Objective To investigate the feasibility,technique and clinical significance of preserving the great auricular nerve in parotid benign tumors surgery during the first postoperative year.Methods Fifty-two patients with parotid benign tumors were randomly divded into 2 groups.24 patients (group sacrificed) underwent classic parotidectomy with sacrifice of the great auricular nerve.The surgeons spare the nerve in the 32 patients with FOCUS ultrasonic harmonic scalpel (group preserved).Results After surgery,both groups showed lower levels of subjective sensation and sensory function test at auricle.These alterations were less pronounced in group preserved.Both groups showed improvement over time.In group preserved the sensory function reached normal level by 12 months after surgery.The recuperation in group sacrificed was partial at 12 months after operation.Conclusion The great auricular nerve preservation during parotidectomy is feasible,It can decrease sensory disturbance in the early postoperative period and avoid the permanent sequelae that occur when the nerve is sacrificed.The FOCUS ultrasonic harmonic scalpel technique can reduce the operation time.

Postoperative pancreatic fistula (POPF) is the most common complication after pancreaticoduodenectomy (PD) and remains a challenge to pancreatic surgeons.In pancreaticojejunostomy,the methods of reconstruction,experience and operational techniques of surgeons are closely related to POPF.Based on a literature review and on personal experience,the author presented the basic requirements and principle in reconstructing a safe pancreaticojejunostomy (PJ).The traditional methods of pancreaticojejunostomy and their recent developments were evaluated,with their advantages and disadvantages compared.The indications of various types of PJ and the special skills required were summarized.According to his own experience,the author described in detail his recommended method of anastomosis.

Objective To explore the ways to strengthen the mode and effect of the standard community management of the diabetes,and the management model of diabetic mellitus that adopt to current situation of China.Methods 80 diabetics patients were divided into intensive group and common group,and the period of the treatment is three consecutive months.We observed the levels of FBG,2hPG,HbA1c and the cost of drugs.Results The levels of FBG(6.82 ± 1.23),2hPG[(9.51 ± 2.18)mmol/L]and HbA1c(7.52 ± 1.31)％ in intensive group were significantly lower than common group[(8.65 ± 2.31)mmol/L、(12.22 ± 3.11)mtmol/L,(10.32 ± 3.51)％](t =3.12,3.25,3.56,3.69,all P ＜ 0.05).The cost of drugs in intensive group[(621.5 ± 204.5)yuan]was significantly lower than common group[(796.5 ± 240.6)yuan](t =3.69,P ＜ 0.05).Conclusion The ways to strengthen the mode could spend less but control disease well,and improving the existing community diabetes management should be truly effective in reducing medical costs.

Objective To investigate the clinical efficacy and safety between laparoscopic and transabdomi -nal hysterectomy ,reduce the occurrence of complications measures .Methods On 154 cases of hysterectomy indica-tions were nonrandomly divided into two groups ,one group for the observation group of 79 cases of laparoscopic opera-tion,another group was control group of 75 patients with transabdominal operation;two groups had no significant differ-ence in age and disease .The clinical effect ,postoperative complications and safety between the two groups during and after operations were observed .Results The operation time of the laparoscopic group (72.0 ±13.2) min was signifi-cantly shorter than that of the control group (98.0 ±20.7)min (t=3.396,P=0.021);The bleeding quantity of the laparoscopic group(96.0 ±75.4)mL was significantly shorter than that of the control group (159.4 ±98.0)mL(t=9.680,P=0.014);The aerofluxus time of the laparoscopic group (17.2 ±4.2) h was significantly shorter than that of the control group(28.6 ±6.1)h(t=9.760,P=0.013).The average postoperative hospital stay time was significantly shorter in laparoscopic group(5.2 ±1.9)d than those in abdominal group(9.5 ±3.2)d (t=-5.025,P=0.018). The analgesic used in the laparoscopic group (3/89)was significantly shorter than that in the control group (48/78) (t=-8.820,P=0.000).Conclusion Laparoscopic hysterectomy is safe and effective .It is worth to promote in clinical,while improving the operation skills is the key to reduce the complications .

As a distinct clinicopathological entity, mediastinal gray zone lymphoma cannot be classified by using differential diagnostic criteria. The cases represent a spectrum of tumors having characteristics of both primary mediastinal large B-cell lymphoma (PMBL) and classic Hodgkin lymphoma (cHL). In the 2008 WHO Classification, a novel category designated B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma (BCLu) has been created to include these neoplasms. The main features of BCLu are clearly different from those of conventional mediastinal large B-cell lymphomas. Diagnosis of BCLu requires a multiparameter approach incorporating morphological, immunophenotypic, immunohistochemical and other features. These lymphomas generally have a more aggressive clinical course and poorer outcome. There is no consensus on the optimum treatment, while the recommended therapies for aggressive B-cell lymphomas might be effective options.

Intestinal trefoil factor(ITF)is a low molecular weight polypeptide expressed in intestine. ITF is also found in the brain,respiratory,eyes and so on.To study recombinant ITF will have an important impact for the treatment of gastrointestinal disease, respiratory tract disease, eyes disease and so on.

Objective: To investigate the effects of devascularization procedure on portal hemodynamics and recent and long-term hepatic function of portal hypertensive patients. Methods: A retrospective clinical analysis about portal hemodynamics and recent and long-term hepatic function was made in 367 cases of portal hypertensive patients, who admitted to our hospital and subjected to double devascularization from January 1989 to January 2008. Results: It was found that FPP was decreased from (36.2?4.2)cmH2O preoperatively to (31.4?3.3)cmH2O postoperatively (P0.05), but if was improved significantly after 6 and 12 month (P

The cellular sources of leukoregulin (LR) and lymphotoxin (LT) from human peripheral blood leukocytes or spleen cells were examined The ratios of LT activity to LR activity in lymphokine preparations from different individuals were not constant but varied over 640-fold, suggesting that LR and LT activities were mediated by distinctly different entities.Purified LR was used to examine the relative susceptibilities of human or mice cells to LR.Most human tumor cells were very sensitive to LR while human normal cells and mice normal or tumor cells were less sensitive or resistant.Crude preparations of human interferon (Hu IFN)-? or Hu IFN-? were more cytotoxic to human tumor cells than partially purified natural Hu IFN-? or highly purified rHu IFN-?D, and crude or purified LR were more cytotoxic to human tumor cells than Hu IFN-? Hu IFN-?.Hu IFN-? activity but not cytotoxic activity could be removed from preparatons containing Hu IFN-?,LR and LT activities with the aid of monoclonal antibody to Hu IFN-?. Natural killer cytotoxic factor (NKCF) supernatants from the co-culture of human spleen cells and NK susceptible cell line K562 or Molt-4 were strongly cytotoxic to various tumor cell lines.The NKCF activity was completely adsorbed after incubation with Molt-4 cells and completely inactivated by incubating at pH2 for 24 h.The putative receptor for LR or LT was studied using adsorption assay.The present study reveals that human LR activity can be adsorbed from crude LR supernatants by incubation with native or formalin-treated K562 or SMMC-7721 cells at 37℃ or 4℃; LT activity can be adsorbed with L929 cells.Therefore, LR appears to be a cytotoxic/cytostatic factor that is distinct from LT, 1FN and NKCF.

The rank order for the spectrum of death causes of non-war wounds had changed significantly among troops at a certain area in China from 1950 to 1986. In 1980s, the chief death causes were malignant tumors,accidents and acute infectious diseases, respectively. When the rank order among the troops was compared with that among the citizens at the same area during this period, we have found that the former was similar to the latter for malignant tumors,but the former was higher for accidents and acute infectious diseases, and lower for cerebrovascular diseases, heart diseases and tuberculosis of lungs than the latter. Hepatitis and leukemia made up a high proportion of death cases in≤29 years age group, and lung cancer, stomach cancer, liver cancer, cirrhosis and coronary heart disease in ≥40 years age group. So it indicates that the focal point of surveillance for diseases should be different between these two age groups in the medical work and health examination in future. The mean age of death for accidents was 24.92 years, and 83.30% of the subjects belonged to≤29 years age group, which shows that special attention shouldbe given to the prevention of accidents in this age group.