Objective To analyze the effect of different procedures of alimentary reconstruction for the digestive and absorptive functions of patients after total gastrectomy. Methods From January 2012 to January 2013,there were 114 patients with gastric cancer,of which 58 patients received Roux-en-Y anastomosis were the control group,56 patients received P-type jejunal loop esophageal jejunal Roux-en-Y anas-tomosis were the observation group,the nutritional status and postoperative complications of two groups were compared. Results The level of RBC,HGB,TP and ALB of the observation group were significantly higher than that of the control group(P<0. 05),the incidence rate of in-traoperative complications,diarrhea and reflux esophagitis of the two groups had no significant differences (P>0. 05),but the incidence rate of postoperative dumping syndrome and abdominal distension of the observation group were significantly lower than that of the control group (P<0. 05). Conclusion The efficacy of P-type jejunal loop esophageal jejunal Roux-en-Y anastomosis for gastric surgery was superior to Roux-en-Y anastomosis.

Cytomegalovirus(CMV) is an important pathogen of congenital and postnatal infections in children,which causes a series of acute and chronic infectious diseases and nervous system sequelaes.Early and accurate diagnosis of pediatric CMV infection is an effective way to improve health in children.This paper will introduce the types,laboratory techniques and diagnostic strategies of CMV infection based on the diagnostic standards at home and abroad,and also focus on current progress in diagnosis of pediatric CMV infection.

Objective To compare the levels of murine basophils distribution in different organs and analyze the characteristics of CD4+T cells activation/differentiation regulated by basophils.Methods Firstly,the mononuclear leukocytes were isolated separately from periphery blood,liver,spleen,lung and lymph nodes and the percentages of FcεR I+CD49b+ basophils in different organs were investigated.Secondly,liver basophils were purified by immuno-microbead strategy and co-clutured with different cytokines for 24 h.Apoptosis status of basophils was detected by Annexin V straining method.Thirdly,Mice were subcutaneously implanted with a miniosmotic pump containing 5 μg IL-3.At day 7 after implantation,liver mononuclear cells were harvested and the percentages of basophils were analyzed.Finally,Th1/Th2 polarization influenced by basophils orientated cytokines was investigated when naive OT-Ⅱ CD4 T cells were stimulated with spleen dentritic cells and OVA peptides.Results The percentage of murine basophils in mononuclear leukocytes of liver was significantly higher than that of periphery blood,spleen,lung and lymph nodes under physiological condition.Both of in vitro and ex vivo experiments showed that IL-3 played an inhibitory role on apoptosis of basophils.Cytokines secreted by basophils was investigated to induce Th2 polarization and inhibit Th1 response when naive OT-Ⅱ CD4 T cells were co-cultured with spleen dentritic cells and OVA peptides.Conclusion Th2 response was enhanced and Th1 response was down-regulated by murine basophils,which implied that basophils might participate in the construction of liver specific physiological immuno-tolerant microenvironment.

To sacrifice the function of the sphincter of Oddi in the routine management of iatrogenic biliary injury,e.g. by using cholangio-enterostomies, is often complicated by ascending biliary infection, cholangitis and an increased risk of cholangiocarcinoma. It is necessary to find a material which can protect the bile duct. As reported, biodegradable materials which are hopeful to be used clinically have the advantages of being non-immunogenic, gives temporary supportive function, and produces harmless degradation products. This article aims to review the advances in researches on biodegradable materials for bile duct repair.

Objective To discuss the clinical efficacy and surgical indications of one?stage transforaminal debridement, interbody fusion combined with posterior instrumentation for thoracolumbar spinal tuberculosis. Methods All of 34 patients with thoracolumbar spinal tuberculosis were retrospectively analyzed,treated by one?stage transforaminal debridement, interbody fusion and posterior instrumentation from June 2010 to April 2013, including 21 males and 13 females, aged 21 to 64 years old, av?erage 38.2 years. All patients were treated by preoperative quadruple antituberculosis drugs therapy for 2-4 weeks, postoperative regular chemotherapy for 12-18 months. Preoperative and postoperative changes in clinical symptoms, nervous function, the situa?tion of the erythrocyte sedimentation rate (ESR) and C?reactive protein (CRP) with strict follow?up, as well as other related compli?cations were observed. The spinal fusion rate and fusion situation, changing of the physiological curvature, as well as loosening or breaking of the internal fixation device were detected through regular imaging examination. Results The surgery duration time was 60-150 min, average 110 min, and the blood loss was 80-550 ml, average 320 ml. Cerebrospinal fluid leakage occurred in one case. All of the operations were completed successfully without nerve or spinal cord injuries. Postoperative follow?up time was 1 to 4 years, average 2.5 years. Clinical symptoms improved significantly in three months after operation. The visual analogue scale (VAS) improvement rate was about 93%. All patients' ESR and CRP returned to normal levels at the last follow?up. The Kirkaldy?Willis function score showed that the total fine rate was 94%. 12 cases of patients had various degrees of neurological dysfunction before operation, which were back to normal at the final follow?up, except one case of ASIA class B turned to C. Inci?sion fistula formation happened in one case at the third months after surgery, and the wound was healed after debridement. All pa?tients got solid fusion between vertebral body, and there was no graft absorption or collapse, pseudarthrosis, tuberculosis recur?rence, and loosening or breaking of internal fixation devices. Cunclusion One?stage transforaminal debridement, interbody fu?sion and posterior instrumentation is a simple, effective and safety surgical approach, which has great application value for surgi?cal treatment of patients with thoracolumbar spinal tuberculosis.

Objective To study the pathologenesis and to evaluate an operative method of blepharochalasis. Methods A double eyelid-fold incision was made. The lacrimal glands were found and repositioned into lacrimal glands fossa behind superolateral orbital rim. Then redundant skin and muscles as well as hernia septal fat were removed. Results Twenty-three patients were successfully treated by the mentioned methods from 1998 to 2002. A good clinical results in both function and appearance were achieved. Conclusion It is convenient and effective to treat blepharochalasis through a double eyelid fold incision.

Objective To study the causes of misdiagnosis between renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods Since 1990, 228 cases of RCC and 62 RAML were surgically treated.13 of them,4 RCC and 9 RAML were incorrectly treated because the misdiagnosis on imaging examination or intraoperative frozen section study. The causes were analyzed. Results 4 RCC underwent enucleation or simple nephrectomy because of the frozen section diagnosis of RAML.None have developed recurrent RCC with 1～4 years of follow up.Of the 9 RAML cases,6 have been misdiagnosed as RCC on imaging procedures.The other 3 patients that failed to reach a proper diagnosis on imaging examination were submitted to intraoperative frozen section studies.1 was diagnosed as RCC and the other 2 remained uncertain. Radical nephrectomy have been performed for 9 patients. Conclusions Difficult interpretation due to poor quality of frozen sections is a potential cause of diagnosis error.RCC might be confused with RAML when the specimens contained highly vascular tissue. The content and distribution of fat is the main cause of imaging misdiagnosis.

Acoustic parameters of 145 normal adults (18-80 years old) were measured with Universal Signal Spectrum Analysis System. The results showed that fundamental frequency (F0) ,the second and third formant (F2, F3 ) , frequency perturbation quotient (FPQ) between male and female in same age as well as amplitude perturbation quotient (APQ) between two sexes in young and middle age were statistically different. APQ reduced with the growing of age but increased obviously after 60 years old in male. F0 rose in old man but decreased significantly in old woman. The article indicated that voice had distinctive features in different sex or age, which could provide objective grounds for clinical voice evaluation.

Objective To investigate the clinical features, diagnosis and treatment of acute mesenteric isehe-mic disease. Methods Clinical data of 15 patients with acute mosenteric ischemic disease were analyzed retrospective-ly. Results Operation was performed on 14 patients and 1 patient received conservative treatment, 9 cases recovered and 5 died postoperatively. Conclusion Color ultrasound and selective angiography are effective examinations for early diagnosis of acute mesenterie ischemic disease. Early resection of necrotic bowel and application of anticoagulant post-operatively are effective to reduce the mortality. Conservative treatment is still effective for elective patient.