General anesthesia combined with epidural anesthesia and postoperative epidural analge-sia is capable of accelerating the recovery of gastrointestinal function,providing better postoperative pain re-lief,improving the patient's satisfaction as well as shortening hospitalization dates.The article summarized the mechanisms of epidural analgesia influencing the recovery of gastrointestinal function.

The configuration of the air cleaner and operating principle of high-voltage static electrical field (HVEF) are introduced. The primary bactericidal mechanism and broad-spectrum effect are also mentioned.

Objective To observe the influence of Edaravone on the level of serum gastrin and efficacy in patients with craniocerebral injury.Methods 60 patients with craniocerebral injury were randomly divided into Edaravone group(30 cases) and Dexamethasone group(30 cases).Then each group received corresponding treatment.The level of serum gastrin was detected at 1st d,3rd d,5th d and 7th d after treatment.The curative effect was evaluated based on the neuroligical deficit score(NDS) and Barthel index(BI) one month after treatment.Results The level of serum gastrin in Edaravone group began to decrease at the 3rd d after treatment,at the 5th d and 7th d became to normal value.While,in Dexamethasone group 5th d after treatment,the level of serum gastrin began to decrease,but at the 7th d was still significantly higher than the normal value.The levels of serum gastim at 3 d,5 d and 7 d after treatment were significant difference between the two groups(P

砄bjective:To investigate the expression of integrin ? 1 during mandibular fracture healing.Methods:Rabbit mandibular fracture model was used,the fractured bone tissues were obtained and paraffin slices were made on the day 1,3,5,7,14,30,60 and 90 after surgery respectively.Non fractured mandible was used as the control.The expression of integrin ? 1 in bone tissue, especially in osteoblasts and osteoclasts, was studied with LsAB immunohistochemical method.Results:Integrin ? 1 was widely espressed in the bone tissure close to fracture and surrounding soft tissue.In osteoblasts increased expression of integrin ? 1 was observed on day 7,maximum on day 14～30 and normal on day 90.While in osteoclasts,it was increased and kept at maximum 14～90 days aftere fracture.Conclusion:During mandibular fracture healing,the expression of integrin ? 1 in bone,especially in osteoblasts and osteoclasts,was increased.Integrin ? 1 has a critical influence on bone fracture healing.

[Objective]To determine whether discectomy resulted in improvement in low back pain(LBP)associated with lumbar disc herniation. [Method]Two hundred and one consecutive single-level lumbar discectomy were followed up,one hundred patients underwent microendoscopic discectomy(MED group) and 101 patients were treated with conventional open discectomy(COP group).Outcomes were assessed using Visual Analog Scale(VAS) and patient satisfaction.The changes in LBP were compared between the MED group and COP group.The effects of severity of low back pain before surgery on the improvement of back and leg pain were also determined.The mean duration of follow-up was 45 months.[Result]The mean VAS leg pain significantly decreased from 70.02?15.80 before operation to 7.73?12.13 at final follow-up.A significant improvement was also noted in LBP,the mean VAS LBP score was 43.61?26.18 before surgery and 16.89?14.73 at the time of final follow-up.The important improvement in LBP and leg pain was seen in 70.1%～78.1% and 97.0% patients respectively.Improvements in back pain and leg pain were correlated(r= 0.1656,P=0.0304).The rate of important improvement of low back pain was greater in MED group than in COP group.The rate of important improvement in LBP was similar in the patients of a preponderance of LBP,a preponderance leg pain and an equivalence of LBP and leg pain,the patients with a preponderance of LBP showed a lower rate of important improvement in leg pain than the others.[Conclusion]Discectomy for relief of sciatica of lumbar disc herniation provides effective relief of LBP.The MED is more likely effective as a surgery way to relief LBP.Furthermore,it certified that the severe LBP maybe a negatively predictive factor for the follow-up outcome of leg pain.

Objective To screen the genes differentially expressed in gene expression in human lymphoma cell line Jurkat cells treated with phosphonoformate (PFA). Methods cDNA microarray technique was employed to detect the mRNA expressed in Jurkat cells treated with PFA or 0.9 percent sodium chloride, respectively. Results Among 1 152 genes there were 94 genes with different expression, of which 38 genes were upregulated and 56 genes were downregulated in Jurkat cells treated with PFA compared with those treated with 0.9 percent sodium chloride. Conclusions cDNA microarray technique was successfully used to screen the genes with different expression in Jurkat cells treated with PFA, and the results brought some new clues for the study of the immune regulation mechanism of PFA.

Objective To determine the clinical value of contrast enhanced MRI in differentiating benign and malignant pancreatic endocrine tumors (PNETs).Methods MRI findings on 13 cases who were pathologically diagnosed as PNETs were retrospectively analyzed , including the tumor volume , border , MRI signal and adjacent organ involvement of Grade 1~3 tumors, and the sensitivity, specificity and accuracy of MRI for diagnosing PNETs were calculated .Results A total of 18 tumors were detected , including 12 benign (Grade 1) and 6 malignant (Grade 2~3) tumors.Eight Grade 1 tumors′(66.7%) maximal diameters were≤2 cm, while 100%(6 /6) Grade 2 ~3 tumors′maximal diameters were ≥2 cm.All of Grade 1 tumors (100%) had clear boundary , while 50%(2/4) Grade 2 and 100%(2/2) Grade 3 tumors had unclear boundary.Ten Grade 1 tumors (83.3%) had intratumoral homogeneous signal , while 100%(6/6) Grade 2~3 tumors had heterogeneous intratumoral signal .Two Grade 3tumors ( 100%) had organ infiltration and retroperitoneal lymph node metastasis .The sensitivity ,specificity and accuracy of MRI for differentiating benign and malignant PNETs were 833.%, 85.7%and 84.6%, respectively.Conclusi ons MRI had higher sensitivity, specificity and accuracy in differentiating benign and malignant PNETs , but it was still difficult to differentiate Grade 1 from Grade 2 tumors by MRI.Tumors size could not be considered to be a reliable indicator for differentiating benign and malignant PNETs .

Objective To discuss the clinical effect of Da Vinci robot-assisted free fibula flap for the management of mandibular and mouth segmental defect.Methods There was a patient with malignant neoplasm of lower gum,which underwent robot-assisted free fibula flap for the management of mandibular and mouth segmental defect,was analyzed.The surgery was divided into two groups:a group resected the primary tumors,another group cut fibula free flap.Use of Da Vinci robotic surgical system for vascular anastomosis and suture of the oral mucosa.Results Four weeks after surgery,the free fibula flap survived completely.There was no infection in the mouth.The patient can walk freely and eating semifluid.Conclusion The Da Vinci robotic surgical system is a stable,minimally invasive,clear and safe method for microsurgery.

Objective To investigate and summarize the clinical characteristic of autoimmune pancreati-tis(AIP).Methods Clinical data of 13 patients with AIP, admitted to the West China Hospital from 2009 to 2013, were retrospectively analyzed .Results The median age of the 13 patients was 48 years old.The main clinical manifestations included epigastric pain or discomfort (8 cases), obstructive jaundice(7 cases)and weight loss(10 cases).Diffuse enlargement of pancreas and localized pancreatic enlargement were observed in 6 cases, pseudocyst and pancreatic stones were observed in 1 case.Dilation of pancreatic duct was found in 4 cases.Bili-ary stricture and thickened wall of bile duct were detected in 8 cases, dilated gallbladder with delayed enhance-ment of the thickened wall in 7 cases, retroperitoneal fibrosis surrounding the aorta in 1 case, abdominal lymph-adenopathy in 6 cases, stenosis of splenic vein in 4 cases, and Sjogren's disease and ulcerative colitis in 1 case. The positive rate of serum IgG, RF, ANA was 71.43%(5/7), 42.86%(3/7), and 42.86%(3/7), respec-tively.8 patients were misdiagnosed and underwent surgery .Steroid therapy was administered in all patients with satisfactory response.Conclusions AIP is a rare and autoimmune disease ,without speci? c symptoms,and often be misdiagnosed as pancreatic cancer or bile duct carcinoma .We must give more attention to AIP and keep pa-tients from undergoing unnecessary surgery .

Objective To investigate the effect of hydrogen sulfide postconditioning on the systolic function of left ventricle during myocardial ischemia-reperfusion (IR) in rats. Methods Part Ⅰ Adult male SD rats weighing 200-250 g were anesthetized with pentobarbital 40 mg/kg and heparin 250 U/kg. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95% O2-5% CO2 at 37 ℃. Forty isolated rat hearts were randomly divided into 5 groups ( n = 8 each) after 20 min of equilibration: control group (group C); IR group; sodium hydrosulfide 1,10, 100 μmol/L postconditioning group (group SP1, SP10, SP100 ).In group Cthe hearts were perfused continuously for another 100 min. In group IR, the hearts were reperfused for 60 min after 40 min ischemia induced by 10 ml/kg ST. Thomas solution. In group SP1 , SP10 and SP100 the hearts were perfused with K-H solution containing sodium hydrosulfide 1, 10, 100 μmol/L for 2 min before reperfusion.LVDP and ± dp/dtmax were recorded at the end of equilibration and reperfusion. Part Ⅱ Cardiomyocytes were isolated from the male SD rats (weighing 200-250 g) and then cultured in CO2 incubator for 4 h. Sixty-four dishes of cultured myocytes were randomly divided into 4 groups( n = 16 each): control group (group C), hypoxia/reoxygenation group (group HR), hydrogen sulfide postconditioning group (group SP) and hypoxia postconditioning group (group HP). Group C were cultured continuously for 2 h. Group HR, SP and HP were exposed to 1 h hypoxia (95%N2-5%CO2 ) followed by 1 h reoxygenation. In group SP 10 μmol/L sodium hydrosulfide was added and the myocytes were then incubated for 2 min before reoxygenation. In group HP the cultured myocytes were expased to 3 min reoxygenation followed by 3 min hypoxia for 3 times before the 1 h reoxygenation. Mitochondrial membrane potential and F-actin expression were determined. Results Part Ⅰ Compared with group C, LVDP and ± dp/dtmax were significantly decreased at the end of reperfusion in group IR (P ＜ 0.05), while no significant difference was found in group SP1 , SP10 and SP100(P ＞0.05). Compared with group IR, LVDP and ± dp/dtmax were significantly increased in group SP ( P ＜ 0.05). There was no significant difference in LVDP and ± dp/dtmax among group SP1, SP10 and SP100(P ＞0.05). Part H Compared with group C, the mitochondrial membrane potential was significantly decreased in group HR and HP, and the expression of F-actin was significantly up-regulated in group HR, SP and HP ( P ＜ 0.05). Compared with group HR, the mitochondrial membrane potential was significantly increased and the expression of F-actin up-regulated in group SP and HP ( P ＜ 0.05 ). There were no significant difference in the mitochondrial membrane potential and expression of F-actin between group SP and HP ( P ＞0.05).Conclusion Hydrogen sulfide postconditioning can improve left ventricular systolic function during IR in rats by stabilizing mitochondrial membrane potential and promoting aggregation of F-actin.