Objective To study the effects of L-arginine on the reperfusion injury of hypothermic perfusion and on preservation of isolated pancreas(ISP) in canines . Methods After segmental pancreatic transplantation(SPTS) model were set up,the animals were randomly divided into 3 groups:(1)ISP irregulated and preserved with Euro Colln Solution(ECS)plus L-arginine(L-arg group);(2)IPS irregulated and preserved with ECS plus N-nitro-L-arginine methy ester(L-NAME group);and(3)IPS irregulated and preserved with ECS plus normal saline(Control group).The IPS were irregulated and preserved at 0-4℃ for 24h.Serum concentration of amylase and lipase were detected. NO,NOS and myeloperoxidase (MPO) and expression of iNOS mRNA in the pancreas graft were measured. Histological examination was performed. Results The level of NO in the L-arg group was significantly higher than that in the control group(P

96 anterior teeth with different degree of caries in 80 patients were randomly divided into 2 groups(n =48 teeth,40 patients). In the experimental group the teeth were repair with nanometer resin filling,in the control group with ceramic crown.In 0.5 to 1 year follow-up,the satisfaction rate and the clinical success rate were similar in the 2 groups(P >0.05).Application of nano resin aesthetic restoration can lower tooth injury,postoperative complications and the cost.

Objective To study the different expression of microRNA(miRNA) including mir-29c,mir-200a,mir-145 in the mid-secretary endometrium and its relationship with infertility of endometriosis.Methods From August 2011 to February 2013,36 infertile cases with endometriosis confirmed by laparoscopy and pathology and excluded the other infertile factors in Department of Reproductive Medicine in Peking University Shenzhen Hospital were enrolled in this study,which were divided into 17 cases with stage Ⅰ-Ⅱ,19 cases with stage Ⅲ]-Ⅳ according to the revised classification American Fertility Society.Forty-four healthy women with male factor infertility were chosen as control group.The relative expression levels of mir-29c,mir-200a,mir-145 in the endometrium of women in two groups were detected by using real-time quantitative polymerase chain reaction.Those women were followed up for pregnancy outcome of endometriosis group after assisted reproductive techniques (pregnancy and nonpregnancy group respectively).Results (1) The expression of miRNA between endometriosis and control groups:the average expression level of mir-29c,mir-200a,mir-145 in the endometrium of endometriosis group was 2.46 ± 1.98,3.20 ± 2.45,6.378 ± 3.275,which were significantly higher than 1.36 ± 1.05,2.04 ±1.16,4.548 ± 1.885 in control group (P =0.026,0.027,0.041,respectively).(2) The expression of miRNA between Ⅰ-Ⅱ stage and Ⅲ-Ⅳ:the average expression level of mir-29c,mir-200a,mir-145 in the endometrium was 0.53 ± 0.51,0.33 ± 0.26,0.048 ± 0.021 in patients with of stage Ⅰ-Ⅱ,while 0.26 ±0.18,0.28 ±0.12,0.045 ±0.016 in stage Ⅲ-Ⅳ respectively,there were no statistically significant differences between the two groups(P =0.191,0.661,0.753,respectively).(3) The expression of miRNA between pregnancy and non-pregnancy groups:the average expression level of mir-29c,mir-200a,mir-145 in the endometrium were 0.60 ± 0.30,1.23 ± 0.48,0.886 ± 0.238 in pregnancy group,while 2.64 ± 1.73,4.39 ± 2.58,7.199 ± 3.945 in non pregnancy group,there were statistically significant differences between the two groups(P =0.030,0.039,0.028,respectively).Conclusion Up-regulation of mir-29c,mir-200a,mir-145 in the endometrial tissue might play a role in endometriosis associated infertility.

ObjectiveTo study the efficacy of different doses of tamsulosin hydrochloride sustained release tablets for treatment of premature ejaculation (PE). MethodsEighty PE patients from September 2010 to January 2011 were divided into two groups randomly,the 0.2 mg dose group and the 0.4 mg dose group.The therapeutic effect was assessed by the changes of the patients' CIPE-5 scores.ResultsThe intra-vaginal ejaculation latency time (IELT) of the two groups were (0.98 ± 0.47 ) and ( 0.89 ± 0.47 ) min respectively before treatment,and (4.40 ± 1.86 ) and (6.40 ± 5.10) min respectively after treatment.There were significant differences ( P ＜ 0.01 ).As for satisfaction degree of sexual life,lessening the patients' sexual anxiety and nervousness,and decreasing the difficulty in retarding ejaculation,the group of 0.4 mg had better effect than the other group.ConclusionLarge dose of tamsulosin hydrochloride sustained release tablets could prolong IELT and increase the sexual satisfaction.

Objective To explore a reasonable and secure anesthesia induction in painless induced abortion.Methods 120 patients of painless induced abortion were randomly divided into six groups,control group was injected with Propofol 3.5mg/kg through vein,besides given Propofol 3.5mg/kg,other 5 groups were injected with ketamine 0.1mg/kg、0.2mg/kg、0.3mg/kg、0.4mg/kg、0.5mg/kg through vein respectively.The parameter of hemodynamics,effect of analgesia,time of unconsciousness,recovery time of consciousness,recovery time of orientation,incidence of respiratory depression,side effect,time of discharge from hospital were observed.Results The recorded time and incidence of side effect have statistical significance between group of ketamine 0.5mg/kg and group of ketamine 0.3mg/ks(P<0.05);effect of analgesia have statistical significance between group of ketamine 0.3mg/kg、0.4mg/kg、0.5mg/kg and control group.Conclusion Ketamine 0.3mg/kg combined with Propofol is an ideal choice of painless induced abortion.

Objective To evaluate the effect of distal splenorenal shunts (DSRS) in treatment of portal hypertension.Methods A retrospective analysis was made on 16 patients undergoing DSRS between 2009 and 2015 in a single institution.Perioperative free portal pressure (FPP),blood routine,liver function were collected and analyzed.Postoperative complications,long-term anastomotic status and the rate of re-bleeding were observed.Results Before and after DSRS,FPP were (43 ± 9) cmH2O and (31 ± 6) cmH2 O,a decrease of 29.1％ (t =7.326,P ＜ 0.01).Postoperative serum total bilirubin and peripheral blood leukocyte increased significantly (t =-3.462,t =-2.822,P ＜ 0.05).There was no significant difference in the changes of platelet and albumin before and after surgery.7 patients (7/16,43.8％) had one or more complications including 5 cases (31.3％) of portal vein thrombosis,massive ascites in 4 cases (25.0％),1 case (6.3％) of pulmonary infection and 1 case (6.3％) of wound infection.There was no inhospital mortality and all the 16 cases were followed up with no shunt anastomotic stenosis as showed by enhanced CT scan,meanwhile postoperative re-bleeding occurred in 1 case (6.3％) and 1 case (6.3％) died from liver failure.Conclusions Distal splenorenal shunts provides an effective method for the treatment of portal hypertension.

Objective To explore the clinical effects of S-1 single agent chemotherapy for the patients undergoing radical resection of cholangiocarcinoma.Methods The clinical data of 51 patients receiving radical resection of cholangiocarcinoma who were admitted to the Second Affiliated Hospital of Zhejiang University from November 2011 to December 2013 were retrospectively analyzed.After radical resection of cholangiocarcinoma,25 patients receiving non-special treatment and 26 patients receiving S-1 single agent chemotherapy were divided into the operation group and chemotherapy group,respectively.S-1 was taken orally twice per day.Forty mg/once of S-1 was applied to patients with the body surface area ＜ 1.25 m2,50 mg/once of S-1 was applied to patients with the body surface area ≥ 1.25 m2 and ＜ 1.50 m2,and 60 mg/once of S-1 was applied to patients with the body surface area ≥ 1.50 m2.The 14 days usage and 7 days withdrawal of S-1 were used as one course of treatment.The standard usage of S-1 was 6-8 courses of treatment.All the patients were followed up by outpatient examination and telephone interview till December 1,2014.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s and analyzed using the t test.Survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results Twenty-six patients in the chemotherapy group finished the courses of chemotherapy without chemotherapy-related death,and 14 patients had chemotherapy adverse reactions with remission after discontinuation of S-1.All the 51 patients were followed up for 5-37 months with a median time of 19 months.The median overall survival time,1-,3-year overall survival rates,tumor-free median survival time and 1-,3-year tumor-free survival rates were 22 months (range,18-27 months),72.3％,42.9％,21 months (range,16-26 months),60.0％,55.0％ in the operation group and 32 months (range,29-35 months),84.6％,44.4％,26 months (range,21-31 months),76.9％,61.9％ in the chemotherapy group,respectively.There was a significant difference in the overall survival between the 2 groups (x2=6.032,P ＜ 0.05).There was no significant difference in the tumor-free survival between the 2 groups (x2=0.498,P ＞ 0.05).Conclusion S-1 single agent chemotherapy after radical resection of cholangiocarcinoma could improve the survival of patients,while no obvious advantages of inhibiting tumor recurrence is observed.

Objective To investigate the electrophysiological characteristics of carpal tunnel syndrome (CTS) and CTS-associated cervical spondylotic radiculopathy (CSR),and to examine the relationship between CTS and CSR. Methods The clinical characteristics and electrodiagnostic features of 81 patients with CTS and 20 patients with both CTS and CSR (the double crush,DC) were analyzed and compared.The data were analyzed according to the severity of the deficit in median nerve conduction using electromyography. Results The 81 patients with CTS had 123 median nerves with abnormal conduction (39 cases with unilateral abnormalities and 42 cases with bilateral abnormalities).The 20 patients with DC had 31 median nerves with abnormal conduction (9 cases with unilateral abnormalities and 11 cases with bilateral abnormalities).The rate of abnormal sensory nerve conduction velocity (SCV) was 100％ in C6 and C7 level radiculopathies.The rate of abnormal distal motor latency (DML) was 92.31％ in C5 level radiculopathies.There was a statistically significant difference between CTS and DC in the rate of abnormal SCV from the middle finger to the wrist.The other electrodiagnostic data were not significantly different between the CTS and DC patients.Neurophysiological tests were used to grade CTS into categories according to the American Association of Electrodiagnostic Medicine's criteria,but there was no statistically significant difference between CTS and DC. Conclusions CSR lesions on a proximal nerve root may cause the nerve to be more susceptible to distal injury and increase the risk of CTS.The findings support the DC hypothesis,but DC on a median nerve did not result in more severe injury than a single crush.

Objective In the patients with calcaneal fractures,the surgical method with intact peroneal tendon sheath was used to treat them,and compared with the traditional surgical method with dynamic retraction of the peroneal tendon,to analyze the influence of the surgical method on the posterior foot movement.Methods A retrospective analysis was made on 60 patients with calcaneal fracture admitted to the Department of Orthopaedics of our hospital from December 2016 to December 2020.The patients were divided into two groups according to the surgical method.The patients in the distraction group received the surgical treatment of traditional dynamic distraction of peroneal tendon(28 cases),and the patients in the preservation group received the surgical treatment of preserving the integrity of peroneal tendon sheath(32 cases).The outcome measures included perioperative indicators,Maryland score of foot function 12 months after surgery,AOFAS score of posterior foot and imaging indicators(Boler Angle and Gissane Angle)12 months after surgery.Results The surgical time(89.34±12.21 minutes)and hospitalization time(5.26±1.47 days)of the retention group were significantly better than those of the traction group[(124.22±11.56)min,(11.59±2.43)d](P＜0.05).At the last follow-up,the AOFAS score(70.56±3.62)and Maryland's excellent and good rate(87.5％)of patients in the retention group were better than those in the traction group(81.37±3.58,71.4％)(P＜0.05).The difference in imaging indicators between the two groups was relatively small(P＞0.05).Conclusion The surgical method of keeping the peroneal tendon sheath intact in the treatment of patients with calcaneal fracture has definite clinical effects,and can also effectively reduce the adverse effects of surgical trauma on posterior foot activity.

OBJECTIVETo explore the value of Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in treating benign tumors of pancreatic head (BTPH).

METHODSThe clinical data of 12 patients diagnosed as BTPH and treated by Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in Department of General Surgery, Peking University Third Hospital from November 2006 to October 2013 were retrospectively analyzed.Of the 12 cases, 5 patients were male, 7 patients were female, the age of patients ranged from 21 to 64 years(average 42.3 years). Diameter of tumors was 3.0-4.8 cm.Diameter of pancreatic wound after resection was 5.1-7.9 cm, and main pancreatic duct injury happened in 1 case.

RESULTSTwo cases of mucinous cystadenoma, 2 insulinoma, 3 solid pseudopapillary tumor and 4 nonfunctional pancreatic neuroendocrine tumors were confirmed histopathologically.No mortality and pancreatic leakage occurred during the perioperative period.All the 12 patients had no sign of recurrence.Experienced good life quality without occurrence of diabetes during the follow-up period of 24-108 months(more than 60 months in 4 cases).

CONCLUSIONSRoux-en-Y pancreaticojejunostomy after local pancreatic head resection is a reasonable choice for benign tumors of the pancreatic head as long as the patient is properly selected.

Adult ; Anastomosis, Roux-en-Y ; Cystadenoma, Mucinous ; surgery ; Female ; Humans ; Insulinoma ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pancreas ; surgery ; Pancreatic Neoplasms ; surgery ; Pancreaticojejunostomy ; Retrospective Studies ; Treatment Outcome ; Young Adult