Objective To study the influence of splenectomy on the surgical efficacy in the patients with gastric cancer in the up-per and middle portion and entire stomach .Methods 86 patients with gastric cancer in the upper and middle portion and entire stomach receiving the gastric cancer D 2 radical operation in the two hospitals from April 2003 to January 2008 were selected and di-vided into the observation group(47 cases) and the control group(39 cases) .The observation group accepted the modified lymph-adenectomy with spleen-preserving ,while the control group accepted the D2 total radical gastrectomy with splenectomy .The long-term effects were compared between the two groups .Results The total hospitalization time and the occurrence rate of postoperative complications were(20 .62 ± 7 .93)d and 10 .64% in the observation group ,which were less than (27 .51 ± 12 .44)d and 30 .77% in the control group ,and the differences between the two groups showed the statistical significance (t=3 .128 ,χ2 =5 .446 ,P=0 .000) . The 5-year survival rate in different TNM stages had no statistical difference between the two groups (P>0 .05) .Conclusion For the patients with gastric cancer in the upper and middle portion and entire stomach without spleen or splenogastric ligament metas-tasis ,the modified spleen-preserving lymphadenectomy could make the patients to get the same prognosis as the gastrectomy com-bined with splenectomy ,which reduces the occurrence rate of complications and is worth promoting clinically.

To correlate the ultrasound and MR imaging of carotid atherosclerotic plaque with its histologic compositions,20 patients(22 lesions) scheduled for carotid endarterectomy were examined by B mode ultrasound and MRI preoperatively. The specimens were also examined postoperatively and the images of carotid plaque were recorded. The transverse pathological sections of plaques were made and matched with images of ultrasound and MRI. 256 gray scale ultrasound densitometric analysis of carotid plaque compositions was performed. Ultrasonic density of calcium, fibrous tissue, hemorrage/thrombus and lipid deposits was (89?12), (53?8), (37?6) and (39?3) respectively in vivo , and was (168?11), (136?12), (85?12) and (89?10) respectively in vitro . In vivo relative signal intensities of calcium, fibrous tissue, old hemorrhage/thrombus and lipid deposits were low, equal, equal and very high respectively on T 1 W MR image, and very low, equal, high and high respectively on PDW MR image, and low, equal or slightly high, high and high respectively on T 2 W MR image. Signal intensities of plaque contents ex vivo were correlated to signal intensities in vivo. Densitometric analysis of ultrasound images of carotid plaques can quantify possible components of plaque, and MRI has the feasibility to identify the components of plaque.

To study the distribution of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries, 32 samples of endarterectomy and 10 autopsies of normal carotid specimens were fixed and embeded in paraffin, sections were stained with hematoxylin-eosin, toluidine blue,monoclonal antibodies against the two major proteases of mast cells(tryptase and chymase) and monoclonal antibodies against CD-3 of T lymphocytes and CD-68 of macrophages. The quantity,distribution and degranule of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries were investigated,and the ratio of mast cells to T lymphocytes and macrophages in atherosclerotic lesions was calculated. The density(cells/mm 2 ) of mast cells in shoulder region of plaque(6 3?4 0) was much higher than that in normal intima,cap and core region(1 3?2 3,2 3?2 6,2 2?3 7) .The proportion of chymase-containing mast cells to tryptase-containing mast cells was 0 36,0 51,0 47 and 0 39 respectively in normal intima,cap,core and shoulder region of plaque.The propotion of degranulated mast cells was the highest in shoulder region of plaque(65%).The ratios of mast cells to T lymphocytes and to macrophages were 0 25 and 0 14 respectively in shoulder region of plaques.Light microscopic studies of mast cells revealed that mast cells were more commonly observed in thrombus and around calcification and blood vessels of plaque.Mast cells play a role in the formation of plaque,and participate in the destabilization of plaque.

Objective:To create hospital data fusion centers to solve the problems involving data incompatibility between business system and administration system and incomplete data-sharing service.Methods:The needs for hospital data fusion center were analyzed, and the protocol design for creating hospital data fusion center was put forward according to the needs.Results:The protocol design for creating hospital data fusion center facilitates the specific methods of promoting hospital data fusion.Conclusion: The protocol design for creating hospital data fusion center may promote in-and out-hospital data-sharing service and comprehensive data utilization, so as to improve hospital information utilization.

Objective To study comparatively reduction and prevention of surgery-induced peritoneal adhesion by methylene blue and hyaluronate sodium. Methods 46 patients with acute diffuse peritonitis or adhesion intestinal ileus were divided at random into 3 groups: methylene blue ( MB) group, hyaluronate sodium (HS) group and control ( C ) group. The alteration of postoperation recovery,serum MDA, TNF? and erythrocytes SOD in patients were investigated. Results The recuperation in group MB was better than in group C (P

Objective To investigate the effect and implying mechanism of continuous veno-venous hemofiltration(CVVH) on endoplasmic reticulum stress(ERS) and apoptosis of HUVEC cells which induced by serum of patients with multiple organ dysfunction syndrome(MODS).Methods Ten patients with MODS who received CVVH and 10 healthy volunteers were involved in this study.This experiment was divided into 4 groups: healthy control,group of pre-CVVH,group of 6-hour-CVVH and group of 20-hour-CVVH.Serum of healthy volunteers and the sera of patients with MODS at pre-CVVH,6-hour-CVVH and 20-hour-CVVH were used to induced HUVEC cells respectively in vitro for 24 h.The cell apoptosis was examined by TUNEL assay,the intracellular GRP78 protein was observed by immunocytochemistry,and the mRNA expressions of GRP78,CHOP,TNF-?,and IL-6 in the cells were measured by RT-PCR.The levels of serum SOD and MDA were detected by colorimetric method,and those of of TNF-? and IL-6 of by ELISA.Results Compared with healthy control,the group of pre-CVVH showed higher cellular apoptosis rate(P

Objective To evaluate the clinical use of delayed open reduction and internal fixation technique in the treatment of Rud?i Ⅲ Pilon fractures. Methods From May 1997 to June 2003, 38 patients with Rud?i Ⅲ Pilon fractures underwent immediate calcaneal traction as well as treatment with methylprednisolone and mannitol. After 5-8 days, all patients underwent regular open reduction and internal fixation with cloverleaf buttress plates. One week after the operation, ankle joint began to exercise with no weight bearing. Results All patients were followed up for average 18 months and evaluated subjectively and objectively by using systems of Teeny and Wiss, which showed good results for 74 %, mild for 21% and poor for 5%. All fractures healed within an average of 5.7 months except for two cases of infections and one soft tissue complication. Conclusion Delayed open reduction and internal fixation offers acceptable way for treatment of severe Pilon fractures.

Objective To compare the serum index after colonoscopy high-frequency electric snare combined with nylon cord ligation and high-frequency electric resection in treating broad pedicle polyps. Methods 70 cases of broad pedicle polyps patients from July 2012 to May 2016 were chosen as research object. The operation methods and laboratory examination results of all the patients were reviewed. All patients were divided into observation group (n = 37) and control group (n = 33). Patients in observation group were treated by colonoscopy high-frequency electric snare combined with nylon loop ligation, while patients in control group were treated by high-frequency electric resection only. The blood loss and related indexes of the two groups were recorded. Before and after operation, stress hormones and acute phase proteins in serum was determined. Results Intraoperative blood loss of observation group was less than that in control group, postoperative hemoglobin levels was higher than that in control group, postoperative early bleeding rate, postoperative delayed bleeding rate of observation group were lower than that in control group (P < 0.05); 1 hour after surgery, Cor, ACTH, AT II, NE, CRP, SAA, AAT in serum were lower than those in control group (P < 0.05). Conclusion Through colonoscopy high-frequency electric snare combined with nylon cord ligation can reduce bleeding during and after surgery, relieve stress and inflammation.

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar's score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivaeaine and anisodamine was injected into the epidural space of the parturients in the analgesic group while those patients in the control group did not receive any analgesics. Results The analgesic effect was satisfactory (91.8 %), and no side effects occurred in the second stage of labor. The instrument delivery rate was lower in the analgesic group, and there was no significant difference between the two groups in neonatal Apgar's score. Conclusion The method is feasible in clinic for labor pain relief without increasing the rate of dystocla and complications of delivery.

Objective To investigate the dilating effect of dexmedetomidine (DEX)on isolated vascular smooth muscles and to explore the mechanism.Methods Tension of isolated mesenteric arterial rings of male Sprague-Dawley rats was recorded.The effects of DEX on the rings and the effects of DEX on vascular reaction induced by various drugs were recorded. Results DEX completely relaxed the contraction induced by phenylephrine (PE)and KCl in a concentration-dependent manner in endothelium intact mesenteric arterial rings in rats.The vasodilating effect of DEX was increased by sodium nitroprusside.In phenylephrine (10-5 mol/L)based on pre-vasoconstriction,adding acetylcholine could not suppress DEX’s vasodilating effect.Vasodilation was not related to the endothelial cells.In physiological saline solution without calcium,DEX significantly inhibited the contraction induced by addition of CaCl2 .Conclusion DEX can induce vasodilation in a concentration-dependent manner,which is not dependent on the endothelial cells.