Perihilar surgery is full of challenge,risk,variability and uncertainty.Because of the anatomic variability,the pathophysiological complexity and invasion of the diseases,hepatic hilar biliary surgery has the characteristics of high operative difficulties,low resection rate,easy intraoperative bleeding,more postoperative complications,high recurrence rate and mortality rate.The cure rate and safety of the operation can be improved only through comprehensive imaging examinations and preoperative evaluation of liver function as well as the correct use of surgical techniques of anatomic paths,lesions excision and hepatic hilar reconstruction.The core of perihilar surgical techniques is hepatic hilar anatomy and explosion,including hilar plate dissection,dissection of liver along the medial fissure,quadrate lobe of liver resection and perihilar resection.Perihilar surgery is a comprehensive technique involving preoperative,intraoperative and postoperative procedures.The cure rates of perihilar biliary diseases can be improved by a combination of enhanced recovery after surgery and optimized and individualized surgical plans for patients.

Objective To explore the effects of different concentrations of propofol postconditioning against glutamate neurotoxicity to brain slices of neonatal rats.Methods The brain slices of neonatal rats were prepared and cultured in complete medium.They were randomly divided into five groups:the normal control group,glutamate injury group(RI group),1 mg/L propofol postconditioning group(PL1+RI group),3 mg/L propofol postconditioning group(PL3+RI group),5 mg/L propofol postconditioning group(PL5+RI group),12 cases in each group.The RI,PL1+RI,PL3+RI,PL5+RI groups were cultured for 6 days,then the brain slices were moved into the culture medium containing glutamate(1 mmol/L) and incubated for 30 minutes.And then,respectively,the brain slices of RI group were put into another complete culture medium,the PL1+RI group,PL3+RI group and PL5+RI group were put into the medium containing corresponding concentrations of propofol medium and long chain fat emulsion injection.All of the above were cultured for 24 hours in order to establish the injury model.The numbers of the Nissl body,the LDH release rates and the brain tissue damage rates of each brain slice were detected to evaluate the effects of propofol postconditioning on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.Results Compared with the RI group,the numbers of the Nissl body of the PL1+RI group,PL3+RI group and PL5+RI were higher,the LDH release rates and the brain tissue damage rates of the PL1+RI group,PL3+RI group and PL5+RI were lower,the diferences were significant(P<0.05).Among the three PL+RI groups,the LDH release rates and the brain tissue damage rates of the PL3+RI group were lower than those of the other two groups,the diferences were significant(P<0.05),at the same time,the numbers of Nissl body were more than the other two groups,the diferences were significant(P<0.05).Conclusion Propofol postconditioning has protective effects on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.However,the protective effects are not dose-dependent,and 3 μg/mL is the best dose of propofol to keep the glutamate-damaged brain slices from reperfusion injury in this research.

Objective To investigate the effect of preconditioning electrostimulation of fastigial nucleus (FNS) on the neuronal mitochondrion of rats early after cerebral ischemia. Methods Forty Wistar rats were used and divided into 5 groups: a normal control group, a sham FNS group and 3 FNS groups. The FNS of the rats in the FNS groups was conducted for 1 hr, 1 day or 7 days, respectively, before the models of middle cerebral artery occlusion(MCAO)were made with them. Three hours after the model was established, the animals were sacrificed and the water content of the brain of the ischemic side was measured. The neuronal mitochondrion was observed by electron microscope, and its Vv, specific volume (Sv) and specific surface (Ss) were analyzed. The rats in the normal control group were not given any special treatment. For the rats in the sham-FNS group, intrinsic neurons of FN were destroyed with ibotenic acid (IBO), and 5 days later, the FN was electrically stimulated, and 1 day later, MCAO models were made. Results Three hours after MCAO, the water content of the brain increased and neurological function score decreased in the sham-FNS group, while the Vv and Sv of neuronal mitochondrion increased and the Ss decreased, which were significantly different from those of the normal control group(P

Objective To research the clinical efficacy of Sini decoction adjustment combined rabeprazole enteric capsules in treatment of gastroesophageal reflux cough and its effect on interleukin 8 (IL-8) and substance P (SP), the mast cell tryptase (MCT) levels.Methods 92 cases of gastroesophageal reflux cough were divided into control group and experimental group by drawing method , each had 46 cases.Control group were treated by rabeprazole enteric capsules, experimental group were treated with rabeprazole enteric capsules based on the control group.The curative effect, cough symptoms integral, IL-8, SP, MCT, gastric dynamic element (MOT) and the gastrin-releasing (GAS), pulmonary function and safety were compared between two groups.Results The total effective rate of experimental group(93.47%) was higher than the control group(76.08%), the difference was statistically significant (P<0.05).After treatment, the symptoms of experimental group(1.53 ±0.19) points was higher than the control groupthe difference was statistically significant(1.96 ±0.24)points,P<0.05.The IL-8, SP, MCT levels of experimental group were all lower than the control group ( P<0.05 ) .The MOT, GAS, and lung function of experimental group improved more significantly than the control group ( P <0.05 ) .The security between two groups has no significant difference .Conclusion The curative effect of Sini decoction adjustment combined Rabeprazole enteric capsules in treatment gastroesophageal reflux cough is obvious, can decrease IL-8, SP, MCT levels.

Objective To investigate the effects of Naoluoxintong which is representative prescription of supplementing Qi and activating blood therapy(Yiqihuoxue),the prescription of supplementing Qi therapy(Yiqi) and the prescription of activating blood therapy(Huoxue) on local cerebral ischemia-reperfusion injury rats.To observe the changes of neural stem cells(NSCs) and correlated SVZ factors.Methods Models of local cerebral ischemia-reperfusion were established by thread-occluding the MCA.The time points were observed at 1,3,7 d after reperfusion following 2 h of MCAO respectively.The expression levels of Nestin were measured by immunohistochemical staining.Results The expression of Nestin of treatment groups increased significantly compared with model group at 7 d(P

Objective To analyze the clinical feature, treatment and prognosis of ventricular septal rupture after myocardial infarction Methods Clinical data of 16 patients with ventricular septum repture after acute myocardial infarction were who were hospitalized between January 1990 and July 2004 were analyzed retrospectively Results Among 2?057 patients with acute ST segement elevation myocardial infarction, 16(0 7%) patients (8 males and 8 females) were found to have ventricular septal rupture The average age was 59 4?11 6 years 7 (43 8%) patients had hypertension, 5(31 3%) patients had diabetes and 5 (31 3%) patients smoked 15(93 8%) patients were diagnosed as acute anterior infarction and among them, 6 patients also had posterior infarction 1 patient were diagnosed as inferior infarction 11 patients received coronary arteriography and ventriculography, and in 10 cases, the infarct related arteries (IRA) were found to be LAD (90 9%) Total occlusion was found in 9 cases out of the 11 patients (81 8%) Cardiogenic shock was found in 3(18 8%) patients 12 cases (75%) of ventricular septal rupture occurred within the first seven days after the onset of symptoms The defect on rentricular septumn and its size were confirmed by means of ectocardiography The size of the rupture varied from 0 68 cm to 2 5 cm Surgery was performed in 10 (62 5%) patients, and 3 of them survired All the 6 patients who only received medical therapy died within 30 days Conclusion Ventricular septal rupture after AMI was relatively rare which mostly happened in patients with acute anterior infarction Mortality rate was righ in patients who only received conservative medical treatment Surgical therapy could improve the survival rate

Objective To evaluate MRI in diagnosis and follow-up of Achilles tendon rupture. Methods From April 2003 to May 2005, 24 cases of closed Achilles tendon rupture were examined in our department with MRI. It was performed through sagittal T1WI, T2WI, GE-STIR and axial TME imaging. Four cases were followed up with MRI after 4 to 8 weeks. Results MRI could determinate the severity and exact location of Achilles tendon rupture by demonstrating signal changes of Achilles tendon. In this series, complete rupture of Achilles tendon mostly occurred at the median part, with augmentation and high signal on T2WI. MRI demonstrated high signal on T2WI in partial rupture of Achilles tendon. The signal intensity in the four cases followed up by MRI was shown to decrease. Conclusion MRI is a valuable tool for clinical diagnosis and follow-up of Achilles tendon, because it provides enough information through signal changes at the tendon.

OBJECTIVE To enhance the control of nosocomial infection and improve the quality of medical nursing. METHODS The risk factors and etiological factors of nosocomial infection in sickroom were analyzed. RESULTS In order to control the nosocomial infection we needed to strength the disinfection management in the following aspects: air in the ward,nursing procedures,implements and hands of doctors and nurses. CONCLUSIONS Strict sterilizing procedures and standardized monitoring are the important measures to reduce the nosocomial infection.

Objective To investigate effect of coagulation, fibrinolysis, platelet and tumor markers in patients with advanced lung cancer by chemotherapy.Methods 21 cases of advanced lung cancer patients were selected to be the experiment group, and 20 healthy people were selected to be the control group.The experiment group were treated by chemotherapy,coagulation, fibrinolysis, platelet and tumor markers were compared before and after the treatment.ResuIts Compared with experiment group before chemotherapy, PT, APTT, TT levels of the patients after chemotherapy were lower, serum FIB concentrations were higher (P<0.05); PC and FPS were lower , D-D, PAI-1 concentration level were higher (P<0.05); PLT, MPV, PDW levels were lower (P<0.05); CEA, CYFRA21-1, NSE, CA125 levels were lower (P<0.05).ConcIusion Chemotherapy can enhance the effect of coagulation system in patients with advanced lung cancer, inhibit the fibrinolytic system and reduce the level of tumor markers.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pterygopalatine Fossa ; innervation ; Rhinitis ; physiopathology ; therapy ; Smell ; Treatment Outcome ; Young Adult