Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.

BACKGROUND:Titanium-niobium al oy holds high biomechanical strength and low elastic modulus that is close to the human cortical bone, so it has been extensively used as implant materials of dental, orthopedics and artificial hip joints. OBJECTIVE:To observe the biomechanical strength and cytocompatibility of porous titanium-niobium al oys with different porosities. METHODS:Porous titanium-niobium al oys with the porosity of 40%and 70%were prepared using powder metal urgy technology. Afterwards, the pore size, elasticity modulus and compressive strength of the two al oys were detected. Then the rabbit bone marrow mesenchymal stem cel s were seeded onto the 40%and 70%porous titanium-niobium al oys, and cel adhesion and proliferation were observed at 3, 24 and 72 hours after inoculation, respectively. RESULTS AND CONCLUSION:Pore size of porous titanium-niobium al oys with rough surface was 200-500μm, and both main pore size was 350 and 400μm, and there was three-dimensional connectivity between the pores;in the 70%group, honeycombed pores were partly fractured, and connected mutual y;pores distributed unevenly and there was little communication between the pores in the 40%group. In addition, both groups had high compressive strength and low elastic modulus, but there was no difference between the two groups. Furthermore, both two al oys promoted cel adhesion, and the number of cel adhesion in the 70%group was significantly higher than that in the 40%group (P<0.05), and extracel ular matrix could be found in the 70%group. These results show that porous titanium-niobium al oy with the porosity of 70%is significantly conducive to cel adhesion.

OBJECTIVETo study effects of autogenous femoral head bone grafting combined with total hip replacement for the treatment of old center dislocation of hip joint, and to evaluate the superiority of acetabular defect reconstruction with autogenous bone.

METHODSFrom March 2008 to December 2013, 16 patients (16 hips) with old center dislocation of hip joint were treated with autologous bone graft combined with total hip replacement. There were 11 males and 5 females, ranging in age from 41 to 72 years old, with an average of 56.3 years old. The duration of the disease ranged from 3.6 to 37.2 years. Twelve patients had injuries caused by traffic accidents and 4 patients were caused by falling down. The hip joint pain at the first month after operation, Harris score and hip joint movement of all patients were observed by using electronic case follow-up system.

RESULTSAll the patients were followed up, and the duration ranged from 11 to 78 months, with an average of 27.3 months. The postoperative hip joint movement of (56.2±23.4)° VAS 86.3±7.2 and Harris score 32.6±12.6 were all better than preoperative (181.8±17.6)°, 11.1±2.6 and 86.3±7.2. The joint pain was reduced and the function limitation was improved after operation, and the prosthesis position was good.

CONCLUSIONWhen the autologous femoral head bone grafting combined with total hip arthroplasty is used to treat old hip central dislocation, the initial and long-term stability of acetabular bone grafting is good, and the technique can avoid allogeneic bone complications, bone source rationally and reduce the economic burden of patients.

Adult ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femur Head ; transplantation ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Transplantation, Autologous

Animals ; Dental Implantation, Endosseous ; adverse effects ; Dental Implants ; adverse effects ; Dental Prosthesis, Implant-Supported ; adverse effects ; Dentition ; Humans ; Malocclusion ; etiology ; Maxillofacial Development

Aging ; Cytoskeleton ; Endothelium ; Humans ; Research

A number of studies have shown that migraine, particularly migraine with aura, has certain correlation with stroke.However, their related potential mechanism remains unclear. Migraine may be a cause and/or a risk factor for stroke. Stroke may cause the occurrence of migraine, and it may also be a disease with two clinical manifestations.

[Objective]To evaluate the feasibility of repairing cartilage defect with tissue-engineered cartilage ,which was made of chondrocytes and osteoblast seeded onto a biodegradable porous bioceramic ?-tricalcium phosphate (?-TCP).[Method] A porous bioceramic template of ?-TCP was created in the shape of a circular cylinder. Chondrocytes and osteoblasts induced from dog bone marrow stem cells were seeded onto the ?-TCP and then kept them growing together for 1 week prior to transplantation into the cartilage defects. After 12 , 16 weeks ,the specimens were harvested and examined macroscopically, histologically and immunohistochemically. [Result] Gross morphological and histological analysis of the specimens from the ?-TCP complex demonstrated new cartilage construction. The result was better than that in control group. [Conclusion] These findings suggest that porous bioceramic (?-TCP) is a good "matrix" for chondrocytes and osteoblasts, and can be used for cartilage engineering.

Background Light leads to the damage of retinal function and structure by promoting the reproduction of radicals and lipid peroxides when retina is exposed to an intense light environment for a long time.It is necessary to study how to protect the retina against light-induced injury in ophthalmology.Objective The aim of this study was to evaluate the effect of anthocyanidin extracts in preventing retinal photic damage.Methods Eighteen clean male Sprague-Dawley (SD) rats were randomly assigned to normal saline group,anthocyanidin group and mixed (hydrogen-rich saline (HRS) + anthocyanidin,1:1 in volume) group and 6 rats for each.The electroretinogram (ERG) with international standardized 5 items was recorded from all the rats before experiment.Normal saline,anthocyanidin extracts or mixed solution of 5 ml/kg were intraperitoneally injected in the three groups,respectively,for consecutive 5 days.Then the diffused light with the luminance intensity of (5000±300)lx was used to irradiate the right eyes of the rats for consecutive 3 hours during 19:00 through 7:00 in a device made by our laboratory,and the left eyes were covered at the same time.The ERG was repeatedly recorded 5 days after light irradiation.The rats were sacrificed at the end of the experiment and retinal sections were prepared for the histopathological examination.The functional and structural changes of retinas were compared among the different groups.The use of the rats followed the Statement of ARVO.Results The differences of rat body weight were not statistically significant among the three groups (before experiment:F =0.472,P =0.841 ; after experiment:F =0.658,P=0.762).No any significant difference was found in scotopic 0.01 ERG b wave,scotopic 3.0 ERG a and b waves,scotopic 3.0 oscillatory potentials,photopic 3.0 ERG b wave and 3.0 flicker P1wave between the left eyes and the right eyes in the three groups before experiment (P＞0.05).The amplitudes of various waves of ERG were significantly declined in the right eyes compared with the left eyes (P＜0.05).The mean differential values of scotopic 0.01 ERG b wave,scotopic 3.0 ERG a and b waves,scotopic 3.0 oscillatory potentials were significantly different(F =4.594,P=0.029; F=3.834,P=0.037; F=12.823,P=0.000; F=3.976,P=0.032),but those in photopic 3.0 ERG b wave were not statistically significant (F =1.488,P =0.259).Compared with the normal saline group,the differential values of scotopic 0.01 ERG b wave,scotopic 3.0 ERG a and b waves,scotopic 3.0 oscillatory potentials were all reduced in the anthocyanidin group and mixed group (P ＜ 0.05).The cells of outer nuclear layer were decreased in the right eyes in the three groups compared with the left eyes,especially around the optic nerve head and the upside of the retina,with significant differences between them (P＜0.05),and those in the anthocyanidin group and mixed group were significantly less than normal saline group (P＜0.05).Conclusions Anthocyanidin has a protective effect on light-induced retinal damage of SD rats.The protective effect of anthocyanidin extracts is similar to the integrated effect of the mixed group.

Objective To observe pathological process of intestinal epithelial cells subjected to ischemia,ischemia/reperfusion injury and inflammation simulated hypoxia/reoxygenation (H/R) and lipopolysaccharide (LPS) challenged human fetal normal colonic cell (FHC) line in vivo,and to observe the changes when the assaulted intestinal epithelial cells were treated with emodin,in order to explore the possible intervention targets of emodin.Methods Normoxia group:the FHC cells were cultured in 95％ air and 5％ CO2 at 37 ℃.Hypoxia (H) group:the cells were cultured with a mixed anaerobic gas of 1％ O2,5％ CO2 and 94％ N2 at 37 ℃ for 1,2,3,4 hours.H + LPS group:the cells were cultured in hypoxic condition as H group with simultaneous challenge of LPS (1 mg/L).H/R group:the cells were cultured in hypoxia for 3 hours followed by reoxygenation for 1,2,3 and 4 hours,respectively.H/R + LPS group:the cells were cultured in H/R as H/R group and LPS (1 mg/L) simultaneously.Emodin intervention group:the cells were cultured in H3 h/R2 h + LPS and emodin (20,40,60,80 μmol/L) simultaneously.The variation trends of phosphorylation nuclear factor-κB profilin-o (pIκB-α),phosphorylation NF-κBp65 (pNF-κBp65) and their downstream target gene cyclooxygenase-2 (COX-2),and hypoxia-inducible factor-1α (HIF-1 α) were determined by Western Blot.The morphological changes in intestinal epithelium in different groups were observed using light microscope.The effect of emodin on the proliferation of intestinal epithelial cell was measured by methyl thiazolyl tetrazolium (MTT) assay.Results ① H group:the expressions of pIκB-α,pNF-κBp65 and COX-2 were upregulated,peaking at H1 h (0.350 ± 0.018,1.083 ± 0.054,0.903 ± 0.045),and then they gradually lowered (F value was 3.011,7.247,5.754,P value was 0.013,0.000,0.005,respectively).The expression of HIF-1 α peaked at H3 h (1.511 ± 0.076),but there was no significant difference among different groups (F=1.881,P=0.062).H + LPS group:the expressions of pIκB-α,pNF-κBp65,COX-2,HIF-1α were increased with elongation of duration of hypoxia,and a maximal induction was observed at H3 h (0.504 ± 0.025,1.255 ± 0.063,0.812 ± 0.041,1.209 ± 0.075,F value was 2.683,8.774,9.765,2.432,and P value was 0.011,0.000,0.000,0.026,respectively).H/R group:with the prolonged duration of reoxygenation,the expressions of NF-κB signaling pathway proteins (pIκB-α,pNF-κBp65,COX-2) were decreased and dropped to nadir at H3 h/R4 h (0.712 ± 0.034,1.202 ± 0.048,0.691 ± 0.042,F value was 1.923,6.765,2.719,and P value was 0.063,0.000,0.016,respectively).Compared with H group,HIF-1α was decreased with a prolonged duration of reoxygenation in H/R group,but there was no significant difference in value among different time points (F=1.280,P=0.081).H/R + LPS group:pIκB-o,pNF-κBp65,COX-2,HIF-1α showed no sign of degradation with the prolonged duration of reoxygenation,and their expression increased to maximum analogously at R2-3 h (3.302 ± 0.061,2.315 ± 0.055,2.017 ± 0.043,2.413 ± 0.098,Fvalue was 4.614,1.652,5.970,2.076,and Pvalue was 0.001,0.067,0.000,0.037,respectively).Emodin group:emodin when co-treated with H/R + LPS inhibited the expression of HIF-1o and NF-κB pathways with a dose-effect relationship (P＜0.05 or P＜0.01).Emodin at the dose of 80 μmol/L showed most marked inhibition (2.599 ± 0.130,1.772 ± 0.089,2.590 ± 0.129,2.518 ± 0.125).However,after treatment of emodin did not show such effect.② After treatment with H/R + LPS,there were morphological changes in cells:vacuoles,deformation and fusion.The speed of cell growth became much slower compared with H group.③ Emodin (20-80 μmol/L) had no significant effect on cell proliferation.Although emodin produced biological effect in this concentration range,it had no cellular toxicity.Conclusions Both hypoxia and inflammation can activate the hypoxia pathway of HIF-1α and the pro-inflammatory pathway of NF-κB,but different stimuli cause varying degrees of activation in these two pathways.In H/R group,both pathways were weakened during reoxygenation.However,in H/R + LPS group,the proteins remained to show a relatively high expression during the process of reoxygenation.This may be related to the pathophysiological mechanism of intestinal ischemia/reperfusion injury:hypoxia/reperfusion injury and LPS act together to destroy the intestinal epithelial cells and induce gut-derived sepsis.Emodin may inhibit inflammation by blocking HIF-1α/NF-κB-COX-2 signaling pathways.

Objective: To investigate the effects of fibrin glue(FS) and glutamine(Gln) on the healing of colon anastomoses after immediate postoperative intraperitoneal administration of 5-fluorouracil.Methods: Thirty two female Wistar rats were randomized into four groups.After resection of a 1-cm segment of the transverse colon,an end-end sutured anastomosis was performed.Then the rats were divided into control group,5-FU group,FS group,and Gln group.All rats were killed on the 8th postoperative day and the anastomoses were examined microscopically.The bursting pressure measurements were recorded and anastomoses were graded histologically.Results: The adhesion formation score was significantly higer in the rats of the 5-FU group than in the other groups.Bursting pressures were also significantly lower in the 5-FU group than in the other groups.Conclusion: The immediate postoperative intraperitoneal administration of 5-FU inhibited wound healing.However,FS and Gln can improve early healing of colon anastomoses after immediate postoperative intraperitoneal administration of 5-fluorouracil.