ObjectiveTo evaluate the surgical management regarding acute duodenal ulcer perforation in adolescence.Methods24 cases underwent simple neoplasty with postoperative oral Losec for 3 months,13 cases did subtotal gastrectomy, 3 cases did vagotomy with partial gastrectomy, 5 cases did neoplasty with super-selective vagotomy.ResultsThere was no mortality, patients were followed up for 24 months. Complication rate in neoplasty group was 8.3%, and in gastrectomy group was 38.1% (P0.05).Weight gaining in neoplasty group is better than in gastrectomy group( P

Benign biliary strictures(BBS) have different etiologies, and the most common causes are strictures secondary to iatrogenic and ischemic injury after hepatobiliary and transplantation surgery. Fibroblast proliferating activity, extracellular matrix overdeposition and scar proliferation are closely related to BBS. The mechanism of development of BBS involves a variety of cells, cytokines and extracellular matrix. In recent years, biological treatment is emerging as an effective option for BBS, but the clinical application is not yet mature and the curative effect needs to be evaluated further in the future.

Objective To explore the relationship between the pathologic features of the cancer and postoperative recurrence in patients with early stage gastric carcinoma.Methods 139 patients with early stage gastric carcinoma underwent radical resection in our hospital from 1984 to 1995. All cases were followed up for more than 5 years. ? 2 test was used for statistical analysis.Results 7 cases died of hematogenic metastasis, 3 cases died of lymph node metastasis, and stump carcinoma was found in the other 3 cases. The recurrent rate was significantly higher in submucosal tumors (14.1%) than in mucosal tumors (1.9%), in lymphatic and vascular vessel invasion-positive cases (37.5%) than in negative cases (7.6%), in lymph node positive (31.3%) than in negative (6.5%), in synchronous multiple gastric cancer (33.3%) than in solitary tumors (7.9%)(P

Objective To investigate the role of apoptosis and the regulating role of receptor interacting protein 1(RIP1) in acute pancreatitis .Methods Thirty C57 mice were divided into three groups :control group ,acute edematous pancreatitis (AEP) group and acute necrotizing pancreatitis (ANP) group .The AEP group was continuously injected by cerulein 50 μg/kg for 13 times ,the ANP group was continuously injected by cerulein 50μg/kg for 13 times and lipopolysaccharide 15 mg/kg once;the con‐trol group was injected by the same volume of normal saline for 7 times .The acinar cell apoptosis was observed by the terminal de‐oxynucleotidyl transferase‐mediated deoxyuridine triphosphate nick‐end labeling (TUNEL) assay .The RIP1 mRNA expression was measured by real time fluorescence PCR .The expression of RIP1 protein was detected by Western blotting .Results The mouse models of AEP and ANP were established successfully .Compared with the control group ,acinar cell apoptosis existed in both AEP and ANP model groups ,moreover compared with the AEP group ,apoptosis in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Compared with the control group ,the expression of RIP1 mRNA and protein in the AEP group was increased ,while which in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Conclusion RIP1 participate in the pathogenesis of acute pancreatitis ,which may associate with acinar cell apoptosis .

OBJECTIVE:To study inhibitory effects of propofol on PC12 cells injury induced by glutamic acid via mitogen-acti-vated protein kinase/extra-cellular regulated kinase (MAPK/ERK) signal pathway. METHODS:PC12 cells were randomized into normal control group,model group(10 mmol/L glutamic acid),propofol low-concentrations,medium-concentrations and high-con-centrations groups(12.5,25,50 μmol/L+10 mmol/L glutamic acid). The optical density of cells,cell apoptosis,the phosphoryla-tion of ERK1/2 and the expression of c-fos,Bax,Bcl-2 were detected after treated with relevant medicine for 48 h. RESULTS:Compared with normal control group,optical density of cells,the phosphorylation of ERK1/2 and Bcl-2 decreased in model group (P<0.01);apoptotic rate,the expression of c-fos and Bax increased (P<0.01). Compared with model group,optical density of cells,the expression of Bcl-2 and the phosphorylation of ERK1/2 increased in propofol group (P<0.01);apoptosis rate,the ex-pression of c-fos and Bax decreased (P<0.05 or P<0.01). There were statistical significant between the different concentrations (P<0.01). CONCLUSIONS:Propofol can inhibit the apoptosis of PC12 cells induced by glutamic acid,which is associated with the up-regulation of ERK1/2 phosphorylation.

Objective To evaluate the value of the clinical application of piezosurgery-assisted sliding genioplasty.Methods A total of 9 patients (7 women,2 man,aged 19-40 years) with microgenia were performed operation by intraoral V incision with subperiosteal exposure of the mandibular mentum area.Note relaxtion and preservation of the mental nerves.A horizontal osteotomy of cortical bone on anterior mandible was underwent by the conventional electric bone saw and internal plate bone was sectioned with the piezoelectric device.The segment was divided with preservation of the lingual soft tissue attachment and was advanced in the mandibular mentum area.These was fixed in the reposition by titanium plate and screw for preventing displacement.Results The piezoelectric device produced selective sectioning of the mineralized bone structures,bone was cut precisely without damage to vital anatomic structures and dental pulp,and was much easier to control and less aggressive,creating only minimal damage to soft tissues.The operative effects were satisfactory during 3- 6 months of follow-up.Stable chin contours were created and became nature.Iatrogenic problems with bleeding,in fection,mental nerve injury had been avoided.Conclusions Piezosurgery is a safe and precise technique to reduce the complication rate and to improve the treatment outcomes of genioplasties.

Objective To investigate a safe and effective method of lengthening the short nose.Methods Thirty-nine cases of short nose were corrected by the bilateral septal spreader graft and columellar strut using autologous cartilage,combined with expanded polytetrafluoroethylene (e-PTFE)to reconstruct the supporting structures to improve the forward and upward strength of the nasal tip in order to increase the nasal length and to correct the over rotation of nasal tip.The shield and cap grafts were also used for the patients whose nasal tip were too low with vertical dome division technique.Results All the patients showed preserved nasal length after surgery with well-proportioned nasal features and the nasal lip angles were normal.There was no evidence of postoperative nasal shortening.No operative or postoperative complications were observed by follow-up for 6 months to 1 year,except for 2 cases with graft cartilage being apparent on nasal tip.All the patients were satisfied with the surgical results achieved.Conclusions It is necessary to provide powerful forward and upward strength to lengthen nose and correct the over rotation of nasal tip effectively and safely.The application of bilateral septal spreader graft and columellar strut using autologous cartilage and combined with e-PTFE represents a valuable tool for the short nose and proper cartilage grafts of nasal tip can improve the height of the nasal tip and further correct the over rotation of the nasal tip.

BACKGROUND: The cerebral edema after brain injury is associated with the generation of oxygen-derived free radicals after ischemia reperfusion.Hyperbaric oxygen can relieve the cerebral edema and ameliorate the tissue hypoxia.OBJECTIVE: To observe the influence of hyperbaric oxygen on cerebral edema and the lipid peroxide after brain injury in rats.DESIGN: A random controlled trial.SETTING: Institute of Field Surgery, Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Department of Hyperbaric Oxygen and the Fourth Room of the Institute of Field Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA between March and June 2004. Fifty-eight 3-month-old Wistar rats of clean degree with the body mass of (256±23) g were used.METHODS: The 58 rats were randomly divided into control group (n=17),brain injury group (n=22) and hyperbaric oxygen group (n=19). The struck test was not conducted in the control group. The rats in the brain injury group and hyperbaric oxygen group were anesthetized, then the right calveria was struck with the BIM-Ⅲ striker, and closed brain injury was duplicated. After brain injury, rats in the hyperbaric oxygen group were placed into a hyperbaric oxygen chamber of 2 absolute atmospheric pressures for 2 hours, and the rats were killed at 24 hours after injury by taking blood from heart.MAIN OUTCOME MEASURES: The water content of brain tissue, content of Evans blue, and the contents of the lipid peroxide malondialdehyde (MDA) in brain and plasma after brain injury were observed.RESULTS: Totally 41 rats were injured, and 7 died after 24 hours, including 2 in the hyperbaric oxygen group and 5 in the brain injury group, and brain tissue: The water content of right brain in the brain injury group was obviously higher than that in the hyperbaric oxygen group and control group [(79.06±0.52)%, (78.38±0.37), (78.21±0.25)%, t=3.022-3.285, P ＜ 0.01]. In the brain injury group, the water content of right brain was obviously higher than that of left brain [(79.06±0.52), (78.57±0.14)%, t=2.651, P ＜ 0.05].injury group was obviously higher than that in the hyperbaric oxygen group and control group [(197.28±31.49), (167.65±25.88), (145.07±30.45) nmol/g,t=2.231-3.347, P ＜ 0.01-0.05]. In the brain injury group, the MDA content of right brain was obviously higher than that of left brain [(197.28of MDA: It was markedly higher in the brain injury group than in the control group [(2.69±0.54), (1.94±0.40) μmol/L, t=2.473, P ＜ 0.05].CONCLUSION: The hyperbaric oxygen therapy after brain injury can obviously decrease the water content and MDA content in brain tissue of the injured side, and such is the case with the MDA content in plasma,which is indicated that hyperbaric oxygen has a therapeutic effect on brain injury.

Objective To investigate the effects of 810 nm semi-conductor laser irradiation on the proliferation of olfactory ensheathing cells in vitro. Methods Olfactory ensheathing cells obtained from adult rat olfactory mucosa using the method based on different rates of attachment were irradiated with a semi-conductor laser ( wave length 810 nm; power density 10.3 mW/cm2) for 30, 60 or 120 seconds. Laser irradiation was performed 3 times with a 24 h interval. After the last irradiation, the cells were cultured. At the 3rd, 5th and 8th day of cell culture,cell proliferation was assessed with cell counts and a methylthiazoletetrazolium ( MTT) colorometric method. Results After 3 days of cell culture, the number of cells and average MTT values showed no statistically significant difference between the irradiated and control groups. At the Sth and 8th day, the differences among all the laser exposure groups and with the control group were significant, except for the average MTT values of the control group and the 30 s exposure group. Maximal effect was achieved with a 60 s exposure. Conclusions Low power laser irradiation can stimulate the proliferation of olfactory ensheathing cells in vitro, and the effect is time-dose dependent. The optimal irradiation time was found to be 60 s daily for 3 times, with a 24 h interval.

BACKGROUND: Osteoblasts have become a kind of important seed cells in bone tissue engineering. However, it is difficult to harvest osteoblasts, and the purity and calcification ability of osteoblasts isolated by different methods are inconsistent. OBJECTIVE: To compare the purity and calcification ability of osteoblasts induced from mouse bone marrow mesenchymal stem cells, MC3T3 cell lines, and cultured primarily from the neonatal mouse cranium. METHODS: Mouse bone marrow mesenchymal stem cells were isolated by differential adhesion method, and after passaing, passage 3 cells were cultured in osteogenic induction medium for 21 days. MC3T3 cell lines were cultured in osteogenic induction media 1 and 2 for 21 days. Osteoblasts were cultured primarily from neonatal mouse cranium by type Ⅰ coll agenase digestion method. Calcium nodules of osteoblasts obtained by three methods were observed by Alizarin red staining to detect osteogenic activity of cells. RESULTS AND CONCLUSION: (1) There were average 16.3 calcium nodules per low-power field after osteogenic induction of bone marrow mesenchymal stem cells. (2) There were sparsely distributed calcium nodules in MC3T3 cells after induction with osteogenic induction medium 1, accounting for 1.7 calcium nodules per low-power field, while there were dense calcium nodules in MC3T3 cells after induction with osteogenic induction medium 2, accounting for 44.6 calcium nodules per low-power field. There was a significant difference in the calcium nodule formation ability between the two groups (P < 0.01). (3) After primary culture, there was only 0.6 calcium nodule per low-power field. (4) Except for the insignificant difference between osteogenic induction medium 1 and primary culture groups, there were significant differences in pair-wise comparison of any other two groups. Except the insignificant difference between group I of MC3T3 inducing conditional media and primary culture osteoblasts, there were significant differences in the osteogenic ability between groups (P < 0.01). In conclusion, it is a better method to culture MC3T3 cells in osteogenic induction medium 2 containing dexamethasone, because many uncontrol able factors are involved in the isolation and culture of bone marrow mesenchymal stem cells.