Objective:With a scrutiny of the gastroscope aspects of hepatogenic ulcer (HU),this sutdy was to find out the relationship between HU and hepatocelluar damage and portal hypertension.Methods:262 cases of portal hyprtension of cirrhosis were reviewed with HU being grouped according to the clinical gravity of cirrhosis and the gravity of esophageal varies (EV).Results:①Duodenal ulcer prevails under endoscopy.Superficial ulceration accounted for 70.49% while ulceration less than 0.5cm in full diameter made up 55.74%.The figure was 62.3% with erosive gastritis.②Out of a total of 262,61(23.28%) cases of HU were found in connection with portal hypertension.The χ2 test showed that HU was related with hepatocellular grade and the gravity of EV (P＜0.05).Conclusions:The incidence of HU were higher than normal.indicating that the onset of HU responded positively to the clinical intensity of cirrhosis and the gravity of EV.

Objective To investigate the application value of three-dimensional (3D) laparoscopic pancreaticoduodenectomy (LPD) and compare the clinical outcomes between 3D-LPD and open pancreaticoduodenectomy (OPD).Methods The retrospective cohort study was adopted.The clinicopathological data of 349 patients who underwent pancreaticoduodenectomy at the Affiliated Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology between July 2014 and March 2016 were collected.Of 349 patients,146 undergoing 3D-LPD were allocated into the 3D group and 203 undergoing OPD were allocated into the OPD group.Observation indicators:(1) surgical situations:operation time,volume of intraoperative blood loss,cases of blood transfusion,number of lymph node dissected,resection margin and vascular resection and reconstruction,(2) postoperative situations:time of gastric tube removal,duration of intensive care unit (ICU) stay,duration of hospital stay,(3) complications:pancreatic fistula,delayed gastric emptying,intra-abdominal infection or abscess,bile leakage,hemorrhage,pulmonary infection or wound infection,(4) follow-up.All the patients were followed up by telephone interview to detect the tumor-free survival rate up to June 2016.Measurement data with normal distribution were presented as (x) ± s and comparison between groups was analyzed using the t test.Count data were analyzed using the chi-square test.Results (1) Surgical situations:all the patients underwent successful pancreaticoduodenectomy.Operation time,volume of intraoperative blood loss,cases of blood transfusion,number of lymph node dissected and positive resection margin were (334 ± 175)minutes,(254 ± 107)mL,29,13 ±8,1 in the 3D group and(320 ±91)minutes,(290 ± 101) mL,35,14 ±9,5 in the OPD group,respectively,with no statistically significant difference between the 2 groups (t =0.975,1.383,x2=0.390,t =12.155,x2=1.589,P ＞ 0.05).Vascular resection and reconstruction were respectively applied to 0 patient in the 3D group and 14 patients in the OPD group,with a statistically significant difference between the 2 groups (x2 =10.490,P ＜ 0.05).(2) Postoperative situations:time of gastric tube removal,duration of ICU stay and duration of hospital stay were (2.9 ± 1.9) days,(6.9 ± 2.1) days,(12.9 ± 7.2) days in the 3D group and (5.1 ± 1.7) days,(7.4 ± 1.2) days,(19.8 ± 7.1) days in the OPD group,respectively,with statistically significant differences between the 2 groups (t =11.350,2.814,8.903,P ＜ 0.05).(3) Complications:of 146 patients in the 3D group,40 had postoperative complications with incidence of complications of 27.40％ (40/146).Twenty-nine patients with pancreatic fistula (20 in grade A,9 in grade B and C) were improved by conservative treatment.Thirteen patients with delayed gastric emptying were cured by gastrointestinal decompression and enhancing gastric motility.Of 5 patients with postoperative hemorrhage,3 were improved by conservative treatment,and 2 were improved by small vein hemostasis behind the head of pancreas.One patient died of systemic inflammatory response syndrome.Partial patients were combined with multiple complications.Of 203 patients in the OPD group,60 had postoperative complications with incidence of complications of 29.56％ (60/203),including 39 patients with pancreatic fistula (31 in grade A,8 in grade B and C),25 with delayed gastric emptying,15 with intra-abdominal infection and 13 with systemic inflammatory response syndrome,and they were improved by conservative treatment.Of 8 patients with postoperative hemorrhage,4 were improved by conservative treatment,and 4 were cured by hemostatic therapy after ineffectual blood transfusion and interventional treatment.Two patients died of cardiopulmonary complication.Partial patients were combined with multiple complications.There was no statistically significant difference in the incidence of postoperative complication between the 2 groups (x2 =10.490,P ＞ 0.05).(4) Follow-up:all the patients were followed up at postoperative month 6.Tumor-free survival rate was 90.41％ (132/146) in the 3D group and 85.22％ (173/203) in the OPD group,with no statistically significant difference between the 2 groups (x2 =2.076,P ＞ 0.05).Conclusion Compared with OPD,3D-LPD can provide the more realistic visual effects and refinement of surgical procedures,with a good short-term outcome.

Objective To study the relationship between cognitive dysfunction and location of lesion and prognosis in patients with cerebral infarction.Methods 120 patients with cerebral infarction in the Second People's Hospital of Yueqing were selected.According the results of the cerebral CT or MRI,the patients were divided into primary group(58 cases)and recurrence group (62 cases).3 -10days after admission,the cognitive impairment was evaluated with the method of simple mental state examination (MMSE)scale.The stroke score of the National Institutes of health(NIHSS)in the United States and ability of daily life activity Barthel index score before the admission and after the discharge were conducted on the patients.And the relationship between different lesion location of primary or recurrent infarction,cognitive disability and prognosis were observed.Results The incidence of cognitive impairment in the ecurrence group was 90.32%,which was obviously higher than 72.41% in the primary group(χ2 =6.419,P =0.011);In the two groups,the proportion of thalamic cortex was the highest,but there was no significant difference between the two groups (χ2 =0.000,P =1.000).The NIHSS and Barthel scores of patients with thalamic infarction were (11.4 ±1.6)points and (27.5 ±3.7)points respectively,both of which were the highest(FNIHSS =47.22, PNIHSS =0.000;FBarthel index =17.77,PBarthel index =0.000);the NIHSS and Barthel indexes in each part of the two groups at discharge were lower than those before the admission (all P <0.01),and the differences at admission was not statistically significant(P >0.05);the NIHSS scores of the primary group and the recurrent group at discharge were (6.3 ±0.5)points and (7.8 ±0.7)points respectively;the Barthel scores were (24.3 ±7.3)points and (30.8 ± 6.8)points respectively.And all of them were lower than those at admission and the improvement degree of the primary group were more significant than those of the recurrence group(tNIHSS =13.43,PNIHSS =0.000;tBarthel index =5.05, PBarthel index =0.000).Conclusion Cognitive impairment after cerebral infarction is associated with lesion,and thalamic infarction is the most prone to perform cognitive disfunction with poor prognosis,and the frontal and temporal lobe are also common parts where targeted prevention is needed.

Organ-specific tumor cell adhesion to extracellular matrix (ECM) components and cell migration into host organs often involve integrin-mediated cellular processes. Direct integrin-mediated cell adhesion to ECM components in the space of Disse appears to be required for the successful liver metastatic formation of colon cancer. In the present study, human colon cancer HT-29 cells were transfected by liposome with integrin-beta(1) antisense oligodeoxynucleotide (ASODN). The integrin-beta(1) gene expression in HT-29 cells was significantly down-regulated. The migration of HT-29 cells was assayed using transwell cell culture chambers in vitro. The number of migrating HT-29 cells in experimental group was far less than that in control group (P<0.05). The models of hepatic metastasis in nude mice were established by the intrasplenic injection of transfected HT-29 cells. Thirty days later, the nude mice were killed and the average number of hepatic metastases (4.00+/-0.93 per mouse), average volume (10.10+/-6.50 mm(3) per mouse), average weight (0.0440+/-0.0008 g per mouse) in experimental group were remarkably reduced as compared with those in control group (P<0.05). Integrin-beta(1) expression in the hepatic metastasis was studied by immunohistochemistry (SP). Positive cell percentage of hepatic metastases in experimental group was markedly decreased as compared with that in control group (P<0.05). It was concluded that integrin-beta(1) may take part in hepatic metastasis, and down-regulation of integrin-beta(1) expression may play a key role in decreasing migration and hepatic metastasis of human colon carcinoma cells (HT-29).

Objective To apply Windows presentation foundation (WPF) to rapid access and report printing of medical data.Methods Data access was realized by abstracting database to form data structure through entity framework (EF) and mapping datasheet as attribute.Multipage printing was executed by using Flow Document Scroll Viewer as the container and putting contents into different paragraphs with the block element.Results EF of WPF decreased the frequency of database access by the program greatly,and the reaction speed of the program was increased significantly.Flow document could be used for data printing.Conclusion WPF enhances the efficiency of system development and the beauty of man-machine interface,and thus is worthy promoting for medical system and software development.

ObjectiveTo explore the tumor igenic property of side population cells (SP) from human gallbladder carcinoma cell line GBC-SD. Methods SP and non-SP cells were isolated from GBC-SD staining with Hoechst33342 dye by fluorescence-activated cell sorting (FACS). The soft agar clonal assay and xenograft assay were performed to characterize tumorigenic property of side population cells in vitro and in vivo, respectively. The percentage of SP cells was analyzed by FACS in 5 hu man gallbladder carcinoma specimens. ResultsThe percentage of SP cells accounted for approximately 0.87 ％ of GBC-SD cells. The clone-formed rates of SP was more frequent than that of non-SP cells (14.74％ ± 3.53％ vs 5.17％ ± 1.05％), there was statistically significant difference (t =2.75,P＜0. 05). SP cells could generate tumors with as few as 5 × 103 cells (four of seven animals), whereas at least 1 × 105 non-SP cells were needed to form a tumor (one of seven animals). Re-analysis of SPderived tumors by FACS showed that SP cells under in vivo conditions also have the capacity to regenerate the SP and non-SP fractions. Besides, analysis of Hoechst33342 revealed s small fraction of SP cells, ranging from 0. 27％ to 2.3％ in gallbladder carcinoma specimens. ConclusionSP cells from GBC-SD are highly tumorigenic similar as the cancer stem cells.

Objective To investigate the drug resistance of side population cells in human gallbladder cancer cell line GBC-SD and explore its mechanism. Methods Drug sensitivity assays of 5chemotherapeutic agents were performed on side population cells (SP) and non-SP cells of GBC-SD.GBC-SD was cultured and then treated with the chemotherapeutic agent gemcitabine. The frequency of SP by FACS was measured. RT-PCR and Western blotting were used to detect the expression of AB-CG2 in both the SP and the corresponding non-SP subsets. Results After 1 d treatment with 4 chemotherapeutic agents (gemcitabine, cisplatin, 5-fluorouracil and mitoxantrone) in IC50 concentration to GBC-SD cell line, the reproductive ability of SP was higher than that of non-SP (P<0.05). However, statistical significance was not achieved when compared with epirubicin (P>0.05). The percentage of SP in GBC-SD treated with chemotherapeutic agent gemcitabine after 3 weeks was sharply elevated by FACS (8.02% ±0.13% vs 0.62% ±0.08%, P<0.05), and the expression of ABCG2mRNA and protein were increased in SP as compared with non-SP. Conclusion SP from human gallbladder cancer cell line GBC-SD, like stem cell, showed a heighten resistance to drugs. Increased expression of ABCG2 was largely responsible for the multi-drug resistance.

Objective To evaluate the diagnostic valve of double balloon enteroscopy in patients with obscure abdominal pain and analyze the etiology of chronic abdominal pain resulted from enteral diseases. Methods Sixty-seven cases with chronic abdominal pain underwent a previous negative gastroscopy, colonoscopy, gastrointestinal barium, B ultrasound and electrocardiogram were received double balloon enteroscopy during June 2005 to June 2008. Results Thirty-six of 67 patients was done by enteroscopy via anus, and 19 cases via oral, and 12 cases via both anus and oral. The lesions were found in 41 of the 67 patients, with overall diagnostic yield of 61.19%. Among 41 cases of abdominal pain resulted from small bowel diseases, Crohn's disease were found in 15 cases (36.59%), non-specific small enteritis in 10 cases (24.39%), tumors in 8 cases (19.51%),other enteral diseases in 8 cases (19.51%). Conclusions Double balloon enteroscopy was a diagnostic modality with a high diagnostic value for obscure abdominal pain resulted from small bowel diseases. The most common causes of obscure abdominal pain were Crohn's disease, non-specific small enteritis and tumors.

Objective To explore the influence of nonylphenol(NP) on the filial generation rats spatial learning and memory capacity which were exposed to the parent rat during its pregnancy. Methods At the first day of the pregnancy, the rats were divided into four groups, which were orally administered with NP at doses of 0,50, 100 and 200 mg/kg,respectively, on gestational days 9～15. Cognitive function was tested by Morris water maze and step-down test. The ultrastructure of hippocampus tissues were observed by electronic microscope.Result The escape latency extended ((61.14±5.92) s) and erroring time increased ((4.57±1.13)times) in Morris water maze, and step down latency extended ((37.5±6.3)s), step through latency shortened((97.8±11.0)s) and erroring time increased ((3.0±1.4) times) in step down test in the N P 200 mg/kg treated groups (P<0 05). The correspond indexes were separately (35.85±4. 29) s, (2.57±0.97) time, (27.1±3.8) s,(172.0±89.2)s and(0.9±0.7)time in control group. Compared to the control group, there were significant differences in the results of the water maze test and step-down test between NP 200 mg/kg and the control group (P <005). The changes of the uhrastructure were found among the hippocampus neurons of NP 200 mg/kg group that characterized with chromatin condensed,clumped in circa-nuclei and mitochondrial tumefaction and vacuolization.Conclusion Exposures to NP during gestation might decreased abilities of spatial learning and memory capacity on F1 rats significantly.

Objective To evaluate a modified technique for digestive tract reconstruction after pancreaticoduodenectomy(PD).Methods 171 admitted patients were enrolled from January 2012 to January 2014 at our department.According to the preoperative CT scan and intraoperative exploration,pancreaticogastrostomy was performed in cases of soft pancreas texture,while pancreaticojejunostomy was performed in fibrotic pancreas after PD.Bypassed biliary-pancreatic reconstruction were applied on all cases.Results For the digestive tract reconstruction after PD,92 patients underwent pancreaticogastrostomy,79 patients underwent pancreaticojejunostomy.The median time for the surgery was 240.0 minutes (ranging from 186 to 414 min).Operative mortality was zero,and morbidity was 18.1％ (n =31),including hemorrhage (n =4),biliary fistula (n =3),pulmonary infection (n =2),adipose liquefaction and operative incision infection (n =0),delayed gastric emptying (DGE) (n =6),abdominal abscess (n =4).Fout patients developed a pancreatic fistula (type A in 2,type B in 2).Conclusions Modified pancreaticogastrostomy,pancreaticojejunostomy and biliary-pancreatic bypass is safe for digestive tract reconstruction after pancreaticoduodenectomy.