Objective To summarize the diagnosis and treatment experience of the pancreatic fistula secondary to abdominal operations.Methods The clinical data of 27 patients with pancreatic fistula due to abdominal operations were analyzed retrospectively.Results 25 patients were diagnosed by the amylase concentration of the drainage fluid and 2 patients were diagnosed by the percutaneous puncture fluid amylase concentration.Four patients underwent percutaneous puncture drainage by BS-guide.Five patients underwent re.operation drainage.Enteral feeding,total parenteral nutrition,total parenteral plus oral nutrition were applied to 15,6 and 6 patients,respectively.Altogether 3 patients died,all of these patients were in the total parenteral nutrition group.13 cases were discharged with draining tubes,including 2 patients who developed Dseudocyst and received surgical treatment,and the others 1 1 patients were discharged with tubes for(9.0±3.2)months.The mean hospital stays for oral feeding,jejunum tube nutrition and total parenteral nutrition groups were(36.3±10.2)d,(57.6±17.3)d and(63.3±33.4)d,respectively;and difference was statistically significant(F=3.49,P=0.049).The mean hospital stays for patients with or without somatostatin treatment were(53.5±20.3)d and(51.5 ±21.0)d,and difference was not statistically significant(t=0.207,P=0.838).Conclusions hereasingthe understanding ofpancreaticfistula,adequate drainage and rational nutrition phyed a key role in impmving the treatment effects of pancreatic fistula.

Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.

Objective To investigate the possibility of XIAP inhibition by RNA interference(RNAi) vectors,and the chemotherapeutic sensitivity change of pancreatic carcinoma cells of SW1990 after XIAP inhibition.Methods RNA interference vectors against XIAP was constructed and transfected into the pancreatic carcinoma cell line SW1990,the expression of XIAP was determined by RT-PCR and Western blot,while flow cytometry and Hoechst 33258 stain were employed to examine the apoptosis index of SW1990 induced by gemcitabine.The relationship between XIAP and apoptosis index was analyzed by linear regression.Results Four RNAi vectors against XIAP were constructed,two of the four RNAi vectors could instantaneous inhibit XIAP expression more than 50%,The sensitivity of SW1990 to gemcitabine increased after XIAP was inhibited(P

Objective To explore the method and points for attention in laparoscopic cholecystectomy(LC) of porcelain gallbladder.Methods Twenty-eight cases of porcelain gallbladder, especially 17 LC cases, from January 1980 to January 2005 were analyzed retrospectively.Results Of 28 cases(0.44%) of porcelain gallbladder in 6328 cholecystectomy patients,calcification of gallbladder occurred in 92.86% patients diagnosed by B ultrasonography 17 LC patients were cured. Two cases with gallbladder carcinoma no implantion or metastases happened.Conclusion B ultrasonography before operation and improving of the operative mode and skill in LC are the keys to get the successful results.

Objective To investigate the apoptosis of HepG2 cells and their sensitivities to the ciglitazone after inhibiting the activity of nuclear factor-kappa B (NF-kB) by NF-kB decoy oligonucleotide. Methods After transfecting HepG2 cells with NF-kB decoy oligonucleotide, the activity of NF-kB was observed by electrophonetic mobility shift assay and the protein expression of Bcl-2 and Fas by Western blot. The transfected and untransfected HepG2 cells were processed with 100 umol/L of ciglitazone for 1 to 4 days, and the growth curve and cell cycle of HepG2 cells were observed. Results After transfecting NF-kB decoy oligonucleotide to HepG2 cells, the activity of the NF-kB was inhibited, the Bcl-2 protein expression decreased and the Fas protein expression increased. The inhibition effect of the ciglitazone on the growth of HepG2 ceils was strengthened and more HepG2 cells were arrested at G1/G0 phase. Conclusions NF-kB decoy oligonucleotide could accelerate the apoptosis of HepG2 cells and enhance the inhibition effect of ciglitazone on HepG2 proliferation, the mechanism of which might be attributable to the increased expression of Fas protein and the decreased expression of Bcl-2 protein after NF-kB decoy oligonucleotide inhibiting the activity of NF-kB.