Objective To evaluate the therapeutic effectiveness of postoperative hemorrhage of cholejejunal or pancreato - jejunal anastomotic stoma after pancreato - duodenectomy by the way of fibercholedochoscopy. Meth- ods The drainge tube was extracted out of choledochojejunal anastomotic stoma. And fibercholedochoscopy was in- serted in fistula to affirm hemorrhagic position of choledochojejunal or pancreato - jejunal anastomotic stoma. And then local coagulation and microwave solidifying was proceeded with. Local spray of Galla - chineses compound solution was performed for hemostasis. Results We succeeded in hemorrhage of four choledochojejunal and six pancreato - jejunal anastomotic stoma One failed for frequent hemorrhage in pancreato - jejunal anastomotic stoma. Conclu- sion Fibercholedochoscopy is the first selective and effective method in the diagnosis and treatment of postoperative hemorrhoge of pancreato - jejunal or choledochojejunal anastomotic stoma after whipple operation.

Objective To investigate the clinical effects of early aneurysm surgery clipping in the treatment of intracranial aneurysm.Methods 72 patients with intracranial aneurysms were selected.42 patients (44 aneurysms) were taken microsurgical clipping( clipping group),30 patients( 33 aneurysms ) were taken vascular embolization(embolization group).The prognostic evaluation and clinical indicators of two groups were observed.Results There were no significant differences in GOS evaluation when discharge and mRS evaluation after postoperative 3 months in two groups(all P ＞0.05 ).The length of stay,hospital cost and complete occlusion rate of clipping group was ( 17.1 ± 3.2 ) d,( 5.5 ± 1.2) ten thousand yuan,100.0％,respectively,and better than those of embolization group [ (9.1 ± 2.6) d,( 12.1 ± 2.6) ten thousand yuan,83.3 ％ ] ( all P ＜ 0.05 ).There were no significant differences in cerebral aneurysms rupture rate and complication rate between the two group ( x2 =0.01,0.02,all P ＞ 0.05 ).Conclusion The microsurgical clipping has the therapeutic equivalence with embolization group,and has respective advantages and disadvantages.The microsurgical clipping could be the preferred treatment method,especially suitable for application in the primary hospital.

Hydroxypropyl-chitosan with substitution degree of 0.56 is prepared by the reaction of chitosan and epoxypropane by controlling condition. The water solubility of modified hydroxypropyl-chitosan is enhanced. When suitable concentration of hydroxypropyl-chitosan water solution responds to certain concentration of sodium polyphosphate based on ion gel method, the hydroxypropyl-chitosan nano-spheres with particle size of 500-700nm are obtained. Transmission electron micrograph shows that the shape of prepared hydroxypropyl-chitosan nano-sphere is uniform.

Objective To study the effect of recombinant human growth hormone(rhgh) on the expressions of tumor necrosis factor a(TNFa) and endotoxemia in murine experimental obstructive jaundice(OJ) models.Methods Sixty adult male wistar rats.were randomly divided into three groups A: sham operation group(SO),20;B:OJ group,20;C: OJ+rhGH group,20.The rats in group OJ and OJ+rhGH suffered from bile duct ligation,while the SO group did not.Two weeks later,rats in OJ+rhGH group were injected with rhGH subcutaneously once a day.The dose was 0.75 Iu/kg.The other two groups were injected with the same amount of saline.The endotoxin(ETX),the liver function and TNFa were detected four weeks later.Result The level of ETX(0.036?0.010EU/m1) and TNFa(182.00?88.37lpg/ml) in OJ+rhGH were much lower than those in OJ group(0.065?0.011EU/m1 P

Objective To compare four pretreatment methods of human plasma coagulation factor Ⅷ( FⅧ) before column purification.Methods Cryoprecipitate was dissolved in Tris , before the supernatant was treated with glycine precipitation, PEG precipitation, acid precipitation and aluminum hydroxide gel adsorption , respectively.Activated partial thromboplastin (APTT) was used to measure the activity of the supernatant clotting FⅧ after treatment.The total activity recovery and specific activity of the final samples were used to weigh the efficacy of those methods .The purity of the intend-ed protein was estimated by non-reducing SDS-PAGE electrophoresis .Results Total activity recovery of glycine precipitati-on was the highest (94.00%±7.60%), followed by that of acidic precipitation (89.47%±2.60%) and PEG precipita-tion (80.92%±9.67%) methods.The lowest was aluminum hydroxide gel adsorption (78.65%±7.52%).Glycine precipitation and PEG precipitation could more effectively remove contaminating protein than acid precipitation and aluminum hydroxide gel adsorption .Treated by four different methods , the specific activity of FⅧ of glycine precipitation sample was the highest (0.6856 ±0.1258 IU/mg), followed by PEG precipitation (0.5773 ±0.0787 IU/mg) and acidic precipitation (0.3885 ±0.0301 IU/mg).The specific activity of aluminum hydroxide gel adsorption was the lowest (0.2879 ±0.0472 IU/mg).Conclusion PEG precipitation is more effective for the actual production process than the other three methods .

Objective To investigate the relationship between plasma albumin and hemoglobin(Hb) levels and prognosis in patients with severe craniocerebral trauma. Methods The clinical data of 124 patients with severe craniocerebral trauma form January 2010 to January 2014 were analyzed retrospectively. The relationship between plasma albumin and Hb levels and prognosis were analyzed. Hb level was obtained in 3 days of admission, and then the patients were divided into Hb <90 g/L group, Hb 90-99 g/L group, Hb 100-110 g/L group, Hb >110 g/L group, and also were albumin <25 g/L group, albumin 25-28 g/L, albumin 29-31 g/L group, albumin>31 g/L group according to the mean albumin level. Multifactor Logistic regression analysis was used to analyze the relationship between Hb, albumin levels and prognosis. Results Among 124 patients, 37 patients (29.8%) were given red blood cell (RBC) transfusion, and 28 patients (22.6%) received albumin treatment. The hospital mortality was 20.2% (25/124). The age, scores of Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ), and hospital mortality in different Hb level groups had no significant differences (P>0.05). The age, scores of GCS score and APACHEⅡ score in different albumin level groups had no significant differences (P>0.05), but the hospital mortality in different albumin level groups had significant difference: 31.2%(10/32), 24.2%(8/33), 9.7%(3/31), 14.3%(4/28), P<0.05. Multifactor Logistic regression analysis showed that albumin level was the relevant factor for the severe craniocerebral trauma (P<0.01), the hospital mortality was decreased with the rising of the albumin level, but the risk of death was higher in albumin>31 g/L group than that in albumin 29-31 g/L group. Conclusions 29-31 g/L albumin level is the best for severe craniocerebral trauma patients. There is no significant impact of Hb on the prognosis for severe craniocerebral trauma patients.

Objective To evaluate the differences of the lower extremity atherosclerosis between patients with and without type 2 diabetes using dual-source CT angiography.Methods Dual-source CT angiography of lower extremity was performed in 87 patients with (n=30)or without (n= 57 )diabetes.Extent of luminal stenosis,and the type,distribution and range of the plaques were compared.Results 342 plaques in 540 segments (63.3%)in diabetic patients,and 500 plaques in 1 026 segments (48.7%)in non-diabetic ones were detected respectively.Compared with non-diabetic patients,the diabetic ones had a higher overall incidence of plaques (P <0.05).Calcified plaques were the most common in both kinds of patients,and the incidence of mixed plaques was high-er in diabetic patients than that in non-diabetic ones (35.6 % vs.28.4%,P <0.05).Light to moderate stenosis occurred in most diabetic patients,and fewer occlusion was found compared with non-diabetic ones (9.1% vs.1 7.0%,P <0.05).The most common sites of the plaques in diabetic patients were located at distal small arteries below the knee.However,those were located at proximal arteries above the knee for non-diabetic ones.The involvement of atherosclerosis in diabetic patients was more diffused,and the de-gree of Ⅳ (75%-100%)was higher than that in non-diabetic ones (P <0.05).Conclusion Atherosclerosis in lower extremity on dual-source CT angiography is very common in diabetic patients with multi-segmental,diffused,non-obstructive involvement of dis-tal small arteries below the knee.

Objective To observe the relationship between brachial-ankle pulse wave velocity(baPWV)and cardiovascular risk factors as well as clinical cardiovascular events in high cardiovascular risk patients.MethodsRelevant clinical data,including baPWV,height,weight,waist circumference,blood pressure,heart rate,history and blood biochemistry test were collected in 111 consecutive patients with high cardiovascular risk.High cardiovascular risk patients are defined as those who developed cardiovascular events (coronary heart disease,ischemic stroke and transient ischemic attack) before or those who have two or more cardiovascular risk factors(more than 50 years old,smoking,obesity,hypertension,diabetes mellitus and hyperlipidemia).The number of risk factors and cardiovascular events between patients with high baPWV (≥1700 cm/s) and low baPWV (<1700 cm/s) were compared.ResultsCompared with low baPWV group,the cardiovascular events and the number of cardiovascular risk factors were higher in high baPWV group(35.3% versus 60.5%,P<0.01 and (3.9±1.2)versus (4.4±0.9),P<0.05,respectively).The factors influencing baPWV were age (P<0.001)and systolic blood pressure (P<0.01).ConclusionIn patients with high cardiovascular risk,the cardiovascular events and the number of risk factors were more frequent in patients with higher baPWV.Age and systolic blood pressure are independent risk factors of baPWV.

Objective To investigate the application value of methylene blue excretion test in early reasonable nutritional support for severe traumatic brain injury.Methods One hundred and thirty-three cases of severe traumatic brain injury admitted to hospital from January 2010 to June 2012 were chosen as treatment group,while the 127 cases of similar patients admitted to hospital from January 2007 to December 2009 were chosen as control group.Patients in treatment group underwent methylene blue excretion test in 3 days,8 days,15 days after injury,and the nutritional support ways were determined according to the elimination time of methylene blue in patients' urine.The control group conventionally receive enteral nutrition support therapy firstly,after 15 days if they still cannot be tolerant of the enteral nutrition,then parenteral nutrition therapy were adopted.The weight,serum albumin and hemoglobin circumstances of the two groups were determined and the complications were recorded.Glasgow coma score (GCS) of 3 months after injury were followed up.Results There was no significant difference on the average body weigh between these two groups before treatment.The average body weight of the treatment group was significantly higher than that of control group after 3 months treatment((56.3 ± 5.5) kg vs.(52.6 ± 5.3) kg,t =5.93,P ＜ 0.01).The serum albumin and hemoglobin of 14 d,21 d after injury were significantly higher than those of the control group (serum albumin of 14 d:(32.7 ±3.4) g/L vs.(28.8 ±3.1) g/L; serum albumin of 21 d:(34.3 ±3.8) g/L vs.(30.7 ±3.3) g/L;hemoglobin of 14 d:(113.4±12.5) g/L vs.(102.2 ±11.6) g/L;hemoglobin of 21 d:(118.5 ±13.3) g/L vs.(106.7 ± 12.4) g/L.Nutritional status of treatment group was significantly better than that of the control groupall P ＜ 0.05).After three months,the effective rate of treatment group (93.23％ (124/133)) was significantly higher than that of the control group (84.25％ (107/127)),the difference was statistically significant (x2 =5.29,P ＜ 0.05).Conclusion Determining the early reasonable nutrition support ways for patients with severe traumatic brain injury according to the elimination time of methylene blue in the urine,can provide comprehensive nutrition to patients,enhance their body resistance,reduce the incidence of complications,and create an important clinical value for improving prognosis.

Objective To investigate the clinical effect of early application of nimodipine on a large area cerebral infarction after severe traumatic brain injury operation.Methods Fifty-one patients with severe head injury after large area cerebral infarction were as treatment group who hospitalized from January 2009 to January 2012,and 48 hospitalized cases as the control group from January 2005 to January 2008.The patients in control group were received drugs to decrease intracranial pressure,and enhance nerve nutrition therapy,while in the treatment group,beside the therapy method of control group,were received nimodipine intravenously by micro-pump for 10 days,and then oral administration for 10 days.Plasma endothelin-1 was detected at 0,5th,7th,14th day days after hospitalization.Dopple was pplied to record the middle cerebral artery (MCA) peak systolic velocity(Vp) of the injured side for 7 d.Glasgow outcome score(GOS) was recorded in the 3 months follow-up.The awakening time was recorded consciousness.Results At 21 st day after treatment,22 cases were died in the treatment group and survival patients with cerebral vasospasm were 14 cases (48.28％,14/29).However,30 cases were died in control group and cerebral vasospasm(CVS) of survival patients was 15 cases (83.33％,15/18),significantly higher than that in treatment group (x2 =5.78,P ＜ 0.05).The variable tendencies of Vp,plasma endothelin-1 and the intracranial pressure were significantly different between the treatment group and the control group (Vp:F group =276.27,Ftime =603.54,F interactive =85.68 ; plasma endothelin-1:F grouP =281.16,F time =608.32,F interactive =87.45 ; intracranial pressure:F grouP =326.58,F time =78.63,F interactive =27.39 ; P ＜ 0.05).Mter 3 months of treatment,the value of GOS was significandy higher in treatment group than that of control group (x2 =4.76,P ＜ 0.05).Furthermore through three months treatment,the effective rate in treatment group was higher than that in the control group (52.94％ (27/51) vs.(31.25％ (15/48)),the awakening periods was shorter than that in control group((20.7 ±6.5) d vs.(27.8 ± 7.6) d,t =3.19,P ＜ 0.05)).Conclusion Early applications of nimodipine treatment after severe traumatic brain injury patients with massive cerebral infarction can significantly improve the clinical efficacy and shorten the duration of coma.