Objective To summarize the clinical features of uncinate process carcinoma of the pancreas and improve the resection rate. Methods From Jan. 1990 to Jun.1999, Ten cases of pancreas uncinate process carcinoma received Whipple′s procedure. Portal vein resection and reanastomosis was performed in 5 cases, among them the resected length varied between 20～42 *!cm.Two cases underwent PV lateral wall partial resection. The longest time of PV blood occlusion was 40 *!minutes.Results Among 7 cases undergoing PV resection, 1 died with hepatic failure 3 days post-op. 1 case suffered postoperative chylous ascites.These 6 cases survived 13 to 29 months post-op. Among 3 cases not undergoing PV resection, 2 cases survived 13 months and 14 months, respectively. 1 case is still alive at the follow-up of 115 months post-op. Conclusion Pancreas uncinate process carcinoma has the tendency of invading adjacent PV and SMV, which should not be simply regarded as a contraindication of the radical resection.

Objective To detect the expression level of miRNA-575 by pancreatic cancer stem cells.Methods Pancreatic cancer cell lines were cultured with serum-free medium.The cancer stem cells were obtained and their characteristics were observed with an invasion assay,a xenograft experiment,and flow cytometry analysis.Moreover,qRT-PCR was used to detect the expression of miR-575.Results A small subpopulation of cells in both ASPC-1 and PANC-1 cells survived and formed spheres in the absence of serum.The mean number of migrated cells of PANC-1 and ASPC-1 spheres was (147.3±18.6) cells and (113.2±12.9) cells.Therefore,the spheres have higher invasive ability compared with those of parental cells.As few as 5 × 105 cells in PANC-1 and ASPC-1 spheres could initiate a xenograft tumor in NOD/SCID mice,which suggested the tumorigenicity of the spheres was 100 times those of parental cell lines.The percentages of CD24+CD44+ in spheres were 0.38％-0.43％ and 4.91％-5.21％,which showed increased expression compared with ASPC-1 and PANC-1 cell lines (P＜0.05).The expression of miR-575 in spheres was 3.71 and 3.83 times its expression in cell lines ASPC-1 and PANC-1 respectively (P＜0.05).Conclusions Pancreatic cancer cell spheres may be a source for collecting cancer stem cells in a serum-free medium culture,and MiR 575 may play an important role in regulating the biological characteristics of pancreatic cancer stem cells.

Objective To explore the clinical selection of surgical methods for pure stenosis at the end of the common bile duct.Methods The clinical data of 43 cases of pure stenosis at the end of the common bile duct treated in this hospital from October 2003 to June 2009 were retrospectively analyzed.Of the 43 cases, 12 underwent endoscopic sphincterotomy(EST), 9 sphincteroplasty of Oddi, 5 pancreaticoduodenectomy,8 Roux-en-y choledochojejunostomy and 5 choledocoduodenostomy,4 underwent drainage of the T tube after exploration of the biliary passage.Results Among 37 patients did not undergo the radical pancreaticoduodenectomy,6 had space-occupying lesions 5-19 months postoperatively.Five of them received pancreaticoduodenectomy again.Conclusion Pure stenosis at the end of the common bile duct should be carefully managed.

Objective To assess the effect of ultrasound-guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation of hepatic carcinomas. Methods Ninety-six patients with 112 liver malignancies were treated with ultrasound-guided percutaneous radiofrequency ablation using multiple-spot sector stereotaxis method. Conventional multi-section ultrasound scanning was performed to determine the exact location of tumors. Contrast enhanced ultrasound (CEUS) was performed 15 minutes after treatment to determine whether the tumors were completely inactivated. Contrast enhanced CT (CECT) and CEUS were performed 1 month after treatment to evaluate the therapeutic effect. Results A total of 293 punctures were performed for 112 tumors, technical successful rate with a successful rate of puncture was 91.81% (269/293). CEUS showed no blood flow signals in the tumors 15 minutes after therapy. One month after therapy, CT showed the volume of tumors shrunk, no enhancement was found in 100 tumors (100/112, 89.29%), while partial reinforcement was noticed in 12 tumors (10.71%). Meanwhile, CEUS showed no enhancement in 90 tumors (90/103, 87.38%), when partial reinforcement was noticed in 13 tumors (13/103, 12.62%). Conclusion Ultrasound-guided multiple-spot sector stereotaxis unipolar cooling cycle radiofrequency ablation is an effective and reliable method to treat hepatic carcinomas.

No abstract available.
Carotid Artery, Internal* ; Dandy-Walker Syndrome*

Objective To conduct a comprehensive study on pulsatile blood flow in arteries by proposing a convenient theoretical research system for hemodynamics. Methods Based on Womersley algorithm for fully developed pulsatile flow, numerical algorithm was introduced to establish the solving and analytical system of hemodynamics based on flow rate in arteries during one cardiac cycle. The flow rate of carotid artery in pig was measured under three blood flow states: the ideal state with a sinusoidal inflow waveform, the normal physiological state and the enhanced external counterpulsation (EECP) state for comprehensive hemodynamic research. Results Important hemodynamic parameters such as the axial speed vector, the wall shear stress (WSS), and the oscillatory shear index (OSI) during one cardiac cycle under the mentioned three flow states were solved respectively. The waveform of flow rate had a certain effect on WSS distributions and OSI level; the EECP performance obviously resulted in a significant increase in the level of WSS (WSS peak in particular) and OSI. Conclusions The solving system developed in this paper can be used for hemodynamics study conveniently and effectively. One of the most important hemodynamic mechanisms that lead to EECP’s good clinical effect may lie in its promotion to WSS level under physiological state, but the effect of OSI on endothelial function of the artery might much smaller than WSS itself; therefore, OSI may not be an ideal hemodynamic index for predicting the lesion of atherosclerosis.