Surgical treatment of cirrhotic portal hypertension and its accompanied abdominal diseases is one of the medical problems currently.Accurate evaluation of the hepatic function reserve,degree of portal hypertension and accompanied abdominal disease is important to decrease the postoperative morbidity and mortality as well as to raise the efficacy.The surgical procedure selection should be based on the analysis of portal vein hemodynamics of patients.There are clear indications for portosystemic shunt,devascularization and combinative surgery with shunt and devascularization.Treatment for portal hypertension should be carried out when treating the accompanied abdominal diseases.The principle of operation,operation time,operation mode,operation sequence,staging indications and the key techniques of operation were discussed in the article.Only these principles be mastered,proper selection of surgical procedures and desired treatment effect with minimal trauma can be achieved.

Oxidative stress is involved in cirrhotic portal hypertension and a close relationship exists between oxidative stress and hyperdynamic circulation.This article elaborates on the function of various reactive oxygen species (e.g.,superoxide anion and hydrogen peroxide) and corresponding anti-oxidants (e.g.,NAD(P) H oxidase inhibitor,the scavengers of superoxide anion,hydrogen peroxide,and vitamin C or E) on the occurrence and development of hyperdynamic circulation in cirrhotic portal hypertension.We observed that the level of reactive oxygen species in cirrhotic portal hypertension was elevated over normal.The potential clinical value is that inhibition or removal of these reactive oxygen species can relieve hyperdynamic circulation and reduce complications for cirrhotic portal hypertension.

It is now popularized that the multi-media and network technology are applied in the field of college English teaching.This essay discusses the characteristics of multi-media network auxiliary English teaching and the cultivation of independent learning ability.

It is related to the treatment effect of the disease and the quality of life of the patient that perioperative management of ruptured esophagogastric varices bleeding with portal hypertension.According to the individual characteristics of the patient combined with the experience of the surgeons,the key points of individualized treatment consist of accurate and comprehensive preoperative preparation,fine post-operative treatment,and the changes of pre-and post-operative hemodynamics of portal vein system to choose a reasonable procedure,meanwhile,the delicate postoperative managements can improve the surgical effect of portal hypertension.

Objective To inquire into the forward clinical results of ventricular pacing, dual-chamber sensing, atrial-triggered, and ventricular-inhibited (VDD) Pacemaker in an unipolar lead.Methods 16 patients with the pacemaker were studied from 1993 to 2002, including 12 male patients and 4 female patients at 49 to 75 years old (average age 64 4 7 8 years old). They were in normal sinus rhythmia with complete or high degree atrial-ventricular block. Lead electrode was inserted through subclavian venous access, and the pacemaker was implanted in the same side as the electrode.Results All patients were followed up from 1 to 112 months (average 68 8 6 3 months) after pacemaker implantation. Their heart functions were improved, symptoms disappeared, life quality remarkably improved. Atrial sensing of VDD was good. One patient was died from coronary heart disease with heart failure by following up for 42 months, but the rest were healthy. Conclusions VDD pacemaker implantation was simple, easy to perform if its indication was appropriate. It could alleviate patients symptom and its therapy was effective. We should think highly of using VDD pacemaker, especially at poor region.

Angiopoietin family is a recently discovered type of cellular factors that specifically bind to the TIE-2 receptors located exclusively in endothelial cell membrane. The protein structures of this family members are similar. They can be structurally divided into three domains: an N-terminal region lacking homology to any known structures, an alpha-helical rich coiled-coil segment, and a fibrinogen-like domain. The distribution and biological activity of these factors are different in organism. Angiopoietin-1 as a agonist, mostly locates in close proximity with vascular endothelial cells, keeps the stability of blood vessels, enhances the affinity of vascular endothelial cells with surrounding cells and matrix, decreases the leakage of vessel. Ang-2 is a naturally occurring antagonist of Ang-1, exists in the angiogenic remodeling region and is related to the decrement of the stability of vessel. Ang-3 is widely distributed in multiple mouse tissues, while Ang-4 is expressed only in lung. Although Ang-3 and Ang-4 are structurally diverged from each other, they appear to represent the mouse and human counterparts of the same gene locus. Biological functions of Ang-3 and Ang-4 have not been elucidated yet. Angiopoietin family has potentially clinical applications for incurring illnesses which lead to vessel wound and vascular abnormal development.

Objective To explore the pre-requisite "highlight" of information system in a new outpatient building and its significance on outpatient information construction.Methods The importance of new outpatient information system for improving the treatment of the environment and optimizing the outpatient treatment processes were analyzed from information dissemination system,self-service system and intelligent queuing system.Results The systemic design plan and actual role of the three systems were given by combining actual situation of the new outpatient building construction.Conclusion Having greatly improving for the outpatient information construction and the new outpatient building will have a positive impact on hospital management model,medical model and informationation construction.

The epiphysis is an unique structure in pediatric skeletons,which mainly reflect in its unique blood supply,anatomical structure,pathological basis and so on.Epiphyseal injury is common in children with skeletal injury.Fracture,tumor,infection can cause epiphysis injury,and inappropriate treatment is often easy to cause growth obstacle and skeletal deformity.Its treatment is relatively difficult.At present,there had not yet formed a consistent therapeutic strategy.Aiming at the pathobiologic basis,causes,mechanism and clinical manifestation of pediatric epiphyseal injury,now,its diagnosis,therapeutic strategy,the principle of treatment and the latest research progress were summarized,which would provide useful guidance for clinical treatment of pediatric epiphysis injury.

Objective To investigate the effects ofTongbicapsule on the knee joint function and the synovial fluid levels of matrix metalloproteinase (MMP)-3,-9 in patients with knee osteoarthritis.Methods A total of 76 patients with knee osteoarthritis were randomly divided into a control group and an observation group according to the random number table, 38 in each group. Patients in the control group were treated with glucosamine hydrochloride capsules, while patients in the observation group were givenTongbicapsule on the basis of the control group. Both groups were treated for 12 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index was used to measure the knee joint function, and enzyme-linked immunosorbent assay was used to determine the synovial fluid levels of MMP-3 and MMP-9.Results The knee joint function in the observation group was significantly improved than that in the control group (94.74%vs. 78.95%;χ2=4.146, P<0.05). The synovial fluid levels of MMP-3 (67.58 ± 22.35 ng/mlvs.93.51 ± 27.84 ng/ml;t=4.477,P<0.01) and MMP-9 (36.24 ± 10.56 ng/mlvs.51.87 ± 12.35 ng/ml;t=5.930,P<0.01) in the observation group patients were significant lower than those in the control group after treatment.ConclusionsTongbicapsule was effective in treating knee joint function in patients with knee osteoarthritis, and its mechanism may be related to its reducing the synovial fluid levels of MMP-3 and MMP-9.

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.