Objective To investigate the causes of intractable abdominalgia after simple choleystectomy and analyse the therapeutic effect of endoscopic sphincterotomy (EST).Methods 84 patients undergoing EST were retrospectively viewed from 1987 to 1998. Results Sixty five out of 84 patients were followed up, in which the clinical signs disappeared completely in 51 cases (78%), and there were 6 cases with relapsing symptom(9%),3 cases with intermittent relapsing symptom (4%). Therapy was ineffective in 5 cases. The intractable abdominalgia is a specific sign of postcholecystectomy syndrome. EST is effective in removing the nervous structure in duodenal papilla submucosa and sphincter muscle layer responsible for abdominal pain, therefore eliminated or relived the pain.Conclusion EST has a significant effect on intractable abdominalgia after simple cholecystectomy in the majority of patients.

10.3969/j.issn.1007-3969.2013.05.011

Objective To explore the expression and clinical significance of two oncogenes,CerbB-2 and p53,on cervical squamous carcinoma.Methods The immunohistochemical S-P process was performed on 45 cases of cervical squamous carcinoma.The expressions of CerbB-2 and p53 on 15 cases of CIN(cervical intraepithelial neoplasia)and on 10 cases of normal cervical tissues were chosen and the relationship between the expressions and the related clinicopathological factors were analyzed.Results The positive expression rate of CerbB-2 on normal cervical tissues, CIN and cervical squamous carcinoma was 0,26.7% and 66.7%, respectively; that of p53 was 0,13.3% and 68.9% ,respectively.From the normal cervical epithelium to the CIN and to the cervical squamous carcinoma,the positive rate of CerbB-2 and p53 was increased significantly(P<0.05);the positive rate of CerbB-2 was associated with the pathological grade and the metastasis of lymph node(P <0.05) and that showed no statistic significance with the clinical stage ,the diameter of tumour,the infiltration of vessel and infiltrative depth(P > 0.05) ;the positive rate of p53 is only associated with the pathological grade(P <0.05) ;the difference between the CerbB-2 and p53 expressions on cervical squamous carcinoma were not statistically significant(P> 0.05).Conclusion The expressions of CerbB-2 and p53 have some practical values on the occurrence, the development and the clinical prognostic evaluation for the cervical squamons carcinoma.

Objective To explore the pathogeny, pathology, ultrasonic and clinical expression of upper extremity deep venous flow obstruction and superior vena cava syndrome. Methods Retrospective analysis and summarize the disease changes of 10 cases in recent 5 years. Results 7 patients of 10 cases were superior vena cava syndrome, in which 4 cases caused by upper right lung malignant tumor, 3 cases caused by upper and media mediastinal malignant tumor. 2 patients of 10 cases were found thrombosis in right subclavian vein caused by duct of artificial pacemaker. The left 1 patient was no reason thrombosis in right axillary vein. Conclusion Ultrasonography combine with color and spectral Dopper image can evaluate the clinical development and therapeutic efficiency, which is a useful and effective non-invasive examination.

A service system was created that the tertiary hospitals as the leader, the secondary hospitals as the core and the basic hospi-tals as the foundation, formed the one-stop three level medical rehabilitation service system. It made the referral process more convenient with the operation of the one-stop service, along with the integrated management, the homogenization treatment and the one-stop three level medical institutions;and also solved the problems of the inadequate of rehabilitation medical institutions, the lackage of rehabilitation profes-sionals and the uneven professional and technical condition, that realized hierarchical rehabilitation and two-way referral to meet the rehabil-itation needs of patients.

Objective To evaluate the effect of early clinical interference strategies on preventing the conversion of acute pancreatitis to the severe form and aggravation of severe acute pancreatitis(SAP).Methods The patients with acute pancreatitis admitted to this hospital were divided into two therapeutic phases by different therapeutic methods from January 2001 to December 2008.Patients in the first phase(from January 2001 to December 2004) were treated by the routine management,and the second phase(from January 2005 to December 2008) by the routine management combined with early clinical interference strategies.Then,the ratio of conversion from acute pancreatitis to SAP and prognosis of SAP between two phases were compared.Results Compared with the first phase,the rate of aggravation of acute pancreatitis was significantly decreased in the second phase(4.48% vs.21.18%),the average healing time of SAP,the incidences of systemic and local complications and the mortality of pancreatitis were reduced(P

Defecography was performed in 110 patients without any anorectal symptoms which included 57 male and 53 female with an average age of 43. 15. Normal defecography was found in 82 cases and abnormal one in 28. The normal features of defecography in 82 patients were as follows;1.There was an increase of anorectal angle during defecation. The increase was 21. 27 degrees measured-with precise axis method and 36. 72 degrees with approximate axis method.2. Reduction or obliteration of the impression of the puborectal muscle.3. There was a shortening of the anal canal by 1. 20 cm and a widening of the caliber of the anal canal to an average of 2. 23 cm.4. The resistance of the pelvic floor was good and the decending of the perineum was smaller than 3 cm during straining. The rectovaginal septum of female subjects was not deformed during straining.5. The barium paste in the distal rectum was largely or totally evacuated with an average e-vacuation rate of 90. 55%.

Objective To assess the effects of propofol on left and right ventricular function of isolated rat heart against ischemia reperfusion injury Methods Sixteen male SD rats were randomly divided into control and experiment groups The isolated rat hearts was connected to Langendorff preparation and perfused as in our previous experiment After being perfused for 25 min, the isolated heart was subjected to 30 min no flow global ischemia followed by 40 min reperfusion The temperature of the isolated heart was maintained at 36℃ 37℃ during global ischemia In experiment group the isolated heart was perfused with propofol 6?g/ml in perfusate for 10 min before global ischemia The heart rate was paced at 348 beats/min The isovolumetric force velocity indexes and coronary flow were monitored continuously with MacLab instruments Results As compared with the isolated hearts in control group, propofol (6?g/ml) perfusion before ischemia significantly improved left and right ventricular diastolic function by decreasing ventricular end diastolic pressure, dp/dt min and T value At the same time, propofol protected left and right ventricular systolic function by elevating developed pressure, dP/dtmax and Vpm during reperfusion At the end of reperfusion, ventricular tissue superoxide dismutase (SOD) activity was significantly well preserved in the hearts pretreated with propofol Conclusions Propofol 6?g/ml perfusion before ischemia protects the isolated rat heart against ischemia reperfusion injury by improving diastolic and contracting function of right and left ventricles and intrinsic contractivity of myocardium Propofol increases coronary blood flow during reperfusion and increases SOD activity of myocardial tissue

In order to obtain more experience of endoscopic retrograde cholangiopancreatography (ERCP) ,and in this way, more correct diagnosis and much more effective treartment were received ,we studied 1 257 cases of ERCP we had performed in last two years . The results were: In 1 25 7 cases of ERCP,1 229 cases(97. 77% ) were successful and 435 cases (34. 61% ) received treatment. Ninety-four cases received papillotomy and extraction, 309 cases received biliary drainage in therapeutic ERCP. lt in- dicated that the importance of gallbladder visualization and biliary drainage should be emphasised.

Targeted drug delivery can significantly increase the concentration of the drug in treatment site, and decrease the dosage of drugs, cost of treatment and the drug's adverse effects on the body. So targeted drug delivery is the hotspot of recent studies. This paper reviews the development of targeted drug delivery research in recent years, including three areas: passive targeting, active targeting, and physical and chemical targeting.