With the increasing incidence and high malignancy, pancreatic cancer is still expected to be treated by radical resection. However, because of the unique anatomical and biological features, such as rapid progression, early metas-tasis and direct invasion to the vessels, the resection rate of pan-creatic cancer is still at a lower level. The standard procedures of diagnosis and treatment, including early detection, preopera-tive resectability assessment, and judgement of the resection area based on the tumor staging, benefit the patients and significantly improve the prognosis.

Objective To investigate the clinical significance of the expression of microvessel density and adhesion molecules in the tissue of chronic gastritis and gastric cancer. Methods Fifty-six patients with chronic superficial gastritis (chronic superficial gastritis group), 55 cases of gastric cancer without lymph node metastasis (gastric cancer without lymph node metastasis group) and 57 patients with gastric cancer and lymph node metastasis (gastric cancer with lymph node metastasis group) were included in this study. Gastric pathology paraffin blocks was studied using immunohistochemical Envision method. Microvessel density CD34 and cell adhesion molecule Syndecan-1 expression was examined. In 112 gastric cancer patients, 47 patients were highly differentiated, and 65 patients were poorly differentiated. Results Microvessel density CD34 results:in chronic superficial gastritis group was (13 ± 10)/HP,in gastric cancer without lymph node metastasis group was (27 ± 11 VHP, in gastric cancer with lymph node metastasis group was (28 ± 10)/HP. There were significant differences between chronic superficial gastritis group and gastric cancer without lymph node metastasis group,and between chronic superficial gastritis group and gastric cancer with lymph node metastasis group (t = 7.044,7.908, P ＜0.05), but there was no significant difference between gastric cancer without lymph node metastasis group and gastric cancer with lymph node metastasis group (t = 0.506,P ＞ 0.05). In chronic superficial gastritis group, gastric cancer without lymph node metastasis group and gastric cancer with lymph node metastasis group, Syndecan-1 positive expression ratewas 96.43%(54/56),45.45%(25/55),24.56%(14/57),and there was significant difference between chronic superficial gastritis group and gastric cancer without lymph node metastasis group,and between chronic superficial gastritis group and gastric cancer with lymph node metastasis group (x2 = 163.560,17.197,P＜ 0.01). There was significant difference between gastric cancer without lymph node metastasis group and gastric cancer with lymph node metastasis group (x2 = 5.340, P ＜ 0.05). Conclusions Microvessel density is related with the occurrence of gastric cancer;adhesion molecule Syndecan-1 expression reduces the incidence of gastric cancer development, and might further promote the metastasis of gastric cancer. Detecting the expression changes of microvessel density CD34 and cell adhesion molecule Syndecan-1 facilitates the diagnosis and prognosis of gastric cancer.

OBJECTIVE: To evaluate the cost-effectiveness of five regimens of antibacterial drug therapy in the treatment of community acquired pneumonia. METHODS: A retrospective study was conducted, in which a total of 128 cases with pneumonia were enrolled and randomly assigned to receive each of the following 5 therapies,cefoperazone sodium/ sulbactam sodium(Group A),levofloxacin(Group B),amoxicillin/ clavulanate potassium(Group C),azithromycin plus ceftazidime(Group D),and cefoxitin(Group E),the therapeutic effects were monitored and the cost-effectiveness analyses were conducted on the five groups. RESULTS: The costs of the five regimens were 2 137.0 yuan, 1 393.0 yuan, 1 152.5yuan, 2 044.2 yuan and 1 827.0 yuan, respectively;The effective rates were 85.2%, 86.6%, 80.6%, 89.6% and 78.5%, respectively;The cost-effectiveness ratios were 25.08 , 16.09, 14.30, 22.82 and 23.27, respectively; As compared with group C, the incremental cost-effectiveness ratios of the other four groups were 214.02,40.08, 99.08 and —321.19, respectively. CONCLUSION: The therapy of amoxicillin/ potassium clavulanate is superior to the other regimes in the treatment of community acquired pneumonia.

Objective To explore the effect of family constellation therapy on the spouses of female tumor patients . Methods Two hundred and two spouses of 202 female tumor patients were divided to the control group ( n = 43 ) and experiment group according to their wills(n=159):the former were intervened with health education and skills training and the latter trained in a workshop with family constellation by psychology training specialists in addition to health intervention and skill training intervention. After the intervention, the two groups were compared in terms of quality of life, family function and marriage status. Result The total scores of the experiment group on quality of life , social relationship and environment were all higher than those of the control group (all P<0.05) and the experiment group got higher score in trusting their spouses than the control group (P<0.05). Conclusion The family constellation can improve female tumor patients'quality of life and promote the trust in their spouses.

Background Auto-fluorescence(AF)imaging is a new non-invasive fundus examining technology.It is now playing an increasingly important role in the diagnosis of retinal diseases.Using a confocal Scanning Laser Ophthalmoscope microscope(cSLO),two types of AF can be obtained:melanin-related near-infrared fundus auto-fluorescence(NIA)and lipofuscin-related fundus auto-fluorescence(FAF).Objective The purpose of this study was to compare the outcome between NIA and FAF in patients with central serous chorioretinopathy (CSC).Methods FAF,NIA imaging and fundus fluorescein angiography(FFA)were performed on 28 eyes of 23 subjects using a cLSO.AF images were evaluated and compared with angiographic findings.Written informed consent was obtained before the initiation of this study.Results In 17 eyes of 15 cases with acute CSC,the leakage points on the FFA image showed three kinds of AF patterns:(1)hyper-AF,including FAF hyper-AF in 2 eyes(11.76％)and NIA hyper-AF in 4 eyes(23.53％).(2)Non-AF,including FAF non-AF in 10 eyes(58.82％)and NIA non-AF in 13 eyes(76.47％).(3)Normal AF,including normal AF of FAF in 5 eyes(29.42％).The AF in the retinal serous detachment area showed two kinds of characteristics:(1)hypo-AF,including 12 eyes(70.59％)with FAF hypo-AF and 10 eyes(58.82％)with NIA hypo-AF.(2)hyper-AF,including 5 eyes(29.41％)with FAF hyper-AF and 7 eyes (41.18％)with NIA hyper-AF.In 11 eyes of 8 cases with chronic CSC,the leakage on the FFA also showed an absence of AF.However,AF-absent areas also partly appeared in the non-leakage area of FFA.In NIA,the non-AF areas were often more visible than that in FAF.Serous detachment areas in chronic CSC usually displayed multiple AF forms,including granular-like non-AF,hyper-AF and hypo-AF,and the abnormal AF areas were often greater than that of the corresponding abnormal fluorescent area in FFA.Conclusions AF can be used to detect the functional status and metabolic activity of RPE in CSC eyes.

? AIM: To evaluate efficacy of Ranibizumab and Conbercept for wet age-related macular degeneration ( wAMD) .?METHODS: This was a retrospective case series study. Thirty patients ( 30 eyes ) with wAMD were enrolled to receive intravitreal injections of ranibizumab (0.5mg) on 3 consecutive monthly schedule and 28 patients (30 eyes) with wAMD were enrolled to receive intravitreal injections of conbercept ( 0.5mg ) on 3 consecutive monthly schedule.Best corrected visual acuity ( BCVA ), optic coherence tomography ( OCT ) measurement were compared at 1mo after injections.?RESULTS: One month after every injection, the BCVA increased while the central macular thickness ( CMT ) decreased compared with those before treatment in group A and B (P<0.05).BCVA and CMT changes between two groups were no statistically different (P>0.05).?CONCLUSION:Ranibizumab and conbercept therapy can control the prognosis of wAMD and improve the vision effectively. There is no statistical difference on the curative effect between two drugs for 3mo.

Intestinal trefoil factor(IFF) is a low molecular weight polypeptide expressed in intestine.With the research on its structure and physiological function,ITF is beginning to attract attention.This review is mainly about the structure,localization,function,mechanism of action,expression regulation,signal transduction pathway,recombinant expression and so on.

Objective To explore the replantation method of upper limb's biplane mutilation in conjunction with soft tissue defect.Methods From January 2003 to January 2013,29 patients with upper limb's biplane mutilation in conjunction with soft tissue defect were treated.There were 21 males and 8 females with the average age of 28.6 years.The youngest one was 1 year old and the oldest one was 70 years old.All the cases underwent different replantation order and transplantation by using vascular and nerve and flap according to the lesion they suffered,including the defected plane and soft tissue.Results All replantation limbs were survived besides 2 cases with infection and 3 cases of delaying healed due to the part of tissue necrosis.Among all 29 cases,9 cases got excellent recovery,14 cases were in good condition,4 cases were poor and 2 cases were bad.The totally excellent and good rate of upper limb function was 79.3％ according to the limb reattachment function evaluation criteria of Hand Surgery of the Chinese Medical Association.Conclusion It can obtain higher survival rate due to our different replantations and method of tissue replantation to cure double plane mutilation in conjunction with soft tissue defect of upper limb.

Object To investigate the effects of ethanol sediments obtained from the tuber of Angelica sinensis (Oliv). Diels (ESA) and its litmusless component (ESA 1) on the secretion of TNF ? and IL 1 by mice peritoneal macrophages in vitro. Methods L929 cell line cytotoxicity was used for the assay of TNF ?. The proliferation of L929 cell line was used for the assay of IL 1. Results The secretion of TNF ? and IL 1 by mice peritoneal macrophages which were co cultured with ESA or ESA 1 in vitro can be significantly promoted. At the concentrations in range of 5～20 ?g/mL, there is a dose dependence in the action of ESA, while there is not the similar effect of ESA 1, even though it showed the marked effect. Conclusion ESA and ESA 1 can enhance the secreting TNF ? and IL 1 of mice peritoneal macrophages in vitro.

Objective To investigate the clinical application and therapeutic effect of reservation cortical expand resection and reconstruction for extremities bone tumor. Method Twelve cases with extremities invasion bone tumor were reviewed,including 6 male and 6 female.The average age was 37.1 years old.According to the MRI,TypeⅠtumor located in metaphysic and growth eccentricity,and was treated with outside tumor osteotomy with reservation of one side as integumentale,the cut line was shape of "匚".Type Ⅱ tumor was with invasion part articular surface,and was operated with part joint osteotomy with reservation of one side as integumentale,the cut line was shape of"L".Type Ⅲ was with invasion total joint surface and as integmentale,all tumor segment including joint could be cut,but the shape of cut close to the diaphysis was echelonment. Result The operation time was 1~3 h,the operative bleeding quantity were 150~400 ml,all incisions were obtained primary healing.Twelve cases were followed up from 6 months to 8 years.The average extremity functional score according to the system of ISOLS(International Society of Limb Salvage):upper extremity was 22.3 and the lower was 25.3 The average bone healing time of returned deactivation bone graft and bone allograft healing with the osteotomy plane was 3 months,original tumor recurrence in local was 1,the recurrence rate was 7.69%,no malignant change and metabasis was found. Conclusion The reservation cortical expand resection and reconstruction could increase the treatment effect of extremities bone tumor,it is key to decrease the recurrence with strict indication,non-neoplasma and aseptic technique.Tumor shell and osteotomy plane should be deactivated thoroughly.