Objective To investigate the selection of the types of anastomosis of bilioenterostomy and evaluate the therapeutic effects.Methods From 1990 to 2000,536 patients with obstructive jaundice underwent bilioenterostomy in our hospital.The patients included 279 cases(52%) of hilar strictures with hepatolithiasis,108 cases(20%) of end stage periampullary tumors,96 cases(17%) of proximal cholangiocarcinoma and 53 cases(12%) of congenital choledochus cyst.The types of anastomosis included extra or hilar hepatic bilioenterostomy in 302 cases(56%),intra hepatic duct anastomosis with different type of hepatectomy in 222 cases(42%),of which 44 cases(8%) were anastomosed by roud ligament approch,27 cases(5%) through gallbladder fossa.Results The short term and 1～9 years long term follow up indicated that the jaundice of different patients can be completed relieved by suitable type of bilioenterostomy.Conclusions The good therapeutic effects of bilioenterostomy come from the correct selection of the anastomosis methods.

Objective To study cancer metastasis in mesorectum and ischiorectal loss in cases of ultra-low rectal cancer and evaluate the rationale of Miles procedure. Methods Whole-mount slice and tissue mieroarray technique were used to study the dissected specimen from 23 cases of uhra-low rectal cancer for metastatic lymph nodes. Result 415 lymph nodes were harvested in 23 mesorectum specimen, 169 and 59 lymph nodes were metastasic and micrometastasie respectively. 12 eases were diagnosed with metastasis, 4 cases were found to have micrometastasis. Metastatic lymph nodes in the lateral and anterior mesorectum were 29.0% (49/169) and 17.2% (29/169) respectively. There were 2 patients with metastasis and 1 with micrometsstssis in ischiorectal fossa lymph nodes, accounting for 13% patients. Conclusion Regional metastasis exists in ultra-low rectal cancer and its incidence varies in different location of mesorectum and ischiorectal fessa. The value of Miles procedure as the standard therapy for ultra-low rectal cancer should undergo an evaluation.

Based on the characteristics of oncology clinical teaching and the defects of current teaching methods,we launched teaching reform including the combination of basic and clinical medical curriculum,the practice of clinical problem-based learning (CPBL) method and the introduction of some guidance for medical practice.The teaching reform was effective,but there were drawbacks for improvement.

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Objective To set up the standard of normal prostate volume based on MRI measurement.Methods 30 healthy male adults without any urogenital symptoms were included in this study.The subjects were divided into four groups according to their ages.The length,width and height of the prostate and central gland were measured by MRI.The volume,weight and the rate of central gland to prostate proportion were calculated and compared in various age groups.Results For normal prostate:the average width was(3.02?0.47)cm,the length was(4.19?0.52)cm,the height was(3.24?0.34)cm,the volume was(22.01?7.48)cm 3,and the weight was(23.11?7.86)g.There were significant differences in the value of length,the width,the volume and the weight in various age groups(P=0.006,0.001,0.014 respectively);For the central gland:the width was(2.01?0.41)cm,the length was(2.06?0.34)cm,the height was(2.01?0.32)cm,the volume was(4.46?1.74)cm 3,the weight was(4.68?1.82)g,and the ratio of central gland volume to whole prostate volume was 20.4%.The volume and weight of central gland was significantly different in various age groups.There were significant differences between the contrast-enhancement of central gland and peripheral zone(P=0.0001).The central gland was obviously enhanced at vein phase.Conclusion The volume of the prostate and the central gland are positive correlated with the age.With the ages increased,the prostate and the central gland volume are increased.

Objective To study the diagnosis and stage of benign prostatic hyperplasia(BPH)with quantitative MRI measurement.Methods 25 cases of BPH proved by pathology were undergone MRI examinations.The length,width and height of the prostate and central gland were measured on MR images.The volume,weight and the central gland to prostate proportion were calculated and compared in various age groups.Results The width,length,height,volume and weight of prostate in BPH were larger than those in normal prostate.The central gland to prostate proportion in BPH was 46.1%,which was much larger than that of normal prostate(20.4%).The width,length,height,volume and weight of prostate and central gland were significantly different in various hyperplasia degree groups(P

Objective: To explore the approaches and ideas of clinical pharmacists participating in drug therapy of patients with brucellosis. Methods: Clinical pharmacists participated in the clinical consultation for one patient with brucellosis. Clinical pharmacists analyzed comprehensively by asking medical history, occupation and contact history in details, adjusting the treatment scheme and performing medical education etc. Results: The consultation comments and suggestions proposed by clinical pharmacists were recognized by clinics, which played an important role in assisting doctors in the rational drug use and significantly improved the medical treatment. Conclusion: Clinical pharmacists should participate in the individualized medication and help clinicians optimize drug therapy, which can improve the safety and efficacy of medication.

AIM: To investigate the effects of dehydroepiandrosterone (DHEA) on experimental osteoarthritis in rats. METHODS: Forty rats were randomly divided into four groups. Group A is normal control group. Osteoarthritic models of rats were established by intraarticular injections of papain into the right knee joints of groups B, C and D. Then the right knee joints of rats in groups C and D, respectively, received 150 ?l intraarticular injections of DHEA at a concentration of 50 ?mol?L~(-1) and 100 ?mol?L~(-1), and the right knee joints of rats in groups A and B both received 150 ?l physiological saline, twice weekly for five weeks. Six weeks later, all rats were sacrificed, and the articular cartilage was assessed by gross morphologic, histologic, biochemical and immunohistochemical methods. RESULTS: The cartilage damage in groups C and D was much less than that in group B through observation under a surgical microscope. The Mankin's score, nitric oxide (NO) in the douche of articular cavity, malondialdehyde (MDA) in synovium, the expression of matrix metalloproteinase-1 and 9 in articular cartilage in groups C and D decreased in comparison with group B, and the foregoing indexes in group D decreased significantly compared with group C. However, the activities of superoxide dismutase (SOD) in the douche of articular cavity and blood serum in groups C and D increased in comparison with group B, and the foregoing indexes in group D increased significantly compared with group C. CONCLUSIONS:DHEA shows a cartilage-protecting effect which is in a dosage-dependent manner. The mechanism probably is to inhibit the expression of matrix metalloproteinases and to decrease the release of (NO and enhance the antioxidation.

Objective To investigate the relationship between the calcium ion and the effects of ECA on the contraction of the smooth muscles of Oncomelania foot, and explore the mechanism of ECA in decreasing the snail climbing adhesion and increasing snail-killing. Method The in vitro experiment was used to observe the effects of ECA on contraction activities of foot smooth muscles of Oncomelania. Results ECA 5. 0, 10. 0, 20. 0 mg/L. enhanced the resting tension, decreased the contraction range and increased the contraction frequency of the foot smooth muscles of Oncomelania in Ringer's solution with or without Ca2+ , with a characteristic of the dose-dependent, but stronger in solution with Ca2+ than that in solution without Ca2+. Conclusions ECA can enhance the resting tension, decrease the contraction range and increase the contraction frequency of the foot smooth muscles of Oncomelania. This suggested that ECA could be related to increasing the intracellular Ca2+ release and influx of the extracellular Ca2+. This could provide an explanation why ECA decreases the rate of Oncomelania climbing adhesion and enhances snail-killing.

Objective To explore the effect of applying functional movement screen (FMS) in the sport injury risk assessment of Chinese rugby athletes.Methods Rrugby athletes of Chinese national and provincial teams were selected and their data were collected using the standard FMS test.Their non-impact injury of the lower limbs and trunk were tracked and recorded.FMS diagnostic value and diagnostic cut-off value were evaluated using the receiver operating characteristic curve (ROC) and odds ratio (OR).Results The area under curve of all,male and female rugby athletes was 0.780 (P=0.000),0.877 (P=0.001) and 0.7130 (P=0.013) respectively,with significant differences from AUC=0.5.FMS score optimal cut-off point of all,male and female rugby athletes corresponding to the maxi mum Youden index was 13.5,15.5 and 13.5 respectively.Among all,male and female rugby athletes,the injury rates of the positive group (with FMS score less than the corresponding optimal cutoff point) were significantly higher than that of the negative group (with FMS total score greater than a corresponding cut-off point)(P＜0.01),and OR value of the positive group was 25.85 (95％CI:3.34～200.23),25 (95％CI:2.36～264.80) and 14.22 (95％CI:1.76～114.92) respectively.Conclusion In China,the average FMS score of rugby athletes had a strong correlation with non-contact sport injury,which might become an assessment index of non-contact sport injury risks.There is a significant difference in FMS score optimal cut-off points between the male and female rugby athletes,with that of the female being 13.5 points and the male being 15.5 points.