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.

The intraportal islet transplantation is the most hopeful method for the treatment of type 1 dia-betes mellitus. However about 70% of transplanted islets would be destroyed in the early two weeks after transplantation, only a few parts of them could engraft in liver and become functional. This results in the lower efficiency of islet transplantation. Here we review the reasons of this early islet loss and its preventive strategies.

Objective:To observe the influences of sleep deprivation and antioxidant agent ?-lipoic acid on the expression of IRE1 in the cortex and hippocampus in rats.Methods:Rats were randomly divided into control groups and sleep deprivation group.The control groups included blank control group(n=10) and environmental control group(n=10).Sleep deprivation group included 120 rats,and rats were further divided into ?-lipoic acid group(25 mg?kg-1?d-1) and sleep deprivation model group.The two were further divided into 6 groups according to the periods of sleep deprivation and sleep restoration(SD 1 d,SD 3 d,SD 5 d,SD 7 d,SD 7 d/RS 6 h,SD 7 d/RS 12 h[n=10]).The expression of IRE1 mRNA and protein was examined by RT-PCR and immunohistochemistry,respectively.Results:RT-PCR results showed that the expression of IRE1 mRNA in the cortex and hippocampus were significantly higher in sleep deprivation group than in the blank and environmental control groups(P

Complications that follow ischemic stroke are common,frequency ranging from 28% to 95%.It may either directly lead to death or prevent optimal recovery.54% of deaths after ischemic stroke are attributed to medical complications.Most complications occur during the first week,and stroke severity is the most important risk factor.The common serious medical complications are chest or urinary tract infection,deep venous thrombosis,pulmonary embolism,cardiac events,gastrointestinal bleeding,hyperglycemia,pressure sores.Falls,shoulder pain and depression are also common complications.Most of medical complications are preventable or treatable to some extent if recognized,so preventive strategies and appropriate treatment should be employed as early as possible.Prevention,early recognition,and management complications could improve short-term and long-term prognoses after ischemic stroke.

Objective:To investigate the effects of various degrees of rapid eye movement (REM) sleep deprivation (RSD) and sleep recovery on cognitive function (learning and memory) and expression of brain-derived neurotrophic factor (BDNF) in the rat hippocampus. Methods: Male SD rats were divided into 8 groups (n=12): blank control group (with normal sleep), environmental control, RSD 1 d, RSD 3 d, RSD 5 d, RSD 7 d, recover sleep 6 h after 7 d RSD (RS 6 h), and recover sleep 12 h after 7 d RSD (RS 12 h). The modified multiple platform method (MMPM) was used to establish sleep deprivation model in rats. The cognitive functions of rats were tested by Y-type maze. The hippocampal BDNF mRNA and protein levels were detected by real-time PCR and immunohistochemical method. Results: The failure reaction times of all RSD groups and the 2 RS groups were significantly more than those in control group and environmental control group (P

Sleep deprivation, as a stress just like starvation and anoxia, can induce the physiological function changes, such as emotion disorders, cognition disorders, and immune disorders. Oxidative stress is common in cells and is closely related to aging, Alzheimer disease, Pakinson diseases, etc. Previous studies showed that sleep deprivation could induce oxidative stress via different pathways, namely, the increase of the metabolic rate and free radicals, the depress of antioxidant ability, and the indirect effects of endoplasmic reticulum stress. In this review we summarize the recent progress on the above fields.

Unfolded protein response(UPR) is a protective response in cell endoplasmic reticulum(ER) under stress condition.Three ER transmembrane proteins,IRE1,PERK,and ATF6,coordinately regulate the UPR function in mammalian cells through their signaling pathways.In addition,some proteins and transcription factors during the UPR can provide negative and positive feedback loops to maintain the normal function of ER.UPR can trigger cell death or apoptosis and eventually cause related diseases if the ER stress persists.Several key mediators of UPR are candidates for therapeutic targets in many studies.Up to now progress has been made in the area,which provides new ideas for clinical practice and holds a great potential for future application.

Patients possibly incur cognitive disorders when they suffer from obstructive sleep apnea hypopnea syndrome (OSAHS). The pathogenesis of OSAHS is mainly associated with turbulence of sleep structure and chronic episodic hypoxia during sleep, and the pathological changes in cerebral areas hypersensitive to hypopnea may be responsible for cognitive dysfunction. It has been preliminarily showed that cognitive disorder in OSAHS is a generalized cognitive impairment and is possibly associated with Alzheimer's disease (AD). Recently, measures for cognitive evaluation have been improved by the application of the neuroimage; however,to build a highly specific,maneuverable evaluation system still demands more exertion. Despite the fact that early remedies for OSAHS may slow down the cognitive dysfunction,there still lacks specialized treatment for cognitive disorders. OSAHS is not rare in children and it can affect their cognitive function, which demands more attention.

[Objective]To discussthe clinic effective and the application value of the fibula fixation in treating the complex and comminuted fracture of the tibiofibular.[Method]At first,we reduced and fixed up the fibula fracture anatomically as the support to reduce the tibia fracture indirectly,then we fixed up the tibia fracture by using intramedullary nail or external fixators.[Result]In the 23 cases of the tibiofibular fracture,10 cases of the fibula fracture were almost anatomically reduced,13 cases were reduced functionally,the wounds were cured without parenchyma infection or bone infection.The follow-up time was 13 months averagedly.The time of clinical healing was from 13 weeks to 21 weeks.The cases which were excellently cured was 20,which were well cured was 2,which was tolerably cured was 1 by the Johner-Wrushs grade standard.[Conclusion]This method was designed reasonably,operated simply,acceded with the minimal-invasive and biological rule of the bone fractuer treatment,profited to the heal of the fracture,it was a prefect mean to cure the complex and comminuted fracture of the tibiofibular.

Glycogen storage disease (GSD) is a rela-tively rare inherited metabolic disease. However, its relative rarity implies that no metabolic centre has experience of large numbers of patients and experience with long-term manage-ment is limited. In addition, there is wide variation in meth-ods of medical treatment. With the development of medical care, life-expectancy in glycogen storage disease (GSD) has improved considerably. With ageing liver adenoma may de-velop which will bring about several complications-compres-sion, hemorrhage, or even transformation into carcinomas-and needs immediate intervention. In this paper, reviews for the mechanism and surgical intervention of GSD are presented.