Most of the pancreatic cancer was diagnosed at advanced stages and the resection rate was only 10％-20％.Vascular invasion was a common event in the pathogenesis of pancreatic cancer.However,in the traditional view,vascular invasion is a contraindication of pancreatic resection.With the development of surgical techniques and perioperative management,radical resection of pancreatic cancer with vascular resection and reconstruction was performed in some large centers.Preliminary results suggested that this procedure could increase the resection rate and 5-year survival to 26％-46％ and 20％ respectively,without increasing morbidity and mortality.Radical resection of pancreatic cancer with vascular resection and reconstruction was a safe and effective method for the surgical treatment of advanced pancreatic cancer,which should be performed by experienced pancreatic surgeons.

More than 25％ pancreatic cancers are locally advanced and unresectable.For patients underwent pancreatectomy,about 80％ of patients had pancreatic cancer recurrence in 2 years.The aim of palliative treatment for locally advanced and metastatic pancreatic cancer is to relieve the disease-associated symptoms,including biliary obstruction,duodenal obstruction,and intractable abdominal pain.Surgical strategies,such as palliative resection (R1 resection ),biliary drainage and gastroenterostomy have been widely used.During recent years,neoadjuvant chemotherapy and radiation have been recommended as the palliative treatment of choice for patients with locally advanced and metastatic pancreatic cancer.However,The controversy still exists.This article summarized current data of surgical and non-surgical strategies for the treatment of locally advanced and metastatic pancreatic cancer.

Abnormal motion at apex area of heart is a pathological phenomenon and it can be found with ultrasound cardiography and it occurs mainly in the patient of prophase coronary heart disease with difficulty in diagnosis for a short while. Bu Xin Decoction was used with satisfactory results. Treatment based on differentiation of symptoms and signs and treating both the principal and the secondary aspects of the disease can make most patients to improve or eliminate the symptoms and correspondingly improve or cure abnormal motion of apex of the heart, the cured rate plus markedly effective rate being 87%. Bu Xin Decoction can postpone or prevent occurrence of coronary heart disease for the patient of prophase corconary heart disease.

BACKGROUND: Some researches indicated that the acupuncture treatment, especially at Sanjiao meridian might be effective for otopathy. However, the mechanism is not clear yet.OBJECTIVE: To observe the hearing improvement of the cavies induced by gentamicin after the animals received the acupuncture at Sanjiao meridian acupoints: Yifeng (SJ 17), Ermen (SJ 21) and Zhongzhu (SJ 3).DESIGN: Complete randomization.SETTING: Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences.MATERIALS: Sixty healthy white male cavies of 3-4 months old, common grade, 250-300 g weight and normal auricle reflex were selected and randomly arranged into 5 groups: normal group, model group, acupuncture groups of Yifeng (SJ 17), Ermen (SJ 21) and Zhongzhu (SJ 3), with 12 ones in each.METHODS: The experiment was conducted at the Laboratory of Acupuncture and Moxibustion, Beijing University of Chinese Medicine from January to July in 2001. ①The normal cavies were bred at normal conditions, while other cavies were injected intramuscularly with 80 mg/kg gentamicin every day, continuously for 20 days. At the same time of gentamicin injection, Yifeng (SJ 17), Ermen (SJ 21) and Zhongzhu (SJ 3) were selected for acupuncture treatment in the corresponding groups. The fixed cavies were pricked subcutaneously with 0.35 mm×25 mm stainless steel acupuncture needles for 10 mm straight depth. The needles were twisted with mild reinforcing-reducing method once in half a minute, repeated every 10 minutes, and remained for 30 minutes one day for 20 days.②Before and after the intervention, auditory brain-stem response (ABR) was detected with 7S11A evoked potential apparatus, in which the sound source was input by earphone for measuring the threshold value of ABR in cavies. ③The difference of measurement data were compared with t test between groups.MAIN OUTCOME MEASURES: The effect of acupuncture treatment at Yifeng (SJ 17), Ermen (SJ 21) and Zhongzhu (SJ 3) on the ABR threshold in cavies injured by gentamicin.RESULTS: Totally 60 cavies were involved in the result analysis. There was insignificant difference in the ABR threshold of each group before the intervention (P ＞ 0.05); After the intervention, the ABR threshold was obviously lower in normal group than in other 4 groups (P ＜ 0.01), and also obviously lower in 3 acupuncture groups than in model group (P＜ 0.01),and especially in Yifeng group than in model group.CONCLUSION: The acupuncture treatment at Ermen (SJ 21), Zhongzhu (SJ 3), and especially at Yifeng (SJ 17) acupoints can relieve the hearing impairment in the cavies due to drug toxicity.

BACKGROUND: At present, there is no ideal way to treat auditory injury, and acupuncture would become an effective method to prevent and cure drug auditory injury.OBJECTIVE: To observe the effect of acupuncture at Yifeng, Ermen and Zhongzhu acupoints on improving histopathologic form of basilar membrane of guinea pig with drug poisoning auditory injury.DESIGN: Completely randomized design on the basis of experiment al animals.SETTING: Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences.MATERIALS: A total of 45 white male guinea pigs with normal Preyer's reflex were selected in this study. Guinea pigs were 3-4 months old, of general grade and weighted from 250 g to 300 g. All guinea pigs were randomly divided into 5 groups: normal group, model group, Yifeng group, Ermen group and Zhongzhu group with 9 in each group.METHODS: The experiment was completed at the Laboratory of College of Acupuncture and Moxibustion Affiliated to Beijing University of Traditional Chinese Medicine from April to July 2002. ① Normal group: Guinea pigs were fed with normal feed. Other four groups: Guinea pigs were injected into muscle with 80 mg/kg gentamycin for 20 days, and guinea pigs in Yifeng group, Ermen group and Zhongzhu group were acupunctured at corresponding acupoints at the same time. Before acupuncture, guinea pigs were fixed and rapidly acupunctured into subcutaneous tissue with stainless steel needle sized 0.35 mm × 25 mm. The needle was inserted about 10 mm. According to uniform reinforcing-reducing method, the needle was thrusted once every 10 minutes with each for 30 seconds and retained for 30 minutes. The course was 20 days. ② Basilar membrane of guinea pigs was established. Amount of hair cell was calculated under optic microscope (×200) to record deletion amount of hair cell and observe activity of succinic dehydrogenase; meanwhile, ultrastructure of hair cells was observed with transmission electron microscope (×5 000). Measurement data were compared with t test among groups.MAIN OUTCOME MEASURES: Activities of succinic dehydrogenase of hair cell in stretched preparation and changes of ultrastructure of hair cell in cochlea of guinea pigs.RESULTS: All 45 guinea pigs were revolved in the final analysis. ① Comparing activities of succinic dehydrogenase: Activity in normal group was great, and structures of inter and outer hair cells were normal. Activity in mode group was reduced gradually till disappeared. Outer hair cell at base was damaged severely, and there was significant difference from that in normal group (P ＜ 0.01). Activity of succinic dehydrogenase in Yifeng group was changed a little as compared with that in normal group, and difference was not obviously (P ＞ 0.05). Activity of succinic dehydrogenase in Ermen group was decreased, and hair cell showed a little swelling and deletion. Activity of succinic dehydrogenase in Zhongzhu group was decreased remarkably, and outer hair cell at base was damaged severely.There was significant difference between Ermen group and Zhongzhu group as compared with that in normal group (P ＜ 0.01). ② Deletion amount of outer hair cells in basilar membrane of guinea pigs: Amounts in Yifeng group, Ermen group and normal group were less than those in model group (P ＜ 0.05-0.01), but those in Zhongzhu group were similar to those in model group. ③ Ultrastructure: Structure of hair cell of cochlea was normal in normal group, pathological changes were observed on hair cells in model group, and pathological changes in acupuncture groups were milder than those in model group. Pathological changes of outer hair cells were mild in Yifeng group, structure of hair cells was changed a little in Ermen group,pathological changes in Zhongzhu group were severe, but its degree was milder than that in model group.CONCLUSION: Acupuncture can improve and maintain the activity of succinic dehydrogenase, relieve or resist toxic effect of gentamycin, especially at Yifeng, then at Ermen and Zhongzhu.

The majority of the pancreatic cancer was diagnosed at advanced stage.The tumor may invade portal vein and/or superior mesenteric vein.Moore et al.firstly reported pancreaticoduodenectomy combined with portal vein and superior mesenteric vein resection and reconstruction in 1951.This procedure has improved the resection rate of pancreatic cancer.A 72-year-old man suffered from pancreatic cancer was admitted to the Southwest Hospital in September 2011.Because the tumor invaded the confluence of portal vein and superior mesenteric vein,thus the patient underwent a pancreaticoduodenectomy combined with portal vein and superior mesenteric vein resection and reconstruction.The patient recovered smoothly without any complication,and he had a normal liver function and CA19-9 value,and no local and remote metastasis was detected during the follow-up.

Objective Overexpressing gax gene in vascular smooth muscle cells(VSMC) mediated by adenovirus transfection.Methods Replication defective adenovirus type 5 (Ad5) vector encoding the rat gax gene (AdCMV gax) was constructed via site specific recombination and amplified in 293 cells. The resulting adenovirus was purified for a high viral titer. The expression of gax mRNA and protein was evaluated by a series of methods such as reverse transcription polymerase chain reaction (RT PCR), flow cytometry and immunocytochemical technique after gax gene was transferred to VSMCs. Results When AdCMV gax was transfected to VSMCs, the expression of gax protein increased significantly in VSMCs, and reached 80% in 24 hours. High expression of gax protein could keep for over 5 days. Before AdCMV gax was transfected to VSMCs, gax mRNA and protein could be down regulated by platelet derived growth factor (PDGF) BB. After AdCMV gax was transfected to VSMCs, the level of gax expression was significantly higher than that before transfection, and no correlation with the stimulation of PDGF BB.Conclusions gax gene can be transfected to VSMC by AdCMV gax and translated to protein, which is advantageous to exploring the effects of gax gene on biological behaviour of VSMC.

0.05). The expression of IL－ 1, IL－ 6, TNF－? in fibromatosis and the periosteum of CPT was higher than that in normal periosteum and traumatic pseudarthrosis (P

0.05).Conclusion On clinical,MMP-9 C-1562T genotype of IgA nephropathy patients may impact on the degree of urinary protein,but not other clinical manifestations,and prognosis of IgA nephropathy.

36 week of gestation who requested labor analgesia were assigned to one of two groups according to cervical dilation (n = 60 each): latent group (cervical dilation