Lymph node dissection was the key procedure of pancreatic surgery.The majority of guidelines indicated that extended lymph node dissection was helpless for improving survival rate.However,there were still quite a few researches which demonstrated that the extended dissection was a valuable procedure.It was still a controversial topic considering lymph node dissection.To review the shortcomings of previous randomized controlled trials (RCT),this article combined the experience of new techniques in pancreatic surgery,which are developing rapidly in recent years,and our theory and practice of radical resection of retroperitoneal lipo-lymphatic layer (RRRLLL).Therefore,the controversy and update of extended lymph node dissection for pancreatic head carcinoma were discussed,which could provide references for standardizing the treatment of extended lymph node dissection in clinical practice.

Objective To design a vehicle-mounted X-ray diagnosis simulation training system based on the field X-ray diagnostic vehicle to solve the problems during its training and utilization.Methods The field X-ray diagnostic vehicle had its internal and external structure analyzed,and was divided into several functional modules.The technologies of computer programming and database were used for the simulation of the modules.An example was given to simulate the operating process of the vehicle by establishing traumatic condition model,war injury image library and etc.esults The system developed realized the simulation training of the vehicle,and the trainee gained feedback after simulation as references.Conclusion The system implements informatized training of the field X-ray diagnostic vehicle,shortens the training period,decreases the training cost and increases the training efficacy.

The aticle briefly introduced the working principle and clinical applicability of Coblation. The application of Coblation promoted the improvement of traditional surgery and the generation of new operation, it is the most important to hold the indication of the operation strictly. This review summarized that and discussed the advantages and the notes of Coblation in operations of the pharynx and larynx.
Humans ; Larynx ; surgery ; Laser Therapy ; Pharynx ; surgery

Objective To investigate the streptomycin(SM)-resistance of Mycobacterium tuberculosis (MTB) in urine and to examine their relationships with the mutation of rspL gene. Methods 47 strains of MTB were isolated from the urine of patients with renal tuberculosis.The mutation of rspL gene were analyzed by PCR-SSCP with silver-staining,and the strains were tested for the sensitivity to streptomycin. Results All the 47 strains had positive expression of rspL gene of MTB,with 28 SM-resistant and 19 SM-sensitive.Among the 28 SM-resistence strains 19(68%) had rspL gene mutation by SSCP testing.The 19 strains of SM-sensitive had no mutation. Conclusions Detecting mutation of MTB rspL gene in urine by PCR-SSCP can rapidly and exactly identify the MTB's sensitivity to streptomycin,which is significantly important in clinical treatment of anti-tuberculosis.

Central pancreatectomy is an ideal surgical procedure for the treatment of benign or low-grade malignant tumors in the pancreatic neck or the proximal body of the pancreas,and it can preserve more normal pancreatic tissue in order to reduce the incidence of endocrine and exocrine insufficiency after surgery.Although some clinical studies have demonstrated the feasibility and safety of this procedure,laparoscopic central pancreatectomy was technically challenging with a few number of cases.This article reviews the current status of laparoscopic central pancreatectomy and introduces our clinical experience of laparoscopic central pancreatectomy and pancreaticojejunostomy.

Objectives To investigate current status in asthma education in the remote suburban districts and counties of Beijing and to provide basis to draw up and modify the work plan for asthma education. Methods Ten district or county hospitals in the remote suburban areas of Beijing were investigated, and 81 professionals in respiratory disease subspecialty of internal medicine were selected to answer the questionnaire and their practical performance was observed, including 35 residents, 27 attending physicians and 19 chief or deputy chief physicians. Results Only 8.6% (7/81) of them could correctly answer the question "What is the GINA?" And, 55.6% (45/81) of them could correctly answer the question "Is the Guidelines for Prevention and Treatment of Asthma in China formulated by Chinese Society of Respiratory Disease, Chinese Medical Association? " About one fifths of the interviewee (22.2% , 18/81) could correctly master the six steps in manipulation of metered-dose inhaler. Nearly two thirds of the interviewee (31.7% , 50/81) could correctly answer that "Inhalation of glucocosteroids is the most important treatment to control persistent episodes and chronic symptoms in asthma patients and to prevent asthma attack. About two thirds of physicians (61.7% ,50/81) did not attend any lectures or workshops on asthma during the recent year, and only 22 of them attended lectures or workshops on asthma sponsored by the medical association, reflecting its influence in asthma education. Only 15 of 81 physicians (18.5%) could instruct a few patients to use the peak airflow meter to monitor their conditions, and other 81.5% of the physicians "never heard about peak airflow meter" or "having ever heard about it but never instructed the patients to use it". Conclusions Asthma education by the respiratory disease specialists in the hospitals at remote suburban districts and counties hasn't improved obviously. It is worthy to have a try in changing and modifying asthma education model and going round the remote suburban districts and counties to provide asthma education.

Objective To investigate the efficacy and safety of Technetium 99m Tc methylenediphos-phonate injection (Yunke) and various combination therapy on rheumatoid arthritis.Methods All 137 patients enrolled in trial group.Among them 67 patients received Technetium 99m Tc methylenediphosphonate alone,42 patients received combination therapy with methotrexate and mobik and 28 patients received calcium orally meanwhile.Clinical manifestations and lab markers were observed carefully.Results The conditions of 67 patients receiving Technetium 99m Tc methylenediphosphonate alone were improved,42 patients received combination therapy had better effect and 28 patients in middle and old-age taking calcium orally simultaneously showed superiority in remission of rest pain and descent of ESR.Conclusion Technetium 99m Tc methylenediphosphonate is an effective and safe drug in the treatment of rheumatoid arthritis.Results is suggest calcium be taken in the same time.

Objectives The aim of the study was to detect the frequency of B regulatory cells (Breg)and the correlation between Breg and T regulatory cells (Treg) in pancreatic cancer patients,and to investigate its role in pathogenesis of pancreatic cancer.Methods 50 pancreatic cancer patients and 21 healthy controls were enrolled.CD19+CD24hiCD38hi Breg and CD4+CD25high Treg was also determined via flow cytometry.The correlation between Breg and Treg was analyzed by Spearman correlation test.Results Upregulation of CD19+CD24hiCD381hi Breg was associated with pancreatic cancer progression.Furthermore,this B cell subset was positively correlated with the frequency of CD4 + CD25high Treg cells.Conclusions Together,CD19 + CD24hiCD38hi Breg cells are significantly elevated in pancreatic cancer patients,indicating this B cell subset might play an vital role in clinical progression of pancreatic cancer.The significant positive correlation between Breg and Treg may suggest CD 1TCD24hiCD38hi Breg are affecting tumor progression through Treg cells.

Objective To validate cystatin (Cys C)-based equations for evaluation of residual renal function (RRF) in patients on continuous ambulatory peritoneal dialysis (CAPD).Methods Fifty patients on CAPD from our department were enrolled in the study.Eight patients with residual urine volume ≤ 100 ml/d and 42 patients with residual urine volume ＞ 100 ml/d were enrolled into anuria group and non-anuric group respectively.The clinical and laboratory status of each group were compared and equations (Hoek' s,Yang' s and abbreviated MDRD equations) were validated in the non -anuric group by comparing with the arithmetic average of residual renal creatinine clearance rate and residual renal urea clearance rate which was considered as the golden standard for RRF.Results (1) Anuric group had significantly higher serum Cys C than the non-anuric group [(7.73±1.13) mg/L vs (6.46± 1.15) mg/L,t =2.39,P =0.02)].(2) RRF estimated by each equation was correlated well with measured RRF (r =0.56,0.56 and 0.39,all P ＜ 0.05).(3) Yang' s equation [0.10 ml· min1· (1.73 m2)-1]was least biased,followed by Hoek' s equation [-0.73 ml· min-1 · (1.73 m2) 1] and abbreviated MDRD equation [3.15 ml· min-1 · (1.73 m2)-1].(4) The precision of Yang' s equation was equivalent to that of Hoek' s equation and both of them were better than abbreviated MDRD equation [6.2 and 6.1 vs 8.4 ml· min-1 · (1.73 m2)-1].(5) 50％ accuracy according to Yang' s equation and Hoek' s equation revealed an elevated results in comparison to that according to abbreviated MDRD equation (59.5％ and 54.8％ vs 23.8％,respectively,all P ＜ 0.01).Conclusions Serum Cys C-based prediction equations are better than the abbreviated MDRD equation in bias,precision and 50％ accuracy.For patients undergoing CAPD,the use of Cys C-based equation to estimate RRF may be a clinically acceptable alternative.

Objective To analyze the space-time characteristics of hand-foot-mouth disease (HFMD) in Shijiazhuang by using geographic information system (GIS).Methods The data of HFMD during 2009 to 2011 in Shijiazhuang were collected and GIS database was created.Special map was drawn by PHGIS software to analyze the space-time characteristics of HFMD in Shijiazhuang.Results The epidemic situation of HFMD in Shijiazhuang appeared sporadic with local centralization.The attack ranked alternately rise year after year and high epidemic areas were geographically complimentary.Overall epidemic levels tend dropping from 2009 to 2011 and there were differences among areas.The high-attack areas of HFMD changed over time.Conclusions GIS can provide direct-viewing of the space-time characteristics of HFMD and further understand the prevalence of HFMD,which could help to provide the scientific basis of HFMD control in Shijiazhuang.