Objective To compare the operation situation of pancreatico duodenectomy (PD) and pylorus‐preserving pancreatico duodenectomy (PPPD) ,and analyze the clinical efficacy of PPPD .Methods Data of 47 patients with periampullary carcinoma and pancreatic head carcinoma underwent pancreatico duodenectomy from January 2010 to December 2013 were retrospectively analyzed and divided into PPPD group (20 cases) and PD group (27 cases) according to different surgery method .Then compare the situa‐tion of intra‐operative and post‐operative situation in two groups of patients .Results The operation time of PPPD group was sig‐nificantly lower than that of PD group (P<0 .05);the incidence of postoperative complication rate of PPPD group was obviously lower than PD group (P< 0 .05);and postoperative infection rate of PPPD group was significantly lower than PD group (P<0 .05);there was no significant difference between two groups in pancreatic leakage ,bile leakage ,gastrointestinal leakage ,post oper‐ative bleeding ,mortality and the incidence of delayed gastric emptying after surgery (P>0 .05) .Conclusion PPPD operation could shorten the operation time ,promote post‐operative recovery ,lower complication rates and shorten hospitalization time ,and could al‐so help to improve the nutritional status of patients ,improve the postoperative quality of life of patients ,thus it should be further promoted .

Objective To observe the effect of somatostatin on liver function in patients after splenectomy combined with de-vascularization.Methods The clinical data of 48 patients with liver cirrhosis,portal hypertension and esophageal varices were retro-spectively analyzed,26 cases (somatostatin group)were used somatostatin after splenectomy combined with devascularization,and the other 22 cases (control group)were not used.The changes of serum albumin (Alb),alanine aminotransferase (ALT),aspartate transaminase (AST),prothrombin activity (PTA)and total bilirubin (TBIL)was observed.Results All patients recovered well af-ter surgery,and no deaths occurred.However,ALT,AST and TBIL of using somatostatin group were significantly reduced than those of control group(P <0.05),Alb and PTA were also improved significantly (P <0.05).Conclusion The combination of som-atostatin can not only reduce postoperative portal pressure,control of bleeding,but also to be significantly promote recovery of liver function.

Objective To investigate the expression of BAMBI in pancreatic carcinoma tissue and its clinical value.Methods Expression of BAMBI was detected by immunohistochemistry in 69 cases of pancreatic cancer and 15 normal pancreatic samples.The survival and its association with clinicopathologic parameters were analyzed.Results The expression of BAMBI in the cancer tissue was much higher than that in the normal tissues (56.5％ vs 16.7％,P ＜0.01).The expression of BAMBI was not associated with age,sex and tumor size,differentiation,but expression of BAMBI in patient with lymph node metastasis was higher than that in patient without lymph node metastasis (67.4％ vs 38.5％,P =0.019),the expression of BAMBI in TNM stage Ⅲ was higher than that in stage Ⅰ + Ⅱ (75.0％ vs 31.0％,P =0.001).The median survival of BAMBI-positive group (6 months) was lower than that of BAMBI-negative group (10 months).Conclusions BAMBI is over-expressed in pancreatic carcinoma,and its expression is associated with lymph node metastasis,TNM staging,differentiation and prognosis.

OBJECTIVETo review and summarize the experience of urethral reconstruction using lingual mucosal graft for the treatment of complex hypospadias.

METHODSWe evaluated the methods using lingual mucosal graft for the treatment of complex hypospadias. The dorsal inlay graft method and the tube graft method were used in our study.

RESULTSFrom Nov. 2010 to Oct. 2011,21 cases were treated. All the cases had at least one failed hypospadisa surgery before. The dorasl inlay grafting technique was used for 16 patients, the tube grafting technique was carried out in 5 patients(2 cases received Tube + Duply method). The follow-up period ranged from 3 months to 12 months (by average 6 months). The success rate of the methods was 61.9% with complications in 8 cases. Urethral fistula developed in 3 patients and urethral stricture developed in 5 patients. All cases who suffered stricture received the tube grafting technique. The fistula and urethral stricture were occurred at the site of the urethral termonoterminal anostomosis. Urethral stricture is the most common complication after the tube graft method for the treatment of the complex hypospadias.

CONCLUSIONSHarvesting the lingual mucosal graft is feasible and easy to perform. The complex hypospadias repair technique using lingual mucosal graft method provides good results. There fore it should be one of the preferred techniques for complex hypospadias repair. The dorsal inlay grafting technique has lower complication rate than the tube grafting technique. Early and regular urethral sounding should be carried out when patients received the tube graft method.

Adolescent ; Child ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; adverse effects ; Tongue ; Urethra ; surgery ; Urethral Diseases ; etiology ; Urethral Stricture ; etiology ; Urinary Fistula ; etiology ; Urologic Surgical Procedures, Male ; adverse effects

OBJECTIVETo summarize the experience of urethral reconstruction using circular fasciocutaneous flap for the treatment of complex anterior urethral strictures.

METHODThe circular fasciocutaneous flap was harvested from the distal penile shaft or foreskin. Then the circular configuration was converted into longitudinal strip of skin which was rotated to ventral side to repair the exposured urethral strictures using the ventral onlay method. The surveillance protocol after urethroplasty was urination observation, regularly uroflowmetry and urethrography examination.

RESULTSFrom Nov. 2006 to Oct. 2012, 15 cases were treated. The mean age was 45 years (20-76 years) and mean follow-up period was 18 months(3 months-3 years). Stricture was caused by chronic urethritis in 4 cases, long-term urethral catheterization in 3 cases, transurethral perfusion chem other aphy in 3 cases, transurethral prostatectomy in 3 cases and hypospadias after surgery in 2 patients. The mean stricture length was 7.0 cm (3.5-12.0 cm). The overall success rate was 80.0% (12/15). Recurrence stenosis was noted in 2 cases and diverticulum formation in 1 case.

CONCLUSIONSThe penile circular fasciocutaneous flap can be used for anterior urethral stricture in nearly any length. The flap has the characteristics of hairless, adequate mobile and length, well-vascularized pedicle and easy to harvest. The onlay reconstruction provides excellent cosmetic results, less trauma, higher success rate. Therefore it should be one of the preferred techniques for complex anterior urethral stricture repair.

Follow-Up Studies ; Foreskin ; Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Prostatectomy ; adverse effects ; Recurrence ; Surgical Flaps ; transplantation ; Urethra ; surgery ; Urethral Stricture ; etiology ; pathology ; surgery ; Urologic Surgical Procedures, Male ; Wound Healing

Objective To evaluate the usability of magnifying laryngoscopy for the diagnosis of nasopharyngeal diseases.Methods An analysis was made on the nasopharyngeal figure and letter data among 6774 cases undergone magnifying laryngoscopy.Among these cases,biopsy would be given to those with suspected lesion in the nasopharynx carried out under magnifying laryngoscopy or endoscope.Results Compliance of patients to magnifying laryngoscopy at the rate of 98.9%(6700/6774)was superior to indirect nasopharyngoscopy 30.9%(2095/6774).The difference was statistically significant(X~2=6872.75,P＜0.005).Magnifying laryngoscopy could clearly show a variety of diseases in nasopharynx,early detection of suspicious lesions.Among 615 cases,both fiber nasopharyngoscopy(192 cases)and nasal endoscopy(423 cases)with nasopharyngeal uplift were used,magnifying laryngoscopy found 418 cases bilateral symmetry,the surface smooth,no abnormal.The pathological examination confirmed normal tissue.Other 197 cases in the larger laryngoscopy also showed the uplift in nasopharynx by pathologically examination confirmed a variety of benign and maligant lesions.Conclusions Magnifying laryngoscopy with strong brightness,high resolution,can early detect the nasopharyngeal lesions,increase the diagnostic accuracy rate and biopsy-positive rate.Therefore,it is valuable for the diagnosis of nasopharyngeal diseases.

OBJECTIVETo explore the mid-term surgical results of arterial revascularization for femoro-popliteal arterial occlusive disease (lesion type C and D).

METHODSFrom January 2005 to February 2009, 191 arterial bypass had been performed on 170 patients (21 cases bilateral). There were 108 male and 62 female, age ranged from 45 to 85 years old with an average of 67 years old. The operative indication was claudication in 78 cases, rest pain in 62 cases, ischemic ulcer in 19 cases, and distal tissue necrosis in 11 cases. Arterial angiography were performed on all cases. According to TASC II document, type C lesions were seen in 127 limbs, type D lesions were seen in 64 limbs. Autogenous greater saphenous vein bypass in situ were done on 15 limbs, autogenous greater saphenous vein bypass reversed in 20 limbs, revascularization with artificial prosthesis in 128 limbs, composite grafts consisting of a prosthetic conduit with a distal venous segment in 28 limbs.

RESULTSThere were no 30-day mortality. Follow-up periods ranged 6 to 36 months with an average of (24 + or - 6) months. Seventy-three cases were lost during follow-up periods, follow-up rate was 57% (109/191). Primary patency rate was 84.4% (92/109). The patency rate was 88.2% with artificial prosthesis, 70.8% with greater saphenous vein (in situ or reversed). Secondary patency rate was 89.9%.

CONCLUSIONSArterial revascularization with artificial prosthesis is main treatment for diffused superficial femoral artery occlusive disease (TASC II type C and D lesion) with satisfied surgical results.

Aged ; Aged, 80 and over ; Arteriosclerosis Obliterans ; surgery ; Blood Vessel Prosthesis Implantation ; Female ; Femoral Artery ; surgery ; Humans ; Male ; Middle Aged ; Popliteal Artery ; surgery ; Retrospective Studies ; Saphenous Vein ; transplantation ; Treatment Outcome

OBJECTIVETo study the mechanism of male reproductive toxicity of metadoxine (MTDX) on mice and rats.

METHODSMouse multiple endpoints assay and Hershberger assay were employed to evaluate the potential estrogenic and/or antiandrogenic effects of MTDX. In mouse multiple endpoints assay, MTDX (0, 640, 1500 and 4000 mg/kg, respectively) were administered once daily p.o. for 5 days in sexually matured and ovariectomied female NIH mice. Five endpoints evaluated as markers of estrogenicity included the ratio of uterine weight to body weight, incidence and extent of uterine fluid imbibition (hydrometra), vaginal epithelial cornification during estrous cycle (estrinization) and thickness of uterine epithelial cell and stroma cell. In Hershberger assay, MTDX (0, 600 and 1500 mg/kg, respectively) was administered once daily p.o. for 10 days to castrated male SD rats with or without testosterone propionate (TP, 12.5 mg/kg, i.p. for 10 days) substitution. Relative weight of androgen dependent issues was measured.

RESULTSIn mouse multiple endpoints assay, ratio of uterine weight to body weight was 1.33, 1.38 and 1.31 x 10(-4) in MTDX 640, 1500 and 4000 mg/kg groups, respectively, without significant difference from that in control group (1.22 x 10(-4)). Thickness of uterine uterine epithelial cell (0.90 and 1.03 microm) and stroma cell (3.38 and 3.25 microm) in MTDX 1500 and 4000 mg/kg groups was not significantly different from the control group (0.85 microm and 2.77 microm, respectively). In Hershberger assay, relative weight of prostate plus seminal vesicle, levator ani muscle and bulbocavernous muscle was 1.13, 0.17 and 0.42, respectively, in the 1500 mg/kg group, significantly decreased as compared with those in the control group (1.46, 0.24 and 0.70, respectively) (P < 0.01). Relative weight of prostate plus seminal vesicle (1.29) in the MTDX 600 mg/kg group reduced slightly, with statistical significance (P < 0.05), as compared with that in the control group (1.46).

CONCLUSIONSIn the present study, MTDX did not exhibit any estrogenic effect in mice in vivo. However, it had antiandrogenic activity in castrated male SD rats, indicating that its antiandrogenic effect may be involved in it's male reproductive toxicity.

Androgen Antagonists ; toxicity ; Animals ; Drug Combinations ; Endpoint Determination ; Female ; Genitalia, Male ; drug effects ; pathology ; Male ; Mice ; Orchiectomy ; Ovariectomy ; Pyridoxine ; toxicity ; Pyrrolidonecarboxylic Acid ; toxicity ; Rats

OBJECTIVETo discuss the trend of displacement on the side of nondistraction when distraction osteogenesis with unilateral incomplete osteotomy of canine mandible.

METHODSThe method of finite element analysis was used to simulate distraction osteogenesis with unilateral incomplete osteotomy and the displacement of six marked point such as the temporomandibular joint and the angle of mandible and coracoid process and teeth were observed on nondistractional side when the transport disc was distracted with a distance and without a distance.

RESULTSWhen the transport disc was distracted without a distance, the Von Mises stress was 0 in the six marked point of nondisractional side and their displacement in 3 dimensions (X, Y, Z axis) was 0. When the transport disc was distracted with 1 mm width, all marked point had some displacement.

CONCLUSIONWhen distracted and observed from the side of distraction, the mandible at the side of nondistraction has the trend of contrarotation round the center of the transverse ridge mid-point of condyle process on the plane of sagittal, whereas it has the trend of parallel movement approximately in the direction of opposite side on the plane of coronary.

Finite Element Analysis ; Humans ; Mandible ; Osteogenesis, Distraction ; Osteotomy ; Temporomandibular Joint

OBJECTIVETo evaluate the efficacy and safety of electrochemotherapy in treating venous malformations.

METHODSElectrochemotherapy was applied to 665 patients with venous malformations of limbs and trunk, and 505 cases were followed up for half to 6 years. In this study, 228 male and 277 female patients were involved. Diagnosis was made by clinical manifestations and magnetic resonance imaging. The platinum electrodes were inserted into tumor through a trocar with plastic insulating cannula percutaneously and connected with the electrochemical therapeutic apparatus in anodes and cathodes separately. Then electricity was given. The treating voltage is 6-12 V and volume 100-180 mA, the total electricity used is in general 80-100 coulombs per 1.0 square centimeter of tumors' area. The treating time was usually from several dozen minutes to over 2 h depending on the size of the tumor. The severe cases which needed to be treated once again usually were operated after 6 months.

RESULTSThe primary efficacy end point was defined as an improvement of patients' symptoms and a reduction in size of tumor 6 months after treatment. Effects were divided into 4 grades, and the efficacy rate decreased from grade 1 to grade 4. The efficacy turned out that 30.1% (152/505) of patients was classified as grade 1; 46.3% (234/505) as grade 2; 19.0% (96/505) as grade 3 and 4.6% (23/505) as grade 4.

CONCLUSIONSElectrochemotherapy shows special superiorities in treating venous malformations. It might bring a confirmed clinical efficacy with the advantages of less injury, quick recovery, simple operation and less complications.

Adolescent ; Adult ; Child ; Child, Preschool ; Electrochemotherapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms ; drug therapy ; pathology ; Retrospective Studies ; Vascular Malformations ; drug therapy