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.

目的改善了脑梗死患者及家属的遵医行为和自护能力,预防再发脑梗死。方法运用整体护理对576例脑梗死患者及家属进行健康教育。结果提高了脑梗死患者的生存质量和健康水平。结论使患者及家属掌握了脑梗死的相关知识,增进了护患沟通,能积极配合医护人员进行治疗和护理;也提高了护理人员的理论知识水平。

Objective To investigate the effects of specific immunotheraphy(SIT) using allergens for children atopic dermatitis(AD) to find an efficacious method to treat AD. Methods 148 children with AD were divided into SIT group and control group. All patients were given allergen intradermal tests. The patients in SIT group received SIT using positive aero-allergens for 8 to 18 months. The patients in control group received the treatment of antihistamine drugs and drugs for external use. Results Total effective rate and curative rate of SIT group were 93.2% and 68.9% respectively, and those of control group were 68.9% and 17.6% respectively, which had a significant difference between the two groups(P

Objective To study the expression of survivin and its relationship with the proliferative activity in hepatocellular carcinoma.Methods Using immunohistochemistry ABC methods, the expression of survivin and PCNA were evaluated in 31 hepatocellular carcinoma, 8 cirrhosis of liver and 4 normal livers tissues.Results No expression of survivin were detected in normal livers and cirrhosis of liver. In contrast, survivin protein was expressed in 19 of 31 patients with HCC(61.3%). When compared with normal livers and cirrhosis of liver, hepatocellular carcinoma had significantly more frequencies of survivin expression(P

Objective To investigate the expression of myeloid antigen(MyAg) in acute lymphoblastic leukemia (ALL) and its correlation with clinical characteristics and prognosis.Methods The clinical data of 103 newly diagnosed ALL 1patients were retrospectively analyzed.These patients were divided into myeloid antigen-positive group (MyAg+ ALL) and myeloid antigen-negative group(MyAgALL) based on the flow cytometry(FCM) analysis in bone marrow.The correlation of MyAg expression with the clinical features,short-term efficacy and 5-year overall survival were assessed in the two groups.Results MyAg expression was detected in 46.5％ out of 103 cases and CD13,CD33 were the most commonly expressed MyAg(34.2％ and 21.4％ respectively).The expression of CD34 in MyAg+ ALL group was higher than MyAgALL group(75.3％ vs 60.5％,P ＜0.05).The expression of MyAg in T-ALL group (66.7％) was higher than B-ALL group (42.8％) (P ＜ 0.05).The clinical and biological characteristics of ALL patients between MyAg+ and MyAggroups showed that higher percentage of incoincidence of classification between morphology and immunology.Conclusion MyAg expression was not correlated with clinical characteristics and prognosis of ALL patients.

Objective To evaluate the efficiency, safety and complications of transcatheter closure of atrial septal defect (ASD) using Amplatzer and sideris occluder under the guidance of transthoracic echocardiography and fluoroscopy. Methods Fourteen patients of ASD, 6 male and 8 female, age ranged from 2.6 to 43 years old, were treated by transcatheter closure of ASD with Sideris or Amplatzer occluders. All cases were guided by thansthoracic echocardiography and fluoroscopy. Results The diameter of ASD (balloon stretched diameter) was 14-34 mm (24.16 ? 5.16)mm. The Amplatzer devices were used in 9 cases, all of them were successfully occluded with satisfactory results. Of 5 patients treated by Sideris buttoned devices, 4 had success procedure and one failed, in which unbuttoning occurred and retrieval of the device was performed by emergency surgery. Conclusion Transcatheter closure of ASD is a simple and convenient method with a high success rate and reliable curative effect. The indication of Amplatzer method is much wider and the instant success rate after the procedure is much higher than those of Sideris device. Thansthoracic echocardiography plays a key role for guiding transcatheter closure of ASD in this study.

Objective To observe the therapeutic effect of porcine myocardium against porcine myocardial infarction (MI) by porcine myocardial infarction model with connexin-43/zonula occludens-1 (CX43/ZO-1) double gene induced pluripotent stem cells (iPS) transplantation.Methods Porcine myocardial infarction model was established by balloon occlusion.One week later,1640 culture medium,CX43 gene ips cells and CX43/ZO-1 gene ips cells were injected into the different coronary arteries.After 3 months,electron microscopy and color Doppler ultrasonography were used to evaluate the curative effect.Results Compared to ips group of CX43 and 1640 culture group,in CX43/ZO-1 gene ips group,electron microscope showed a large number of island-like cardiomyocytes,blood vessels and intact intercalated discs in the infarct area and normal myocardial junction area structure,color Doppler echocardiography showed left ventricular end diastolic diameter reduced,and ejection fraction was significantly increased (P ＜ 0.05).Conclusions Transfection of CX43/ZO-1 double gene ips cells can promote cardiomyocyte regeneration and cardiac function recovery in porcine myocardial infarction model.

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 effects of established swine acute myocardial infarction and following ventricular remodeling model by occluding Coronary with balloon. Methods Ten healthy Domestic swine are enrolled. Each swine's left anterior descending coronary artery was occluded for three hours by dilated balloon, and then reperfusion was performed. During the whole course of operation, the electro-cardiogram was monitored. B-ultrasound and single -photon emission computed tomography examination (SPECT) were performed to detect left ventricular end diastolic dimension, left ventricular tip wall thickness, left ventricular end diastolic volume and left ventricula ejection fraction before operation and one week, three month, six month after acute myocardial infarction. Results Five swine died during the period of opera-tion for lack of experience, the remains survived. Electrocardiogram revealed significant ST-elevation and Q-wave formation. B-untrasound and SPECT witnessed deteriorating left ventricular end diastolic dimension expansion, left ventricular tip wall thickness thinning, left ventricular end diastolic volume expansion and left ventricular ejection fraction depression. Conclusions Coronary artery occlusion by balloon can successfully establish acute myocardial infarction and following left ventricular remodeling models.

BACKGROUND: Recent researches demonstrate that transplantation of bone marrow stem cells in the area of myocardial infarction can directionally differentiate into myocardial cells having normal physiological function and can promote newborn vascularization so as to repair infarction myocardium and improve injured cardiac function.OBJECTIVE: To observe short-term clinical effect of autologous bone marrow stem cell transplantation (ABMSCT) in percutaneous coronary artery on the treatment of acute myocardial infarction.DESIGN: Self-control study.SETTING: Department of Cardiology, Xiangtan Central Hospital.PARTICIPANTS: A total of 27 patients with acute myocardial infarction, including 16 males and 11 females, were selected from Department of Cardiology, Xiangtan Central Hospital from June 2004 to December 2006. Their ages coronary artery was finished after onset emergently; in addition, blood flow of infraction related vessels recovered to grade TIMI3. All patients provided the confirmed consent.METHODS: Operative procedure: All patients were performed with emergently interventional therapy of coronary artery after onset of acute myocardial infarction. One week later, percutaneous cavity tube technique was used to establish infarction related arterial pathway, and guiding filament was used to send micro-perfusion tube into stents. And then,separated bone marrow stem cell suspension was poured through central cavity of micro-tube into the distal end of infarction vessels. Operative evaluation: Dynamic electrocardiogram was evaluated for 24 hours before and after transplantation; in addition, left ventricular ejection fraction and myocardial perfusion defect scores were detected before and at 6 and 12 months after transplantation; otherwise, recovery state and complication were observed in follow up at 6 and 12 months after operation.defect scores: At 6 and 12 months after operation, left ventricular ejection fraction was higher than that before transplantation, and there was significant difference before and after transplantation (P＜0.05). While, myocardial perfusion defect scores were lower than those before transplantation, and there was significant difference before and arrhythmia were not found out, cardiac arrhythmia was not increased, and cardiac arrhythmia combining with malignancy not have any complications and in-stent constriction after operation.