Pancreatic neuroendocrine tumor (pNET)is a rare type of pancreatic tumors.The incidence of pNET shows a gradually increas-ing trend in recent years.The most common organ of distant metastases is the liver.Surgical resection is still the optimal treatment for resect-able,well -differentiated liver metastases with no evidence of extrahepatic spread.For unresectable patients,a combination of multiple mo-dalities,such as transarterial chemoembolization,radiofrequency ablation,systemic chemotherapy,and molecular targeted therapy,can pro-long the survival time of patients.Liver transplantation should be strictly evaluated on an individual basis.

This paper discussed multiple teaching methods used in classroom instruction which are used for Medicianl Chemistry Education of Preclinical Medicine Graduate Students,which were proved to be effective.

Objective To investigate ulnar impaction syndrome imaging characteristics and wrist arthroscopy in the diagnosis and treatment effects.Methods From September 2006 to April 2014,41 patients with ulnar impaction syndrome were treated.Of all 41 patients,28 were male and 13 female with an average age of 34.5±3.9 years old (ranging from 15 to 52 years old).The preoperative values of wrist range of motion (ROM) were 44.17°±6.22° at volar flexion,42.72°±3.37° at dorsal extension,17.45°±4.11° at radial deviation,19.12°±3.70° at ulnar deviation,66.81°±4.28° at pronation,and 70.27°±5.30° at supination.Arthroscopic exploration was conducted in all patients,aiming to observe the ulnar variance,wrist osteonecrosis,articular cartilage damage and triangular fibrocartilage complex tear.Arthroscopic synovectomy were performed in all cases;33 cases of articular cartilage injury were treated with arthroscopic chondroplasty;16 cases of osteonecrosis were treated with arthroscopic drilling decompression;30 cases with tear of TFC were treated with arthroscopic repair;26 cases with ulna positive mutation were treated with arthroscopic distal ulna resection.Patients were followed at 3,6,and 12 months after operation.At 12 months follow-up,the values of wrist range of motion was evaluated for volar flexion,dorsal extension,radial deviation,ulnar deviation,pronation,and supination.GreenO'Brien method was used to evaluate the function of wrist joint.Results Primary healing was presented in all patients without neurovascular injury and joint infection.All patients were followed up 12-36 months (mean,17.5 months).At 12 months followup,the values of ROM compared with that preoperative increased with significant difference,49.13° ±3.47° at volar flexion,47.13°±2.39° at dorsal extension,19.33°±3.29° at radial deviation,25.17°±4.89° at ulnar deviation,75.73°±7.66° at pronation,and 77.22°±4.89° at supination.According to Green-O'Brien standard,the results were excellent in 21 case,good in 17 cases and fair in 3 case,with 93％ excellent and good rate.Conclusion Wrist arthroscopy dose not only contribute to the diagnosis in ulnar impingement syndrome but also can be used in treating inflammatory synovium and cartilage lesions,bone drilling decompression,TFC repair and arthroscopic distal ulna resection with improvement in the range of motion of the wrist joint and function.

Numerous studies showed that changes in serum pepsinogen( PG)and gastrin-17( G-17)levels can reflect histological condition of gastric mucosa,that can be served as serological biopsy of gastric fundic glandular mucosa. The decrease of serum PGⅠ level and PGⅠ/ PGⅡ ratio(PGR)as well as increase of G-17 denotes a high risk of gastric cancer. Helicobacter pylori(Hp)infection can cause chronic active gastritis,and the progress of inflammation can lead to atrophy and intestinal metaplasia of mucosa. This article reviewed the diagnostic value of serum PG,G-17 and Hp antibody for atrophic gastritis and gastric cancer.

Objective To determine the main predictors of circulatory crisis after replantation in patients with severed distal finger so as to establish the theoretic basis in reducing the morbidity of circulatory crisis. Methods 65 severed distal fingers underwent replantation were respectively reviewed. All the clinical parameters including age, sex, dominant hand or finger, preservation of the severed finger, platelet level, ischemia duration, cause of injury, manner of venous drainage, repair of artery, order of reparation and plane of division were investigated as predictive risk factors for circulatory crisis of finger after replantation. In order to find the risk factors of circulatory crisis, the data was dealt with t test, ?2 test, analysis for variance or multivariate Logistic regression analysis. Results 13 replanted finger suffered from impaired circulation in 65 fingers. Univariate analysis demonstrated that many factors were significantly correlated with the circulatory crisis of finger, such as the manner of venous drainage(?2=6.714,P=0.035), the cause of injury (?2=9.049,P=0.011), the preservation of severed finger(?2=6.452,P=0.040), the age(?2=14.838,P=0.001), the platelet level(uc= 2.961, P=0.003). The multivariate Logistic regression analyses showed that platelet level (OR=1.015, P=0.030), the age(OR=0.349, P=0.031) and the manner of venous drainage(OR=0.278,P=0.036) were the significant independent predictors for circulatory crisis. The incidence of circulatory crisis in patients less than 6 years old was 61.5%, significantly higher than any other age group(P

Objective To explore the significance of complement split product C4d in monitoring chronic rejection of renal allografts in rats.Methods Healthy closed population rats were used as donors and SD rats as recipients. The Wistar to SD model of graft rejection was developed. All the 42 recipients were randomly divided into 2 groups: group A receiving nothing except CsA (5mg?kg~ -1 ? d~ -1 ) in the first 10 days after operation, and group B receiving MMF (10 mg/kg) and CsA after operation. On the 3rd, 5th and 10th week, all the allografts were tested by light microscopy and immunofluorescence. Pathological changes of the kidneys and the expression of C4d in allograft tissue were observed.Results From the 3rd week, the rats in group A showed light pathological changes of chronic rejection and they became more and more obvious as time increased. Pathological changes occurred in group B at the 5th week and lighter than in group A. At the same time, C4d deposition in PTC was obviously observed on the 3rd week in group A, and on the 10th week C4d widespread deposition in allografts.Conclusion The deposition of complement split product C4d in allografts appears earlier than pathological change of chronic rejection, which can be regarded as a significant indicator to predict chronic rejection of renal allografts.

Objective To investigate the relationship of the nutritional status with liver function and clinical outcomes of liver cancer patients treated with surgery.Methods Altogether 112 hospitalized patients undergoing surgical treatments for liver cancer were enrolled from October 2011 to October 2013.Their general clinical data were collected,including creatinine-height index (CHI),arm circumference,grip strenghth,albumin,prealbumin,and transferrin.The nutritional status was assessed using Patient-Generated Subjective Global Assessment (PG-SGA).The liver function was assessed with Child-Pugh classification.Postoperative infectious complications and the hospital stays were recorded to assess the clinical outcomes.The correlation between nutritional status and liver function,and that between nutritional status and clinical outcomes were analyzed.Results Among the 112 patients,70 (62.5％) were in normal nutritional status,34 (30.4％) were with moderate malnutrition,and 8 (7.1％) were with severe malnutrition according to PG-SGA scores.PG-SGA assessment showed strong consistence with CHI nutritional assessment (κ =0.760,P =0.000),and moderate consistence with arm circumference assessment (κ =0.564,P =0.000),and grip strength assessment (κ =0.523,P =0.000).The live function classified by Child-Pugh was found highly correlated with PG-SGA assessment (rs =0.829,P =0.000).Postoperative infectious complications and hospital stays were both positively correlated with PG-SGA assessment (r =0.349,P =0.000 ; r =0.624,P =0.000).Conclusions PD-SGA combining with CHI can be used for the nutritional status assessment of liver cancer patients undergoing surgical treatments.The nutritional status of the patients has positive correlation with live function,infectious complications,and postoperative hospital stays.

Objective To study the antagonism of taurine-zinc coordination compound (TZC) to the adverse effect of mercury (Hg) on the neurons in the cerebral cortex. Methods 32 male Wistar rats aged 21days were randomly divided into 4 groups, one control group (fed on distilled water), three experimental groups fed on HgCl2 (0.06 g/L), HgCl2+0.23 g/L TZC and HgCl2+0.46 g/L TZC respectively, treated for one month. The NOS activity in the cerebral cortex neurons was determined by NADPH-d histochemistry. Results NADPH-d positive neurons increased in HgCl2 group (P

Purpose:To investigate the effect of replication defective retroviral vectors carried sense or antisense TGF?1 fragment on the cell cycle regulation and proliferation of human bladder cancer. Methods:The replication defective retroviral vectors that integrated sense or antisense bioactive fragment of transforming growth factor?1 were constructed,and named as pRevT? and pRevT?-AS respectively. The influence of each vector on the cell proliferation,clone-formation and alteration of cell cycle of bladder cancer cell line EJ were observed in vitro.Results:The titre of pRevT? and pRevT?-AS were 0.84,0.88?10 5 CFU/ml respectively,the vectors integrated to EJ cells and expressed efficiently. Inhibition TGF?1 gene expression reduced proliferation and clone-formation rates of EJ cells. The G 0 /G 1 stage ratios in the antisense TGF?1-transfected EJ cells were increased,simultaneously,the S stage ratios were decreased. Conclusions:The antisense TGF?1 vector can reduce the expression of endogenous TGF?1 in EJ cells,induce G 1 stage arrest and inhibit proliferative growth in vitro.

Objective To explore and analyze the influence of endoscopic lumbar discectomy on limb function and quality of life in patients with lumbar disc prolapse.Methods 90 cases of lumbar intervertebral disc protrusion were selected,and they were divided into control group and observation group according to the operation method,45 cases in each group.The control group was given open lumbar disc excision treatment,the observation group was given percutaneous endoscopic lumbar disc resection treatment.The perioperative therapeutic index,physical function and quality of life were compared between the two groups.Results The intraoperative blood loss,time in bed,hospital stay,postoperative VAS score of the control group were (60.21 ± 20.32) min,(30.36 ± 14.25) mL,(26.96 ± 9.69) d,(8.21 ± 2.36) d,(5.12 ± 1.36) points,respectively,which of the observation group were (58.96 ± 19.88) min,(12.88 ± 10.28) mL,(100.69 ± 18.75) d,(12.99 ± 3.88) d,(1.98 ± 0.33) points,respectively.Compared with the control group,the observation group had less intraoperative blood loss,shorter time in bed,shorter hospital stay,lower postoperative VAS score,the differences were statistically significant (t =4.25,4.66,5.12,5.78,6.12,all P ＜ 0.05).The excellent and good rate of the control group was 89.89％,which of the observation group was 93.33％,there was no significant difference between the two groups (x2 =7.68,P ＞ 0.05).After treatment,the physical function,role function,emotional function,cognitive function and social function score of the control group were (7.89 ± 0.78) points,(7.99 ± 1.25) points,(7.84 ± 0.65) points,(7.65 ± 0.75) points,(7.45 ± 0.77) points respectively,which of the observation group were (8.96 ± 1.78) points,(8.75 ± 1.12) points,(8.56 ± 0.88) points,(8.42 ± 0.66) points,(8.56 ± 1.47) points,respectively.Compared with before treatment,the physical function,role function,emotional function,cognitive function and social function score in the two groups after treatment were higher.After treatment,compared with the control group,the scores increased more significantly in the observation group (t =6.55,7.56,7.88,7.56,7.89,all P ＜ 0.05).Conclusion Endoscopic resection and open lumbar disc excision technique in treatment of patients with lumbar intervertebral disc protrusion of lumbar can obtain similar curative effect,but the former has less incision,less intraoperative blood loss,postoperative recovery fast,can better improve the patients' quality of life.