Pancreatic neuroendocrine neoplasms (pNENs) can be divided into functional and non-functional.Insulinomas,gastrinomas,glucagonomas and VIPomas are the common types of pNENs.Radical resection is the only way for curing pNENs or for a long-time survival of patients.The basic surgical procedures for pNENs are consist of local resection (tumor enucleation) or anatomical resection [pancreatoduodenectomy (standard or pylorus-preserving pancreatoduodenectomy),distal pancreatectomy (combined with splenectomy or spleen-preserving pancreatectomy) and middle segmental pancreatectomy].Liver is the most common site for metastases.Surgical resection is the method of choice for liver metastases.Radiofrequency ablation,transcatheter arterial chemoembolization and liver transplantation could be the adjunctive therapies.

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with the onset or first recognition during pregnancy,excluding diagnosed diabetes or prediabetes before pregnancy.It is one of the most common medical complications of pregnancy.There is almost no agreed diagnostic criteria for GDM until the hyperglycemia and adverse pregnancy outcome (HAPO) published in 2008.IADPSG published new diagnostic criteria for GDM,which is gradually acknowledged by the whole world.IADPSG diagnostic criteria has been adopted in China since 2011.Human insulin is the first-line therapy for GDM.Recently,insulin analogues such as insulin aspart and determir have been approved,and the safety and efficacy of oral antidiabetic drug-metformin are getting more and more attention and certification.Here,we reviewed the research progress of the diagnosis and treatment of GDM.

Aim To study the effect of BNIP3 on hy-poxia-induced autophagic cell death in gastric carcino-ma.Methods The protein levels of BNIP3 and LC3-Ⅱ of 1 8 cases of gastric carcinoma were studied with immunocytochemistry and Western blot analysis be-tween normal and tumor tissues.The expression of LC3-Ⅱ in SGC-7901 cells was assessed while knock-down of BNIP3 by siRNA in CoCl2-induced hypoxia, and the effect of 3-MA was also studied.Cell viability in hypoxia treatment for 48 h was estimated with cell counting kit-8 (CCK8).Results Compared with nor-mal tissues,the protein levels of BNIP3 and LC3-Ⅱwere increased in tumor tissues.BNIP3 siRNA could decrease the expression of LC3-Ⅱ and enhance the cell viability,while inhibition of autophagy could also in-crease the cell viability in SGC-7901 cells.Conclu-sions BNIP3 may play a role in hypoxia-induced cell death in gastric carcinoma,and the possible mecha-nism may be related to the regulation of autophagy.

Inflammatory bowel disease( IBD),comprising Crohn’s disease( CD)and ulcerative colitis( UC),is a chronic intestinal inflammatory disease and its etiology has not yet been clarified. Studies showed that intestinal microbiota disorder is closely associated with the development and progression of IBD. Currently,fecal microbiota transplantation (FMT)is considered as a special organ transplantation and used in treatment of IBD,Clostridium difficile infection, irritable bowel syndrome,metabolic syndrome,etc. This article reviewed the relationship between FMT and IBD.

Objective To explore the levels and the significance of IL-11 and sgp130 in the treatment of newly-diagnosed acute leukemia(AL)during the treatment of the induced remission,and to evaluate the curate effect of rhIL-11 on AL.Methods The levels of IL-11 and sgp130 in patients with AL were determined by ELISA respectively before treatment and after completing remission(CR).1.5 mg of rhIL-11 was injected subcutaneously,once a day,continuously for 14 days as one course,of treatment time 1～2 courses as total.Results Plasm IL-11 level in AL patients was significantly lower than normal(P

Objective To investigate the effect of chronic intermittent hypoxia on blood pressure,sympathetic nerve activity and myocardial mitochondrial oxidative stress status in aged rats.Methods Chronic intermittent hypoxia(CIH)rat models were established.A total of 84 male Wistar rats(3-4 and 23-24 months old,respectively)were randomly and equally divided into four groups according to age:young control group,young CIH group,aged control group and aged CIH group.CIH exposure lasted for 3 weeks.The arterial blood pressure,the frequency of carotid sinus nerve action potential,the lung function,the levels of catecholamine,aconitase/fumarate ratio (A/F),plasma superoxide dismutase(SOD)in the plasma were measured and compared between four groups.Results The arterial blood pressure was significantly higher in young CIH group than in the young control group[(150.4 ±25.6)mmHg vs.(102.2±7.4)mmHg,P＜0.01].There was no significant difference in the arterial blood pressure between the aged CIH group[(132.8 ±16.2) mmHg] and the aged control group[(127.1 ± 26.8)mmHg].The minute volume ventilation was significantly lower in the aged control group than in young controlgroup[(331.7±53.5)ml· min-1 · kg-1vs.(554.8±111.9)ml· min-1 · kg-1P＜0.05].The min-1 · kg-1 ventilation showed no significant difference between the agedCIH group[(354.1±51.9)ml· min-1 · kg-1]and the aged control group[(331.7 ±53.5)ml· min-1 · kg-1].The rate of CSN frequency change by hypoxia stimulation was lower in the aged control group than in young control group[(6.2± 5.5)times vs.(11.8 ±6.6)times,P＜0.01],and was lower in the aged CIH group than in the young CIH group[(22.2 ± 13.5) times vs.(44.2± 12.1) times,P＜0.01].The levels of plasma norepinephrine and epinephrine were higher in the young CIH group than in the control group[(39.0±8.9)nmol/L vs.(20.8±10.6)nmol/L,(48.1±13.6)nmol/L vs.(26.7 ± 14.3)nmol/L,both P＜0.05].The levels of plasma norepinephrine and epinephrine showed no significant difference between the aged control group and the young control group,also no significant difference was found between the aged CIH group and the aged control group.The A/F ratio was lower in the young CIH group than in the young control group[(0.26±0.13)vs.(0.58 ±0.04),P＜0.01].The A/F ratio was lower in the aged control group than in the young control group [(0.29±0.02)vs.(0.58± 0.04),P＜0.01],but there was no significant difference in the A/F ratio between the aged CIH group and the aged control group.The level of SOD was significantly lower in the young CIH group than in the young control group [(5.30 ±± 0.90) NU/mgprot vs.(6.10 ± 1.73)NU/mgprot,P＜0.05].There was no significant difference in SOD level between aged control group and aged CIH group.Conclusions The effect of CIH on blood pressure in aged rats is different from the youth rats.This study shows adecreasedsympathetic nervous over activity and a reducedmitochondrial oxidative stress in aged rats.Aging probably suppresses two important pathogenic mechanisms,by which CIH affects blood pressure,therefore releases CIH induced blood pressure abnormality.

Objective To compare the results of different operative methods for old acromioclavicular dislocation. Methods Forty three patients with old acromioclavicular dislocation were treated with three different operative methods: 1)open reduction plus Kirschner wire fixation (9 cases); 2)open reduction plus reconstruction of acromioclavicular ligament (14 cases) and 3)open reduction plus modified Dewar s operation (20 cases). After surgery, the subjective symptoms of the arm, muscular contraction power, function of the shoulder joint and space of acromioclavicular joint in 43 cases were followed up for an average 4.8 years. Results The excellent results following three operative methods were seen in 33％ , 50％ and 74％ respectively. There was no significant difference between Kirschner wire fixation and reconstruction of acromioclavicular ligament (P > 0.05). Modified Dewar's operation was better compared with Kirschner wire fixation and reconstruction of acromioclavicular ligament (P< 0.05). Conclusion A satisfactory surgical procedure for treatment of old acromioclavicular dislocation should accomplish the following points: removal of scar tissue and intra articular cartilaginous fragments, reconstruction of joint stability and effective internal fixation until complete healing of the ligament structures.

Objective To investigate the surgical collaboration in laparoscopic live donor nephrectomy.Method A retrospective analysis was made on the clinical data of 18 cases of laparoscopic live donor nephrectomy.Result All laparoscopic live donor nephrectomy were completed successfully,without severe complications caused by surgical collaboration.Conclusion The key points of successful operation are delicate mental care,sufficient preoperative preparation,good cooperation during the operation and related health education.

It has been over two decades from the discovery of extracorporeal shock wave(ESW).The therapy of ESW has been proved effective in improving fracture healing,and has been developed quickly both in the choice of indications and in the medical equipments research.The status quo of ESW research,application in orthpedic trauma and treatment mechanism are summarized in this paper.Successful cases are reviewd in treating post-traumatic nonunion,renovation of artificial joints,and traumatic osteonecrosis of the femoral head.Common complications and its preventive measures are given.Detailed description of ESW operating principles and selection of working parameters are also described,with the expectation of wider range of clinical applications of ESW.

Objective To explore the different doses of dexmedetomidine for prevention of shivering in cesarean section effect in patients with spinal and epidural anesthesia, summarize the clinical experience.MethodsIn 40 cases of spinal epidural anesthesia in cesarean section with large doses of dexmedetomidine for intervention, and classified into control group, according to the in the other 40 patients using small doses of dexmedetomidine for intervention, and classified as the observation group, then observe two groups of patients with chills were compared, the patients were in our hospital from February 2016 to January 2017 were found.ResultsWith comparison of two groups of patients with chills, two group in the overall number of cases no significant difference.The observation group, a total of 9 cases of patients with chills, the control group had 10 cases of chills, while no significant difference between the two groups of shivering grade;the patients in the observation group of 2 cases (5%) had adverse reaction, the control group had 9 (22.5%) cases of adverse reactions,P<0.05 between the two groups showed significant differences.ConclusionDifferent doses of dexmedetomidine on preventing shivering effect analysis of cesarean section in patients with spinal and epidural anesthesia after the discovery, which can play the effect of the intervention in patients with chills, and can reduce the incidence of adverse reactions in patients after surgery, it is worthy of reference.