The progress time caput pancreatis cancer expands the root governing skill add-on complex therapy to cause 5 years survival rate distinct enhancement,the complication obvious reduction.The progress time caput pancreatis cancer expands in the root governing skill Canada to improve the Whipple technique type and the TACE clinical research h~ the distinct improvement in near forward quality of life,but this is the beneficial exploration after all,is treats the caput pancreatis cancer stubborn illness to the surgical operation to make great strides forward one step has the clinical practice value.Summarized the domestic and foreign recent years to progress the time caput pancreatis cancer surgical treatment method and the curative effect present situation.The discussion progress time caput pancreatis cancer expands the root governing skill the clinical research curative effect prospect.

Because the gene right has the attribute of basic human right , as a legal basis for resolving the prob-lem of genetic discrimination , we should confirm its basic legal status .Genetic discrimination has caused the ethi-cal and legal issues in the field of insurance and employment , then put forward the following measures to solve these issues:In the field of insurance , the principle of utmost good faith should be followed to prevent the unscientific use of gene information;In the field of employment , the principle of general prohibition should be combined with the principle of limited exceptions .

To determine the effect of pulmonary lobectomy on myocardial blood supply and hemodynamics, 18 dogs were randomized into 3 groups. The dogs in group A and C were subjected to about 75% occlusion of the left anterior descending coronary artery. One week later, dogs in group C were sacrificed by arterial bleeding, while dogs in group A and B underwent right upper pulmonary lobectomy, and extremity ECG, blood routine, blood gas, hemodynamics and morphological changes of the myocardium were examined. The results showed that pulmonary lobectomy could result in or worsen myocardial ischemia. There was significant decrease in PO 2 , SaO 2 ; and CI, and significant elevation of LVEDP, PCWP and MPAP. There were more elevation of LVEDP and less decrease in CI after lobectomy in group A compared with group B. It suggested that pulmonary lobectomy could intensify myocardial ischemi and indace hemodynamic disturbances by lowering PO 2 and SaO 2 , especially where there was coronary artery stenosis before the operation.

Objective To observe the influence of sodium phosphocreatine on the hemodynamics,human heart fatty acid binding protein (hFABP),cardiac troponin Ⅰ (cTnI) during perioperative period.Methods Forty patients (ASA grade Ⅱ to Ⅲ ) with extensive myocardial ischemia diagnosed by preoperative electrocardiogram were divided into two groups:sodium phosphocreatine group (group A) and control group (group B) with 20 cases each by random digits table. Both groups underwent routine preoperative preparation and group A were given sodium phosphocreatine 2 g/d till anesthesia induction immediately in the operation day. Hemodynamic parameters including mean artery pressure (MAP),heart rate (HR),cardiac output (CO), stroke index (SI) and pulmonary vascular resistance (PVR) were recorded respectively at 3 d before treatment (T0), anesthesia induction immediately before ( T1 ), tracheal intubation immediately after (T2),tracheal extubation immediately after (T3). And blood hFABP and cTnl levels were detected. Results Compared with group B, there was no significant difference in HR of group A at To to T3 (P ＞ 0.05 ). MAP,CO, SI at T1 to T3 of group A were significantly higher than those of group B(P＜ 0.05 ) ;whereas PVR,blood hFABP and cTnI levels were lower than those of group B (P ＜ 0.05 ). The incidence of arrhythmogenesis of group A [20%(4/20)] was lower than that of group B [45%(9/20)](P＜0.05). Conclusion Sodium phosphocreatine has good protective effect on the myocardium in the patients with myocardial ischemia during perioperative period.

Objective To establish rat heart failure(HF)model following myocardial infarction(MI)and then detect the possible cytokines expression levels at different HF groups,so to explore the development of cytokines levels during the progression of heart failure.Methods The model was established by ligature of the left descending coronary artery.The rats were assessed by echocardiography and cardiac catheterization before and after 4 and 16 weeks following coronary ligature.Serum levels of TNF-α and IL-6 were determined.Results ①Serum cytokines could not be detectable in sham group using ELISA Methods,while in operated group,the concentration of TNF-α and IL-6 were significantly higher,especially IL-6.②The diagnosis coincidence between echocardiography and hemodynamics was high.Echocardiography can be used as an invasive measure to assess cardiac function in rat heart failure models.Conclusion ①Cytokines content is higher in compensated compared with the other two groups,especially to the IL-6 expression.②Cardiac ultrasound can be used as a useful method in monitoring postinfarction heart failure rat model,especially as an invasive measure.It can provide us successive data of the model.

Objective To investigate the feasibility of repairing surgically ablated cavernous nerves with silastic nerve tube conduit filled with nerve growth enhancing media. Methods 54 male adult Sprague-Dawley rats were randomized into 3 groups,the sham operated controls,the bilateral cavernous nerve ablation and entubulization nerve reconstruction with insulin like growth factor(IGF).1,3 and 6 months after surgery,rats models were evaluated with apomorphine test,followed by nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining to identify NOS in penile nerve fibers of the proxiamal portion of penile shaft and penile crus. Results There was no statistically significant difference between the ablated and the entubulization nerve reconstruction groups at 1 month,however,at 3 and 6 months,Apomorphine test studies resulted in tumescence from 42% and 50% of the entubulization nerve reconstruction groups versus 0% and 0% of the ablated group,respectively (P

To investigate changes in density of platelet glycoprotein (GP)Ⅱb/Ⅲa receptor during the perioperative period of hepatectomy in rats with myocardial infarction. 26 adult SD rats were randomly divided into 2 groups: the control group(1)( n =13) and the infarction group(2)( n =13). Myocardial infarction was produced by celiac injection (1 time/d) of isoproterenol (30mg/kg) for 3 days. All rats underwent hepatectomy after 3 weeks. Platelet surface density of GPⅡb/Ⅲ receptors was determined by flow cytometric analysis before and 6, 12, 24, 48, 72 hours after the operation. 12 hours after the operation, the density of GPⅡb/Ⅲa was transiently increased compared with preoperative period in control group ( P

Objective To study the relationship of epithelial nitric oxide synthase (eNOS) expression with the germ cell development and apoptosis in the rat cryptorchid. Methods Germ cell apoptosis was detected by terminal deoxynucleotidyl transferase mediated d UTP nick end labeling (TUNEL) in the unilateral cryptorchid.Expression of eNOS was detected by immunohistochemical S P method. The dispersion characteristics of expression of eNOS mRNA was investigated by in situ hybridization. Results On the 7th day after the operation,as compared to the control,the number of apoptotic germ cell in the cryptorchid was increased significantly,but its testis weight was decreased predominantly,and expression of eNOS gene was localized to the cytoplasm of Legdig cell,Sertoli cell and germ cell in both testes.On the 40th day,expression of eNOS gene was localized to the cytoplasm of lengthened spermid.On the 3rd day and 7th day,expression of eNOS mRNA had no apparent change in the cryptorchid as compared to the control. Conclusions In adolescence,expression of eNOS regulates secretion of hormone and germ cell development;whereas after adulthood,expression of eNOS is only related to the mature and activity of sperm.Expression of eNOS has no apparent relationship with germ cell apoptosis.

Objective To evaluate the influence of patellar resurfacing and non-patellar resurfacing on the effect of total knee arthroplasty to provide the evidence-based basis for selecting the clinical treatment scheme.Methods The clinical randomized controlled trials(RCT)on the whether having patellar replacement in total knee arthroplasty were retrieved from the databases of Pubmed,Cochrane,Medline,Embase,CNKI and WanFang data.The screening was independently performed by two researchers according to the including and excluding criterion.The related data were extracted.The reoperation rate,knee joint pain score and knee joint score served as the measurement criteria.The RevMan 5.2 software was adopted to conduct the meta analysis.Results Fifteen literatures were included to analyze,involving 1 788 patients,among them 871 cases were in the patellar resurfacing group and 917 case sin the non-patellar resurfacing group.The reoperation rate in the patellar resurfacing group was significantly lower than that in the non-patellar resurfacing group(RR=0.50,95 ％CI:0.33-0.76;P =0.001),moreover the knee joint function was significantly improved(WMD=3.04,95％CI:0.41-5.67;P=0.02).However,the anterior knee joint pain(WMD=0.96,95％CI:-0.85-2.76;P=0.30)and knee joint score(RR=0.81,95 ％ CI:0.50-1.32;P =0.41) had no statistical difference between the two operation modes.Conclusion Conducting patellar resurfacing in total knee arthroplasty can reduce the reoperation risk and improves the postoperative knee joint function,but does not improve postoperative knee joint pain score and knee joint score

Objective To investigate the relationship between IL-18 and apoptosis in patients with SLE by using testing the changes of IL-18 and soluble Fas/soluble Fas ligand in sera from the patients.Methods 58 patients with SLE were divided into three groups according to their SLEDAI score;sera from 58 patients,and 30 normal controls were tested for IL-18 and sFas/sFasL using ELISA assay.Results The level of IL-18 and sFas in sera from SLE patients was significantly higher than that of normal controls(P0 05).Besides,the increased level of IL-18 was correlated well with the increased level of sFas (?=0 496,P0 5).Conclusion The increased level of IL-18 may result in the elevation of serum sFas/sFasL in patients with SLE.They may play important roles in the pathogenesis of SLE.