Objective To investigate the surgical approach of the reasonable radical resection for carcino-mas of pancreatic head. Method 35 of 110 patients with carcinomas of pancreatic head underwent the surgical ap-proach of the posterior aspect of the radical resection for carcinomas of pancreatic head, and histopathological findings and prognosis were analyzed. Results The rate of curative resection rate was 31.82%. 3 patients underwent pancre-atoduodenectomy with partial resection of SMV for 9 patients with macroscopic suspicion of invasion of the SMV. The survival rate of the 5 years was 17.14% and the patients exceed 10 years. Conclusion Surgical approach of the reasonable radical resection for carcinomas of pancreatic head allows the reasonable radical resection,and may lead to increasing the resectability rate and the prognosis in the patients with carcinomas of pancreatic head.

BACKGROUND: Some researches report that diffusion-weighted imaging (DWI) can appear abnormal signal in minutes after cerebral ischemia.OBJECTIVE: To investigate the manifestation and regularity of diffusion coefficient in middle cerebral artery occlusion (MCAO) of rats after cerebral ischemia.DESIGN: Randomized controlled study.SETTING: Neurological Department of Clinical College of ChongqingMedical University.MATERIALS: The experiment was conducted at the Radiological Department of the First Affiliated Hospital of Chongqing Medical University from April to July 2004. Totally 18 adult Wistar rats with clean grade were randomly divided into three groups: control group, sham operation group and cerebral ischemia group with 6 rats in each group.METHODS: The origin of right middle cerebral artery was blocked with filament into right internal carotid. In the sham-operated group, the filament was just inserted into the common carotid artery not into the origin of middle cerebral artery, rats in normal control group were not treated with anything after anesthesia. MRI experiments were performed on a 1.5 T GE signa Highspeed NMR spectrometer to obtain DWI and ADC values at the time-point of 7, 15, 30, 60 minutes, 3,6, 12, 24 hours, 3, 7, 15 days, 1 and 2 months after operation.MAIN OUTCOME MEASURES: Changes of ADCs in infarct hemisphere and contralateral hemisphere.RESULTS: There was no significant change in MRI T1-and T2-weighted imaging in rats at 7 minutes post-infarction, but abnormal high intensity was emerged during the period of 1 hour to 3 hours, and enlarged over time. Finally, the infarction area located the right basal ganglia and the frontal-parietal lobes at 12 hours and increased less significantly later.Focal abnormal high signal was noted in DWI 7 minutes after cerebral ischemic insult, and the ADC values was decreased at the same time,reduced gradually after significant recover at 30 minutes, dropped to the lowest level at 12 hours and again increased at 24 hours, since then all the ADC values were remained high throughout follow-up, which increased by 5 times at 2 months than that at 12 hours. Correspondingly,rADC values showed the contrary pattern of evolution.CONCLUSION: It is reflected that ADC is highly sensitive not only to onset of cerebral ischemia but also to chronic cerebral ischemia.

Objective To study the relationship with internet addiction disorder(IAD)of the youth,the degree of IAD and home environment,attachment.To study the relationship with home environment and attachment.Methods 490 students were assessed with Internet Addiction Disorder Test,FES-CV,Attachment Questionnaire.Results 37 subjects can be defined as IAD according to Internet Addition Disorder test;IAD group have a higher score in contradictoriness(P＜0.05)of home environment and lack of maternal love,lack of fatherly love,father's rejection,parent's passive entangle,angry with parent[the average score of IAD group Was 13.16±4.62,14.18±5.42,14.41±5.44,19.10±4.59,18.89±4.42,12.37±4.80,11.35±4.17;the average score of normal group was 11.77±4.06,11.59±4.02,16.56±4.99,15.78±4.91,9.87±4.52,9.65±4.25,P＜0.05,0.01].Home environment were significantly correlated with all factors of attachment except independence(P＜0.05,0.01).There Was a significant negative correlation between the degree of IAD and lack of maternal love(r=-0.360).Conclusion Contradiction in home environment and passive attachment,that played an important role in internet addiction disorder of the youth.

To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods　Textual researches of materia medica were carried out and their history in clinical application were traced. Results　T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion　We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

With the development of the dialysis technology,the survival time of patients with chronic renal failure is prolonged,while more complications which affect the quality of life or even threat the life of patients are followed.Secondary hyperparathyroidism(SHPT)with a certain incidence and mortality is one of the common complications,and its main characteristic performances ale hyperphosphatemia,hypocalcemia and high level of parathyroid hormone.Most patients Can be cured by the treatment of medicine while surgical treatment is still required by some cases in which the disorder of the parathyroid function can not be well regulated through medicine treatment.The purpose of this paper is to make a review of the recent studies of surgical treatment in patients with SHPT.

The Proposal for the Standardization of Urinary Sediments Examination and the expert consensus have provided effective and timely instruction on urinalysis normalization,but there are still some puzzles about the methods and requirements on quality improvement for urinalysis normalization.This paper is discussing about some issues referring to American and European urinalysis guidelines,which include establishment of examination procedure,specifications and methods of testing system evaluation,specimen stability,the influence of sample centrifugation,the usage of sample staining,confirmation tests,requirements on result reporting,internal quality control and external quality assessment.These discussions will contribute to the quality improvement of urinalysis in clinical laboratories.

Objective:To investigate the dynamic changes of coagulation system following radiofrequency catheter ablation(RFCA) and effect of molecular weight heparin. Methods:Blood samples were collected at 6 different times to measure the thrombin-antithrombinⅢcomplex (TAT) and hepatocyte growth factor (HGF) in 60 RFCA candidates and 22 controls undergoing electrophysiological study (EPS).Patients were randomly divided into 2 groups.Low molecular weight heparin was given to 31 pationts (subgroup B) after RFCA,but not to the others (subgroup A). Results:①Plasma TAT exhibited a double peaked pattern in the subgroup A.The first peak occurred instantly after RFCA (42.8?15.7 ng/ml),and the second 3 days later (20.1?19.4 ng/ml).The second peak was significantly higher than that of the control group (2.7?1.5 ng/ml) and the subgroup B(4.3?5.2 ng/ml)(P

Object To probe tentatively into the relations of Terminalia chebula Retz., Terminalia billerica (Gaertn.) Roxb, and Phyllanthus emblica L. between TCM and Tibetan medicine. Methods Textual researches of materia medica were carried out and their history in clinical application were traced. Results T. chebula, T. billerica, P. emblica were all of foreign origin and were introduced into China with Buddhism. As compared in medical practice, the Tibetan autonomony region has their particular choice and preference. Conclusion We should apply modern scientific research achievements to carry out deep mutual exchanges to enrich TCM.

Objective To analyse the effect of hedyotisdiffusa on expressions of apoptosis related protein Fas , caspase3 and caspase7 in Renca renal cell carcinoma of model mice.Methods One hundred and twenty BALB/C male mice were randomly divided into normal control group, model control group, interleukin group, hedyotisdiffusa group, 30 mice in each group, half male and female.Excepted for normal control group , renal cell carcinoma models were established in the other groups , and were given corresponding drug treatment.The tumor size and weight , and the tumor inhibition rate of all mice were observed, and the expression levels of Fas,FasL,caspase3 and caspase7 were detected.Results Compared with model control group, the tumor size and weight were lower , the tumor inhibition rate were higher , the positive expression rates and protein levels of Fas were higher , the positive expression rates and protein levels of FasL were lower, the positive expression rates and expression levels of Caspase3,Caspase7 protein were higher in the mice of interleukin group and hedyotisdiffusa group, all with significant differences ( P<0.05 ).The above indicators in hedyotisdiffusa group were significant improved compared with interleukin group (P<0.05).Conclusion The hedyotisdiffusa can effectively promote the expressions of apoptosis related protein Fas,caspase3 and caspase7 in renal cell carcinoma of model mice, inhibit the expression of FasL protein, improve the tumor suppression rate.

Objective To observe the influence of intensive insulin therapy on inflammatory fac-tors and prognosis in severe multiple trauma patients.Methods A total of 53 cases of severe multiple trauma were randomly divided into the treatment group(n =27)and the control group(n =26).Besides basic treatment,patients in the treatment group received additional intensive insulin therapy by micro-pump.The level of blood glucose in the control group was controlled under 11.1 mmol/L.Levels of TNF-α,IL-1β,IL-6,and CRP were tested before and after treatment.Multiple organ dysfunction syndrome,noso-comial infection rate,and mortality rate were also observed.Results The levels of TNF-α,IL-1β,IL-6, and CRP in the treatment group were significantly lower than those of the control group(P <0.05 or P <0.01).The incidence of multiple organ dysfunction syndrome,nosocomial infection,and mortality rate in the treatment group was lower(P <0.05).Conclusion Intensive insulin therapy can effectively decrease the expressions of inflammatory factors in patients with severe multiple trauma,improve the prognosis,re-duce the incidence of nosocomial infection and mortality.