Objective To clarify the clinical features of solid pseudo-papillary tumor of pancreas. Methods Clinical data of 38 patients with solid pseudo-papillary tumor of pancreas were analyzed retrospectively. Results The clinical manifestations included a palpable abdominal mass, abdominal pain and discomfort. Tumor occured in 1 case younger than 10 years old, 11 cases between 11 years old and 20 years old, 7 cases between 21 years old and 30 years old, 9 cases between 31 years old and 40 years old, 5 cases between 41 years old and 50 years old and 1 case older than 50 years. Immunohistochemistry staining showed CgA( + ) in 6 cases,Vim( + )in 29 cases,AAT( + ) in 29 cases,Syn( + ) in 21cases,CD10( + ) in 34 cases,CD56( + ) in 37 cases, Ki-67 ( + ) in 36 cases and PR( + ) in 38 cases. Conclusion Solid pseudo-papillary tumor of pancreas is closely associated with gonadal hormone and reproductive system.

Objective To study the risk factors of early complications and methods of treatment after pancreaticoduodenectomy(PD).Methods There were 79 patients who undercoent PD at our hospital between January 1998 and December 2007.All of the patients were divided into complication group and non-complication group according to the outcomes.Their clinical features,preoperative tests,and surgical factors were retrospectively analyzed.Results The postoperative complication rate was 58.2%,and the hospital mortality was13.9%.Logistic regression showed that the level of total bilirubin and liver function classification were the independent risk factors(P0.05).Conclusions The early complications after PD are closely related to the preoperative level of serum bilirubin and liver function.Proper periopertive management can effectively decrease the occurrence of pancreatic leakage and other postoperative compliccations.

Objective To assess the clinical effect of Novonorm on treating type 2 diabetic patients with atherosclerosis. Methods Sixty-five patients of type 2 diabetes with atherosclerosis were randomly divided into 2 groups :36 patients took Novonorm,and the other 29 individuals were treated with Glipizide. The blood glucose and CIMT were compared before and after treatment for 12 months. Results The postprandial blood glucose decreased by(1.99 ± 1.06)mmol/L after the treatment of Novonorm,which was significantly higher than that of(0. 99 ±0. 54)mmol/L after the treatment of Glipizide(P ＜ 0. 05). CIMT significantly decreased from (1.11 ± 0. 07)mm before treatment to(1.02 ± 0. 08)mm after treatment in the Novonorm group(P ＜ 0. 05),whereas CIMT were similar between after and before treatment in the Glipizide group(1.07 ± 0. 06)mm vs.(1.10 ± 0. 08)mm(P ＞ 0. 05).Conclusions Novonorm is a kind of effective and safe regent,which can be used to treat type 2 diabetic patients with atherosclerosis.

Objective To evaluate effects of steep meridian clear corneal incisions on corneal anterior surface and total astigmatism in phacoemulsification surgery . Methods Clinical data of 56 cases of phacoemulsification surgery with steep meridian clear corneal incisions from August to December 2015 were analyzed in this retrospective study .Corneal anterior surface and total astigmatism were measured with the Pentacam 3D anterior segment measurement and analysis system at the time before surgery and 1 month and 3 months after surgery .The polar coordinate analysis was used to evaluate effects of steep meridian incisions on corneal astigmatism . Results All the operations were accomplished successfully with smooth recovery .The corneal anterior surface and total astigmatism reduced significantly after 1 month and 3 months in astigmatic polar value AKP ( +0) (P<0.05), but no significant difference was found in AKP(+45) (P>0.05).No significant differences were detected between both corneal anterior surface and total astigmatism in AKP(+0) or AKP(+45) between 1 month and 3 months after surgery. Conclusion Steep meridian incision performed on the preoperative steeper meridian of keratometric astigmatism may reduce corneal total astigmatism .

Objective To investigate the characteristics,treatment and prognosis of Rowell's syndrome.Methods Clinical data were collected from 6 inpatients with Rowell's syndrome from July 2009 to July 2015,and retrospectively analyzed.Results All the patients were female,of them,2 developed skin lesions after sun exposure,2 had medication history,1 had Staphylococcus aureus infection before occurrence of skin lesions,and 1 had no obvious precipitating factor.Skin lesions spread from the face to the whole body in 4 cases,from the dorsal hauds to the whole body in 1 case,and were confined to the face,both hands and feet in 1 case.All the 6 patients had chilblain-like lesions in the digit tips,and 5 patients had fever.Among these patients,6 were positive for antinuclear antibodies (granular pattern),4 for anti-Sm antibodies,5 for anti-U 1RNP antibodies,4 for anti-SSA antibodies,2 for anti-dsDNA antibodies,and 1 was positive for both anti-SSA and anti-SSB antibodies.Histopathological examination revealed hyperkeratinization,mild hyperplasia,partial necrosis,many dyskeratocytes,liquifaction degeneration of basal cells in the epidermis,and perivascular infiltration of lymphocytes in the superficial dermis.After admission,1 patient was finally diagnosed with subacute cutaneous lupus erythematosus (SCLE),and 5 with systemic lupus erythematosus (SLE).All the 6 patients were treated with prednisone at a dose of 0.6-1.0 mg·kg-1 ·d-1,and 1 was also treated with gamma globulin (200 mg/d).During the process of glucocorticoid tapering,hydroxychloroquine was administered at 0.2 g twice a day.During 1-year follow-up,neither erythema multiform nor chilblain-like lesions recurred in 5 patients,and 1 patient was lost to follow-up.Conclusions Rowell's syndrome frequently occurs in women.Glucocorticoids are a mainstay of its treatment,and their tapering should be slower in patients with Rowell's syndrome than in those with lupus erythematosus.

Objective To analyze and evaluate the relationship between hepoatocelluar carcinoma incidence and hepatitis B e antigen (HBeAg) expression in choronic hepatitis B (CHB) patients with long-term treatment of nucleoside analogue therapy.Methods The clinical data of 56 CHB patients with long-term treatment of nucleoside analogue therapy except for hepoatocelluar carcinoma (experimental group)were summarized retrospectively,and all patients underwent anti-viral therapy with no less than 5 years.The clinical data of 56 CHB patients without anti-viral therapy in the same period (control group) were collected.The risk factors of hepoatocelluar carcinoma were analyzed.Results The incidence of hepoatocelluar caroinoma was 7.14％ (4/56) in experimental group and 19.64％ (11/56) in control group,and there was significant difference (P ＜ 0.05).The incidence of hepoatocelluar carcinoma was 0 in patients with positive HBeAg without cirrhosis (36 cases) in experimental group and 1/8 in patients with negative HBeAg without cirrhosis in experimental group,and there was significant difference (P＜ 0.05).Conclusions Long-term treatment of nucleoside analogue therapy can reduce but bot eliminate the hepatocellular carcinoma risk in patients with CHB,especially in those with negative HBeAg.HBeAg negativity is a significant risk factor for the development of hepallerular carcinoma in CHB patients without liver cirrhosis.

Combined with the features of clinical practice teaching of cardiothoracic surgery ,we discuss how to improve the quality of clinical practice teaching of cardiothoracic surgery and strengthen the cultivation of medicos'capability and diathesis,thus correctly guiding medicos to finish their interim study commendably and change their roles from students to doctors.

Objective To evaluate the expression of endothelial Per-ARNT-Sim domain protein-1(EPAS-1)/hypoxia-inducible factor-2?(HIF-2?) and its relationship with vascular endothelial growth factor (VEGF) in bladder transitional cell carcinoma (BTCC). Methods The expression of EPAS-1/HIF-2? and VEGF by immunohistochemical staining was examined in 60 cases of BTCC (Grade Ⅰ in 28 cases,Grade Ⅱ in 12,Grade Ⅲ in 20) and 8 subjects with normal urothelium. Of the 60 cases 29 had superficial (≤pT 1) bladder cancer and 31 had invasive (≥pT 2 bladder cancer).?2 test was used to assess the relationship between EPAS-1/HIF-2? and VEGF expression versus tumor grade and stage. Results The expressions of EPAS-1/HIF-2? and VEGF were negative in all normal bladder tissue but high in BTCC.Of the 60 cases,34 (56.6%) were positive and 26 ( 43.4%) were negative for EPAS1/HIF-2?.Four cases (14.3%) of Grade Ⅰ,11 (91.7%) of Grade Ⅱ and 19 (95.0%) of Grade Ⅲ were positive for EPAS-1/HIF-2?. Positive staining was seen in 5 (17.2%) of the superficial and 29 (93.5%) of the invasive cancer cases.EPAS-1/HIF-2? positivity was correlated with high histological grade (r=0.862,P

Objective To investigate the effects of gene transfection with human growth/differentiation factor 5(hGDF5)on the differentiation and proliferation of rabbit bone marrow mesenchymal stem cells (BMSCs).Methods BMSCs were obtained from adult New zealand rabbits and purified by gradient centrifuge.Exogenous recombinant human GDF5 was transfected into BMSCs with liposome method.Then hGDF5 expression at mRNA and protein level was measured separately by reverse transcription-polymerase reaction and indirect immunofluorescence method.Activity of alkaline phosphates(ALP),expression of TypeⅡcollagen(ColⅡ),proteoglycan and growth of the cells were all measured by biological methods to evaluate the effects of hGDF5 gene transfer on the differentiation and proliferation of rabbit BMSCs.Results After hGDF5 gene transfection,BMSCs expressed hGDF5 mRNA and protein,and compared with the control groups,expression of proteoglycan and ColⅡ increased significantly,but no significant difference appeared in ALP activity and cell proliferation.Conclusion Gene transfer with hGDF5 is an effective way to enhance the expression of GDF5 at mRNA and protein.The expression of heterogenetic hGDF5 gene can induce BMSCs' differentiation to chondrogenic cells.But the gene transfection has no obvious effects on the proliferation and ALP activity of BMSCs.

Laryngeal conservation surgery trys for more laryngeal function reservation in precondition of radical cure,and presently has been the main method of treating larygeal carcinoma.The article discusses the moral principle that should be followed in the course of developing conservation laryngeal surgery on the point of view of medical ethics.To get curative effect,the surgeons should possess high responsibility and masterly skill,and highly regard multi-discipline cooperation and multimodality therapies.