Objective To evaluate the impact of pancreatic duct hanging and continuous suturing maneuver in end-to-side pancreaticojejunostomy on the incidence of pancreatic fistula after pancreaticoduodenectomy (PD),and to study the feasibility,safety and efficacy.Method 165 patients who underwent pancreaticoduodenectomy were randomly selected and the incidences of pancreatic fistula for the different types of pancreaticojejunostomy were analyzed.Results The overall rate of pancreatic fistula was 13.9％ (23/165).The incidences of pancreatic fistula after pancreatic duct hanging and continuous suturing maneuver in end-to-side anastomosis (3.1％,2/65,group C) was significantly lower than the traditional intussusception anastomosis (23.1％,12/52,group A,P＜0.05) and the mucosa mucosa anastomosis (18.8％,9/48,group B).There was no significant difference between the traditional intussusception anastomosis and the mucosa mucosa anastomosis (P＞0.05).In group C,the average operative time,intraoperative blood loss,and postoperative drainage was obviously superior to the A and B group (P＜0.05).There was no significant difference between the A and B group (P＞0.05).The other complications showed no significant differences among the three groups (P＞0.05).Conclusion Pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis significantly reduced the rate of pancreatic fistula after pancreaticoduedenectomy.It was feasible,safe,convenient to use and should be popularized.

Animals ; Disease Models, Animal ; Electric Stimulation ; Neurons ; metabolism ; Nitric Oxide Synthase ; metabolism ; Parkinson Disease ; metabolism ; Rats ; Subthalamic Nucleus ; metabolism

Objective To establish real-time fluorescence quantitative polymerase chain reaction(RFQ-PCR) for measurement of the expression level of a proliferation-inducing ligand(APRIL)and its receptors in children with non-Hodgkin′s lymphoma(NHL).Met-hods Specific primers and TaqMan probes of APRIL and its receptors had been designed,and fluorescence of the PCR products were detected continuously during amplification.According to the standard curves created by plasmid DNA,the expression level of target genes in clinical samples had been determined using software,and these results were presented as the ratios of target genes′ mRNA to ?2 microg-luobulin(?2M)′s mRNA.Results The detection range of RFQ-PCR was between 101-109 ng/L,the coefficient of variation values for both intra-experimental and inter-experimental reproducibility ranged from 1.68% to 5.97% and 6.40% to 10.58%,respectively.The results from 22 samples showed that the expression level of APRIL,B cell maturation antigen(BCMA) and transmembrane activator and calcium modulator and cyclophilin ligand(TACI) in peripheral blood of NHL were significantly higher than those in normal children(P

Objective:To evaluate the effects of the flowable resin used as pit and fissure sealant using different etching adhesive systems.Methods:60 caries-free extracted human premolars were randomly divided into 4 groups(n =1 5)and treated by Gluma, NT and 3M-Z350 flowable resin(group A);Clearifil SE Bond adhesive and 3M-Z350 flowable resin(group B),phosphoric acid etching,3M-Z350 flowable resin and phosphoric acid etching(group C)and 3Mconcise sealant(group D)respectively.After pro-cessing the tooth surface the pit and fissue of 1 0 sample in each group were sealed.The microleakage was measured by 1 % methyl-ene blue staining(n =8).The material-enamel interface was observed by SEM(n =2).The shear bond strength of the column-shaped samples with the diameter and the height of 3 mm(n =5)on the mesial or dental surface was examined by a test machine. The sealant cartridges and flowable resin cartridges with the diameter and height of 4 mm were used for the crushing strength exami-nation(n =1 0).Results:There was no significant difference in the microleakage among the 4 groups.SEMobservation showed that the resin tags of group A were long and dense and the resin tags of group B were short and sparse,bubbles and cracks were found on the local site in group A and B.The resin tags of group C were long and thin,but combined with tooth tightly;the resin tags of group D were short and dense;the penetration was poor at the bottom of the fissures in the 4 groups.The shear bond strength of Group A was the highest(P <0.01 ),that of group C was higher than that of group B and D(P <0.05).There was no significantly difference between group B and D(P >0.05).The compressive strength of flowable resin groups was higher than that of fissure seal-ant group(P <0.05).Conclusion:The shear bond strength and compressive strength of all-etching bonding system combined with flowable resin is superior to that of self-etching bonding system combined with flowable resin and the traditional sealant.Using Prime&Bond NT bond after acid etching may improve the shear bonding strength.

BACKGROUND:Bacterial adhesion is closely related to the surface properties of cobalt-chromium al oys, and therefore, the surface modification technology has become the focus of research in this area. OBJECTIVE:To verify whether the cobalt-chromium al oy with zirconium nitride coating can improve the bacterial adhesion of metal denture materials. METHODS:Magnetron sputtering deposition method was used to plate zirconium nitride film on the surface of cobalt-chromium al oys (experimental group), and cobalt-chromium al oy specimens uncoated served as control group. Streptococcus mutans, Candida albicans, and Actinomyces viscosus were respectively inoculated on the two kinds of test specimen, and at end of culture, the colony counting was done. RESULTS AND CONCLUSION:In the bacterial adhesion test, the number of colonies of three kinds of bacteria in the experimental group was significantly lower than that in the control group (P<0.05). The number of bacterial adhesion in the control group was significantly higher than that in the experimental group. These findings indicate that the cobalt-chromium al oy covered with zirconium nitride coating can significantly reduce the adhesion amount of Streptococcus mutans, Candida albicans and Actinomyces viscosus, and thus improve bacterial adhesion properties of cobalt-chromium al oys.

Bronchogenic Cyst ; Humans ; Laryngeal Diseases ; Male ; Middle Aged

Objective To investigate laparoscopic-guided selective portal vein ligation in the two-stage hepatectomy for patients with primary hepatocellular carcinoma (HCC).Methods Twenty-three patients with HCC who were not suitable for one-stage hepatectomy were admitted to the Sichuan Provincial People's Hospital from March 2009 to February 2012.Their clinical data were retrospectively analyzed.Laparoscopic-guided selective portal vein ligation was firstly performed,dynamic changes of hepatic volume and predicted volume of liver to be resected were detected by computed tomography.Two-stage open hepatectomy was performed after assessment of resectability of HCC.All data were analyzed using the analysis of variance or q test.Results Laparoscopic-guided selective portal vein ligation was successfully performed on 22 patients (2 patients received concomitant cholecystectomy because the right branch of portal vein was difficult to expose),1 patient was converted to open surgery because of hemorrhage during portal vein separation.Three patients with multiple lesions received transcatheter arterial chemoembolization at 1 week after selective portal vein ligation.Dull pain in the hepatic region,low fever,nausea and vomiting were observed in the 23 patients,while no severe complications including peritoneal hemorrhage,bile leakage,hepatapostema was observed.The levels of aspartate aminotransferase,alanine aminotransferase and total bilirubin were back to normal at 1 week after the surgery.The right liver volume at postoperative week 3 was (590 ± 154)cm3,which was significantly smaller than (698 ± 135)cm3 before surgery.Compared with right liver volume at postoperative week 1,2,3,the right liver volume before operation was significantly smaller (F=15.62,P ＜0.05).The left hepatic volume at postoperative week 3 was (408 ± 149)cm3,which was significantly bigger than (331 ± 68)cm3 before operation.The left liver volume before operation was significantly different from those at postoperative week 1,2,3 (F =17.48,P ＜ 0.05).The predicted ratio of liver to be resected was 60％ ± 18％ at postoperative week 3,which was significantly smaller than 67％ ± 15％ before operation (F =12.35,P ＜ 0.05).Two patients with insufficient hyperplasia of offside liver,2 patients with intrahepatic metastasis at postoperative week 3,2 patients were lost to follow up and 3 patients gave up hepatectomy,14 patients received hepatectomy at 2-4 weeks after laparoscopic-guided selective portal vein ligation.The resection rate was 60.9％ (14/23).There were 2 patients received extended right hepatectomy,8 received right hepatectomy,4 received non-anatomical hepatectomy.All the 14 patients recovered well,and no hepatic failure,severe peritoneal effusion and infection was observed.Conclusion Laparoscopic-guided selective portal vein ligation is easy to perform,and it extends the indication of hepatectomy,increases the safety of two-stage hepatectomy.

ObjectiveTo observe the effect of transcutaneous electric nerve stimulation (TENS) and physical therapy on shoulder pain after stroke. Methods60 patients of shoulder pain after stroke were randomly divided into treatment group (30 cases) and control group(30 cases). The patients in the treatment group were treated with TENS and physical therapy. The cases in the control group were treated with TENS only. All patients were evaluated with visual analogous score of pain (VAS) and Fugl-Meyer measure (FM) before and after treatment. ResultsThe scores of VAS and FM improved more significantly in treatment group than in control group(P<0.01).ConclusionTranscutaneous electric nerve stimulation combined with physical therapy showed more effective on shoulder pain after stroke.

Objective To provide the promoting effect of extract of leave Ginkgo biloba(EGb_(50))on nerve regeneration and the dose-effect relationship.Methods Sciatic nerve injury model was set up in 96 male Spraque-Daweiy rats and then randomly divided into four groups:normal saline (NS) group,the low dose EGb_(50) group (50mg?kg~(-1)?d~(-1)),the moderate dose EGb_(50) group (100 mg?kg~(-1)?d~(-1)) ,the high dose EGb_(50) group (200 mg?kg~(-1)?d~(-1)).Electrophysiological,histological examinations and functional eval- uation were used to assess nerve regeneration and the functional recovery in 2,4,6,8 weeks of operative inter- vals respectively.Results The recovery rate of sciatic functional index(SFI),tetanic tension,motor nerve conduction velocity,muscle cell cross-section area of triceps surae and the passing rate of myelinated nerve were significantly higher in EGb_(50) group in all the time point than in control(P＜0.01).Except the recovery rate of sciatic functional index (SFI),there was significant difference between high dose group and moderate, low dose group.(P＜0.01,P＜0.05).Conclusion EGb_(50) has the effect of promoting regeneration of in- juried peripheral nerve and the high dose can get the best result.

Objective:To evaluate of the feasibility of low-dose CT(LDCT)in the reconstruction of three-dimensional(3D)model of maxillofacial hard and soft tissues.Methods:Lightspeed 16-slice spiral CT scanner was used to scan one adult cadaveric head specimens with conventional parameters(280 mA)and low dose parameters(200,150,100,50,35,25,15 and 5 mA)respectively;the 3D model of the hard and soft tissues were reconstructed with Mimics 10.01 software,and 3D comparison were carried on with Geomagic 11.0 software.A comparison of the surface morphology of the hard and soft tissues of the 3D models with different scanning parameters was made.Results:With the reduction of the tube current,the model surface became rough gradually.Compared with the 280 mA scan results,the model surface produced by 35 mA scanning was still fairing,when the dose fell to less than 25 mA,the model surface became rough and the exact shape of the model could not be recognized.The same results of model surface were pro-duced after registration.Conclusion:The low-dose (35 mA)CT can be used to reconstruct 3D model of the maxillofacial hard and soft tissues.