We compare the contents of trace elements and amino acids in different parts of Cambarus clarkii Girard and Penaeus orientalis Kishinouye and reveal that the contents of the two compositions in some parts of Cambarus clarkii Girard are higher than those in Penaeus orientalis Kishinouye. Therefore the results suggest similar medicinal value of Cambarus clarkii Girard with Penaeus orientalis Kishinouye.

Objective To investigate the risks and benefits of different surgical treatments for cystic neoplasms of the pancreas (CNP).Methods The clinical data of 243 CNP patients were reviewed retrospectively.Different surgical treatments were adopted according to the site,size and invasiveness of the tumors.A long term follow-up was carried out for patients with small benign CNP,and a surgical excision is proposed if tumors progressed during the observation.Results 58 outpatients with no evidence of malignancy was followed up and had long-term survival,in which 4 patients received a surgical resection in case of tumor progression,and all of them were confirmed benign tumors.185 cases received surgical treatments,with a resection rate of 97.3％ (180/185),including 127 non-invasive tumors,and 58 cases of invasive tumors.Perioperative mortality was 2/185,and morbidity rate was 41/185.Pancreatic fistula was the most frequent complication,which was significantly associated with tumor site and excision extension.All patients with non-invasive CNP acquired a long term survival after surgical treatments.The postoperative 1,3,5 year survival rates for patients with invasive lesions were 89.6％,52.1％ and 29.2％,respectively.Conclusions Long term follow-up and observation is feasible for asymptomatic patients with benign CNP.A radical resection should be performed for malignancy,and a combined multi-organ resection may improve the prognosis for local advanced tumors.

Objective To study the causes of pancreatic fistula following pancreatioduodenectomy, and evaluate the effect of total pancreatic uncinate process resection on the prevention of pancreatic fistula by analyzing the potential aetiology of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 68 patients, who were admitted into the No. 1 ward of Surgical Department of Peking University First Hospital during the period from Jan. 2004 to Jun. 2009, were retrospectively analyzed. The day-average level of amylase higher than 3 times of normal value, as measured from the drainage of peritoneal cavity, serves as the diagnostic criterion of the postoperative pancreatic fistula.Factors relevant to fistula, which result in the abnormal increase of the amylase in the drain, such as the extent of resection of pancreatic uncinate process, the anastomotic manners of pancreas and digestive tract, and the pancreatic fibrosis were statistically analyzed. Results The incidence of pancreatic fistula was 33. 8% according to the diagnostic criterion mentioned above; Single factor analysis showed that the resection extent of uncinate process (P = 0. 000) and the level of serum glucose ( P = 0. 045 ) were correlated with the occurrence of pancreatic fistula. Multivariate analysis identified that the independent risk factor for pancreatic fistula was the resection extent of uncinate process(P =0. 000). Pancreatic fibrosis, the manners of the anastomosis of pancreas and digestive tract were not independent risk factors. Conclusion Total resection of uncinate process could prevent pancreatic fistula from residual pancreatic uncinate process, hence reduce the incidence of pancreatic fistula following pancreaticoduedenectomy.

Objective To evaluate the diagnostic effect of intro-operative tissue puncture biopsy and find its influential factors.Methods The clinical data of 94 patients with pancreatic mass treated in our hospital from July 1994 to December 2007 and undergoing intro-operative tissue puncture biopsy were retrospectively analyzed.Results The sensitivity,the specificity,the positive predictive value and the negative predictive value were 74.6%,93.8%,98.0%and 46.9%,respectively.The single factor analysis showed that the size of pancreatic mass,the number of puncture and complicating with pancreatic fibrosis or not were related to the diagnosis of tissue puncture.The multiple factor analysis showed that the size of pancreatic mass(P=0.014)and the number of puncture(P=0.020)were crucial to the diagnosis of puncture.The sensitivity and specificity of intro-operative tissue puncture biopsy for the pancreatic mass less than 25 mm were lower than that for the mass larger than 25 mm (P=0.000).The sensitivity and specificity would be increased as the number of puncture increased (P=0.000).For the mass less than 25 mm,increasing the humber of puncture would improve the sensitivity(P=0.002).Conclusion Intro-operative tissue puncture biopsy is a simple and accurate procedure for differentiating the pancreatic mass.The sensitivity and specificity could be improved by increasing the number of puncture,especially for the patients with pancreatic mass less than 25 mm.

ObjectiveTo analyze the underlying causes of postoperative gastrointestinal (CI)bleeding after pancreaticoduodenectomy and to discuss the strategies in diagnosis,prevention and management.MethodsThe clinical data of 331 patients who were admitted to the Surgical Department of the First Hospital,Peking University from Jan. 1998 to Jan. 2010 was retrospectively analyzed.ResultsThe overall postoperative morbidity was 37.2 ％,with a bleeding complication rate of 6.7 ％,and a GI bleeding rate of 1.5％.For postoperative GI bleeding,the main bleeding sites were from the pancreaticointestinal anastomosis (40.0％) and the gastrointestinal anastomosis (20.0％). Embolotherapy using vascular intervention alone (20.0％),open abdominal operation following vascular interventional therapy (40.0 ％ ) and open abdominal operation alone (40.0 ％ ) were used to control GIbleeding.ConclusionsThe common bleeding sites in the GI tract were at the pancreaticointestinal anastomosis and the gastrointestinal anastomosis. The main procedures used to control bleeding were embolization using vascular interventional therapy,endoscopic therapy and open abdominal therapy.

Objective To evaluate the feasibility,security and efficiency of general anaesthesia compared with regional anaesthesia for minimally-invasive thyroid surgery(MITS)with short-stay discharge.Methods 103 cases undergoing MITS with short-stay discharge from Jan.2013 to Jun.2013 in Fuzhou General Hospital were collected.54 patients were operated under regional anaesthesia and 49 under general anaesthesia.All variables of patients including demographic characteristics,vital signs (blood pressure,heart rate,blood glucose) during the operation,duration and type of operation,postoperative complications,difficulty in airway management and anesthesia consumption were recorded and analyzed.Results There was no difference in respect to level of blood glucose,length of hospital stay,discharge time,patient or operator satisfaction rate,anesthesia or operation complications rate between the two groups.Blood pressure (T1:(90 ± 7.0) vs (79 ± 8.3) mmHg,T2:(88 ± 6.8) vs (80 ±7.6) mmHg,P ＜0.05) and heart rate(T1:(130 ± 18.2) vs(101 ± 12.0)/min,T2:(120 ± 19.7) vs(103 ± 13.3)/min,P ＜ 0.05)level were higher,while the recovery time of anesthesia((0.3 ± 0.14)vs(0.8 ± 0.35)h,P ＜ 0.05)) and anesthesia consumption ((1350 ± 78) vs (2580 ± 220) yuan,P ＜ 0.05)) were lower in the regional anaesthesia group compared with those in the general anaesthesia group.Conclusions Both general anaesthesia and regional anaesthesia for MITS with short-stay discharge are safe and effective.General anesthesia has less psychological trauma,while regional anaesthesia has shorter recovery time and lower anesthetic consumption.

Objective To evaluate the clinical significance of intraoperative accurate localization of bleeding slte for acute intestinal hemorrhage. Method Twenty-two patients with acute intestinal hemorrhage,admitted from January 1995 to June 2007,were reviewed retrospectively.GrouD A included 5 patients who were treated with intestinal resection following intervention radiological marking.Group B included 5 patmnts who were treated by intestinal resection without intervention radiological marking.Group C included 12 patients who were treated by interventional embolization.The exact diagnostic rate,the recurrence of hemorrhage,the length of intestine removed and the operative time were calculated and analyzed respectively.Results All the cases in group A were correctly diagnosed.The diagnostic rale of group A was higher than that of group B significantly(x2=6.667,P=0.024).The average length of intestine removed in group A was(12±7)cm shorter than that in group B(108±23)cm significantly (t=-8.574,P=0.000).The procedure lasted(119±12)min in group A shorter than the(218±45)min in group B significantly(t=-4.730,P=0.001).There was no case with recurrent hemorrhage in group A,but the recurrence of hemorrhage was up to 60.0%(x2=4.286,P=0.083)in group B and 66.7%in group C(x3=6.296,P=0.020). Conclusions The treatment outcome after intestinal removal following intervention radiological marking is better than those of non-marking groups.The locating method with alloy coil made of Nickel-Platinum is rapid and accurate.C-arm X ray device helps to find the metal marker hence to give an accurate guide for bowel resection.

Objective:To investigate the expression and clinical relevance of micro RNA (miR)-324-5p in pancreatic cancer tissues, and to explore the effects and potential mechanisms of miR-324-5p on the proliferation and migration of pancreatic cancer cells.Methods:Real-time quantitative PCR was used to detect the expression of miR-324-5p in 34 pairs of pancreatic cancer and adjacent normal tissues resected at Peking University First Hospital from October 2018 to September 2019. The correlations between miR-324-5p expression and clinicopathological characteristics and prognosis of pancreatic cancer were analyzed using data from the Cancer Genome Atlas (TCGA) database. Real-time PCR was used to detect the expression of miR-324-5p in pancreatic cancer cell lines, and PANC-1 cell was used for functional study by overexpressing miR-324-5p via mimic transfection. CCK8 assay was used to evaluate cell proliferation. Both transwell and scratch wound healing assay were used to assess the cancer cell migration ability. Related proteins were detected by Western blot. The potential downstream target genes of miR-324-5p were selected using data from miRNA target genes predicted webs, in combination with functional analysis and their expressional correlation with miR-324-5p.Results:Data from TCGA database showed that the expression of miR-324-5p in tumor tissues was significantly lower than that in normal pancreatic tissues. And low level of miR-324-5p in pancreatic cancer was correlated with poor prognosis. Analysis of 34 pairs pancreatic cancer and adjacent normal tissues showed that miR-324-5p expression in tumor tissues (11.7±2.0) was significantly lower than that in adjacent normal tissues (70.9±14.4), and the pancreatic cancer patients who had the nerve invasion cancer showed low level of miR-324-5p (82.1%, 23/28) was significantly higher than that patients with high level of miR-324-5p (33.3%, 2/6). The expression of miR-324-5p in human pancreatic cancer cell line was also significantly lower than that in normal pancreatic ductal cells. CCK-8 assay showed that the proliferation ability of PANC-1 cell was significantly decreased when miR-324-5p was overexpressed. Transwell and wound healing assays showed that the capabilities of vertical migration and the horizontal movement were significantly inhibited in PANC-1 cell with miR-324-5p overexpressed [(30.11±5.2) and (174.6±27.0) μm, respectively] than those in control groups [(63.6±4.2) and (458.3±22.3) μm, respectively]. Moreover, Western blots showed a significant overexpression of miR-324-5p inhibited epithelial-mesenchymal transition (EMT). According to the data from miRNA target genes prediction and the functional analysis we found KLF3, MGAT3, PBX1 and ZNRF2 were considered as the potential downstream target genes of miR-324-5p.Conclusions:Our results indicated that miR-324-5p is lowly expressed and acts as the tumor suppressor gene in pancreatic cancer, and low level of miR-324-5p is correlated to a higher rate of nerve invasion and poor prognosis. In human pancreatic cancer cell, miR-324-5p may regulate EMT by directly inhibiting target genes such as KLF3, MGAT3, PBX1, ZNRF2, which in turn suppresses cancer cell proliferation and migration.

Objective To determine the value of liver analysis application in liver segmentation and planning of surgery.Methods Thirty patients suspected having hepatic disease were recruited in this study.Contrast-enhanced CT examinations were performed with Philips Brilliance 64-slice CT,and multi-phase images were obtained.The patients were divided into group B(with focal hepatic lesion,15 patients),and group A(without hepatic lesion,15 patients).We use the portal-venous(60-70 s)images to analysis.Liver volume and vessel recognition were edited manually if necessary,then liver segmentation proceeded automatically.All data were analyzed by the t test,chi-square test,Mann-Whitney U analysis,with SPSS 15.0 software.Results There was no significant difference of post-processing procedure between the two groups(P =0.361).The liver volume was(1374.61 ±444.05)cm3 in the group B and(1225.70±272.07)cm3 in the group A(P=0.108).The accuracy of vessel recognition was no significant difference between the two groups(P=0.87).21 vessels were recognized incorrectly include 18 hepatic veins.Conclusion The liver analysis application provides a 3D reconstruction allow vivid observation of liver segmentation and accurate estimation of the liver volume.It has broad prospect in diagnosing and surgical planning of the liver disease.

Objective To assess the therapeutic efficacy and safety of CT-guided percutaneous radiofrequency ablation(PRFA) for hepatocellular carcinoma in the bare area (HCCBA). Methods During the period from April 2000 to June 2009, 26 patients with HCCBA were treated with CTguided PRFA, and 26 other HCC patients were selected as controls, whose lesions were located in the right lobe ≥1.0 cm away from the liver capsule, gallbladder, and main portal branches. One month after PRFA, the residual tumors of each patient were examined by contrast-enhanced CT and alpha-fetoprotein test, and repeated PRFA was undertaken if residual was present. Tumor-free survival was defined as the duration from complete ablation to diagnosed local recurrence. The 2-independent-samples t-test was used to compare tumor diameter between HCCBA patients and controls. The MannWhitney U test was used to compare patient's age, etiologies of liver disease, liver function status,number of needle punctures and the value of AFP. A χ2 test was used for comparison of the complete tumor ablation rate and the cumulative local tumor-free survival rate. Results No significant difference was observed in the incidence of complication between the HCCBA patients and the controls (26. 9% vs 19.2%,P＞0.05). There were no differences between the two groups in the number of needle punctures and the complete tumor ablation rate at first PRFA. Furthermore, no differences were observed in the cumulative 1-,3- and 5-year local tumor-free survival rates between HCCBA patients (88. 5%, 46.2% and 19. 2% respectively) and patients in the control group (92.3%, 53.8% and 15.4% respectively). Conclusion CT-guided PRFA is effective and safe for HCCBA and could be preferred as one therapeutic option for HCCBA.