Objective To discuss the experience of the diagnosis and treatment of closed pancreatic injury.Methods Clinical data of 35 cases of closed pancreatic injury in recent 22 years were reviewed. All cases underwent surgical treatment.Results Of the 35 cases,33(94 3%)were cured ,19(54 3%)developed into surgical complications including 8 cases of pancreatic fistulas ,4 cases of abdominal abscesses and 4 cases of pancreatic pseudocysts Two cases died and the mortality was 5 7%.Conclusions Early diagnosis for pancreatic trauma is difficult. Exploratory is the most simple and effective method for early diagnosis.Whether the operation in time and rational could be a key factor of the prognosis.

Since the mechanism reform in 2001,the quality construction has been the center of our publication work.With the awareness of brand and service strengthened continuously,the publication quality is raised and the publication scope is widened so that the benefit in military,economy and society is enhanced comprehensively.This paper reviews the five-year publication practice of Chinese medical equipment journal and explores its prospects,which can be a reference for further development and the realization of new aim.

As the leading cause of death among lung cancer patients, brain metastasis occurs in approximately 10 percent of non-small cell lung cancer (NSCLC) patients at first diagnosis.Whole-brain radiation therapy (WBRT) is still the standard treatment for patients with brain metastasis, however, the efficacy of WBRT reaches a plateau.It has been proved that tyrosine kinase inhibitors (TKIs) make considerable therapeutic effect for NSCLC patients with brain metastasis.The combination therapy of TKIs with WBRT may provide new major treatment for epidermal growth factor receptor (EGFR) mutant NSCLC with brain metastasis.

In our gastroenterology clinic from Jun. 2008 to Jan. 2009, 20. 9% (277/1320) patients were diagnosed with functional dyspepsia (FD) and 14. 8% (41/277) of them with psychological problems according to Minnesota Multiphasic Personality Inventory (MMPI). In those with psychological disorders,92.7% were found with somatization, 60. 9% with depression and anxiety, 97.6% with abdominal pain,75.6% with bloating, 63.4% with early fullness and 36. 6% with nausea. More than 80% patients with anxiety and depression complained irritability, worry, fatigue, poor concentration, memory loss and insomni.a. After 4 weeks of psychological consultation and anti-depression treatment, 5 patients had significant improvement, 31 had improvement and 3 had no response. The overall response rate was 87. 8%.In summary,there is a high prevalence of depression and anxiety in population with FD. Hypochondria and somatization are common among these patients. Psychological consultation with anxiolytic drugs may have good therapeutic effects.

Cancer associated fibroblast (CAF) is the most important component in the tumor environment,and some researchers even propose that CAF can be the new target in cancer therapy.However what make it difficult for researchers are the various origins of the CAF,such as resident fibroblast,epithelium,endotheliocyte,mesenchymal cell,stem cell and so on.The various origins define their different phenotypes and functions.Further understanding about the origins of the CAF will help us to explore a novel approach for cancer therapy.

Objective To evaluate the efficacy and safety of endoscopic therapy in the treatment of symptomatic pancreatic divisum (PD).Methods Data of 8 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with the diagnosis of pancreas divisum at our institution from June 2006 to June 2013 was retrospectively analyzed.Results The patients were identified as pancreatic divisum with 28 ERCP procedures.All patients received stent placement,7 underwent minor papilla sphincterotomy,6 pancreatic duct stricture dilatation,and 1 stone extraction.Post-endoscopic retrograde cholangiopancreatography pancreatitis occurred in 1 patient,and no other complications occurred.After a follow-up of 2-47 months,1 patient died of pancreatic carcinoma,3 patients removed the stents,3 patients were followed up regularly,and 1 was unavailable for the interview.The episode of chronic pancreatitis and the extent of abdominal pain decreased after the operations.Conclusion Endoscopic therapy is effective and safe for the pancreatic divisum patients.It can reduce the episode of chronic pancreatitis and relieve the chronic abdominal pain in PD patients with low incidence of complication.

BACKGROUND:Self-made Distraction Reduction Fixation System is characterized by Distraction Reduction Fixation functions,which can completely fuse to the design of steel plate,and by no need to provide many surgical instruments,by reduction of bleeding and trauma.OBJECTIVE:To test changes in the stiffness of porcine short spinal segments in integrity and following destabilizing and internal fixation of the Distraction Reduction Fixation System.DESIGN,TIME AND SETTING:The control observation experiment was performed at the Laboratory of Biodynamics,Institute of Onhopedics,General Hospital of Chinese PLA from December 2004 to December 2005.MATERIALS:Twelve fresh porcine lumbar spines(T11-S2 segments)were bought from a market.Upper and lower segments were crossed and inserted with Kirschner wire to make porcine spine samples of the L1-7 segments.METHODS:Stiffness of intact samples was recorded during forward-bending,backward-bending,lateral-bending and axial rotation.Intervertebral discs,facet ioints,anterior and posterior longitudinal ligaments were removed to loose the spine.Stifrness of each motion was measured.Stiffness tests were repeated again after internal fixation on short segments using Distraction Reduction Fixation System.MAIN OUTCOME MEASURES:Stiffness in the intact,unstable and internal fixed spines during each motion.RESULTS:The stiffness iu unstable porcine spine were significantly lower than those in intact porcine spine(P<0.05),but the stiffness after internal fixation was significantly higher than in unstable porcine spine(P<0.05).No significant difference was detected in stifiness during forward-bending,lateral-bending and axial rotation(P>0.05)except that it was significantly higher during backward.bending after internal fixation compared with the intaet spine(P<0.05).CONCLUSION:Biodynamics confirms that the stiffness in short-segment fixation porcine after using Distraction Reduction Fixation System is markedly increased than in unstable porcine spine,except during backward-bending,which is comparable with that in intact porcine spine.

Objective To investigate the impact of accelerator′s multi-leaf collimator (MLC) on the radiotherapy dose with different gantry angles.Methods Measured with Mapcheck 2D diode array and 30 cm×30 cm×3 cm solid water, Pre-selecting the 30 appropriate single fields and 0°,45°,90°,270°,315° gantry angles of static and dynamic intensity modulated radiation therapy (IMRT), quantification analysis of the passing rate with MapCheck γ(3%/3 mm) and (5%/3 mm) analysis methods, and the same method to 30 examples static and dynamic IMRT plans.Results When the accelerator collimator angle is 0°,the 30 appropriate single fields′ passing rate of between 0°gantry angle and 45°,90°,270°,315°gantry angles of static and dynamic IMRT accordingly is 97.71% and 96.25%(t=1.70, P=0.389), 96.34% and 93.72%(t=2.95, P=0.002), 96.65% and 92.98%(t=2.87, P=0.005), 95.87% and 93.15%(t=2.71, P=0.006), 96.09% and 93.51%(t=2.89, P=0.004) with MapCheck γ(3%/3 mm) analysis methods, however, the passing rate also does not have the difference, respectively is 99.31%-99.73% and 98.89-99.68%(t=0.57-1.90, P=0.913-0.725) with MapCheck γ(5%/3 mm) analysis methods;the passing rate of 30 examples static and dynamic IMRT plans accordingly is 96.11%-96.76% and 94.88%-95.78%(t=1.02-1.61, P=0.317-0.235).Conclusions When the accelerator collimator angle is 0°, at different gantry angles, MLC leaves due to gravity, friction, inertia, etc caused by errors in place, the physical penumbra and leakage radiation will indeed affect the IMRT dose, however, the deviation of dose distribution is within acceptable 5%.

Objective To measure the distortion of digital images generated by radiotherapy simula-tor,and to study the appropriate method of correction. Methods The grid correction plate and Microsoft Visual C + + 6.0 were used for correction. The area error and boundary maximum displacement error of dig-ital images before and after correction were calculated. The post-correction images were compared with film images to evaluate the correction method. Results The area error was 0.31% - 12.36%, and the bounda-ry displacement error was more than 0 -6 mm for 4 cm ×4 cm - 12 cm × 12 cm radiation field before correc-tion. For commonly used radiation field(12 cm × 12 cm) ,the post-correction area error and the boundary displacement error were 0.48% and 0.46 mm,respectively. Conclusions The least square and polynomi-al fitting correction method can fulfill the requirement of conventional radiotherapy.

Objective To evaluate special diagnosis and treatment of occult breast cancer. MethodsDiagnostic means used included breast roentgenography,selective mammary ductography, fine needle aspiration and excision biopsy in 28 cases. ResultsBreast roentgenography detected 4 cases ( 7/16), selective mammary ductography identified 4 cases(4/6). The definite diagnosis rate by lump biopsy and immunohistochemistry was 10 cases (10/13). Postoperative follow-up was abtained in 18 cases,with 5 dying of recurrence or distant metastases. Among them 4 patients underwent only axillary node excision. Conclusion Nipple discharge,localized thickening the gland are very important clue to the diagnosis of occult breast cancer.Lump biopsy and immunohistochemistry is a mainstay for the final establishment of the diagnosis of breast cancer. Radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment modality for occult breast cancer.