Insulinoma is a rare tumor derives from pancreatic islet B cells,the cause of etiology is unknown with insidious onset.Its clinical manifestations are of diversification,the high misdiagnosis rate with the low cure rate owing to the complex of pancreatic anatomy and the lack of effective localization diagnosis and differential diagnosis method for benign and malignant lesions,the treatment of insulinoma is still one of challenge in clinical application considering that some patients unable to tolerate surgery or unwilling surgery.In recent years there have been some new treatments except surgery,this review will introduce the some treatment methods of insulinoma for the moment.

Objective To explore the advantage of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm.Methods One hundred and seven patient underwent removal of bilateral huge thyroid neoplasm were selected.Fifty-two patients were given neck white line incision thyroid surgery (control group) and 55 patients were given anterior cervical muscle group approach at sternal end transection for thyroid surgery (observation group).The operative time,operation field exposure effect,amount of bleeding in operation,postoperative complications,and postoperative drainage volume were compared between two groups.Results The operative time [(88.53 ± 5.95) min],amount of bleeding [(18.58 ± 5.95) ml],and postoperative drainage volume [(47.58 ± 14.76) rnl] in observation group were less than those in control group [(113.98 ± 15.85) min,(39.27 ± 16.32) ml,(73.90 ± 14.40) ml] (P ＜ 0.05),the postoperative complication rate was lower than that in control group (P ＜ 0.05).Operation field exposure effect in observation group was better than that in control group (P ＜ 0.05).Conclusions Removal of bilateral huge thyroid neoplasm with the sternal end approach is feasible and simple.The operation field exposure is better than the neck white line incision,complications after operation is less.It is worthy of clinical application.

Objective:To investigate the expression of CXCL1 2 and CXCR4 in adenoid cystic carcinoma(ACC)and to explore its re-lationship with clinicopathologic characteristics and prognosis of the patients.Methods:The expression of CXCL1 2 and CXCR4 in af-fected tissue was detected immunohistochemically in 62 cases of ACC.Both of the two factors and clinicalpathology factors were pro-cessed in accordance with the Kaplan-Meier method and the COX regression model.Results:The positive rates of CXCL1 2 and CX-CR4 expression were 54.8%(34/62)and 77.42%(48/62)respectively.Patients with the 2 factor expression had a shorter survival time than those without them(P<0.05).Multivariate analysis revealed that CXCR4 expression,clinical stage,histological differentia-tion and metastasis/recurrence were independent risk factors for the prognosis of ACC patients.Conclusion:The expression of CXCR4 may be correlated with the malignancy of ACC.CXCR4 expression,clinical stage,metastasis/recurrence and histological differentia-tion can indicate the prognosis of ACC patients.

Tissue factor(TF)is the most important factor in the physiological coagulation process.TF also plays important roles in tumor growth,angiogenesis,invasion and metastasis by combining with factor VII.In recent years,targeted therapy for the TF has made remarkable progress,showing its significant inhibition of tumor tissue and metastasis.

Objective To assess the efficency and safety of non-peritoneal drain versus peritoneal drain after appendectomy of severe appendicitis. Methods Randomized controlled trials (RCTs) or quasi-randomize controlled trials(QRCTs) were searched and identified from CNKI (1994 to Oct 2008) ,CBM (1978 to Oct 2008), VIP (1989 to Oct 2008), Wanfang Data (1997 to Oct 2008), MEDI.INE (1966 to Oct 2008), EMBASE (1974 to Oct 2008),The Cochrane Library (issue3, 2008) and SCI (1974 to Oct 2008), and related journals were also scanned. We evaluated the quality of the included studies by Jadad scale and analyzed the data by Cochrane Collaboration' s RevMan 5. 0. Results We included 15 randomized controlled trials or quais-randomized controlled trials (n = 2809). Meta analysis showed that there were statisticly differences between two groups on the incidence of wound infection [OR = 0.43,95%CI (0.29,0.65)], postoperative intestinal adhesion [OR = 0.26,95%CI(0. 18,0.37)]and the duration of hospital stay [WMD = - 0.38,95%CI(- 4.96, - 1.20)], but no difference was found on the incidence of abscesses [OR = 0. 77,95% CI(0. 39, 1. 51)]. Conclusions The current evidences show that contrast with peritoneal drain, the non-peritoneal drain can significantly reduce the incidence of wound infection and intestinal adhesion, and shorten the duration of hosipital stay. Before draw the conclution into clinical practice, further high-quality, large scale, double-blind randomized controlled trials are still needed.

Bupleurum chinense used in the study were cultivated in the experimental fields of Gansu agricultural University for three years. The seeds of B. chinense were collected every 3 days 10 d after the blossom. The result showed that the 1 000-grain fresh weight reached the maximum 43 d after the blossom and then decreased rapidly, at the mature period the fresh weight of seeds were falling to the same level of the dry weight. The dynamic change of the grain dry matter accumulation showed as an S-shape curve, the rapid increase stage was 25-34 d following the flower, and the grain filling was ended 46 d after blossom. Grain filling rate was under the law "fast-slow-fast-slow". And there were two peaks of grain filling rate appeared, after reached the second peak 28 d after the flower the filling rate decreased rapidly and stayed steadily 43 d after flowering. The dehydration rate was also measured at its maximum 43 d following flower. The indexes of seeds all reached the top 52 days following the blossom, when the germination rate reached the peak (34.33%) and water content of seeds was near 10%. The rate of germination and the 1 000-graid weight of seed showed significant positive correlation, while the water content of seeds was found significant negatively correlation with germination percentage. So the best time for harvest should be 52 d after flowering (9 month), the seeds collected at that time showed both high quality and germination rate.
Bupleurum ; chemistry ; growth & development ; Flowers ; growth & development ; Germination ; Seeds ; chemistry ; growth & development ; Water ; analysis

Objective To discuss the management of solid-pseudopapillary tumor of the pancreas. Methods Four patients of solid-pseudopapillary tumor of the pancreas (SPT) were diagnosed by pathology. One patient was underwent magnetic resonance and two enhanced computer tomography scan. The mass was located in tuberculum (1 case), neck (1 case), and body-tail (2 cases) of pancreases respectively. Four cases were underwent duodenopancreatectomy, local resection of mass, resection of body-tail of pancreases respectively. The maximal diameter of tumor ranged from 5 cm to 16cm, averaged 10.3cm. The blood regular test and biochemistry were normal, and the tumor markers including AFP,CA19-9,CA125,CEA also were normal. The specimens were examined by pathology and immunohistochemistry. Results Four cases all were diagnosed solid-pseudopapillary tumor of the pancreas by pathology. At histologic analysis, the tumor was composed of uniform polygonal cells with moderate to abundant amphophilic cytoplasm and arranged in solid nests with areas of degeneration characterized by separation of the cells into pseudopapillary aggregates with intervening accumulation of mucopolysaccharide rich ground substance. The expressions of Vimentin, α-ACT, α-AAT were positive, and CgA negative. Four cases were followed up for six months and norecurred. Conclusions SPT of pancreases was a kind of tumor of low potential malignancy, and the magnetic resonance and computer tomography were often to be used. The effective therapy was thoroughly resection, and the prognosis in most patients is excellent.

Objective To evaluate the expression of CyclinD1 in gallbladder carcinoma and its relationship with clinlicopathological parameters.Method SABC immunohistochemistry was used to detect the expression of CyclinD1in 41carcinoma,15 chronic cholecystitis,10 normal tissue of gallbladder .Gallbladder carcinoma cell proliferation condition was detected by PCNA counting score .Results There were no positive signal of CyclinD1 deteted in chronic cholecystitis and in normal tissue,the positive rate of CyclinD1 in gallbladder carcinoma was 58.5%(24/41).The expression of CyclinD1 was related to tumor TNM stage, lymph node metastasis and cell differentiation (P

Objective:This study aimed to analyze the correlation of the expression of CXCR4, CD44, and CD133 proteins with the clinicopathological characteristics of patients to identify the factors affecting the post-operation survival rate of tongue squamous cell carcinomas (TSCCs). Methods:Clinical data of 44 patients with TSCCs were collected and retrospectively analyzed. The diagno-ses of all cases were pathologically confirmed. CXCR4, CD44, and CD133 expression in 44 TSCCs patients with different pathological grades was examined immunohistochemically. Survival curves were processed in accordance with the Kaplan-Meier method. The Cox regression model was used for the multivariate analysis of relevant clinical and survival data. Results:Among the 44 examined TSCCs patients, 29 cases were well differentiated and 15 were moderately or poor differentiated;11 cases were stageⅠ, 12 were stageⅡ, 8 were stageⅢ, and 13 were stageⅣ. Positive staining of CXCR4, CD44, and CD133 was found in all cases with different degrees. Ac-cording to the pathological tumor grade, the positive rates of CXCR4, CD44, and CD133 expression were 79.54% (35/44 cases),77.27%(34/44 cases), and 75.00%(33/44 cases), respectively. Expression of CXCR4, CD44, and CD133 significantly differed between different histological grades (P<0.05). Correlation analysis indicated that the expression of CXCR4, CD44, and CD133 was positively correlated with the metastasis, recurrence of TSCCs. COX multivariate analysis indicated that CXCR4 expression, clinical stage, and neck metastasis were independent prognostic predictors of TSCCs patients and risk factors of death. Conclusion:CXCR4, CD44, and CD133 may be correlated with the malignancy of TSCCs. CXCR4 expression, clinical stage, cervical lymph node metastasis were the correlated prognosis factors of TSCC patients after operation.

Objective To study the gas analysis of umbilical cord artery blood and radial artery blood on predicating the prognosis of asphyxia neonate?Methods From September 2014 to September 2015, 328 neonates were divided into groups by Apgar score:290 patients in the control group and 27 patients in the mild asphyxia group,11 patients in the severe asphyxia group?After birth,umbilical artery blood,radial artery blood gas analysis was perfomed, oxygenation index was calculated, Outcome of neonatal behavioral neurological assessment ( NBNA) in neonates with asphyxia was regular follow?uped,the relationship between pH value and umbilical artery blood gas analysis was analyzed?Results The pH, PO2, PCO2 and oxygenation index of umbilical cord blood and radial artery blood in the severe asphyxia group was(7?11±0?25,(73?93±23?35) mmHg,(51?36±16?37) mmHg,206?23±98?12),significant different than the mild group(7?24±0?05,(86?35 ±12?56) mmHg,(45?89± 9?21) mmHg,411?22±57?94) and the control group(7?28±0?08,(87?80±12?07) mmHg,(43?68± 6?45) mmHg,426?23±73?30)(P<0?05)?The pH,PO2,PCO2 and oxygenation index of umbilical cord blood and radial artery blood in the severe asphyxia group was(7?25±0?18,(74?66±24?09) mmHg,(51?42±17?83) mmHg,332?03±65?19),significant different than the mild group(7?31±0?09,(87?24 ±11?75) mmHg,(45?73±10?21) mmHg,405?67±82?65) and the control group(7?32±0?06,(87?99±11?81) mmHg,(42?84± 9?32) mmHg,439?89±60?76)(P<0?05)?The NBNA scores of the severe asphyxia group was (34?09±5?02) points,lower than the mild group(36?62±2?04)(F=21?65,P<0?05)?The NBNA scores showed significant relationship with umbilical cord blood pH in the severe asphyxia group( r=0?877,P<0?01)?Conclusion The pH,PO2 and oxygenation index of umbilical cord blood and radial artery blood was lower while PCO2 was markedly high in the severe asphyxia group than other groups?For neonates, there is a correlation between umbilical cord blood pH and NBNAs core, neonates borned with hypoxia and acidosis should monitor blood gas analysis and oxygenation index dynamically