Objective To investigate the effects of preoperative biliary drainage ( PBD ) on the morbidity and mortality of pancreaticoduodenectomy in patients with malignant obstructive jaundice in the lower bile duct. Methods Clinical data of 74 cases undergoing pancreaticoduodenectomy from Jan. 2000 to Dec. 2005 with preoperative total bilirubin level over 85 μmol/L were collected and retrospectively analyzed. Comparison was performed between patients receiving PBD and those not. Before surgery. The parameters sincluding perioperative situation, in-hospital death rate, post-operative complications and were calculated to evaluate the influence of pre-operative biliary drainage on the outcomes. Univariate analysis and Logistic analysis were used to identify the risk factors for post-operative complications. Results Forty (40/74) cases received PTCD procedure. The total bilirubin was significantly reduced from (338. 10±88. 38 )μwnol/L to ( 228. 50±82.24) μ,mol/L in PTCD population and was significantly lower than ( 328. 60±93. 02) μmol/L of the non-PTCD group. There was no significance between the two groups in terms of total complications and individual complication Logistic regression analysis showed that preoperative TB over 340 μmol/L and blood loss over 600 ml were important risk factors for post-operative complications. Conclusion High pre-operative total bilirubin over 340 μmol/L increases the risk of post-operative complications in the patients with malignant jaundice. Preoperative biliary drainage is useful to reduce the total bilirubin and improve the hepatic function of the patients. Prolonged pre-operative biliary drainage could be considered in the patients with high preoperative bilirubin,poor nutritional condition and impaired coagulation to enhance the tolerance of surgery.

Ezrin protein function as molecular linker between the actin-cytoskeleton and the plasma membrane,which involves in the formation of microvilli and the maintenance of cello-morphology, movement, adhereance as well as survival, intimate studies of its structure and function have been done. At present many studies indicate that Ezrin involves in the tumor development and tumor metastasis,relate to prognosis. To study Ezrin protein in tumor will provide us other way and standard for diagnose and treatment of tumor and prognostic evaluation.

Acute Disease ; Aneurysm, Dissecting ; complications ; Aortic Aneurysm, Thoracic ; complications ; Female ; Humans ; Myocardial Infarction ; etiology

Angioplasty, Balloon, Coronary ; adverse effects ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; therapeutic use ; Postoperative Hemorrhage ; drug therapy

The expression mode in presentations may affect the efficiency during the teaching. In this study, we used a random-controlled trial to compare the educational efficiency in three different expression modes: script, pictures, animation. Test scores and questionnaire survey were statistically analyzed. It showed that the presentations with animation led to the highest average test score of the students. Visual objects could attract students' interest, enhance memory, and academic achievement. A proper insert of visual objects in teaching presentation is encouraged in the education of medical neurobiology for those medical students.

Objective To analyze the feasibility, safety, and technique of laparoscopic myomectomy in patients with large hysteromyoma. Methods A total of 82 hysteromyoma patients with the uterus larger than 14-week gestational size were treated by laparoscopic myomectomy. The outcome of the operation were compared with that in 182 hysteromyoma cases with the uterus smaller than 14-week gestational size. Results In the 82 patients with the uterus larger than 14-week gestational size, 77 were treated successfully by laparoscopy, in which pneumoperitoneum was used in 68 cases and gasless laparoscopy in the other 9. One of the cases converted to open surgery, and small abdominal incision was made in 4 patients. Compared with the patients with the uterus smaller than 14-week gestational size, the 77 patients who had been successfully by laparoscopy had longer operation time [(157.6?89.7) min vs (35.3?26.2) min, t=16.926, P=0.000] and more blood loss [(218.0?108.2)ml vs (108.5?67.5)ml,t=9.904,P=0.000]. Conclusions Myomectomy can be performed under a laparoscope for patients with the uterus larger than 14-week gestational size. Highly skilled technique is important for the surgery.!Gasless laparoscopy is applicable to myomectomy for patients with the uterus smaller than 16-week gestational size.

Objective To investigate the relationship between fractional exhaled nitric oxide (FENO) and asthma predictive index (API) in infants under 3 years of age. Methods Totally 62 cases (under 3 years of age) who were hospitalized from June 2015 to June 2016 and had more than 3 times wheezing over the past year were enrolled in this study. They were divided into two groups according to API:API positive group with 37 cases and API negative group with 25 cases. FENO levels and peripheral blood eosinophil levels were detected and skin prick allergy test (inhalation and ingestion of allergens)was done in all selected children, did skin prick allergy test (inhalation and ingestion of allergens), simultaneous detected peripheral blood eosinophil levels. The parents of the children were investigated by questionnaire to know the children′ history about atopic dermatitis (such as urticaria, eczema, etc) and parents′ wheezing history. Above information was recorded and statistics analysis was made. Results There were no significant differences between two groups in atopic dermatitis inhalation and ingestion of allergens (P<0.01 or <0.05). The level of FENO in API positive group and API negative group was (16.70 ± 11.07), (13.52 ± 11.01) ppb(1 ppb=1 × 10- 9 mol/L), and there was significant difference (P<0.01). Conclusions There are associations between FENO and API, and they have good reference value in predicting the risk of asthma.

Objective To discuss the effect of blood glucose monitoring during pregnancy and pregnancy outcome in patients with gestational diabetes mellitus (GDM). Methods One hundred and fifty-three GDM patients from July 2007 to July 2008 were analysed.The cases were divided into satisfactory group (74 cases)and unsatisfactory group (79 cases) based on the level of bleod glucose and compared the pregnancy outcome between the two groups. Results The incidences of pre-eclampsia, polyhydramnios, macrosomia, neonatal hypoglycemia, hyperbilirubinemia of satisfactory group were lower than those of unsatisfactory group(5.41% vs 17.72%,4.05% vs 20.25%, 12.16% vs 31.65% , 5.41% vs 20.25%,8.11% vs 30.38%). The difference is statistically significant (P <0.05). The incidence of premature rupture of membranes, premature birth, postpartum hemorrhage, fetal distress of satisfactory group were lower than those of unsatisfactory group, but there was no significant difference between the two groups. Conclusion GDM can cause great harm to maternal and child health, and satisfactory blood glucose control during pregnancy may reduce maternal and child complications.

Objective To investigate the effects of lappaconitine on the perioperative immune function.Methods Twenty-four ASA I or II patients aged 23-64 yr undergoing elective radical mastectomy (8 patients),iaminectomy and vertebral canal decompression (8 patients) or femoral head replacement (8 patients ) were randomly divided into 2 groups (n=12 each): control group (C) and lappaconitine group (L).In group L ondansetron 4 mg was given IV and lappaconitine 8 mg was infused IV over 30 rain before induction of anesthesia.In group C equal volume of normal saline was infused instead of lappaconitine.Anesthesia was induced and maintained with propofol,remifentanil and rocuronium.Lappaconitine 0.28 mg/ml was continuously infused at 2 ml/h after induction of anesthesia in group L.When the patients recovered from anesthesia after operation,PCA with 0.28 mg/ml lappaconitine was started (background infusion 2 ml/h,bolus dose 0.5 ml and lockout interval 15 min).In group C pethidine 50 mg and droperidol 2.5 mg were given IM on demand.Venous blood samples were taken at 30 rain before induction of anesthesia(T1,baseline),immediately (T2) and at 24 h(T3) and 48 h (T4)after operation for determination of TNF-α,IL-2,IFN-γ and sIL-6R concentration by ELISA.CD3,CD4,CD8 and NK cell expression was determined using flow cytometry and the ratio of CD4/CD8 was calculated.The concentrations of IgA,IgM,IgG,CD3 and CD4 were determined by radioimmunoassay.Results Plasma SIL-6R and TNF-α concentrations were significantly lower while IL-2,IgA,IgG,IgM concentrations and CD4/CD8 ratio were significantly higher after operation in group L than in group C.Conclusion Lappaconitine can improve perioperafive humoral immune function thus contributing to its analgesic and anfi-inflammatory effects.

Objective To study proliferation,secreted cytokines,immune phenotypes and cytotoxicity on Raji cells by cytokine induced killer (CIK) cells co-cultured with dendritic cells (DC).Methods The mononuclear cells from peripheral blood of healthy individuals were extracted,then cultured the cells under 5 ％ CO2 at 37 ℃ for 2 hours.DC were induced from suspended cells,and CIK cells were from adherent cells.After 9 days of nurturing,two types of cells were mixed.CIK cells were cultured alone as the control.The cytotoxic activity of CIK and DC-CIK cells were detected by MTT assay.The morphologies,proliferation,secreted cytokines,and immune phenotypes of the two cells in day 0,3,6,9,12,15 in culture were monitored.Results In day 12 in culture,comparing with CIK cells,DC-CIK cells significantly enhanced the proliferation rate [(42.44±2.68) fold vs (30.01±2.05) fold] (t =11.64,P ＜ 0.05) and had increased IL-2,IFN-γ,IL-12 and TNF-α secretion [(124.34±12.57) ng/L vs (56.32±6.58) ng/L,(496.60±95.32) ng/L vs (247.80± 69.45) ng/L,(84.92±6.07) ng/L vs (24.18±3.31) ng/L,(380.6±45.95) ng/L vs (196.61±24.19) ng/L] (t =15.16,P ＜ 0.05; t =6.67,P ＜ 0.05; t =27.78,P ＜ 0.05; t =11.20,P ＜ 0.05),and there were more CD3+ CD8+ cells and CD3+ CD56+ cells in the co-culture [(71.79±1.73) ％ vs (60.37±3.24) ％,(48.54±3.30) ％ vs (33.07±2.22) ％](t =9.83,P ＜ 0.05; t =12.30,P ＜ 0.05),and DC-CIK cells had a significandy increased cytotoxicity on Raji cells in vitro at the same ratio of effector cells to target cells.Conclusion CIK cells have higher proliferation rate and cytotoxicity against Raji cells when co-cultured with DC.