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 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 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 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 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 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 analyze the therapeutic effect of Masquelet technique in the treatment of bone defects.Methods From January 2008 to December 2014,20 patients with bone defects were treated by Masquelet technique.There were 15 males and 5 females,from 18 to 69 years of age (average,38.4 years).Four cases had open bone defects and 16 infectious ones.At the first stage,radical debridement of the bone defects and soft tissue was conducted via conventional approaches.The bone defects ranged from 2 to 9 cm,averaging 6.1 cm.At the second stage,internal fixation was applied in 18 cases and external fixation in 2.The interval from the second stage to the first stage operation ranged from 6 to 23 weeks (average,11.5 weeks).The healing of bone defects and the functional recovery of adjacent joint were evaluated by Paley scoring at the last follow-up.Results The 20 patients were followed up for 12 to 50 months (average,19.7 months) after the second stage operation.All the patients obtained uneventful wound healing and control of infection after the first stage operation except the one with infectious defects who had to receive 2 operations to control the infection at the first stage operation.At the second stage operation,obvious injury and defect of the induced membrane occurred in 4 cases.All the patients achieved clinical healing of bone defects after 3 to 6 months (average,4.8 months).The bone defect healing was graded as excellent in all.After bone healing,all the patients resumed weight-bearing activities,with no breakage or infection of fixators,or recurrence of infection.By the Paley scoring at the last follow-up,the functional recovery of the adjacent joint was excellent in 8 cases,good in 10 and fair in 2,yielding an excellent and good rate of 90.0％.Conclusion As a kind of modified free bone grafting,Masquelet technique has advantages of simplicity,limited complications,a high rate of healing,and good control of bone infection.

Objective To study the prognostic influencing factors for intravenous thrombolysis combined with endovascular interventional therapy in patients with acute moderate to severe cerebral infarction. Methods From September 2013 to December 2015,the clinical data of 179 patients with moderate to severe acute cerebral infarction treated with intravenous thrombolysis combined with endovascular interventional therapy at the Cerebrovascular Disease Center,Shanghai Changhai Hospital were analyzed retrospectively. They were all treated with intravenous thrombolysis combined at least 1 endovascular interventional therapy (intra-arterial thrombolysis,mechanical thrombectomy or stenting)within 4. 5 h after onset. The patients with mRS ≤2 were divided into a good prognosis group (n = 71),those with 3≤mRS≤ 6 were divided into a poor prognosis group (n = 108)according to the modified Rankin Scale (mRS) scores after 3 months of treatment. The clinical data of both groups were analyzed,including age,sex,previous history,the National Institutes of Health Stroke Scale (NIHSS)score and Alberta stroke program early CT score (ASPECTS)immediately before and after treatment. The influencing factors of prognosis were further analyzed with multivariate Logistic regression analysis. Results The rate of good prognosis was 39. 7%(71 / 179). There were significant differences in age,history of transient ischemic attack at 1 week before the disease onset,the NIHSS score,and ASPECTS score before thrombolysis (62 ± 14 years vs. 71 ± 11 years,8. 4% (6 / 71)vs. 1. 9% (2 / 108),16 ± 6 vs. 19 ± 6,and 9. 5 ± 1. 0 vs. 8. 5 ± 1. 9,respectively;all P < 0. 05). There were no significantly difference in other stroke risk factors between the 2 groups (all P > 0. 05). There were significant differences in the NIHSS score immediately after treatment,24 h intracranial hemorrhage transformation,and intraparenchymal hemorrhage between the good prognosis group and the poor prognosis group (10 ± 3 vs. 15 ± 7,7. 0%[5 / 71]vs. 28. 7%[31 / 108],and 0 vs. 12. 0%[13 / 108];all P < 0. 01). Multivariate Logistic regression analysis showed that the age (OR,1. 047,95% CI 1. 014 -1. 081;P = 0. 005),NIHSS score immediately after treatment (OR,1. 121,95% CI 1. 050 -1. 196;P =0. 001)were the prognostic risk factors for intravenous thrombolysis combined with endovascular interven-tional therapy for moderate to severe cerebral infarction. The ASPECTS on admission (OR,0. 382,95% CI 0. 233 -0. 627;P < 0. 01)was the protective factor. Conclusions The age and the NIHSS score immediately after treatment are the prognostic risk factors for intravenous thrombolysis combined with endovascular inter-ventional therapy for moderate to severe cerebral infarction. With the increase of age and the NIHSS score after treatment,the prognosis of patients is even worse. With the increase of ASPECTS score at admission,the prognosis is better.