Objective To study the characteristic of 8 to 16-year-old children's short-term memory.Methods 157 subjects participated in this study (8,10,12,14 and 16 years old).All subjects completed the digit recall,word recall,spatial recall and position recall tests.Results Short-term memory spans increased with age (F(4,145)= 35.56,P<0.01) and peaked at 14 years old [ digit (8.83±1.31),word (4.79±0.68),spatial (5.90±0.77),position (5.42±1.28)].Conclusion The developmental trends of four tasks' memory span were similar.But the exact span-scores were different from what Pascual-Leone's model predicted.

Bile duct injury is the most common complications of biliary surgery.With the development of tissue engineering,using artificial bile duct to treat the biliary tract disease has become the focus for the treatment of bile duct injury.This article summarizes the applications in clinical work and animal experiment of artificial bile ducts made of biological material,autologous tissue,non-absorbable polymer materials,as well as absorbable polymer materials in the clinical application and animal experiments.The advantageof each material is also discussed here.

Objective Inhibitory ability plays an important role in individuals' development process.It has close relationship with intelligence and other cognitive ability.This study aims to explore the development of inhibitory ability on 7- to 12-year-old children.Methods A sample of 187 children aged from 7 to 12 were divided into three age-groups:7- to 8-year-old,9- to 10-year-old and 11-to 12-year-old.They perfonned the Stroop Color and Word Test and their reaction time and accuracy were recorded.Results Compared with incongruent trials ( ( 801.88 ± 344.05 ) ms ),the reaction time on congruent trials ( ( 743.16 ± 227.20ms ) of all the children was shorter( F ( 1,181 ) =7.29,P ＜ 0.0 1 ).The accuracy of congruent trials (0.94 ± 0.11 ) was higher than that of incongruent trials (0.90 ± 0.13 ) (F ( 1,181 ) =28.41,P ＜ 0.001 ).The reaction time difference of 7- to 8 -year-old children ( 117.81 ± 396.68 ) ms was longer than that of 9- to 10-year-old children ( ( 24.70 ± 177.65 ) ms) (P ＜0.05).There was no significant difference between the reaction time of difference 9- to 10-year-old children and 11- to 12-year-old children ( (32.44 ± 120.07 ) ms) (P ＞ 0.05 ).The gender effect was not significant (F ( 1,181 )=1.69,P＞ 0.05).Condusion The inhibitory ability increases from 7 to 12-year-old.The ability of 9-to 12-year-old children is reasonably stable.There is no gender effect on children's inhibitory ability.

Recently,there is a gradual increase in the incidence of hyperlipidemic pancreatitis with high serum triglyceride (TG) levels.The treatments include general measures,lipid-lowering drugs,blood purification,low molecular weight heparin and insulin,traditional medicine,improving microcirculation,surgical therapy and gene therapy.The prevention of recurrence of hyperlipidemic pancreatitis is different from other types of pancreatitis.

Objective To determine if the cardiac index (CI) measured by transesophageal echocardiography (TEE) through the mitral valve (MV) agrees with that measured by transesophageal echocardiography through the ascending aorta (AA).Methods Sixteen ASA Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ),aged 18-70 kg,weighing 46-72 kg,undergoing mitral valve replacement under cardiopulmonary bypass (CPB),were studied.Total intravenous anesthesia was used for induction and maintenance of anesthesia.After tracheal intubation,the TEE probe was placed in the esophagus.CI was measured by transesophageal echocardiography through the MV (CIMV)and AA (CIAA) at 15,30 and 60 min after termination of CPB and recorded.All the data were compared by Bland-Altman analysis.Results CIMV values were significantly lower at each time point than CIAA values (P ＜0.01).The results of Bland-Altman comparison:CIMV 1.29-5.52 L· min-1 · m-2,mean was (2.6 ± 0.9)L·min-1·m-2,and CIAA 2.7-8.8 L·min-1·m-2,mean was (4.9± 1.7) L·min-1 ·m-2,bias was-2.3 L·min-1 ·m-2,and limit of agreement was-5.62-1.03 L· min-1 · m-2 resulting in r =-0.577,P ＜ 0.01.Conclusion CI values obtained through the MV agrees well with that measured through the AA using TEE in patients undergoing mitral valve replacement,but CIAA values are significantly higher than CIMV values,there is a large difference between them for clinical use,and both methods for CI measurement cannot replace each other.

As a new kind of perioperative management strategy and ideas,enhanced recovery after surgery (ERAS) brings a series of traditional perioperative treatment measures for optimization based on evidence-based medicine.Its primary aim is to decrease surgery-related stress,complications,and also to facilitate recovery with multimodal treatments.The ERAS pathway has been widely applied and proved to be efficient in gastrointestinal,colorectal,orthopedic,thoracic and gynecological surgery.Owing to the complexity of surgical procedure,long operation time and high perioperative complication rate in liver transplantation compared with other surgeries.This new concept has not been widely accepted or recommended in liver transplantation,although some previous studies have validated its safety and effectiveness.This paper overviewed the recent literature on the specific procedures,efficacy,safety and development of ERAS applied in liver transplantation.

Pancreatic leakage is most common among numerous complications after pancreaticoduodenectomy surgery.Predicting at early stage and taking preventive measures in time are of great importance to reducing the incidence of pancreatic leakage as well as its related complications.The article reviewed pancreatic leakage monitoring related reports worldwide in recent 10 years.It was found that some factors were useful for the prediction of pancreatic leakage including the drainage fluid amylase and leukocyte count on postoperative day 1 and 3,C-reactive protein on postoperative day 3,the combined detection of white blood cells and albumin on postoperative day 4,the serum urea nitrogen and the serum albumin on postoperative day 1 and 5-8 days,as well as the ratio of amylase level in abdominal drainage to abdominal drainage volume.

Objective To evaluate the changes in early left ventricular myocardial diastolic function after cardiopulmonary bypass (CPB) in the patients undergoing mitral valve replacement.Methods Twenty patients of both sexes,aged 40-70 yr,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅱ or Ⅲ),with left ventricular ejection fraction (LVEF) ≥ 45 ％,scheduled for elective mitral valve replacement with CPB,were enrolled in the study.Global and regional left ventricular diastolic function was measured by using TEE.After splitting of sternum and at 30 and 90 min after termination of CPB,HR,mean arterial pressure,central venous pressure,cardiac index,LVEF,early diastolic transmitral velocity (E),early diastolic tissue velocity (Ea),right ventricular early myocardial velocity (Em) and right ventricular late myocardial velocity (Am).E/Ea and Em/Am ratios were calculated.Results There was no significant difference in the parameters of hemodynamics and left ventricular diastolic function at each time point before and after CPB.LVEF was greater than 50％ and E/Ea ratio was greater than 20 at each time point in the patients.Conclusion There is no further damage to the early left ventricular myocardial diastolic function after CPB in the patients undergoing mitral valve replacement.

Objective To investigate the safety and clinical effect of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in the treatment of hepatocellular carcinoma (HCC) with cirrhosis.Methods The retrospective cohort study was adopted.The clinical data of 5 patients with primary HCC with cirrhosis who underwent ALPPS at the First Bethune Hospital of Jilin University between October 2014 and August 2015 were collected.The surgical plan was determined according to preoperative liver function and liver functional reserve.The patients underwent portal vein (PV) ligation and liver partition in the first staged surgery.The second staged surgery was performed when growing future live remnant (FLR) came up to the standard of safe section by rescan of computed tomography (CT) at 10,14,18 days after the first staged surgery,and hemihepatectomy and hepatic segmentectomy were applied to patients.(1) The intraoperative situations were observed,including the severity of liver cirrhosis,first staged surgery time,volume of intraoperative blood loss and FLR in the first staged surgery,interval time of surgery,growth rate of liver volume,ratio of FLR and standard liver volume (SLV),time and volume of intraoperative blood loss in the second staged surgery.(2) Pre-and postoperative biochemical indicators in the first and second staged surgeries were detected,including total bilirubin (TBil) and alanine phosphatase (ALT).(3) Postoperative situations were observed,including occurrence of complications,results of pathological examination and duration of hospital stay.(4) The follow-up using telephone reservation and outpatient examination was performed to detect tumors recurrence and metastasis and survival of patients by imaging examination and tumor marker test up to November 2015.Count data were represented as mean (range).Results (1) Intraoperative situations:of 5 patients,there were 1 patient with F3 of liver cirrhosis and 4 with F4 of liver cirrhosis.One patient was complicated with lots of peritoneal effusion,followed by acute renal failure,and didn't receive the second staged surgery.Four patients underwent successful ALPPS.The first staged surgery of 5 patients:average operation time,volume of intraoperative blood loss,FLR,interval time of surgery,growth rate of liver volume,ratio of FLR and SLV were 282 minutes (range,240-320 minutes),500 mL (range,300-700 mL),457 em3(range,338-697 cm3),15 days (range,14-18 days),58％ (range,46％-67％) and 42％ (range,32％-44％),respectively.Average operation time and volume of intraoperative blood loss in second staged surgery were 220 minutes (range,200-260 minutes) and 412 mL (range,300-600 mL).(2) Pre-and post-operative biochemical indicators:levels of TBil and ALT of 5 patients from pre-operation to postoperative day 12 in the first staged surgery were from 4.9-30.4 μmol/L to 9.8-56.1 μmol/L and from 12.9-156.1 U/L to 46.3-207.3 U/L,respectively.Levels of TBil and ALT of 4 patients from pre-operation to postoperative day 10 in the second staged surgery were from 10.1-21.2μmol/L to 6.9-38.0 μmol/L and from 30.8-55.5 U/L to 19.8-72.8 U/L,respectively.(3) Postoperative situations:there were no perioperative death and postoperative complications of liver failure and intraperitoneal infection.One patient complicated with bile leakage was cured by non-operative treatment for 30 days.Results of pathological examination:5 patients were confirmed as Ⅱ-Ⅲ stage HCC,and 4 tumors had vascular tumor thrombi and negative resection margin with tumor size of 8-13 cm.Duration of hospital stay of 5 patients was 36 days (range,28-48 days).(4) Results of follow-up:4 patients undergoing successful ALPPS were followed up for 4-12 months.One patient was emerged with a new lesion of 2 cm in left half liver at postoperative month 7,level of AFP of which was 512 μg/L before the first staged surgery reduced to normal level at postoperative month 2,and then the patient received transcatheter arterial chemoembolization (TACE) and radio frequency ablation (RFA) treatments without tumor recurrence up to postoperative month 12.No tumor recurrence and new lesions in liver were detected in other 3 patients by abdominal enhanced scan of CT,with a normal level of AFP.Conclusion ALPPS is safe and feasible for HCC with cirrhosis,with a satisfactory short-term outcome.

ObjectiveTo investigate postoperative application of multidisciplinary treatment (MDT) in hepatobiliary and pancreatic malignancies based on the pathological results. MethodsThe clinical data of patients who were diagnosed as hepatobiliary and pancreatic malignancies who were diagnosed and treated with postoperative MDT in our hospital from Apirl 2014 to March 2015 were analyzed. MDT was performed by consultation for four to six patients once every other week. The postoperative comprehensive treatment strategy for each patient was discussed and determined by all experts in the consultation. The effect of postoperative treatment and prognosis was summarized . Results25 postoperative MDT consultations on hepatobiliary and pancreatic malignancies were held for 131 patients, including 53 patients with hepatocellular carcinoma, 7 patients with intrahepatic cholangiocarcinoma, one patient with mixed-type liver cancer, 3 patients with metastatic liver cancer, 2 patients with liver sarcoma, 29 patients with extrahepatic cholangiocarcinoma, 22 patients with pancreatic cancer, 5 patients with gallbladder cancer, and 9 patients with periampullary cancer. After surgery, 38 patients received interventional treatment, 19 systemic chemotherapy, 15 radiotherapy, 17 cell biotherapy, and 5 molecularly targeted therapy. The case fatality rate was 2.29%（3/131）. ConclusionPostoperative MDT provides scientific and rational personalized comprehensive treatment for patients with hepatobiliary and pancreatic malignancies, and improves medication compliance in patients, which holds promise for wide application.