Objective To study clinical feature of diagnosis of pancreatic cancer,in order to reach early diagnosis.Methods 70 cases of pancreatic cancer from ours in-patients 1990 to 2000 were reviewed and analyzed.Results The number of patients with stage Ⅰ～Ⅱ were only 8 cases(11 4%). 40 patients (57 1%) hospitalized within one month after they felt ill.19 cases(29 1%) were diagnosed as pancreatic cancer within one month,including 5 patients(26 3%) with stage Ⅰ or Ⅱ .Abdominal pain(73 4%),jaundice(10 1%) and discomfort of upper abdominal(5 8%) were the most common initial symptoms.misdiagnosis were 40(57 1%) cases .The most common misdiagnosis were chronic gastritis(21 4%),chromic cholecystitis(7 14%) and peptic ulcer(5 71%).The serum levels of CA199,CA125 were higher in 16/18 cases (88 9%) and 6/7 cases (85 7%) respectively. Three cases in stage I or II were found higher serum CA125 and other tumor marker normal.Five patients were diagnosed as diabetes within five months before the diagnosis of the cancer.Conclusions For most of the patients with pancreatic cancer ,usually they were definite diagnosis in moderate or advanced stage. So the status of the diagnosis of pancreatic cancer is disappointed . Hospitalizing late,being misdignosed and developing quickly were the main causes;The most common misdiagnosis are chronic gastritis, cholecystitis and peptic ulcer;elevation of serum CA199 and CA125 are sensitive to diagnose pancreatic cancer. Detections of CA125 and hyperglycemia may favour earlier diagnosis of pancreatic cancer.

Objective: To observe the short-term effects of electroacupuncture at different acupoints on patients with hemiplegia after cerebral infarction. Methods: Patients with cerebral infarction were randomly allocated into a group of electroacupuncture nerve trunk and a group nerve trunk or routine acupoints, respectively, once a day, for 14 d. Results: Electroacupuncture at nerve trunk had better effects than at routine acupoints. The short-term improvement of electroencephalogram had significant differences (P＜0.05). Conclusion: Electroacupuncture at the nerve trunk could improve the neurologic impairment and brain function, and it has a better result than routine electroacupuncture.

Objective To compare the effect of thoracoscopic and laparoscopic surgery with conventional thoracic surgery on esophageal cancer and its influence on pulmonary function. Methods Ninety?four patients with esophageal cancer treated in the Second Affiliated Hospital of Chengdu Medical College from March 2010 to March 2016 were selected and were divided into the control group ( 54 cases) and the study group ( 40 cases) according to operation methods. The control group received traditional thoracotomy. The study group received thoracoscopic and laparoscopic surgery. The operation and pulmonary function indexes were compared. Results The operation time of the patients in the study group was significantly longer than that in the control group ( (218. 1±35. 8) min vs. (192. 3±40. 1) min,t=3. 23,P<0. 05). Intraoperative blood loss of the patients in the study group was significantly less than that in the control group ( (286. 4±83. 5) ml vs. (343. 7 ±96. 7) ml,t=3. 01,P<0. 05) . The number of lymph nodes cleared of the patients was significantly higher in the study group ( (18.0±5.4) node vs. (15.5±4.6) node,t=2.42,P<0.05).Thoracic drainage of the patients in the study group was significantly less than that in the control group ( (650. 3±61. 3) ml vs. (1153. 5 ±133. 7) ml,t=22. 12,P<0. 05). Chest tube pull out time in the study group was significantly earlier than that in the control group ( (5. 1±1. 3) d vs. (8. 0±1. 8) d,t=8. 65,P<0. 05). First exhaust time in the study group was significantly earlier than that in the control group ( (33. 2±6. 7) h vs. (40. 7±7. 3) h,t=5. 10,P<0. 05). Hospital stay in the study group was significantly shorter than that in the control group ( ( 13. 8 ± 2. 8 ) d vs. (18. 2± 3. 6) d, t=6. 42, P<0. 05) . Postoperative complications occurred in 4 cases in the study group, accounting for 10%, significantly lower than that in the control group, 15 cases, 27. 8%, the difference was statistically significant (χ2=4. 50,P<0. 05) . VC,FEV1 and MVV in the study group were significantly higher than those in the control group ( VC:( 81. 5 ± 15. 6 )% vs. ( 42. 3 ± 8. 1 )%;FEV1: ( 85. 7 ± 9. 1 )% vs. ( 43. 6 ±6. 8)%;MVV:(76. 0±8. 9)% vs. (48. 3±7. 6)%,t=15. 83,25. 68,16. 24,P<0. 05). 3?year survival rate of the study group and the control group were 45. 0% (18/40) and 44. 4% (24/54),respectively. There was no significant difference between the two groups (χ2 = 0. 01, P> 0. 05 ) . Conclusion Thoracoscopic and laparoscopic surgery for esophageal cancer has the advantages of small trauma,rapid recovery and low incidence of complications and obvious protective effect on pulmonary function. It is safe and feasible.

Objective To explore the effect of fat on 1,2-dimethylhydrazine (DMH)-induced colon tumors.Methods A total of 50 7-week-old male Wistar rats were further divided into four groups:standard diet feed control group (n =10),standard diet feed plus DMH-induced tumor group (SDT,n =15),high-fat diet feed control group (n =10) and high-fat diet feed plus DMH-induced tumor group (HFDT,n =15).Rats were killed 18 weeks later,and enzyme-linked immunosorbent assay was used to detect serum triglyeeride,tumor necrosis factor (TNF-α),and colonic TNF-α,interleukin-6.After the intestinal tracts were removed,the location,amount,and size of the tumors were observed.The pathological changes of the tissue sections were observed,and the distributions of TNF-α and Ki-67 in the normal tissues and tumors were detected by immunohistochemistry.Results Upon the completion of the study,the mortality rate of rats was 20.00％ in the SDT group and 26.67％ in the HFDT group,the tumor formation rate was 75.00％ in the SDT group and 81.82％ in the HFDT group,and the tumor-bearing rate was 117％ in the SDT group and 191％ in the HFDT group.No statistical significance difference between the two groups in mortality rate,tumor formation rate (P =0.545) and tumor bearing rate (x2 =1.343,P =0.247).The average tumor volume was significantly different between the standard diet feed control group and high-fat diet feed control group (28.57％ vs 66.67％,P =0.030).Also,the serum triglyceride and TNF-α levels significantly differed between the SDT group and HFDT group [TG (1.39 ± 0.31) mmol/L and TNF-α (124.80 ± 21.69) ng/L in the HFDT group and TG (0.46 ±0.20) mmol/L and TNF-α (85.83 ± 17.45) ng/L in the SDT group] (P =0.000).The expressions of TNF-α,IL-6,and Ki-67 in colonic mucosa were significantly higher in the high-fat diet feed control group than in the standard diet feed control group [TNF-α:(6.22 ± 0.63) ng/g vs (2.33 ± 0.44) ng/g,P=0.020; IL-6:(13.50±0.67) ng/gvs (7.31 ±0.41) ng/g,P=0.000; and Ki-67:40％ vs 10％,P =0.028].The Ki-67 expression rate was 90.48％ in the HFDT group,compared to 50％ in the SDT group (P =0.015).Conclusions High-fat diet can increase the serum triglyceride and TNF-α levels in rats,upregulate the expressions of TNF-α,IL-6 and Ki-67,and thus promote inflammation and cell proliferation,and ultimately affect the tumor formation and development.However,the effect of fat on DMH-induced colon tumors warrants further studies.

BACKGROUND: The treatment of multilevel cervical spondylotic myelopathy (MCSM) aims at sustaining the spinal cord compression and restoring the stability of the cervical vertebrae at most.OBJECTIVE: To analyze the clinical characters of anterior cervical discectomy with fusion and expansive open-door laminoplasty for MCSM.METHODS: Sixty-seven patients with MCSM were divided into two groups, and treated with anterior cervical discectomy with fusion (group A) or posterior cervical expansive open-door laminoplasty (group B). All the patients were followed up for 12 months, and the range of motion of cervical vertebrae, cervical curvature index were observed,as well as the Visual Analogue Scale and Japanese Orthopaedic Association scores were condueted. Moreover, the operation time, blood loss and adverse reactions were recorded.RESULTS AND CONCLUSION: (1) The loss of range of motion of the cervical vertebrae in the group B was significantly less than that in the group A (P < 0.05). (2) The cervical curvature index in the group A was significantly improved (P < 0.05), but the index had no significant change in the group B. (3) The axial systems were significantly improved in both groups, especially in the group A (P < 0.05). (4) The neurological function was significantly improved in both groups (P < 0.05), which showed no significant difference between two groups (P > 0.05). (5) The intraoperative blood loss in the group B was significantly more than that in the group A (P < 0.05). (6) The incidence of hoarseness and dysphagia in the group A was 19％. The incidence of wound infection, cerebrospinal fluid leakage and C5 nerve root palsy in the group B was 9％. (7) These results suggest that during choosing an appropriate method for MCSM,surgeons' skills and patients' situation should be considered.

Objective To study the correlation between 8-Iosmerie Porastglnadin-2a(8-iso-PGF2α) 、hypersensitive C-reactive protein(hs-CRP) and coronary heart disease(CHD). Methods 153 CHD patients were divided into 3 groups,including 52 cases of acute myocardial infarction(AMI) ,50 cases of unstable angina(UAP) ,51 cases of stable angina(SAP) and control group consisted of 50 healthy people. The levels of hs-CRP and 8-iso-PGF2α were measured. Person correlation analysis was used to analyze the relationship between the level of hs-CRP and 8-isoPGF2α. Results The levels of hs-CRP and 8-iso-PGF2α were significantly higher in AMI, UAP and SAP group than those in control group(all P ＜0.05). Compared with SAP group,the levels of hs-CRP and 8-iso-PGF2α were increased in AMI and UAP groups (all P ＜ 0. 05) . The level of hs-CRP was positively associated with the level of 8-iso-PGF2α. Conclusion hs-CRP and 8-iso-PGF2α should be the markers of coronary atherosclerosis and involved in the process of CHD. The levels of serum hs-CRP and 8-iso-PGF2α were correlated with the severity of CHD.

Objective: To investigate the relationship between long-, short-term systolic blood pressure variability (SBPV) and renal damage in elder population. Methods: Our research was conducted in the 3rd physical examination of healthy population from Kailuan group by cohort study. Cluster sampling was used by 25% ratio in subjects≥60 years of age to monitor their 24-hour ambulatory blood pressure and finally, 2464/3064 participants with inclusion criteria were recruited. SBPV indexes as standard deviation of systolic blood pressure (SSD), variability independent of the mean (VIM), maximum-minimum difference (MMD) and average real variability (ARV) were examined; renal damage indexes as estimated glomerular filtration rate (eGFR) and microalbuminuria (ALBU) were detected. Relationships between different long-term, short-term SBPV indexes and eGFR, ALBU were studied by multi-liner regression analysis. Results:①The mean age of 2464 participants was (67.41 ± 6.05) years including 1667 (67.7%) male and 797 (32.3%) female.②Multi-liner regression analysis indicated that different long-term SBPV indexes were not related to eGFR and ALBU; 24h SBPV in all 4 indexes and day-time SSD, MMD, ARV were negatively related to eGFR; 24h ARV and day-time MMD, ARV were positively related to ALBU; night-time SBPV indexes were not related to eGFR and ALBU.Conclusion: Different short-term SBPV indexes were, at certain point related to eGFR and ALBU

OBJECTIVETo investigate the distribution and major influencing factors of annual systolic blood pressure variability from a large population cohort.

METHODSIn this prospective cohort study, data from Kailuan Group employees who attended all 4 physical examinations ( taken in June 2006 to October 2007, June 2008 to October 2009, June 2010 to October 2011, June 2012 to October 2013, respectively) were analyzed (32 959 males and 10 401 females, mean age: (48.2 ± 11.5) years old). Systolic blood pressure variability was defined as the standard deviation (SSD) and the coefficient of variation (SCV) of systolic blood pressure of 4 physical examinations. Multivariate linear regression analysis was used to determine the related influencing factors of SSD and SCV.

RESULTS(1) The mean of SSD and SCV for this cohort was 10.91 mmHg (1 mmHg = 0.133 kPa) and 8.34%, respectively. SSD and SCV increased in male and female with increasing age (both P < 0.001). (2) Multiple linear regression analysis showed that systolic blood pressure (β = 0.225, P < 0.001), age (β = 0.163, P < 0.001), fasting blood glucose (β = 0.038, P < 0.001), the use of anti-hypertensive drugs (β = 0.038, P < 0.001), sex (β = 0.038, P < 0.001), smoking (β = 0.025, P < 0.001), alcohol drinking (P = -0.022, P < 0.001), physical exercise (β = -0.018, P = 0.001), high-sensitivity c-reactive protein (β = 0.016, P = 0.001) body mass index (β = -0.011, P = 0.018) were related to SSD. Age (β = 0.139, P < 0.001), sex (β = 0.055, P < 0.001), systolic blood pressure (β = 0.047, P < 0.001), fasting blood glucose (P = 0.033, P < 0.001), drinking (β = -0.030, P < 0.001), body mass index (β = -0.026, P < 0.001), the use of anti- hypertensive drugs (β = 0.026, P < 0.001), smoking (β = 0.024, P < 0.001), physical exercise (β = -0.015, P = 0. 001), high-sensitivity c-reactive protein (β = 0. 014, P = 0. 001) were related to SCV.

CONCLUSIONSSSD and SCV increase with increasing age. Systolic blood pressure, age, fasting blood glucose, the use of anti-hypertensive drugs, sex, smoking, drinking, physical exercise, high-sensitivity c-reactive protein, body mass index are major influencing factors for SSD. Age, sex, systolic blood pressure, fasting blood glucose, alcohol drinking, body mass index, the use of anti-hypertensive drugs, smoking, physical exercise, high-sensitivity c-reactive protein are major influencing factors for SCV.

Alcohol Drinking ; Antihypertensive Agents ; Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cohort Studies ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Smoking