Pancreatoduodenectomy (PD) is considered as a complex and difficult surgical procedure even to the experi-enced surgeons, and it is thought to be the last frontier for mini-really invasive surgeons. Laparoscopic PD, despite the initial enthusiasm towards it, discourages laparoscopic surgeons by its long operating time and procedure-related fatigue resulting from technical difficulties associated with laparoscopic instruments and unstable camera platform. Although robotic surgical system with its known advantages has successfully overcome the limita-tions of traditional laparoscopic surgery, and completed the com-plex and advanced surgical procedures required in PD, reports on robot-assisted (laparobotic) PD remain few. Furthermore, there has not yet been a single report detailing PD techniques modified to take advantage of the Da Vinci platform. In this report, laparobotic PD was successfully performed on 7 patients. Five patients underwent pyloric preserving PD and 2 had stand-ard PD. All the 7 patients have been followed up till January 2009. The overall mean operative time was 326 minutes (290-400 minutes) and the mean length of postoperative stay was 10.2 days (5-30 days). There was no mortality. Five patients had perioperative complications but went on well after manage-ment. The stepwise cando-cranial approach PD is a unique approach, which is ideal for robotic platform. Although it has been shown to be feasible, safe, efficient, and reproducible in this small series, a larger scale multi-institutional study is needed to validate its efficacy.

Objective To investigate the effects of dexmedetomidine on acute lung injury induced by hind limb ischemia-reperfusion in rats. Methods Sixty healthy male Wistar rats were randomly allocated into 4 groups: group C(control), group I-R(ischemia-reperfusion), group Pre-Dex(dexmedetomidine)and group Post-Dex. The morphological changes of the lung tissues were observed under light microscope , and polymorphonuclear neutrophils (PMN) in alveolar septum were counted. Meanwhile, lung coefficient, arterial partial PaO2, lung levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, interleukin (IL)-10, and malondialdehyde (MDA) were measured. Results Rats in the I-R group were resulted in the damage of the lung tissues. The rats in group Pre-Dex and group Post-Dex were featured with obvious mild lung injury. TNF-α、IL-6、IL-10 and MDA in lung levels were significantly increased in group I-R , Pre-Dex and Post-Dex. TNF-α, IL-6 and MDA in the lung were significantly decreased in group Pre-Pex and group Post-Dex. IL-10 was increased in group Pre-Dex and group Post-Dex. Conclusions Inflammatory response and oxidative stress are involved in the pathogenesis of acute lung injury induced by hind limb ischemia-reperfusion in rats. Dexmedetomidine attenuated the lung injury through anti-inflammation and anti-oxidation.

ObjectiveTo investigate the influence of age on hypnotic target plasma concentration (CT) of dexmedetomidine (Dex) administered by TCI.MethodsSixty ASA Ⅰ - Ⅱ patients aged 18-85 yr undergoing lower abdominal or extremity operation under combined spinal-epidural anesthesia were divided into 2 age groups ( n =30each):18 yr＜groupⅠ＜55 yr (Y) and 65 yr＜group Ⅱ＜85 yr (E).Each group was further divided into 5subgroups (n =6 each) receiving Dex administered by TCI at CT of 0.54,0.64,0.76,0.90,1.07 ng/ml in group Y and 0.36,0.42,0.51,0.60,0.71 ng/ml in group E respectively.Hypnosis was defined as no response to verbal command (OAA/S score ≤2) and loss of eyelash reflex.A quantal response model (probit analysis) was used to calculate the concentration-effect curve and predict plasma EC50 and EC95 (95％CI) of Dex.ResultsEC50 (95％CI) was 0.478(0.424-0.536) ng/ml and EC95(95％CI) 0.641 (0.567-0.816) ng/ml in group E,significantly lower than EC50 (95 ％ CI) 0.738 (0.657-0.827) ng/ml and EC95 (95％CI) 0.990 (0.874-1.267 ) ng/ml in group Y.ConclusionThe EC50 and EC95 of dexmedetomidine for hypnosis were significantly lower in the elderly than in younger patients.

Objective: To replace esophageal defects with artificially composed biodegradable materials and non-biodegradable materials. Met hods: A two-layered tube consisting of a collagen-chitosan sponge and an inner polyurethane stent was used to replace 5 cm esophageal segmental defect s in 15 dogs. The inner polyurethane stent was removed endoscopically at weekly intervals from 2 or 4 weeks. Results: Partial regeneration of es ophageal epithelia was observed in 5 dogs at week 2, and progressing constricti on occurred and the dogs became unable to swallow within 1 month. In the 10 dog s that the polyurethane stent was removed at week 4, regenerated esophageal tiss ue successfully replaced the defects, and complete epithelization was observed 1 month after surgery. Complete regeneration of esophageal mucosa structures, inc luding mucosal smooth muscle and mucosal glands were observed 3 months after surgery, and partial regeneration of esophageal muscle tissue was also observed 6 months after surgery. Conclusion: Our artificial prosthesis i n reconstruction of the cervical esophagus segment in dogs is feasible. Through temporary polyurethane tube, collagen-chitosan sponge provides a three-dimensi onal structure suitable for the regeneration and sufficient degradation time for the complete regeneration of esophagus.

To compare the luminescent characters in different bacteria of two different recombinant mycobaceriaphages by using biolimenescent methods in order to understand the differences between sensitivity and specificity of these phages, and to set up methods to use recombinant mycobacteriaphages in detecting drug suscepbility of mycobacteria. Result showed that both two phages have high light production in action with mycobacterium selectively and have almost no light production with E. coli , the difference is very obvious. Among different mycobacterium, BCG has the highest light production and mycobacterium tuberculosis has the lowest light production. The sensitivity of Phage 88 is higher than Phage 40, the difference is obviously. It can be considered that both recombinant mycobacteriaphages can detect mycobacterium specifically, but Phage 88 is more suitable for clinical usage.

OBJECTIVE:To establish a method for the content determination of Esomeprazole sodium for injection. METH-ODS:UPLC-MS/MS was performed. The column of ZORBAX Eclipse Plus C18 with 0.1% formic acid-methanol(73∶27,V/V)at a flow rate of 0.3 ml/min,column temperature was 35℃,analysis time was 5 min,injection volume was 2μl;ionization mode was positive ion mode,ion source temperature was 150 ℃,capillary voltage was 3.0 kV,cone voltage was 50 V,cone flow was 150 L/Hr,desolvation temperature was 450 ℃,desolvation gas flow was 900 L/Hr,nebuliser pressure was 7.0 Bar,parent ion scan range was 100-800 mz/mz,working mode was multiple reaction monitoring mode. RESULTS:The linear range of esomeprazole was 0.2-20.0 ng/ml(r=0.999 7);the limit of quantitation was 50 pg/ml;RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 99.93%-100.05%(RSD=0.1%,n=9). CONCLUSIONS:The method is simple and accurate,and can be used for content determination of Esomeprazole sodium for injection.

Objective To construct a model of small caliber vascular endothelial growth factor(VEGF) in tissue engineering,to investigate the performance of the sustained-release microspheres and vascular stent,and to provide materials and theoretical basis for animal experiment.Methods The sheep carotid arteries were treated with a cellular reagents,the cellular conditions and the stent properties were observed.Preparation of sustained release microspheres containing VEGF,particle size,encapsulation efficiency,drug loading and release curve were measured.The effective combination of the slow release microsphere and the vascular stent was used in the freeze drying technology.The rat vascular endothelial cells grown in tissue engineered blood vessel model release lumen,observe the growth of endothelial cells.Results After the treatment,the original performance of the vascular stent can be maintained.The average particle size of the microspheres was (9.8 ± 6.0) μm,which could be released slowly in 20 days,and the release rate was 70％.Microspheres can effectively with the tissue.engineering blood vessel tight binding.Rat vascular endothelial cells can grow in the vascular stent surface.Conclusion Using Triton X-100,DNA/RNA ribozyme for acellular reagent,stent performance is good.PLGA microspheres have good sustained release performance,and constructing appropriate tissue engineered small caliber vascular release model by using freeze drying technology can make the stent compact structure.

Objective Several physiological reactions of human periodontal ligament cells (hPDLCs) are effected by a varie-ty of long-chain non-coding RNA , and nicotine as the major risk factor of smoking-related periodontitis , would lead to many cytokines changes in hPDLCs .The aim of the study was to explore the effect of nicotine on the expression of lncRNA NEAT 1 and IL 8 in the nucleus of hPDLCs. Methods We cultured the hPDLCs in vitro and used the 4th generation cells for subsequent experiments .hPDLCs were randomly divided into 4 groups:control group , nicotine group ,α-BTX group, nicotine+α-BTX group.Control group:hPDLCs without any ir-ritation;nicotine group: 10-5 mol/L nicotine stimulated hPDLCs for 4h;α-BTX group:10-8 mol/Lα-BTX stimulated hPDLCs; nicotine+α-BTX group:10-5 mol/L nicotine+10-8 mol/Lα-BTX stimulated hPDLCs .Real-time quantitative PCR was taken to detect the expres-sion level of NEAT1 and downstream IL 8 mRNA.In addition, the protein expression of IL-8 was tested by ELISA. Results After we primary cultured the periodontal ligament tissue for 3 weeks, the cells around the tissue were arranged radially .After a stable passage, microscopic observation showed that hPDLCs were long spindle-shape or spindle-shape with clear contour and adherent growth .Com-pared with nicotine group , the expression of NEAT1-1, NEAT1-2, IL-8 mRNA in hPDLCs in other three groups were all decreased ( P<0.05) .The expression level of IL-8 protein in the supernatant of the nicotine group was significantly higher than the control group , about 4.8 times higher than the control group ( P<0.05) , while theα-BTX group and nicotine+α-BTX group were not significantly dif-ferent from the control group (P>0.05). Conclusion Nicotine can promote the expression of NEAT1 and IL-8 in hPDLCs, which suggets that NEAT 1 may be involved in the development of smoking-related periodontitis by promoting early inflammatory reaction .

BACKGROUND:At present, the internal fixation and fusion surgical treatment of lumbar degenerative disease tends to diversify, but posterior lumbar interbody fusion within a single bilateral pedicle screw fixation is stil common in clinical practice; the two ways after treatment can achieve satisfactory clinical efficacy, but which way has advantages is stil controversial. OBJECTIVE:To evaluate the efficacy and safety of unilateral and bilateral pedicle screw fixation and single segment lumbar interbody fusion in the repair of lumbar degenerative disease by a meta-analysis system. METHODS: According to the Cochrane Colaboration search strategy, we searched MEDLINE, PubMed, EMBASE, CBMdisc, CNKI, VIP and WanFang Data. Randomized controled trials concerned unilateral and bilateral pedicle screw fixation and single segment lumbar interbody fusion in the treatment of lumbar degenerative diseases. By two reviewers, in strict accordance with inclusion and exclusion criteria, literatures were screened, data were extracted, and the methodology quality of included trials was criticaly assessed. RevMan5.1 software was used for meta-analysis. RESULTS AND CONCLUSION: Six randomized controled trials involving 507 patients were included. The results of meta-analysis showed that fixed unilateral and bilateral pedicle screw between single lumbar fusion and surgery in the treatment of lumbar degenerative diseases, significant differences were detected in surgical time [WMD=-40.29, 95% CI (-43.79, -36.79)], intraoperative blood loss [WMD=-74.13, 95%CI (-86.13,-62.13)], length of hospital stay [WMD=-1.04, 95%CI (-1.30,-0.79)], final folow-up Visual Analogue Scale score [WMD=0.33, 95% CI (0.24, 0.42)], final folow-up Oswestry dysfunction index [WMD=-1.07, 95%CI(-1.57, -0.56)]; unilateral side was better than bilateral side (P < 0.000 1). There was no significant difference in complication rate [RR=0.54, 95% CI(0.25, 1.17)] and fusion rate [RR=0.53, 95%CI (0.22, 1.28)] (P=0.12 andP=0.16). These results suggested that unilateral and bilateral pedicle screw fixation and single lumbar fusion in the treatment of lumbar degenerative disease has achieved satisfactory results. Unilateral pedicle screw fixation can reduce operation time, intraoperative blood loss and length of stay. Visual Analogue Scale score and Oswestry dysfunction index improved significantly in a short period after treatment.

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on non-fluent aphasia in patients after stroke.Methods Forty stroke patients displaying non-fluent aphasia were randomly assigned to an rTMS group and a control group using a random number table.Both groups were treated with conventional language therapy,while the rTMS group was additionally given 0.5 Hz rTMS over the Broca's homologues of the unaffected hemisphere 5 days a week for 3 weeks.The patients were stimulated at 90％ of the motor threshold (MT),with 16 second trains and intervals of 3 seconds 48 times (384 pulses) in a session.Before and after the 3 weeks of treatment,the Western Aphasia Battery (WAB) and the Communicative Abilities in Daily Living (CADL) test were conducted in both groups to evaluate their language function and communication ability.Results Only spontaneous speech improved significantly (P＜0.05) in the control group after 3 weeks of treatment.In the rTMS group,the spontaneous speech,auditory comprehension,repetition,naming and aphasia quotient (AQ) had all improved significantly (P＜0.05).Moreover,after the treatment,the average score of the auditory comprehension (153.90± 31.79),repetition (82.65± 15.14),naming(81.28±22.12) and AQ (63.66± 13.64) of the rTMS group were significantly higher than those of the control group (P＜0.05).Conclusion rTMS applied to the Broca's homologues of the unaffected hemisphere can significantly improve language function in those exhibiting non-fluent aphasia after stroke.