To clarify the difference between benign and malignant tumours of tongue on the PC-NA expression and AgNOR c0unts. Methods: Immunohistochemical and AgNOR stainings were carriedout to detect the PCNA expressi0n and to count AgNOR particles in 14 cases of papillomas and 36 cases ofsquamous cell carcinomas of tongue. Results: The positive index(PI) of PCNA was 7. 15 ? 1. 32 in papillo-mas and 24. 28? 2. 47 in squamous cell carcinomas, and there was a significant difference between them. Asignificant difference between low 19. 45? 15. 88, medium 22. 5 ?18. 79 and high grade carcin0mas 65. 3 ?17. 39 was also observed. The AgNOR counts were higher in squamous cell carcinomas 4. 76 ?1. 59 than inpapillomas 2. 16 ? 0. 33. There was no difference of AgNOR counts in high, medium and low grade ofsquamous cell carcinomas. Conclusion:The PCNA expression and AgNOR counts may be related to activi-ty of cell proliferation and be helpful for differentiating benign from malignant tumours of tongue. In addi-tion, the former may be helpful for grading malignancy.

Objective To evaluate the pancreaticojejunostomy procedures selection strategy after pancreaticoduodenectomy.Methods The clinical data of 305 cases who received pancreaticoduodenetomy at Shanghai Renji Hospital from Jan 2010 to Jan 2013 were retrospectively analyzed.For patients with pancreatic duct diameter≥3 mm,duct-to-mucosa pancreaticojejunostomy was applied(120 cases).For duct diameter ＜ 3 mm,modified Child pancreaticojejunostomy was applied to 80 cases when pancreatic stump was large,or binding pancreaticojejunostomy procedures was applied to 105 cases while pancreatic stump was small.Results The diameter of the pancreatic stump in modified Child group was significantly larger than that in the binding group (F =5.78,P ＜ 0.05).The overall incidence of pancreatic fistula was 11.1％ (34/305).There were no significant differences in the incidences of pancreatic fistula,peritoneal bleeding,abdominal infection,digestive dysfunction rate,the mean duration of hospital and the death cases among the three groups (x2 =1.51,2.78,1.16,3.75,1.94,F=2.13,P＞0.05).Conclusions Three different pancreaticojejunostomies based on the size of pancreatic duct and pancreatic stump are equally safe and effective as a reconstructive method after pancreaticoduodenectomy.

Objective To study the mechanism of the hyperuricemia among the middle and elderly populations. Methods Serum uric acid, creatinine (Cr), blood urea nitrogen (BUN), fasting gluose (FG), total cholesterol (TC), triglyceride (TG) were detected in 1073 subjects with hyperuricemia and 1235 subjects with normal serum uric acid as control of middle and elder groups. Results The means of Cr, BUN, FG, TG ,TC in hyperuricemia were significantly higher than those in the control group,respectively (males: t′ =7. 508,P ＜0.05;t′ =9. 484,P ＜0.05;t=6.208,P＜0.05;t′ =7.055,P ＜0.05;t = 5. 097,P ＜0.05;females;t′ = 11.221,P ＜0.05;t′= 8.314,P ＜0.05 ;t =5. 641 ,P ＜0.05 ;t′ =8. 328 ,P ＜0.05 ;t =7. 227 ,P ＜ 0.05). In males,the mean of the BUN; FG and TG were significant different among the different age groups (the control group: F = 3. 500, P ＜ 0.05; F = 5. 607, P ＜0.05 ;F =3. 378,P ＜0.05 ;the hyperuricemia group: F= 15.400,P ＜0.05 ;F =5. 111 ,P ＜0.05 ;F = 11. 143 ,P ＜0.05), the positive rate of BUN, Cr, FG and TG were significant different among the different age groups (control group:χ2 = 17. 112,P ＜ 0.05;χ2 =7. 807,P ＜0.05 ;χ2 = 17. 829,P ＜0.05;χ2=8.433,P ＜0.05; hyperuricemia group:χ2 =35. 587,P ＜0.05 ;χ2 =83. 005 ,P ＜0.05 ;χ2 =41. 639,P ＜0.05 ;χ2 =31. 466,P ＜0.05). In the same age group,the mean and the positive rate of BUN and Cr were significantly higher in the hyperuricemia group than in the control group(P ＜ 0.05). The mean of TG was significantly higher in every age group of the hyperuricemia group than controls (P ＜ 0.05), but the positive rate had no significant differences in the age group of ≥ 70 years (P ＞0.05). The mean and the positive rate of FG and TC were significant differences in middle age group between the hyperuricemia and the control group (P ＜ 0.05), but were no differences in elder age group(P ＞ 0.05). In females,the mean and positive rate of Cr, BUN, FG,TG and TC were significant different in different age groups of the controls(BUN:F = 13. 759,P ＜0.05;χ2 = 19. 491 ,P ＜0.05; FG: F = 13. 554,P ＜0.05;χ2 = 33. 438,P ＜0.05;TG:F= 18. 160,P ＜0.05;χ2 = 16. 978,P ＜0.05;TC: F = 37. 647,P ＜0.05;χ2 =60.547,P ＜0.05) ,but in the hyperuricemia group that were only significant difference in BUN, Cr and TC (BUN:F = 5. 830, P ＜ 0.05; χ2 =11.941,P＜0.05;Cr:F=4.057,P ＜0.05;χ2 =20.097,P＜0.05;TC:F=7.934,P ＜0.05;χ2 = 16.405,P ＜0.05). In same age group compared of all the indices were similar with male. Conclusions The mechanism of serum uric acid increasing are different in middle age and elderly age. In middle age, it is metabolic disturbance. However,in elderly age it is descending of the kidney function.

Objective To evaluate the mechanism of altered gastrointestinal motility in portal hypertensive rats. Methods Thirty-two male Sprague-Dawley rats were divided into four groups:sham- operation control (SO, n=8), prehepatic portal hypertension by partial stenosis of the portal vein (PHPH, n=8 ), intrahepatic portal hypertension induced by injection of CCl 4 (IHPH, n=8), and intrahepatic portal hypertension with portacaval shunt (IHPH-PCS, n=8). Gastrointestinal myoelectrical activity and motility were monitored. Gastrointestinal hormones were measured with radioimmunoassay.Results Compared with SO rats, gastrointestinal motor index(MI) were reduced and abnormal myoelectrical activity were recorded (P

Objective To explore changes of levels of interferon‐γ(IFN‐γ) ,interleukin‐32(IL‐32) and interleukin‐6(IL‐6) in pe‐ripheral blood and the correlation between peripheral IFN‐γ,IL‐32 ,IL‐6 and liver function level and hepatitis B virus(HBV) DNA load in HBV carriers .Methods Sixty HBV carriers ,including 39 cases of chronic HBV carriers and 21 cases of inactive hepatitis B surface antigen(HBsAg) carriers ,and 50 healthy individuals were collected .Serum levels of IFN‐γ,IL‐32 and IL‐6 ,the amount of HBV DNA and liver function were detected ,and clinical correlations were analysed .Results Compared with the control group ,ser‐um levels of IFN‐γ,IL‐32 and IL‐6 of chronic HBV carriers and inactive HBsAg carriers were significantly increased (P<0 .05) . Compared with chronic HBV carriers with low amount of HBV DNA loads and high amount of HBV DNA loads ,chronic HBV car‐riers with medial HBV DNA loads had higher serum levels of IFN‐γ,IL‐32 and IL‐6 ,but no statistically significant differences were observed(P>0 .05) .There was positive correlation between IL‐32 level and ALT level (r=0 .32 ,P<0 .05) ,and negative correla‐tion between IL‐32 level and ALB level(r= -0 .27 ,P<0 .05) .Conclusion IFN‐γ,IL‐32 and IL‐6 may play important roles in chro‐nic HBV infection ,the levels of IFN‐γ,IL‐32 and IL‐6 could be used as important indicators to assess the severity of inflammation in HBV carriers .

Objective To evaluate measures in the prevention of pancreatic fistula after distal pancreatectomy.Methods Clinical data of 124 cases of distal pancreatectomy performed during 2000 and 2009 in our hospital were retrospectively analyzed,including 86 cases of pancreatic carcinoma,12 cases of pancreatic pseudocyst and pancreatic benign tumor,18 cases of gastroenteric tumor with pancreatic body/tail invasion,3 cases of chronic pancreatitis with body/tail pseudocyst,5 cases of pancreatic injury.Cases were divided into two groups retrospectively by ways the stump pancreas were closed.Group A included 63 cases in which the stump end was closed by simple interrupted mattress suture,group B including 61 cases in those the stump was sutured by interrupted mattress combined with a safe ligation of the main pancreatic duct.Results Pancreatic fistula occurred in 22 cases in group A,the incidence was 34.9％,among the 22 cases,10 cases were high-flow type,12 cases were low-flow type; while the pancreatic fistula occurred in 9 cases in group B,the incidence was 14.7％,there was no high-flow type fistula.Conclusions Interrupted mattress suture combined with interlocking suture and suture of main pancreatic duct is effective in decreasing the rate of pancreatic fistula after distal pancreatectomy.

Objective To discuss the perioperative management of cirrhotic patients undergoing abdominal operation. Methods From Jan. 2000 to Jul. 2007, 93 patients with PHT underwent operation in our hospital. We retrospectively analyzed the data according to different therapy result. Results 21 cases developed postoperative ascites. The occurrence of ascites in patients dealt with PHT and coexistent other abdominal disease was 7% and 12% respectively for Child A and B grade patients. The occurrence of ascites in patients dealt with only abdominal disease was 13% and 17% respectively for Child A and B grade patients. The occurrence of ascites in patients dealt with PHT and abdominal disease was amazingly 83% for Child C cases. Patients suffered from tumors didn't have more risk of ascites than the other patients. Conclusion The proper perioperative management of patients can decrease the mortality. To deal with PHT together with abdominal operation is reasonable for patients in Child A or B liver function, and it would not increase the postoperative ascites. For the selective patients, we must try our best to decrease the ascites preoperatively to improve the condition.

Objective To assess the clinical value of high-frequency electrocautery in the treatment of massive hemorrhage of presacral venous plexus. Methods The clinical data of 8 patients with presacral venous hemorrhage treated with high-frequency electrocautery from February 2005 to March 2008 were analyzed. Once the presacral venous hemorrhage happened, the bleeding site was pressed with a gauze or finger and the accumulated blood was aspirated. Then, while simultaneously withdrawing the gauze or finger over the bleeding sites, high-frequency electrocautery was applied with a power of 80-100 W to coagulate all the bleeding sites. Results High-frequency electrocautery was used to stop bleeding in the 8 patients, and no electrocautery related complica-tions occurred postoperatively. Conclusions High-frequency electrocautery for massive hemorrhage of presacral venous plexus is simple, efficient and safe.

Objective To investigate the preopera ti ve diagnosis and the surgical treatment of primary retroperitoneal tumor(PRT). Methods The clinical dat a of 71 patients with PRT were retrospectively analyzed including clinical manif estation, radiologic studies, pathologic examination and surgical procedures. Results There were 32 cases of benign tumor, 38 cases of malignant tumor and 1 case of borderline tumor. Of the 32 patients with benign tumor, 31 underwent complete surgical resection. Of the 38 patients with malignant tumor, 29 underwent complete resection. One patie nt with borderline tumor underwent total resection. The 5-year survival rate of benign PRT was 89.29%, the 5-year survival rate of malignant PRT was 20.80%. Four cases of recurrent benign PRT underwent complete resection. Ten cases of r ecurrent malignant PRT underwent complete resection and 3 underwent partial rese ction. ConclusionsRadiolog ical study is crucial for the diagnosis. Complete resection is the key for the t reatment of PRT.

Objective To investigate the augmentation plating for femoral fractures and postoperative femoral nonunion. Methods A retrospective analysis was conducted of 60 patients with femoral fracture or postoperative femoral nonunion who had been treated with augmentation plating from January 2008 to July 2015. They were 36 males and 24 females, aged from 15 to 79 years ( average, 43. 4 years ) . Of them, 20 cases suffered nonunion following intramedullary nailing of femoral shaft fracture, 18 nonunion following lateral plating for femoral distal or lower fracture, and 22 femoral distal or lower fracture complicated with comminuted fracture of medial column. An incision ranging from 6 to 10 cm was made around the fracture ends for augmentative plating for all the patients. Autogenous iliac bone graft was performed in patients with atrophic nonunion or ob-vious gap after reduction of the comminuted fracture. Operation time, intraoperative bleeding, healing time, complications, and functionary recovery of the affected knee were recorded. Results The operation time averaged 121. 5 min and the intraoperative bleeding 356. 3 mL. All the patients were followed up for 12 to 36 months ( average, 16. 9 months ) . All the fractures and nonunions healed after an average time of 4. 2 months ( from 3 to 4 months ) . The time for initial partial weight-bearing averaged 4. 5 weeks ( from 2 to 6 weeks ) and the time for initial full weight bearing 3. 3 months ( from 2 to 4 months ) . Evaluation according to the Karlstrom and Olerud criteria at the last follow-up revealed 29 excellent, 24 good and 7 fair cases, yielding an excellent and good rate of 88. 3％. No infection, loosening, bending or breaking of internal implants, or refracture was noted during follow-ups. Conclusion Augmentation plating through a small incision can lead to fine outcomes for femoral fractures and postoperative femoral nonunion, because it makes up the deficient stability of original in-ternal fixation, reduces the dislocated bone blocks and provides bone grafting to improve defective local bone structure and defective osteogenesis.