Biliary-pancreatic-duodenal junction is a special region in the human body.It is difficult to diagnose and treat diseases in this region because of the complicated anatomy,the limitation of diagnosing methods,the variety of disease,the high risks of operation and the severity of complications. We should pay more attention to the pathophysiology aspects and the laboratory researches of diseases in this region.Proper diagnosis and combination of different diagnosing methods could improve the rate of early diagnosis and identify the characteristics of the disease. Individualized operation should be considered to deal with iatrogenic injury of biliary-pancreatic-duodenal junction according to different patients' condition.The principle of operation is to control damage firstly and to preserve the function of biliary-pancreatic-duodenal junction and the physiological passway of bile and pancreatic juice to the greatest extent.

ObjectiveTo evaluate the clinical efficacy and toxicity of the regimen of paclitaxel combined with gemcitabine for anthracycine-resistant metastatic breast cancer. MethodsThirty patients with anthracycine-resistant metastatic breast cancer were enrolled in the study: paclitaxel 135mg/m2 infusion on day 1; Gemcitabine 850mg/m2 infusion on day 1,8 ,and administered in three weeks cycle. The clinical efficacy was evaluated every two cycles. ResultsOf all thirty patients qualified for efficacy analysis and among them CR 3 cases( 10％ ) ,PR 11 cases (36.7 ％ ), SD 11 cases ( 36.7％ ), and PD 5 cases ( 16.7％ ), with an overall response rate of 46.7％. The median TTP and overall survival in those 30 patients was 7.1 and 15.6 months. The main toxicities with grade 3 and 4 were hypoleucocytosis in 10 patients(30.0％ ) ,thrombocytopenia in 4 patients( 13.3％ ). ConclusionThe regimen of paclitaxel combined with gemcitabine was effective,well-tolerated scheme in the anthracycine-resistant metastatic breast cancer.

Objective To evaluate the safety and effect of adefovir dipivoxil (ADV) on hepatitis B in HBeAgpositive patients.Methods 131 patients were divided into two groups randomly.Two groups were treated with ADV (10mg/d)and matrine (0.6g/d),respectively.The rate of HBV negative,the normalization rates of ALT,HBeAg loss and anfi-HBe seroconversion were evaluated respectively.Results After 12 weeks of treatment,the rate of HBV negative,the normalization rates of ALT,HBeAg loss and anti-HBe seroconversion of ADV were all significantly higher than those of matrine group(53.2％ vs 7.8％,36.0％ vs 8.7％,13.6％ vs 3.1％,6.2％ vs 0,respectively,x2 =56.32,23.18,all P ＜ 0.01).Conclusion The domestic ADV superior to matrine in HBeAg-positive patients.

Iatrogenic injury in choledocho-pancreatico-duodenal junction is usually difficult to discover in the course of operation because of its unique anatomical position. The injury can lead to postoperative chilis, fever, pain and swelling of the waist, which would easily be misdiagnosed as acute necrotizing pancreatitis. Controlling operations, such as bile and pancreatic juice separation, duodenal diverticularization, jejunal fistulation for enteral nutrition and abdominal drainage should be performed in dealing with the injury in choledocho-pancreatico-duodenal junction. Combined application of pyloric suture with absorbable thread and ligatian, gastric fistulation, ligation of the distal common bile duct and T-tube drainage is minimally invasive, and can fulfill a fully separation of bile and pancreatic juice and duodenal diverticularization. It will improve the possibility of secondary radical operation by ameliorating pyemia and general nutritional condition.

Thyroidectomy provides rapid solution of hyperthyroidism and the goal of perioperative management is to make patient as close as possible to euthyroidism clinically and biochemically before surgery.It is recommended to target at the thyroid hormone synthetic,secretory,and peripheral pathway with concurrent treatment to correct any latent decompensation of normal homeostatic mechanisms.

Objective To study the relationship between HCV chronic infection and expression of CXC chemokines mRNA.Methods The levels of IL-8,IP-10 and Mig mRNA in peripheral blood mononuclear cells(PBMC) of chronic hepatitis C patients were detected by real-time quantitative polymerase chain reaction(RT-PCR) before,and 3,6 months after combined therapy of interferon-?(IFN-?) and Ribavirin.The rate of chemokine/GAPDH was regarded as the extreme level of chemokine.Results The mean level of HCV-RNA and expressive levels of IL-8,IP-10,Mig mRNA in peripheral blood of HCV chronic infection were 2.09?10~(6)copies/ml,and(1.243 7?0.071 2),(0.682 8?0.073 8),(0.668 3?0.075 4),with significant difference with those of normal controls(P0.05).Conclusion The expressions of IL-8,IP-10 and Mig mRNA in PBMC are high in patients with chronic hepatitis C,and associated with the replication level of HCV,and less associated with the gene type of HCV.IFN-? can effectively restrain the replication of HCV and down-regulate the levels of IL-8,IP-10 and Mig mRNA near to normal level in patients with chronic hepatitis C.IFN-? plays an important role in down-regulating inflammation response and controlling the development of the patients' condition.

Objective:To study the nutritional therapy of GDM and IGT.Methods:50 g glucose challenge test was done 610 in patients at examination in our hospital.The oral glucose tolerance test(OGTT)was performed in glucose challenge test positive patients to diagnose GDM and IGT.The blood glucose of fasting and postprandial 2h,perinatal mortality,incidence of large neonates were observed after treatment with nutrition in the GDM and IGT patients.Results:There were 15 cases of GDM and 61cases of IGT during the 140 cases of GCT positive patients.After nutritional therapy,the GDM's fasting and postprandial 2 h blood glucose decreased significantly(P

Objective: To study the effect of acute hypoxia with simulated high altitude on the expression of orexins in rats hypothalamus. Methods: Rats were exposed to different high altitude(3 000 m,(4 000) m,5 000 m and 6 000 m for 8 h daily) in a hypobaric chamber.The expression of orexins in rat hypothalamus was determined by immunohistochemistry and the pathology changes of rat hypothalamus was observed with transelectricity. Results: The number of orexin-A immunoreactive positive cells in hypothalamus decreased obviously with hypoxia for 1 day(P

OBJECTIVE: To remind the concerned party of the importance of safe and rational use of drugs and the reevaluation of drugs after they have been put into market. METHODS: To analyze the occurring process and the treatment of six death/disability cases related to adverse drug reactions in Ningxia area as well as the problems existed in the management on safe drug use and the solutions. RESULTS & CONCLUSIONS: Management on safe drug use should be reinforced within the system of health and drug administration, and great importance should be attached to the reevaluation of drugs after they have been put into market to ensure safe and rational drug use.

OBJECTIVE: To investigate the protective immunity in mice immunized with rEg.EF-1 and its potential as vaccine candidate.METHODS: ICR mice were subcutaneously immunized with rEg.EF-1 for three times(with an interval of 2 weeks) and challenged with Eg 2 weeks after the completion the immunization,sacrificed at 20 weeks after infection with Eg.The rate of reduced hydatid cyst and the levels of IgE,IgG and IgG subclasses in sera were examined by enzyme linked immunosorbent assay,with adjuvant group as control.RESULTS: As compared with adjuvant group,the immunoprotection ability(rate of reduced hydatid cyst) in rEg.EF-1 group was 85.6%;The levels of IgG,IgG1 and IgG2a in mice immunized with rEg.EF-1 significantly increased(P0.05),and no significant difference was noted in IgG3 and IgE levels.CONCLUSIONS: The rEg.EF-1 antigen could induce certain immunoprotection,suggesting the potential of rEg.EF-1 as an vaccine candidate.