Objective To compare the operation situation of pancreatico duodenectomy (PD) and pylorus‐preserving pancreatico duodenectomy (PPPD) ,and analyze the clinical efficacy of PPPD .Methods Data of 47 patients with periampullary carcinoma and pancreatic head carcinoma underwent pancreatico duodenectomy from January 2010 to December 2013 were retrospectively analyzed and divided into PPPD group (20 cases) and PD group (27 cases) according to different surgery method .Then compare the situa‐tion of intra‐operative and post‐operative situation in two groups of patients .Results The operation time of PPPD group was sig‐nificantly lower than that of PD group (P<0 .05);the incidence of postoperative complication rate of PPPD group was obviously lower than PD group (P< 0 .05);and postoperative infection rate of PPPD group was significantly lower than PD group (P<0 .05);there was no significant difference between two groups in pancreatic leakage ,bile leakage ,gastrointestinal leakage ,post oper‐ative bleeding ,mortality and the incidence of delayed gastric emptying after surgery (P>0 .05) .Conclusion PPPD operation could shorten the operation time ,promote post‐operative recovery ,lower complication rates and shorten hospitalization time ,and could al‐so help to improve the nutritional status of patients ,improve the postoperative quality of life of patients ,thus it should be further promoted .

Objective To observe the effect of somatostatin on liver function in patients after splenectomy combined with de-vascularization.Methods The clinical data of 48 patients with liver cirrhosis,portal hypertension and esophageal varices were retro-spectively analyzed,26 cases (somatostatin group)were used somatostatin after splenectomy combined with devascularization,and the other 22 cases (control group)were not used.The changes of serum albumin (Alb),alanine aminotransferase (ALT),aspartate transaminase (AST),prothrombin activity (PTA)and total bilirubin (TBIL)was observed.Results All patients recovered well af-ter surgery,and no deaths occurred.However,ALT,AST and TBIL of using somatostatin group were significantly reduced than those of control group(P <0.05),Alb and PTA were also improved significantly (P <0.05).Conclusion The combination of som-atostatin can not only reduce postoperative portal pressure,control of bleeding,but also to be significantly promote recovery of liver function.

Objective To investigate the expression of BAMBI in pancreatic carcinoma tissue and its clinical value.Methods Expression of BAMBI was detected by immunohistochemistry in 69 cases of pancreatic cancer and 15 normal pancreatic samples.The survival and its association with clinicopathologic parameters were analyzed.Results The expression of BAMBI in the cancer tissue was much higher than that in the normal tissues (56.5％ vs 16.7％,P ＜0.01).The expression of BAMBI was not associated with age,sex and tumor size,differentiation,but expression of BAMBI in patient with lymph node metastasis was higher than that in patient without lymph node metastasis (67.4％ vs 38.5％,P =0.019),the expression of BAMBI in TNM stage Ⅲ was higher than that in stage Ⅰ + Ⅱ (75.0％ vs 31.0％,P =0.001).The median survival of BAMBI-positive group (6 months) was lower than that of BAMBI-negative group (10 months).Conclusions BAMBI is over-expressed in pancreatic carcinoma,and its expression is associated with lymph node metastasis,TNM staging,differentiation and prognosis.

OBJECTIVETo summarize the experience of urethral reconstruction using circular fasciocutaneous flap for the treatment of complex anterior urethral strictures.

METHODThe circular fasciocutaneous flap was harvested from the distal penile shaft or foreskin. Then the circular configuration was converted into longitudinal strip of skin which was rotated to ventral side to repair the exposured urethral strictures using the ventral onlay method. The surveillance protocol after urethroplasty was urination observation, regularly uroflowmetry and urethrography examination.

RESULTSFrom Nov. 2006 to Oct. 2012, 15 cases were treated. The mean age was 45 years (20-76 years) and mean follow-up period was 18 months(3 months-3 years). Stricture was caused by chronic urethritis in 4 cases, long-term urethral catheterization in 3 cases, transurethral perfusion chem other aphy in 3 cases, transurethral prostatectomy in 3 cases and hypospadias after surgery in 2 patients. The mean stricture length was 7.0 cm (3.5-12.0 cm). The overall success rate was 80.0% (12/15). Recurrence stenosis was noted in 2 cases and diverticulum formation in 1 case.

CONCLUSIONSThe penile circular fasciocutaneous flap can be used for anterior urethral stricture in nearly any length. The flap has the characteristics of hairless, adequate mobile and length, well-vascularized pedicle and easy to harvest. The onlay reconstruction provides excellent cosmetic results, less trauma, higher success rate. Therefore it should be one of the preferred techniques for complex anterior urethral stricture repair.

Follow-Up Studies ; Foreskin ; Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Prostatectomy ; adverse effects ; Recurrence ; Surgical Flaps ; transplantation ; Urethra ; surgery ; Urethral Stricture ; etiology ; pathology ; surgery ; Urologic Surgical Procedures, Male ; Wound Healing

OBJECTIVETo review and summarize the experience of urethral reconstruction using lingual mucosal graft for the treatment of complex hypospadias.

METHODSWe evaluated the methods using lingual mucosal graft for the treatment of complex hypospadias. The dorsal inlay graft method and the tube graft method were used in our study.

RESULTSFrom Nov. 2010 to Oct. 2011,21 cases were treated. All the cases had at least one failed hypospadisa surgery before. The dorasl inlay grafting technique was used for 16 patients, the tube grafting technique was carried out in 5 patients(2 cases received Tube + Duply method). The follow-up period ranged from 3 months to 12 months (by average 6 months). The success rate of the methods was 61.9% with complications in 8 cases. Urethral fistula developed in 3 patients and urethral stricture developed in 5 patients. All cases who suffered stricture received the tube grafting technique. The fistula and urethral stricture were occurred at the site of the urethral termonoterminal anostomosis. Urethral stricture is the most common complication after the tube graft method for the treatment of the complex hypospadias.

CONCLUSIONSHarvesting the lingual mucosal graft is feasible and easy to perform. The complex hypospadias repair technique using lingual mucosal graft method provides good results. There fore it should be one of the preferred techniques for complex hypospadias repair. The dorsal inlay grafting technique has lower complication rate than the tube grafting technique. Early and regular urethral sounding should be carried out when patients received the tube graft method.

Adolescent ; Child ; Humans ; Hypospadias ; surgery ; Male ; Mouth Mucosa ; transplantation ; Reconstructive Surgical Procedures ; adverse effects ; Tongue ; Urethra ; surgery ; Urethral Diseases ; etiology ; Urethral Stricture ; etiology ; Urinary Fistula ; etiology ; Urologic Surgical Procedures, Male ; adverse effects

Objective To evaluate the usability of magnifying laryngoscopy for the diagnosis of nasopharyngeal diseases.Methods An analysis was made on the nasopharyngeal figure and letter data among 6774 cases undergone magnifying laryngoscopy.Among these cases,biopsy would be given to those with suspected lesion in the nasopharynx carried out under magnifying laryngoscopy or endoscope.Results Compliance of patients to magnifying laryngoscopy at the rate of 98.9%(6700/6774)was superior to indirect nasopharyngoscopy 30.9%(2095/6774).The difference was statistically significant(X~2=6872.75,P＜0.005).Magnifying laryngoscopy could clearly show a variety of diseases in nasopharynx,early detection of suspicious lesions.Among 615 cases,both fiber nasopharyngoscopy(192 cases)and nasal endoscopy(423 cases)with nasopharyngeal uplift were used,magnifying laryngoscopy found 418 cases bilateral symmetry,the surface smooth,no abnormal.The pathological examination confirmed normal tissue.Other 197 cases in the larger laryngoscopy also showed the uplift in nasopharynx by pathologically examination confirmed a variety of benign and maligant lesions.Conclusions Magnifying laryngoscopy with strong brightness,high resolution,can early detect the nasopharyngeal lesions,increase the diagnostic accuracy rate and biopsy-positive rate.Therefore,it is valuable for the diagnosis of nasopharyngeal diseases.

OBJECTIVETo study the mechanism of male reproductive toxicity of metadoxine (MTDX) on mice and rats.

METHODSMouse multiple endpoints assay and Hershberger assay were employed to evaluate the potential estrogenic and/or antiandrogenic effects of MTDX. In mouse multiple endpoints assay, MTDX (0, 640, 1500 and 4000 mg/kg, respectively) were administered once daily p.o. for 5 days in sexually matured and ovariectomied female NIH mice. Five endpoints evaluated as markers of estrogenicity included the ratio of uterine weight to body weight, incidence and extent of uterine fluid imbibition (hydrometra), vaginal epithelial cornification during estrous cycle (estrinization) and thickness of uterine epithelial cell and stroma cell. In Hershberger assay, MTDX (0, 600 and 1500 mg/kg, respectively) was administered once daily p.o. for 10 days to castrated male SD rats with or without testosterone propionate (TP, 12.5 mg/kg, i.p. for 10 days) substitution. Relative weight of androgen dependent issues was measured.

RESULTSIn mouse multiple endpoints assay, ratio of uterine weight to body weight was 1.33, 1.38 and 1.31 x 10(-4) in MTDX 640, 1500 and 4000 mg/kg groups, respectively, without significant difference from that in control group (1.22 x 10(-4)). Thickness of uterine uterine epithelial cell (0.90 and 1.03 microm) and stroma cell (3.38 and 3.25 microm) in MTDX 1500 and 4000 mg/kg groups was not significantly different from the control group (0.85 microm and 2.77 microm, respectively). In Hershberger assay, relative weight of prostate plus seminal vesicle, levator ani muscle and bulbocavernous muscle was 1.13, 0.17 and 0.42, respectively, in the 1500 mg/kg group, significantly decreased as compared with those in the control group (1.46, 0.24 and 0.70, respectively) (P < 0.01). Relative weight of prostate plus seminal vesicle (1.29) in the MTDX 600 mg/kg group reduced slightly, with statistical significance (P < 0.05), as compared with that in the control group (1.46).

CONCLUSIONSIn the present study, MTDX did not exhibit any estrogenic effect in mice in vivo. However, it had antiandrogenic activity in castrated male SD rats, indicating that its antiandrogenic effect may be involved in it's male reproductive toxicity.

Androgen Antagonists ; toxicity ; Animals ; Drug Combinations ; Endpoint Determination ; Female ; Genitalia, Male ; drug effects ; pathology ; Male ; Mice ; Orchiectomy ; Ovariectomy ; Pyridoxine ; toxicity ; Pyrrolidonecarboxylic Acid ; toxicity ; Rats

OBJECTIVETo explore the mid-term surgical results of arterial revascularization for femoro-popliteal arterial occlusive disease (lesion type C and D).

METHODSFrom January 2005 to February 2009, 191 arterial bypass had been performed on 170 patients (21 cases bilateral). There were 108 male and 62 female, age ranged from 45 to 85 years old with an average of 67 years old. The operative indication was claudication in 78 cases, rest pain in 62 cases, ischemic ulcer in 19 cases, and distal tissue necrosis in 11 cases. Arterial angiography were performed on all cases. According to TASC II document, type C lesions were seen in 127 limbs, type D lesions were seen in 64 limbs. Autogenous greater saphenous vein bypass in situ were done on 15 limbs, autogenous greater saphenous vein bypass reversed in 20 limbs, revascularization with artificial prosthesis in 128 limbs, composite grafts consisting of a prosthetic conduit with a distal venous segment in 28 limbs.

RESULTSThere were no 30-day mortality. Follow-up periods ranged 6 to 36 months with an average of (24 + or - 6) months. Seventy-three cases were lost during follow-up periods, follow-up rate was 57% (109/191). Primary patency rate was 84.4% (92/109). The patency rate was 88.2% with artificial prosthesis, 70.8% with greater saphenous vein (in situ or reversed). Secondary patency rate was 89.9%.

CONCLUSIONSArterial revascularization with artificial prosthesis is main treatment for diffused superficial femoral artery occlusive disease (TASC II type C and D lesion) with satisfied surgical results.

Aged ; Aged, 80 and over ; Arteriosclerosis Obliterans ; surgery ; Blood Vessel Prosthesis Implantation ; Female ; Femoral Artery ; surgery ; Humans ; Male ; Middle Aged ; Popliteal Artery ; surgery ; Retrospective Studies ; Saphenous Vein ; transplantation ; Treatment Outcome

Objective To observe the effect of breathing exercise based on core strength training on nonspecific low back pain (NLBP). Methods From January to June, 2017, 60 patients with NLBP were randomly divided into control group (n=30) and ob-servation group (n=30). The control group accepted core strength training, and the observation group accepted breathing exercise in addition, for four weeks. They were assessed with Visual Analogue Scale (VAS) and Oswes-try Disability Index (ODI) before and after treatment, and their efficiency was compared. Results The scores of VAS decreased in both groups after treatment (t>4.173, P<0.001), and the scores of ODI de-creased in the observation group (t=3.875, P<0.01). The scores of both VAS and ODI were less in the observa-tion group than in the control group (t>2.595, P<0.05). The efficiency was better in the observation group than in the control group (χ2=3.874, P<0.05). Conclusion Breathing exercise based on core strength training can further improve function and relieve pain in patients with NLBP.

Objective To observe the changes of the pulmonary ventilation(VE)volume under different exercise intensities along with time,and to explore the best time for measuring VE under different intensities of exercise.Methods Sixty-one young mals were selected as subjects,who engaged in exercise of different intensities on the cycle ergometer(20, 40, 60, 80, 100, 120, 140, 160, and 180 W).The duration of exercise of each intensity was 6 minutes,the cardiopulmonary function was detected using a portable instrument,and real time monitoring of VE changes was enforced. Results (1)For exercise of intensity 20 W, VE initially increased fast with time, but after 1 min,it ceased to rise and remained stable.There was no significant difference at 1 min and afterwards(P>0.05).(2)The case was the same with exercise of the intensity 40 and 60 W.(3)For intensities of 80,100,120,140,and 160 W,VE became stable at 3 min. (4)For exercise of intensity 180 W,VE became stable at 4 min.Conclusion The time taken for VE to achieve stability under different intensities is different,which is positively correlated with the intensity of exercise.The greater the intensity of exercise,the longer it takes to achieve stability.