6 hours). The APACHE Ⅱ and POSSUM scoring system during perioperative period was in positive correlation with postoperative morbidity and mortality. Conclusions Pancreatoduodenectomy for the treatment of periampullary carcinomas is with high risks. Postoperative mortality and morbidity were in close correlation with the risk factors.

Objective To investigate the clinical outcomes of radical surgery for pancreatic body and tail tumors accompanied with sinistral portal hypertension (SPH).Method The clinicopathological data of 35 patients with pancreatic body and tail tumors accompanied with SPH operated from January 2004 to December 2014 were retrospectively analyzed.Results Of 35 patients,22 patients had body and tail pancreatic carcinomas,10 patients had malignant solid pesudopaillary tumors and 1 patients had a neuroendocrine tumor.All these patients developed splenomegaly and varices in the gastric fundus with normal hepatic function.The splenic vein pressure was (27.3 ±3.8)cmH2O (1 cmH2O =0.098 kPa),its average diameter was (1.3 ± 0.3) cm,and the speed of splenic vein blood flow was (8.9 ± 0.8) cm/s.Of the 35 patients with pancreatic body and tail tumors who underwent radical resectional operations,22 patients in addition underwent devascularization.There were 13 of these 22 patients who underwent pericardical devascularization and the remaining 9 underwent total or proximal gastrectomy.The main complications were pancreatic fistula (n =5,14.2％),intra-abdominal infection (n =4,11.5％),delayed gastric emptying (n =1,2.8％),lymphatic fistula (n =1,2.8％) and gastric perforation (n =1,2.8％).The post-complication morbidity rate was 34％.All these patients were followed-up for 6 to 60 months after operations.There was no upper gastrointestinal bleeding which occurred within 6 months of operation.Conclusion Multi-disciplinary treatment,complete preoperative evaluation,correct perioperative and individualized management enhanced efficacy in the surgical treatment of patients with pancreatic body and tail tumors with SPH.

Objective To investigate the clinical efficacy of radical operation for gastric cancer with liver cirrhosis.Methods The clinicopathological data of 56 gastric caner patients with liver cirrhosis performed on between Jan 2000 and Dec 2013 were analyzed retrospectively.Results The morbidity rate was 71％.The main complications of the group with liver cirrhosis were postoperative ascites (7 cases),delayed gastric emptying(6 cases),pulmonary infection(8 cases),intra-abdominal infection (5 cases),anastomotic leakage (3 cases).wound infection (2 cases)and,astrointestinal bleeding(1 cases).Postoperative complications of gastric cancer with liver cirrhosis were associated with age (＞ 60 yrs),Child-pugh grade(B),lymph node dissection(D2).There were no mortality.The 1-,3-and 5-year survival rates of the 56 cases were 73.2％,41％ and 26.7％.Conclusion Multi-disciplinary treatment,complete preoperative evaluation,correct perioperative management,individualized principle were the best mode on effective treatment of the patients with liver cirrhosis.

Objective:To investigate the clinical value of serological test indicators in the identification of primary and metastatic liver cancers. Methods:We detected the serum levels of ALT, AST, ALP, TBIL, DBIL, GGT, CHE, 5'-NT, CA199, CEA, and AFP in primary hepatic carcinoma (PHC;120 cases), metastatic hepatic carcinoma (MHC;135 cases), and no liver metastatic control (135 cas-es) groups. The methods used were variance analysis and Scheffe test. ROC curve analysis was used to determine the diagnostic value of CA199 , CEA, and AFP in PHC and MHC. Results:The difference between the serum levels of AST, ALP, GGT, 5'-NT, AFP, and CEA of the PHC and MHC groups was statistically significant (P<0.05). The AFP, CEA, and CA199 areas under the ROC curve of the PHC and MHC groups revealed that AFP diagnosis of primary liver cancer had certain accuracy, whereas CEA and CA199 have some diagnostic value in differentiating primary and metastatic liver cancers. Conclusion: The detection of serum levels of AST, GGT, 5'-NT, AFP, CA199, and CEA in malignant tumor was a preliminary diagnosis of liver metastasis and can provide evidence for the dif-ferential diagnosis of PHC and MHC.

OBJECTIVE:To observe the clinical efficacy and transdermal absorption of Suhong bone-penetrating massage drug for rheumatic arthralgia. METHODS:Suhong bone-penetrating massage drug(Chinese medicine) was applied in 300 cases with rheumatic arthralgia characterized by various symptoms such as bone spur, injury, scapulohumeral periarthritis, acute injury or chronic strain of articular surrounding soft tissue; Suhongtougu powder was used as control to treat another 120 cases with the same disease. The curative efficacies in two groups were compared. The effects of the effective components such as Muskone,Borneo Camphor,Menthol in Suhong bone-penetrating massage drug on the transdermal absorption of this preparation was investigated by transdermal test on mice. RESULTS:The total effective rate in the treatment group was 93.24% as compared with 80.00% in the control group, showing significant difference between two groups(P

Objective To study the surgical treatment of the primary retroperitioneal sarcoma(RPS). Methods The treatment and prognosis of 63 patients with primary retroperitoneal sarcomas (liposarcomas and leiomyosarcomas) from Jan 1992 to Dec 2000 were analyzed retrospectively. Results The rate of complete tumor resection was 88.2%, and concomitant resection of involved adjacent organs was 21.6%. There was no operation death. The median survival time(MST) in liposarcomas that for was 36.5months, and leiomyosarcomas was 27.6 months. The MST in highly differentiated tumor was 34.7 months,and that of intermiade and low differtiated tumors was 18.1months(P

Objective To study the best preparation technique of compound Thallus laminaria granules volatile oil-?-cyclodextrin clathrate and examine the stability of the elathrate.Methods The orthogonal design method was used to optimize the formulation.The yeild of the volatile oil and the content of the clathrate were used as the test target.Results The best preparation process was as follows:?-cyclodextrin:compound Thallus laminaria=12:1(g?mL~(-1)),at 50～60℃for 2 hours.Making distillation twice while adding water to the first decoction, steaming 1h after boiling;A_2 B_1 was the best extraction scheme.Conclusion The preparation process can be a scheme to obtain the clathrate with high content of effective component,which can be used in the preparation of the clathrate.

OBJECTIVE:To evaluate 3 therapeutic schemes for the infections of urinary tract and look for the more rational one METHODS:To use pharmacoeconomic decision tree analysis RESULTS:By means of therapeutic schemes A,B,C,the anticipant costs for curing one case of urinary tract infection were 1 586 36 yuans,931 13 yuans and 899 24 yuans respectively CONCLUSION:The scheme C is the best one among 3 therapeutic schemes for infection of urinary tract

Objective To investigate the effect of dexmedetomidine on the serum concentrations of S-100 β protein and neurone specific enolase (NSE) in elderly patients undergoing surgery.Methods One hundred ASA Ⅱ or Ⅲ patients,aged 65 ～75 yr with a body mass index of ＜25 kg/m2,scheduled for elective hip joint replacement surgery under general anesthesia,were randomly divided into 2 groups (n =50):control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.5 μg/kg was infused intravenously over 15 min before anesthesia induction in group D and was maintained 0.4 μg/(kg·h) until 30 min before operation end,while the same volume of normal saline was infused in group C.Anesthesia was induced by iv injection of sufentanil 0.4 μg/kg and propofol 1 ～ 2 mg/kg until loss of consciousness.Tracheal intubation was facilitated with 0.6 mg/kg rocuronium bromide and the patients were mechanically ventilated.Anesthesia was maintained with sevoflurane by target controlled inhalation (TCI) (end-tidal concentration set at 1％～3％) and sufentanil 0.2 μg/(kg·h) in both groups.BIS was maintained at 40～60 during operation.Venous blood samples were obtained for determination of serum concentrations of S-100β protein and NSE before anesthesia (baseline),operation end and at 12h after operation.Patients were sent to Intensive Care Unit when operation end.All the patients were assessed for the development of delirium by experience research staff using Confusion Assessment Method for Intensive Care Unit.The incidence of postoperative delirium within 24h after operation were recorded,and compared between the two groups.Results The serum concentrations of S-100β protein and NSE was significantly increased at T1～2 than at T0 in two groups.The total dose of each anesthetic (propofol,sevoflurane),the serum concentrations of S-1005 protein and NSE,and the incidence of postoperative delirium were significantly lower in group D than in group C (P＜0.05).Conclusions Dexmedetomidine can reduce the serum concentrations of S-100 β protein and NSE,and can also reduce the occurrence of postoperative delirium in elderly patients undergoing hip joint replacement surgery.Dexmedetomidine can provides cerebral protection in elderly patients undergoing surgery.

Objective To analyze the regulation of estrogen receptor α (ERα) on truncated neurokinin-1 receptor (NK1R-Tr), and the influence of this regulation on cell proliferation in estrogen receptor-positive breast cancer cell lines. Methods The chromatin immune coprecipitation (CHIP) was used to observe the transcriptional regulation function of ERαon NK1R-Tr in breast cancer cells. Luciferase reporter gene assay was used to verify whether ERα played a positive regulatory role in the expression of NK1R-Tr. Western blot assay and real-time-PCR were used to detect the expression of ERα and NK1R-Tr in breast cancer cells, MCF-7 and T47D, as well as the expression of NK1R-Tr protein and mRNA level. NK1R-Tr levels were also detected after using estradiol (E2, ERα agonist) and small interfering RNA (knock out ERα). CCK-8 and clone formation experimen were used to detect the proliferation ability of breast cancer cells after knocking out NK1R-Tr with small interfering RNAs. Results CHIP test and Luciferase reporter gene assay proved that ERα can positively regulate the expression of NK1R-Tr via the ERα sequences in the upstream of the NK1R-Tr gene promoter. The expression of NK1R-Tr at both protein level and mRNA level dropped in the estrogen receptor-positive breast cancer cell line MCF-7 upon knocking out ERα. After knocking out NK1R-Tr, the proliferation ability of estrogen receptor-positive breast cancer cells was lower than that of the control group. Conclusion The ERα positively regulates the expression of NK1R-Tr, resulting in the increased cell proliferation in estrogen positive breast cancer cells.