ObjectiveTo assess the value of intraoperative radiotherapy (IORT) combined with postoperative concurrent chemoradiotherapy for locally advanced pancreatic cancer. MethodsFrom May 2008 to May 2011, 85 cases of locally advanced pancreatic cancer patients in our hospital were analyzed retrospectively.The treatment group included 40 cases treated by IORT plus drainage combined with postoperative concurrent chemoradiotherapy ( group A), and the control group included 45 undergoing IORT plus drainage ( group B).The clinical manifestation, operation plan etc.were summed up and all cases were followed up regularly to evaluate the survival time.ResultsThe follow-up time was from 6 to 15 months and the follow-up rate is 90％ (77/85).For group A and group B, the mean survival time was 10.17 ±0.58 months VS 8.05 ±0.48 months and the median survival time was 11.40 months VS 8.30 months.The survival analysis showed that group A had a significant survival advantage than group B (P =0.027 ).10 patients died in group A and 12 patients died in group B.The difference had no statistical significance (P =0.805 ).ConclusionIORT plus postoperative concurrent chemoradiotherapy can improve the survival rate of patients with locally advanced pancreatic cancer.

Objective To discover the value of endoscopi c ultrasonography (EUS) in predicting the resectability of pancreatic carcinoma.Methods Thirty-eight consecutive patients were prospectively i nvestigated using EUS to determine the tumor resectability. Two specialists eval uated the EUS findings in each of the patients prospectively. All patients were explored and their resectability noted. In the meantime, we compared the accurac y of EUS diagnosis with that of CT, MRI and sonography respectively.Results Ten out of 38 cases with pancreatic carcinoma were cons idered to be resectable by EUS with a positive predictive value of 80 0% in com parison with surgical findings. EUS also had high correlation with surgical resu lts in assessing un-resectability of pancreatic carcinoma, the negative predic tive value is 96 4%. There was 1 false negative and 2 false-positive assessmen ts (sensitivity, 88 9% and specificity, 93 1%). The accuracy of EUS was the hi ghest. The diagnostic accuracy of EUS, CT, MRI and sonography were 97 4%, 94 6 %, 89 5% and 73 7% respectively.Conclusion It is an effective method to use endoscopic ultrason ography in predicting the resectability of pancreatic carcinoma before operation .

Autophagy is a biological process in which cells maintain homeostasis through degradation of cytoplasmic macromolecules and damaged organelles by membrane vesicle structure .Autophagy plays a critical role in maintai-ning survival of intestinal epithelial cells during intestinal mucosal barrier dysfunction .A negative regulator of auto-phagy may lead to intestinal inflammation and tumorigenesis .

This study was to evaluate the feasibility of hepatectomy for primary liver cancer (PLC) without hepatic blood flow occlusion. Methods 194 PLC patients admitted between 1988～1998 underwent hepatectomy without hepatic blood flow occlusion including nonanatomical hepatectomy (100 cases),hepatolobectomy (41 cases), combined adjacent organ resection (30 cases), hepatic segmentectomy (22 cases) and left hemihepatectomy (3 cases). Results Operative time was 2 4 hr, intraoperative blood transfusion averaged at 649 ml. Operative complication rate was 18 0%, and there was no mortality. Conclusion Hepatectomy without hepatic blood flow occlusion for PLC patients can be performed safely, so it is a useful technique for hepatectomy.

Matrine is a traditional Chinese medicine extraction which can inhibit the proliferation, migration and apoptosis of tumor cells. Cell signal transduction affects the tumor biological behavior and growth condition. Except for the widely research of MAPK, JAK-STAT, NF-κB signal transduction pathways, the latest signaling pathways about matrine are Wnt/β-catenin signaling pathway and mTOR signaling pathway. These pathways are mainly activated by the phosphorylated key proteins to alleviate inflammatory reaction and inhibit the growth of tumor cells and tumor biological behaviors. The research of matrine by cell signaling pathways can provide molecular targeted therapy with theoretical basis. The relationship among different signaling pathways related to the anti-tumor effect of matrine is worth studying deeply in the future.

Objective To explore rational surgical treatment for rectal villous adenoma with canceration. Methods Sixty-two cases of rectal villous adenoma with canceration undergoing different surgical procedures were analyzed retrospectively. Among them 28 underwent local excision including 20 with transanal resection and 8 with Kraske resection; Thirty-four underwent extended excision consisted of 11 Miles operation, 21 with Dixon operation and 2 with other procedures. Results Among 62 cases, 82%(51/62)were in early stage. 68%(42/62) and 26%(16/62) of the patients were of high and middle differentiation in pathology respectively. Six cases suffered from recurrence or metastasis in both local and extended excision groups. The 5-year survival rate after local and extended excision were 79% and 76% respectively. Conclusions Most rectal villous adenomas with malignant change were less invasive; Prudent selection of surgical modality is both effective and less dangerous for the treatment of this entity.

Multidrug resistance (MDR) limits the clinical application and efficacy of chemotherapy drugs. Thus, MDR is the big-gest obstacle to the success of chemotherapy. Complex and diverse MDR mechanisms exist, including the following:adenosine triphos-phate-binding cassette membrane transport protein family, anti-apoptotic or enhanced DNA repair, mutations in drug targets or metabol-ic enzymes, microRNA, and cancer stem cells. Autophagy can degrade organelles and proteins that have been damaged in the cyto-plasm through the formation of autolysosome and recycle metabolites. Maintaining intracellular homeostasis and a balanced internal en-vironment is highly significant. Recent studies found that autophagy is closely related to the pathophysiology of MDR. The interaction between autophagy and MDR and the possible molecular mechanisms underlying these phenomena are reviewed. This paper elucidates the occurrence of MDR in relation to autophagy in order to provide new information on chemotherapy MDR.

The current situation of large-scale medical imaging equipment in Zhenjiang region is briefly summarized.Investigation and study are made on DSA,CT and MR of 19 hospitals in Zhenjiang.Data are treated statistically.Suggestions on management and disposition of large scale medical imaging equipment are put forward at last.

Objective To explore the value of enhanced T2 star weighted angiography(ESWAN)in the treatment of uterine fibroids with high intensity focus ultrasound(HIFU) by analyzing the changes of ESWAN. Methods Uterine fibroids were detected through pelvic conventional MRI and ESWAN 1 day before and after HIFU operation. Different indexes of ESWAN were measured ,and differences were compared with the paired t-test. Results The preoperative and postoperative values of magnitude were 1624.59 ± 53.07 and 1750.13 ± 39.81, phase values were 0.0012 ± 0.0081 Hz and 0.0025 ± 0.1063 Hz,R2*value were 27.69 ± 1.27 Hz and 24.19 ± 1.20 Hz,and T2*values were 34.66 ± 2.07 ms and 36.46 ± 2.14 ms. After HIFU operation,magnitude value,phase value and T2*value were higher(P=0.04,P=0.91 and P=0.45),and R2*value was lower(P=0.019). Conclusions ESWAN can provide more information about histopathologic changes of uterine fibroids after HIFU.