The morbidity of pancreatic duct calculus is increasing every year in China. Currently the main therapeutic methods include non-surgical treatment and surgical treatment. Non-surgical treatments contain endoscopic calculus extracting and / or extracorporeal shock wave lithotripsy. Surgical treatment has two categories: drainage of the pancreatic duct decompression and pancreatectomy. Concrete treatment or surgical options should follow the strategy of individual.

Cancer pain can seriously disturb patients′quality of life.Intractable cancer pain not ame-nable to standard analgesics is a horrifying truth in parts of the patients.Interventional pain management tech-niques can be an effective alternative for those patients.Based on the evidence of evidence-based medicine, celiac plexus block or splanchnic nerve block are recommended for the management of upper abdominal cancer pain,pelvic cancer pain can be managed with superior hypogastric plexus block,and back pain due to vertebral compression fractures with tumor invasion can be managed with percutaneous vertebroplasty or kyphoplasty. Intercostal nerve block for chest wall cancer pain,ganglion impar block and saddle block for perineal pain due to pelvic tumors should be used only in the context of an experimental study or in cases of compassionate use with no other available forms of effective pain relief.

Objective To compare the safety and efficiency of endoscopic total extraperitoneal patchplasty(TEP)and modified Kugel hernioplasty for inguinal hernia.Methods The clinical data of 284 cases(312 surgeries)of preperitoneal inguinal hernia repair,including 134 cases(152 surgeries)of TEP and 150 cases (160 surgeries)of modified Kugel hernioplasty,were retrospectively evaluated from June 2009 to June 2011.Mean operative time,postoperative hospital stay,postoperative complications and recur-rence were compared between groups.Results There were no significant differences in mean operative time [(48.75 ±12.14)min vs(51.46 ±24.76)min,P=0.248],postoperative hospital stay [(5.23 ± 1.85)d vs(5.84 ±1.52),P=0.126],postoperative complications [5 cases(3.3%)vs 8 cases(5.0%), P=0.598]and recurrence [1 case(0.7%)vs 2 cases(1.3%),P=1.00]between TEP and modified Kugel hernioplasty,espectively.Conclusion TEP and modified Kugel hernioplasty are both methods for preperitoneal hernia repair and they can completely repair the defect of myopectineal orifice.They are safe and effective,which is worthy of being spread in clinical practice.

[Objective]To discuss the diagnosis and surgical management of lumbar degenerative juxtafacet joint cysts. [Methods]From June 2004 to June 2007,seven patients were diagnosed as degenerative juxtafacet joint cysts and were treated by surgery. The authors made a retrospective analysis on the clinical data of these 7 patients. Among these 7 patients,there were one as ligamentum flavum cyst and six as facet joint cysts. Five lesions were located at the L4、5 level and two were located at the L5S1 level. According to the preoperative lateral films and CT scan,segment instability were found in two patients. Fenestration decompression,resection of cyst and 1/3 medial articular process were performed on five patient without preoperative segment instability,while additional posterior fixation and posterolateral fusion were done to two patients with preoperative segment instability.The mean length of follow up were 14 months (range: 9~24 months ). The VAS score and ODI score were used for clinical outcome assessment.[Results]The pathological results confirmed the preoperative radiological diagnosis in all patients. Improvement were found in all patients,including completely recovery in five patients and significant relief of pain in other two patients.[Conclusion]Lumbar degenerative juxtafacet joint cysts has been proved to be a cause of low back pain. Preoperative CT scan and MRI are helpful in the diagnosis and the clinical outcome of surgery is satisfactory.

34 patients who suffered from NVG, excluding patients with shallow anterior chamber.All patients were assigned to groups A and B according the different therapy.Group A ( 15 eyes ) was treated with Ex -PRESS glaucoma filtration device implantation. Group B ( 19 eyes ) underwent a trabeculectomy combined with mitomycin C. All the patients were followed up to 1a.The results of best-corrected visual acuity ( BCVA ) , intraocular pressure ( lOP ) , the combination of lOP lowering medications, complications were recorded statistically analyzed preoperative and 1d, 1, 4wk, 6 and 12mo after operation. · RESULTS: Mean lOP decreased significantly frompreoperative values in both groups ( P=0.01 ) .The both group had similar lOP values changes after 1, 4wk, 6, 12mo, and there were no significant difference in statistics (P=0.451).There was no significant difference in BCVA changes after operation in both groups ( P =0.832).Success rate was 66.7%and 63.1%at 1a after Ex-PRESS glaucoma filtration device and trabeculectomy, respectively. Anterior chamber bleeding occurred to 8 cases after trabeculectomy in group B and to 3 cases with Ex-PRESS glaucoma filtration device implantation in group A.Choroidal detachment occurred to 3 cases in
group A and 6 cases in group B. No other ocular or systemic adverse events were found during the follow-up duration.
·CONCLUSlON:ln the short-term, Ex-PRESS glaucoma filtration device implantation has the advantages of simpleness, safety, minimally invasive, short learning curve for neovascular glaucoma, which provides us an available strategy to conquer NVG by simply operation and less suffering.

AIM: To investigate therapeutic effects of combination therapy for neovascular glaucoma ( NVG) .
METHODS: This retrospective study comprised 34 eyes of 34 patients who suffered from NVG. All patients were assigned to group A, B, C and D according to the different combination therapies. Group A ( 11 eyes of 11 patients ) was treated with intravitreal injection of ranibizumab and panretinal photocoagulation ( PRP ) . Group B ( 10 eyes of 10 patients ) was treated with transcleral cyclophotocoagulation and PRP. Group C ( 6 eyes of 6 patients) was treated with 3 therapies together. Group D (7 eyes of 7 patients) was treated with 810nm transcleral cyclophotocoagulation and soft gas-permeable contact lenses. All the patients were followed-up for 1a. The best- corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) were recorded and analyzed prior to operation and 1, 4wk, 6 and 12mo after operation.
RESULTS: All the post treatment IOP decreased significantly ( P<0. 05 ) from the values before therapy, and the IOP values after 4wk, 6, 12mo were not significantly different ( P > 0. 05 ) in statistics. Most patients' IOP can be controlled below 23mmHg after combination therapy. The visual acuity in group A after 1, 4wk, 6mo compared with those before treatment was significantly increased ( P<0. 05 ) in statistics and other groups did not significantly change before and after treatment (P>0. 05). Anterior chamber bleeding occurred to 2 cases after 1wk of transcleral cyclophotocoagulation. No other ocular or systemic adverse events were found during the follow-up duration.
CONCLUSION: After the combination of intraocular injection of the anti - VEGF drugs, 810nm laser cyclophotocoagulation and PRP, most patients with NVG disease can be effectively treated, can effectively control IOP, and retain part of the visual function, significantly improve the quality of life. In the short - term, combination therapy is safe and effective for NVG, which provides us an available strategy to conquer NVG by simply programmable operation and less suffering.

Afferent Pathways ; drug effects ; Animals ; Freund's Adjuvant ; adverse effects ; Ganglia, Sensory ; drug effects ; Hyperalgesia ; chemically induced ; Inflammation ; Male ; Morphine ; pharmacology ; Rats ; Rats, Sprague-Dawley

40/h) and non-severe group(n=15,AHI 5-40/h).Anthropometric measurements,fasting plasma glucose,insulin,blood fat,and CT quantitative measurement of abdominal adipose tissue were recorded. Results Insulin resistance index(HOMA-IR) in patients with OSAS was related to hypoxia independently of obesity variables.The severe group was characterized by more serious metabolic disorders and higher prevalence of metabolic syndrome than the non-severe group.OSAS was positively associated with an increased metabolic disorders risk for the severe group versus the non-severe group(OR=8.8).Using the receiver operating characteristic(ROC) curve analysis,waist circumference had the greatest areas under the ROC curves compared with body mass index and neck circumference.The results of multiple stepwise regression of lowest pulse oxygen saturation(LSpO2)during overnight sleep indicated that neck circumference followed by epworth sleepiness score(ESS) entered the equation(P

Objective:To explore the effects of dexmedetomidine on the blood glucose,tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6) in perioperative patients with neurosurgery.Methods:50 patients with meningioma who were ready to accept craniotomy in department of neurosurgery of our hospital from February 2016 to November 2016 were enrolled,they were randomly divided into research group and control group,with 25 patients in each group.The research group was given DEX 1.0 μg/kg at 10 min before anesthesia,which was added in 0.9％ sodium chloride injection 50 mL,the injection was finished in 10 min,then the DEX change to the rate of 0.5 μg/kg/h.Control group was given 0.9％ sodium chloride injection with constant rate and volume.Record heart rate (HR),mean arterial pressure (MAP) and blood glucose,serum TNF-α,IL-6 levels of the two groups at 10min before anesthesia(T1),after the anesthesia (T2),the beginning of surgery(T3),1 hour after the surgery beginning(T4),the end of surgery(T5).Results:Compared with T1,HR of the two groups at T2 and T3 raised significantly,but research group was lower than control group(P＜0.05);In research group,compared with T1,MAP at T3 raised significantly;in control group,compared with T1,MAP at T3 and T4 raised significantly,but MAP of research group at T3 and T4 were lower than control group (P＜0.05).Compared with T1,blood glucose of the two groups at T2,T3,T4 and T5 raised sig-nificantly,but the research group at same points were lower than control group (P＜0.05).Serum TNF-α,IL-6 levels of control group at T2,T3 and T4 were significantly higher than T1 (P＜0.05),which in research group at different time points had no significant change (P＞0.05),and were lower than control group at T2,T3 and T4 (P＜0.05).Conclusion:DEX could maintain stable hemodynamics,antiinflammation,inhibit elevated blood glucose,so as to reduce the inflammatory response and stress response in patients with neurosurgery,then it could promote these patients postoperative recovery.

Objective: To investigate limonoids in the seeds of an Indian mangrove, Xylocarpus moluccensis. Methods: Compounds were isolated and purified by silica gel, ODS gel column chromatographies, and HPLC. The structures of the obtained limonoids were identified by NMR spectra and ESI-MS. Results: Eighteen limonoids, such as fissinolide (1), 3-propanoylproceranolide (2), 3β- hydroxyangustidienolide (3), 3β-acetoxy-6-deoxy-swietenine (4), febrifugin (5), granatumin I (6), 3-de(2-methylbutanoyl)-3- propanoylcipadesin (7), granatumin H (8), tigloylseneganolide A (9), ruageanin A (10), swietemahonolide (11), khayasin T (12), andhraxylocarpin D (13), granatumin D (14), 7-oxo-7-deacetoxygenunin (15), gedunin (16), methyl angolensate (17), and 20,21,22,23- tetrahydro-23-oxoazadirone (18), were isolated and identified. Conclusion: 3-propanoylproceranolide (2) is a new compound, and compound 3 is a new natural product.