Objective To discuss the manifestations, diagnosis and management of acute superior mesenteric artery occlusion (ASMAO). Methods The clinical data of 15 cases of ASMAO admitted in our hospital between 2000 and 2007 were analyzed retrospectively. Results The causes of ASMAO were mesenteric artery embolism in 11 patients and mesenteric artery thrombosis in 4 patients. All cases underwent emergency laparotomy, in which 2 cases underwent removal of the embolus, 11 cases were subjected to resection of necrotic bowel after removal of the embolus, and 2 cases gave up definite surgery. Postoperative heparin anticoagutherapy was used in all patients. The overall mortality rate was 27% (4 cases). Conclusions Acute superior mesenterie artery occlusion should be suspected in a patient with sudden abdominal pain, especially in those who have organic cardiac disease. Early diagnosis and prompt embolectomy are the key to save the patients.

Objective To approach the effect of prosthetic valve at preventing reflux esophagitis.Methods After the total gastrectomy and esophagojejunostomy,interrupted suture was apphed to form a prosthetic valve at output and input beyond Braun's stoma.Results Only one got light reflux esophagitis in 15 patients.Conclusion Prosthetic valve can prevent reflux esophagitis,and the operation is convenient and safe,which is deserved to be in generalization and approach the latest method.

Objective: To observe the role of parenteral nutrition and laparoscopic therapy in chylous ascites.Methods: A patient with chylous ascites was therapied with parenteral nutrition(4 weeks) and laparoscopic therapy and parenteral nutrition(1 week) subsequently.Output of ascites was daily measured from the drainage catheter of abdominal cavity.The body weight and other nutritional indexes were determined.Results: During the course of parenteral nutrition,the production and output of ascites gradually decreased,the body weight increased,and the serum album in level kept unchanged.After laparoscopic therapy and parenteral nutrition(1 week),ascites decreased significantly and did not rebound after diet,the body weight and the serum album in level also obviously increased.Conclusion: Laparoscopic therapy and parenteral nutrition are very useful in the treatment of patients with chylous ascites.

Objective To evaluate the clinical significance of the intraoperative detection of peritoneal micrometastases of gastric cancer.Methods In selected 50 cases of gastric cancer in which no obvious peritoneal metastasis was found preoperatively or during laparotomy,Douglas′s pouch peritoneal biopsy was undertaken intraoperatively,then HE and CK-20 immunohistochemistry staining of the specimens was performed.The expression of CK-20 mRNA in peritoneal irrigation fluid was also determined by RT-PCR.Results HE staining of all cases was negative.The positive rate of CK-20 immunohistochemistry staining was 24.0 %(12/50),and 36.0 %(18/50) with RT-PCR method.The positive rate of CK-20 mRNA was significantly related with the histological type,the depth of invasion and the number of lymph node metastasis(P

Objective: To investigate the clinical characteristics of invasive Haemophilus influenzae (HI) infection in children. Methods: The clinical manifestations, laboratory examinations and treatment outcomes of 84 children with HI infection confirmed by bacterial culture in 7 tertiary children′s hospitals from 2014 to 2018 were analyzed retrospectively. Results: Among the 84 cases, 50 were males. The age was 1.54 years (ranged from 5 days to 13 years).Twenty cases (24%) had underlying diseases and 48 cases (57%) had not received antibiotics before collecting specimens. Eighty-two cases (98%) had fever and 75 cases (89%) had clear infection foci, among which 31 cases (37%) had meningitis and 27 cases (32%) had pneumonia. Blood culture was positive in 62 cases (74%), cerebrospinal fluid culture was positive in 10 cases (12%), blood culture and cerebrospinal fluid culture were both positive in 11 cases (13%). Antibiotics susceptibility test showed that 27% (22/82) of all HI strains produced β-lactamases and 48% (37/77) strains were resistant to ampicillin. The drug resistance rates to cefuroxime, ampicillin-sulbactam, trimethoprim-sulfamethoxazole and azithromycin were 25% (20/80) , 20% (9/45) , 71% (44/62) and 19%(11/58), respectively. All strains were sensitive to meropenem, levofloxacin and ceftriaxone. After sensitive antibiotic therapy, 83% (70/84) of all patients were cured and improved, the mortality rate and loss of follow-up rate were 13% (11/84) and 4% (3/84) respectively. Conclusions Meningitis and pneumonia are common presentation of invasive HI infections in children. Mortality in HI meningitis children is high and the third generation of cephalosporins, such as ceftriaxone can be used as the first choice for the treatment of invasive HI infection.