Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a rare tumor which has malignant potential.Differentiating IPMN from other cystic lesions of the pancreas is difficult. Its clinical symptoms are nonspecific,including nausea,vomiting,abdominal pain,fever or jaundice,possibly accompanied by hyperamy lasemia of blood and urine.Some patients have acute pancreatitis or chronic cholecystitis.According to the result of a retrospective study on clinical and imaging data of 11 patients with IPMN,we drew a conclusion that cystic dilatation of the main or branch of pancreatic ducts and mural nodules,and cystic dilatation linked with the main pancreatic ducts are the characteristics of IPMN of the pancreas.Computed tomography diagnosis is feasible to provide important information for the diagnosis of IPMN of the pancreas.

Adult ; Biomarkers ; blood ; Bone Marrow Transplantation ; Child ; Diagnosis, Differential ; Drug Therapy, Combination ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphohistiocytosis, Hemophagocytic ; diagnosis ; drug therapy ; therapy ; Practice Guidelines as Topic

Objective To evaluate the clinical efficacy of neo-adjuvant chemotherapy in the treatment of cervical cancer. Methods A total of 32 patients,of which 12 cases of Ⅰ b2,8 cases of Ⅱ a,5 case of Ⅱ b and 7 cases of Ⅲ, were all treated with 2 - 3 cycles of PF chemotherapy before treatment with cisplatin 100 mg/m2, d 1;5-fluorouracil 1000 mg/m2 ,d1-5. The chemotherapy was performed for 3 weeks followed by three weeks rest as one cycle. Results Short-term effect was 81.3% (26/32), with 3 cases of Ⅰ b2 and 1 cases of Ⅱ a had been completely relieved after 2 - 3 cycles of chemotherapies. Simultaneously, chemotherapy improved the removal rate of surgery. Among these 32 patients, there were 4 cases achieved complete response (CR) ,22 cases achieved partial response (PR) ,5 case of stable disease ( SD), 1 cases of progressive disease(PD). The overall response rate( CR +PR) was 81.3% (26/32) ,and the control rate ( CR + PR + SD) was 96. 9% (31/32). The main adverse events included myelosuppression and gastrointestinal response, which were all tolerable. Conclusions The neo-adjuvant chemotherapy reduced the size of cancer,which can improve removal rate of surgery and the quality of life.

Objective To explore imaging features of IgG4-related diseases (IgG4-RD)and to evaluate curative effect after treatment with steroid.Methods Imaging data were reviewed retrospectively in thirteen patients with pathologically proved IgG4-RD.CT scans were performed in all patients,while MR scans in five of them.Six patients were examined before and after steroid treatment in 3-6 months. Imaging data were analyzed with regard to the shape,distribution and characteristics of the lesions.The image changes between pre-and post-treatment with steroid were analyzed as well.Results The IgG4-RD occurred in the lacrimal gland in 1 case,submandibular glands in 1 case,biliary duct in 1 case,pancreas in 3 cases,kidney in 4 cases,retroperitoneum in 2 cases and lung in 1 case.Multiple organs including the retroperitoneum,kidney and pancreas were involved in two patients.Diffusely swelling organ or soft tissue mass, which manifested as low density on CT and low signal intensity on T2-weighted images on MR,were characteristics of IgG4-RD.All lesions mildly enhanced with contrast media administration.The lesions decreased in size accompanied by raised signal intensity on T2 WI after treatment with steroid in six patients.Conclusion Diffusely swelling organ,low density and low signal intensity on T2 WI with mildly homogenous enhancement are characteristics of IgG4-RD.CT and MR plays a vital role in diagnosis of IgG4-RD and monitoring the curative effect with steroid treatment.

[ ABSTRACT] AIM:To investigate the effects of everolimus on the experimental IgA nephropathy in rats and its possible mechanisms .METHODS:The rat model of experimental IgA nephropathy was established .The rats were ran-domly divided into control group , IgA group and everolimus treatment group .After the corresponding treatments were gi-ven, urinary red blood cells , protein and N-acetyl-β-D-glucosaminidase ( NAG) were examined .Immunofluorescence stai-ning was used to analyze the level of IgA precipitation in the renal tissues .Additionally, the protein expression of myeloid differentiation factor 88 (MyD88), TLR4, NF-κB, IL-4 and IL-13 was determined by Western blot.The mRNA levels of IL-4 and IL-13 were detected by qPCR .RESULTS:Everolimus significantly inhibited the increases in the urinary levels of red blood cells, protein and NAG in experimental IgA nephropathy rats .Furthermore, IgA nephropathy-induced increases in the protein expression of MyD88, TLR4, NF-κB, IL-4 and IL-13 were attenuated after everolimus treatment .Similar re-sults were obtained in the mRNA levels of IL-4 and IL-13 by qPCR detection .CONCLUSION: Everolimus improves the impairments of renal function in experimental IgA nephropathy rats as evidenced by decreasing urinary red blood cells , pro-tein and NAG, which may be related to the inhibition of MyD 88, TLR4, NF-κB, IL-4 and IL-13 expression.

Objective To observe the effect of nasal inhalation of Compound Acorus Liquid(CAL) and oxygen on the recovery of nervous function in cerebral infarction patients.Methods Forty ischemic stroke patients were equally randomized into the treatment group and the control group.The two groups received anti-fibrinogen drug,antiplatelet aggregation drug,and symptomatic treatment;additionally,the treatment group received nasal inhalation of CAL and oxygen,and the control group received nasal inhalation of CAL and oxygen.Ten times constituted one treatment course,and the treatment lasted two courses.Therapeutic effect was evaluated,and the changes of nervous function were assayed by MESSS scoring and Barthel index,and activities of daily life(ADL) were also observed.Results The total effective rate was 90.0% in the treatment group and 55.0% in the control group(P

Objective To explore clinical advantages of N‐terminal pro‐B‐brain natriuretic peptide(NT‐proBNP) in early diagno‐sis and therapeutic effect monitoring of acute coronary syndrome(ACS) .Methods A total of 97 cases of patients with chest pain and obvious discomfort who treated with coronary angiography in this hospital from February to December 2014 were selected .A‐mong these patients ,34 cases with non‐ACS were enrolled in the control group ,while other 63 cases with ACS were divided into the ST‐segment elevation myocardial infarction(STEM ) group ,non‐ST‐segment elevation myocardial infarction(NSTEM ) group and unstable angina pectoris(UA) group .The glycemia ,lipemia ,blood pressure and other indicators were observed .Results The levels of fasting blood‐glucose were within the normal reference interval in all groups ,while levels of lipemia ,plasma NT‐proBNP and blood pressure were higher than the upper limits of normal reference intervals ,and plasma levels of NT‐proBNP were higher than standard of good prognosis(NT‐proBNP<200 pg/mL) .There was statistically significant difference in plasma levels of NT‐proB‐NP among these groups(P<0 .05) ,while no statistically significant differences were found in other indicators among these groups (P>0 .05) .The levels of lipemia and plasma NT‐proBNP and blood pressure were obviously decreased in patients with ACS at each treatment stage .Conclusion NT‐proBNP as a kind of myocardial marker has high accuracy in early diagnosis of ACS ,which could be applied in therapeutic effect monitoring and provide guidance for reasonable selection of treatment strategy .

Objective To explore the difference between the diagnosis of osteoporosis based on the measured value of lumbar spine and hip bone mineral density in middle-aged and elder people in Chongqing .Methods Dual energy X-ray absorptiometry was used to measure of lumbar spine and hip bone mineral density to people over the age of 40 in 2 151 cases ,grouped according to age and gender .Results Both male and female lumbar spine and hip bone mineral density values decreased gradually with increasing age;the detection rate of osteoporosis of the male′s hip was higher than that of the lumbar spine among each age group ,which was of statistical significance(P<0 .05);the detection rate of osteoporosis of the female′s lumbar spine was higher than that of the hip among each age group ,which was of statistical significance (P<0 .05) .Conclusion As for elderly male ,the sensitive position for osteoporosis detection is the hip .However ,as for elderly female is the lumbar spine .In order to improve the detection rate of osteo-porosis ,joint detection of both two positions is well suggested .

The instance reality of medial equipment combined with the center problem of standardization management on medical equipment stock to discuss the questions of how to manage and what about manage.According to correlated management demand and the fact of medical procurement,from the point of view on frame construction flow to the problem of elementary demand on medical equipment procurement,the stock process of medical instrument,the stock process of medical consumable and the management of purchase invoice etc were analyzed.The beneficial research reference can be provided by the daily management jobs of stock and maintenance,the management question of more refinement and general standardization.

The general principles on maintenance and management of technical specification are discussed. Through summarizing many years maintenance experiences of the hospital or medical institutions technical support department, the beneficial mentalities and referential experiences are provided by standardized and effective management on maintenance of medical equipment, according to the medical technology level of medical equipment management department, the economic efficiency, the size of medical equipment, the quality of maintenance technicians, and service ability as well as the management methods of medical equipment material.