Objective To investigate the effects of preoperative biliary drainage ( PBD ) on the morbidity and mortality of pancreaticoduodenectomy in patients with malignant obstructive jaundice in the lower bile duct. Methods Clinical data of 74 cases undergoing pancreaticoduodenectomy from Jan. 2000 to Dec. 2005 with preoperative total bilirubin level over 85 μmol/L were collected and retrospectively analyzed. Comparison was performed between patients receiving PBD and those not. Before surgery. The parameters sincluding perioperative situation, in-hospital death rate, post-operative complications and were calculated to evaluate the influence of pre-operative biliary drainage on the outcomes. Univariate analysis and Logistic analysis were used to identify the risk factors for post-operative complications. Results Forty (40/74) cases received PTCD procedure. The total bilirubin was significantly reduced from (338. 10±88. 38 )μwnol/L to ( 228. 50±82.24) μ,mol/L in PTCD population and was significantly lower than ( 328. 60±93. 02) μmol/L of the non-PTCD group. There was no significance between the two groups in terms of total complications and individual complication Logistic regression analysis showed that preoperative TB over 340 μmol/L and blood loss over 600 ml were important risk factors for post-operative complications. Conclusion High pre-operative total bilirubin over 340 μmol/L increases the risk of post-operative complications in the patients with malignant jaundice. Preoperative biliary drainage is useful to reduce the total bilirubin and improve the hepatic function of the patients. Prolonged pre-operative biliary drainage could be considered in the patients with high preoperative bilirubin,poor nutritional condition and impaired coagulation to enhance the tolerance of surgery.

Ezrin protein function as molecular linker between the actin-cytoskeleton and the plasma membrane,which involves in the formation of microvilli and the maintenance of cello-morphology, movement, adhereance as well as survival, intimate studies of its structure and function have been done. At present many studies indicate that Ezrin involves in the tumor development and tumor metastasis,relate to prognosis. To study Ezrin protein in tumor will provide us other way and standard for diagnose and treatment of tumor and prognostic evaluation.

Objective To discuss the effect of blood glucose monitoring during pregnancy and pregnancy outcome in patients with gestational diabetes mellitus (GDM). Methods One hundred and fifty-three GDM patients from July 2007 to July 2008 were analysed.The cases were divided into satisfactory group (74 cases)and unsatisfactory group (79 cases) based on the level of bleod glucose and compared the pregnancy outcome between the two groups. Results The incidences of pre-eclampsia, polyhydramnios, macrosomia, neonatal hypoglycemia, hyperbilirubinemia of satisfactory group were lower than those of unsatisfactory group(5.41% vs 17.72%,4.05% vs 20.25%, 12.16% vs 31.65% , 5.41% vs 20.25%,8.11% vs 30.38%). The difference is statistically significant (P <0.05). The incidence of premature rupture of membranes, premature birth, postpartum hemorrhage, fetal distress of satisfactory group were lower than those of unsatisfactory group, but there was no significant difference between the two groups. Conclusion GDM can cause great harm to maternal and child health, and satisfactory blood glucose control during pregnancy may reduce maternal and child complications.

The expression mode in presentations may affect the efficiency during the teaching. In this study, we used a random-controlled trial to compare the educational efficiency in three different expression modes: script, pictures, animation. Test scores and questionnaire survey were statistically analyzed. It showed that the presentations with animation led to the highest average test score of the students. Visual objects could attract students' interest, enhance memory, and academic achievement. A proper insert of visual objects in teaching presentation is encouraged in the education of medical neurobiology for those medical students.

In view of the main problems of Matlab teaching of biomedical engineering profession,the paper proposes main measures for teaching reforming,including the adjustment of teaching hours,teaching content,teaching materials and other aspects,as well as reform of teaching methods and examination.The investigation result shows that the reform has a positive meaning on the improvement of students' learning quality.

Objective To study the changes and its clinical prognostic value of plasma endothelin 1 (ET-1) and P-selectin on early in-stent restenosis after percutanous intervention (PCI) in patients with acute coronary syndrome (ACS). Methods Venous blood samples were drawn from a total of 108 patients who underwent PCI before and right after the operation, as well as at 1 week, 2 weeks, 1 month, 3 months and 6 months post-procedure. Plasma was separated immediately by centrifugation at 4℃ and stored at -70℃ until detection. All patients received coronary angiography after six months and were catagorized into the restenosis and non-restenosis group according to the result. Plasma levels of ET-1 and P-selectin of the two groups were analyzed. Results Four cases received acute PCI died and another 4 cases lost follow-up. The remaining cases were divided into the restenosis (n=16) and non-restenosis (n=84) group according to their coronary angiography result. Plasma levels of ET-1 and P-selectin reached the peak concentration in the two groups right after PCI. In the non-restenosis group, plasma levels of ET-1 and P-selectin resumed to pre-opeation level at 24 hours and resumed to normal level at 2 weeks. In the restenosis group, plasma levels of ET-1 and P-selectin did not resume to normal level at 2 weeks but increased persistently, and showed their second peak value at 3-6 months after PCI. Conclusion The risk of restenosis increased accompanied by the persistent increase of plasma levels of ET-1 and P-selectin in early stages (1-2 weeks) after PCI in ACS patients. ET-1 and P-selectin may be regarded as makers for early recognition of restenosis.

Objective To analyze the feasibility, safety, and technique of laparoscopic myomectomy in patients with large hysteromyoma. Methods A total of 82 hysteromyoma patients with the uterus larger than 14-week gestational size were treated by laparoscopic myomectomy. The outcome of the operation were compared with that in 182 hysteromyoma cases with the uterus smaller than 14-week gestational size. Results In the 82 patients with the uterus larger than 14-week gestational size, 77 were treated successfully by laparoscopy, in which pneumoperitoneum was used in 68 cases and gasless laparoscopy in the other 9. One of the cases converted to open surgery, and small abdominal incision was made in 4 patients. Compared with the patients with the uterus smaller than 14-week gestational size, the 77 patients who had been successfully by laparoscopy had longer operation time [(157.6?89.7) min vs (35.3?26.2) min, t=16.926, P=0.000] and more blood loss [(218.0?108.2)ml vs (108.5?67.5)ml,t=9.904,P=0.000]. Conclusions Myomectomy can be performed under a laparoscope for patients with the uterus larger than 14-week gestational size. Highly skilled technique is important for the surgery.!Gasless laparoscopy is applicable to myomectomy for patients with the uterus smaller than 16-week gestational size.

AIM: To study apoptosis and related genes expressions of cardiomyocytes in sinoaortic-denervated(SAD) rats. METHODS: SAD or sham-operation (Sham) was performed in male SD rats at the age of 10 weeks. After 16 weeks, apoptotic cells were stained in situ by terminal dexynucleotidyl-transferase mediated-dUTP nick end labeling (TUNEL). All stained results were analysised using computer image analysis techniques. Protein products and mRNA of Bcl-2, Bax, Fas and Fas-L were assessed by quantitative immunohistochemistry and RT-PCR. RESULTS: The numbers of apoptotic cardiomyocytes were significantly increased in SAD rats, the expressions of Bcl-2 were significantly decreased, whereas Bax,Fas and Fas-L were significantly increased in SAD rats. THZ]CONCLUSIONCONCLUSION: Apoptosis and dysregulation of gene expressions may be involved in the cardiomyocytes remodeling in SAD rats.

Objective To investigate the relationship between fractional exhaled nitric oxide (FENO) and asthma predictive index (API) in infants under 3 years of age. Methods Totally 62 cases (under 3 years of age) who were hospitalized from June 2015 to June 2016 and had more than 3 times wheezing over the past year were enrolled in this study. They were divided into two groups according to API:API positive group with 37 cases and API negative group with 25 cases. FENO levels and peripheral blood eosinophil levels were detected and skin prick allergy test (inhalation and ingestion of allergens)was done in all selected children, did skin prick allergy test (inhalation and ingestion of allergens), simultaneous detected peripheral blood eosinophil levels. The parents of the children were investigated by questionnaire to know the children′ history about atopic dermatitis (such as urticaria, eczema, etc) and parents′ wheezing history. Above information was recorded and statistics analysis was made. Results There were no significant differences between two groups in atopic dermatitis inhalation and ingestion of allergens (P<0.01 or <0.05). The level of FENO in API positive group and API negative group was (16.70 ± 11.07), (13.52 ± 11.01) ppb(1 ppb=1 × 10- 9 mol/L), and there was significant difference (P<0.01). Conclusions There are associations between FENO and API, and they have good reference value in predicting the risk of asthma.

BACKGROUND:Although there is a general consensus with regard to the treatment of Rockwood types I, II, IV, V and VI injuries, the treatment of type III injury is inconsistent. OBJECTIVE: The aim of this systematic review was to evaluate the efficacy and safety of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation. METHODS:Studies were identified from databases (PubMed, Embase, Cochrane Library, China Biological Medicine, VIP, CNKI and Wanfang Database) up to May 2015. Eligible studies that investigated and compared the effectiveness and/or complications of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation and provided sufficient data were included. RESULTS AND CONCLUSION:In total, eight studies were included. Implant fixation (n=207) included the Bosworth technique, Clavicle Hook Plate technique, the TightRopeTM system (titanium plate and Arthrex fiber suture), Weaver-Dunn technique (coracoacromial ligament displacement, instead of coracoclavicular ligament fixation), Phemister technique (Kirschner wire fixation) and the use of a poly dioxanone sutures cord. The conservative treatments (n=137) consisted of immobilisation management with a sling, Kenny-Howard brace, or with a sling and clavicle fastening taping tape or a simple brake, or with a sling or tape. There were no significant differences in the Constant score (P=0.90) and infection rate (P=0.07) between the two groups. The rate of satisfaction with aesthetic outcomes was higher in the implant fixation group (P < 0.000 01), although the incidence of coracoclavicular ligament calcification was also higher (P=0.03) in this group. The time to resumption of normal work and normal activities was shorter after conservative treatment than that after implant fixation treatment. However, implant fixation could return to the game faster. These results indicate that both implant fixation and conservative treatments can result in satisfactory levels of shoulder function; however, the rehabilitation time was shorter after conservative treatment. Although implant fixation results in superior aesthetics, the risk of coracoclavicular ligament calcification is higher than that with conservative treatment. Time to resumption of normal work and normal activities was shorter after conservative treatment.