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 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.

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 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

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.

The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional clinical data repository (CDR).
Humans ; Information Dissemination ; methods ; Medical Informatics ; organization & administration ; Medical Record Linkage

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.

Objective To study the diagnosis and management of extra-adrenal pheochromocytoma.Methods A retrospective clinical study was done on 33 patients of extra-adrenal pheochromocytoma treated at our department.Results Extra-adrenal pheochromocytoma accounted for 16.2％ (33/204) of all pheochromocytoma patients admitted between Jan 2005 and Dec 2012.There were 13 males and 20 females.The mean age at diagnosis was 45 years,with a range from 17 to 81 years.14 patients were hospitalized for abdominal discomfort,8 patients suffered from typical hypertension symptoms including headache and dizziness and blurred vision,one of bladder pheochromocytoma was found paroxysmal hypertension and 10 patients had no obvious clinical symptoms.All the patients underwent CT scan,and 8 extra-adrenal pheochromocytoma were discovered.11 patients were given circulation expansion therapy.Most of the tumors were located at bladder(3 case),renal hilus (7 case) and para-aorta(23 case).There were two patients with multiple tumors.In 26 cases,blood pressure fluctuated when touching tumor during operation.All the patients were treated with surgical operation.Except for 1 biopsy,32 patients underwent total resection of tumor including a case combined resection with left kidney and a case with the spleen.There were no perioperative mortality.Postoperative follow up showed very good prognosis,with no death.Conclusions Compared with imaging examination,clinical manifestations and laboratory tests were less evaluable for the diagnosis of extra-adrenal pheochromocytoma.Proper preoperative preparation and precise operation is essential for the prognosis.

Objective To compare the short-term clinical outcomes of hand-assisted laparoscopic surgery(HALS),laparoscopic-assisted surgery (LAS)and open surgery(OS)for colorectal cancer treatment. Methods The clinical data of 74 patients underwent HALS,LAS and OS for colorectal cancer treatment between October 2011 and December 2015 were assessed retrospectively. All the surgeries were performed by the same surgical team. The intraoperative details,postoperative recovery,postoperative complications,oncologic results and cost were compared among the three groups. Results A total of 24 patients in HALS group,25 patients in LAS group and 25 patients in OS group were finally included. The gen-eral data and oncologic baseline were comparable among the three groups. The comparative results showed that the operative time increase d and in-cision length shortened gradually in OS group,HALS group and LAS group(P<0.05). HALS group was favor of less number of trocars used com-pared with LAS group(P<0.05),but there was no statistical difference of the conversion rate between the two groups(P>0.05). In terms of post-operative recovery,postoperative complications and oncologic results,there was no statistical difference between the three groups(P>0.05). As for cost,the total cost and operative cost of OS group were lower than HALS group and LAS group(P<0.05),but there was no significant differ-ence between HALS group and LAS group(P>0.05). The material cost increase gradually in OS group ,HALS group and LAS group(P<0.05), and there was no significant difference on the part of other cost among the three groups(P>0.05). Conclusion HALS,LAS and OS are compen-satory with each other,and clinicians can choose the reasonable procedure according to personal proficiency and situation of patients.