Radical pancreaticoduodenectomy is the most effective method for the treatment of malignant tumor of pancreatic head.Safe and complete resection of the uncinate process of the pancreas is the most difficult and important part in radical pancreaticoduodenectomy.For the past years,we put forward the new idea of prior selective arteriovenous treatment in radical pancreaticoduodenectomy according to whether the portal vein and superior mesenteric vein was invaded by the tumor.Thin slice scan and vessel reconstruction using multidetector spiral CT can accurately evaluate the condition of the blood vessels near the pancreatic tumor and judge whether the tumor was resectable.By exchanging superior mesenteric artery,controlling blood stream of pancreatic uncinate process and using 3 or 4 vascular blocking bands and the integrated radical resection of uncinate process for those patients can be successfully completed.It can reduce the operating bleeding,operating time and the miscut of superior mesenteric vein and (or) superior mesenteric artery,and also avoid postoperative pancreas necrosis,infection and hemorrhage caused by the pancreas uncinate process residues,and theoretically reduces the chance of tumor cells spread.

Objective To investigate the clinical efficacy and safety of endoscopic variceal ligation (EVL) combined with endoscopic variceal sclerosis (EVS) for treating patients with esophageal variceal bleeding (EVB).Methods Ninety patients with EVB were divided into observation group and control group by treatment methods with 45 patients each.The observation group was given EVL combined with EVS and the control group was given EVL.The elimination of varicosity after the first treatment,time and times required to eliminate,rehaemorrhagia,varicosity recurrence,complication and prognosis of the 2 groups were observed.Results The elimination rate of varicosity of observation group was 97.8％(44/45),the control group was 93.3％(42/45),there was no significant difference (P＞ 0.05).The elimination rote of varicosity after the first treatment of observation group was significantly higher than that of control group,the time and times required to eliminate were significantly lower than those of control group [71.1％(32/45) vs.48.9％(22/45),(17.24±5.65) d vs.(36.01 ± 11.81) d,(1.42 ±0.47) times vs.(1.87 ±0.61) times,P ＜ 0.05 or ＜0.01].The rates of early-onset rehaemorrhagia,delayed rehaemorrhagia and varicosity recurrence of observation group were significantly lower than those of control group [4.4％(2/45) vs.17.8％(8/45),6.7％(3/45) vs.22.2％ (10/45),2.2％ (1/45) vs.22.2％ (10/45),P ＜0.05].The rate of complication of observation group was significantly lower than that of control group [11.1％ (5/45) vs.42.2％ (19/45),P ＜0.01].Conclusion The EVL combined with EVS is an effective method for emergency hemostasis and preventing rehaemorrhagia in the patients with EVB.

aminobutyric acid(GABA) is a principal inhibitory neurotransmitter in the mammalian central nervous system(CNS). In recent years,some studies have demonstrated that GABA is also present in various peripheral tissues,including the gastrointestinal tract. GABA acts as a gut hormone in addition to its role as an enteric neurotransmitter,which involves in the transport and regulation of intracellular information in stomach. Therefore,it inhabits development and growth of gastric cancer. Glutamic acid decarboxylase(GAD) is a major GABA synthesizing enzyme. This review will narrate the relationship between GABA,GAD and gastric cancer.

Objective By taking emergency treatment of craniocerebral trauma for example, we studied the competence characteristic composition for emergency treatment of eraniocerebral trauma aiming at doctors and nurses, besides,their competence characteristics were compared as well. Methods By comprehensive application of qualitative and quantitative methods, the competence characteristic eomposi-tions of doctors and nurses were obtained, the corresponding competence characteristic scale was estab-lished, and underwent subsequent application for its validity and reliability. Results After many times of factor analysis and factor rotation, competence characteristic compositions and scale for doctors and nurses engaged in emergency treatment of eraniocerebral trauma were obtained, accumulative contribution of com- mon factors was 69.33% and 69.99%,ot coefficient was 0.826 and 0.930, split-half reliability was 0.771 and 0.791 ,α coefficient of internal consistency of every subseale ranged from 0.574 to 0.898, which showed good validity and reliability. Conclusions Doctors and nurses engaged in emergency treatment of cranio-cerebral trauma possess different competence characteristic compositions from general medical workers,their competence characteristics are both overlapping and different.

Objective To investigate the effects of docosahexaenoic acid (DHA) on the growth of human pancreatic cancer cell lines. Methods Human pancreatic cancer cell lines Patu8988 and SW1990 were treated with DHA. The cell proliferation was evaluated by MTT assay. Cell cycle, apoptosis, and cyclooxygenase-2 ex-pression were evaluated by flow cytometry. Results After incubation of pancreatic cancer cell with DHA for 24 to 72 hours, cell proliferation significantly decreased (P<0. 01) and apoptosis increased, both of which were time- dependent and dose-dependent After incubation with 50μg/ml DHA for 24 hours, cyclooxygenase-2 expression of pancreatic cancer cell lines significantly decreased (P < 0. 05). Conclusions DHA can inhibit the growth of hu- man pancreatic cancer cells via decreasing cell proliferation and inducing apoptosis. These effects may be associat- ed with the decrease of cyclooxygenase-2 expression.

Objective To perform the sentinel lymph node biopsy (SLNB) in the patients with early breast cancer by the strict screening conditions and to analyze the accuracy of the sentinel lymph node for predicting the axillary lymph node status .Methods SLNB combined with methylene blue dye and isotope was performed in 266 cases of early breast cancer treated in this department with full treatment courses .Then the axillary lymph node dissection(ALND) was routinely conducted .With the pathological ex-amination as the standard ,the related factors affecting SLNB were analyzed .Results The detection rate of SLN ,accuracy rate ,sen-sitivity and the false negative rate were 100% ,98 .5% ,95 .56% and 4 .44% respectively ;the accuracy of SLN was significantly cor-related with the tumor size ,pathological type and axillary lymph node status(P<0 .01);the false negative rate of SLN was related with the tumor location(P<0 .05) .Conclusion The combination of methylene blue dye and isotope used in SLNB is feasible in the patients with early breast cancer ,SLN could accurately predict the axillary lymph node metastasis status .

Portal hypertensive gastropathy (PHG), a term used to describe the endoscopic appearance of gastric mucosa with a characteristic mosaic-like pattern, is characterized entities that can be associated with gastrointestinal blood loss in patients with portal hypertension. More than 65% of patients with portal hypertension from cirrhosis will develop PHG,however,it could also occur in the setting of non-cirrhotic portal hypertension. In patients with portal hypertension, the incidence of PHG was associated with severity of liver disease and the presence of both oesophageal and gastric varices. The exact etiology of PHG is not clearly defined, the diagnosis of PHG depends on endoscopy and histology, therapy of PHG is directed at lowering portal pressure by ?-blockers or shunt procedures.

Objective To study the changes of COX-2 and apoptosis gene Bcl-2,Bax expression in the inhibition effect of DHA on pancreatic cancer cell lin(ePatu8988)in vitro and investigate the mechanism. Method The inhibition of cell proliferation was evaluated by MTT assay. Cell apoptosis induction and COX-2, Bcl-2, Bax expression were evaluated by flowcytometry. Results DHA could inhabit the proliferation of pancreatic cell and induce cell apoptosis, both of which were time-dependent and dose-dependent(P

Administration, Cutaneous ; Amoxicillin ; therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Penicillins ; therapeutic use ; Phytotherapy ; Respiratory Tract Infections ; drug therapy ; prevention & control ; Secondary Prevention

The aim of our study was to investigate the effectof mannitol on treatment of brain edema.Focal ischemic brain edema model was established by left middle cerebral artery occlusion(LMCAO) .The ratswere divided into 1 1 group.Each ratwasintravenously injected with2 0 % mannitol(0 .5 g/ kg within1 0 minutes) .The dose of mannitol was differ- ent.One dose of mannitol at1 2 h,1 6 h,2 0 h,2 4h after L MCAO,three doses,five doses,seven doses of mannitol at 2 4h after L MCAO.Again respective control animals were 1 2 h,1 6 h, 2 0 h,2 4h after L MCAO.Brain water content(BWC) ,morphological changes and ischemic size were used to evaluate the brain edema.The result showed that the BWC reduced in damaged brain atone dose,three doses,five doses of mannitol,(P