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.

Objective To design a new type of field operation instrument for easy to spread a rescue surgery rapidly in field first -aid at the present stage. Methods The traditional field operation instrument set is innovated in its composition, structure and function. The packing instrument procedure can be omitted. The new field operation instrument set is made of four different operation instrument boxes, two of which can be put into a standard field medical case. Results It is designed to be convenient to have a rescue surgery rapidly and to be washed, sterilized, conveyed and kept in aseptic storage. Conclusion The new field operation instrument case has such advantages as compactness, reasonable allocation and function completed, so it can be used easily.

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 investigate the protective effect of preconditioning on rabbit liver during total ischemia and reperfusion and its mechanism. METHODS: Using hepatic ischemia and reperfusion injury (HIRI) model in rabbits, animals were randomly divided into three groups: control group (A), non-preconditioning group(B) and preconditioning group(C), different effects of preconditioning on several parameters including alanine aminotransferase (ALT) activity and levels of nitric oxide (NO) and malondialdehyde (MDA) in plasma or liver tissue as well as hepatocellular morphological changes were measured and observed during HIRI. RESULTS:In C group NO levels of plasma and liver tissue were higher than those in B group (P0.05); abnormal morphological chages of liver cells in A group were ameliorated remarkably too during HIRI. CONCLUSION:Preconditioning can attenuate HIRI by improving NO level and reducing oxygen free radicals level.

AIM: To study the role of nitric oxide and endothelin in myocardial ischemia-reperfusion injury (MIRI) and effect of ligustrazini (LGT). METHODS: The rabbits were randomly divided into three groups (n=10, in each ),sham operated group( A ),MIR group( B ) and LGT group(C).Plasma nitric oxide products( NOP,in terms of NO - 2/NO - 3 ) contents,endothelin (ET) levels,and lactate dehydrogenase (LDH) activities were measured before ischemia, 40 minutes after ischemia and 20 minutes after reperfusion.Meanwhile NOP, ET concentrations and LDH activity in myocardium were measured ,and the ultrastructure changes in myocardium were observed under electron microscope at 20 minutes after reperfusion. RESULTS: As compared with group A,NOP decreased and ET as well as LDH increased at 40 minutes (P