Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a rare tumor which has malignant potential.Differentiating IPMN from other cystic lesions of the pancreas is difficult. Its clinical symptoms are nonspecific,including nausea,vomiting,abdominal pain,fever or jaundice,possibly accompanied by hyperamy lasemia of blood and urine.Some patients have acute pancreatitis or chronic cholecystitis.According to the result of a retrospective study on clinical and imaging data of 11 patients with IPMN,we drew a conclusion that cystic dilatation of the main or branch of pancreatic ducts and mural nodules,and cystic dilatation linked with the main pancreatic ducts are the characteristics of IPMN of the pancreas.Computed tomography diagnosis is feasible to provide important information for the diagnosis of IPMN of the pancreas.

ObjectiveTo explore a procedure to correct the multiple facial deformities by using the expanded frontal flap combined with the axial flaps.MethodsAccording to the face deformity we used the rectangle 100-350 ml expanders behind the frontal hairline,after finishing the tissue expanding,adopted two or three axial flaps based on the supraoribital,supratrochlear or temporal vessels. ResultsA total of 13 cases were treated with this approach.7 eases were nose and lip defect reconstruction after burn,in which temporal vessel-based flap was used in 2 cases and supraoribital or supratrochlear vessel-based flaps in 5 cases.The other 6 cases were nasal reconstruction combined with the frontal defect correction by using random flaps,including 2 cases of pigmented nevus,1 neurofibroma,and 3 burn scars.All the flaps survived and satisfactory appearance was obtained.Conclusions The expanded frontal flap combined with axial flap based on multiple vessels is a good approach to correct the multiple facial deformities.

Objective To investigate the value of video-assisted thoracoscopy in the diagnosis and treatment of pleural effusion with unknown causes.Methods Video-assisted thoracoscopic biopsy or pleurodesis was performed in 45 cases of pleural effusion unexplained by routine examinations from March 2002 to March 2005.Results The diagnosis was clarified in all the 45 cases.There were 3 cases of malignant effusion,38 cases of tuberculous pleurisy,3 cases of nonspecific effusion,and 1 case of idiopathic pleural effusion.No severe surgical complications occurred.Follow-up checkups for 2~36 months found no recurrence.Conclusions Video-assisted thoracoscopy is a safe,effective,and micro-traumatic approach for the diagnosis and treatment of pleural effusion.

Objective To explore the effects of static wrist on radial nerve palsies. Methods 60 patients with radial nerve palsies were devided into wrist group (n=20), acupuncture group (n=20) and intermediate-frequency (IF) group (n=20), who accepted static wrist wearing, electroacupuncture, and intermediate-frequency electro-stimulation respectively. Results The efficacy was not significantly different among these groups, but the time out of working and the cost for the management were the least in the wrist group. Conclusion Wearing static wrist is not only effective on radial nerve palsies, but also reduce the loss of working time and cost of treatment

Multidrug resistance (MDR) plays a major obstacle to successful gastric cancer chemotherapy. The purpose of this study was to investigate the MDR reversal effect and mechanisms of hyperthermia in combination with neferine (Nef) in adriamycin (ADM) resistant human SGC7901/ADM gastric cancer cells. The MDR cells were heated at 42°C and 45°C for 30 min alone or combined with 10 μg/mL Nef. The cytotoxic effect of ADM was evaluated by MTT assay. Cellular plasma membrane lipid fluidity was detected by fluorescence polarization technique. Intracellular accumulation of ADM was monitored with high performance liquid chromatography. Mdr-1 mRNA, P-glycoprotein (P-gp), γH2AX expression and γH2AX foci formation were determined by real-time PCR, Western blot and immunocytochemical staining respectively. It was found that different heating methods induced different cytotoxic effects. Water submerged hyperthermia had the strongest cytotoxicity of ADM and Nef combined with hyperthermia had a synergistic cytotoxicity of ADM in the MDR cells. The water submerged hyperthermia increased the cell membrane fluidity. Both water submerged hyperthermia and Nef increased the intracellular accumulation of ADM. The water submerged hyperthermia and Nef down-regulated the expression of mdr-1 mRNA and P-gp. The water submerged hyperthermia could damage DNA and increase the γH2AX expression of SGC7901/ADM cells. The higher temperature was, the worse effect was. Our results show that combined treatment of hyperthermia with Nef can synergistically reverse MDR in human SGC7901/ADM gastric cancer cells.

OBJECTIVE:To evaluate effects of dexmedetomidine hydrochloride on cardiovascular response of middle aged and elderly patients during tracheal extubation period. METHODS:110 general anesthesia patients with colorectal cancer were collected and randomly divided into observation group and control group,with 55 cases in each group. All patients received general anesthe-sia with same dose. Observation group was given intravenous pump of dexmedetomidine hydrochloride 0.5 μg/kg after surgery,and control group was given intravenous pump of propofol 0.5 μg/kg. HR and MAP of 2 groups were compared 10 min before tracheal extubation,at the moment of tracheal extubation,5 and 10 min after tracheal extubation. The oxygen saturation of blood,the time of respiration recovery,opening eyes and extubation were recorded in 2 groups. RESULTS:There was no statistical significance in HR and MAP between 2 groups 10 min before extubation and 10 min after extubation (P>0.05). HR and MAP of observation group were significantly lower than those of control group at the moment of extubation and 5 min after extubation,the levels of HR and MAP were significantly increased in the 2 groups with statistical significance (P<0.05). There was no statistical signifi-cance in oxygen saturation of blood,the time of respiration recovery and extubation between 2 groups(P>0.05). The time of open-ing eyes in observation group was significantly shorter than in control group,with statistical significance (P<0.05). CONCLU-SIONS:Dexmedetomidine hydrochloride could significantly decrease cardiovascular stress response and shorten recovery time of middle age and elderly patients with colorectal cancer during tracheal extubation period.

OBJECTIVE:To investigate the cardiac-protective effects and safety of dexmedetomidine on cardiac muscle of elder-ly patients with non-coronary artery bypass grafting (OPCABG). METHODS:50 elderly patients underwent OPCABG were se-lected and randomly divided into observation group and control group,with 25 cases in each group. Both groups received mor-phine 0.2 mg/kg+scopolamine 0.3 mg/kg intramuscularly 30 min before operation,and were given sulfentanyl 1 μg/kg+etomidate 0.1-0.2 mg/kg+pipecurium bromide 0.1 mg/kg for anesthesia induction. Observation group was given Dexmedetomine hydrochloride injection 1 μg/kg,ivgtt,within 15 min,and then by pump injection at 0.5 μg/(kg·h) till the end of operation;control group was given constant volume of 0.9% Sodium chloride injection,ivgtt. cTnⅠ,IMA,SOD and MDA levels and the occurrence of ADR were observed in 2 groups after entering the operation room(T1),at the end of vascular anastomosis(T2),6(T3),12(T4),24 h (T5) after operation. RESULTS:IMA of observation group at T2,T3 and T4 were significantly lower than those of control group, and cTnI at T2,T3,T4 and T5 were significantly lower than those of control group,with statistical significance (P<0.05). There was no statistical significance in SOD level at T1,T2,T3,T4 and T5 between 2 groups(P>0.05). Serum level of MDA in 2 groups at T4 and T5 were decreased significantly,and the observation group was lower than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Dexmedetomidine can protect cardiac muscle of elderly pa-tients with OPCABG to certain extent,and relieve myocardial injury with good safety.

Objective To design a virtual console for the movable high frequency X-ray machine system type MME2002. Methods An experimental circuit was designed to simulate the real circuit and realized the serial communication between microcomputer and MCU (micro control unit). The simulating software was designed in Visual Basic 6.0, using MSComm to control serial communication. It simulated the functions of the initial console, including setting parameters, sending commands to the machine and storing and transferring the best data of a special condition by file operation in VB. Results The console was designed based on PC. Conclusion This console can replace the console using circuit boards and keys. It can be combined with the X-ray machine systems' image collection software, making the machine's operation more easy and convenient.

OBJECTIVE:To investigate the effects of target-controlled infusion of etomidate combined with remifentanil on in-dexes of immune and stress response in elderly surgery patients. METHODS:Totally 60 patients undergoing elective surgery were randomly divided into control group(n=30)and observation group(n=30). Control group was given Propofol injection 1.5-2 mg/kg intravenously. Observation group was given Remifentanil hydrochloride for injection with pump volume of 0.5 μg/(kg·min), and then target controlled infusion of Etomidate injection 0.1-0.3 mg/kg;the dose of etomidate increased by 0.05-0.1 mg/kg accord-ing to physical activity during surgery. Postoperative eye opening time,recovery time of orientation and extubation time were com-pared between 2 groups as well as the levels of immune indexes(CD4+,CD8+,CD4+/CD8+),stress response indexes [serum norepi-nephrine(NE),adrenaline(E)and cortisol(Cor)]. The occurrence of ADR was recorded during surgery. RESULTS:Postopera-tive eye opening time,recovery time of orientation and extubation time in observation group were significantly shorter than control group,with statistical significance(P<0.05). Before surgery,there was no statistical significance in CD4+,CD8+ and CD4+/CD8+between 2 groups(P>0.05). After surgery,CD4+ and CD8+ of 2 groups were significantly higher than before surgery,and the ob-servation group was significantly higher than the control group,CD4+/CD8+ of 2 groups was significantly lower than before,and the observation group was significantly lower than control group,with statistical significance(P<0.05). Before surgery,there was no statistical significance in the levels of NE,E and Cor between 2 groups(P>0.05);after surgery,the levels of NE,E and Cor in 2 groups were significantly higher than before surgery,but the observation group was significantly lower than the control group, with statistical significance(P<0.05). There were no obvious adverse reaction occurred in 2 groups during the surgery. CONCLU-SIONS:The target-controlled infusion of etomidate combined with remifentanil is ideal for perioperative anaesthesia in the elderly patients and effectively improves related immune indexes and stress response indexes with good safety.

AIM: To observe the change of insulin receptor in rabbit kidney with acute ischemic-reperfusion injury. METHODS: 15 Japanese white rabbits were allocated randomly into control group, ischemic-reperfusion group(IR group). IR group received clamping for 1 h followed by 2 h or 48 h of reperfusion. At 2 h or 48 h after reperfusion, glucose and insulin in serum were determined. Insulin receptor in renal tissue was analyzed by radioligand binging assay(BAD). RESULTS: The level of serum glucose increased after 2 h reperfusion in 2 groups, but in IR group the value increased much more higher than those in control groups(P