Objective To discuss the predisposing factors,prognosis and treatment of pancreatic encephalopathy(PE) in acute pancreatitis(AP). Methods Nineteen cases of AP complicated with PE were retrospectively studied. Results The occurrence rate of PE was 12.0%. PE often occurred in association with such factors as hyperpyrexia, water-electrolyte disturbance, and hypoxemia. Among the 19 patients,11 patients received surgical operation and 8 were treated conservatively.The total fatality rate reached 52.6%(10/19), significantly higher than other concurrently treated cases of severe acute pancreatits(SAP) (20.7%,P

Objective To study the treatment of intra-abdominal hypertension syndrome (IAHS) secondary to fulminant acute pancreatitis(FAP). MethodsWe retrospectively analyse therapeutic results of 14 IAHS cases secondary to FAP during the period of 1998～2003. ResultsFour out of the 6 cases receiving nonoperative therapy died with motality rate of 67.7% (4/6). Two out of the 8 cases treated by early surgery died. The motality rate was 25% (2/8), which was significantly different from that treated conservatively . ConclusionModerate to severe IAHS cases secondary to fulminant acute pancreatitis should undergo exploration in the early phase of disease to improve the prognosis of FAP.

Objective To study the diagnosis and treatment of primary liver cancer(PLC) with bile duct cancer thrombus (BDT). Methods The clinical data of 21 patients with PLC and BDT admitted in the past 8 years were analyzed retrospectively . Results The major clinical manifestations were the symptoms of primary liver cancer and obstructive jaundice. The correct diagnosis rate was 76.2% before operation. The diagnosis rate of B-us, CT, MRI, ERCP and PTC was 14.3%, 9.52%, 14.3%, 71.4% and 100% respectively. The operative procedures included hepatectomy with removal of BDT ( n =10), hepatectomy combined with extrahepatic bile duct resection ( n =5), thrombectomy through choledochotomy with TACE ( n =3), removal of BDT with HAI ( n =3). The 3,5-year survival rate were 43.20% and 24.60% respectively. Conclusions Multi-examinations should be applied in the diagnosis of PLC with BDT. The comprehensive therapy including surgery and other therapies must be adoptted for PLC with BDT.

Objective To study the significance of expressions of smad_4mRNA,TGF-?_1, and TGF-?R_1 in pancreatic carcinoma(PC) . Methods Smad_4mRNA was detected by in situ hybridization. TGF-?_1 and TGF-?R_1 were detected by immunohistochemical method. Results The positive rates of smad_4mRNA,TGF-?_1 and TGF-?R_1 were singnificantly lower in 53 slices of pancreatic carcinoma than those in 25 slices of paracancerous tissue (all P

Objective To explore the upper bound of Ⅱb region in the clinical target volume ( CTV ) for intensity?modulated radiotherapy ( IMRT ) for nasopharyngeal carcinoma ( NPC ) , and to establish a standard for personalized reduction in the range ofⅡb region. Methods A retrospective analysis was performed on the IMRT results of 142 patients newly diagnosed with NPC who were admitted to our hospital from 2012 to 2014. According to the American Joint Committee on Cancer 2010 staging system, there were 8 patients with stageⅠ disease, 37 stage Ⅱ, 41 stage Ⅲ, and 56 stage Ⅳ. The distribution pattern of cervical lymph nodes in NPC was studied based on the imaging results. Comparison of the dose to parotid glands between patients with and without reduction in the range ofⅡb region was made by t test and t'test. Results The metastasis rates of the most common diseased lymph nodes, lateral retropharyngeal lymph node and Ⅱb lymph node, were 75?4% and 67?6%, respectively. In the patients with metastases inⅡb region, 51?0% had high?risk positive lymph nodes and 6?3% had positive lymph nodes beyond the upper bound of Ⅱb region defined by the Radiation Therapy Oncology Group system. It was safe to narrow down Ⅱb region in patients who met the formulated standard. The D50 and V26 values for parotid glands were significantly reduced after optimization of CTV ( P=0?000) . Conclusions The upper bound ofⅡb region, in principle, should reach the lateral skull base during the delineation of the cervical CTV for NPC. In order to protect the parotid glands, however, personalized reduction in the upper bound of Ⅱb region is recommended for patients who meet the formulated standard.

Objective To investigate the relationship between the incidence of radiation-induced brain stem injury after intensity-modulated radiotherapy (IMRT) and the radiation dose volume in patients with nasopharyngeal carcinoma.Methods A retrospective analysis was performed on the data of 258 patients newly diagnosed with nasopharyngeal carcinoma who received IMRT in our group from 2005 to 2013.The radiation dose per unit volume of brain stem was analyzed.The relationship between the incidence of brain stem injury induced by IMRT and the radiation dose volume was studied.The survival rate was calculated using the Kaplan-Meier method.The factors influencing the radiation-induced brain stem injury were analyzed using the Cox regression model.Results Two patients with stage T3 disease and three patients with T4 disease had radiation-induced brain stem injury.The 3-and 5-year injury incidence rates were 1.6％ and 2.4％,respectively.The latency ranged between 9 and 58 months,with a median latency of 19 months.The median D1％ and Dmax for the brain stem were 54.24 and 59.22 Gy in all patients,54.31 and 59.45 Gy in patients with stage T3 disease,and 61.29 and 66.37 Gy in patients with stage T4 disease,respectively.In the five patients with brain stem injury,the D1％ and Dmax were larger than 60 and 63 Gy,respectively.The univariate analysis showed that the incidence of radiation-induced brain stem injury was correlated with D1％,Dmax,D0.1 cm3,D0.5 cm3,and D1.0 cm3 (all P=0.01).The incidence of radiation-induced brain stem injury was significantly lower in patients with D1％,Dmax,D0.1 cm3,D0.5 cm3,and D1.0 cm3 no larger than 60,63,60,58,and 56 Gy,respectively (all P =0.00).Conclusions The incidence of radiation-induced brain stem injury after IMRT is relatively low in patients with nasopharyngeal carcinoma.Strict control of the dose to the brain stem may help to reduce the incidence of brain stem injury and improve the long-term quality of life.

Objective To investigate the relationship between NF-kB activity of pancreatic acinar cells(PAC) and blood inflammatory cytokines ( IL-2, IL-6, IL-10, TNF-? and ICAM-1) in rat's ANP. Methods Fourty rats were randomly divided into two groups: ANP model group and contrast group. ANP was induced by retrograde injection of 5% sodium taurocholate into the pancreatic duct. NF-KB activity in the cell nuclear and IkBa activity in the cell spasm of PAC were measured by EMSA and Western-blot. Inflammatory cytokines were measured by ELISA. Results ANP model's NF-KB activity increased [(31.4?5.7) ?mol/L vs. (8.3?2.4) ?mol/L.(39. 4 ? 6. 4) ?mol/L vs. (10.7 ?2.6) ?mol/L. (33. 8?6.0)?mol/Lvs. (11. 5 ?2. 7) ?mol/L.(25. 7 ?4. 9) ?mol/L vs. (9.4 ?2.6) ?mol/L](P

Objective To evaluate the effect of surgical therapy for hepatolithiasis by hepatectomy and choledochofiberscopy. Method We retrospectively analyzed hepatolithiasis patients in our hospital during the past 5 years, comparing the therapeutic effect of different surgical modality. Data were analyzed by chi-square test. Result A total of 469 patients underwent surgical treatment, 412(87.85%) cases were followed up for an average of 3 years and 6 months. The residual calculus rate was 5. 14% and 14. 81% (x2 =9.32,P

Objective To study the clinicopathological significance of the expression of glutameta decarboxylase 65(GDA65) and protein kinase C(PKC) in the central cancer tissues, cancer edge tissues, paracancerous liver tissue and non-cancer liver tissues. Methods The expression of GDA65 and PKC were detected by immunohistochemical method in 10% neutral formalin- fixed and routinely paraffin-embedded sections in 37 hepatic cancer specimen. Results The positive rate and the score of GDA65 and PKC in the cancer tissues were significantly higher than that in the paracancer tissues or non-cancer liver tissues, but the PKC expression was no difference between the central cancer tissues and the cancer edge tissues . The expression of GDA 65 was related to the pathological types, differentiated degrees, liver cirrhosis or metastasis of hepatocarcinomas. No correlation was found between the expression of PKC and the clinicopathological features of hepatocarcinomas. Conclusions The expression of GDA65 and PKC might be closely related to the carcinogenesis of hepatocarcinoma, they might be important biological markers of hepatocarcinoma.

Objective To investigate the survival data and acute toxicities in patients with locoregionally advanced nasopharyngeal carcinoma who receive intensity-modulated radiotherapy (IMRT)with concurrent chemotherapy using nedaplatin plus 5-fluorouracil (PF) or taxol plus nedaplatin (TP).Methods A retrospective analysis was performed on the clinical data of 152 patients with stage Ⅲ or Ⅳa nasopharyngeal carcinoma who were admitted to our hospital in 2009-2010.Of the 152 patients,80 received IMRT with concurrent PF chemotherapy,and 72 received IMRT with concurrent TP chemotherapy;there were at least 2 cycles of concurrent chemotherapy in both groups.The Kaplan-Meier method was used to calculate the survival rates,and the log-rank test was used to analyze the survival difference ; the chisquare test was used to compare the acute toxicities in the two groups.Results The follow-up rate was 100％.The 2-year relapse-free survival rate,distant metastasis-free survival rate,progression-free survival rate,and disease-specific death rate for the IMRT/PF group were 95％,82％,81％,and 13％,respectively,versus 97％,83％,79％,and 12％ for the IMRT/TP group (x2 =0.03,0.02,0.62,and 0.22,P=0.861,0.881,0.431,and 0.638).The incidence rates of leukopenia (grade ≥3),neutropenia (grade ≥ 3),thrombocytopenia (grade ≥ 3),ALT elevation (grade ≥ 2),and oral mucositis (grade ≥3) for the IMRT/PF group were 33％,23％,14％,8％,and 12％,respectively,versus 60％,47％,28％,18％,and 25％ for the IMRT/TP group (x2 =11.33,10.29,4.59,3.94,and 3.94,P =0.001,0.001,0.032,0.047,and 0.047).Conclusions Compared with IMRT with concurrent PF chemotherapy,IMRT with concurrent TP chemotherapy does not lead to significantly better survival and results in more acute toxicities in the patients with locoregionally advanced nasopharyngeal carcinoma.