 2 vascular pedicles taken and the vascular pedicles were treated by venous super drainage technique. The postoperative blood supply of the flap was good; The skin temperature was closed to surrounding normal skin; Swelling of flap was minor and there was little seepage. The flaps all survived after surgery with stage one healing. Followed-up time was 3-32 (average 16.1) months. The recipient site healing was good, and the function and appearance were satisfactory. The joint movement at the donor site was normal, and there was no obvious loss of local sensation.Conclusion:More than one third of the oblique branches appear in this group. The oblique branch vessels should be preserved as much as possible to avoid issues in relation to the oblique branch. Reasonable handling of oblique branch is the key to the success of the surgery.