Objective To investigate the effect of iodine-125 seed implantation in the treatment of unresectable pancreatic carcinoma.Methods A total of 26 pancreatic carcinoma patients were retrospectively analyzed.Patients undergoing palliative operation in combination with iodine-125 seed implantation.jundice recovery,objective tumor response,pain relieved,clinical benefit response,median survival time and complication were investigated.Results Half of cases with jundice has reduced and totally normal in 3 weeks.Abdominal pain was relieved in 94.7％ patients,average recovery duration was (5.0 ± 1.5) d.18 cases had gastroenterol function disorder (69.2％),gastroparesis in six cases (23％) and average recover time was (16 ± 5.1) d.24 of 26 cases were follow up study,median survival time was (12 ± 5.1) months,objective tumor response was smaller than preoperation in 9,no change in 10 and 5 cases became larger than before.Conclusions Palliative operation in combination with iodine-125 seed implantation is safe and effective in the treatment of unresectable pancreatic carcinoma.

OBJECTIVE To provide current tendency of viral transmission by test-negative blood components changing among blood donors and to improve the safety of blood for transfusion.METHODS The test data of 1 608 816 blood donors in Beijing Red Cross Blood Center from 2001 to 2008 were analyzed.RESULTS Before voluntary blood donation,the positive rate of anti-HCV was 0.16%,that of anti-HIV was 0.005% and that of anti-TP was 0.15%.After voluntary blood donation,positive rate of these components increased,there were 0.45%,0.017% and 0.48%,respectively,but the positive rate of HBsAg and ALT was decreased.After voluntary blood donation,the positive rate of HBsAg,anti-HCV,anti-HIV and anti-TP were elevated,that of ALT was decreased in greatly.CONCLUSIONS As the increasing risk of viral transmission disease,it is more important for blood safety to screen volunteer blood donors.

Objective To study the complications after laparoscopic bile duct exploration.MethodsTwo approaches for bile duct exploration were used in 105 patients: (1) laparoscopic transcystic common bile duct exploration (LTCBDE) was used for patients with gallstones with choledocholithiasis and cystic duct dilation. No T tube was used for drainage, (2) Laparoscopic common bile duct exploration (LCBDE) was used for patients with gallstones with choledocholithiasis but without cystic duct dilation. The common bile duct was sutured primarily without T tube drainage in those patients with a small number of stones. T tube drainage was used in those patients with many stones or severe edema at the lower end of the common bile duct. ResultsWe carried out LTCBDE+ LC in 70 patients and LCBDE+LC in 35 patients, 14 patients had T tube drainage and 21 patients had no T tubes in the latter group of patients. Postoperatively, there were ascites in 17 patients (LTCBDE 6 and LCBDE 11 ), biliary peritonitis in 5 patients (1 LTCBDE and 4 LCBDE), abdominal pain in 13 patients (LTCBDE 4 and LCBDE 9), and fever in 11 patients (LTCBD 3 and LCBDE 8). All the complications responded to conservative treatment. 14 patients in the LCBDE group had residual stones.Choledochoscopy was used to remove the residual stones.There was no pancreatitis. Conclusions Adequate preoperative workup, good clinical judgment and precise treatment skill help to reduce complication rates after operation for gallstones with choledocholithiasis.

Objective To study the morphological changes of the cyctic duct in bile duct stones secondary to choledocholithiasis.Methods The results of imaging examinations before cholecystectomy and biliary exploration with laparoscopy and cholechodoscopy were respectively analyzed in 108 patients.Meanwhile, the cystic duct morphology, diameter and dilatation during the operation were determined to investigate the features of changes in its morphology.Results Gallstones were confirmed in all of the 108 cases by B-model ultrasonography preoperatively.The gallstone was positive in common bile duct in 76 cases.Common bile duct dilatation was seen in 75 cases and cystic duct dilatation in 21.Common bile duct dilatation was found in 81 cases by MRCP and in 45 by CT.Cystic duct dilatation was found in 36 cases by MRCP and in 19 by CT.Cystic duct variety was found in 9 cases by MRCP.Laparoscopic transcyctic common bile duct exploration(LTCBDE)was performed in those patients with short and wide cystic duct.Conclusion MRCP is the effective method for considering the outlooks of the cystic duct in bile duct stones secondary to choledocholithiasis.

Objective To study the application of cyctic duct dilatiion in bile duct exploration through the cystic duct by laparoscope combined with choledochoscope.Methods LC + laparoscopic transcyctic common bile duct exploration were performed in gallstones combined choledocholithiasis in 70 cases.The dilation of cyctic duct was performed by gas-baloon or metal dilator in 39 cases.The dilation of cyctic duct was not performed in 31 cases.Results There was one case of bile leakage and one case of cystic duct damaging in cystic duct dilation group.One case was found bleeding in abdomen postoperation in non-dilation group.Abdominal drainage was(60 ±11)mL and(55 ±8)mL in dilation group and non-dilation group,respectively.Conclusions The dilation of cyctic duct is simple and safe to create the tunnel for common bile duct exploration through the cystic duct by choledochoscope.

Objective To evaluate regional blood flow occlusion (RBFO) in hepatectomy for liver neoplasms. Methods In this study, hepatic tumors were resected under RBFO in 28 cases (RBFO group), and under Springle's technique (control group) in 24 cases. The Child-Pugh classifications of liver function were grade A in all patients. The ligature ribbon was put in liver parenchyma around tumor to block the blood supply before resecting the tumor under guiding of B sounography in RBFO group. Anesthesia time, blood loss and transfusion, hospitalization, change of liver function and complications were compared between the two groups. Results Blood loss, anesthesia time and postoperative hospital stay were (340±92) ml, (98.4±25.0) min, ( 10.2±2.3 ) d in RBFO group and (620±124) ml, ( 135.8±47.5 ) min, (16.5±5.1 ) d, respectively, in control group, differences were all significant between the two groups (P <0.01, t = 9.222,9.328 and 5.875, respectively). On post-op day 2, ALT (U/L) was (378.4±35.2) vs. (539.2±115.4) (t=7.012, P<0.01), TBIL (37.5±11.2) vs. (51.8±29) mmol/L(t=8.818, P<0.01),PT (17.4±2.4) vs. (20.4±2.8) see(t =4.16, P<0.01) in RBFO group and control group, respectively. ALT was (57.1±15.5) vs. (98.1±21.2) U/L(t =8.039),TBIL (25.4±4) vs. (46.3±13) mmol/L(t=8.085),PT (13.2±4.2) vs. (15.7±2.2) see (t=2.621)on post-op day 7 respectively, again the differences were all significant between the two groups (all P<0.01). Conclusion Regional blood flow occlusion is an effective technique to control blood loss during hepatectomy for liver neoplasms.

ObjectiveTo discuss the treatment of complications post-pancreticoduedenectomy by reviewing the experiences from 62 cases.MethodsSixty-two cases of pancreticoduedenectomy from March 2001 to April 2011,mean age 59.3 ±4.1 years,were reviewed.All cases were divided into early group 24 cases and recent group (38 cases) by the difference in following aspects:perioperative management,the way of pancreatic bowel anastomosis and material choice,the vessels management,materials using in preventing leakage and bleeding.The differences in leakage,bleeding,infection,the stomach retention,biliary infections,liver abscess and incision infection in two groups were compared.ResultsThe early group showed pancreatic leakage in 10 cases,bleeding in 4 cases,celiac infection in 10 cases,gastric retention in 9 cases,biliary infections in 11 cases,liver abscess in 6 and infection of incision in 7 cases,respectively.Recent groups were in 4,0,0,0,1,2 and 3 cases,respectively.The comparisons showed the complications had reduced significantly in recent group than in the early group (x2 =77.08,P ＜ 0.001 ).ConclusionsMinimally invasive and high quality materials use,strengthening the perioperative management are the effective measures to reduce the postoperative complications.

Objective:To investigate plasma levels of fibrinopeptide A(FPA)and platelet alpha-granule membrane glycoprotein 140(GMP-140), and to analyze the changes of coagulation activity in elderly patients with primary microvascular angina(PMVA).Methods:In this prospective case-control study, a total of 45 elderly patients(aged 60-80 years, 27 males and 18 females)admitted to our hospital from Jan.2019 to Dec.2020 were diagnosed as PMVA(as microvascular angina group)by clinical symptoms, electrocardiogram, dynamic electrocardiogram and coronary angiography.Forty-three age-and sex-matched elderly subjects who took a medical check-up and had no primary microvascular angina were included as the control group.Plasma levels of FPA, GMP-140 and high-sensitivity C-reactive protein were determined.The levels of systolic blood pressure, diastolic blood pressure, platelet, fasting blood glucose, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein, uric acid, renal function and liver function were detected.Results:The FPA level was higher in the PMVA group than in the control group[(430.32±364.05)μg/L vs.(263.73± 118.29)μg/L, t=2.913, P<0.01]. There was no difference in GMP-140 level between the PMVA group and the control group[(5.78±3.92)μg/L vs.(6.95±1.91)μg/L, t=-1.790, P>0.05]. The high-sensitivity C-reactive protein level was higher in the PMVA group than in the control group[(3.33±5.70)mg/L vs.(0.81±0.86)mg/L, t=2.927, P<0.01]. Conclusions:Compared with the control group, the FPA level is significantly increased with elevated coagulation activity in patients with primary microvascular angina.The increased inflammatory state in the PMVA group might promote the occurrence and development of microvascular angina, but whether the inflammatory state promotes the enhancement of coagulation activity needs further study to confirm.

Objective To investigate the effect of different etiology on the serum level of carbohydrate antigen 125 (CA125) in elderly patients with chronic congestive heart failure (CHF), and to assess any correlation of CA125 with serum level of B-type natriuretic peptide (BNP). Methods The 155 aged patients with New York Heart Association (NYHA) class Ⅲ or Ⅳ were enrolled and grouped into four reasons of hypertension, coronary heart disease (CHD), cardiomyopathy and other reasons, and 25 healthy old persons as control.CA125 and BNP levels were measured by automatic chemiluminescent immunoassay and enzyme immunoradiometric assay, respectively. Results CA125 level in patients with CHF was (83.4±6.6)U/L for hypertension, (36.8±1.4)U/L for CHD, (38.1±1.6)U/L for cardiomyopathy and (38.4±1.4)U/L for other reasons, which significantly higher than for healthy controls [(14.3±1.15) U/L, P＜0.05].Especially, CA125 level in hypertension group was notable higher than in other reasons of group (P＜0.05), and was positively related to BNP level (r=0.67,P＜0.05). Conclusions Serum CA125 level is a predictor for clinical pathogen of CHF.Therefore, it may be a useful additional marker for the evaluation of clinical treatment of these patients

A patent cardiac support system which is used as a bridge treatment for acute myocardial infarction has been designed and tested in vitro and in two dogs in vivo. This is an easy-to-use intelligentized pulsatile flow cardiopulmonary bypass device to replace the function of heart. The device consists of two identical pumps and perfusion chambers, a sensing and control system, a gas exchanger between the vein and pump, two one way valves between pump and veins or arteries. Arterial pressure and EKG feedback mechanisms are used for maintaining blood pressure and coordinating the pumping activity with heart contraction. A prototype of the device was built to perform hydraulic in vitro tests with aims of verifying the new device's pumping behavior. Functional evaluation of the device was carried out by using it in a model circuit made with standard CPB components plus a mock hydraulic pipeline. This system demonstrated easy manipulation, good controllability, and provided a 65+/-2ml x beat(-1) flow volume. There was a linear correlation between peak pressure value and pulsatile frequency. In the two in vivo experiments, the primary objective was to determine whether the device could work well in dog, whether physiologic pulsatility could be achieved and whether the blood supply to heart should be sufficient during asystole status by drugs. The results suggest that all the goals have been achieved.
Animals ; Cardiopulmonary Bypass ; Computer-Aided Design ; Dogs ; Equipment Design ; Heart-Assist Devices ; Materials Testing ; Myocardial Infarction ; therapy