Objective To study the diagnosis and treatment of iatrogenic bile duct injury(IBDI).Methods The clinical data of 92 patients with IBDI who had been admitted to our hospital from January 1994 to December 2007 were retrospectively analyzed.Results The diagnosis of IBDI was based on the clinical findings,diagnostic abdominocentesis and imaging examination.Sixteen patients gave up treatment because of economic reasons,and 2 patients who were complicated with sepsis and multiple organ dysfunction syndrome died shortly after being transferred to our hospital.Forty-eight patients were treated by Roux-en-Y choledochojejunostomy,14 by endoscopic treatment.2 by bile duet repair+T tube drainage,3 by percutaneous catheter drainage,1 by choledochoduodenostomy,4 by percutaneous transhepatic cholangiodrainage,and 2 by ultrasound guided percutaneous puncture drainage.Sixty-two patients were followed up for 4 month to 10 years(mean,3.6 years),and satisfactory results were obtained.Conclusions Detection of IBDI during operation and prompt repair yield favorable outcome.Roux-en-Y choledochojejunostomy is the best choice for bile duct injury complicated with biliary stricture.Endoscopic and interventional treatments are important auxiliary measures in the treatment of bile duct injury.

Objective To observe the effects of octreotide combined with enzyme supplementation in treatment of pain in chronic pancreatitis. Methods Fifty-six patients were divided into two groups. Thirty-six patients in the treatment group were treated with octreotide combined with enzyme supplementation,and twenty patients in the control group were treated with enzyme supplementation alone. The pain relief rate,analgesic requirement per day and average days in hospital were analyzed between the two groups. Results Compared with the control group,the treatment group presented better improvement of abdominal pain(P〈0. 05),less requirement of analgesics(P〈0. 05),and shorter duration in hospital(P〈0. 05). Conclusion Octreotide combined with enzyme supplementation is effective in alleviating pain and improving quality of life in patients with chronic pancreatitis.

Pituitary tumors, originated from homoral adenohypophyseal cells, are very common in intracranial neoplasms. They are characterized by a wide range of biological behavioral related to hormoral and proliferative activities. Previous pituitary adenoma studies mainly devoted to histological and ultrastructural classification with immunohistochemical techniques. Molecular biology allowed new approaches, especially concerning the pathogenesis and progression. This article reviews the progress of these researches regarding chromosomes, oncogenes, antioncogenes, transgenic animal models and genetic therapy.

ObjectiveTo discuss the causes and the managem ent of hemorrhagic c omplications after sterotactic surgery for Parkinson's disease (PD).Me thodsA total of 350 PD patients unresponsive to drug therapy from April 1999 to Decemb er 2001 underwent sterotactic surgery. Intracranial hemorrhage occurred in 6 cas es, consisting of 3 cases of lesion hemorrhage and 3 cases of puncture path hemo rrhage.ResultsOf the 6 cases, 4 were treated by surgical ope rations, with re covery of consciousness but hemiplegia left, and 2 were treated conservatively w ithout dysfunction left. No fatal cases were seen in the study.Conclus ionsHe morrhagic complications are often in association with repeated puncture, excessi ve heat, operative skills, patient's general condition and so on. Accurate targe t location by MRI combined with microelectrode guidance, reduce of microelectrod e recording times, lowering of the lesion temperature, and sufficient perioperat ive care contribute to the prevention of intracranial hemorrhagic complications.

Electret is a kind of functional material which can store charge for a long time. The external electrical field and microcurrent produced by electret can be applied to restore the electret state of the injured tissue, to improve the microcirculation and to accelerate the union of fracture, wound and nerve regeneration. Recently, the application study of electret in life science has been proceeding briskly. This paper briefly summarizes the application situation of electret in life science.

Objective To compare the effects of sevoflurane and isoflurane on ventilation function during laparoscopic cholecystectomy by monitoring side stream spirometry(SSS).Methods Totally 40 adult patients(ASA grade Ⅰ-Ⅱ),who were to undergo laparoscopic cholecystectomy,were randomly divided into sevoflurane group(group Ⅰ) and isoflurane group(group Ⅱ),with 20 cases in each.The two groups were given same preoperative medication and induction of anesthesia.Anesthesia maintenance was performed with inhaling of 1% sevoflurane or 1% isoflurane,combined with continuous intravenous infusion of propofol [3 to 5 mg/(kg?h)] and atracurium [0.3 to 0.5 mg/(kg?h)].The changes of the lung compliance and Airway resistance of the two groups,as well as dead space ratio,were observed in the two groups.Results ① Compared with the patients received intubation at the supine position,the two groups showed reduced pulmonary compliance(Cdyn) and significantly increased airway pressure(Paw,P

The vocal cord polyp is easy to relapse after surgery, but if the patient has recurrence in a short term, it is necessary to consider it as postoperative vocal cord contact granuloma. If the patients with contact granuloma after surgical treatment had severe impact on the pronunciation, it is necessary to be operated and confirmed by pathology and given the treatment of acid suppression, in order to avoid postoperative recurrence.
Granuloma ; diagnosis ; Humans ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; Polyps ; surgery ; Vocal Cords ; surgery

Objective To investigate the expression of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in hippocampus after status convulsion (SC) and explore the influence of age and duration of SC on the expression of BDNF and NGF. Methods Animal model with the different durations of SC (30 min,3h) were established by intraperitoneal injection of 3 mEq/kg lithium chloride,18-20 h later,followed by 5 mg/kg pilocarpine in 40 adult Wistar rats aged 2-3 months and 40 20-day-old Wistar rats. The normal control and experimental control were made in ten adult rats and ten 20-day-old rats (n=5 for each control). The rats were sacrificed at 3 h,6 h,12 h,1 d,3 d,7 d after 30-minute SC,or 3 h,1 d after 3-hour SC respectively. The location and cell type expression of BDNF and NGF in the hippocampus were observed by immunohistochemistry. The levels of BDNF and NGF at different time points were quantitatively analyzed by enzyme-linked immunosorbent assay (ELISA). Results The cells expressing BDNF and NGF located mainly in the dentate granule cells and CA1-CA4 pyramidal cells of hippocampus. The most positive immunoreactivity was in cytoplasm,partly in axons. The expression of BDNF had the tendency of increase in all rats after 3-hour SC,peaked at 1 d and 3 d respectively. These increases lasted for at least 7 d. Moreover,a several-fold increase was observed at the peak levels. The patterns of NGF expression were similar to that of BDNF after SC. The elevated degree and duration of NGF expression were remarkably lower than that of BDNF,declining abruptly to below control levels by 12 h with the characteristic of biphasic increase. The expression of hippocampal BDNF had the positive correlation with the duration of SC,but that of NGF was not. No matter the duration of SC,there was more rapid and evident induction of BDNF in 20-day-old rats and adult rats. Moreover,the age-related difference was more obvious for the longer duration of SC. Conclusion SC induced the expression of BDNF chiefly in hippocampus,and had minor influence on that of NGF. The expression of BDNF was related to age and duration of SC. There was a more rapid and marked induction of BDNF in 20-day-old rats and adult rats. The age-related difference had the positive correlation with the duration of SC.

Objective To research the role of matrix metalloproteinase-9(MMP-9), transforming growth factor ?1(TGF-?1) in viral myocarditis(VM) and their relationships with myocardial fibrosis, and to explore the forensic significance on sudden death due to viral myocarditis. MethodsSelected 30 cases of VM as experimental group,there cases were divided into definite VM group(n=18) and borderline VM group (n=12);Non-VM(n=10) were selected as control group. Collagen hyperplasia was observed by Masson staining. The expression and localization of MMP-9 and TGF-?1 in viral myocarditis were quantified by immunohistochemical method. Image analysis systems and statistical methods were used for quantitative analysis. ResultsThe amount of collagen fibre in the viral myocarditis group was more than that in the control group. The expression of MMP-9 and TGF-?1 were increased obviously. MMP-9、TGF-?1 expression were positively correlated with the collagen hyperplasis. ConclusionsThe MMP-9 and TGF-?1 may contributes to myocardial fibrosis, and may act as the assistant diagnostic indexes of sudden death due to viral myocarditis.

Objective To explore the effect of deep vein thrombosis(DVT)assessment scale on prevention of deep vein thrombosis in malignant tumor patients?Methods Eight hundred malignant tumor patients were divided into intervention group and control group according to admission time,400 cases in each group?The control group received traditional nursing.Methods of treatment and nursing,while the intervention group received pertinent nursing care based on the risk factors for DVT induced for the investigation among the patients using deep vein thrombus assessment scale.Result The incidence of DVT in the intervention group was significantly lower than that of the control group(P<0?05).Conclusions The deep vein thrombosis assessment scale may effectively predict the population at high risk of deep vein thrombosis?The implementation of effective nursing intervention may reduce the incidence of DVT?