Pancreaticoduodenectomy (PD) is the main method for treatment of the benign and malignant tumor of pancreas and periampullary. The operation is complicated, and complications are more and serious. Among the complications, the pancreatic fistula is the main factor influencing postoperative recovery and decides the operation effect. With the continuous development of technology, pancreaticojejunostomy shows continuous improvement, which includes invagination pancreaticojejunostomy, duct-to-mucosa pancreaticojejunostomy and binding pancreaticojejunostomy, and each has its advantages, disadvantages and indications. Therefore, it is necessary to abide by individualized principle for the methods of pancreaticojejunostomy.

WAE. Conclusion SBE method is better than the other three methods in the extraction of Jiaotai Pill components.

Objective To investigate the epidemiological characterization , effect of prevention and control measures during an outbreak in a military unit caused by Mycoplasma pneumoniae.Methods All the cases were investigated to learn about their basic characteristics , clinical symptoms and aggregation activities using epidemiological cross-sectional study . Results From May 16 to June 11,2013, forty-nine confirmed cases and thirty-five suspected cases who were all males were found at an attack rate of 7.8%.The epidemic peak period was from May 27 to Jun 2(seven days), and the number of total cases was 66(75.9%).During the outbreak, the attack rate of the 10th cadet team, other cadet teams and a non-student population was 47.5%, 4.5% and 1.2% respectively.The difference was significant (P<0.01).The age of forty-nine confirmed cases ranged from 17 to 26 years old , the attack rate did not differ significantly between different age groups, and no aggregation was found in the place of birth and soldier source .The most frequent clinical symptoms were fever and cough for the confirmed cases , 62.5% of whom showed unilateral or bilateral lung inflammation change , while few positive lung symptoms were present .All the confirmed cases were hospitalized and no severe or critically ill cases were present.The outbreak was controlled effectively after implementation of case surveillance , contact precaution , termination of aggregation activities , dispersed habitation and prescription of azithromycin for disease prevention .Conclusion The confined and crowed environment for learning and training can increase the risk of M.pneumoniae outbreak , making it nec-essary to enhance disease prevention awareness , improve case management , live dispersed , reduce close contact and imple-ment personal hygienic measures .

OBJECTIVE:To optimize the extraction technology of Zishen yangyin granules.METHODS:The yield of the extractum and the content of the extraction using 80% alcohol as solvent were used as indexes to optimize the extraction technology of Zishen yangyin granules by orthogonal experiment with the times of extraction,the extraction time and the amount of water added as factors.RESULTS:The optimal extraction conditions were as follows:the extraction was carried out for 3 times by adding water at an amount of 9 times,6 times and 6 times,respectively that of solid substance with decoction time of 3 h,2 h and 1 h,respectively.CONCLUSION:The optimal extraction process was proved to be time-saving and energy-saving and suitable for large production.

AIM:To study testicular pathological change and its pathogenesis. METHODS:Testicular structure of alloxan induced diabetic rats was observed under light microscopy (LM)and transmission electron microscopy(TEM). Activity of superoxide dismutase(SOD),glutathione peroxidase(GSH-PX)，nitric oxide synthase(NOS)and content of malondialdehyde (MDA),nitric oxide(NO) were detected biochemically in testicular homogenate. RESULTS:It is manifestated as atrophy of seminiferous tubule and germinal arrest under LM and expansion of mitochondria and smooth endoplasmic reticulum, cytoplasmic inclusion of sertoli cell under TEM.Activity of SOD, GSH-PX decreased while activity of NOS, content of MDA, NO increased in diabetic rats compared with control one. CONCLUSION:Disturbance of spermatogenesis and damage of sertoli cell are the main morphological change of diabetic testis, lipid peroxidation and NO may be involved in it.

Background and purpose:Differentiation of tumor tissue is an important factor on determining the prognosis of gastric cancer. This study aimed to investigate the expression levels and clinical signiifcance of gender determining region Y-box 2 (SOX2) gene and octamer binding factor 4 (OCT4) gene in gastric cancer tissues varying different differentiation degrees. Methods: Sixty cases with gastric cancer were recruited in this study. The gastric cancer tissues and corresponding normal mucosa of the 60 cases were obtained. The mRNA and protein level of SOX2, OCT4 gene are evaluated by the quantitative real-time PCR (qRT-PCR), Western blot and immunohistochemistry, respectively. The relationship between the expression levels of SOX2, OCT4 gene and clinical pathological parameters were also analyzed in this study. Results:The expression of SOX2 in both mRNA and protein levels had no signiifcant difference between the well-differentiated gastric cancer tissues and normal gastric mucosa (mRNA levels:t=0.1033, P>0.05;protein levels:t=0.116, P>0.05). However, both the mRNA and protein expression of SOX2 in patients with well-differentiated gastric cancer tissues were signiifcant higher than not only in patients with moderately differentiated gastric carcinoma (mRNA levels: t=12.48, P<0.05; protein levels: t=22.78, P<0.05) but also in patients with than poorly differentiated gastric carcinoma (mRNA levels:t=17.56, P<0.05;protein levels:t=30.00, P<0.05). In contrast to SOX2, both the mRNA and protein expression of OCT4 in patients with well-differentiated gastric cancer tissues were signiifcant lower than not only in patients with moderately differentiated gastric carcinoma (mRNA levels:t=13.23, P<0.05; protein levels: t=25.56, P<0.05) but also in patients with poorly differentiated gastric carcinoma (mRNA levels: t=12.10, P<0.05; protein levels: t=69.48, P<0.05). There was no significance of OCT4 mRNA and protein expression between the well-differentiated gastric cancer tissues and normal gastric mucosa (mRNA levels:t=2.436, P>0.05;protein levels:t=1.064, P>0.05). Immunohistochemical study demonstrated that the positive rate of SOX2 in patients with well-differentiated gastric cancer tissues (10/21) were higher than in patients with not only moderately differentiated gastric carcinoma (7/20) but also poorly differentiated gastric carcinoma (2/19, P<0.05), while the positive rate of OCT4 in cases with well-differentiated gastric cancer tissues (2/21) were lower than in cases with not only moderately differentiated gastric carcinoma (6/20) but also the poorly differentiated gastric carcinoma (12/19, P<0.05). There was no correlation between the expression of SOX2, OCT4 in gastric cancer and gender or age (P>0.05). Nevertheless, the expression of SOX2, OCT4 were positive or negative correlated with the pathological staging, the degree of inifltration and lymph node metastasis (P<0.05). Conclusion:Decreased SOX2 expression and increased expression level of OCT4 can promote the formation, development and invasion of gastric cancer and they may become biomarkers or the diagnosis, treatment and prognosis evaluation in gastric carcinoma.

AIM: To study the effect of L-arginine (L-Arg) on function and structure of mitochondria in ischemia-reperfusion (MRI) myocardial cells. METHODS: Thirty rabbits were randomly divided into three groups (n=10 in each), control group, MIR group and MIR+L-Arg group. The mitochondrial respiratory function, Ca~(2+) concentration ([Ca~(2+)]m), malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were determined. Meanwhile, the contents of adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), total adenylic acid number (TAN) and energy charge (EC) in the myocardial tissue were respectively measured. Moreover, the ultrastructure changes in myocardial mitochondria were observed during MIR. RESULTS: The mitochondrial respiratory control rate (RCR), velocity 3 (V_3), SOD, surface density (Sv) and specific surface (?) in MIR+L-Arg group were higher than those in MIR group, velocity 4 (V_4), [Ca~(2+)]m, MDA, volume density (Vv), horizental diameter (Hd) were lower than those in MIR group. ATP, ADP, TAN and EC levels of myocardial tissue were higher than those in MIR group. There was no significant difference between MIR+L-Arg and control group in V_3, V_4, SOD, MDA, Vv, Sv, ?, Nv, Vd, AMP and TNA. CONCLUSION: It is suggested that L-Arg improves the function and structure of mitochondria in myocardial cells in the reperfusion injury after myocardial ischemia by decreasing oxygen free radical level and Ca~(2+) overload in the mitochondria. [

Objective To explore the impact of blood-activatingand qi-nourishing therapy on the hypercoagulable state of rats after femur fracture.Methods One hundred and twenty SD rats were randomly divided into 4 groups,namely normal group,model group,low-molecular-weight heparin(LMWH) group,combination group (LMWH + Tongmai Decoction),30 rats in each group.The rat model of femur fracture was established.After successful modeling,LMWH group was given subcutaneous injection of LMWH 600 U/kg,and the combination group was given subcutaneous injection of LMWH 600 U/kg together with gastric gavage of Tongmai Decoction,the model group was given subcutaneous injection of the same volume of normal saline.The treatment lasted for 1-7 days after the surgery.The pathologic features of the left great saphenous vein were observed by HE staining method,and the relative volume,thickness and quantity of the blood vessels were also measured.The plasma D-dimer (D-D) and fibrinogen (FIB) levels were determined by biochemical analyzer,and the plasma levels of whole blood viscosity at low shear rate (WBV-lsr) and whole blood viscosity at high shear rate (WBV-hsr) were measured with hemodynamic detector.Results On day 7 after the modeling,less endothelium cells,agglomerative red cells,and large thrombi were found in the great saphenous vein tissue section of the model group under microscope.Compared with the normal group,the levels of D-D,FIB,WBV-lsr and WBV-hsr in the model group at various time points were increased,the difference being significant (P ＜ 0.05).After 7-day treatment,the levels of D-D,FIB,WBV-lsr and WBV-hsr in LMWH group and combination group were lower than those of the odel group,and the decrease in the combination group was superior to LMWH group(P ＜ 0.05).The blood vessel endothelium cells in the combination group were arranged neatly with same cellular width while without enlargement or swelling,the effect being superior to that of LMWH group.Conclusion Blood-activating and Qi-nourishing therapy can effectively relieve hypercoagulable state of rats after femur fracture.

AIM: To study testicular pathological change and its pathogenesis. METHODS:Testicular structure of alloxan induced diabetic rats was observed under light microscopy (LM)and transmission electron microscopy(TEM). Activity of superoxide dismutase(SOD),glutathione peroxidase(GSH-PX),nitric oxide synthase(NOS)and content of malondialdehyde (MDA),nitric oxide(NO) were detected biochemically in testicular homogenate. RESULTS: It is manifestated as atrophy of seminiferous tubule and germinal arrest under LM and expansion of mitochondria and smooth endoplasmic reticulum, cytoplasmic inclusion of sertoli cell under TEM.Activity of SOD, GSH-PX decreased while activity of NOS, content of MDA, NO increased in diabetic rats compared with control one. CONCLUSION: Disturbance of spermatogenesis and damage of sertoli cell are the main morphological change of diabetic testis, lipid peroxidation and NO may be involved in it.

AIM: To study the protective effect of Ligustrazini(LGT) on gut barrier function after hemorrhagic shock-reperfusion. METHODS: Thirty white rabbits were divided randomly into 3 groups: control group (A),shock group (B) and LGT group (C). Malondialdehyde(MDA), tumor necrosis factor-?(TNF ?), interleukin-1?(IL-1?) and nitric oxide products(NO - 2/NO - 3) contents were measured in intestinal mucosa at 3 hours following reperfusion,culture of bacteria in blood from rabbits of 3 groups was carried out,the intestinal mucosa was examined under optical and electron microscope. RESULTS: MDA, TNF ?, IL-1? and NO - 2/NO - 3 contents of intestinal mucosa remained unchanged in group C,but increased significantly in group B, compared with group A. Incidence of bacterial translocation in group B was markedly higher than that in group A at 30 min following reperfusion,there was not any difference between group A and group C. Under light and electronic microscope,in comparison with A and C groups,intestinal mucosa damage in B group became more severe. CONCLUSION: LGT can protect gut barrier from intestinal ischemia-reperfusion injury induced by hemorrhagic shock through reducing oxygen free radicals,raising nitric oxide and preventing inflammation.