Objective To study the sources and the relationship between the management and the outcome of hemorrhage after cephalic pancreatoduodenectomy.Methods The clinical data of 370 patients who underwent pancreatic resection at the Lihuili Hospital and the Second Affiliated Hospital of Zhejiang University were retrospectively analyzed.Results Postoperative bleeding occurred in 35 patients with 11 deaths.Among those intraabominal bleeding occurred in 14 cases and gastrointestinal hemorrhage occurred in 22,with one case suffering from both.Bleediug developing within 72 hours after operation in 12 cases (early-stage group),which was caused by improper intraoperative homeostasis.In other 23 cases,bleeding 72 hours after operation(later stage group)was caused by the erosion following pancreatic and/or bile leakage.Relaparotomy was performed in 13 cases and endoscopic homeostasis was performed in 3. Relaparotomy or endoscopic homeostasis was superior to that of conservative therapy in the early-stage group (P0.05).Pancreatic or bile leakage was identified as the significant risk factors for the postoperative bleeding.Conclusions In order to prevent the postoperative hemorrhage and to reduce the mortality of pancreatic resection,skillful techniques,expeditious homeostasis,proper management of stump pancreas and the prevention of pancreatic and bile leakage are essential.

Brain Neoplasms ; metabolism ; Cell Line, Tumor ; Glioma ; metabolism ; Humans ; Neoplastic Stem Cells ; drug effects ; metabolism ; Reactive Oxygen Species ; metabolism ; Sodium Selenite ; pharmacology

Objective To observe the results and reality of transurethral resection of bladder tumor(TUR-Bt) with upside down loop and plsamakinetic in the prevention of obturator nerve reflex.Methods A total of 211 patients with lumbar anesthesia received TUR-Bt.Firstly,the tumor tower above bladder wall was cut with the traditional way.When intraoperative findings were obturator nerve reflex,or to the obturator nerve mapping area,operation should be changed to superimpulse plasma column electrode vaporization to cut off residual tumor tissue,then after flipping the loop,the residual tumour was resected with upside-down loop from the tumour side wall.Results In 211 cases,192 cases had a little obturator nerve reflex,but the movement of body was not obvious,which did not influence the operation.The serious complication,such as perforation of bladder and injury of nerve and vessel,did not occur.Conclusions The lateral resection of bladder side wall tumour with upside-down loop can effectively avoid strong obturator nerve reflex,which is safe,uncomplicated,and efficacious and it does not increase the additional outlay and hurt.

Objective To detect anti-M3 receptor antibodies in primary Sj(o)gren's syndrome(pSS)patients and to explore its association with clinical manifestations.Methods Anti-M3 antibodies were tested in 70 patients with pSS,50 patients with systemic lupus erythematosus(SLE)and 76 normal controls with ELISA and Western blot.The correlation between anti-M3 antibodies and other clinical manifestations was analyzed.Results (1)The positive rate of anti-M3 antibodies in pSS Was 47.14% using ELISA and 60.00% using Western blot in SLE 4.00% using ELISA and 12.00% using Western blot and in normal controls 14.47% using ELISA and 15.79% using Western blot.(2)The incidence of sehirmer test,tear break-up time(BUT),whole saliva flow rate,punctate epithelial erosions(PEE)on the corneas and external eye examination were not significantly different between the anti-M3 positive and negative groups.(3)The incidences of IgG,rheumatoid factor,SSB and fluorescence index(FI)＞3 were higher in the positive group than in the negative group using EUSA.Conclusion The positive rate of anti-M3 antibodies is higher in pSS than in SLE and normal controls and in some degree it has correlation with the lesion in salivary gland.

Bone Neoplasms ; diagnosis ; pathology ; surgery ; Child ; Diagnosis, Differential ; Femur ; pathology ; Fibroma ; diagnosis ; pathology ; surgery ; Humans ; Male

Antibodies, Monoclonal ; metabolism ; CD79 Antigens ; metabolism ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunoglobulin G ; metabolism ; Male ; Middle Aged ; Nose Neoplasms ; metabolism ; pathology ; therapy ; virology ; Paranasal Sinus Neoplasms ; metabolism ; pathology ; therapy ; virology ; Plasmacytoma ; metabolism ; pathology ; therapy ; virology

Adenocarcinoma ; pathology ; surgery ; Biopsy ; Diagnosis, Differential ; Gastric Fundus ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Myelolipoma ; pathology ; surgery ; Neoplasms, Multiple Primary ; pathology ; surgery ; Pleural Neoplasms ; pathology ; surgery ; Stomach Neoplasms ; pathology ; surgery

Objective To investigate the whole genomic expression profiles of chronic atrophic gastritis with interleukin(IL)-1β-31CC/-511TT genotype as measured by oligonucleotide microarray technique.Methods Genomic RNA was extracted from gastric biopsies of 12 patients with chronic atrophic gastritis(6 with IL-1β-31CC/-511TT and 6 with IL-1β-31TT/-511CC).The genomic profiles of IL-1β gene polymorphisms 31CC/-511TT and 31TT/-511CC were compared and tested for differential expressed genes associated with 31CC/-511TT using Agilent human whole genomic oligonucleotide microarrays.The results were further analyzed in terms of gene ontology(GO).Results There were 200 differentially expressed genes associated with IL-1β-31CC/-511TT,159 of which were up-regulated and 41 were down-regulated.These genes mainly involved in macromolecule metabolic process,post-translational protein modification,ubiquitin cycle,and protein kinase cascade.Five genes had biological activities,one of which was down-regulated gene(PCSK5)and 4 were upregulated genes(PRKCA,NPLOC4,TRIB3 and MAPKAPK3).Conclusions The chronic atrophic gastritis with IL-1β-31CC/-511TT genotype has molecular phenotypes which is associated with malignance and inflammation.These individuals are needed more intensive preemptive treatment and dynamic surveillance.

Objective To construct and identify the incompetent-replication adenovirus carrying the fusiongene composed of the encoding gene of prepropeptide of mouse nerve growth factor(PN)and human beta-endorphin(?-EP)geue.Methods The gene segments of PN obtained from total RNA of the submandibular glandof a 2-week old Kumning mouse were amplified by RT-PCR and joined with the segment of ?-EP to form the fusiongene which was sequenced.The fusion gene contained in the incompetent-replication adenovirus was formed in theBJ-Ad Easy-1 susceptible cells and identified by PCR so as to choose the positive clone without wild vectors.Thecorrect clone was amplified and purified.The titers of adenovirus were determined using the specific 50% tissueculture infection dosage(TCID 50)method.Three days after the adenovirns was transferred into the cultured A431cells,RT-PCR was performed to showed the transcribed mRNA of this fusion gene and the intracellular ?-EPexpression was quanlitatively detected by inummo-histological method.Finally the concentration of human ?-EP inthe culture medium was determined by quantitative radio-immunoassay on 1st,3rd and 7th day afterinfeetion.Results The sequence of the fusion gene was correct.The titer of recombinant adenovirus Ad-NEP was1.5?10~10 pfu/ml.Three days after infection a 475 bp segment was amplified by RT-PCR and abundant orangegranules were shown in the infected cell.The ?-EP concentration in the culture medium was significantly higher inAd-NEP group than in the control group on 1st,3rd and 7th day(P

Objective To explore the diagnostic values of X-ray and CT examinations for the traumatic diaphragmatic rupture. Methods Totally 17 patients with traumatic diaphragmatic rupture were retrospectively analyzed, who underwent X-ray chest radiograph and 64-slice spiral CT examinations as well as coronal and sagittal imaging by multi-planar reconstruction with GE ADW 4.6 workstation. Results Of the 17 patients, there were 15 ones had the rupture occurred on the left side (93.7%), one case on the right side (6.3%) and the remained one had no diaphragmatic injury;there were 10 ones of diaphragmatic contour discontinuity, 6 ones of intrathoracic hernia, 2 ones of cervical stenosis, one case of hanging sign and two cases of falling viscera sign. Conclusion Routine chest X-ray radiography has difficulty in diagnosing diaphragmatic rupture, while CT multiplanar imaging contributes to determining traumatic diaphragmatic rupture. Diaphragmatic rupture may occur after multiple trauma, and CT with multiplanar reformations has to be used as the routine examination for diagnosing diaphragmatic rupture.