The surgical management and the nutritional support in patients with AHNP were reported.We consider that the necrosis of the pancreas complicated with infection should be operated and that parenterally nutritional support could be helpful to patients with AHNP.

Objective To investigate the interrelations of ALOX5AP SG13S114A/T , COX-2 765G/C , COX-1-50C/T polymorphisms and cerebral infarction. Methods The ALOX5AP SG13S114A/T, COX-2 765G/C and COX-1 50C/T polymorphisms in 411 cases with cerebral infarction and 411 controls were measured by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism method. The generalized multifactor dimensionality reduction (GMDR) method was employed to detect gene-gene interactions. Results Single-gene analysis showed that there were no significant differences in the genotype and allele frequency distributions of ALOX5AP SG13S114A/T, COX-2 765G/C and COX-1 50C/T between two groups. However, in those cases carrying ALOX5AP SG13S114AA as well as COX-2 765CC , the risk of cerebral infarction increased significantly by 2.842 times. Conclusions The combinational analysis among genes used in this study may be helpful in the elucidation of genetic risk factors for common and complex diseases.

Objective To investigate the relationship between preoperative anemia,low albumin,low body mass index and the prognosis of advanced gastric cancer.Methods Three hundred and seventeen patients diagnosed with advanced gastric cancer as well as complete clinical pathology data from January 2006 to January 2008 were retrospectively analyzed.The clinical pathologic factors including age,gender,tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth,lymph nodes metastasis.The single factor and multiple factors were analyzed.Results Tumor size,type of Borrmann,hemoglobin,serum albumin,body mass index,type of histology,blood vessels and lymphatic invasion,infiltration depth and lymph node metastasis were identified as influencing factors of the prognosis,while independent factors associated with the prognosis of gastric cancer were serum albumin (OR =1.546,95％ CI:1.069-2.237),infiltration depth (OR =1.933,95％ CI:1.182-3.162) and lymph nodes metastasis (OR =1.586,95％ CI:1.358-1.853).Conclusion Anemia and low body mass index are the influence factors but not the independent factors in the prognosis of gastric cancer,while low albumin concentration is the independent factor in the prognosis of gastric cancer.

Objective To investigate the effects of nutritional support on the hypermetabolism of patients with digestive tract fistula complicated with severe abdominal infection. Methods Twenty-nine patients with digestive tract fistula complicated with severe abdominal infection were administered parenteral nutrition (PN) for 4 to 8 days, and then followed by enteral nutrition (EN) or EN + PN. The body weight, serum albumin, transferrin, prealbumin, fibronectin were monitored before and on the 10th and 28th day after nutritional support. Results The levels of serum prealbumin and fibronectin were increased significantly on the 10th day after nutritional support (t = 3.72, 3.52, P <0.01). The body weight, the levels of serum albumin, transferrin, prealbumin and fibronectin were significantly higher than those before nutritional support (t=3.97, 6.57, 7.09, 3.51, 3.58, P<0.01). Conclusion Nutritional support is effective in alleviating hypermetabolism of patients with digestive tract fistula complicated with severe abdominal infection.

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.

Objective:To summarize experience of diagnosis and surgical treatment of tuberculosis in ileocecal junction.Methods:Clinical data of 74 cases of tuberculosis in ileocecal junction were analysed retrospectively.Results:Clinical manifestations consisted of chronic abdominal pain(87.8%),right lower abdominal mass(95.9%),low fever、emaciation and anemia(36.5%),alternation of constipation and diarrhea(39.2%).Diagnosis rate of barium enema was 63.8%,colonoscopy and biopsy was 100%.Diagnosis rate before operation was 68.9%(51/74).In 74 cases,53 cases performed right hemicolectomy,15 cases performed anastomosis of end of ileum and transverse colon,6 cases performed building fistula of end of ileum.Conclusion:Tuberculosis in ileocecal junction should be diagnosed early and be identified with cancer of ileoceum.Good prognosis depend on positive surgical treatment and systematic medicine treatment.

Objective:To determine if growth hormone (GH) and glutamine (Gln) reduce the time and dose of parenteral nutrition (PN) in patients with short bowel syndrome. Methods: Sixteen PN-dependent patients with short bowel syndrome were randomly assigned to Group A (control, oral Gln [0.6 g/kg/d] + GH placebo + diet, n= 5), B (Gln placebo + GH [8 IU/d] + diet, n= 5), and C (Gln + GH + diet, n= 6). PN volume and content were determined by standard criteria based on clinical measurements. After 4 weeks, GH and GH placebo were discontinued, but the diet with Gln or Gln placebo was continued for 12 weeks. Results: Group B showed greater reductions in PN volume, PN calorie and PN frequency than Group A (P

20 patients with paralysis at thoracic or lumbar level were randomly divided into twogroups. Patients in the lst group receive thiopental, pancuronium, fentanyl in small dose and nifedipine10mg before intubation.Patients in the 2nd group receive thiopental and pancuronium. Hemodynamic indices and serum catecholamine concentrations were measured at different time intervals pre and post-intubation.The results show that each variables of hemodynamic indices and serum concentration in the lst groupare approximate or lower than the values of pre--intubation,but each value of the 2nd group at post--intubation increase significantly.The study demonstrated that nifedipine and fentanyl in small dosage may effectively ameliorate thestress response during intubation.

Objective To investigate 4 variants single nucleotide polymorphisms (SNPs) of 5-lipoxygenase-activating protein(ALOX5AP) in lipoxygenase pathway and in cytochrome P450 pathway as susceptibility genes for stroke in a southeastern Chinese population,and evaluate the associations between susceptibility genes and cerebral infarction,to find whether gene-gene interactions increase the risk of cerebral infarction.Methods By case-control study,two hundred and ninety-two patients with cerebral infarction and 259 healthy control subjects were included.Eight variants in 5 candidate genes were examined for stroke risk,including the SG13S32 (rs9551963),SG13S42 (rs4769060),SG13S89 (rs4769874),and SG13Sl14 (rs10507391) variants of the ALOX5AP gene,the G860A (rs751141) variant of the soluble epoxide hydrolase (EPHX2) gene,the A1075C (rs1057910) variant of the CYP2C9 *2 gene,the C430T (rs1799853) variant of the CYP2C9* 3 gene,and the A6986G (rs776746) variant of the CYP3A5 gene.Gene-gene interactions were explored using generalized multifactor dimensionality reduction (GMDR)methods.Results There were no statistically significant differences in the frequencies of the genotypes of the 8 candidate genes.The GMDR analysis showed a significant gene-gene interaction between SG13S114 and A6986G,with scores of 10 for cross-validation consistency and 9 for the sign test (P =0.011).These genegene interactions predicted a significantly higher risk of cerebral infarction (adjusted for age,hypertension,and diabetes mellitus;OR =1.804,95％ CI 1.180-2.759,P =0.006).Conclusions A two-loci gene interaction confers significantly higher risk for cerebral infarction.The combinational analysis used in this study may be helpful in the elucidation of genetic risk factors for common and complex diseases.

Objective To evaluate the diagnosis and surgical treatment of adult congenital choledochal cyst(ACCC). Methods Clinical data of 345 ACCC cases from 1974 to 2007 were analyzed retrospectively. Results There were only 110 patients (31.9%) with typical triad (abdominal pain, palpable mass and jaundice). B-ultrasound, CT, ERCP, PTC and MRCP were methods for diagnosis. Cancer arising from choledochal cysts was found in 19 cases who had undergone internal drainage and its incidence of cholangiocarcinoma is much higher than in the general population. All cases underwent surgical treatment, in which total excision of choledochal cyst and Roux-en-Y hepaticojejunostomy was main operation, 337 cases recovered well and 8 (2. 3%) died. C..ondusions Accurate diagnosis of ACCC was difficult depending on clinical symptoms only. B-ultrasound was the choice of atraumatic diagnosis. All patients with an established diagnosis of ACCC should undergo exploratory laparotomy. Total excision of eholedochal cyst and Roux-en-Y hepaticojejunostomy is most effective treatment for ACCC.