�����������˵���ά���ӻ�����3D��ӡ

??From visual human to three-dimensional visualization 3D printing of liver FANG Chi-hua, CAI Wei, FAN Ying-fang,et al. The First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University; the Clinical Engineering and Technological Research Center of Digital Medicine of Guangdong Province, Guangzhou 510282, China
Corresponding author: FANG Chi-hua, E-mail: fangch_dr@126.com
Abstract Digital medicine is a discipline which crosses over many subjects, involving various fields. It is widely used in many aspects of clinical medicine gradually. It makes digital medicine the model of translational medicine through its rapid development in hepatopancreatobiliary surgery from the “visual human” system established in America in 1989 to three-dimensional(3D) visualization 3D printing of liver now. Digital medicine, especially the 3D visualization technology, could bring us new ideas about diagnosing diseases, choosing therapeutic schedules, evaluating the risks of surgery and so on. It is changing the strategy of diagnosis and treatment and making the hepatopancreatobiliary surgery enter the era of 3D.     

�������Ϲ��������ȡʧ�������

??Prevention and accident injury in the process of combined liver and kidney graft rapid harvesting FU Bin-sheng, ZHANG Tong, LI Hua, et al. Liver Transplant Center, the Third Affiliated Hospital?? Sun Yat-sen University, Guangzhou 510630, China
Corresponding author: CHEN Gui-hua, E-mail: chgh1955@263.net
Abstract Objective To evaluate accident injury in the process of combined liver and kidney graft rapid harvesting and summarize clinical experiences. Methods From January 2008 to June 2009, a quick procedure for combined liver and kidney procurement was used in 232 cases. The clinical data of the cases, including accident injury of graft and anomalous hepatic arteries were analyzed retrospectively. The procedure included in situ perfusion through aorta and superior mesenteric vein plus drainage through inferior vena cava. Liver and kidney were separated after harvested en bloc. Results Varied degree laceration of liver capsule existed in 25 cases (10.8%), and knife wound in left lobe of liver in 1 case. Primary non-function was found after implanted the severe fatty liver graft in 1 case. Kidney injury existed in 2 cases including 1 case of cuts in renal parenchyma of the right kidney and 1 cases of renal vein laceration in renal sinus, which were discarded because they could not be repaired. The first hepatic portal was cut at the high level during separation in 1 case. Anomalous hepatic arteries were found in 46 grafts (19.8%) with 76 percents of anomalous arteries originating from the left gastric artery and the superior mesenteric artery. Accident injury of anomalous hepatic artery was found in 3 cases (6.5%), including the left hepatic artery originating from the left gastric artery (2 cases) and the right hepatic artery originating from the superior mesenteric artery (1 case). Conclusion Combined liver and kidney graft rapid harvesting is a simple and safe procedure, which can protect the quality of liver and kidney simultaneously. Adequate perfusion, skilled procurement techniques and the prevention of anomalous hepatic arteries injury are critical to assurance of graft quality.     

��ͯ�����ж��ٴ���������521�����棩

??Objective??To explore the clinical features of acute poisoning in children to search for effective preventive measures. Methods??A total of 521 cases of acute poisoning in Xi’an Children’s Hospital from January 2012 to January 2017 were collected and all clinical data were retrospectively analyzed. Results??Among the 521 cases of acute poisoning??291 cases??55.9%?? were boys??and 230 were girls??44.1%??. Acute poisoning occured in all ages of children and children in infancy period and pre-school period were more susceptible??257 cases and 147 cases???? poisoning occured mostly at home??508 cases?? accounting for 97.5%???? and in the countryside??431cases?? 82.7%???? the most common season was summer??187cases??35.9%??. The intoxication from digestive tract was the most common in all intoxicated pathways ??492 cases??94.4%??. After timely and reasonable treatment??most children had a good prognosis. Conclusion??Acute poisoning is most common in infants and preschool children. The majority of the patients are from rural areas. The most common season is summer. The most common intoxication is digestive tract.     

θ���ڹ�ע����֧���ܾ��۲취�Զ�ͯ����������ʳ������ϼ�ֵ����

??Objective To assess retrospectively the diagnostic roles of methylene blue test observed by bronchoscopy in congenital tracheoesophageal fistulas??TEFs?? in children. Methods We collected the clinical data of 5 patients??two of whom were diagnosed with congenital H-TEF and three of whom were diagnosed with recurrent TEF??rTEF?? over the past 8 months in Shenzhen Children’s Hospital. We respectively analysed and compared the results of contrast esophagography??regular bronchoscopy??methylene blue test observed by bronchoscopy and chest MDCT??all of which were performed on the above 5 patients. Results Each of these five cases was observed by bronschoscopy that methylene blue came out from the fistula of the trachea when methylene blue was injected into esophagus. Although all cases were examined by regular bronchoscopy??two recurrent TEFs cases weren’t found the fistulas. Four cases were examined by contrast esophagography??but only one rTEF case was diagnosed. None of these 4 cases could be diagnosed by the results of chest MDCT??but air trapping in the lower esophagus could be seen in chest MDCT in these cases. Conclusion Methylene blue test observed by bronchoscopy is reliable in the diagnosis of congenital TEFs in children??which is the first recommendation. Both of esophagography and regular bronchoscopy can miss the diagnosis in congenital TEFs in children. The diagnostic value of MDCT is limited for this disease??but air trapping in the lower esophagus in MDCT implicates the possibility of congenital TEFs.     

�����ᱴ��˹͡����Һ���칹����������о�

??OBJECTIVE To establish a method for isomer analysis of bepotastine besilate eye drops and test the stability of isomer in the preparation. METHODS The analysis was performed on an ULTRON ES-CD chiral column (6.0 mm??150 mm,5 ??m). The mobile phase was 0.02 mol??L^-1 potassium phosphate monobasic-acetonitrile(75??25) at the flow of 0.8 mL??min^-1. The column temperature was maintained at 35 ?? and the detection wavelength was set at 225 nm. The injection volume was 10 ??L. RESULTS The limit of detection and limit of quantification of bepotastine besilate R-isomer were 12 and 48 ng, respectively. The linear range of bepotastine besilate R-isomer was 0.01-0.1 mg??mL^-1 and the repeatability was good at high, medium and low concentrations. CONCLUSION The method is simple and accurate, which can be used for isomer separation of bepotastine besilate and testing the stability of isomer in bepotastine besilate eye drops.     

��֫Ѫ˨��dz�����ײ������Ѫ˨�γ�21���������

??Hepatic segment resection in the treatment of cholangetic calculus in the left lateral liver: A clinical analysis of 21 cases CHEN Nan??WU Lin-quan??YUAN Rong-fa??et al. Department of Hepatobiliary Surgery??the Second Affiliated Hospital of Nanchang University??Nanchang 330006??China
Corresponding author??WU Lin-quan??E-mail??Wulqnc@163.com
Abstract Objective To investigate the clinical effect of hepatic ??segment or ?? segment resection in the treatment of cholangetic calculus in the left lateral liver. Methods The clinical data of 21 cases of cholangetic calculus in the left lateral liver admitted from June 2013 to February 2016 in the Second Affiliated Hospital of Nanchang University were analyzed retrospectively. The hepatolithiasis were limited to section ?? or section III of the liver. The surgical methods were anatomical hepatic ??segmentectomy or ?? segmentectomy. Results All the cases recovered and were discharged. A total of 21 cases were followed up in 18(2-32)months??during which residual calculi of left liver happened in 1 case??and other cases showed no sign of recurrent calculus and cholangitis through ultrasound, CT or MRI examination. Conclusion For hepatic calculus limited to bile ducts of hepatic ?? segment or hepatic ?? segment??while other hepatic bile ducts have no primary stones and stenosis??anatomical hepatic ??segmentectomy or ?? segmentectomy should be performed rather than left lateral liver resection blindly.     

��Ĥ�����г�������ɨ���������ٰ�28����Ч����

??Pancreatectomy with en-bloc retroperitoneal clearancefor pancreatic cancer WU Peng-fei??LU Zi-peng??YIN Jie??et al. Pancreas Center??the First Affiliated Hospital of Nanjing Medical University??Pancreas Institute of Nanjing Medical University??Nanjing 210029??China
Corresponding author??JIANG Kui-rong??E-mail??jiangkuirong@njmu.edu.cn??MIAO Yi??E-mail??miaoyi@njmu.edu.cn
Abstract Objective To investigate the feasibility and safety of pancreatectomy with en-bloc retroperitoneal clearance??PERC?? in pancreatic cancer. Methods From Jan. 2014 to Jul. 2015??a total of 28 patients underwent PERC procedure in the First Affiliated Hospital of Nanjing Medical University. After a thorough radiologic assessment, all tumors were considered to be resectable or borderline resectable. Specimen together with retroperitoneal soft tissue containing different stations of lymph nodes (LNs) and nerve plexus were removed en-bloc??only retained the necessary artery and vein. Results Median operative time was 340(150-540)min with estimated median blood loss 400??200-700??mL. Complications occurred in 12 of 28 patients (42.9%) with no perioperative mortality. Median postoperative hospital stay was 13??8-30??d. Median number of harvested LNs was 12(5-36). R0 resection was achieved in 19 (67.86%) of 28 patients. At a median follow-up of 12 (3-27) months, local recurrence occured in 4 patients and distant metastases in 11 patients. 15 of 28 patients (53.57%) are dead??9 patients death due to tumor progression??6 patients died without local recurrence and distant metastasis. Among 13 patients still alive, 6 patients was not found local recurrence or distant metastases??the longest disease-free survival time was 27 months until the last time of follow-up. Conclusion PERC is a safe and feasible procedure, which may increase the possibility of R0 resection and improve survival in patients with pancreatic cancer.