Pancreaticobiliary maljunction(PBM)is closely related to many surgical diseases in which are commonly seen in clinical practice.However,diagnosis of PBM is difficult and it is easily missed.The lack of knowledge and awareness of PMB has once made PBM “the forgotten corner of abdominal surgery”.This essay summarized the current knowledge on the diagnosis of PBM by medical imaging.

Cardiac muscles of mouse embryos, newborn and suckling mice were used for histological and histochemical studies. This paper presents the observations on the morphogenesis and ultrastructure of cardiac myocytes under electron microscope and on their reactions of nucleic acids (DNA and RNA), glycogen, lipids, succinodehydrogenase (SDH), alkaline and acid phosphatases (AKP and AcP), glucose-6-phosphatase (G-6-Pase) and adenosine triphosphatase (ATPase) under light microscope.The heart of mouse embryo before 12-day, contained numerous polygonal or star-shaped myoblasts which had not yet acquired myofibrils but a few myofilaments. As the myoblast developed, the number of myofilaments increased in number and formed myofibrils, then the cells became myocytes. By the end of embryonic period, all the special elements of myocyte were basically constituted. The myocytes of embryos were rich in RNA granules, and their DNA was deeply stained. Flourishing mitosis appeared only in the early embryonic phase. RNA of adult myocytes was much less than that of embryos. From the early phase of embryos myocytes were full of glycogen but short of lipid droplets. From the day it was born, glycogen decreased apparently but lipid droplets increased rapidly.The reaction of SDH steadily increased in intensity from its early phase to late one. After birth it became more intensive. G-6-pase first appeared in the myocytes of 14 day's embryos. In the fetal period it showed moderate positive reaction, but in the myocytes of suckling muose it appeared negative. The enzyme showed positive reaction again at the age of 2 weeks. The ATPase reaction was found to be weak in the fetal specimens, only appeared in the endothelium of the capillaries. After birth it gradually became intensive and from the 2nd week positive reaction was obvious in adult, it was very vigorous.The above observations showed that the embryonic development and differentiation were gradually completed. Histological and histochemical features of each developmental period showed their individualities, which confirmed the evidence that the cardiac muscle developed not only successively but also by stages, and approached adult's level at 2nd week end after birth.

Objective To study the expression of prepro-orexin mRNA in circadian rhythms and sleep-deprived rats.Methods Sleep was deprived with “rotation cylinder” in rats. RT-PCR was used to determine the change of prepro-orexin mRNA expression in cortex and hypothalamus of circadian rhythms and sleep-deprived rats.Results There was a significant changes of prepro-orexin mRNA expression with circadian rhythms in hypothalamus of rats. But there was no significant change in cortex. More prepro-orexin mRNA expression was found in hypothalamus than in cortex of rats. The expression of prepro-orexin mRNA in hypothalamus and in cortex of rats was not effected by short times of sleep deprivation. However the expression was raised by a 8-hour sleep deprivation.Conclusions There should be a close relationship between orexin and sleep. The control of sleep may be dependent on regulation of orexin in hypothalamus.

Objective To investigate the effects of short-term sleep deprivation(SD)at different time during night on serum cortisol level and emotion state of healthy men,and to find out the influence of work shift onto human circadian rhythm.Methods Two periods of sleep-time were deprived in the present study:the late-night SD(permitted to sleep from 0:00 to 3:00 each day)and the early-night SD(permitted to sleep from 3:00 to 6:00 each day).Ten healthy male adults were chosen to undergo the late-night SD first,followed by normal sleeping for eight nights for washout,and then underwent early-night SD.Each SD period lasted 6 days,i.e.1 day before SD,4 days of SD and 1 day after SD for recovery.Fasting blood samples,for detection of serum cortisol,were collected at 7:00 am every SD day,and the state anxiety inventory(S-AI)scoring was done at the same time.Results The cortisol levels were lowered after 2 types of SD(P0.05).Dependability analysis showed that the cortisol level during the late-night SD period was negatively related to the SD days(r=-0.954 7,P0.05).Both types of SD could elevate anxiety scores,which positively correlated with the SD days(late-night SD:r=0.990,P

Objective To investigate the value of clinical use of laparoscopy combined with choledochoscopy in treatment of cholecystolithiasis complicated with choledocholithiasis.Methods Of 120 patients suffering from cholecystolithiasis combined with choledocholithiasis,56 patients underwent laparoscopic cholecystectomy together with choledocholithotomy and T-tube drainage(LCTD),and 64 patients received routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy.Postoperative administration of analgesics,wound infection,recovery of function of gastrointestinal tract(RFGI),and hospital stay were compared between the two groups.Results In both groups,there were no severe complications.Wound infection rate was 12.5 %,average hospital stay was(14.9?3.1) d,and RFGI was(26.1?8.6) h in routine operation group;while in LCTD group,there was no wound infection occurred,hospital stay was(5.8?1.4) d and RFGI was(10.6?3.4) h.There were significant difference in postoperative recovery conditions between the two groups(P

As medicine is a "health related,and life entrusted" career,medical humanities education is an indispensable part of medical education.On the one hand,it makes medical students remain sober-minded and kind-hearted.On the other hand,medical humanities education calls for passionate,knowledgeable and responsible teachers.Through the roles of empathy in medical humanities education and sustained humane knowledge edification,it trains medical students′ sense of social responsibility.

Chronic insomnia is a severe disease that seriously influence the human health,and about 10%-15% of the adults suffer from it.No definite conclusion has been made about its etiology up to now,possibly associated with heredity,hormone secretion and living habits.Insomnia not only decreases the patients' quality of life,but also adds burden to society,families and individuals.The diagnosis of chronic insomnia should be based on the patients' sleep history,medication history,psychiatric history and necessary examinations.International diagnosis criteria should be combined if possible.Presently the treatments for chronic insomnia mainly include the OTC medicine,prescription drugs,self-medication with alcoholic beverage,cognitive behavior therapy,melatonin and some traditional herbal therapies.Limited information is available presently about insomnia and a large amount of laboratory and clinical research need to be done to further understand and solve this public problem.

Objective To evaluate the clinical features and treatment of posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods To retrospectively analyse the clinical features and therapy results of 120 patients with PC-BPPV from January 2003 to November 2004 in the Chang Zheng Hospital of the Second Military Medical University.Results Vertigo attack of PC-BPPV had such characters as brief period,positioning,latency and fatigability.Geotropic rotatory nystagmus occurred in 108 patients and apogeotropic rotatory nystagmus in 12 patients in the test of Dix-Hallpike,and the former received the repositioning maneuver therapy of Epley and the later received the therapy of Semont maneuver.The symptoms disappeared completely in 88 patients after a single session and 12 patients after twice、6 patients after triple sessions of Epley repositioning maneuver therapy in the former,no effectiveness in 2 patients;the symptoms remitted in 8 patients after once,2 patients after twice and 1 patient after triple sessions therapy of Semont repositioning maneuver in the later,no change in 1 patient.The total success rate was 97.5%(117/120).Fifteen patients had relapse during follow-up and the recurrence rate was 12.5%(15/120).They also responded to repositioning maneuver therapy.Conclusion The diagnosis of PC-BPPV is based on the typical clinical features and the test of Dix-Hallpike.The repositioning maneuver therapy is safe and effective for PC-BPPV and should be used for all patients when the diagnosis is clearly made.

1.200 cerebral hemispheres were used to observe the morphology of the brain sulci. 2.The superior and inferior frontal sulci not only run from tbe precentral sulcus or in the front of it,but also run behind it. 3.The posterior end of the collateral sulcus may extend to the superolateral sur- face of the occipital lobe. 4.The orbital sulci are irregular but generally are of the ?-shaped and H- shaped. 5.Anterio-superiorly to the cingulate sulcus a parallel accessory cingulate sulcus is usually present. 6.The intraparietal and intraoccipital sulci are usually continuous. 7.The superior and inferior transverse occipital sulci are present at the same time,being over 80% of the total number. 8.The parieto-occipital sulcus which commences on the superolateral surface is over 90% of the total number. 9.The calcarine sulcus is divided into four types,among which the“superior convex”and “linear”types are present more often. 10.Most of the superior sagittal cunuate sulcus and the inferior sagittal cunuate sulcus are present. 11.The lingual sulcus is constant.Its configuration is changed,following the change of the posterior part of the calcarine fissure and the posterior end of the collateral sulcus.

Objective To evaluate the long-term effectiveness of transurethral laser ablation of prostate in patients with benign prostatic hyperplasia (BPH). Methods We retrospectively reviewed 72 patients with BPH treated by transurethral laser ablation from November 1993 to September 1999. Follow-up observations ranged (3～9) years, mean 7 0 year. Results Pre- and post-operative International Prostate Symptom Score (IPSS), Quality of Life score (QoL), MFR, estimating weight of prostate and Post-Void Residual Urine (PVR) were (27 5?2 6) and (20 7?4 2) ( t =11 68, P 0 05), (71 5?46 2) ml and (42 3?28 6) ml ( t =4 56, P