Objective To investigate the diagnosis and treatment of secondary sclerosing cholangitis after billary tract operation.Methods The clinical clata of 7 cases with secondary sclerosing cholangitis after billary tract operation treated in our hospital from January 2000 to June 2008 were retrospectively analyzed.Results Recurrent episodes of bacterial cholangitis were present in all patients,and they all had history of biliary tract operation.After definite diagnosis,2 cases underwent operation and 5 cases underwent conservative treatment.Among the latter,1 case underwent endoscopic sphincterotomy and 1 case had liver transplantation.Of all the patients,2 cases recovered(2/7),2 cases died(2/7) and 3 cases are still undergoing treatment.Conclusions The prognosis of secondary sclerosing cholangitis after billary tract operation is relatively poor.The key measure is prevention,and early diagnosis together with rational treatment can have certain therapeutic effect.

Objective To investigate the clinical effect of splanchnicectomy for pain palliation with advanced pancreatic carcinoma.Methods Altogether 27 cases were treated from January 2005 to February 2008,retrospective study was used to analyze the clinical data of them.All the patients had diverse extent pain,among these 16 cases who had underwent splanchnicectomy (therapy group),others were in control group.Results Pain extent was scored according to visual analogue scale (VAS),preoperative score of therapy group (6.06±1.93) scores,postoperative score 3 months(2.67±1.68) scores,6 months(2.69±1.75) scores,the discrepancy had statistical significance (P<0.01),preoperative score of control group (5.91±1.87) scores,postoperative score 3 months(5.11±2.03) scores,6 months(5.33±2.25) scores,the discrepancy had no statistical significance.Intergroups contrast,showing significant difference (P<0.05).Conclusion For the patients who request to deal with primary disease,splanchnicectomy is manipulated easy,short of complication,significantly relief of pain,and deserve to be spreaded.

Objective To establish the solid phase extraction (SPE) with GC/MS technology for fish poi-soning cases to determine five pesticides in fishpond. Methods By three solid phase extraction column including Oasis HLB cartridge, Bond Elut C18 and SampliQ C18, the recovery rate was compared to ex-tract and purify five pesticides in fishpond. The effects of different kinds and dosages of eluents on ex-tract rate were also reviewed. Results Using Bond Elut C18 as solid phase extraction column and 3 mL benzene as eluent, the linear range of mass concentration of five pesticides in fishpond was 1-50 μg/mL, and the correlation coefficient was 0.996 2-0.999 6. The limit of detection was 3.4-26 μg/L and the re-covery was 61.49%-102.48%. The relative standard deviations was less than or equal to 3.01%. Conclu-sion With high sensitivity, good accuracy and precision, SPE -GC/MS has simple and quick operation and less solvent. It can be applied to determination of five pesticides in fishpond.

Objective To develop the accelerated solvent extraction (ASE ) for determ ining pesticides pre-sent in blood sam ples. Methods Pesticides were extracted by ASE with optimized param eters to study recovery rate affected by extraction tem perature, time and agent. GC/MS was used to perform quantita-tive analysis.Results The recovery rates of eight pesticides were 70.6%-92.4%. The coefficient of variation was less than 5.0%. Agood linear relationship was obtained at the concentration range of 0.5-5.0μg/m L . Conclusion The m ethod was fast and sim ple with high recovery rate and good repeatability. It can be applied to analyze pesticides present in the blood specimen.

Objective To investigate the therapeutic effect of bilateral combined flap transfer in reconstruction and repairation of thumb and finger defects.Methods A partial fibular side wrap-around flap was harvested from both big toes.The flaps were tailored and designed based on measurements taken from the finger of the intact side.These two flaps were combined to reconstruct the defects of the finger.From March,2008 to December,2015,a total of 9 fingers (9 cases) which had defect degrees range from Ⅰ ° to Ⅲ° underwent reconstruction surgeries in this way.Appearance,sensation and function of the thumb and foot flap were followed-up.Simultaneously how to improve the outcoming and success rate were explored and investigated.Results All 9 thumbs and fingers in 9 cases with these procedures were survived.No vascular crisis happened.All patients were followed up from 3 to 24 months.The reconstructed thumbs and fingers were all with abundant blood supply,having similar shape to the normal thumbs and fingers,good pain and temperature sensation,with two-point discrimination of 4-8 mm.All patients were satisfied with the thumb and finger shape,regained life and work ability as before.The donor sites had no obvious discomfort,and walking and weight-bearing function remained normal.Judged by the tentative evalution standard of function of upper limb,which was made by Chinese Medical Association for Surgery of the Hand.The results were excellent in 6,good in 2,fair in 1.Conclusion There is less damage on foot and most hand function recovery using bilateral combined flap transplantation to repair multiple fingers defect.

AIM To investigate the effects of trifluoperazine on naloxone precipitated withdrawal symptoms in morphine dependent rats and mice, and its pharmacological mechanisms. METHODS\ Naloxone precipitated tests in morphine dependent rats and mice were used. RESULTS\ Trifluoperazine(2～20 mg?kg -1 ) dose dependently inhibited naloxone precipitated withdrawal jumping, wet dog shakes, paw tremor and weight loss in morphine dependent mice. With ip trifluoperazine (5～20 mg?kg -1 ), most of positive withdrawal symptoms, including jumping, wet dog shakes, defeacation, weight loss, teeth chattering, salivation, diarrhea, ptosis and irritating, induced by naloxone in morphine dependent rats were significantly reduced. Apomorphine (2～8 mg?kg -1 ), a mixed DA 1/DA 2 receptor agonist, did not affect inhibition of trifluoperazine on naloxone precipitated withdrawal symptoms in morphine dependent mice. However, nifedipine(5～20 mg?kg -1 ), a L type voltage sensitive calcium channel blocker, enhanced a pharmacological action of trifluoperazine against naloxone precipitated symptoms in morphine dependent mice. CONCLUSION\ Trifluoperazine attenuates naloxone precipitated withdrawal symptoms in morphine dependent rats and mice by inhibiting the activity of post receptor calmodulin, but it does not antagonizes DA 2 receptor, in central nervous system.

Objective To explore the clinical aspects and related EEG characteristics of epilepsy (EP) in children with cerebral palsy (CP).Methods The clinical data and the EEG Results of seizure-interictal-period in 84 CP children complicated with EP were collected and compared with the data of 124 CP children without EP.Results Among 84 CP children complicated with EP, 46 cases (54.76%) were partial seizures. Followed 26 cases (30.95%) were infantile spasms, 6 cases (7.14%) were tonic-clonic seizures. Spastic CP children tended to be the most patients seizures in EP, it was 82.14%. Children with teraplegia CP were the most type among the spastic CP children compliated with EP. The abnormal rate of EEG of CP children complicated with EP was significantly higher than that of CP children without EP ( P＜0.001), and local epilptiform discharges and multilocal epileptiform discharges were main types.Conclusion Partial seizures is the most epilepsy type in CP children complicated with EP, and spastic CP is the main type. EEG abnormal ratio is obviously higher in the CP children complicated with EP than the CP children without EP. The types of abnormal EEG are mainly local epilptiform discharges and multilocal epileptiform discharges.

Objective:To explore the predictive value of serum thyroglobulin autoantibody (TgAb) for recurrence / metastasisin of thyroglobulin (TG)-negative and TgAb-positive patients with differentiated thyroid carcinoma(DTC) after thyroid ablation.Methods:The clinical data of 57 patients with DTC,undergoing complete resection of thyroid tissue,TG negative and TgAb positive,who were reviewed in Liaocheng People's Hospital during April 2013 to April 2015,were selected and divided into recurrence/metastasis group (n=20) and no recurrence/metastasis group (n=37).The TG and TgAb levels in the two groups were detected and compared by the electrochemical luminescence method,the sensitivity,specificity,positive predictive value and negative predictive value of TgAb in the diagnosis of DTC recurrence / metastasis were analyzed;the independent risk factors of DTC recurrence / metastasis were analyzed by Logistic regression.Results:The TgAb levels(72～3850 IU/mL) in the recurrence/metastasis group was higher than that(18～3638 IU/mL) in the no recurrence/metastasis group,the difference was statistically significant (P＜0.05).The sensitivity,specificity,positive predictive value,negative preictive value of TgAb in the diagnosis of recurrence/metastasis of DTC were 85.71％,83.33％,75.00％,90.91％,respectively.Logistic Regression analysis showed that the 100≤ TgAb ＜204 IU/mL,204≤ TgAb≤ 1000IU/mL,and ＞ 1000IU/rnL levels of TgAb were the independent risk factors of rucurrence/metastasis ofDTC (OR=1.267,2.853,6.791,P＜0.05).Conclusion:TgAb can be used as evaluation of an important index of the recurrence/metastasis of patients with DTC when serum thyroglobulin (TG) was negative and TgAb was positive after thyroid ablation.The higher the TgAb levels,the more probability of the recurrence/metastasis.

Objective To investigate the causes and prevention of postoperative pain of laparoscopic transabdominal preperitoneal (TAPP) and Lichtensteinrepair in the treatment of adult recurrent inguinal hernia.Methods Sixty adult recurrent inguinal hernia patients were enrolled in this study.They were divided into TAPP group and Lichtenstein group by random digits table,with 30 cases in each group.At 6 h Mter operation,the pain degree was evaluated by visual analogue scale (VAS) and compared between two groups.The level of VAS in TAPP group was (3.76 ± 1.47) scores,in Lichtenstein group was (6.36 ± 1.54) scores,and there was significant difference (t =-5.978,P =0.000).In TAPP group,pain was mainly moderate (17 cases,56.67％) and mild (11 cases,36.67％).In Lichtenstein group,pain was mainly moderate (14 cases,46.66％) and severe (13 cases,43.33％).Postoperative follow-up ranged from 6 to 48 months.No chronic pain appeared in TAPP group.There were 4 cases with chronic pain in Lichtenstein group,and the incidence rate of chronic pain was 13.3％.Conclusions The operation of TAPP in the treatment of recurrent inguinal hernia in adult patients has the advantage of shorter operation time,less postoperative pain,faster postoperative recovery,and can effectively reduce the incidence of postoperative pain.

Objective:Anti-synthase syndrome (ASS) is a rare autoimmune disease. To increase the understanding of the disease and reduce the rate of miss diagnosis.Methods:The clinical data of 8 patients with positive anti-synthase antibody afterprimary Sj?gren's syndrome (pSS) were retrospectively analyzed and descriptive statistical analysis was carried out.Results:The diagnosis of Sjogren's syndrome (SS) was in accordance with the revised European criteriaof SS issued by the US-Europe consensus Group in 2002 or the classification criteria of American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) SS in 2016, and the diagnostic ASS was in accordance with the diagnostic criteria of Conners in 2010 or Solomon in 2011. Eight(100%) patients had a history of interstitial lung disease, and 7 (88%) patients had fever (oral temperature >38.5 ℃). All patients were positive for anti-Ro-52 antibody, 4 patients were positive for anti-PL-7 antibody, 2 patients were positive for anti-EJ antibody, 1 patient was positive for both anti-PL-7 antibody and anti-EJ antibody, and 1 patient was positive for anti-PL-12.Conclusion:pSS patients with severe interstitial lung disease or high fever of unknown causes should be screened for anti-synthase antibodies and the possibility of ASS.