Objective To analyze the postoperative complications in aged patients receiving pancreaticoduodenectomy. Methods Pancreaticoduodenectomy was employed for the treatment of 52 aged patients. Of the 52 patients with a mean age of 70.5(65-76), 32 were male and 20 female. Postoperative pathological examination confirmed that 24 patients suffered from Vater,s ampullary and duodenal cancers, 16 from pancreatic carcinoma and 12 from cholangiocarcinoma. Results The mortality was 7.7%. Severe complications included bleeding (upper gastrointestinal tract or abdominal cavity),MOF, ARDS, postsurgical gastroparasis syndrome(PGS), mental disorder, pancreaticogastrostomy leak and biliary-enteric anastomotic leak et al. Conclusion MOF is the main lethal complication. Incidence of PGS and mental disorder is high.

Neutrophil gelatinase associated lipocalin(NGAL),also known as lipocalin 2,has close relationship with human neoplasias,which is up-regulated in a number of malignancy and involves in the process of tumor development.But it appears to exist paradoxical effects attributed to NGAL in human neoplasias.For instance,through protecting MMP9 from autodegradation,NGAL has a clear pro-tumoral and pro-metastatic effect,as has already been observed in breast cancer and esophageal cancer.However,on the contrary,for pancreatic cancer and ovarian cancer,NGAL can inhibit FAK phosphorylation and vascular epidermal growth factor synthesis,having an anti-tumoral and anti-metastatic effect.This review summarizes the current knowledge about the dual effects of NGAL in the process of tumor development,and attempts to explore the possible underlyins mechanism.

OBJECTIVE To study the change in drug-resistance to antibiotics in Gram-negative bacteria in Jinhua region in order to guide clinical application of antibiotics reasonably.METHODS The antibiotics resistance of Gram-negative bacteria from clinical samples in four general hospitals in Jinhua region during from Jan 2005 to Dec 2007 was studied retrospectively.RESULTS The detecting rates of extended-spectrum ?-lactamases in Escherichia coli and Klebsiella pneumoniae were rising from 41.0%and 25.3% in 2005 to 56.0%and 53.2% in 2007,respectively.Furthermore,0.8% isolates were resistant to carbapenemase from all E.coli and K.pneumoniae strains.The rate of antimicrobial resistance to carbapenemase was 20.0% in Pseudomonas aeruginosa and was increased from 27.0% in 2005 to 41.0% in 2007 in Acinetobacter baumannii.CONCLUSIONS The drug-resistance rate in Gram-negative bacteria hase increased obviously in past three years in Jinhua region.It suggests that there be an urgent need for surveillance of Gram-negative bacterial resistance in different hospitals and rational antibiotics usage be emphasized during clinical therapy.

AIM: To establish the fingerprint analysis of Yadanzi Youru Injection(Fructus Bruceae) and to provide the quality information by capillary gas chromatography(CGC). METHODS: The CGC method was used.The capillary column was Supelcowax~(TM)-10(30 m?250 ?m?0.25 ?m),The detector was FID. RESULTS: The result showed that 4 peaks were common and the content of oleic acid in Yadanzi Youru Injection was determined.The linear ranges were within(0.34)～(2.07) ?g/L,r=0.999 9 n=5; CONCLUSION: The method is simple,accurate and reproducible.It can be applied to the quality control of Yadanzi Your Injection.

Objective To investigate the expression and significance of survivin in hepatocellular carcinoma(HCC).Methods All reports published in the past 13 years on survivin and hepatocellular carcinoma (HCC) were reviewed.A Meta-analysis was conducted on these studies and it was used to determine the prognostic significance of the expression of survivin on patients with HCC.Results 18 studies were included into this Meta-analysis.There were 1 021 HCC patients and 208 normal controls.There was a significant difference between the positive rate of survivin in hepatocellular carcinoma and in normal tissues (0R =30.61; 95％ CI:16.67-56.23).The expression of survivin correlated with clinical staging,pathological differentiation,tumor metastasis,portal vein tumor thmmbus,and survival (P ＜ 0.05).There was no correlation with gender,age,AFP,HBsAg,tumor diameter,and tumor capsule (P ＞ 0.05).Conclusiom Survivin can be used as a molecular marker for the definitive prognosis of HCC.It is also a reliable marker in the choice of standardized and individualized therapy.

Objective To investigate the protective mechanism of trace element-selenium(Se) on the myocardium by against free radical superoxidation during myocardial ischemia/reperfusion(I/R) period in patients undergoing pulmonary bypass.Methods 46 patients with ASD or VSD were divided into control(23 patients) and Se administration(23 patients) groups.Before heart surgery,patients in the Se group orally received 400?g Se supplementation per day,for 7 days.The blood and myocardium samples were collected before clamping and after release respectively during pulmonary bypass.Biochemistry,electron spin resonance spectrometer(ESR),atomic absorption,RT-PCR and cDNA sequencing,were used to measure Se concentrations,MDA level,glutathione peroxidase(GPX) activity,GPX mRNA expression and GPX cDNA sequence in blood and myocardium.Results In Se group,before clamping,Se contents in blood cells and plasma, were not changed,but at reperfusion 30 minute,myocardial Se concentrations was evidently increased by about 1.1-fold,contrary to reduction 41% in blood cells.In Se administration group,at myocardial reperfusion 10 minute,free radical levels of the coronary sinus blood were significantly decreased 28%.No significantly changes in myocardial GPX activity or MDA level were found till reperfusion 30 minute.However,Se group had a higher myocardial GPX mRNA expression than that in controls in both before ischemia and after reperfusion.Conclusions Se supplementation can enhance Se content,expression of GPX-mRNA in myocardial tissue,and protect myocardium from radical lipooxidation damage.

Objective To investigate the value of micro-course in colostomy patients in self-care. Methods A total of 120 patients with colostomy patients were divided into the intervention group and the control group with 60 cases each according to the first time in the hospital bed and odd number. The intervention group was given micro-course in colostomy patients discharge health education. The control group was taken the traditional health education missionary single conduct health education of discharged. The self-efficacy (divided stoma care effectiveness and social effectiveness of two dimensions and six separate entries, score 28-140 points. Using five no confidencethere a little confidence some of confidencequite confident or very confident scoring 1-5 points) and stoma care skills (including two parts, a total of 18 entries, each entry method using Likert scale of 51-5 points representing very unskilledsomewhat skilledordinary skillskilled and very skilled, score 18-90 points, higher scores indicate better skills) of patients after 3 months of discharge between the two groups were compared and evaluated. Results After 3 months of discharge, the self- efficacy scores of the intervention group were evaluated with respect to stoma care, social performance, diet choice, confidence in sex life, confidence in sexual life, confidence in physical activity, confidence in vitality and confidence in self-care (53.17±3.54), (38.62±5.25), (3.45 ± 1.06), (2.43 ± 1.06), (2.22 ± 0.86), (2.88 ± 0.94), (3.52 ± 0.89), (3.88 ± 0.64) points, respectively, compared with the control group (50.45 ± 4.79), (35.33 ± 3.42), (3.03±1.15), (1.77±0.81), (1.78±0.72), (2.47±0.96), (3.02±0.70), (3.40±0.81) points, there were significant differences (t=-4.366--2.076, all P<0.05) . According to the comparison of stoma nursing skills, the score of stoma care and the related knowledge of stoma care were (36.33±4.21), (37.13±3.85) points in the intervention group, and (34.22±3.87), (31.32±4.95) points in the control group, and there were statistically significant difference (t=-3.140,-7.741, P < 0.05). Conclusions Colostomy patients discharged from hospital health education classes in the use of micro-course, can effectively improve patients' self-efficacy and ostomy care capacity, enhance the quality of life.

Objective To observe the change of nitric oxide(NO) and superoxide dismutase(SOD) in the epileptic rat brain cortex, and study the effect of the redox states of NO on epilepsy.Methods Using epileptic rat model induced by bemegride, the level of NO and the activity of SOD were measured in rat cerebral motor cortex during and only after seizures.Results The level of NO in rat cerebral motor cortex was significantly increased during and only after seizures than the normal controls. During seizures, SOD activity was decreased; but only after seizures, SOD activity was significantly increased.Conclusion The value of SOD activity than NO content had significantly difference in rat cerebral cortex between during and only after transient seizures. These results suggested that the different redox state of NO would play different role du ring the seizure.

Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm (PSN). Methods The clinical data of 31 patients with PSN treated in our hospital were retrospectively analyzed. Results Amongst the patients, 25 were diagnosed as PSN postoperatively. Fifteen out of the 19 patients with benignancy were treated with splenectomy, and the others underwent partial splenectomy or tumor excision. Eleven out of the 12 patients with malignancy received splenectomy (including two by excision of pancreatic body and tail), and the other one underwent biopsy alone. The pathological types were as follows: varieties of cyst in 11, angiocavemoma in 4, inflammatory pseudotumor in 2, cavernous lymphangioma in 1, cystic degeratin of liomyoma in 1, malignant lymphoma and lymphsarcoma in 6, hemangiosarcoma in 3, fibrosarcoma in 1, liomyosarcoma in 1 and malignant fibrous histiocytoma in 1. Three patients with malignancy survived for 5 years. The reason was that they received radical splenectomy in combination with chemotherapy or radiotherapy and immunotherapy. Conclusions PSN should be diagnosed mainly according to clinical manifestations and image examination. The differentiation between benignancy and malignancy depends on CT, hemangiography and determination of seros AKP and ? GT levels. Early diagnosis, radical operation and comprehensive treatment are important for improving the prognosis of PSN.

Objective To study the processing method,extraction technology and quality evaluation analysis of Paeonialactiflora Pall, so as to provide reference for selecting the best method and improving its quality .Methods One year and 3 years Chinese herbal medicine Paeonialactiflora Pall was used.The use of raw materials and cooked products for processing methods to paeoniflorinas the representative , and the content was determined by high performance liquid chromatography.With the optimization of orthogonal test, the methods for the determination of effective components of radix paeoniaealba were summarized and the quality control methods were analyzed .Results The content of paeoniflorin in raw paeonialactiflora pall was (6.33 ±0.52)%,and the content of paeoniflorinin cooked Paeonialactiflora Pall was (5.74 ±0.45)%, which was with statistical significance(P <0.05).The content of paeoniflorin in raw paeonialactiflora pall was (5.90 ±0.38)%,and 4.85 ±0.45% in three years cooked paeonialactiflora pall, and the differenceswere with statistical significance(P<0.05).Extracted three times with 70% ethanol, time 65 min, 6 times the amount of solvent,the paeoniflorin high cream rate was highest.By means of induction, several active ingredients should be screened out to control the content of paeonialactiflora pall to publish multiple indicatorsquality control methods .Conclusion The preparation method of Chinese herb paeonialactiflora pall has showed that the active ingredient content is morein raw herb.To establish quality control method of multiple indicators of paeonialactiflora pall based on raw herb,gradually improve the quality of more comprehensive paeonialactiflora pall quality control model.To optimize the extraction of Chinese herbal medicine,provide scientific reference for the sustainable utilization and industrial production of paeonialactiflorapall.