The sphincter of Oddi is a valve that controls the biliopancreatic duct and plays an irreplaceable role in maintaining normal physiological functions of the biliopancreatic duct.However,sphincteroplasty and sphincterotomy may cause varying degrees of damage to the function of the sphincter of Oddi,which may further result in postoperative reflux of duodenal fluids and bacterial contamination in bile and increase the risks of recurrent common bile duct stones,reflux cholangitis,and even cholangiocarcinoma.Therefore,clinical physicians should protect the structure and function of the sphincter of Oddi.Based on our experience,under the premise that the extrahepatic bile duct can be preserved,patients with iatrogenic injury of the sphincter of Oddi can be treated with transduodenal sphincteroplasty to restore the structural integrity of the sphincter of Oddi and reduce biliopancreatic duct complications secondary to loss of function.

Objective To investigate the expressions of COX-2 and p53 in human colorectal carcinoma and their correlations with clinicopathological features of colorectal carcinoma. Methods The expressions of COX-2 and p53 were determined by immunohistochemical staining in 72 surgical specimens of colorectal carcinoma and 21 normal mucosal tissues. Results The positive rates of COX-2 and p53 in colorectal carcinoma were 70.8 % and 62.5 %, respectively. The differences between carcinoma group and normal tissues group were statistically significant(P

Objective To study the risk factors of nosocomial infections in patients with cerebrovascular disease and prevent and cure them.Methods A retrospective survey on the hospital infeation in patients with cerebrovascular disease in our hospital during March 2003 to March 2005 was couducted.Results The result showed that 61 of the 360 patients had hospital infection,the rate of infection was 16.94%,and the hospital average infection rate in all was 3.92%,hospital infection aging,treatment days in hospital,consciousness invasive operation Hospital infection was a retated.The main infection sites were at respirate tract,the most common bacteria were Gram-Negative bacilli.Conclusions There is higher hospital infection rate among,the acute cerebrvascular patients.Age,the critical patients,invading operations are prmincipal factors.We should prevent it in time.

Objective To evaluate the correlation of striatum dopamine transporter (DAT) imaging and the scores of Parkinsonian clinical scale in patients with Parkinson's disease(PD).Methods 99m Tc-TRODAT-1 SPECT imaging was used to assess the DAT binding in the striatums of 29 PD patients, their correlations with the subscales of unified PD rating scale (UPDRS), age and disease duration were also evaluated.Results The scores of subscales of UPDRS II, III and V, as well as the disease duration were negatively correlated with DAT bindings in ipsi-, contra- and bilateral striatum regions (r was -0.70, -0.80, -0.49 and -0.54 respectively, all P

Optimization of surgical treatment of biliary dilatation (BD) depends on reasonable clinical classification and standardized classification-based treatment strategy.Due to increasing limits and defects of classic Todani classification,a new classification named Dong-classification has been proposed,which was based on a large series analysis from a single referral center.Some important parameters including anatomical location and range of BD,pathogenic factors,and different surgical managements were main considerations in the new classification.After practical application and evaluation,Dong-classification has been improved step by step.It is believed that Dong-classification may contribute to improving surgical treatment decision and selecting reasonable operative plan.

Objective To explore the diagnosis and treatment for pancreatic cystic neoplasms.Methods The clinical data of 10 cases with pancrestic cystic neoplasms treated from 2004 to 2008 was reviewed and both domestic and internal pertinent literatures were summarized.Results The pancreatic cystic neoplasms mostly happened in middle-aged women.The clinical manifestations showed no specificity.Ultrasonography, CT and MRI could offer important sign for diagnosis.The rate of surgical resection was high and the prognosis was satis-factory.Conclusions The pancreatic cystic neoplasms is being muh with the development of imagings.It is dif-ficuh to distinguish the feature of the cystic neoplasms before surgery, so surgerical resection should be done for all cystic tumors found.

Objective To explore the reasons and preventive measures for the postoperative complications of hilar cholangiocarcinoma.Methods The clinical features,diagnosis,surgical therapy,postoperative complications and follow-up result were retrospectively analyzed on 89 cases of hilar cholangiocarcinoma admitted into our hospital from January 2008 to September 2014.Surgical approach:47 cases of radical resection including hepatoduodenal ligament skeletonized resection in 18 cases; concurrent partial hepatectomy in 29 cases,palliative resection in 17 cases,biliary tract drainage in 25 cases.There were 6 cases receiving partial portal vein resection and reconstruction.Results Among 89 patients there were 93 postoperative complications.Biliary complications developed in 22 cases (24.7％,22/89) including bile leakage in 13 cases (14.6％),biliary tract infection in 7 cases,anastomotic stricture in 2 cases.Wound infection in 19 cases,lung infection in 4 cases,ascites in 31 cases,pleural effusion in 10 cases,liver abscess in 1 case,intraabdominal bleeding in 2 cases,postoperative gastrointestinal bleeding,intestinal fistula,liver failure and multiple organ failure (MODS) developed in one each cases.One case died of MODS with the mortality of 1.1％.Conclusions Postoperative complications were common in hilar cholangiocarcinoma combined liver resection and/or vascular resection and reconstruction.Bile leakage is the most frequently seen necessitating long term proper drainage.

0 05)between AD and aging c ontrol subjects or MCI patients. Conclusions Episodic memory impairment and semantic memory impairment beside the immediat ely recall and naming are the earliest and most pervasive memory deficit in mild AD patients, and episodic memory impairment is more specific than semantic memo ry impairment for the diagnosis of AD.

Objective This study aims to understand the characteristics of the time sequence of ICR mouse first mandibular molar tooth germ development through dynamic observation.Methods Tooth germ of Embryos (E11.5,E12.5,E13.5,E14.5,E15.5,E16.5,E17.5 and E18.5) and postnatal (PN1,PN2) mice were obtained.The heads (E11.5-E15.5) and mandibles (E16.5-PN2) of mice were dissected,fixed and embedded for serial sections and HE staining.All the results were assessed under light microscopy.Results The tooth germ underwent various development stages including the bud,cap and bell stages.Mouse odontogenesis was initiated at E11.5.Proliferation of oral epithelium formed the bud stage at E13.5.Then the cap stage was observed at E14.5-E15.5 and the bell stage was appeared beginning from E16.5.The pre-dentin was observed at PN1,as well as the dentin at PN2.Conclusions Establishing the regular development pattern of the first mandibular molar of ICR mice will provide a reliable basis for the future use in the specific tooth germ developmental research.

BACKGROUND: With the advancements in helical CT myelography and computer image postprocessing, virtual medical imaging has acquired good outcomes in the diagnosis and treatment of complex cervical spondylosis. OBJECTIVE: To observe the effects and significance of helical CT myelography on multiplanar and three-dimensional reconstruction of virtual anatomical models of cervical spondylosis. DESIGN, TIME AND SETTING: The present computer three-dimensional reconstruction, gold standard control study was performed at the Second Hospital Affiliated to Soochow University between January 2001 and January 2006. PARTICIPANTS: Twenty patients with complex cervical spondylosis, who had received surgery, were employed for this study. METHODS: Virtual anatomical model of cervical spondylosis was established by multiplanar and three-dimensional reconstruction through the use of helical CT myelography in 20 patients. Scanning and reconstruction results were used for pre-surgery disease condition evaluation and virtual surgery. In addition, surgical intuitionistic results were considered gold standard to evaluate the accuracy and efficacy of virtual anatomical models. MAIN OUTCOME MEASURES: The accuracy and efficacy of virtual anatomical models. RESULTS: Virtual anatomical models could concurrently show bony and membranate vertebral canals. These exhibited comprehensive and minute bony anatomic structure of cervical vertebrae and anatomic information regarding dura mater, spinal cord, and nerve sleeve for pre-surgery evaluation and virtual surgery. The imaging virtual anatomic information was in accordance with practical anatomical information in patients. CONCLUSION: Virtual anatomical model can be used to comprehensively evaluate the disease condition of cervical spondylosis and simulate the surgery due to its intuitionistic, vivid, and accurate display of anatomy of cervical vertebrae.