Objective To investigate the protevtive effect and mechanism of early using selective digestive decontamination (SDD) on severe acute pancreatitis(SAP) in rats.Methods Sixty rats were randomly assigned into SAP group and SAP+SDD group after SAP model was set up.Rats in the SAP+SDD group underwent SDD immediately after the model was established and last for 3 days. The peripheral and portal vein serum endotoxin, tumor necrosis factor -a (TNF-a) and interleukin -1 (IL-1) at 24 hours, 48 hours, and 72 hours and the mortality, average living time and the degree of pancreatic necrosis were observed and compared in the 2 groups. Results The levels of peripheral and portal vein serum endotoxin, TNF-? , IL-1,and the mortalities in SAP+SDD group were significantly lower than those in SAP group(all P

Objective To investigate the safety and feasibility of pancreatoduodenostomy com-bined with resection of PV/SMV for carcinoma of the head of pancreas.Methods The clinical data of 12 cases of carcinoma of the haed of pancreas underwent pancreatoduodenostomy in combination with resection of PV/SMV were retrospectively analyzed.Their data were compared with those of 40 cases of carcinoma of the haed of pancreas underoing pancreatoduodenostomy in the same period of time.Results Of the 12 cases, 3 underwent PV resection and reconstruction with ePTEE grafts, 3 PV re-section and reconstruction with end-end anastomosis, 6 PV lateral wall partial resection and recon-struction.There were no significantly differences in age, sex, time of operation, operative bleeding, complication, mortality rate, site of tumor,t umor differentiation, lymphtie metastasis, margin posi-tive resection and survival between the two groups.Conclusion Pancreatoduodenostomy combined with resection of PV/SMV is safe for carcinoma of the head of pancreas.

To explore the relationship between thyroid autoantibodies and thyroid function in school children aged 8-10 years,adults,pregnant women,and lactating women in China,in order to provide reference for the prevention and monitoring of thyroid disease.Healthy 8-10 years old school children (693 cases),adults (698 cases),pregnant women(325 cases),and lactating women(332 cases) from six iodine sufficient areas were enrolled.Serum TSH,FT4,and FT3 were determined by chemiluminescent immunoassay,while antithyroid antibody by radioimmunoassay.The positive rate of thyroid autoantibodies in females was significantly higher than that in the male (5.6％ vs 2.0％ in school children,and 22.8％ vs 3.2％ in adults) ; while positive rate of autoantibodies in pregnant and lactating women (8.9％,8.7％) were significantly lower than that in the other healthy adult women (22.8％).The incidence of abnormal thyroid function in antibody-positive people was higher than that in negative ones in all groups,and abnormal thyroid function showed mainly as subclinical hypothyroidism.In addition,lactating women with negative autoantibodies presented a higher incidence of abnormal thyroid function,mainly as low FT4.The abnormal thyroid function is related with the positive thyroid autoantibodies,indicating that it is essential to follow-up these people with positive antibodies in order to facilitate prevention,early diagnosis,and treatment of thyroid disease.Reference data for thyroid hormones in lactating women should be establisbed as soon as possible.

Objective To investigate the effect of tumor necrosis factor alpha ( TNF-?) in combination with Go6976 on murine liver cancer cells (H22). Method H22 cells were divided into two groups. Each group was further divided into four subgroups. Group 1 was treated with TNF-? 0, 20, 40, 60ng/ml. Group 2 was treated with TNF-? 0, 20, 40, 60 ng/ml and Go6976 (4.6 nmol/ml). The apoptotic rate, protein kinase C alpha (PKC-?) expression and phosphorylation-PKC-? (p-PKC-?) were detected by flow cytometer and Western blotting respectively in 4 h, 8 h and 16 h. Result Treated with TNF-? (0, 20, 40, 60 ng/ml) for 4 h, the apoptotic rates of H22 cells were 2. 44% ? 0. 31 % , 1. 80% ? 0. 32% , 2. 73% ?0. 14% and 3. 05% ?0. 78% respectively, with no change on the expression of PKC-? and p-PKC-?; For 8 h, the expressions of PKC-? and p-PKC-? in H22 cells were up-regulated with increasing concentration of TNF-?; When PKC-? was inhibited with Go6976 at the same time, the apoptotic rates of cells increased significantly, being 2. 90% ?0.39%, 7.76% ?0.35%, 11.43% ?1.05% and 12.96% ?2.44% , respectively. Moreover, PKC-? and p-PKC-? were down-regulated accordingly. When H22 cells were treated with TNF-? only or combined with Go6976 for 16 h, the result was similar to that of 8 h; The apoptotic rate dropped in the group in which PKC-? was inhibited by Go6976 with TNF-? at 60 ng/ml, but the proportion of necrotic cells increased. Conclusion TNF-? up-regulates the expression of PKC-? and p-PKC-? in H22 cells. Inhibiting the activity of PKC-? significantly enhances the toxicity of TNF-? to H22 cells.

ObjectiveTo investigate the effect of Blumgart anastomosis (BA) on pancreatic fistula (PF) and other complications after pancreaticoduodenectomy. MethodsThe clinical data of 190 patients who underwent pancreaticoduodenectomy in our hospital from January 2005 to December 2011 were analyzed retrospectively. The patients were divided into three groups, with 55 patients in the BA group, 65 patients in the duct-to-mucosa anastomosis group, and 70 patients in the invaginated pancreaticojejunostomy group. The incidence rates of PF and other complications after different methods of anastomosis were compared. The chi-square test was applied for comparison of the incidence of complications between groups. ResultsNo deaths occurred during surgery. The incidence rate of postoperative complications was 48.4% (92/190), and that of PF was 20.5% (39/190), with 5.5% (3/55) in the BA group, 20% (13/65) in the duct-to-mucosa anastomosis group, and 32.9% (23/70) in the invaginated pancreaticojejunostomy group. In the pancreatic duct with a diameter of ＜3 mm, the incidence rate of PF showed a significant difference between the three groups (χ2=6.089, P＜0.05), while in the pancreatic duct with a diameter of ≥3 mm, there was no significant difference in PF between the three groups (χ2=5.436, P＜0.05). ConclusionBA is a safe, simple, and time-saving technique and can reduce the incidence of PF, which is worthy of clinical application.