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 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 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 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.

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 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 explore the significance of the clinical target volume (CTV) dose optimization in the upper and middle neck in protecting the laryngopharynx, anterior and posterior rings during intensity-modulated radiotherapy (IMRT) and multimodal imaging system for nasopharyngeal carcinoma.Methods:Clinical data of 298 nasopharyngeal carcinoma patients admitted to Jiangsu Cancer Hospital from 2016 to 2018 were retrospectively analyzed. According to the following five strategies of CTV dose optimization in the upper and middle neck: group A, complete optimization of bilateral cervical lymph nodes (CLNs), that is, the CTV doses of bilateral CLNs were 50.4 Gy; group B, complete optimization of unilateral CLNs, that is, the CTV dose of unilateral CLNs was 50.4 Gy and the contralateral CLNs was 60 Gy; group C, incomplete optimization of bilateral CLNs, that is, the CTV doses of bilateral CLNs were 50.4 Gy, while the suspicious positive CLNs were selectively boosted to 60 Gy; group D, incomplete optimization of unilateral CLNs, that is, the CTV dose of unilateral CLNs was 50.4 Gy and the suspicious positive CLNs were selectively boosted to 60 Gy, and the CTV dose of contralateral side was 60 Gy; group E: no optimization, that is, the CTV doses of bilateral CLNs were 60 Gy.Results:Among 298 patients, 215 patients received dose optimization and 83 cases did not receive dose optimization. In the dose optimization schemes, 114 cases were assigned in group A, 36 cases in group B, 60 cases in group C and 5 cases in group D. The median (range) follow-up time was 28.5(6.0-46.3) months. The overall survival rate was 95.6%, the progression-free survival rate was 84.2% and the locoregional control rate of CLNs was 98.0%. Local relapse of CLNs occurred in six patients, including 1 case of retropharyngeal lymph node, 4 cases of Ⅱ area and 1 case of Ⅳ area. The P values of average dose of laryngopharynx in group A, group B, group C and group D compared with that in group E were<0.001, 0.016, 0.001 and 0.572, respectively. The P values of the average dose of the anterior ring in group A, group B, group C and group D compared with that in group E were<0.001, 0.011, <0.001 and 0.805, respectively. The P values of the average dose of the posterior ring in group A, group B, group C and group D compared with that in group E were<0.001, 0.004, <0.001 and 0.252, respectively.Conclusions:Combined with the metastatic rules of CLNs and multimodal imaging system, it is safe to optimize the CTV dose of the upper and middle neck during IMRT in nasopharyngeal carcinoma patients, which can significantly reduce the doses of laryngopharynx, anterior and posterior rings, thereby providing evidence for reducing the CTV dose in the upper and middle neck.

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 assess the effect of intravenous infusion of octreotide in prevention of pancreatic fistula after pancreaticoduodenectomy. Methods The clinical data of 74 cases of pancreaticoduodenectomy performed from January 1996 to July 2003 were retrospectively reviewed. These included 36 cases in control group in which octreotide was not adminstered,and 38 cases in octreotide group in which octreotide was administered by intravenous infusion of 0.5?g/( kg?h) for 12 hours per day from the operative day to postoperative day 7. The study parameters included clinical manifestation,drainage from peritioned cavity and the amount of drainage of pancreatic fluid. Results The drainage of pancreatic fluid at postoperative day 1,3,5 the in octreotide group was significantly less than those in the control group,the average hospital stay and the incidence of pancreatic fistula were significantly lower than those in the control group,and the drainage of pancreatic fluid was significantly increased after the withdrawal of octreotide in the octreotide group. Conclusions Intravenous infusion of octreotide can significantly lower the incidence of pancreatic fistula after pancreaticoduodenectomy.