Objective To assess the feasibility of the treatment of unresectable late pancreatic cancer with laparoscopic choledochojejunostomy and gastric bypass. Methods From June 2000 to December 2003, laparoscopic choledochojejunostomy and gastric bypass were successfully performed in 15 patients with unresectable late pancreatic cancer. Endoscopic noso biliary drainage (ENBD) was performed before the operation. Results All procedures were completed laparoscopically. Jaundice and hepatic function of the patients were obviously improved after the bypass. Oral nutrition was recovered after operation. The mean operative time was (100?26) min (range 70-200 min); the mean operative blood loss was (60?15) ml (range 30-120 ml); the bowel function recovery was on the 3rd-5th postoperative day; the average hospital stay was (8.1?0.7) days (range 6-13 days). Incision infection ocurred in one patient. No operative complications occurred in other patients. Conclusion Treatment of unresectable late carcinoma of the pancreas with laparoscopic choledochojejunostomy and gastric bypass aided by ENBD is a minimally invasive technique with less postoperative pain,shorter hospital stay, lower procedure related morbidity,and better oral nutrition. The life quality of patients with late pancreatic cancer can be obviously improved.

Objective To assess the feasibility and clinical effect of hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma.Methods Hand-assisted laparoscopic cholecystojejunostomy and gastroenterostomy combined with()~(125)I seed implantation was performed in 12 patients with advanced pancreatic carcinoma(pancreatic head,10 patients;pancreatic body,2 patients) between February 2002 and August 2004 in this hospital.Results All the operations were successfully accomplished.The operative time was 104~181 min(122?29 min),the operative blood loss was 45~152 ml(60?18 ml),and the length of hospital stay, 6~17 d(8.5?1.3 d).Postoperatively,the jaundice subsided gradually,and the patient's liver functions recovered to normal in 7~10 days.The abdominal pain disappeared in 3 patients and was obviously remitted in 7.Gastrointestinal dysfunction occurred in 2 patients and was cured with symptomatic therapy.Follow-up checkups with CT scannings in 10 patients for 6 months showed partial remission(PR) in 4 patients,no changes(NC) in 4 patients,and progressed disease(PD) in 2.Conclusions Hand-assisted laparoscopic internal drainage combined with()~(125)I seed implantation for the treatment of advanced pancreatic carcinoma is effective and micro-invasive.

Objective To explore the impact of juxtapapilary duodenal diverticulum on the formation of choledocholithiasis and biliary manometry after surgery.Methods The clinical data of 97 patients with common bile duct stones who successfully underwent ERCP and biliary manometry treatment from May 2011 to March 2014 were retrospectively analyzed.Ninty-seven common bile duct stone patients were divided to two groups,that is,52 cases of juxta-papilary duodenal diverticulum (experimental group) and 45 cases without juxta-papilary duodenal diverticulum (control group).The biliary manometric results before and after EST of both groups were compared.Results The basal pressure of sphincter Oddi of the experimental group before EST [(84.8 ± 26.1) mmHg] was higher than that of the control group before EST [(75.5 ± 14.6) mmHg] (P ＜ 0.05,1 mmHg =0.133 kPa);and that after EST was also higher than that of the control group after the operation[(19.8 ± 14.2)mmHg VS (15.9 ± 9.8)mmHg,P ＜ 0.05].The biliary pressure of common bile duct stone patients with JPD was higher than those without JPD before and after EST but with no significant difference(P ＞ 0.05).The biliary manometry was performed in 81 patients after one month and it was found that the basal pressure of sphincter Oddi of experimental group was still higher than that of the control group [(34.8 ± 17.1) mmHg VS (29.6 ± 15.3)mmHg,P ＜ 0.05].The biliary pressure of common bile of the experimental group was higher than that of the control group [(19.9 ± 11.2) mmHg VS (17.1 ± 13.1)mmHg,P ＜0.05].Conclusion The existence of juxtapapilary duodenal diverticulum increases the pressure of common bile duct and Oddi sphincter and leads to CBD stones.

BACKGROUND: Recently, there are some researches show that the nutrition and control of nervous system play an important role in the growth of bone and healing of bone fracture.OBJECTIVE: To probe into the effects of brain-derived neurothophic factor on bone fracture healing and its biomechanic features.DESIGN: Randomized controlled study of experiment animals.SETTING: Traumatic orthopaedic and hematology department of a military medical university.MATERIALS: There were 16 SD rats with transverse fracture of shin,which were set up as intramedullary nail internal fixation. They were randomly divided into experiment group and control group with each of 8 mice.INTERVENTIONS: Rats in the experiment group were taken subcutaneous injection of brain derived neurotrophic factor(BDNF) every other day while control group was injected of saline. The shin of mice was collected to observe in the 2nd, 3rd, 4th and 5th weeks.MAIN OUTCOME MEASURES: Gross comparison of fracture healing of each group, biomechanical test and electro microscopic observation.RESULTS: It can be seen by gross observation 2 weeks after operation that the fracture area was linked by connective tissue in both groups and there was obvious movement. In the 3rd week, woven like bone healing could be seen in the experiment group whereas there was obvious fracture end movement in the control group. In the 4th week, bone healing could be seen in both groups, but the bone callus in the experiment group was much smaller with mild angled malformation. In the 5th week, the fracture line in the experiment group already disappeared and the molding of bone fracture was good while there was bigger bone callus in fracture end of the control group. The angle formed by sagittal planes of fracture in the 3rd, 4th and 5th week was(25.00 ± 1.82)°, (24.75 ± 2.50)°, (23.25 ± 3.77)° respectively in the experiment group and(32.00 ±2.45)°, (33.00 ±5.72)°, (29.25± 2.22)° respectively in the control group( P ＜ 0. 05) . The anti-fracture stress in each stage of the experiment group was better than that of the control group( P ＜ 0.05).CONCLUSION: Applying BDNF early and incessantly can stimulate all the stages of bone fracture healing.

Objective To study the expression of nerve growth factor (NGF) in sensory and motor Schwann cells and its significance in the nerve specific regeneration Method Sensory and motor Schwann cells were prepared in vitro,and each group of cells were cultured in common media and IL 1 media respectively The expression of NGF was measured by Sangwich ELISA Result Generally speaking,the expression level of sensory Schwann cells is higher than that of motor cells And the expression modes of the two types of cells are different,according to the timing and peak numbers Conclusion The NGF expressions of sensory and motor Schwann cells are different,such a difference may partly explain the mechanism of the nerve specific regeneration

Animals ; Embryo Culture Techniques ; Embryo, Mammalian ; Female ; Ganglia, Spinal ; cytology ; drug effects ; Glial Cell Line-Derived Neurotrophic Factor ; pharmacology ; Male ; Motor Neurons ; drug effects ; Neurons, Afferent ; drug effects ; Rats ; Rats, Sprague-Dawley

Objective To explore the long-term efficacy of botulinum toxin type A injections on facial beauty and its long-term safety.Methods A total of 33 beauty-seekers with botulinum toxin type A treatment for more than five years were reviewed as observation group,using digital muscle palpation meter (Myoton PRO) for the determination of the orbicularis oculi muscle and masseter muscle tension (F),the muscle characteristic parameters,such as muscle hardness (S) using a homemade facial questionnaire test for satisfactory rate of beauty from both beauty-seekers and physicians.At sametime,33 normal adults that never accepted botulinum toxin injection with matched age and gender were collected as control group.The same-sex indicators were dtermined and compared with using statistic analysis t test.Results The pairwised parameters of the same sex and site were comparied between the two groups;average F and S values in the observation group were lower than those of the control group,but no statistically significant difference were observed between the two groups (P＞0.05);in the observation group,average appearance age was 7.3 years younger than the control group,and the facial shape improved significantly.Conclusions Long-term and repeated application of botulinum toxin A is able to remove crow's feet and decrease the masseter and so the injection is safe with high satisfaction to beauty-seekers.

Purpose To investigate the clinicopathologic features of cervical adenoid basal cell carcinoma. Methods Clinical and pathological data were analyzed in 12 cases of cervical adenoid basal cell carcinoma and the relevant literatures were reviewed. Results The age of 12 cases of with cervical adenoid basal cell cancer patients ranged from 36~70 years ( mean:53. 3 years) , with a medi-an age of 51. 5 years. Amongst 12 patients who contained no gross definite lesion, 5 patients (41. 7%) had the symptoms of vaginal bleeding. 8 cases of patients underwent hysterectomy, while the other four received cervical conization. Cervical intraepithelial neopla-sia ( CIN) lesions were observed in all 12 cases. The tumor cells were small and uniform, with dark oval nuclei without conspicuous nucleoli and scanty cytoplasm. Tumor infiltrated into the stroma in nests and cords. Glandular differentiation within tumor nests were seen in 12 cases, including two cases of squamous cell differentiation accompanied by partial and minor interstitial edema. Peripheral palisading cells around tumor nests were also found. The infiltrating depth of tumor ranged from 0. 5~10 mm with the average 4. 12 mm. Cancer embolis were available in 2 cases with no lymph node metastasis. 10 cases followed up for 3~78 months with no recur-rence and metastasis, but 2 cases were lost. Conclusion Adenoid basal cell carcinoma is a rare uterine cervical tumor found in post-menopausal women, which are often accompanied with CIN. This tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma and other tumors which also have infiltrative growth pattern.

Objective To investigate the expression of poly (ADP-ribose) polymerase-1 (PARP-1 ), cytokeratins (CK) 7/20, and p53 in patients with Barrett's esophagus and esophageal adenocareinoma,and to evaluate their significance. Methods Expression of PARP-1, CK7/20 and p53 were determined by immunohistochemistry in 108 patients (including 40 Barrett's esophagus, 28 esophageal adenocarcinoma and 40 cardiac mucosa). Results The expression of PARP-1 was found in Barrett's esophagus, esophageal ade-nocarcinoma and cardiac epithelium with a significantly higher level in esophageal adenocarcinoma than the other two groups (P <0. 01 ). CK7/20 was expressed in much of intestinal metaplasia, part of cardiac epi-thelium and adenocarcinoma cells. The positive expression of p53 was observed in all three groups, and it was significantly higher in adenocarcinoma group than in other two groups (P < 0. 05 ). PARP-1 expression is highly correlated with that of p53 in Barrett's esophagus ( r= 0.49, P < 0.01 ). Conclusion CK7/20 is a sensitive but less specific indicator for intestinal metaplasia. Both PARP-1 and p53 are involved in the patho-genesis of esophageal adenocarcinoma and might help to determine the risk of Barrett's esophagus developing into esophageal adenocarcinoma.

OBJECTIVE: To observe the protective effects of Corydalis ambailis migo total alkaloids (COAMTA) on cerebral ischemia/reperfusion injury in rats and to investigate its mechanism. METHODS: The effects of COAMTA on decapitated gasping mouse model and rat model of middle cerebral artery ischemia (2 h)/reperfusion (22 h) were observed. The neurological scale, cerebral infarcted volume and cerebral water content subjected to cerebral middle artery ischemia/reperfusion in rats were recorded. The activities of nitric oxide synthase (NOS) and superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in the ratso brain were measured. Cell apoptosis in ischemic penumbral area was observed with light microscope in the method of terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL). RESULTS: The average gasping time of the mice (6.0 mg/kg or 9.0 mg/kg COAMTA) was significantly prolonged, the cerebral infarcted volume and cerebral water content of the rats (5.0 mg/kg or 7.5 mg/kg COAMTA) were significantly decreased, as compared with the control groups. The average activity of SOD in cerebral tissue of the rats (5.0 mg/kg or 7.5 mg/kg COAMTA) was significantly higher than that of the control groups, meanwhile, the average activity of NOS and the content of MDA declined significantly. The cell apoptosis in ischemic penumbral area of the rats (5.0 mg/kg COAMTA) was significantly inhibited as compared with the control groups. CONCLUSION: COAMTA can facilitate the protection against cerebral ischemia/reperfusion damage. The mechanism is related to inhibiting the activity of NOS and lipoperoxidation, increasing the activity of SOD and decreasing the neuronal apoptosis.