Objective To evaluate the diagnosis and treatment of chronic pancreatitis complicated by stricture and dilation of the pancreatic duct. Methods The clinical data of 27 patients of chronic pancreatitis with stricture and dilation of the pancreatic duct undergoing operation in our hospital from 1990 to 1999 were analyzed retrospectively. Results Of the 27 patients, the positive diagnosis rate was 89% by B-US, 100% by CT, 100% by MRCP, 100% by ERCP. All patients received surgical operation, 12 patients received Partington procedure, 3 distal pancreatectomy, 4 pylorus preserving pancreaticoduodenectomy, 4 Beger procedure, 2 Frey procedure, 2 pancreatic cystojejunostmy. The complication rate was 11%. Postoperatively 89%(24/27) patients achieved pain relief,78%(18/23) gained in body weight, and diabetes significantly relieved in 5 cases(33%). Conclusion Appropriate diagnosis and treatment are very important for improving the patients′ life quality and natural history of chronic pancreatitis with stricture and dilation of the pancreatic duct.

Objective To evaluate the curative effect and indications of medical ozone for the treatment of lumbar disc herniation.Methods 10~20 ml(35~45 ug/ml) medical ozone was injected into the lumbar disc percutaneously each case. The patients were followed up for 6~12 months. Results 60 cases (66 lumbar discs) with lumbar disc herniation were treated with the injection of medical ozone. The total effective rate was 96.67% , excellent and good rate was 76%.The efficacy in herniation to be 30% of vertebral canal diameter and lumbardisc bulging group. Conclusion The treatment of lumbar disc herniation with medical ozone is simple,effective and no complications.

Objective To explore the feasibility and significance of hand-assisted laparoscopic splenectomy (HALS) for ruptured spleen. Methods We conducted HALS in 18 cases of ruptured spleen between January 2002 and January 2003. According to the Buntain classification of CT-graded splenic injury, 7 cases were classified as “type Ⅱ” and 11 cases, “type Ⅲ”. Ruptured spleen was complicated by other organ injuries in 12 cases. Results The operation was completed successfully in 16 cases, the operation time being 75～115 min (mean, 92.5 min). A conversion to open surgery was made in 2 cases, which were suspected of having injuries of other major vessels. Postoperative time to normal activities was 20～30 days in 6 cases of simple ruptured spleen and 30～100 days in 10 cases of ruptured spleen complicating other injuries. Conclusions HASL is feasible for “type Ⅱ or Ⅲ” ruptured spleen without severe complicating injuries.

Objective:To investigate the value of 64-slice spiral computed tomography (64SCT) in preoperative evaluation of spinal vascular intervention.Methods: Seventeen patients with spinal vascular malformations(SVM) scheduled for spinal vascular interventional therapy in our hospital between January 2012-December 2014 were collected, all received 64-detector spiral CT angiography (64-MDCTA) before surgery, image postprocessing technologies such as volume rendering (VR), maximum intensity projection(MIP) and multiplanar reconstruction(MPR) were applied to conduct three-dimensional reconstruction, the traveling case of spinal cord feeding artery was analyzed and were compared with DSA test results.Results: All of the 17 patients clearly showed the abnormality of spinal cord blood vessels and lesions scope, the SVM classification and lesions scope were exactly the same as that of DSA and intraoperative performance, the coincidence rate was 100%;1 case of patient was not shown fistula, the rest of the patients clearly shown the draining veins around the spinal cord, open position and flow tendency of radiculomedullary artery, the coincidence rates were 100.00%, 94.12%%, 100.00%.Conclusion: 64-MDCTA is important for SVM patients to preoperative evaluation of spinal vascular intervention, for it can fully and accurately reflect the open position and flow tendency of radiculomedullary artery, spatial relationship with the surrounding vessels, spinal cord and vertebral situation, should be widely applied.

Objective To explore the feasibility and clinical efficacy of hand assisted laparoscopic splenectomy (HALS) for ruptured spleen. Methods From January 2002 to October 2002, HALS was performed in 12 cases, among whom were 8 cases combined with other viceral trauma. Results HALS was accomplished successfully in 10 cases and laparotomy in 2. In 10 cases, the operation time of HALS averaged 102.5 minutes. The mean post operative hospitalization was 5.8 days in 4 cases with only spleen trauma and 15.5 days in 6 combined with other viceral trauma. Conclusions HALS is a feasible, effective and safe surgical procedure for the cases with Buntain CT scalingⅡ or Ⅲ spleen trauma with no severe combined trauma.

Objective: To compare two methods (microbial assay and radioimmunoassay) for measuring plasma folate concentrations, and to examine the relationship between plasma folate levels, and alcohol consumption, tobacco use and body mass index, and the risk of hyperhomocysteinemia in China. Methods: We used a microtiter plate microbial assay and a radioimmunoassay to measure the folate concentration in 88 plasma samples. After comparing the results of these two methods and fitting a regression line, we examined the geographical, seasonal, and gender differences in folate concentration of plasma collected from 2 422 adults in south and north areas in China, and evaluated the association of plasma folate concentration, with alcohol consumption, cigarette smoking, and body mass index, and with the risk of hyperhomocysteinemia, using the data from the two assays. Results: The data from the two assays had a linear relationship ( r =0.879, P =0.000); the regression was Y =0.683 X +0.308 (where X and Y were nature logarithmic transformations of plasma folate by microbial assay and radioimmunoassay, respectively); however, the mean plasma folate levels by microbial assay were much higher than those obtained by radioimmunoassay. Both data sets showed similar plasma folate distributions among Chinese adults, associations with other risk factors, and the risk of hyperhomocysteinemia. We estimated that 19.9% of the Southerners and 67.1% of the Northerners had plasma folate concentrations by radioimmunoassay lower than the 6.8 nmol/L used to define plasma folate deficiency. Conclusion: There is a linear relationship between plasma folate levels determined by microbial assay and radioimmunoassay, but because of the different levels obtained in the two assays, it is difficult to use the microbial assay results to evaluate folate status at this time. The use of 10.5 nmol/L as a cut off for plasma folate deficiency by microbial assay needs further study.

Objective To explore the efficacy of percutaneous intratumoral injection of mixed emulsion with hot lipiodol and pira-rubicin for treatment of liver metastases lack of blood supply.Methods 12 patients with liver metastases,confirmed by the clinical and pathological examination,were treated by intratumoral injection of mixed emulsion with heating lipiodol and pirarubicin using 21G biliary needle under CT guidance.The adverse events were recorded and the treatment efficacy was also assessed according to the imaging findings.Results 8 patients achieved a partial remission of lesions,and 3 ones had stable condition.No serious adverse reactions occurred.Conclusion It is effective,simple,convenient and safe for treatment of liver metastases lack of blood supply with percutaneous intratumoral injection of emulsion with hot lipiodol and pirarubicin.

Objective To explore the role of severity of limb ischemic injury in the treatment of popliteal artery injury.Methods A retrospective analysis was conducted of 259 patients with popliteal artery injury who had been treated from January 2002 to December 2014.They were 187 males and 72 females with a median age of 37.6 years (range,from 14 to 68 years).The time from injury to revascularization was from 4 hours to 29 days.According to the Rutherford classification system,the limb ischemic injury was categorized into 4 grades:grade Ⅰ:presence of sense and motion;grade Ⅱ:presence of sense but loss of active motion;grade m:loss of sense or motion;grade Ⅳ:stiffness.For all the patients with injury of grades Ⅰ and Ⅱ,limb salvage was adopted and opening decompression to osteofascial compartment was performed depending on the intraoperative and postoperative limb swelling.For the patients with grade Ⅲ injury,opening decompression to osteofascial compartment was performed to explore the activity of muscles in those with a strong will to preserve their limbs.When the muscle activity was poor but bright red bleeding was found at the broken muscle ends and there were no fish-like changes in muscles,limb salvage was suggested;otherwise amputation was chosen.For all the patients with grade Ⅳ injury,amputation was suggested.Results Of the 146 cases of limb salvages,142 were successful and 4 failed due to uncontrollable infection,giving a total success rate of 54.83％ (142/259).Complete rupture of the popliteal artery occurred in 23 cases,incomplete rupture or tear in 17,contusion and thrombosis in 219.No patient died due to popliteal artery injury or its complications.The patients with injury of grades Ⅰ,Ⅱ,Ⅲ and Ⅳ were respectively 51,88,67 and 53;their success rates of limb salvage were respectively 100.00％ (51/51),96.59％ (85/88),8.96％ (6/ 67) and 0.For the patients whose time from injury to revascularization was ＜ 6 h,6 h to 12 h,13 h to 24 h,25 h to 1 w,and ＞ 1 w,the success rates of limb salvage were respectively 80.77％ (42/52),54.58％ (73/134),20.51％ (8/39),33.33％ (6/18),and 81.25％ (13/16).The 142 patients whose limbs had been salvaged obtained an average follow-up of 31.4 months (range,from 6 months to 8 years).Of them,those with grade Ⅰ injury obtained normal plantar sensation and active ankle flexion and extension.Of the 85 patients with grade Ⅱ injury,all recovered normal or nearly normal plantar sensation,29 achieved partial recovery of active ankle and digital flexion and extension,but the other 56 obtained no recovery of active ankle motion.Of the 6 patients with grade l injury,none obtained recovery of motion function,4 achieved partial recovery of plantar sensation but the other 2 had no recovery.Conclusion The classification of popliteal artery injury into 4 grades according to its severity of ischemic injury can provide helpful guidance to the treatment and prognosis assessment of the popliteal artery injury.

OBJECTIVE:To observe therapeutic efficacy and safety of domestic Imatinib mesylate tablet in the treatment of chronic myeloid leukemia(CML). METHODS:16 CML patients were selected,including 7 newly diagnosed CML patients and 9 patients diagnosed as CML more than 12 months. Imatinib mesylate tablet 400 mg,qd were used in all patients. Blood routine, bone marrow cytology,ph chromosome Evaluate efficacy,and observed peripheral blood fusion gene,Bcr-Abl/Abl gene mutation and ADR were all detected. RESULTS:After treatment,16 patients achieved complete hematologic remission (CHR);12 cases were pavtial cytogenetic response(MCyR),of which 2 cases achieved complete cytogenetic response(CCyR),2 cases were cyto-genelic remission. 15 patients'Bcr-Abl/Abl transcript levels were less than 10%,and only one case was more than 10%. No ADR difficult to tolerate was found in 16 patients. CONCLUSIONS:Domestic Imatinib mesylate tablet shows definite early therapeutic efficacy and high safety.

Objective To introduce the method and to evaluate the therapeutic effect of collagenase chemonucleolysis for treatment of cervical disc herniation.Methods 92 patients with cervical herniated discs were selected from January 2002 to December 2004.The procedure was guided by DSA and the puncture was defined from C_(6~7) or C_7-T_1 extradural cavity.Collagenase(1200~2400 u) was injcted in the herniated extradural cavity through the micrcatheter.Results The procedure of 88 cases was successful.80 cases were followed up from 6 to 12 months.The effect showed that 70 cases(87.5%) were excellent or good.No serious complication occurred.Conclusion The method of collagenase chemonucleolysis for treating cervical disc herniation is safe and effective,it can be used in clinic.