Perihilar surgery is full of challenge,risk,variability and uncertainty.Because of the anatomic variability,the pathophysiological complexity and invasion of the diseases,hepatic hilar biliary surgery has the characteristics of high operative difficulties,low resection rate,easy intraoperative bleeding,more postoperative complications,high recurrence rate and mortality rate.The cure rate and safety of the operation can be improved only through comprehensive imaging examinations and preoperative evaluation of liver function as well as the correct use of surgical techniques of anatomic paths,lesions excision and hepatic hilar reconstruction.The core of perihilar surgical techniques is hepatic hilar anatomy and explosion,including hilar plate dissection,dissection of liver along the medial fissure,quadrate lobe of liver resection and perihilar resection.Perihilar surgery is a comprehensive technique involving preoperative,intraoperative and postoperative procedures.The cure rates of perihilar biliary diseases can be improved by a combination of enhanced recovery after surgery and optimized and individualized surgical plans for patients.

Objective To explore the effects of different concentrations of propofol postconditioning against glutamate neurotoxicity to brain slices of neonatal rats.Methods The brain slices of neonatal rats were prepared and cultured in complete medium.They were randomly divided into five groups:the normal control group,glutamate injury group(RI group),1 mg/L propofol postconditioning group(PL1+RI group),3 mg/L propofol postconditioning group(PL3+RI group),5 mg/L propofol postconditioning group(PL5+RI group),12 cases in each group.The RI,PL1+RI,PL3+RI,PL5+RI groups were cultured for 6 days,then the brain slices were moved into the culture medium containing glutamate(1 mmol/L) and incubated for 30 minutes.And then,respectively,the brain slices of RI group were put into another complete culture medium,the PL1+RI group,PL3+RI group and PL5+RI group were put into the medium containing corresponding concentrations of propofol medium and long chain fat emulsion injection.All of the above were cultured for 24 hours in order to establish the injury model.The numbers of the Nissl body,the LDH release rates and the brain tissue damage rates of each brain slice were detected to evaluate the effects of propofol postconditioning on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.Results Compared with the RI group,the numbers of the Nissl body of the PL1+RI group,PL3+RI group and PL5+RI were higher,the LDH release rates and the brain tissue damage rates of the PL1+RI group,PL3+RI group and PL5+RI were lower,the diferences were significant(P<0.05).Among the three PL+RI groups,the LDH release rates and the brain tissue damage rates of the PL3+RI group were lower than those of the other two groups,the diferences were significant(P<0.05),at the same time,the numbers of Nissl body were more than the other two groups,the diferences were significant(P<0.05).Conclusion Propofol postconditioning has protective effects on the reperfusion injury in the glutamate-damaged brain slices of neonatal rats.However,the protective effects are not dose-dependent,and 3 μg/mL is the best dose of propofol to keep the glutamate-damaged brain slices from reperfusion injury in this research.

Age Factors ; Aged, 80 and over ; Female ; Hip Fractures ; surgery ; Humans ; Male ; Orthopedic Fixation Devices

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pterygopalatine Fossa ; innervation ; Rhinitis ; physiopathology ; therapy ; Smell ; Treatment Outcome ; Young Adult

Alu Elements ; physiology ; Chromosome Aberrations ; DNA Topoisomerases, Type II ; metabolism ; DNA, Neoplasm ; metabolism ; DNA-Binding Proteins ; genetics ; metabolism ; Humans ; Sarcoma ; genetics ; metabolism ; Soft Tissue Neoplasms ; genetics ; metabolism ; Translocation, Genetic

Adult ; Cardiac Catheterization ; Female ; Heart Septal Defects ; therapy ; Humans

Objective To evaluate MRI in diagnosis and follow-up of Achilles tendon rupture. Methods From April 2003 to May 2005, 24 cases of closed Achilles tendon rupture were examined in our department with MRI. It was performed through sagittal T1WI, T2WI, GE-STIR and axial TME imaging. Four cases were followed up with MRI after 4 to 8 weeks. Results MRI could determinate the severity and exact location of Achilles tendon rupture by demonstrating signal changes of Achilles tendon. In this series, complete rupture of Achilles tendon mostly occurred at the median part, with augmentation and high signal on T2WI. MRI demonstrated high signal on T2WI in partial rupture of Achilles tendon. The signal intensity in the four cases followed up by MRI was shown to decrease. Conclusion MRI is a valuable tool for clinical diagnosis and follow-up of Achilles tendon, because it provides enough information through signal changes at the tendon.

OBJECTIVE To enhance the control of nosocomial infection and improve the quality of medical nursing. METHODS The risk factors and etiological factors of nosocomial infection in sickroom were analyzed. RESULTS In order to control the nosocomial infection we needed to strength the disinfection management in the following aspects: air in the ward,nursing procedures,implements and hands of doctors and nurses. CONCLUSIONS Strict sterilizing procedures and standardized monitoring are the important measures to reduce the nosocomial infection.

Objective To research the clinical efficacy of Sini decoction adjustment combined rabeprazole enteric capsules in treatment of gastroesophageal reflux cough and its effect on interleukin 8 (IL-8) and substance P (SP), the mast cell tryptase (MCT) levels.Methods 92 cases of gastroesophageal reflux cough were divided into control group and experimental group by drawing method , each had 46 cases.Control group were treated by rabeprazole enteric capsules, experimental group were treated with rabeprazole enteric capsules based on the control group.The curative effect, cough symptoms integral, IL-8, SP, MCT, gastric dynamic element (MOT) and the gastrin-releasing (GAS), pulmonary function and safety were compared between two groups.Results The total effective rate of experimental group(93.47%) was higher than the control group(76.08%), the difference was statistically significant (P<0.05).After treatment, the symptoms of experimental group(1.53 ±0.19) points was higher than the control groupthe difference was statistically significant(1.96 ±0.24)points,P<0.05.The IL-8, SP, MCT levels of experimental group were all lower than the control group ( P<0.05 ) .The MOT, GAS, and lung function of experimental group improved more significantly than the control group ( P <0.05 ) .The security between two groups has no significant difference .Conclusion The curative effect of Sini decoction adjustment combined Rabeprazole enteric capsules in treatment gastroesophageal reflux cough is obvious, can decrease IL-8, SP, MCT levels.

Objective To investigate effect of coagulation, fibrinolysis, platelet and tumor markers in patients with advanced lung cancer by chemotherapy.Methods 21 cases of advanced lung cancer patients were selected to be the experiment group, and 20 healthy people were selected to be the control group.The experiment group were treated by chemotherapy,coagulation, fibrinolysis, platelet and tumor markers were compared before and after the treatment.ResuIts Compared with experiment group before chemotherapy, PT, APTT, TT levels of the patients after chemotherapy were lower, serum FIB concentrations were higher (P<0.05); PC and FPS were lower , D-D, PAI-1 concentration level were higher (P<0.05); PLT, MPV, PDW levels were lower (P<0.05); CEA, CYFRA21-1, NSE, CA125 levels were lower (P<0.05).ConcIusion Chemotherapy can enhance the effect of coagulation system in patients with advanced lung cancer, inhibit the fibrinolytic system and reduce the level of tumor markers.