The anatomy and position of choledocho-pancreatico-duodenal junction are unique,so choledocho-pancreatico-duodenal junction is easily be injured during operation,and thus it needs further investigation.Anatomical,pathological and iatrogenic factors are the 3 main causes of choledocho-pancreatico-duodenal junction injury.The diagnosis of choledocho-pancreatico-duodenal junction injury includes intraoperative and postoperative diagnosis; and the treatment methods include intraoperative repaire and suture,T tube drainage,postoperative debridement and drainage,biliopancreatic shunt,duodenal diverticulum,jejunum stoma,gastrointestinal and biliary reconstruction.Precise operation,T tube cholangiography,choledochoscopy can effectively prevent the choledocho-pancreatico-duodenal junction injury.The principle of early discovery,early management,avoiding over-management,and promoting damage control surgery should be awared to reduce the mortality.

Objective To improve the quality of medical image and enhance the image in range of frequency area.Methods Images were enhanced by adopting the arithmetic of Laplacian and Sobel,and using image multiplication and addition.The effects were compared.Results After being transformed in Laplacian,the interior frame of original image turned to be obvious and the original image was led into much noise simultaneously.In comparison with the former one,the image would be more smooth after being transformed by Sobel.Treated by average filter,the influence of noise and tiny detail would be reduced.Conclusion The toolbox of Matlab can simplify the program work,which provides a method for medical image processing.

Hepatocellular carcinoma (HCC) in nonimpaired livers are a type of HCCs arising in non-cirrhotic,non-fibrotic livers without viral hepatitis or alcohol abuse.Liver resection is the major form of treatment.Factors considered when developing a prognostis include R0 liver resection,hepatocellular function,recurrence,vascular invasion,transfusion,tumor size,tumor number,tumor capsule,and daughter nodules.So the prognosis can be predicted through the analysis of these factors during preoperative and perioperative period. The curative effects of the operation can be enhanced by optimizing treatment based on the analysis of these prognostic factors.

Objective To explore the comparison of efficacy of Salmeterol assigned powder inhaler and Aminophylline Tablets treating female COPD with remission.Methods Selected in remission of COPD in female patients of 114 cases.With digital method were divided into observation group and control group with 57 cases in each group.The observation group inhaled salmeterol and fluticasone propionate powder,while the control group oral amin-ophylline tablets for treatment.Effect and Lung function index,such as IC,FEV1 ,FVC,FEV1 % etc.were compared between the two groups after the treatment.Results The observation group treatment effects achieved significantly accounted for 47.37% (27 /57),which was significantly higher than 26.32% (15 /57)in control group,and the total effective rate of the observation group was higher(χ2 =4.150,P =0.042).In addition,the IC,FEV1 ,FVC,FEV1 %index increased significantly in the observation group after treatment,and the TDI,6MWD was also higher.The difference was statistically significant (t =5.077,4.746,P =0.000,0.000).Conclusion Salmeterol and fluticasone propionate inhalation and aminophylline tablets in the treatment of female remission of COPD showed a high efficient results,but the relative effect of salmeterol and fluticasone propionate inhalation therapy effect is better,the degree of dyspnea alleviated better.

Facial Paralysis ; pathology ; Humans ; Tympanoplasty ; adverse effects

Objective: To comprehensively evaluate the different passivation materials on growth and cadmium uptake and accumulation of Ophiopogon japonicus cultivated in cadmium contaminated soil of. Methods: Using one-year-old O. japonicus as experimental material, the effects of five different passivation materials (white marble Ar, straw biochar Br, fly ash Fh, bacterial residue Me, diatomite Dm) on the growth, physiological and biochemical indexes and cadmium absorption and accumulation of O. japonicus were studied by soil pot experiment. Results: The biomass, chlorophyll, soluble sugar and soluble protein of O. japonicus could be significantly increased in soils contaminated with two kinds of Cd under different passivation materials. Among them, Ar and Me were the most improved. In addition, the activities of antioxidant enzyme system of O. japonicus were significantly decreased, and the content of MDA had no noteworthy change. Different passivation materials remarkably increased the content of flavonoids in the underground part of O. japonicus, among which Ar and Fh treatments increased the most. The contents of heavy metal Cd in all parts of O. japonicus were decreased by different passivation materials, and the contents of Cd in aboveground and underground parts of O. japonicus were significantly lower than those of the control, and the effects of Ar, Br and Fh treatments were better than those of the control. Conclusion: Studies have shown that by combining and comparing treatments of different passivating materials, in terms of the biomass of O. japonicus treated with Me, the biomass improvement effect of Me was better than that of Ar and Br. Aiming at the effect of reducing Cd absorption and accumulation of O. japonicus and improving the effective component flavone of O. japonicus, it can be concluded that Ar and Fh have better effects in treating Cd polluted soil and improving the quality of O. japonicus.

Objective To study the relation between coagulation-fibrinolysis and metastasis, hormone receptor and TNM stage of breast cancer. Methods The plasm levels of six coagulation-fibrinolysis indexes of 30 breast cancer patients were tested, which included activated partial thromboplastin time(APTT), fibrinogen(FIB), D-dimer(D-Di), tissue type plasminogen activator (t-PA)and plasminogen activator inhibitor-1(PAI-1). Statistic analysis of the relation between the changes of these indexes and metastasis, hormone receptor and breast cancer cell proliferation was performed. Results There were statistically significant differences between the malignant and benign breast disease in FiB(3.05±0.44)g/L vs(3.39±0.52)g/L(P＜0.05),D-Di(0.27±0.06)μg/ml vs(0.36±0.16)μg/ml(P＜0.05) and PAI-1(26.14±3.30)ng/ml vs(34.59±3.68)ng/ml (P＜0.01). The levels of plasma FIB (3.70±0.47)g/L and PAI-1 (37.36±2.71)ng/ml in metastasis group were higher than those in the non-metastasis group (P＜0.01). Significantly higher levels of PAI-1(36.40±3.57)ng/ml(P＜0.05)in expression of Ki67≥30% in the patients with lymph node involvement were seen. Conclusion Coagulation-fibrinolysis indexes were related to the proliferation, invasion, metastasis and clinical stage of breast cancer and it can serve as an important marker for predicting breast cancer's biological behavior and prognosis.

Objective The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course,but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates.Methods Coronary angiographies of 3368 patients were selected to assess thrombolysis in myocardial infarction (TIMI) frame count (TFC) values.Seventy eight of them had CSFP,and their demographic and laboratory findings were compared with 61 patients with normal coronary flow.Results Patients'demographic characteristics were similar in both two groups.Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (P ＜ 0.001).Furthermore,hematocrit and hemoglobin values,and eosinophil and basophil counts of the CSFP patients were significantly elevated compared with the values obtained in the control group (P =0.005,P =0.047,P =0.001 and P =0.002).The increase observed in hematocrit and eosinophil levels showed significant correlations with increased TFC values (r =0.288 and r =0.217).Conclusion Significant changes have been observed in the cellular composition of blood in patients diagnosed with CSFP as compared to the patients with normal coronary blood flow.The increases inhematocrit levels and in the eosinophil and basophil counts may have direct or indirect effects on the rate of coronary blood flow.

Objective To analyze the outcomes of frozen-thawed blastocyst and cleavage embryo transfer after whole embryos cryopreservation. Methods The data of 489 IVF-ET cycles in reproductive medicine center of our hospital from September 2012 to August 2013 were analyzed retrospectively. Whole embryos cryopreservation in 214 patients were carried out with vitrification method and served as group A , 275 cycles performed fresh embryo transfer were served as group B. Then group A and group B were subdivided into group A1 (83 cycles),group A2 (131 cycles), group B1 (120 cycles)and group B2 (155 cycles)according to blastocyst transfer or cleavage-stage embryo transfer. The clinical outcomes of all groups were compared each other. Results The pregnancy rate and embryo implantation rate in group A1 were significantly higher(71.1% ,53.0%)than those in group A2, B1 and B2 (A2 group: 57.3%, 34.0%, B1group: 55.0%,42.1%, B2 group: 52.9%, 32.7%,respectively)(P<0.05). The embryo implantation rate in group B1 were higher than those in group B2 (P < 0.05). Conclusion F-ET after whole embryos freezing could significantly improve the embryo utilization rate and clinical pregnancy rate. Frozen-thawed blastocyst transfer could get better clinical outcomes than frozen-thawed cleavage-stage embryo transfer.

Objective To observe the clinical effects of sufentanil combined with sevoflurane for anesthesia induction in the elderly.Methods A total of 84 patients undergoing elective laparoscopic were randomly divided into 4 groups by dose of Sufentanil (21 cases,each):0.25,0.50,0.75 and 1.00 μg/kg sufentanil.Mean arterial pressure (MAP)and heart rate (HR)were measured at baseline (To),immediately before intubation(T1),immediately,1,3 and 5 min after intubation(T2-5).Intubation scores were also recorded.Results The intubation scores including visual analogue score (VAS) and Ramsay score at 10 min,30 min and 60 min after tube drawing were as the following sequence:1.0 μg/kg ＞ 0.75 μg/kg ＞0.5 μg/kg ＞ 0.25 μg/kg sufentanil (F =5.78.P＜ 0.05).Compared with T0,MAP and HR decreased in each group at T1,while increased at T2 in group A (P＜0.05).As compared with T0,MAP was decreased and HR was slower at T1 in the 4 groups (F=34.99,P＜0.05),but MAP level was increased in 0.25 μg/kg sufentanil group at T2 (F=12.48,P＜0.05).Compared with group of 0.25 μg/kg sufentanil,MAP was reduced in 0.75 μg/kg and 1.00 μg/kg groups at T4 andT5 (F =6.98,6.25,P＜0.05).MAP was also lower in 0.75μg/kg and 1.00μg/kg groups than in 0.50 μg/kg sufentanil group at T2-T5(F=7.08,20.56,P＜0.05).Conclusions Sufentanil of 0.25 0.50 μg/kg combined with sevoflurane can provide excellent intubating conditions and stable hemodynamics during anesthesia induction in patients undergoing gynecologic surgery.