Pancreatic resection is the treatment choice for pancreatic malignancy and cer-tain benign pancreatic disorders. Althogh, pancreatic resection requires high techndogy whereas current mortality after a pancreaticoduodenectomy has dropped to below 3 % in expe-rienced high-volume centers and post-operative morbidity is still as high as 50%. At pres-ent, the single most significant cause of morbidity and mortality after pancreatectomy is the development of pancreatic leakage and fistula (PF). The occurrence of a PF increases the length of hospital stay and the cost of treatment, requires additional investigations and proce-dures, and can result in life-threatening complications. Early recognition of a PF and prompt institution of appropriate treatment is critical to the prevention of potentially devastating con-sequences; however there is no universally accepted definition of PF that would allow stand-ardized reporting and proper comparison of outcomes between different centers. The present article reviews the conlept evolution of PF and discusses the current preventive strategies.

Objective To investigate the curative effect for lumbar spondylolisthesis by posterior lumbar intervertebral compression bone graft fusion and pedicle screw internal fixation.Method All 39 cases with lumbar spondylolisthesis accepted treatment during January 2003 to October 2007.There were cataplasia spondylolisthesis in 14 cases and isthmic spondylolisthesis in 25 cases.Twenty-two cases had spondylolisthesis in L4 and 17 cases had spondylolisthesis in L5.According to Meyerding grading,11 patients were classified as degree Ⅰ lesion.27 patients as degree Ⅱ lesion and 1 patient as degree Ⅲ lesion.By the help of X-ray machine,pedicle screw Was embedded in the vertebral spondylolisthesis and it Was lower vertebra.Laminectomy decompress was administered in vertebral spondylolisthesis and hold-down bars was placed to open intervertebral space.Then restored the vertebral spondylolisthesis and fixed it temporary.Next,intervertebral compression bone graft fusion was finished and was adjusted.Results Follow-up period was 5 months to 4 years.Clinical outcomes were measured with Prolo evaluation scale,35 cases were cured,4 cases were good effect.Conclusions This operation has been found to be asafe,rapid and effective method for lumbar spondylolisthesis and it produces a high fusion rate and lower expense.

NF-κB is a nuclear transcription factor with multiple adjustion. The activation of NF-κB can occur by three different mechanisms. The multiple NF-κB activation pathways are important due to the large number of genes that are regulated by NF-κB and their effects on cancer cells. These gene products can promote growth and tumori-genesis, inhibit apoptosis, allow metastasis and invasion, promote angingenesis, and cause chemoresistance. All of these roles in pancreatic cancer make NF-κB a promising target in treatment. Therefore, inhibiting the activity of NF-κB becomes a hot spot and novel idea of preventing and treating pancreatic cancer.

Objective To investigate the effect of perioperative fluid therapy on blood glucose in the neonates undergoing gastrointestinal operation. Methods Sixty-four ASA Ⅰ or Ⅱ neonates undergoing gastrointestinal operation were randomly divided into 4 groups ( n = 16 each). Group Ⅰ received water orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅱ received water orally 2 h before operation and iv infusion of 2% glucose (in normal saline) during operation. Group Ⅲ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅳ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of 2 % glucose (in normal saline) during operation. Blood sam ples were collected from radial artery for determination of blood glucose concentrations at the beginning of fluid therapy (T0), immediately after induction of anesthesia (T1), at the beginning of operation (T2), and at 20,40and 60 min (T3-5) and 2 h after operation ( T6 ). MAP and HR were also recorded simultaneously. The blood lactic acid concentration was determined at T0 . Results There was no significant difference in MAP and HR among the 4 groups. Compared with group Ⅰ , blood glucose concentrations were significantly increased at T4-6 in group Ⅱand Ⅳ, but no significant change was found in blood glucose concentrations at each time point in group Ⅲ. There was no significant difference in blood glucose concentrations between group Ⅱ and Ⅳ. The blood lactic acid concentration was significantly higher in group Ⅲ than in group Ⅰ , and in group Ⅳ than in group Ⅱ . Conclusion Oral 10% glucose 5 ml/kg before operation and iv infusion of 2% glucose (in normal saline) during operation is beneficial for the stabilization of blood glucose levels in neonates undergoing gastrointestinal operation.

Objective To summarize the experience in the diagnosis and treatment of adenosquamous carcinoma of the pancreas to better our understanding of this rare exocrine pancreatic neoplasm. Methods The clinical data of five cases of adenosquamous carcinoma of pancreas admitted between July 2002 and June 2008 were analyzed retrospectively, and relevant literature was reviewed and discussed. Results Pancreatic adenosquamous carcinoma was found in 3 men and 2 women with a mean age of 64 ± 18 years old. Tumor was located in the head of pancreas in 2 patients, body and tail in 3 cases. One patient was submitted to pancreaticoduodenectomy, three patients underwent distal pancreatectomy and splenectomy and one had cholecystojejunostomy and gastric bypass surgery, as well as 1251 implantation. The mean size of the tumor was 4.5 cm. One patient had posterior stomach wall, descending duodenum, portal vein involvement; spleen was invaded in 2 cases; neural and vessel invasion was present in 2 cases. Lymph node metastasis was present in 1 case. Pathologically primary tumor and liver metastasis were mixture of adenocarcinoma and squamous cell carcinoma. In all 5 patients with complete follow up, 3 died of tumor recurrence or liver metastasis with a mean postoperative survival time of 11.2 momths (8.5 ~ 13.5 months). The other 2 cases survived for 6 and 56 months , respectively. Conclusions Pancreatic adenosquamous carcinoma was likely to be found in patients in their 60s, and confirmative diagnosis was difficult. The prognosis of this rare tumor appeared to be dismal due to the high degree of malignancy.

Poly(ethylene glycol)(PEG) coated silver nanowires has been hydrothermally prepared at a very slow rate, in which PEG was used as both a mild capping agent and a weak reductant. As-prepared silver nanowires(SNWs) have been characterized using scanning electron microscopy) and transmission electron microscope), which showed that the SNWs are usually longer than 100 μm and their diameters(each SNW has a uniform thickness) vary mainly in the range of 80～300 nm. Surprisingly, some of these silver nanowires connected) by their two ends to form some close-looped silver nanowires, which hitherto has not been reported elsewhere. The existence of close-looped silver nanowires supports the mechanism that nanowires can evolve from fusion of some nanoparticles and/or shorter nanorods. Careful TEM characterization and selected area electron) diffraction revealed that the silver nanowires kept a five-fold twinned structure, which is opposite to some reports) that a long-time incubation will lead to the disappearance of this twin structure. This work demonstrates the situation that deeper investigation is still needed for understanding the structure transformation of silver) nanowires.

Three-dimensional (3D) reconstruction of medical images constructs the 3D models of organs using 2D medical image serials, which provide intuitionistic visual information for medical workers. However, most people concern about the CT images reconstruction, only few people focus on the reconstruction of Ultrasound images. In this thesis, it introduces Insight Segmentation and Registration Toolkit (ITK) and The Visualization Toolkit (VTK) firstly. Then it presents the process of Ultrasound image serials using ITK and VTK. At last, it presents the outcome of the experiment. The results show that the reconstruction of Ultrasound images can also get good effect by using ITK and VTK.

Objective　To investigate the causes and preventive methods of postoperative complications of femoral shaft fracture treated with intramedullary interlocking nails. 　Methods　A total of 116 patients with femoral shaft fractures admitted to our hospital from 1994 to 1999 were retrospectively studied in this article. They were all treated with intramedullary interlocking nails. The locking nails were removed from the 14 patients with delayed union to convert the fixation from static to dynamic. For the 6 patients with bone nonunion, the locking nails were removed, and new locking nails and bone grafts were employed. And for the 4 patients with bone infection, the foci were cleaned and the locking nails were removed, then certain external fixation was applied.　Results　Followed up for 1 year, the fractures of 14 patients with delayed union were completely healed. For the 6 patients with bone nonunion, reoperation was needed in 4 patients and a third operation needed in 2 patients, and they all healed after being followed up for one and half a year. For the 4 patients with bone infection, only 3 patients healed. The whole effective rate was 95.8%. 　Conclusions　Although the intramedullary interlocking nails used for femoral shaft fractures have advantages than other internal fixations, the complications of delayed healing, nonunion, bone infection and breaking nails are often found. The effective measures to reduce the complications include strict master of the operative indications, suitable materials for the implant and conversion of the fixation from static to dynamic in time, careful selection of debriding the realm or debriding no realm, complete debridement and strict abacterial procedures.

Nonvalvular atrial fibrillation (NVAF) is the most common type of arrhythmia and an independent risk factor for ischemic stroke.Warfarin effectively decreases the risk factors for ischemic stroke in patients with NVAF,but substantially increases the risk for severe bleeding.Currently,most clinical guidelines recommend using the CHADS2 score for stroke risk stratification in NVAF patients to guide antithrombotic treatment.Although its application is simple and convenient,the CHADS2 score has been debated because of many limitations; especially some common stroke risk factors were not included.By comparison,the CHA2 DS2-VASc scores have included more risk factors for stroke.It can better identify the truly low-risk patients.Among the AF patients with CHADS2 score of 0 to 1,CHA2DS2-VASc scores may provide the important information for stroke risk,and thus help the decision-making of the anticoagulant therapy.

AimTo realize the regulatory actions of nitric oxide(NO) on supraoptic nucleus (SON) neurons by observing the effects of NO donor sodium nitroprusside(SNP) on SON neurons. Methods The cell electrophysioloical properties were obtained by the intracellular recording techniques from the SON neurons in adult rat hypothalamic slices. Results In 11 silent cells, superfusion of SNP(1 mmol · L-1) for 3～5 min resulted in the depolarization response with a decrease of membrane resistance and time constant(P＜0.05) in 55% of cells, while hyperpolarization with an increase of membrane resistance in 45 % of neurons. In 73% of tested cells, SNP also decreased the amplitude, overshoot, firing frequency and slope of current-voltage curve, and increased the afterhyperpolarization of action potentials evoked by intracellular depolarizing current pulses(P ＜0.05).However, SNP enhanced the spontaneous firing in 67% of 6 tested cells with spontaneous activities. ConclusionSNP presents an inhibitory or excitatory effect on SON neurons in aneurontype-andfunctionalstate-dependent manner, which suggests that NO may exhibit adverse regulatory actions on SON neurons.