Resection margin involvement of pancreaticoduodenectomy is an key prognostic factor for pancreatic head cancer.However,there is a wide variation of reported microscopic margin involvement (R1) rate in the literature,and there is discrepancy between the R1 rate and clinical outcome.Recent studies indicate that the variation and the discrepancy are caused by confusing nomenclature,controversy regarding the difinition of R1,lack of standardization of pathological examination,and inaccurate diagnosis for the pancreatic head mass.This review summarizes the composition and nomenclature of the circumferential resection margin,the difinition of R1,the method of pathological examination,the relationship between R1 rate and prognosis,and the relationship between resection margin involvement and tumor origin.

Insect viruses are attractive as biological control agents and could be a feasible alternative to chemical insecticides in the management of insect infestations. This review describes recent advances in the development of wild-type and genetically modified viruses as insecticides. A new strategy of application of insect viruses in China is reviewed. Also, the assessment of biosafety of genetically modified Helicoverpa armigera Nucleopolyhedovirus (HearNPV) is emphasized as a case-study.

Backgroud EDTA is an important calcium chelator,commonly used as an ophthalmic additive,its role in promoting corneal penetration of drug may facilitate transepithelial corneal collagen crosslinking.However,there were few reports about the penetration of riboflavin to corneal stroma enhanced by EDTA both home and abroad.Objective To determine the concentrations of riboflavin in corneal intrastromal under different interventions using high-performance liquid chromatography (HPLC).To ensure the efficacy and safety of 0.5％ EDTA in riboflavin penetrating to corneal stroma by the transepithelial procedures.Methods Fifteen New Zealand white rabbits were randomized into three groups,corneal epithelium of 5 rabbits were debrided,corneal epithelium of another 5 rabbits were left in situ and 0.5％ EDTA-Na2 was topically applied for 1 hour,and the corneal epithelium of last 5 rabbits were just left in situ,after those procedures 0.1％ riboflavin + 20％ dextran was applied topically to the corneas for 30 minutes(1 drop every 3 minutes).Then,the epithelium in the corneas of EDTA and epi-situ group were carefully removed before all the corneas were punched with an 8.5 mm diameter blade and homogenized subsequently.Ultimately,the riboflavin concentrations were determined by HPLC.Results After treated with riboflavin for 30minutes,the mean concentration of riboflavin in the epi-removed group was (23.54± 1.61)μg/g tissue,the EDTA group was (2.04 ±0.25)μg/g tissue and the epi-situ group was (1.44 ±0.06)μg/g tissue,showing significant difference among them (F =1792.839,P =0.000).There were statistically significant differences between any two groups (t =41.780,7.484,43.408,all at P ＜ 0.05).However,the riboflavin concentration of other two groups were failed to meet the theoretical value 15 μg/g tissue,excepted for epi-removed group.Conclusions The diffusion of riboflavin to the corneal stroma can be fully enhanced by removing the epithelium preoperatively,penetration enhancer EDTA can effectively promote the penetration of riboflavin to the cornea,but it still can not replace the role of removing epithelium on the penetration of riboflavin to the cornea.

AIM: To observe the effect of compound anisodine injection combined with yi-qi-tong-luo acupuncture, hot compress and massage for blepharospasm.
METHODS: Selected in our hospital, 60 cases (78 eyes) with blepharospasm were randomly divided into two groups, 30 cases 39 eyes in each group. The observation group were treated with compound anisodine injection combined with yi - qi - tong - luo acupuncture treatment, and supplemented by hot compress and massage, while the control group only with compound anisodine injection. We compared the treatment effect of the two groups.
RESULTS: In the observation group, 38 eyes were clinically effective, 1 eye was invalid, 35 eyes marked, the total effective rate was 97%, the markedly effective rate was 90%; in control group, 32 eyes were the clinically effective, 7 eyes invalid, 23 eyes marked, the total effective rate was 82%, the markedly effective rate was 59%; the total effective rate and markedly effective rate of observation group were higher than those of the control group with statistical difference (P<0. 05). The recurrence rates of the two groups were 5% and 34%, respectively, and the recurrence rate of the observation group was significantly lower than that of the control group ( P <0. 05).
CONCLUSION: The compound anisodine injection combined with yi - qi - tong - luo acupuncture, hot compress and massage for blepharospasm, can significantly improve the efficiency of treatment, with higher effective rate and lower recurrence rate, compared with using compound anisodine alone.

Animals ; Blood Gas Analysis ; Brain Ischemia ; complications ; metabolism ; physiopathology ; Lung Injury ; etiology ; metabolism ; physiopathology ; Male ; Pyrazines ; pharmacology ; Rats ; Rats, Wistar ; Reperfusion Injury ; complications ; metabolism ; physiopathology

Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Male ; Middle Aged ; NF-kappa B ; metabolism ; Neovascularization, Pathologic ; pathology ; Tryptases ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

Acute Disease ; Adult ; Ethylene Oxide ; poisoning ; Female ; Humans ; Male ; Middle Aged

Objective To understand the pathogenetic role and clinical significance of interleukin 6(IL－ 6 ),tumor necrosis factor(TNF) and soluble interleukin－ 2 receptor(sIL－ 2R) in patients with cerebral infarction(CI) .Methods The IL－ 6,TNF and sIL－ 2R levels were measured in 46 CI patients with ELISA. Results The serum IL－ 6,TNF and sIL－ 2R levels of CI group were much higher than those of controls group .The variation of IL－ 6,TNF and sIL－ 2R levels was closely related to the size of cerebral infarction. The serum IL－ 6,TNF and sIL－ 2R levels of recovery period were much lower than those of acute period in patients with CI .Conclusions The IL－ 6 ,TNF and sIL－ 2R take part in the pathologic process after CI .The measurement of IL－ 6, TNF and sIL－ 2R is useful in determining the size of cerebral infarction.

Objective To explore the clinical manifestations of toxic epidermal necrolysis(TEN) and its rare pulmonary complications.Methods Clinical symptoms,treatment and prognosis of 1 child with TEN caused by carbamazepine were analyzed.Radiological images were reviewed to evaluate the manifestations and the outcome of chronic pulmonary complications associated with TEN.Results The patient had high fever shortly after a dosage increment of carbamazepine.A confluent erythematous exanthema developed rapidly into painful blistering with skin erosion,denudation and involvement of conjunctive and oropharyngeal mucosa.The diagnosis of TEN was made.The mucocutaneous damage was gradually recovered with steroid plus intravenous immunoglobulin for 3 weeks.However,the patient presented with respiratory failure in the recovery phase of TEN.The computer tomography revealed pulmonary bullae and pneumothorax in the right lung.Lung parenchyma was squeezed and pulmonary bullae ruptured with pneumothorax and atelectasis,which were absorbed gradually through thoracic drainages.The patient′s lung function and pulmonary bullae were partly improved during a 7-month follow-up.Conclusions TEN is a severe form of blistering skin di-sease which is characterized by an extensive loss of epidermis and mucous membrane.Chronic pulmonary complications may occur in recovery phase of TEN.Pulmonary bullae,which might be caused by mucous damage and respiratory obstruction,is a rare complication of TEN.

Objective To explore the diagnostic value of neuron-specific enolase(NSE) in cerebrospinal fluid(CSF) in children with meningitis.Methods NSE levels in CSF of 18 children with purulent meningitis,13 children with tuberculous meningitis and 25 children with viral meningitis were determined by enzyme-linked immunosorbent assay(ELISA).Results CSF-NSE levels increased significantly in children with purulent meningitis and tuberculous meningitis compared with that of control group(P0.05);CSF-NSE levels increased significantly in children with purulent meningitis and tuberculous meningitis,compared with that of viral meningitis group(P0.05).Conclusions The determination of the neuron-specific enolase in cerebrospinal fluid can be used as an important parameter for identifying bacterial meningitis from viral meningitis.It also can be used to estimate the severity and prognosis of meningitis in children.