Objective To study the sources and the relationship between the management and the outcome of hemorrhage after cephalic pancreatoduodenectomy.Methods The clinical data of 370 patients who underwent pancreatic resection at the Lihuili Hospital and the Second Affiliated Hospital of Zhejiang University were retrospectively analyzed.Results Postoperative bleeding occurred in 35 patients with 11 deaths.Among those intraabominal bleeding occurred in 14 cases and gastrointestinal hemorrhage occurred in 22,with one case suffering from both.Bleediug developing within 72 hours after operation in 12 cases (early-stage group),which was caused by improper intraoperative homeostasis.In other 23 cases,bleeding 72 hours after operation(later stage group)was caused by the erosion following pancreatic and/or bile leakage.Relaparotomy was performed in 13 cases and endoscopic homeostasis was performed in 3. Relaparotomy or endoscopic homeostasis was superior to that of conservative therapy in the early-stage group (P0.05).Pancreatic or bile leakage was identified as the significant risk factors for the postoperative bleeding.Conclusions In order to prevent the postoperative hemorrhage and to reduce the mortality of pancreatic resection,skillful techniques,expeditious homeostasis,proper management of stump pancreas and the prevention of pancreatic and bile leakage are essential.

Objective To observe the results and reality of transurethral resection of bladder tumor(TUR-Bt) with upside down loop and plsamakinetic in the prevention of obturator nerve reflex.Methods A total of 211 patients with lumbar anesthesia received TUR-Bt.Firstly,the tumor tower above bladder wall was cut with the traditional way.When intraoperative findings were obturator nerve reflex,or to the obturator nerve mapping area,operation should be changed to superimpulse plasma column electrode vaporization to cut off residual tumor tissue,then after flipping the loop,the residual tumour was resected with upside-down loop from the tumour side wall.Results In 211 cases,192 cases had a little obturator nerve reflex,but the movement of body was not obvious,which did not influence the operation.The serious complication,such as perforation of bladder and injury of nerve and vessel,did not occur.Conclusions The lateral resection of bladder side wall tumour with upside-down loop can effectively avoid strong obturator nerve reflex,which is safe,uncomplicated,and efficacious and it does not increase the additional outlay and hurt.

Brain Neoplasms ; metabolism ; Cell Line, Tumor ; Glioma ; metabolism ; Humans ; Neoplastic Stem Cells ; drug effects ; metabolism ; Reactive Oxygen Species ; metabolism ; Sodium Selenite ; pharmacology

Objective To construct and identify the incompetent-replication adenovirus carrying the fusiongene composed of the encoding gene of prepropeptide of mouse nerve growth factor(PN)and human beta-endorphin(?-EP)geue.Methods The gene segments of PN obtained from total RNA of the submandibular glandof a 2-week old Kumning mouse were amplified by RT-PCR and joined with the segment of ?-EP to form the fusiongene which was sequenced.The fusion gene contained in the incompetent-replication adenovirus was formed in theBJ-Ad Easy-1 susceptible cells and identified by PCR so as to choose the positive clone without wild vectors.Thecorrect clone was amplified and purified.The titers of adenovirus were determined using the specific 50% tissueculture infection dosage(TCID 50)method.Three days after the adenovirns was transferred into the cultured A431cells,RT-PCR was performed to showed the transcribed mRNA of this fusion gene and the intracellular ?-EPexpression was quanlitatively detected by inummo-histological method.Finally the concentration of human ?-EP inthe culture medium was determined by quantitative radio-immunoassay on 1st,3rd and 7th day afterinfeetion.Results The sequence of the fusion gene was correct.The titer of recombinant adenovirus Ad-NEP was1.5?10~10 pfu/ml.Three days after infection a 475 bp segment was amplified by RT-PCR and abundant orangegranules were shown in the infected cell.The ?-EP concentration in the culture medium was significantly higher inAd-NEP group than in the control group on 1st,3rd and 7th day(P

Objective To induce mouse embryonic stem(ES)cells to differentiate into insulin-secreting cells by means of a 5-step model system.Methods E14.1 mouse ES cells were cultured in the presence of leukemia inhibitory factor(LIF)for 2 days(step 1),then the cells were cultured in hanging drops to form embryonic bodies(EBs)and the resulting EBs were cultured in suspension for 6 days in the presence of basic fibroblast growth factor bFGF(step 2).Subsequently the EBs were cultured in the medium containing glucagon- like peptide 1(GLP-1),hepatocyte growth factor(HGF),nerve growth factor(NGF)and nicotinamide for 10 days(step 3).After that,the EBs were dissociated into single cells,and the cells were cultured in monolayer in the presence of GLP-1,betacellulin,activin A,bFGF and nicotinamide for 10 days(step 4).Finally,the cells were cultured in low-glucose medium containing nicotinamide for 4 days(step 5).Insulin and some other islet- related genes expressions were investigated using RT-PCR and insulin expression was also investigated by DTZ- staining and immunohistochemistry.The percentage of insulin-secreting cells was evaluated by flowcytometry and insulin concentrations were measured by RIA.Results mRNA expression of insulin became visible at step 3 and more evident at step 5.Additionally,at step 5,mRNAs of glucagon,somatostatin,pancreatic polypeptide(PP), pancreatic duodenal homeobox 1(PDX-1),beta-cell E box transactivator 2(Beta2)and neurogenin 3(Ngn3) were detected.DTZ-staining positive cells and insulin immunohistochemical staining positive cells were observed. The percentage of insulin-positive cells was(24.0?2.5)%(n=6).In the presence of 5.6 mmol/L and 25 mmol/L glucose,insulin concentrations were(0.05?0.01)?g/L and(0.13?0.02)?g/L respectively(n= 6).Conclusion E14.1 mouse ES cells can be induced to differentiate into insulin-secreting cells by the 5-step model system.Insulin-secreting cells can release insulin into culture medium when treated with glucose,and insulin concentrations increase with rising concentration of glucose.

Objective To explore the diagnostic values of X-ray and CT examinations for the traumatic diaphragmatic rupture. Methods Totally 17 patients with traumatic diaphragmatic rupture were retrospectively analyzed, who underwent X-ray chest radiograph and 64-slice spiral CT examinations as well as coronal and sagittal imaging by multi-planar reconstruction with GE ADW 4.6 workstation. Results Of the 17 patients, there were 15 ones had the rupture occurred on the left side (93.7%), one case on the right side (6.3%) and the remained one had no diaphragmatic injury;there were 10 ones of diaphragmatic contour discontinuity, 6 ones of intrathoracic hernia, 2 ones of cervical stenosis, one case of hanging sign and two cases of falling viscera sign. Conclusion Routine chest X-ray radiography has difficulty in diagnosing diaphragmatic rupture, while CT multiplanar imaging contributes to determining traumatic diaphragmatic rupture. Diaphragmatic rupture may occur after multiple trauma, and CT with multiplanar reformations has to be used as the routine examination for diagnosing diaphragmatic rupture.

Objective To compare the relative efficacy and quality of extraction of human fecal DNA using four methods.Methods Real-time PCR were utilized for analysis both quantification and quality of the fecal targeted bacteria(including gut all eubaeterium,Bacteriodes-PrevoteUa group,Bifidobacterium spp Enterobacteriaceae and Enterococcus spp)by using 16s rRNA gene-targeted genus or group-specific primer sets.Results The negative rat of PCR product from method 3(phenol-chloroform plus bead-beating) was about 40%(4/10)by using universal primers,the PCR inhibition disappeared after fecal DNA purified with column.The total fecal 16s rRNA gene copy numbers(per gram of wet weight of feces)as well as the numbers of Bacteriodes-Prevotella group from method 1(QIAamp~DNA stool mini kit)and 4(QIAamp~ DNA stool mini kit combined with bead-beating)was higher significantly than that from method 2(FastDNA ~Kit,Biol01)and 3(P

Objective To investigate the prognosis of children with acute kidney injury(AKI)treated with peritoneal dialysis(PD)following cardiopulmonary bypass.Methods A retrospective study of 46 children aged under 14 years old with AKI treated by using PD following cardiopulmonary bypass from Jan.2006 through Dec.2010.All of them were divided into three groups,namely group A(AKI Ⅰ),group B(AKI Ⅱ)and group C(AKI Ⅲ)according to the stratification of RIFLE criteria.The timing of PD was depended on the phase of AKI.The ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD were compared among three groups.Their APACHE Ⅱ score,sequential organ failure assessment(SOFA)score,serum interleukin-6(IL-6),oxygenate index,serum creatinine,and mean arterial pressure were also compared between before PD and after PD for 48 hours.One-way ANOVA was used for statistical analysis between different phases of AKI.Data got before PD and after PD for 48 hours were analyzed with paired Student' s t-test.Results The APACHE Ⅱ score,SOFA score and serum IL-6 before PD were higher in patients with phase Ⅲ of AKI than those in patients with phases Ⅰ and Ⅱ of AKI(P ＜ 0.01).There were no significant differences in APACHE Ⅱ score and SOFA score between patients with phases Ⅰ of AKI and patients with phase Ⅱ of AKI before PD(P ＞0.05),but serum IL-6 before PD,ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD in patients with phase Ⅱ of AKI were higher or longer than those in patients with phase Ⅰ of AKI(P ＜ 0.01).After PD for 48 hours,APACHE Ⅱ score,SOFA score,serum IL-6,oxygenate index,serum creatinine and mean arterial pressure improved insignificantly in patients with phase Ⅲ of AKI(P ＞0.05),but those were improved significantly in patients with phases Ⅰand Ⅱ of AKI(P ＜ 0.05),while serum IL-6 in patients with phase Ⅱ of AKI was still higher than that in patients with phase Ⅰ of AKI(P ＜ 0.01).Conclusions Therapeutic effect of PD on children with AKI following CPB is better if PD is started in the phases Ⅰ and Ⅱ of AKI,especially in the phase Ⅰ of AKI.The RIFLE criteria and IL-6 are useful guidance to the assessment of patients' illness.

Objective To detect anti-M3 receptor antibodies in primary Sj(o)gren's syndrome(pSS)patients and to explore its association with clinical manifestations.Methods Anti-M3 antibodies were tested in 70 patients with pSS,50 patients with systemic lupus erythematosus(SLE)and 76 normal controls with ELISA and Western blot.The correlation between anti-M3 antibodies and other clinical manifestations was analyzed.Results (1)The positive rate of anti-M3 antibodies in pSS Was 47.14% using ELISA and 60.00% using Western blot in SLE 4.00% using ELISA and 12.00% using Western blot and in normal controls 14.47% using ELISA and 15.79% using Western blot.(2)The incidence of sehirmer test,tear break-up time(BUT),whole saliva flow rate,punctate epithelial erosions(PEE)on the corneas and external eye examination were not significantly different between the anti-M3 positive and negative groups.(3)The incidences of IgG,rheumatoid factor,SSB and fluorescence index(FI)＞3 were higher in the positive group than in the negative group using EUSA.Conclusion The positive rate of anti-M3 antibodies is higher in pSS than in SLE and normal controls and in some degree it has correlation with the lesion in salivary gland.

Myopia is one of the most popular eye diseases all over the world. The development of the current understanding of its mechanism is still limited. Many studies indicated that the growth factors closely related to eye development and myopia. Some growth factors with biological activity, such as transforming growth factor ( TGF ), fibroblast growth factor ( FGF ) and epidermal growth factor ( EGF ), have an impact on scleral thickness variation, the regulation of the development of myopia and so on, which plays a non-negligible role in the pathogenesis of myopia. In this paper, the function of various growth factors in myopia will be reviewed.