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 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 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.

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

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 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.

AIM:To observe the effect of Jingzhui Wentong (JZWT) Capsule (Ramulus Cinnamomi,Radix et Rhizoma clematidis,Radix Puerariae Lobatae,Radix Dipsaci,etc.) on somesthetic evoked potential (SEP),behavior and pathology of rat's cervical radiculitis induced by formalin. METHODS:Experiments were carried out:(1) 60 SD rats were divided randomly into 6 groups:control,model and Jingfukang groups,the high,moderate and low dose groups of JZWT Capsule. Rats of these groups were given water,Jingfukang or JZWT Capsule respectively,and SEP was tested after operation and 14 days after drugs were given to rats. At the same time,the animal behavior was observed daily. (2) 144 SD rats were divided into the same groups and given the same drugs as before. The nerve roots were taken out for pathological observation after 4,7,14,and 21 days with drug administration. RESULTS:In each drug group,the normal SEP was obviously restored,symptoms of encroached nerve were notably lightened,inflammatory reaction and proliferation tissue of mimic cervical radiculitis were more obviously alleviated than that in the model group of rat. CONCLUSION:JZWT Capsule can reduce significantly pathology change of mimic cervical radiculitis in rats,and promote the recovery of nerve function.