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.

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.

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 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.

Objective To investigate the incidence of postoperative hepatic metastasis,clinicolpathological characteristics and the prognosis for pancreatic cancer. Methods Totally 83 cases with pancreatic cancer admitted in our hospital during January 2007 to September 2012 was retro?spectively analyzed according to clinicolpathological data. Results Postoperative liver metastasis occurred in 31 cases with a metastatic rate of 37.3%. The size(χ2=9.606;P=0.002),vascular invasion(χ2=4.794,P=0.029)and UICC stage(χ2=5.318,P=0.021)were correlated with he?patic metastasis. Univariate analysis revealed the poor prognosis in pancreatic cancer patient with hepatic metastasis(χ2=9.967,P=0.002). Cox re?gression analysis revealed hepatic metastasis as an independent prognostic factor(P=0.001). Conclusion Pancreatic cancer has a high possibility of hepatic metastasis. Postoperative hepatic metastasis was one of the independent factors for the prognosis of pancreatic cancer. Tumor size,vascular invasion and UICC stages were risk factors for postoperative liver metastasis of pancreatic cancer.

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.

Objective To explore the diagnostic value of MRI on fetal congenital limb deformities.Methods Sixteen pregnant women,aged from 22 to 40 years (average 29 years) and with gestation from 22 to 39 weeks (average 29 weeks) were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. Acquisitions consisted of coronal, sagittal, and axial slices relative to the fetal brain, spine, thorax, abdomen, especially limbs using 2D FIESTA sequences. Prenatal US and MR imaging findings were compared with postnatal diagnoses (4 fetuses) or autopsy (12 pregnant women,13 fetuses). Postnatal evaluation included US, MR imaging, computed tomography, and physical examination. Results Of the sixteen pregnant women (15 with a single fetus and 1 with twin fetuses) ,17 fetuses were found. Those limb deformities of sixteen pregnant women included congenital both upper extremities amelia (1 case), sirenomelia sequence (1 case), micmmelia (5 cases, 1 of which were twins),bilateral clenched hands (2 cases), right pelydactyly (1 case), simple right ectrodactyly (1 case), right dactylolysis(1 case), simple club foot (2 cases), hydrocele spinalis with club foot (2 cases), 1 of the 2 cases with bilateral clinodactyly. In 14 of 16 cases, the diagnoses established by MR imaging were correct when compared with postnatal diagnosis, and prenatal MR diagnosis was inaccurate in 2 cases. Conclusion Prenatal MRI is effective in the assessment of congenital limb deformities of fetuses, it can yield information additional to that obtained with US, and further correct US diagnosis.