Laparoscopic surgery in hepatobiliary,splenic and pancreatic diseases is being widely used.However,the incidence of postoperative complications is relatively higher due to the complexity of the operative procedures.Surgeons are expected to have familiarity with normal and variant anatomy,as well as a good command of prevention and management of bleeding.Different separation techniques should be used based on the different characteristics of tissues.Moreover,digestive tract reconstruction is the technical bottleneck in laparoscopic hepatobiliary,splenic and pancreatic surgeries,and depending on the team work.Different anastomotic methods should be applied according to patients' condition.Three-dimensional laparoscopy and Da Vinci robot surgical system have greatly promoted the development of complex laparoscopic surgery in hepatobiliary,splenic and pancreatic surgeries.Comprehensive perioperative management and enhanced recovery after surgery are the guarantee of safe and quick postoperative recovery,which also fully embody the advantages of minimally invasive surgery.

Pancreatic cancer is highly malignant with a poor prognosis. The resectability and prognosis of early pancreatic cancer are much better than the advanced, so early diagnosis is crucial for saving patients' lives. Because the symptoms of pancreatic cancer are non-specific, most of the patients are misdiagnosed as gastrointestinal or hepatobiliary diseases. Early diagnosis rate of pancreatic cancer can be greatly improved by combined application of tumor marker detection, endoscopic ultrasound, computed tomography, positron emission tomo-graphy, and etc. Early screening of high-risk population has been advocated by the experts, and its value in early diagnosis of pancreatic cancer has been confirmed by relevant studies. The colaboration of multiple pancreatic surgery centers in conducting prospective studies and setting gnidlines for the pancreatic cancer diagnosis, and relevant fundamental reseaches should also be emphasized.

Pancreatic adenocarcinoma is a highly malignant tumor and its prognosis is poor. The key factors for cure and prolonged survival are early detection, adequate evaluation of resectability and surgical resection with microscopic tumor clearance. Surgeons should pay attention to standardize operative procedures to increase the R0 resection rate. Whipple specimens should be inked and examined carefully. Postoperative adjuvant radiotherapy and chemotherapy are beneficial in the prevention of local tumor recurrence and distant metastasis. Inter-disciplinary cooperation and multimodality treatment are helpful to improve the prognosis and quality of life of patients with pancreatic cancer.

AIM: To investigate the effects of low-dose theophylline on differentiation of the naive T lymphocyte. METHODS: Naive T lymphocytes and monocytes were isolated from cord blood in neonate. Theophylline (10 mg?L-1 ) was added in naive T lymphocytes and monocytes which stimulated by PHA (200 mg?L-1 ) for 3 days, and the differentiation of T cells was analyzed by flow cytometry. Cytokines were measured by enzyme linked immune-sorbent assay ( ELISA ). RESULTS: Theophylline significantly promoted differentiation fromTh1 cells to naive T cells ( P

Objective To investigate the relationship between the number of eosinophil(Eos)and level of eosinophil cationic protein(ECP)in induced sputum and asthma severity and their value of differential diagnosis.Methods From July 2002 to June 2004,59 asthmatic patients were selected in the People Hospital of Wuhan University.The number of eosinophil and level of ECP were measured by Wrights' stain and Immuno-CAP System.The lung function was also evaluated.The same index was measured in 20 patients with COPD and 10 healthy subjects as control.Results The number of eosinophil in induced sputum in asthmatic patients negatively correlated with FEV_1%(r=-0.65,P

An inductively coupled plasma mass spectrometry ( ICP-MS) was developed for the direct determination of Be, Na, Mg, Al, K, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, Zr, Mo, Sr, Cd, Ba, Pd, Ag, Sn, Au and Pb in lithium hexafluorophosphate. The sample was dissolved with absolute ethyl alcohol to analyze the above 26 impurity elements in the solution by ICP-MS. The condensation and deposition of high concentrations of carbon in mass cone interface and ion lens, which will decrease the sensitivity of element analysis, can be avoided effectively by introducing O2 to plasma. The mass spectral interferences of polyatomic ions to analytes were corrected by collision reaction cell (CRC). The matrix matching method was used to corrected matrix effect. Satisfactory linearity of each working curve of 26 impurity elements was obtained. The correlation coefficients being over 0. 9995, the detection limits for the investigated elements were in the range of 0. 6-32 ng / L, the relative standard deviation of each element within 2. 5% -7. 3% , and the recovery of each element at 90. 6% -108. 6% . The method had been applied to the determination of trace elements in lithium hexafluorophosphate with satisfactory results.

Objective:To investigate the effects of enteral nutrition support in inoperable advanced gastric cancer patients during chemotherapy.Methods:This was a prospective randomized study.A total of 62 patients with advanced gastric cancer were firsted evaluated according to the Nutritional Risk Screening 2002 (NRS 2002) scale,and were randomly divided into two groups.All patients received oxaliplatin combined with tegefur gimeracil oteraci.Patients in the control group (n =30) received chemotherapy along with nutrition consultation,and patients in the treatment group (n =32) were provided enteral nutrition-additionally.NRS 2002 assessment was conducted before and after chemotherapy,The body weight,BMI,serum albumin,and the efficacy and toxicity were collected during the study.Results:Patients in the treatment group had significantly higher serum albumin levels,body weight and BMI than those of the control group (P ＜ 0.05).No differences were found as for the efficacy and toxicity of chemotherapy between two groups.Conclusion:Enteral nutrition support therapy can improve the nutrition status of gastric cancer patients who received chemotherapy and reduce the risk of malnutrition.

Pancreatic cancer is a highly malignancy of the digestive system, with low early diagnosis rate and poor prognosis. Cancer cachexia, muscle and adipose tissue wasting are important factors affecting surgical complications and long-term prognosis of patients with pancreatic cancer. On one hand, the occurrence and development of pancreatic cancer cachexia are associated with the decrease of food intake. On the other hand, the characteristic of tumor hypermetabolism, many inflammatory factors, fat and protein regulatory factors and many neuroendocrine pathways are also involved in pancreatic cancer cachexia. At present, the understanding of cancer cachexia and tissue wasting is not comprehensive, and the diagnostic methods are not unified. The main screening method is based on body mass index, but it is not applicable to obese patients. The detection of serum cytokines and determination of intramuscular fat content based on the abdominal computed tomography scan also play pivotal roles in the diagnosis of pancreatic cancer cachexia. Perioperative inhibition of tissue wasting can not only reduce surgical complications, but also improve the prognosis of pancreatic cancer patients. However, there is no effective method to completely reverse cancer cachexia. Multidisciplinary treatment is the routine therapy. Surgical treatment to remove the tumor is the fundamental measure to impede the development of cachexia. In addition, strengthening nutritional support, reducing inflammation and stress reaction, reducing the muscle wasting are also important in the treatment of cachexia during the perioperative period. Combined with self experience, the authors comprehensively analyze research advances, summarize the etiology, molecular mechanism, diagnosis and treatment of tissue wasting, in order to investigate tissue wasting and perioperative treatment strategies of pancreatic cancer patients.

Objective To analyze the differences between the exposure levels of major stroke risk factors and cerebral vascular hemodynamic indexes (CVHIs) in Han nationality and major ethnic minorities in Pu'er People Hospital in southwest Yunnan. Methods In this cross-sectional study,26 640 patients admitted to Pu'er People Hospital for stroke risk assessment were recruited from July 2016 to September 2018. Major risk factors of stroke and CVHIs were investigated and detected. The subjects were divided into six ethnic groups,including Han, Yi, Hani, Dai, Lahu and Wa. The differences of the exposure rate of major stroke risk factors,CVHIs and cerebrovascular function scores among these ethnic groups were compared and analyzed. Results There were significant differences (all P < 0. 01) in the risk factors for stroke. Dai ethnic group had the highest prevalence of hypertension (34. 7% [194/559]) and Wa ethnic group the lowest (26. 3% [94/358]). Han ethnic group had the highest dyslipidemia rate of 7. 9% [1892/23887], and Dai ethnic group was 4. 3% [24/559] . The prevalence rate of diabetes among Lahu ethnic group was highest at 10. 1% [34/335] and Hani ethnic group lowest at 3.3% [30/907]. Among different ethnic groups, the minimum velocity, mean velocity, peripheral resistance, and cerebrovascular function scores were statistically significant (all P <0.05). The proportion of cerebrovascular function scores less than 75 points (stroke high-risk individual) in Han, Y i, Hani, Dai, Lahu, Wa ethnic group was respectively 36.7% [8 759/23 887],32.7% [194/594],34. 1% [309/907], 38. 3% [214/559], 31. 9% [107/335] and 32. 4% [116/358] (P < 0. 05) . Conclusions There were significant differences in the exposure levels of major stroke risk factors and CVHIs among ethnic groups in Pu'er People Hospital in southwest Yunnan. Han and Lahu ethnic groups had higher exposure level of risk factors. Cerebral vascular function damage was more serious in Han and Dai ethnic groups.

Purpose:A comparison of the therapeutic effect studied by ?-rag,selec- tive asteriography and TAIC on advancing gastric carciomas with HM(hepatic metastasis) in 41 cases and NHM(without hepatic metastasis)the other 35 were reported.The correla- tion of primary and metastatic lesions including the efficacy of TAIC were also evaluated, Materials and Methods:Every case was undergone CAG;in addition LGA+CA were al- ways performed in cases of carcinoma of cardiac end of stomach so as CHA,either CA or LGA for gastric antrum carcinomas;while FDM(5Fu+CDDDP+MMC)were the drugs used for the majority of the patients.Results showed the number with large extent gastric carcinoma(≥one part of gastric zone)accompanied by moderate to severe deformaties in HM group were obviously greater than those of the NHM group(P