Objective To improve the accuracy of early diagnosis and choose suitable management for duodenal injury. Methods Clinical experience was summerized during recent 25 years. Results Of the 19 patierts, 14(74%) had multiple injuries. All patients were treated by operations, including 10 with primary repair , 3 with repair plus duodenumcele, and 3 with Roux-en-y duodeno-jejunostomy, 1 with pancreatoduodenectomy, 2 with modified Cogbill's method. Seventeen patients were cured successfully,and 2 died of multiple organs injuries, septic shock and multiple organ failure. Conclusions Correct treatment and appropriate operation are essential for duodenal rupture in severe multiple injuries.

OBJECTIVE:To establish a RP-HPLC method for the determination of aristolochic acid A in decoction of Caulis Aristolochiae Manshuriensis METHODS:The analytical column was Spherisorb ODS2 column(4 6mm?250mm,5?m) The mobile phase consisted of a mixture,methanol-water-acetic acid(70∶27∶1) The flow rate was 1 0ml/min The UV detection wavelength was 250nm RESULTS:The linear range was 0 0 128?g～0 4 096?g(r=0 9 999) The regression equation was Y=4 553 7+5 388 319 3X The average recovery of aristolochic acid A was 97 33%(RSD=2 34%) CONCLUSION:This method is simple,sensitive and accurate

Objective To evaluate surgical mangement of femoral pseudoaneurysm caused by injection of addictive drugs. Methods The clinical data of 13 cases with femoral pseudoaneurysm resulted from drugs injection were retrospectively analyzed. All cases underwent operation treatment. 1 case received aneurysmectomy and lacerative repair, and 13 cases received aneurysmctomy and vascular grafting. The grafts included autogenous saphenous vein, artificial blood vessel and so on. Results The postoperative color ultrasound Doppler detection showed that all of the vascular grafts were patent, and the limbs of all the 13 patients were salvaged. Conclusion Complete debridement,vascular reconstruction and proper treatment of complications were the key factors of treating successfully the femoral pseudoaneurysm resulted from drugs injection.

Objective To assess the value of ultrasonic probe (USP) in the diagnosis of Submucous eminence of colorectume.Methods Sixty-eight patients with colorectal submucous eminence in 70 areas received USP under colonoscope.The accuracy of diagnosis was evaluated.Results Twenty carcinoid tumor were detected which manifested submucous hypoechoic ; Lipoma 12,located in right half colon which manifested submucous layer,clear boundaries hyperechoic; Cyst 12 manifested single or multi lattices no-echo on submucous which have integrated involucrum.Mesenchymoma or myoma levicellulare 12,most of them located inthe rectum manifested uniform or no-uniform hypoechoic on the muscularis mucosa or below and were difficult to discriminate.Malignant lymphoma,3 manifested muscularis mucosa and submucosa thickening,muscularis propria were seldom affected.Vascular diseases (hemangioma,varicosity) 3,manifested no-echoic on mucosa or submucosa,some medium,high echoic,circular or irregular,and also endometriosis 2,pigment deposition 1,appendix abscess 1,extramural compression 2,ultrasonic test is marched with clinic diagnosis.Accuracy rate is 100％.Conclusion USP can diagnose colorectal submucous eminence with high accuracy,and even provide information about the size,layer of origin,border of the colorectal submucous eminence and can distinguish benign or malignant tumor according to ultrasonic check,at the same time provide differentiation with extramural compressive lesions.

Objective To study the method and effect of exposure the recurrent laryngeal nerve(RLN) in preventing the damage of RLN in thyroid surgery. Methods One thousand and ten sides total and(or) subtotal thyroidectomies were operated on 574 cases with RLN exposure in our hospital in recent 9 years. Results The RLN injury rate was 0.3% in this series.Of them, permanent RLN injury occurred in 2 cases and temporary injury in 1. Conclusions The exposure of RLN can greatly decrease the nerve injure in thyroid surgery, especially in total lobectomy. The dissection of RLN must followed the principle of RLN exposure . RLN should be dissected around the inferior thyroid artery first, if the RLN is difficult to be found,then dissecting around the thyroid cartilage, or finding the cervical vagus inside of carotid sheath to find RLN should be done.

Objective Detecting the level of IDO and KYN in ulcerative colitis (UC) patients; using ROC curve to discuss their value in the diagnosis of patients with active UC. Methods 60 cases of UC group, 18 cases of dis-ease control group and 20 cases of healthy control group were included in the study. Immunohistochemical staining methods were used to detect the expression of IDO in colonic mucosa of UC, enzyme-linked immunosorbent (ELISA) methods were used to detect the serum levels of IDO, KYN and CRP, and the value with ROC curve method was analyzed. Results ① There was a positive correlation between IDO level and IDO expression (P<0.05). There was a positive correlation between KYN level and IDO expression (P<0.05). ②The levels of IDO and KYN in UC group were higher than those of disease control group and health control group (P<0.05). ③The levels of IDO and KYN in patients with active UC were significantly higher than that in patients with catabasis UC (P<0.01), and the levels increased with severity of inflammation. ④ The levels of IDO and KYN in active UC were positively related to disease activity and CRP levels (P<0.05). ⑤The IDO,KYN and CRP area under ROC curve were 0.976, 0.856 and 0.864;best cut-off point were 53.66 U/L, 2.34 nmol/L and 1.75 mg/ml;sensitiv-ity were 90.5%, 78.65% and 100.0%; specifity were 94.4%, 83.3% and 61.1%; Youden index were 0.839 2, 0.619 0 and 0.611 1. Conclusion The levels of IDO and KYN in serum can be used as an important index to judge the severity of UC. They have important value in the diagnosis of active UC . The value of IDO is higher than KYN and CRP.

cryⅢ gene,they were found in 75 6%,67 9%,58 4% and14 5% of the strains respectively,no cryⅠ Ⅴ gene was found,10cry gene combination types were concluded.The Bt isolates which contained cryⅠ genes were further characterized by additional PCR detection with specific primers of the cryⅠAc,cryⅠC and cryⅠE genes.20 Bt isolates which contained cryⅠAc,cryⅠC,cryⅡ and cryⅤ genes were found,among them the strain Bt\|15A3 is high toxic to Heliothis armigera,Spodoptera exigua and Plutella xylostella,and has potential developing and applying value.

Objective To study the methods and benefits of exposure of recurrent laryngeal nerve(RLN) in thyroid surgery Methods In this study, 2148 patients admitted in our hospital from July 1993 to July 2003 were divided randomly into two groups: RLN exposure group (936 cases) and RLN non exposure group (1212 cases) RLN was dissected around the inferior thyroid artery, thyroid cartilage, and cervical vagus Results Two cases (0 21%) suffered from RLN injury in exposure group and 5 cases (0 41%) suffered from RLN injury in non exposure group ( P

Objective To explore the association of anti-mullerian hormone(AMH)in seminal plasma and serum with sperm counts and energy for male.Methods For 215 cases of healthy male selected from our reproductive clinic,with women′s reason for infertility,seminal plasma and serum AMH were detected,as semen parameters(sperm density,living rate,vitality and malformation rate),6 items of serum sex hormone.In seminal plasma and serum AMH respectively as the dependent variable,using multiple line-ar regression model to explore its quantitative relation with semen parameters and sex hormone levels.Results 215 cases were en-rolled,aged 34.28±5.70 years,while the median of the seminal plasma AMH was 0.47,quartile 0.05-3.09 pmol/ejaculation.The median of the serum AMH was 53.07,quartile 32.32 -72.20 pmol/L.Through multiple linear regression analysis,after adjusted by age and BMI,the seminal plasma of AMH and total number of sperm,sperm concentration,dynamic motility,total sperm activi-ty,serum inhibin B were positively correlated(P <0.05);The correlation between sperm morphology and other serum sex hormone had no statistical significance(P >0.05);Serum AMH negatively correlated with serum FSH,with serum inhibin B positively(P <0.05);Seminal plasma in various parameters and other related serum sex hormone had no statistical significance(P >0.05).Conclu-sion The seminal plasma of AMH were positively correlated with sperm concentration,sperm counts,sperm vitality,with the asso-ciation for serum AMH not yet found.

Objective: To investigate the changes of serum proneurotensin (PNT) and insulin-like growth factor-1 (IGF-1) levels in patients with diabetic peripheral neuropathy (DPN) and their relationship with nerve conduction velocity (NCV) and Toronto Clinical Scoring System (TCSS), so as to observe the clinical efficacy of modified Buyang Huanwu Tang on DPN patients and its effect on the levels of PNT and IGF-1. Method: Totally 68 patients with DPN were randomly divided into treatment group and control group, with 34 cases in each group. Both groups were given mecobalamin capsules orally in addition to routine therapy of diabetes, while the treatment group was given modified Buyang Huanwu Tang orally for 4 weeks. The sensory nerve conduction velocity (SNCV) of median nerve, motor nerve conduction velocity (MNCV) of median nerve, SNCV of common peroneal nerve, MNCV of common peroneal nerve, TCSS score and serum PNT, IGF-1 levels were observed before and after treatment. Result: Before treatment, there was no significant difference in SNCV of median nerve, MNCV of median nerve, SNCV of common peroneal nerve, MNCV of common peroneal nerve, TCSS score and serum levels of PNT and IGF-1 between two groups. Serum levels of PNT and IGF-1 were positively correlated with SNCV of median nerve, MNCV of median nerve, SNCV of common peroneal nerve and MNCV of common peroneal nerve (P<0.05), and negatively correlated with TCSS score (P<0.05). Compared with those before treatment, SNCV of median nerve, MNCV of median nerve, SNCV of common peroneal nerve, MNCV of common peroneal nerve and the levels of serum PNT and IGF-1 in both groups were significantly increased (P<0.05), while TCSS scores were significantly decreased (P<0.05). Compared with control group, SNCV of median nerve, MNCV of median nerve, SNCV of common peroneal nerve, MNCV of common peroneal nerve and the levels of serum PNT and IGF-1 in treatment group were higher than those in control group (P<0.05), TCSS score was lower than that in the control group (P<0.05), and the total effective rate in treatment group was higher than that in control group (P<0.05). Conclusion: Serum PNT and IGF-1 may be involved in the occurrence and progress of DPN in patients with diabetes mellitus. Modified Buyang Huanwu Tang can increase the levels of serum PNT, IGF-1, NCV but reduce TCSS score in patients with DPN. It has a definite curative effect on DPN.