Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.

Objective To document MRI findings of soft tissue damages involwing the temporomandibular joint (TMJ) after dislocated condylar fracture. Methods Seventy-seven subjects (103 TMJs), who suffered from the dislocated condylar fractures, underwent both sagittal and coronal MR imaging including proton density-weighted image ( PDWI ) and TzWI.Results On MR images, the TMJ structural changes after dislocated condylar fractures included : ( 1 ) displacement of the dislocated fragment in the anterior-inferior direction ( 102 TMJs, 99.0% ) and in the anterior direction ( 1 TMJ, 1.0% ) ; (2)disc displacement (100 TMJs, 97.1% ) in the anterior-inferior direction (99 TMJs) and in the anterior direction (1 TMJ) along with the dislocated condylar fragments on sagittal MR images; (3) joint effusion (103 TMJs, 100%);(4) abnormal signal intensity in the retrodiskal tissues of the TMJ ( 91 TMJs ,88.3% ) ; (5) abnormal changes of inferior posterior attachments of disc ( 89 TMJs, 86.4% ) ; ( 6 )abnormal changes of joint capsule ( 89 TMJs, 86.4% ) ; ( 7 ) abnormal changes of superior posterior attachments of disc ( 37 TMJs, 35.9% ) ; ( 8 ) disc deformation ( 8 TMJs, 7.8% ) ; ( 9 ) disc avulsion (8 TMJs, 7.8% ) and ( 10 ) glenoid fossa fractures (4 TMJs, 3.9% ). Conclusion On sagittal MR images, the TMJ soft tissue changes after dislocated condylar fracture were mainly presented as the disc displacement in the same direction (anterior-inferior direction) as the dislocation of the fractured fragments,usually in association with joint effusion.

BACKGROUND:Three-dimensional printing technique has been applied in medical fields since it was invented in the end of 20th century. Recently it has been widely used in manufacturing scaffolds for bone tissue engineering. OBJECTIVE:To review the basic concept of the scaffold for bone tissue engineering, the basic requirements for three-dimensional printing technique in scaffold engineering, different materials used in bone tissue engineering, the advantages and limitations of three-dimensional printing technique and the outlook of three-dimensional printing technique applied in manufacturing scaffold for bone tissue engineering. METHODS: The first author did a computer-aided retrieval of the MEDLINE database, Science Direct database, CNKI database, and CQVIP database for articles relevant to three-dimensional printing technique used in manufacturing scaffolds for bone tissue engineering published between January 1990 and February 2015. The key words were three-dimensional printing, tissue engineering, rapid prototyping technology, scaffold, materials in English and Chinese, respectively. Repetitive studies were excluded, and 33 of 52 related literatures were adopted in result analysis. RESULTS AND CONCLUSION: Three-dimensional printing technique has many advantages such as high resolution, high velocity and the freedom to build unlimited geometries. There are some requirements for the powder and binder used to construct bone tissue engineering scaffolds using the three-dimensional printing technique, such as the flowability, stability and wettability. A wide range of materials can be used: synthetic and natural polymers, ceramics, as wel as composites of the aforementioned. Various kinds of powder take responsibility of different features of scaffolds, resulting from the advantages and disadvantages of different materials. Although this technique has some limitations such as high cost and the difficulty of commercial production, its application stil has a bright future.

Objective To study and investigate the comprehensive application value of urinary tract dilata-tion combined with cavity technique in patients with ankylourethria.Methods 70 male patients with ankylourethria were collected as the research object,and they were randomly divided into the control group(ordinary urethral dilata-tion treatment group ) of 35 cases and observation group (urinary tract dilatation combined with cavity technique group)of 35 cases by numeration table,then the treatment effect of different stricture length,urodynamic indexes and life quality state before and after the treatment of the two groups were evaluated and compared.Results The cure rates and recurernce rates of the observation group were 91.43% and 2.86%,respectively,which were better than that 68.57% and11.43% of the control group(χ2 =5.396,6.502,all P<0.05).The urodynamic indexes and life quality state at first,third and sixth month after the treatment were all better than those of the control group (t =4.613,4.902,5.263,3.180,all P<0.05).Conclusion The comprehensive application value of urinary tract dila-tation combined with cavity technique in patients with ankylourethria is higher,and it is more benefit for the improve-ment of urodynamic indexes and life quality state.

The specific features of diabetic microangiopathy include thickening of basement membrane with deposition of a transparent material.Diabetic retinopathy,neuropathy,cardiomyopathy,as well as diabetic foot are the main complications.It remains controversial whether intensive treatment may reduce the clinical renal end point events significantly,while evidence-based medicine confirmed that intensive treatment can reduce the trace and heavy proteinuria,neuropathy,and retinopathy.It will benefit the patients if comprehensive,and standard and,persistent treatments,are started as early as possible,and it consider the features of elderly patients.Managing Older People with Type 2 Diabetes Global Guidelines (IDF) and Chinese Elderly Diabetes Expert Consensus on Diagnosis and Treatment Measures point out that microvascular complications in elderly patients with diabetes closely related to the quality of life,to which we should pay great attention.Early prevention,early diagnosis,early treatment,reach the standard in early stage will be of important clinical significance for the prevention and treatment of senile diabetic microvascular lesion.

Objective To investigate the correlation between TNF-β NcoⅠpolymorphism and PDR.Methods PCR-RFLP analysis of frequencies of allele in each group.Results The frequency of allele TNF-β2 was significantly higher in patients with PDR than that without PDR（P<0.05）.Conclusion This polymorphism of TNF-β can be served as a susceptible genetic marker of PDR.

Objective To investigate the correlation between TNF-? NcoⅠpolymorphism and PDR.Methods PCR-RFLP analysis of frequencies of allele in each group.Results The frequency of allele TNF-?_2 was significantly higher in patients with PDR than that without PDR(P

Objective To investigate the application value of transcystic choledochoscopy combined with holmium laser for common bile duct stones . Methods Clinical data of 16 patients with common bile duct stones who underwent transcystic choledochoscopy and holmium laser cholelithotripsy between March 2012 and December 2013 in this hospital were retrospectively analyzed.During holmium laser cholelithotripsy (1.0 J/10 Hz, 400 μm fiber), the stones were fragmented under direct vision of choledochoscopy and were extracted by using water flushing or a stone basket . Results The stones were successfully removed in 15 patients, including 6 cases of laparoscopic operation and 9 cases of open operation .The operation time was (132 ±27) min for open surgery and (156 ±33) min for laparoscopic surgery .The stone fragment and removal time was (30.2 ±8.5) min for open surgery and (45.6 ±10.4) min for laparoscopic surgery .The hospital stay was (9.7 ±1.4) d.There was 1 case of failed cholelithotripsy due to obstructed water flow and blurry vision .Follow-up examinations in 14 cases for 2-24 months found no recurrence of stones or biliary strictures. Conclusion Transcystic choledochoscopy and holmium laser cholelithotripsy is intuitive , accurate, and effective, being a safe and reliable alternative for choledocholithiasis .

Glycosylated hemoglobin A1c(HbA1c)is the products of slow,continuous non-enzymatic saccharification reaction,which can reflect the average blood glucose of 2~3 months of the patients,and it is the most important index for long-term monitoring of glucose.There are so many methods for detecting HbA1c that America,Japan and Swede proposed their own standardized detection methods to reduce the difference laboratories.However,these methods were non-specific.A new method for was developed by International Federation of Clinical Chemistry and laboratory medicine (IFCC) in 2007,which was of high specificity,but which resulted in relatively low glycosylated hemoglobin.To avoid the confusion in reference value of glycosylated hemoglobin,average blood glucose was recommended by American Diabetes Association (ADA),European Association for the Study of Diabetes (EASD),and International Diabetes Federation (IDF).This paper review the origin of average blood glucose substituting HbA1c,relationship of HbA1c with average blood glucose,and the international multiple-center research of ADAG and its enlightenment,and we also discuss the relevant development in future.

By means of the observation of acridine orange-stained lysosomes with fluorescence microscope, we studied the intracellular killing and digestive process after alveolar macrophage (AM) ingested living-yeast. Based on the morphological changes of the cells, we divided the process into three stages: the pre-phagosome-lysosome fusion stage, the phagosome-lysosome fusion and killing stage, and the digestive stage. The results revealed that all the values of phagocytic index, phagocytic rate, fusion index and fusion rate of the isolated AM of rabbits infected with living-BCG were higher than those of normal rabbits (P