Radical pancreaticoduodenectomy is the only effective method for the treatment of malignancies in the pancreatic head and the periampulary region.Early determination of the involvement of the superior mesenteric artery (SMA)is important for the selection of the surgical procedure and judgment of the prognosis.The operation should follow the principle of tumor-free and adequate resection range,safe resection margin and complete lymph node resection.For this purpose,we performed the radical pancreaticoduodenectomy via mesenteric approach.The SMA was dissected first,and then the tumor was en-bloc resected.From December 2011 to December 2012,24 patients with tumors in the pancreatic head or the periampullary region received radical pancreaticoduodenectomy via the mesenteric approach at the Second Affiliated Hospital of Harbin Medical University,and the short-term outcome was satisfactory.

OBJECTIVE: To investigate the effects of Xiehuo Bushen Decoction (XHBSD), a compound Chinese herbal medicine, on the survival and differentiation of transplanted neural stem cells (NSCs) in brains of rats with intracerebral hemorrhage, and to explore the mechanism of Xiehuo Bushen formula in promoting the survival of transplanted NSCs. METHODS: NSCs separated from hippocampuses of neonatal SD rats were cultured. Sixty-five panel reactive antibody (PRA) positive SD rats were selected by lymphocytotoxicity methods. The PRA positive rats were made into intracerebral hemorrhagic model and divided into three groups: cerebral hemorrhage group (n=15), NSCs transplanted group (n=25) and XHBSD group (n=25). XHBSD was orally administered after 5-bromodeoxyuridine (BrdU)-marked NSCs were transplanted in brains of rats with intracerebral hemorrhage in the XHBSD group. Rats in the other two groups were administered distilled water. The expressions of interferon gamma (IFN-gamma) and interleukin-4 (IL-4) mRNAs were measured by reverse transcription polymerase chain reaction (RT-PCR); the numbers of BrdU and 200 kD neurofilament (NF200) positive cells were detected by double-labeling immunofluorescence method. RESULTS: The expression of IFN-gamma mRNA was down-regulated significantly in the XHBSD group, but the expression of IL-4 mRNA was up-regulated significantly (P<0.05). The numbers of BrdU and NF200 positive cells were also increased remarkably in the XHBSD group. CONCLUSION: XHBSD can promote the survival and differentiation of transplanted NSCs, which may be related to inducing the expression of IL-4 mRNA and inhibiting the expression of IFN-gamma mRNA.

Objective To explore the expression of frizzled-7 and β-catenin proteins in hepatocellular carcinoma (HCC),and determine their relationship with clinicopathological features and prognosis.Methods Expression levels of frizzled-7 and β-catenin proteins were detected by the SP immunohistochemical technique in 64 cases of HCC and 15 normal liver tissues.Results Frizzled-7 and β-catenin proteins were found in 42 (65.6％) and 45 (70.3％) of tumor specimens respectively,which was significantly higher than that in normal liver tissues.The expression of frizzled-7 protein was significantly positively correlated with that of β-catenin (P ＜ 0.05) in HCC.The high expression of frizzled-7 was closely correlated to tumor size (P =0.014),histologic grade (P =0.020),portal vein tumor thrombus (P =0.034),tumor recurrence (2 years,P =0.030),TNM stage (P =0.022),and HBsAg (P =0.025),and negatively correlated with 5-year postoperative survival (47.6％ vs.13.2％).The expression of β-catenin protein was significantly associated with histologic grade (P =0.012),tumor recurrence (2 years,P =0.010),and TNM stage (P =0.026),and negatively correlated with 5-year postoperative survival (36.8％ vs.20.0％).Conclusions Frizzled-7 is overexpressed in HCC and associated with decreased postoperative survival.Moreover,frizzled-7 may up-regulate the expression of β-catenin and promote β-catenin-mediated tumor invasion and recurrence.

Objective:To investigate the effect of the musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum on the reconstruction of extensiveness laryngotracheal defect. Method: Retrospectively studied 49 patients, who admited in our department from 1996 to 2005 years for severe laryngotracheal defect. There were 28 males and 21 females aged from 15 to 69 years old (mean age was 47 years old). The causes of laryngotracheal defect were laryngotracheal stenosis(31 cases) and surgery for thyroid carcinoma invading trachea (18 cases). All of 49 cases were treated with the graft of musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum and placed a silicon T-tube stenting for 3 to 6 months. Result; All of 49 cases were successfully decannulated with recuperative normal airway patency and effective phonation. The follow up ranged from 2 to 10 years, and the effect of operation was steady. Conclusion:The musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum is an ideal graft for the reconstruction of cervical extensiveness tracheal defect.

Objective To investigate the expression of alpha 7 nicotinic acetylcholine receptor (α7 nAchR), cholinesterase (AChE), choline acetyl translocase (ChaT) after sevoflurane anesthesia. Methods A total of 120 healthy Sprague-Dawley rats with both two genders, aged 1 week, were randomly divided into 5 groups: blank group; air/O2 group; sevoflurane group (group SEV); α7 nAchR agonist group (group PUN); α7 nAchR antagonist group (group MLA), 24 in each group. Blank group received free feeding, air/O2 group was inhaled 60％ oxygen (carrier gas: 1 L/min O2+1 L/min air) 2 h; group SEV was inhaled 3.4％ sevoflurane and carrier gas for 2 h; group PUN and group MLA were injected with PNU-282987 and methyllycaconitine, respectively, after 24 h inhaled of 3.4％ sevoflurane and carrier gas for 2 h. After that, hippocampus dissection carried out in 2 h, 1 w, 4 w, and Western blot method was used to detect α7 nAchR, AChE, ChaT proteins expression. Results Two hours after anesthesia recovery, α7 nAchR in groups SEV, PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05); AChE in groups PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05); ChaT in groups SEV, PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05). One week after anesthesia recovery, α7 nAchR in blank group and groups SEV and PNU was significantly higher than that in air/O2 group (P ＜ 0.05), α7 nAchR in group MLA was significantly lower than that in air/O2 group (P ＜ 0.05); AChE in blank group and and group PNU was significantly higher than that in air/O2 group (P ＜ 0.05), ChaT in blank group was significantly higher than that in air/O2 group (P ＜ 0.05), ChaT in group SEV was significantly lower than that in air/O2 group (P ＜ 0.05). Four weeks after anesthesia awake, AChE in each group was not statistically significant; α7 nAchR in group SEV was significantly higher than that in blank group (P ＜ 0.05), α7 nAchR in group PNU and MLA was significantly lower than that in blank group (P ＜ 0.05); ChaT in blank group and group PNU was significantly lower than that in air/O2 group (P ＜ 0.05), ChaT in group MLA was significantly higher than that in air/O2 group (P ＜ 0.05). Conclusion Sevoflurane inhalation can inhibit ChaT, α7 nAChR, which had no direct effect on AChE; α7 nAChR agonist can effectively help α7 nAChR and ChaT inhibition inhaled sevoflurane, and reached a peak at about 1 week; oxygen concentration around 60％ can increase α7 nAChR expression quantity, to a certain extent against sevoflurane inhibition.

ObjectiveTo explore the relationship between plasma A-FABP and obesity type and degree,glucose and lipid metabolism parameters and insulin sensitivity.MethodsPlasma adipocyte fatty acid binding protein (A-FABP) was detected by double antibody sandwich ELISA in fasting status in subjects with normal glucose regulation and normal weight (NW-NGR,n =44),overweight or obese subjects with normal glucose regulation (OB-NGR,n =36),newly-diagnosed type 2 diabetes mellitus (T2DM) and its subgroups of T2DM with normal weight ( NW-T2DM,n =89 ) and T2D)M with overweight or obesity (OB-T2DM,n =44).And glucose,lipids,insulin levels as well as anthropometrical parameters such as body mass index ( BMI ),fat content ( Fat％ ),waist circumference (WC) and waist hip ratio (WHR) were measured.Meanwhile insulin sensitivity was assessed by HOMA-IR.ResultsAfter age and sex adjustment,plasma A-FABP levels in OB-NGR,NW-T2DM,and OB-T2DM were significantly higher than that of NW-NGR [11.32(6.54 - 15.43)μg/L,14.60(10.35 -20.10) μg/L,18.25(12.85 -26.65) μg/L vs 9.32(3.72 - 14.00) μg/L,all P ＜0.05].There was no difference in plasma A-FABP levels between OB-NGR and NW-T2DM [ 11.32 (6.54 - 15.43 ) vs 14.60 ( 10.35 -20.10) μg/L,P ＞ 0.05 ],but the plasma A-FABP levels in OB-NGR and NW-T2DM were significantly lower than that of OB-T2DM [ 11.32(6.54 - 15.43) μg/L,14.60( 10.35 -20.10) μg/L vs 18.25( 12.85 -26.65 ) μg/L,P ＜0.01 ].In a multiple stepwise regression analysis,HOMA-IR,sex,WC and age were the most significant independent determinants for plasma A-FABP concentration (all P ＜ 0.05 ).Conclusions Plasma A-FABP is strongly associated with the abdominal obesity and insulin resistance,measurement of plasma A-FABP concentrations might be useful for diagnosis of abdominal obesity and type 2 diabetics.

OBJECTIVE: To discuss the function and operative method of silicon T tube in laryngotracheal reconstruction. METHOD: Two hundred and ninety-seven patients of laryngotracheal stenosis were operated with laryngotracheal reconstruction in our department. All of patients were tracheostomy dependent before reconstruction and were placed a silicon T-tube stenting for 3 to 6 months after reconstruction. RESULT: Two hundred and eighty-nine patients (97.3%) were successfully decannulated with good airway patency and effective phonation. They were followed up from 1 to 10 years, and no recurrence was found. CONCLUSION Silicon T-tube is an effective and safe stent for laryngotracheal reconstruction. Paying attention to some application details may avoid the complication and obtain a satisfactory effect.
Adolescent ; Adult ; Child ; Female ; Humans ; Laryngostenosis ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Silicon ; Tracheal Stenosis ; surgery ; Young Adult

OBJECTIVE: To investigate the effect of the musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum on the reconstruction of extensiveness laryngotracheal defect. METHOD: Retrospectively studied 49 patients, who admitted in our department from 1996 to 2005 years for severe laryngotracheal defect. There were 28 males and 21 females aged from 15 to 69 years old (mean age was 47 years old). The causes of laryngotracheal defect were laryngotracheal stenosis (31 cases) and surgery for thyroid carcinoma invading trachea (18 cases). All of 49 cases were treated with the graft of musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum and placed a silicon T-tube stenting for 3 to 6 months. RESULT: All of 49 cases were successfully decannulated with recuperative normal airway patency and effective phonation. The follow up ranged from 2 to 10 years, and the effect of operation was steady. CONCLUSION The musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum is an ideal graft for the reconstruction of cervical extensiveness tracheal defect.
Adolescent ; Adult ; Aged ; Female ; Humans ; Laryngostenosis ; surgery ; Male ; Middle Aged ; Periosteum ; transplantation ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgical Flaps ; Trachea ; surgery ; Young Adult

Objective:To investigate the epidemiological characteristics of classic human astrovirus (HAstV) among children under five years old with acute diarrhea, and to understand the role of HAstV in children acute diarrhea.Methods:A total of 1 010 fecal specimens were collected in 1 010 outpatients under five years old with acute diarrhea admitted to Children′s Hospital of Fudan University, Shanghai from January 2012 to December 2016. Reverse transcription polymerase chain reaction (PCR) or PCR was used for screening classic HAstV, group A rotavirus, norovirus and adenovirus. Genotypes of classic HAstV were determined by nucleotide sequencing and phylogenetic tree analysis.Results:The overall positive rate of classic HAstV was 2.7%(27/1 010). The detection rates of classic HAstV from 2012 to 2016 were 6.9%(10/144), 3.5%(5/144), 2.1%(3/144), 1.5%(4/265) and 1.6%(5/313), respectively. Almost 96.3%(26/27) of children infected with HAstV were 0 to 36 months of age. The prevalence of classic HAstV infections displayed a typical autumn/winter seasonality except in 2016. All the positive classic HAstV strains were genotyped as HAstV-1 with two lineages of HAstV-1a and HAstV-1b. Among them, the lineage of HAstV-1a was the predominant subtype (63.0%, 17/27). There were 77.8%(21/27) of the children with acute diarrhea only infected with classic HAstV, whereas for the remaining cases a variety of other enteric viruses were detected (three cases co-infected with HAstV and group A rotavirus, two cases co-infected with HAstV and adenovirus, and one case co-infected with HAstV, group A rotavirus and adenovirus).Conclusions:Children infected with HAstV are mainly less than 36 months of age. Although the genotype of classic HAstV detected in this study is single, but the lineages are in a state of dynamic change. Long-time and continuous monitor for the epidemiology of classic HAstV is needed to avoid outbreak of diarrhea in children.

Isoniazid (INH) is highly effective for the management of tuberculosis. However, it can cause liver injury and even liver failure. INH metabolism has been thought to be associated with INH-induced liver injury. This review summarized the metabolic pathways of INH and discussed their associations with INH-induced liver injury.