Objective To evaluate the impact of pancreatic duct hanging and continuous suturing maneuver in end-to-side pancreaticojejunostomy on the incidence of pancreatic fistula after pancreaticoduodenectomy (PD),and to study the feasibility,safety and efficacy.Method 165 patients who underwent pancreaticoduodenectomy were randomly selected and the incidences of pancreatic fistula for the different types of pancreaticojejunostomy were analyzed.Results The overall rate of pancreatic fistula was 13.9％ (23/165).The incidences of pancreatic fistula after pancreatic duct hanging and continuous suturing maneuver in end-to-side anastomosis (3.1％,2/65,group C) was significantly lower than the traditional intussusception anastomosis (23.1％,12/52,group A,P＜0.05) and the mucosa mucosa anastomosis (18.8％,9/48,group B).There was no significant difference between the traditional intussusception anastomosis and the mucosa mucosa anastomosis (P＞0.05).In group C,the average operative time,intraoperative blood loss,and postoperative drainage was obviously superior to the A and B group (P＜0.05).There was no significant difference between the A and B group (P＞0.05).The other complications showed no significant differences among the three groups (P＞0.05).Conclusion Pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis significantly reduced the rate of pancreatic fistula after pancreaticoduedenectomy.It was feasible,safe,convenient to use and should be popularized.

Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P ＜0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P ＜ 0.05).The predicted ratio of liver to be resected was 60％ ± 18％ at postoperative week 3,which was significantly smaller than 67％ ± 15％ before operation (F =12.35,P ＜ 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9％ (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.

Objective To investigate the prevalence and risk factors of postpartum depression among female immigrants at Tianhe district of Guangzhou. Methods A total of 2021 migrant women postpartum in three hospitals at Tianhe district of Guangzhou were screened with Center for Epidemiological Survey Depression Scale , (CES-D), Social Support Rating Scale(SSRS) and self-made related factors questionnaire from May to December, 2013. Results This study showed postpartum depression affected 18.31% of migrant women at Tianhe district of Guangzhou. Unconditional logistic regression analysis showed a significant correlation of PPD with birth place , residence time,newborn disease,fetus gender and household income (P < 0.05). Multivariate logistic regression analysis identified birth place,residence time,newborn disease,fetus gender as the risk factors for PPD,household income was negatively correlated with the incidence of PPD with OR value of 0.680;Compared with healthy female immigrants, the total score of social support rating scale,the score of objective support,subjective support and social utilization degree were significantly reduced respectively in female immigrants with PPD. Conclusion The prevalence of PPD was high at Tianhe district of Guangzhou,health education and comprehensive social support system should be offered in order to prevent PPD.

This article was aimed to study the correlation between iron content inCornus officinalis leaves and its yield as well as quality. The method of microwave digestion atomic absorption spectrophotometer was used to determine the content of iron element inCornus officinalis leaves. HPLC was used to determine the content of loganin and ursolic acid in fruits. Correlation analysis was made among the content of iron element, yield of fruits, loganin and ursolic acid in fruits. The results showed that iron element in leaves of different yield level cornus officinalis was different. It also had some correlation with yield and quality of fruits. It was concluded that the research can improve relations of source-sink inCornus ofifcinalis, adjust source-sink balance, guide farmers to master the period of spraying iron fertilizer, and increase production and quality ofCornus ofifcinalis.

Objective To evaluate a modified liver hanging maneuver(retrohepatic tunnel of the IVC) in patients undergoing hemihepatectomy.Methods Twenty-four patients undergoing hemihepatectomy were divided into two groups:modified liver hanging maneuver group(n=12)and Pringle's maneuver group(n=12).The amount of intraoperative bleeding,operation time,postoperative liver function,liver function recovery and complications were compared between the two groups.Reset All operation were performed successfully and there were no difference in the time of operation etween the two groups.There was a difierence in the amount of mean intraoperative blood loss between the two groups.It was(160±40)ml in liver hanging group and(560±120)ml in Pringle's group(P＜0.01).Liver function recovery measured on postoperative day 3 and day 7 was better in liver hanging groupthan that in Pringle's group(P＜0.01).The volume of postoperative peritoneal serous fluid dranage was significantly less in liver hanging group(P＜0.01).Conclusion The modified liver hanging maneuver is useful for hemihepatectomy.

The article analyses the protrudent problems in teaching foreign students and put forward some countermeasures.

Objective By means of analyzing the antihypertensive use of hypertension patients of Guiyang in 2013 and impact factors for basic drug use,to evaluate the impacts of the essential medicines list in place in Guiyang to hypertension patients in communities in Guiyang.Methods 969 hypertension patients were surveyed with structured questionnaire of stratified random sampling at 6 community health centers in Guiyang city.Results Hypertension patients in communities averaged 1.4 types of antihypertensive,and the essential medicines used accounted for 39.8％of all the antihypertensive.The distribution differences of the ratio of essential medicines use are significant interms of age,gender,and household annual income.Use ratio of non-essential medicines of the 55～64 age group and 65～74 age group are 3.48 times and 0.47 times over that of the 75 and above age group.For hypertension patients of low income and medium income,their probable use of non-essential medicines is 2.05 and 2.87 times that of high income households.Conclusion As the use ratio of hypertension patients in Guiyang is relatively low,and the factors for it are age and household income,focused intervention is recommended for the 65～74 age group and low-income households,for the purpose of high use ratio of essential medicines of such people.

Objective　To investigate the effect of positive pressure ventilation on radiosensitivity of the patients suffering from primary lung cancer. Methods　Thirty cases of lung cancer were randomly divided into two groups: ① combining therapy group: patients treated with posi tive pressure ventilation using BiPAP respirator and radiotherapy;② simple radi otherapy group. The changes of PaO2, SaO2, blood white cells and the cellula r immunological function were observed before and after treatment. Resul ts　Nasal or naso-facial positive pressure ventilation with BiPAP respi rator increased PaO2 significantly with the maximum of 7.5 kPa, SaO2 was ma inteined at above 95%. No significant change for the cellular immunological func tion was found in the combining therapy group （P>0.05）and only one patient with leukopenia（6.7%）. But in the radiotherapy group, the lymphocyte transfor mation efficiency and the ratio of CD4/CD8 were obviously decreased（P<0 .01), and leukopenia was found in 5 cases（33.3%）. Conclusion　 Nasal or naso-facial positive pressure ventilation with BiPAP respirator could improve the effect of radiotherapy for lung cancers. It could also increase PaO 2 significantly and has protective rote to the marrow and cellular immunologic al function of the patients.

OBJECTIVETo observe preventive and therapeutic effect of Yifei Jianpi Recipe (YJR) on chronic obstructive pulmonary disease (COPD) model rats and to explore its mechanism from the way of airway inflammation and airway mucus hypersecretion.

METHODSThe COPD rat model was established by using cigarette smoking combined with intratracheal injection of lipopolysaccharide (LPS). Male SD rats were randomly divided into the blank control group (control group), the model group, the YJR group, 6 in each group. Forced vital capacity (FVC), forced expiratory volume in 0. 1 second (FEV0. 1), FEVO. 1/FVC, peak expiratory flow (PEF) was tested by lung function device. Pathological changes of bronchi and lung tissues were observed by HE staining. Airway Goblet cells were observed using AB-PAS staining. Contents of IL-8, IL-17, and TNF-α in bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay (ELISA). Protein expressions of intercellular cell adhesion molecule-1 (ICAM-1), nuclear factor KB (NF-KB), mucin 5AC (Muc5AC), and Toll-like receptor 4 (TLR4) in rat airway were detected by immunohistochemical assay. mRNA expressions of TLR4 and Muc5AC in bronchi and lung tissues were detected by real-time quantitative PCR (RT qPCR).

RESULTSChanges of bronchi and lung tissues in the model group rats were consistent with typical pathological manifestations of COPD. Compared with the model group, the degree of lung injury was significantly alleviated in the YJR group. Compared with the control group, FVC, FEV0. 1, FEVO. I/FVC, and PEF were decreased (P <0. 01), contents of IL-8, IL-17, and TNF-α in BALF were significantly increased (P <0. 01), protein expressions of ICAM-1, NF-KB, Muc5AC, and TLR4, mRNA expression levels of Muc5AC and TLR4 in bronchi and lung tissues were also significantly increased in the model group (P <0. 01). Compared with the model group, FVC, FEV0. 1, FEV0. 1/FVC, and PEF were significantly increased in the YJR group (P <0. 01, P <0. 05), but the rest indices were significantly lowered (P <0. 01, P <0. 05).

CONCLUSIONYJR could decrease contents of IL-8, IL-17, and TNF-α in BALF of COPD model rats, inhibit protein expression levels of ICAM-1, NF-κB, Muc5AC, and TLR4.in airway and lung tissues, thus playing preventive and therapeutic roles by reducing airway inflammation and airway mucus hypersecretion.

Animals ; Bronchi ; Bronchoalveolar Lavage Fluid ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Inflammation ; Intercellular Adhesion Molecule-1 ; metabolism ; Interleukin-17 ; metabolism ; Interleukin-8 ; metabolism ; Lipopolysaccharides ; Lung ; Male ; Models, Animal ; Mucin 5AC ; metabolism ; Mucus ; metabolism ; NF-kappa B ; metabolism ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; administration & dosage ; Dexamethasone ; administration & dosage ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Lymphoma, Primary Cutaneous Anaplastic Large Cell ; pathology ; Lymphoma, T-Cell, Cutaneous ; drug therapy ; pathology ; Lymphomatoid Granulomatosis ; pathology ; Male ; Middle Aged ; Natural Killer T-Cells ; pathology ; Neoplasm Recurrence, Local ; Skin Neoplasms ; drug therapy ; pathology ; Young Adult