Objective To investigate the feasibility and security of omentum minus cavity xenotransloantation of alginic-polylysine-alginic(APA) microencapsulated neonatal swine islet cells by laparoscopic procedure. Methods 5 patients with IDDM received the xenotransloantation of APA microencapsulated neonatal pig islets in omentum minus cavity by laparoscopic procedure.The patients' general conditions,the change in fast blood glucose level,serum C-peptide and the dose of insulin used were observed before and after the xenotransplantation. Results No complications occurred during operation and after operation.The levels of serum C-peptide increased by 3 to 23 times respectively and the post-operative dose of insulin needed decreased obviously.Insulin independency was achieved in one recipient for up to 31 months. Conclusions Omentum minus cavity xenotransplantation of APA microencapsulated neonatal pig islets for the treatment of IDDM patients by laparoscopic technique is safe and practicable.

Objective To evaluate the effect and result of xenotransplantation with alginic polylysine alginic(APA) microencapsulated neonatal swine islets for the treatment of IDDM patients.[WT5”HZ] Method [WT5”BZ] The neonatal pig islets were microencapsulated with APA technique and cultured in vitro. The secretion of insulin, glucose stimulated insulin release test and histological examination between the microencapsulated and unmicroencapsulated neonatal pig islets were compared. 3 patients with IDDM received a xenotransplantation of microencapsulated neonatal pig islets by laparoscopic procedure. The change in blood glucose level, C peptide and the dose of insulin used were observed before and after the xenotransplantation. [WT5”HZ]Results [WT5”BZ] No significant difference was found between microencapsulated and unmicroencapsulated neonatal pig islets in vitro in terms of biological activity of the islets. The levels of serum C peptide in two of the 3 recipients increased by 11 and 23 times respectively, the postoperative dose of insulin needed decreased by 63% in one, insulin independency was achieved in the other recipient.In these two cases,the microencapsulated islets have functioned effectively for up to 80 ds.[WT5”HZ] Conclusion [WT5”BZ] APA microencapsulated neonatal pig islets have good biological activity and survived while transplanted into IDDM recipients. Omentum minus cavity xenotransplantation of microencapsulated neonatal pig islets by laparoscopic technique is safe, capable of repeated transplantation.

Objective To analyze the major causes of reoperation for abdominal injuries and explore the effective preventive measures so as to enhance operation quality for abdominal injuries. Methods The data of 33 patients undergoing relaparotomy for abdominal injuries during the last 10 years was analyzed retrospectively. Results There were 25 closed injuries and 8 stab penetrating injuries in this group. The causes of reoperation were mainly missed injuries in initial laprotomy 10 cases,inappropriate surgical procedures 8 cases, postoperative complications 13 cases, and negative relaparotomy 2 cases. In these 33 patients, 40 times of reoperation were performed, and among them 2 patients sustained 3 times of laparotomy respectively. Overall mortality rate was 12%(4/33). The main causes of death were MODS resulted from consumption coagulopathy and/or severe septic complication after reoperation. Conclusions The effective preventive steps to decrease the incidence of reoperation in patients with abdominal injuries include complete interventional exploration, right operational methods and sufficient drainage in initial laparotomy for a surgeon.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; In Vitro Techniques ; Mice ; Myocarditis ; drug therapy ; virology ; Phytotherapy ; methods ; Virus Diseases ; drug therapy

Objective To explore the surgical treatment of the primary retroperitoneal tumor (PRT). Methods A retrospective clinical data analysis was made on the 59 cases of PRT who underwent operation. Results 59 cases were diagnosed by operation and pathologic examination.In 41 cases of malignancyt ( 69.49%),complete resection, partial resection, surgical exploration and biopsy were performed on 15 cases (36.6%), 8 cases (19.5%) and 18 case (43.9%) , respectively. The 3- and 5-year survival rates of maligment PRT with total resection were 53.3% and 26.7%,and with partial resection were 19.23% and 7.69% respectively.In 18 cases of benign tumor (30.5%),complete resection, partial resection, surgical exploration and biopsy were performed on 14 cases (77.8%), 3cases (16.7%) and 1case ( 5.6%) , respectively. The 3- and 5-year survival rates of benign PRT with total resection were 92.86% and 85.7%,and with non-completely resection were 75.0% and 50.0%, respectively. Conclusions Operation is the main treatment of PRT. Early diagnosis and radical resection are the keys in improving the prognosis of PRT.

Objective To summarize the experience of adjuvant therapy for primary hepatocellular carcinoma. Methods 316 cases of operable hepatocellular carcinoma were divided into three groups. Only hepatectomy were performed in group one (21 8cases).Preopemtive adjuvant TACE were done in group two (52 cases). Preoperative adjuvant TACE and postoperative trans-portal vein chemotherapy were done in group three (46 cases), which was named hepatectomy sequencing two vessel therapy. Results 1, 3 and 5 year survival rote were 51.2 %, 30.0 % and 20.5 % respectively in group one, 57.2 %, 43.0 % and 31.5 % in group two, 84.0 %, 62.5 % and 51.0 % in group three. The postoperative disease-free survival rate in group three was significantly higher than that in group one and group two (P ＜0.05). Conclusion Hepatectomy sequencing two vessels therapy in perioperative period might improve the survival rate, which can prevent and delay the incidence of recurrence and may improve the effect of liver resection.

Objective:To study the effect of endoscope on the treatment of Hepatocellular Carcinoma (HCC) combined with biliary tract obstrucition (BTO).Methods:We have analyzed retrospectively the results of twelve patients suffering from HCC combined with BTO from 5,1990 to 5,2000.Among these cases,various reasons were found.5 of them were intrabilitary cancer embolus,7 were billary calculus.7 of them were treated with endoscope and following surgical resection,1 was treated with endoscope、TAE and resection,the 3 rest of them were solely treated with endoscope.Results:Of all the 12 cases,1 died of resection,2 failed to follow the survey,these 3 cases above took 25%;among the rest of 9 cases,2 of them survived for 3 to 6 months,3 for half to 1 year,3 for 1 to 2 year,1 for at least 2 years.Those cases suviving for more than 1 year were received surgical resection.Conclusions:We should have no fixed way but to deal with each patient of HCC combined with BTO on his/her merits.As our recognition towards them began accumulating,we found that,in the early stage of obstruction,active endoscopic treatment would prove to be preferable.If combined with other therapy such as surgical resection and TAE,Endoscopy would improve the curative effect of HCC combined with BTO substantially.

Objective In patients with pulmonary atresia and intact ventricular septum ( PAIVS) without right ventricular-dependent coronaries, catheter techniques including the use of a sniff wire, lasers, and radiofrequency have been the most widely used initial therapy. However, percutaneous perforation and balloon valvuloplasty were associated with higher rate of procedural failure and serious complications. Methods We report our experience with a hybrid approach for pulmonary atresia with intact ventricular septum, combining surgery and interventional catheterization techniques. Between March 2005 and March 2010, hybrid procedure was carried out successfully in 30 newboms and infants with favorable anatomy. The age ranged from 1 day to 48 months with a mean of (4.59 ±3.21) months. The heart was exposed through median sternotomy. A pursestring suture was placed in the right ventricular outflow tract 2 cm away from the pulmonary trunk. Then a 16-gauge intravenous catheter was punctured through the right ventrical and perforated the atretic PV with the guidance of echocardiography. A guide wire was then inserted into the sheath and used to guide the balloon across the PV. Sequential dilations were performed until a full opening of the PV with the guidance of epicardial echocardiography. In patients ＜ 3 months PDA ligation was performed followed by modified Blalock-Taussig (B-T) shunt. In patients ＞ 3 months PDA ligation was not performed. A modified B-T shunt was inserted if severe systemic oxygen desaturation occurred after PDA ligation. Bidirectional Glenn shunt was performed for severe hypoplasia. Hybrid procedure was achieved in all patients. The simultaneous procedures included 25 cases of PDA ligation. 6 newborns underwent modified B-T shunt placement (3.5 to 5 mm) after pulmonary valvuloplasty and PDA ligation, and 2 patients ＞ 1 month underwent modified B-T shunt. Another 2 patients were selected for univentricular palliative surgery because of a diminutive monopartite right ventricle and bidirectional Glenn procedure was performed. No pericardial effusion or cardiac tamponade was observed in all patients. Another case without PDA ligation underwent a modified B-T shunt because of hypoxemia three days after hybrid procedure, and the rest patients were discharged without any further surgical intervention.During the follow-up period of 1.5 to 62.0 months, 5 patients died. 25 (83.3%) survived and were all in New York Heart Association functional class 1. Peripheral oxygen saturation increased from 0.73 ± 0.08 to 0.94 ± 0.04 (P ＜ 0.05). One patient remains in a single-ventricle pathway, whereas 24 patients achieved a two-ventricle circulation. Results Conclusion Perventricular balloon pulmonary valvuloplasty using a hybrid approach is a safe and feasible procedure for patients with PAIVS.

To lead students to think actively and develop their innovative abilities,we adopted approaches of self-study,question and answer teaching as well as presentation and discussion teaching,perfected teaching contents and system of basic experiments, formed comprehensive experiments and exploratory experiments,established excellent courseware and carried out network education constructed scientific and reasonable exam systems.These reforms are strong guarantees for cultivating high quality talents in the 21st century.

Objective To investigate the incidence of hearing disorder and analyse the high-risk factors with hearing injury in newborns with hyperbilirubinemia.Methods The newborns with hyperbilirubinemia who admitted to the department of neonate,were received the distortion product otoacoustic emission(DPOAE)test when they recovered from hyperbilirubinemia;those babies who didn′t pass the first test received screening again in 42 days after birth.Those babies who didn′t pass the second test received auditory brain stem response(ABR)test.Results Fifty-eight(33.2%)newborns didn′t pass the first DPOAE test among 235 newborns with hyperbilirubinemia;11(18.9%)infants didn′t pass the second DPOAE test among 58 infants;5 infants failed to pass the ABR test,the ratio of hea-ring disorder in newborns with hyperbilirubinemia was 2.13%;18(9.9%)newborns didn′t pass the first DPOAE test among 182 normal newborns,and those infants all passed the second DPOAE test.Conclusions Hyperbilirubinemia is high-risk population of hearing disorder.The congenital cytomegalovirus infection,neonatal septicemia and hemolytic disease of newborn are the high risk factors responsible for hearing disorder.All high risk newborns should recieve hearing examination regularly.