Objective To analyze the postoperative complications in aged patients receiving pancreaticoduodenectomy. Methods Pancreaticoduodenectomy was employed for the treatment of 52 aged patients. Of the 52 patients with a mean age of 70.5(65-76), 32 were male and 20 female. Postoperative pathological examination confirmed that 24 patients suffered from Vater,s ampullary and duodenal cancers, 16 from pancreatic carcinoma and 12 from cholangiocarcinoma. Results The mortality was 7.7%. Severe complications included bleeding (upper gastrointestinal tract or abdominal cavity),MOF, ARDS, postsurgical gastroparasis syndrome(PGS), mental disorder, pancreaticogastrostomy leak and biliary-enteric anastomotic leak et al. Conclusion MOF is the main lethal complication. Incidence of PGS and mental disorder is high.

Objective To investigate the expression and significance of survivin in hepatocellular carcinoma(HCC).Methods All reports published in the past 13 years on survivin and hepatocellular carcinoma (HCC) were reviewed.A Meta-analysis was conducted on these studies and it was used to determine the prognostic significance of the expression of survivin on patients with HCC.Results 18 studies were included into this Meta-analysis.There were 1 021 HCC patients and 208 normal controls.There was a significant difference between the positive rate of survivin in hepatocellular carcinoma and in normal tissues (0R =30.61; 95％ CI:16.67-56.23).The expression of survivin correlated with clinical staging,pathological differentiation,tumor metastasis,portal vein tumor thmmbus,and survival (P ＜ 0.05).There was no correlation with gender,age,AFP,HBsAg,tumor diameter,and tumor capsule (P ＞ 0.05).Conclusiom Survivin can be used as a molecular marker for the definitive prognosis of HCC.It is also a reliable marker in the choice of standardized and individualized therapy.

Neutrophil gelatinase associated lipocalin(NGAL),also known as lipocalin 2,has close relationship with human neoplasias,which is up-regulated in a number of malignancy and involves in the process of tumor development.But it appears to exist paradoxical effects attributed to NGAL in human neoplasias.For instance,through protecting MMP9 from autodegradation,NGAL has a clear pro-tumoral and pro-metastatic effect,as has already been observed in breast cancer and esophageal cancer.However,on the contrary,for pancreatic cancer and ovarian cancer,NGAL can inhibit FAK phosphorylation and vascular epidermal growth factor synthesis,having an anti-tumoral and anti-metastatic effect.This review summarizes the current knowledge about the dual effects of NGAL in the process of tumor development,and attempts to explore the possible underlyins mechanism.

OBJECTIVE To study the change in drug-resistance to antibiotics in Gram-negative bacteria in Jinhua region in order to guide clinical application of antibiotics reasonably.METHODS The antibiotics resistance of Gram-negative bacteria from clinical samples in four general hospitals in Jinhua region during from Jan 2005 to Dec 2007 was studied retrospectively.RESULTS The detecting rates of extended-spectrum ?-lactamases in Escherichia coli and Klebsiella pneumoniae were rising from 41.0%and 25.3% in 2005 to 56.0%and 53.2% in 2007,respectively.Furthermore,0.8% isolates were resistant to carbapenemase from all E.coli and K.pneumoniae strains.The rate of antimicrobial resistance to carbapenemase was 20.0% in Pseudomonas aeruginosa and was increased from 27.0% in 2005 to 41.0% in 2007 in Acinetobacter baumannii.CONCLUSIONS The drug-resistance rate in Gram-negative bacteria hase increased obviously in past three years in Jinhua region.It suggests that there be an urgent need for surveillance of Gram-negative bacterial resistance in different hospitals and rational antibiotics usage be emphasized during clinical therapy.

AIM: To establish the fingerprint analysis of Yadanzi Youru Injection(Fructus Bruceae) and to provide the quality information by capillary gas chromatography(CGC). METHODS: The CGC method was used.The capillary column was Supelcowax~(TM)-10(30 m?250 ?m?0.25 ?m),The detector was FID. RESULTS: The result showed that 4 peaks were common and the content of oleic acid in Yadanzi Youru Injection was determined.The linear ranges were within(0.34)～(2.07) ?g/L,r=0.999 9 n=5; CONCLUSION: The method is simple,accurate and reproducible.It can be applied to the quality control of Yadanzi Your Injection.

Objective To investigate the protective mechanism of trace element-selenium(Se) on the myocardium by against free radical superoxidation during myocardial ischemia/reperfusion(I/R) period in patients undergoing pulmonary bypass.Methods 46 patients with ASD or VSD were divided into control(23 patients) and Se administration(23 patients) groups.Before heart surgery,patients in the Se group orally received 400?g Se supplementation per day,for 7 days.The blood and myocardium samples were collected before clamping and after release respectively during pulmonary bypass.Biochemistry,electron spin resonance spectrometer(ESR),atomic absorption,RT-PCR and cDNA sequencing,were used to measure Se concentrations,MDA level,glutathione peroxidase(GPX) activity,GPX mRNA expression and GPX cDNA sequence in blood and myocardium.Results In Se group,before clamping,Se contents in blood cells and plasma, were not changed,but at reperfusion 30 minute,myocardial Se concentrations was evidently increased by about 1.1-fold,contrary to reduction 41% in blood cells.In Se administration group,at myocardial reperfusion 10 minute,free radical levels of the coronary sinus blood were significantly decreased 28%.No significantly changes in myocardial GPX activity or MDA level were found till reperfusion 30 minute.However,Se group had a higher myocardial GPX mRNA expression than that in controls in both before ischemia and after reperfusion.Conclusions Se supplementation can enhance Se content,expression of GPX-mRNA in myocardial tissue,and protect myocardium from radical lipooxidation damage.

Objective To observe the efficacy and safety of albumin-bound paclitaxel on the patients with advanced malignance in more than the third-lines (including the third-lines).Methods 34 patients with advanced malignance diagnosed by pathological evidence accepted more than the third-lines (including the third-lines) chemotherapy containing albumin-bound paclitaxel after failure of chemotherapy.The efficacy and safety were observed.Results Totally 110 cycles chemotherapy were completed,with a mean of 3.24 cycles in each of the 34 patients.No CR patients,12 cases of PR,9 cases of SD and 13 cases of PD were found.The response rate (RR) was 35.29 ％ (12/34) and the disease control rate (DCR) was 61.76 ％ (21/34).The main toxicity was hematologic toxicity,including neutropenia in 26 cases (76.47 ％),anemia in 14 cases (41.18 ％) and thrombocytopenia in 3 cases (8.82 ％).Other common adverse reactions included alopecia in 27 patients (79.41％) and muscle and joint pain in 15 cases (44.18 ％).Conclusions The albumin-bound paclitaxel is effective and tolerable in patients with advanced malignance in more than the third-lines (include the thirdlines) chemotherapy.

Fifty-six cases of nerve root sciatica patients were treated by stuck needle method at Ashi and Jiaji points (Ex-B 2) at the waist region, Huantiao (GB 30), Zhibian (BL 54),Weizhong (BL 40), Yanglingquan (GB 34), Chengshan (BL 57) and Kunlun (BL 60) in the diseased region. 40 cases were treated as control by routine even reinforcing-reducing manipulation with above acupoints. The curative effects were 96.4% and 90.0% respectively.

Objective To investigate the laws of the treatment of diabetic retinopathy with traditional Chinese medicine.Methods By searching domestic literature of treating DR with traditional Chinese medicine in CNKI from 2000 to 2010, made primary summary and analyzed. Results 85 eligible published documents were found involving 147 medicinal herbs. Herbs with the functions of tonifying, activating blood circulation and eliminating stasis and heat were mostly seen.Cases reported in literature were mainly non-proliferative lesions,occupying a ratio of 58.82%;drug observation time was mainly 12 weeks, occupying a ratio of 44.17%. Conclusion Asthenia,statis and heat were pathological factors existing throughout the whole process of DR. Invigorating, romoting blood circulation, and,cooling blood should be the basic therapeutic methods.

OBJECTIVE To explore the risk factors and control strategies of nosocomial infection in clinical immunology laboratory.METHODS The positive detection rates of HBV marker and antibodies to HAV,HCV,HEV,HIV,TP,and TB in total of 91 877 samples in clinical immunology laboratory during Jul 2004 and Jul 2005 were retrospectively surveyed and statistically analyzed.RESULTS The number of positive specimens of HBV marker and antibodies to HAV,HCV,HEV,HIV,TP,and TB were respectively 8 376,7,26,24,107,3,522,and 52 and the positive detection rates of these items were respectively 16.68%,0.43%,0.20%,2.22%,6.49%,0.03%,4.75%,and 4.61%.CONCLUSIONS It is very important to understand the infection sources and risk factors in clinical immunology laboratory in order to strengthen management of hospital infection and protection of occupational exposure.