Objective To evaluated the preserving or removing jejunal mucosa pancreatico-jejunal invaginated anastomosis in pancreaticoduodenectomy.Methods Between February 2003 and December 2012,58 patients underwent pancreaticoduodenectomy using pancreaticojejunal invaginated anastomosis in our department.In group A,28 patients received pancreatico-jejunal invaginated anastomosis using jejunum preserving technique.Briefly,3 to 4 cm remanent pancreas was inserted into jejunum and thc jcjunum was bundled up using No.7 silk thread at 2 to 3 cm distant to the cutting surface of the pancreas.In group B,30 patients received pancreatico-jejunal invaginated anastomosis using jejunum removing technique.Briefly,the jejunum mucosa was everted and the proximal 3 cmlong mucosa was removed.Then the everted jejunum was re-positioned and the ending of the jejunum was interruptedly sutured to the remanent pancreas.Finally,the covered jejunum was tied up as the group A.Results The pancrcatico-jejunal anastomosis time was 36 ±0.34 minutes shorter in group A than group B (P ＜0.001).The incidence of pancreatic fistula was higher in group B (20.0％) than group A (0％).In contrast,the incidence of post-operative pancreatic bleeding was compared between the two groups (3.6％ vs 3.3％,P =1.000).Conclusions Preserving ejunum mucosa pancreatico-jejunal invaginated anastomosis was unaffected by pancreatic texture pancreatic duct size and position.This method takes the advantages of simple operation and reducing the incidence of pancreatic fistula.

Objective To evaluate the effects of preventing and treating delayed gastric emptying (DGE)in the patients with pylorus preserving pancreaticoduodenostomy(PPPD).Methods The clinical data about PPPD from 1992～2000 were analyzed retrospectively.Results The incidence rate of DGE was 50%,among which gastrostomy was performed in 2/2 cases and not performed in four tenths.Comparing gastric decompression through noses with gastrostomy,the function of gastric wriggle recovered ahead of seven to fifteen days in the former group.Conclusion The incidence rate of DGE in the patients with PPPD is very high.Preventive jejunostomy should routinely be taken and the application of the thin silicon rubber tube through nose is very effective to gastric decompression,combining the traditional Chinese medicine with western medicine.

Objective To summarize the clinical features of angina pectoris after thoracotomy. Methods Eight males with a mean age of 60? 5. 4 years were reported and analyzed, of which four patients underwent esphagectomy, three patients esophagogastrectomy and 1 patient pneumonectomy. Results Three cases were attacked angina pectoris after surgery 2~4 h, three cases in 5~12 h, one case in 36 h, and one case in 72h. Acute mocardial infarction of different degrees happened in five cases, and one case died. Conclusion Angina pectorls after thoracotomy is very dangerous to the patlents and not easily distinguished from chest pain after thoracotomy. It's important for the surgeons to analysis comprensively , diagnose as early as posslble and treat immediately.

Objective To evaluate the effects of preventing and treating delayed gastric emptying (DGE)in the patients with pylorus preserving pancreaticoduodenostomy(PPPD).Methods The clinical data about PPPD from 1992～2000 were analyzed retrospectively.Results The incidence rate of DGE was 50%,among which gastrostomy was performed in 2/2 cases and not performed in four tenths.Comparing gastric decompression through noses with gastrostomy,the function of gastric wriggle recovered ahead of seven to fifteen days in the former group.Conclusion The incidence rate of DGE in the patients with PPPD is very high.Preventive jejunostomy should routinely be taken and the application of the thin silicon rubber tube through nose is very effective to gastric decompression,combining the traditional Chinese medicine with western medicine.

Objective To understand the current status of students' self-efficacy and sense of life meaning in medical college students, and explore the relationship between them, then give advice to improve the students' general self-efficacy and the sense of life meaning.Methods A random sampling method was used to select 386 undergraduates in a medical college from freshman to senior.The purpose in life test (PIL) revised by He Jiying (1994) and general self efficacy scale (GSES) revised by Wang Caikang (2001) were used in this research.Data were analyzed by SPSS 18.0 software, and the data were analyzed by t test, x2 test, Spearman correlation analysis.Inspection level of alpha=0.01 (double side).Results The score of GSES was (2.62 ± 0.40), and the score of PIL was (74.06 ± 11.09);t test showed that the PIL score of students with higher GSES score was higher than the PIL score of students with lower GSES score (t=5.054, P=0.000);The correlation analysis showed that GSES score was positively correlated with PIL score (r=0.283, P=0.000).Conclusion The general self-efficacy and sense of life meaning of medical college students are in the medium level, and the positive correlation exists between the two.A series of measures should be adopted to strengthen the students' general efficacy, so as to improve their sense of life.

Objective To observe the mRNA expression levels of POT1 in peripheral blood mononuclear cells of acquired aplastic anemia patients with different syndrome, and explore its relationship with acquired aplastic anemia and its TCM syndrome. Methods Peripheral blood mononuclear cells of 52 cases with acquired aplastic anemia and 20 cases as control group were collected to detect mRNA expression of POT1 by using real-time quantitative polymerase chain reaction (RT-qPCR), and its relation with TCM syndrome was analyzed. Results The expression levels of POT1 mRNA in patients with acquired aplastic anemia were lower significantly than control group (P<0.05). The expression levels of POT1 mRNA in patients with deficiency of kidney-yin were lower than patients with deficiency of kidney-yang, and it was lowest in patients with kidney deficiency of both yin and yang. There was significant correlation between the expression levels of POT1 mRNA and age (r=0.374, P=0.038). Conclusion The changes in expression levels of POT1 play a role in the pathogenesis of acquired aplastic anemia. There is correlation between mRNA expression level of POT1 in peripheral blood mononuclear cells and TCM syndrome.

In order to obtain liposomes with properties of heptocyte-specificity and pH-sensitivity,four galactosylated derivatives were synthesized. A series of liposomes were prepared by mixing the galactosylated derivatives with DC-chol/DOPE respectively. The liposome 18-gal was proven to have favorable gene transfer efficiency to human hepatoma HepG2 cells, which was significantly inhibited in the presence of galactose solution, indicating that the liposomal transfection activity was mediated by asialoglycoprotein receptors. The liposome showed prominent pH-sensitivity and low cytotoxicity. Its optimum gene transfer conditions were also determined. The results showed that the liposome may be developed as a potential hepatocyte targeting pH sensitive delivery system for nucleic acid drugs.

Bile duct injury is the most common complications of biliary surgery.With the development of tissue engineering,using artificial bile duct to treat the biliary tract disease has become the focus for the treatment of bile duct injury.This article summarizes the applications in clinical work and animal experiment of artificial bile ducts made of biological material,autologous tissue,non-absorbable polymer materials,as well as absorbable polymer materials in the clinical application and animal experiments.The advantageof each material is also discussed here.

BACKGROUND:Previous study has proved that implantation of the tissue-engineering bone with vascular bundles or sensory nerve tracts can promote bone formation, which may be related to the expression of sensory neuropeptide receptors. OBJECTIVE:To investigate the effect of implantation of tissue-engineered bone containing vascular bundles and sensory nerve tracts on the middle-and long-term expression of calcitonin gene-related peptide type Ⅰ receptor (CGRP1R) in the repair of rabbit large femoral defects. METHODS:Thirty-six New Zealand white rabbits were enrol ed and modeled into 1.5 cm femoral defects, and then randomized into three groups. Bone marrow mesenchymal stem cells (BMSCs) were subjected to osteoblastic induction for 7 days, and then seeded onto the β-calcium phosphate scaffold to construct the tissue-engineered scaffold.In sensory nerve group, the tissue-engineered scaffold was implanted into the defect region, and autologous sensory nerve bundles were implanted into the lateral groove of the tissue-engineered bone;in vascular bundle group, the tissue-engineered scaffold was implanted, and autologous femoral blood bundles were implanted into the lateral groove of the tissue-engineered bone;in blank control group, only the tissue-engineered scaffold was implanted. X-ray examination, immunohistochemistry and real-time PCR were performed at 24 and 48 weeks postoperatively. RESULTS AND CONCLUSION:The X-ray scores in the sensory nerve and vascular bundle groups were significantly higher than that in the control group (P<0.05), but no significant difference was found between sensory nerve and vascular bundle groups. Real-time PCR found that the expression level of CGRP1R mRNA in the vascular bundle group was significantly higher than that in the other two groups (P<0.05), but showed no significant difference between sensory nerve and blank control groups.Immunohistochemistry findings showed that CGRP1R positive expression rate in the sensory nerve and vascular bundle groups was higher than that in the blank control group. These results reveal that implantation of the tissue-engineered bone containing vascular bundles can promote the CGRP1R expression.