With the progress of minimally invasive surgical techniques,the vast majority of general surgery can be safely carried out laparoscopically.But the development of the pancreas laparoscopic surgery is lagging behind.Initially laparoscopy was used only as a diagnostic and staging tool.Nevertheless with more and more successful launch of laparoscopic surgery.Surgeons devoted a great deal of energy to this field in order to benefit more patients.This review focused on the literature of laparoscopic pancreatic surgery in resent years,although the majority of literature suggests that the minimally invasive pancreatic surgery has advantages of rapid recovery,low complication rate compared to traditional open surgery.However,most studies are limited to a small sample and a single institution results.The promotion of this emerging technology still needs more rigorous evidence based medicine.

Objective To investigate the diagnostic and predictive value of spasticity in shunting patients with normal pressure hydrocephalus (NPH).Methods Twenty-three secondary NPH patients who received ventriculo-peritoneal shunt were retrospected. Increased muscular tension were quantified pre and post-shunting by modified Ashworth scale. The dilatated ventricle was measured by Evans' index.Results Four weeks after shunting, spasticity was relieved to some extent on all the identical limbs side of the primary impairment cerebral and 78% cases was improved to zero scale. on the contralateral side limbs, the relieved rate was 86% and 46% cases improved to normal scale. Evans' index improved 35%.Conclusion Increased muscle tonus could be measurement quantified and is readily available and sensitive as a diagnostic criteria in secondary NPH.

Objective To understand the study habits of medical postgraduates in basic cours-es so as to provide references for the reformation of teaching methods. Methods Totally 250 postgra-duates of grade 2010 in our university were investigated with self-made questionnaire. The contents of the questionnaire included basic condition of postgraduates, study methods and suggestions for teaching methods. Rate, percentage and Chi-square test were applied to do statistical analysis. Results Accor-ding to the results of the collected 246 copies of questionnaire, 91.5%(225/246) did not preview lessons before class, 93.5%(230/246) took notes in class, 78.9%(194/246) simply took notes in the book, 60.6%(149/246) preferred more detailed courseware and 27.2%(67/246) reviewed lessons after class. The percentage of simply taking notes in the book of local students (86.5%) was significantly higher than that of army ones (73.2%) (P=0.030), but the percentages of preferring more detailed courseware and reviewing lessons after class of local students were significantly lower than those of army ones (P=0.008, P=0.016). Conclusions The proportion of previewing before class is low among postgrauates. Postgraduates depend heavily on teachers and do not review after class in time. There are differences between local students and army students in taking notes and review habits. It is important to cultivate postgraduates’good study habits.

Objective The present study is to investigate the distribution of endogenous sulfur dioxide (SO2) in severe acute pancreatitis (SAP) rats.Methods Thirty-two SPF male Sprague-Dawley rats were randomized (random number) into sham operation group,SAP rat 3 h group (SAP 3 h),SAP rat 6 hgroup (SAP6h),SAP rat 12 hgroup (SAP 12 h),n=8 in each group.The SAPmodel rats were induced by retrograde cholangiopancreatic infusion of 5％ sodium taurocholate.Rats were sacrified 3 h,6 h or 12 h after treatment.,then we collected pancrease,liver,lung,kidney and serum.The SO2 concentration in each tissue or serum was detected by enzyme-linked immune sorbentassay.Results The concentration of SO2 in tissues of pancreas (1.72 ± 0.14) μmol/g,liver (1.62 ± 0.11) μmol/g,lung (1.65 ± 0.11) μ.mol/g,kidney (1.12 ± 0.06) μmol/g or serum (16.80 ± 1.27) μmol/g in SAP 3 h rats was not significant compared with the sham operation group (P ＞ 0.05 in each group).The SO2 content in the pancreas (1.89 ± 0.17) μmol/g,liver (1.92 ± 0.16) μmol/g,lung (1.91 ± 0.15) μmol/g,kidney (1.30 ± 0.10) μmol /g and serum (14.93 ± 1.00) μmol /g of SAP 6 h was significantly increased compared with sham operation group (P ＜ 0.05 each group).The content SO2 in the pancreas (2.31 ± 0.23) μmol /g,liver (2.22 ± 0.15) μmol /g,lung (2.17 ± 0.07)μmol /g,kidney (1.55 ± 0.15) μmol /gand serum (18.88 ± 1.56) μmol /g of SAP rats reached the peak 12Hafter treatment and was significantly higher compared with the sham operation group (P ＜ 0.05).Conclusions The increase of SO2 concentration in SAP might be,at least in our present opinion,involved into the pathogenesis of SAP rats.

Objective To study the clinical manifestation, pathological character, treatment strategies and prognostic factors of phyllodes tumor of breast .Methods We retrospectively reviewed 41 patients with breast phyllodes tumor.Results The average age was 35. Among all the patients, there were 20 benign cases, 5 borderline cases, 16 malignant cases. 19 patients received extensive local excision, 7 patients received local excision, 9 patients received simple mastectomy of breast and 6 patients were treated with modified radical operation. There were 4 patients undergoing radiotherapy after the operation. Follow-up was obtained for 35 cases, with an average of 26 months (5~101 months), one of the patients died of metastasis 3 years after the operation, two patients suffered from local recurrence.Conclusions Appropriate operation is the most important prognostic factor of breast phyllodes tumor.

ZnO nanoparticle-containing carbon composite nanofiber ( ZnO-CNF ) was prepared by the electrospinning of the ZnCl2-PAN precursor, followed by preoxidation and carbonization. The ZnO nanoparticles were uniformly distributed on the surface of the carbon nanofiber with the size of 20-30 nm, confirmed by scanning electron microscopy ( SEM ) . The wettability of the ZnO-CNF was studied by water contact angle test. With Nafion as an additive, the ZnO-CNF modified electrode was successfully constructed by dip-coating. The surface morphology and electrochemical properties of the modified electrode were investigated by SEM and cyclic voltammetry. There was a sensitive response of the ZnO-CNF modified electrode on Pb ions in solution, demonstrated by square wave stripping voltammetry. Under the optimized conditions, a good linear relationship between peak current and Pb2+concentration was obtained in the range of 2. 4×10-10-2. 4×10-7 mol/L (R=0. 998) by 10 min preconcentration at -1. 0 V in 0. 1 mol/L NaAc buffer solution (pH=4. 6). The detection limit was 4. 8×10-11 mol/L. The practical analytical application of the ZnO-CNF modified electrode was assessed by the measurement of the actual water sample and the result was consistent with that obtained by ICP-MS.

Objective To investigate the related factors of infection post ventricle-peritoneal shunt and explore some preventive measures.Methods 85 cases after ventricle-peritoneal shunt for normal pressure cranial hydrocephalus were analysed retrospectively. The effect of intensive prevention was observed. Results The overall infection rate was 7% after ventricle-peritoneal shunt. There was significant difference between the patients with or without infection post-operation in some factors, such as preoperative infection (pneumonia, urinary tract infection, intracranial infection, biliary infection); the operator; activities of daily living. It was 9.8% (6/61) under routine aseptic operation,and was 0 (0/24) under intensive management. Conclusion Infection after ventricle-peritoneal shunt is associated with many factors, especially the susceptibility and contact to infection. Intensive management can significantly prevent the infection.

Objective To study the efficient conversion of human umbilical cord mesenchymal stem cells (hucMSC) into a neural stem cell-like population (hucNSC). Methods MSCs derived from umbilical cord were cultured and identified with fluorescence-activated cell sorting (FACS). They were induced with epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) and B27, and identified with FACS and immunocytochemistry. Then they were induced with glial-derived neurotrophic fator(GDNF), interleukin-1β (IL-1β) and all-trans retinoic acid (ATRA), and identified with immunocytochemistry and RT-PCR. Results hucMSC expressed CD105, CD44 and CD29. Induced with EGF, bFGF and B27, they expressed CD133 and Nestin. Induced with GDNF, IL-1β and ATRA, they expressed glial fibrillary acidic protein, neuron specific enolase and tyrosine hydroxylase. Conclusion hucMSC may be induced into hucNSC, namely the cells with the characteristic growth, proliferation and differentiation like NSCs.

Objective The regulation of neuroendocrine hormones on the innate immune responses remains controversial.This report investigated whether the adrenal-derived hormones directly enhanced the innate immune responses and alternation of main pattern recognition receptors in adrenalectomized rats following blast injury.Methods Bilateral adrenalectomy was performed on Sprague-Dawley adult rats,who inflicted with mild blast wave injury in 7 d later.Peripheral blood leukocyte counting,macrophage phagocytosis,bacterial translocation(BT) in lungs,livers and mesenteric lymph nodes(MLN) were measured and analyzed,and TNF-? level in the lung tissue was detected.The mRNA expressions of scavenger receptor-A(SR-A),CD14 and Toll like receptor-4(TLR-4) were assessed with RT-PCR.Results After blast injury,the number of peripheral leukocytes was decreased(P

Objective: To understand the HIV infection status and related factors in men who have sex with men (MSM) in Tianjin during 2016-2018. Methods: According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted to collect the information about the awareness of AIDS, related behaviors, HIV infection, syphilis prevalence and HCV infection in the MSM in Tianjin with the annual sample seize of 400 between April and June during 2016-2018. Results: From 2016 to 2018, a total of 1 200 MSM were surveyed. The condom use rate in anal sex was 45.4% (544/1 198) in the past 6 months. The HIV test rate in MSM recruited through network declined with year (trend χ²=42.742, P<0.001). The overall HIV infection rate was 3.3% (40/1 200). The HIV-1 infection rate was 2.6% (95%CI: 1.7%-3.5%). The overall prevalence rate of syphilis was 6.7% (80/1 200). The overall HCV infection rate was 0.8% (9/1 200). Results from multivariate logistic regression analysis showed that the risk factors associated with HIV infection in the MSM included divorced or widowed (compared with unmarried, aOR=7.137, 95%CI: 1.621-31.419) and syphilis positive group (compared with syphilis negative group, aOR=3.684, 95%CI: 1.520-8.932). The protective factors for HIV infection in the MSM included consistent use of condom in the past 6 months (compared with occasional use of condom, aOR=0.343, 95%CI: 0.126-0.932) and HIV test (compared with receiving no HIV test, aOR=0.314, 95%CI: 0.123-0.801). Conclusions The HIV infection rate in the MSM in Tianjin was high from 2016 to 2018. Syphilis prevalence status in MSM should not be neglected. The rate of consistent condom use in anal sex was low in the MSM. It is necessary to take effective measures to promote condom use and strengthen HIV test in MSM.