This paper discusses variations of laparoscopic transgastric cystogastrostomy in management of retrogastric pancreatic pseudocysts for 8 patients with symptom or pseudocysts (larger than 6 cm) companied with clinical manifestations.Using a Harmonic scalpel,two 3-5-cm incisions were made in the anterior and posterior gastric wall respectively.In the last step,the anterior gastrotomy was closed with an Endo-GIA stapler.All cases were successfully treated without large blood loss and without conversion to open surgery.The mean operative time was 114.29±19.24 min,blood loss was 157.14±78.70 mL,and mean hospital stay was 8.29±2.98 days,Gastric fistula occurred in one case on the postoperative day 7,and closed 1 month later.No bleeding was seen in all patients during the perioperative follow-up period.CT scans,given one month after the surgeries,displayed that the pancreatic pseudocysts disappeared or decreased in size,and ultrasounds showed no fluid or food residue in stomas at the third and fifth month following surgery.No patient experienced a recurrence during the follow-up period.Transgastric laparoscopic cystogastrostomy is a minimally invasive surgical procedure with a high rate of success and a low rate of recurrence,accompanied by rapid recovery.It is easy to master,safe to perform and may be the preferred option to treat retrogastric pancreatic pseudocysts.

Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.

AIMTo investigate the roles of serotonergic neurons in dorsal raphe nuclei (DRN) in sleep.

METHODSStereotaxic, microinjection and polysomnography (PSG) were used in the experiment.

RESULTSMicroinjection of L-glutanate (L-Glu) into the DRN decreased slow wave sleep (SWS) and paradoxical sleep (PS), and increased wake (W). Microinjection of kainic acid (KA) and p-chlorophenylalanine (PCPA) respectively into the DRN, SWS and PS were promoted, and W was reduced.

CONCLUSIONSerotonergic neurons in dorsal raphe nuclei involved in the regulation of sleep. Sleep was reduced when the serotonergic neurons were excited, and when the neurons were inhibited. sleep was increased

Action Potentials ; Animals ; Male ; Neurons ; physiology ; Polysomnography ; Raphe Nuclei ; physiology ; Rats ; Rats, Sprague-Dawley ; Serotonin ; physiology ; Sleep ; physiology

Dengue ; epidemiology ; Dengue Virus ; genetics ; isolation & purification ; Evolution, Molecular ; Genes, Viral ; Humans ; Viral Envelope Proteins ; genetics

Objective: To evaluate the method and curative effect of plate fixation or percutaneous screws for the treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ via a minimally invasive sinus tarsi incision combined with a variety of manipulative reduction methods. Methods: Twenty-one patients with closed calcaneal fractures treated in the Department of Orthopedics, the First Affiliated Hospital of Nanchang University from January 2014 to January 2016 were collected. There were 15 men and 6 women, with an average age of 39.3 years(from 25 to 63 years). According to the Sanders classification, 16 cases were type Ⅱ and 5 were type Ⅲ.All cases were treated with internal fixation with plate and percutaneous screws via the mini-open sinus tarsi approach following reduction of the posterior articular surface of the subtalar joint and calcaneal length, width and height.Statistical analysis was performed on calcaneal width and Böhler angle, Gissane angle preoperatively and postoperatively (3 days and 3 months). All data were analyzed by ANOVA, functional recovery was evaluated according to the Ankle and Hind-foot Score of American Orthopedic Foot and Ankle Society (AOFAS). Results: Twenty one patients were followed up for a mean duration of 13.4 months(6 to 24 months). All cases gained primary incision healing, without complications such as skin necrosis, wound infection, tenosynovitis of peroneus longus and brevis muscles, or fracture displacement and hardware failure.Bone union was achieved at an average of 10.5 weeks(9 to 11 weeks). No obvious malunion occurred by the last follow-up. Compared to preoperative, calcaneal width(F=25.62, 38.90) were significantly improved 3 days and 3 months after surgery, Böhler angle(F=440.24, 272.42) and Gissane angle(F=91.86, 43.74) were normal, the differences were statistically significant (all P<0.05). Compared to 3 days after surgery, calcaneal width, Böhler angle and Gissane angle kept normal 3 months after surgery, there were no statistically differences (F=0.26, 1.35, 2.60, all P>0.05). By the AOFAS scoring, 10 cases were rated as excellent, 7 were good and 4 were fair. Conclusions Fixation with plate and percutaneous screws via the mini-open sinus tarsi approach is an effective treatment for Sanders types Ⅱ and Ⅲ calcaneal fractures, which with the advantages of small wound, simple operation, reliable fixation, no incision complication, especially suitable for elderly patients and the patients with severe injury of local soft tissue.

Objective To analyse the prognostic factors and the neck treatment strategy of early tongue squamous cell carcinoma (SCC). Methods Total of 152 cases of early tongue SCC underwent surgery between January 1994 December 2003 were reviewed. The patients, according to their neck managements, were divided into two groups, or wait-whach group (n = 32) and neck dissection group (n =120) ,and the neck dissection group was subdivided into supraomohyoid neck dissection (SND) group and comprehensive neck dissection(CND) group (including radical neck dissection and modified radical neck disssection). Results All patients were followed up over 5 years or until death and the 5-year follow-up rate was 94. 7%. The regional recurrence rates of wait-whach group and neck dissection group were 34. 4% and 14. 2% respectively (χ2 = 6. 865, P < 0. 01) and 5-year overall survival rates of the two groups were 68% and 79% respectively (χ2 = 1. 699, P > 0. 05). There were no significant difference in the regional recurrence rate or 5-year survival rate between SND group and CND group (P > 0. 05). The patients with pathologically node positive had a low 5-year survival rate compared to those with node negative. The patients with regional recurrence had a significant low 5-year survival rate compared to patients without regional recurrence (P<0.01). Conclusions Occult lymph node metastasis and regional recurrence were important prognostic factors for early tongue cancer. Supraomohyoid neck dissection can not improve the 5-year survival rate, but significantly reduce the rate of neck recurrence. The results suggest that the selective neck dissection for ipsilateral level Ⅰ - Ⅲ should be applied to the patients with early tongue carcinoma which does not cross the midline.

OBJECTIVETo analyze the surgical strategy and result of one-stage repair for congenital aortic arch disease associated with other cardiac anomalies.

METHODSBetween April 1993 and November 2009, 25 consecutive patients aged 26 d to 6.5 years underwent one-stage repair for congenital aortic arch disease with other cardiac anomalies. Among them, 6 patients had coarctation of aorta, 6 patients had interrupted aortic arch, and 13 cases had hypoplasia of aortic arch. The surgical techniques include excision of the anterior wall of pulmonary artery, resection of patent ductus arteriosus tissue, aortic arch reconstruction with autologous pulmonary artery wall, reconstruction of the pulmonary artery and repair of the associated defects.

RESULTSTwenty-four patients survived and recovered uneventfully. One patient died of pulmonary hypertension crisis in hospital. The reconstruction of the aorta and the correction of the intracardiac anomalies were proved by postoperative echocardiography and CT scan. There were no neurological or other complications. The follow-up showed that all patients developed normally and there were no restenosis of the aorta arch.

CONCLUSIONSWith the benefits of growth potential and less tension, autologous pulmonary artery tissue is an optimal choice in aortic arch reconstruction. One-stage repair of congenital aortic arch disease associated with other cardiac anomalies can achieve good results.

Aorta, Thoracic ; abnormalities ; surgery ; Aortic Coarctation ; complications ; surgery ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; complications ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Pulmonary Artery ; transplantation ; Retrospective Studies ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVETo investigate the effects of modified vacuum sealing drainage (VSD) technique in treating refractory sinus in the lower leg.

METHODSFrom January 2010 to December 2011, 11 patients with refractory sinus in the lower leg, including 7 males and 4 females, with an average age of 34.5 years (ranged,23 to 56). These patients were treated with modified VSD technique after thorough cleaning sinus and continuous washing. After 14 to 21 days of treatment, removed VSD and re-debrided the sinus and sutured wound.

RESULTSInfections got control after operation, sinus in the lower leg healed. All patients were followed up from 6 to 14 months with an average of 10 months, no recidivations were found.

CONCLUSIONModified VSD technique is an effective method in the treatment of stubborn sinus in the lower leg.

Adult ; Drainage ; methods ; Female ; Fracture Fixation, Internal ; adverse effects ; Humans ; Leg Bones ; injuries ; surgery ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Vacuum

In order to fabricate the HLA-DQA1 genotyping chip and develop an integrated, parallel technical platform to type HLA system, a pair of primers and a set of probes were designed according to the sequences of HLA-DQA1 exon 2, where the polymorphism is concentrated. The oligonucleotide chip was made with the methods developed in our laboratory. The target DNA was asymmetrically amplified with the labeled sense primer. The signals were scanned and analyzed after the hybridization between microarray and PCR product. The allele types of the samples were identified. The result was verified by the standard DNA and DNA sequencing. The results showed that the genotyping was successfully carried out in 50 standard DNA samples and 50 clinical samples. Among them, results of the 50 standard DNA samples matched their templates. In the other 50 samples, results of the randomly selected 10 matched their sequencing results except that two of them got the incompletely result. In reproducible tests, the signal reappear rate was 95%. It is concluded that HLA-DQA1 genotyping by using our array system is simple and convenient with satisfied accuracy and reproducibility.
Genotype ; HLA-DQ Antigens ; genetics ; immunology ; HLA-DQ alpha-Chains ; Humans ; Oligonucleotide Array Sequence Analysis ; Oligonucleotide Probes ; Reverse Transcriptase Polymerase Chain Reaction

AIMTo screen swimming-fatigue related genes in mice and lay theoretic basis for researching the molecular mechanism of fatigue.

METHODS30 male BALB/c mice (20 +/- 2g) were divided into control group, dipping in water group and swimming-fatigue group respectively. After fatigue for swimming in swimming-fatigue group, with control group and dipping in water group, liver tissues in mice were collected. With improved silver staining mRNA differential display method, the differentially expressed genes in mice livers were screened and evaluated by reversed Northern blot. The positive segments were analyzed homology by BLAST.

RESULTS7 of DD-ESTs were gained. Two of them only expressed in swimming-fatigue group, two down-regulated expressed, and three up-regulated. One of them was a novel gene and was accepted by GenBank, AY615302.

CONCLUSIONSeven DD-ESTs in swimming-fatigue mice were gained by silver staining mRNA differential display method.

Animals ; Fatigue ; metabolism ; Gene Expression Profiling ; methods ; Liver ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Polymerase Chain Reaction ; methods ; RNA, Messenger ; genetics ; Silver Staining ; Swimming