Objective To evaluate the diagnostic method for and surgical effect on hilar cholangiocarcinoma. ] Methods The clinical features, diagnosis, surgical therapy and long term result were retrospectively analysed on 192 cases of hilar cholangiocarcinoma admitted into our hospital from Jan.1984 to Jun.1999Results] MRCP delineated 100%(44/44) of the hilar tumors. 153 cases underwent exploration. 88 cases treated by internal or external drainage have survived for 3～15 months. Tumor resection was performed on 53 cases, and orthotopic liver transplantation on 2 cases, with a resection rate of 36%(55/153) including radical resection in 38 cases (median survival period was 31 months). 17 cases undergoing palliative resection have a median survival period of 13 months. Conclusion MRCP was an ideal noninvasive preoperative examination for identifying hilar cholangiocarcinoma. Routine frozen section of the bile duct margin should be adopted. Radical resection definitely prolongs survival period. For Bismuth type Ⅲ、Ⅳ without extrahepatic metastasis, orthotopic liver transplantation was an effective surgical therapy.

Objective To evaluate the effect of operation method in surgical treatment of pancreatic cyst. Method Retrospectively stastical analysis on 118 cases of pancreatic cyst was carried out.Result Thirty-one cases underwent external drainage,54 cases were subjected to internal drainage,and 33 cases to resection.Con- clusion For a genuine cyst,it is better to have it reacted.External drainage is only indicated for pseudocysts in emergent situations such as infection,hemorrhage or rupture,but is often accompanied with multiple complica- tions.Internal drainage is indicated for unresectable cysts and is superior to the external one,but it has some com- plications too.Resection of the pancreatic body and tail is the first choice for cysts located there,and it shows a good and thorough therapeutic effect with seldom recurrence.

Objective To investigate the levels of interleukin-1?,interleukin-6,tumor necro- sis factor-? in preterm labor with intraamniotic infection(IAI).Methods Plasma and amniotic fluid were sampled from 30 women with preterm labor(Group A),31 women with term labor(Group B) and 46 women without labor but after 37 weeks(Group C).Interleukin-6 in blood,interleukin-1?, interleukin-6 and tumor necrosis factor-? in amniotic fluid were examined.IAI were diagnosed accord- ing to clinical criteria or bacterial culture or pathology.Results 1.The levels of IL-6 in blood in Group A were higher than in Group Band C(46.34 vs 20.53,6.67pg/ml,P

Objective: To determine the activity of avidin in hens egg white power after heat treatment.Methods: Avidin from dried hens egg white powder was isolated, purified and characterized. Results: 3—6 mg and 1—3 mg of avidin could be detected from 100 g dried egg white powder after 65 ℃,80 ℃ treatments respectively. The specific activity was 9.7 units (65 ℃) or 6.8 units (80 ℃) per mg protein respectively. Conclusion: Avidin does not lose its activity completely after heat treatment at 65℃ or 80℃.

BACKGROUND:How to control functional activity of donor liver after cardiac death and maintain the optimal function of grafts are the key issues in organ transplantation study.
OBJECTIVE:To preliminarily explore the effect of warm ischemia injury on the morphology and function of rat donor liver after cardiac death.
METHODS:Cardiac death model was established in Sprague-Dawley rats and the successful models were divided into six groups:control group (warm ischemia for 0 minute), warm ischemia 10 group (warm ischemia for 10 minutes), warm ischemia 20 group (warm ischemia for 20 minutes), warm ischemia 30 group (warm ischemia for 30 minutes), warm ischemia 40 group (warm ischemia for 40 minutes) and warm ischemia 50 group (warm ischemia for 50 minutes). The rat liver specimens in each group were cut into ultrathin sections. The structure of liver cells was observed and photographed by electron microscopy. Flameng score was applied to analyze the degree of mitochondrial damage. Liver mitochondria were extracted and then spectrophotometry was used to assess the viability of cytochrome C oxidase.
RESULTS AND CONCLUSION:Under electron microscopy, there were no significant changes in liver cells within 30 minutes of warm ischemia, nuclear membrane was intact, mitochondria mildly swel ed, no mitochondrial crista ruptured, and Flameng score was<2 points. With the extension of warm ischemia time, the cells became swel ing, nuclear chromatin condensated, apoptotic body was clearly visible, mitochondrial matrix coagulated, mitochondria exhibited vacuolation, and Flameng score was 3-4 points. The viability of cytochrome C oxidase showed no significant difference within 30 minutes of warm ischemia, but began to significantly decrease at 40 and 50 minutes. The mitochondrial structure and function after liver injury is not obviously affected by 30 minutes of warm ischemia, and significant changes appear after 40 minutes.

Objective To study the application of intraoperative drug administration in simultaneous pancreas-kidney transplantation(SPK), in order to achieve favorable postoperative results. Methods In the 19 cases of SPK,we primarily administered albumin 1.5~2.0g/kg to increase blood volume. Intraoperative electrocyte fluid dosage was 30~50mL/kg. Isoptin, 5mg/12h and prostaglandin E1(PGE1) 100?g/12h was given to lessen preservation injury and somatostatin(3mg/12h) to inhibit exocrine secretion of the transplanted pancreas. Results After reperfusion,the 19 transplanted pancreas grafts secreted amylase averaging 20 800U/L,and the transplanted kidneys produced urine,through the ureters,in 2~10min.In the 19cases,exogeneous insulin was withdrawn within 1.5h~9d and kidney function returned to normal within 2~4d. Conclusions In the SPK recipients, the rational use of albumin, vasodilators and somatostatin plays an important role in obtaining better function of transplanted pancreas and kidney.

Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of malignant fibrous histiocytoma (MFH) of thyroid. Methods The clinical case and follow-up data (n=3) of MFH of thyroid from our hospital between 2000 and 2007 was analyzed, with the correlating references reviewed. Results MFH of thyroid accounted for 0.574% (3/523) of malignant tumor of thyroid. MFH of thyroid progressed so fast as to invase recurrent laryngeal nerve (RLN) and /or cervical lymph nodes. Conclusions The diagnosis of MFH of thyroid is difficult, for it is easy to be misdiagnosed as thyroid carcinoma. Immunohistochemistry pathology can provide a good differential diagnostic value, with CK negative, Tg negative, and Vimentin positive to support the diagnosis of MFH. Extensive and thorough excision should be the main choice to treat MFH of thyroid. Patients of MFH of thyroid often died of recurrence or metastasis in 2 years after operation. MFH of thyroid is a kind of rare thyroid primary tumor, with malignancy of high grade and poor prognosis. The disgnosis of MFH of thyroid depends on immunohistochemistry staining, while excision should be the main choice for treatment.

Based on summarizing the international experiences and reviewing the historical evolution and current situation of the physicians'compensation system of public hospitals in China,this paper clarified the existing problems of the current compensation system.Such problems namely included lack of security on the source of the physicians'compensation,low level of sunshine salary which caused thecompensatory mechanism,lack of scientific design of the salary structure and allocation,as well as other underlying causes.Drawing lessons from reform practices at home and abroad,the basic principles and reform directions were put forward,as well as 4 route selections,namely establishing an security investment system to guarantee a stable and higher level salary under the current compensation system, implementing a high level of flip-type annual compensation with locking the current salary into files, establishing an appropriate compensation system referring to an innovated evaluation system of physicians in public hospitals,and coordinating closely with public institution reforms to promote physicians' compensation system reform.

OBJECTIVE To understand the pathogens and their drugs resistance in general surgery department and provide rational suggestion of antibiotics use for clinic treatment.METHODS A total of 158 cases with nosocomial infection among the general surgery department inpatients from Jun 2006 to Oct 2008 were retrospectively analyzed and summarized.RESULTS The common nosocomial infection sites were the lower respiratory tract,gastrointestinal tract,urinary tract and surgical sites.The G-bacilli of nosocomial infections in turn were Escherichia coli(18.02%),Acinetobacter baumannii(11.26%),Pseudomonas aeruginosa(7.66%),and Klebsiella pneumoniae(4.50%).The main G+cocci were Staphylococcus aureus(21.62%),Enterococcus faecium(5.86%)and E.faecalis(3.15%)in turn.In G-bacilli,the sensitivity to imipenem was the highest from 58.82% to 100.00%.The sensitivity to amikacin were more than 70.00% except A.baumannii,and to sulbactam/cefoperazone were more than 50.00% except Pseudomonas aeruginosa.In G+ cocci,the sensitivity to vancomycin of S.aureus and E.faecium was 100.00% and 84.62%.CONCLUSIONS Investigating the pathogens and their drug resistance in general surgery department is very important to prevent and control nosocomial infections.

Objective To provide the utilization information of drugs in Chongqing ,which has been analyzed the statistical data from 18 Chongqing medical organizations'sales volume from 2005 to 2007. Methods We have investigated and graded the sum of the drug purchasing money,the significant medical varieties,and the pharmaceutical manufactories to analyze the latest situation during this three years. Results According to the analysis,the sales number was increasing at a rate of about 20% per year. Water,heat and balance of electrolyte were the most positive rate increased (106.85%). However,the vitamin sell was the negative one dropping down at the rate of 10.47%. In addition,there was only three pharmaceutical companies in Chongqing ranked top 100. Conclusion To predict the future of the drug purchasing money will still rise successively. Nevertheless,it is influenced by rectifying the domestic medicine market so that Chongqing pharmaceutical enterprises are developing slowly without new varieties of drugs being produced.