Objective The experiences of peri-operative management in senile acute abdominal patients were summarized in order to raise the successful rate.Method We analysed retrospectively 575 cases who were senile acute abdominal patients from 1990 to 2000.Results Among 575 cases,540 cases(93.9%)were cured.423 cases(73.5%) were with other chronic diseases and dysfunctions before operation.Various complications occurred in 168 cases(29.2%)and 35 cases(6.1%) died.The death causes mainly were correlated with accompanied chronic diseases.Conclusion Strengthen peri operative care,active management of other chronic diseases and adequate operation time are important significantly for senile acute abdomen to get satisfied outcome.

Objective To investigate the earlier diagnostic methods and operative procedures of gastric remnant cancer. Methods Clinicopathologic data of 19 cases of gastric remnant cancer were retrospectively analysed,and the diagnostic value of the gastroscopy and barium meal was compared.Influencing the prognosis of gastric remnant cancer treated by different operations according to the situation seen during operation were observed. Results The diagnostic rate of gastroscopy and barium meal was 78.9% and 47.4%, respectively.All the 5 cases who underwent radical remnant gastrectomy sarvived≥3 years postoperatively.Two of the 3 cases who underwent palliative remnant gastrectomy survived 2 years and 1 alived 1.5 years postoperatively. In 6 cases of gastrojejunostomy, 4 cases died within half year, 2 cases died 12.5 and 14 months postoperatively. Conclusions The diagnostic value of gastroscopy takes advantage over barium meal examination. The patients who treated by radical remnant gastrectomy have better prognosis.

Objective To establish a model of pancreatic cancer induced by 7,12-dimethylbenzathracene (DMBA) in SD rats, and to detect the expression levels of RAD51 and Myc-associated factor X (MAX) and their effect on carcinogenesis of rat pancreas. Methods Ninety SD rats were randomly divided into 3 groups: a model group, an intervention group, and a control group. DMBA was directly implanted into the parenchyma of rat pancreas (the model group and the intervention group). Rats in the intervention group were treated with 1 mL trichostatin A (TSA) saline solution (1 μg/mL) via ip weekly. Rats within 3～5 months in the model group and the intervention group were executed and observed by macrograph and under microscope. Meanwhile, the rats in the control group were executed at 5th month. The EnVision~(TM) immunohistochemistry to assay the expression levels of RAD51 and MAX was used in conventional paraffin-embedded sections from the above pancreatic specimens.Results The incidence of pancreatic cancer in the model group within 3-5 months was 48.7% (18/37), including 17 ductal adenocarcinomas and 1 fibrosarcoma. The incidence of pancreatic cancer in the intervention group within 3-5 months was 33.3%(12/36), including 11 ductal adenocarcinomas and 1 fibrosarcoma. The maximal diameter of mass in the model group was significantly higher than that in the intervention group (P＜0.05). No pathological changes were found in pancreas of the control group and other extra-pancreatic main organs of the model group and the intervention group (such as the liver, biliary tract, gastrointestine tract, kidney, and lung). The positive rate of RAD51 was significantly higher in ductal adenocarcinoma in the model group, the intervention group, and the model group +the intervention group than those in corresponding groups of non-cancerous pancreatic tissues (P＜0.01), but the positive rate of MAX expression was opposite to RAD51 expression(P＜0.01). The positive tissues of RAD51 expression and/or negative tissues of MAX expression in non-cancerous tissues showed atypical-hyperplasia of ductal epitheli. Pacncreas of the control group showed the negative expression of RAD51 and positive expression of MAX. Two cases of fibrosarcoma showed the negative expression of RAD51 and MAX.Conclusion DMBA directly implanted into the parenchyma of pancreas can obtain an ideal pancreatic cancer model with high incidence in a short time. The TSA might have an inhibitive effect on carcinogenesis and growth of rat pancreas. The over-expression of RAD51 and/or lose-expression might have important effect on carcinogenesis induced DMBA in rat pancreas.

Objective To study the expressive levels of EZH2 and PTEN in pancreatic cancer and non-cancerous tissue,and the effects on carcinogenesis of rat pancreas.Methods dimethylbenzathracene(DMBA) was directly implanted into the parenchyma of rat pancreas(group A,group B).The rats of group B were treated with 1 mL trichostatin A(TSA) solution(1?g/mL) intravenously per weer 1 week after the model were set up.The rats of group A,B were killed within 3-5 months and the rats in the control(C group) were executed at 5 months to observe the develope of pancreatic cancer by macrograph and microscopy,The EnVisionTM immunohistochemistry was used to assay the expression of EZH2 and PTEN in above pancreatic specimens.Results(1) The incidence of pancreatic cancer within 3-5 months in group A was 48.7%(18/37),including 17 cases of ductal adenocarcinoma and 1 case of fibrosarcoma.The incidence of pancreatic cancer in group B was 33.3%(12/36),including 11 cases of ductal adenocarcinoma and 1 cases of fibrosarcoma.The mean maximal diameter of mass was significantly higher in group A than that in group B(P 0.05).The non-cancerous pancreatic tissues with positive expression of EZH2 and/or negative expression of PTEN showed mild to severe atypical hyperplasia of ductal epithelium.An inconsistency was found between the expression of EZH2 and PTEN in ductal adenocarcinoma(P =0.045).Pancreas of group C showed negative expression of EZH2 and positive expression of PTEN.Two cases of fibrosarcoma showed negative expression of EZH2 and PTEN.Conclusions By use of higher dose of DMBA directly implanted into the parenchyma of pancreas,high incidence of pancreatic cancer can be obtained.TSA could have an inhibitive effect on carcinogenesis and growth of pancratic cancer.The activation of EZH2 gene and inactivation of PTEN gene might have Key effects on pancreas carcinogenesis induced by DMBA in rat.

Objective To establish a pancreatic cancer model in Sprague Dawley(SD) rats,and to study the distribution and the counts of myofibroblast(MF) in pancreatic cancer and non-cancerous pancreatic tissues.MethodsDirectly implanted DMBA into pancreas parenchyma of SD rats and established TSA intervening group and control group. The carcinogenesis of rats executed within 3～5 months were inspected by HE stain and microscopy for pathomorphological changes.Myofibroblast(MF) was stained by Heidenains method. Results (1)The prevalence of pancreatic cancer in experimental group was 48.7%(18/37), including 17 pancreatic ductal adenocarcinoma and 1 fibrosarcoma. The prevalence of pancreatic cancer in intervering group was 33.3%(12/36), including 11 pancreatic ductal adenocarcinoma and 1 fibrosarcoma. The maximal diameters of tumor mass of experimental group was higher than that of intervering group (P

The experiment contents were integrated into three parts such as basic skills and verification experiment, systematic experiment and designing experiment. Basic skills and confirmato-ry experiments were performed alone with theory teaching by combination of modern teaching methods and traditional teaching methods, which consisted of “speaking”(experimental principles, methods and main technical points using multimedia), “looking”(demonstrating related operation on teaching website), teachers' demonstration, students' doing experiment independently and summarizing. In this part, the experimental operation skills such as the sterile operation technology, staining technology, microscopy technology and pure culture were emphasized. Systemic experiments would be carried out after completion of the most theory, the experiment time could be adjusted according to the experiment content, and the PBL teaching method was taken in this stage. After the theory teaching of Medical Microbiology was finished, students voluntarily participated in design experiments in the last stage, which were the fusion of scientific research subject and the experimental teaching. From the preview experiment, experiment operation, experiment report, to the final test, the multi-dimensional evalua-tion was implemented throughout the course of experiment teaching.

Objective To compare the therapeutic efficacy betweenLing Gui Ba Fa(eight magic turtle techniques) acupuncture and ordinary acupuncture in treating irritable bowel syndrome with diarrhea (IBS-D).Method Sixty patients were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened byLing Gui Ba Faacupuncture at Gongsun (SP4) and Neiguan (PC6), and the control group was intervened by ordinary needling Gongsun and Neiguan. For both groups, Tianshu (ST25), Dachangshu (BL25), Shangjuxu (ST37), Fenglong (ST40), and Pishu (BL20) were added. Theclinical efficacies of the two groups were compared by evaluating the irritable bowel syndrome (IBS) clinical symptoms score and IBS Quality of Life (IBS-QOL) questionnaire. The two groups were treated 3 times a week, 10 sessions as a treatment course, andwere evaluated by using the scales before and after the treatment followed by statistical analysis and determination of the therapeutic efficacy.Result The scales were significantly improved in both groups after the treatment (P<0.05), and the improvement in the treatment group was superior to that in the control group (P<0.01); the total effective rate was 90% (27/30) in the treatment group, higher than 80% (24/30) in the control group(P<0.05).Conclusion Ling Gui Ba Faacupuncture can produce a more significant efficacy than ordinary acupuncture in treating IBS-D, and can obviously enhance the quality of life of thepatients, providing an advantageous treatment scheme to clinic.

Objective To study the efficacy of emergency orthotopic liver transplantation(EOLT) for acute(hepatic) failure(ALT).Methods A retrospective review was undertaken on the clinical data of 8 patients undergoing emergency liver transplantation for ALT.Results The 8 patients completely regained consciousness in 12 to 72 hours after operation.No case developed central nervous complications.One case of severe(hepatitis) complicated by acute renal failure died of respiratory infection and ARDS on postoperative day 7.One case who refused to take medication died from chronic rejection 12 months after operation.One case was(complicated) by bile duct stricture and biliary sludge at 14 months postoperatively and survived for 18 months.Four of the other 5 cases were followed up for 17 months and 1 cases for 14 months,and thir quality of life was excellent.3 of them have returned to work.Conclusions Emergency orthotopic liver thansplantation is an effective means to treat ALF.Intensive care and effective treatment preoperatively are pre-requisite(conditions) to ensure the success of EOLT.

Objective To compare the size of ablation lesions created by normal saline enhanced radiofrequency ablation (NS-RFA) and dilute hydrochloric acid enhanced radiofrequency ablation (HCl-RFA), explore their affecting factors, and observe the morphological manifestations of the ablated lesions.Methods NS-RFA and HCl-RFA were performed on 30 excised porcine livers with 9 different combinations of durations (5, 10, 15, and 20 minutes), temperatures (83, 93, 103, and 113 ℃ ) and powers (20, 30,and 40W). For each ablated lesion, the longitudinal and transverse diameters were measured, and volumes calculated. Multifactor analysis of variance was used to analyze the affecting factors of the size of ablated lesions. Macroscopic and microscopic morphological characteristics of lesions were observed. Results ( 1 )NS-RFA lesion volumes under 9 combinations were ( 3.53 ± 0. 34 ), (6. 41 ± 0. 42 ), ( 10. 69 ± 0. 37 ),(11.40±0.51), (3.20±0.23), (6.59 ±0.50), (12.11 ±0.70), (11.12 ±0.52), (11.81 ±0. 64) cm3, respectively. HCl-RFA lesion volumes under 9 combinations were ( 11.97 ± 1. 00), (28.72 ±0.99), (59.45 ±1.33), (105.65 ±2.40), (13.64±0.60), (29.70±0.58), (59.22±1.32),( 57. 22 ± 3.99 ), ( 59. 74 ± 2. 18 )cm3, respectively. The size differences of ablation zones caused by different types of ablation ( F = 948.9 ) ( main factor), durations ( F = 269. 3 ) and temperatures ( F =214. 6) (covariates) were statistically significant (P ＜ 0. 01 ), whereas which caused by power ( F = 0. 2 )(covariate) was not statistically significant (P ＞ 0. 05 ). (2)At gross examination, all ablation lesions were elliptical in cross section and there were three zones in NS-RFA induced lesions and five zones in HCl-RFA induced lesions. At microscopic examination of NS-RFA induced lesions, a small amount of liver cell debris were found at the edge of zone Ⅰ , a few of deformed and ruptured liver cells in zone Ⅱ. The shape of the most of the liver cells in zone Ⅲ was normal. At microscopic examination of HCl-RFA induced lesions, a small amount of liver cell debris were found at the edge of zone Ⅰ , classical coagulation necrosis in zone Ⅱ and Ⅲ, widened hepatic sinusoids lossened junction of hepatocytes and some hepatocytes detached into sinusoids in zones Ⅳ. The liver cells in zone V were normalexcept a small amount of hepatoeytes with pyknosis, karyorrhexis and karyolysis. Condusion Compared with NS-RFA, HCl-RFA can produce lager ablation zones. The duration and temperature were the factors that affected the size of ablation zone. HCl-RFA lesions typically showed coagulation necrosis at microscopical examination.

Objective To explore the prevalence of 11 efflux pumps in isolates of multidrugresistant Escherichia coli(MDR-ECO). Methods Efflux pumps emrB, emrD , emrE, mdfA, sugE, mdtl,tehA, oqxA, qacE△1, qacE and smr-2 were detected by polymerase chain reaction(PCR)in 20 MDR-ECOs isolated from clinical samples. Results Efflux pumps emrB, emrD, emrE, mdfA, sugE, mdtI, qacE △1, tehA and oqxA were detected, and 8 efflux pumps were found in the same strain. Conclusion Multidrug- resistance in Escherichia coli may be related with efflux pumps.