Objective To study the clinicopathologic features of giant cell carcinoma of the pancreas(GCCP). Methods The clinicopathologic features of 19 pathologically diagnosed as GCCP were retrospecti- vely analyzed in detail, compared with 96 cases of common pancreatic carcinoma (PC). Results Tumors that occurred in the head of pancreas were found in 8 patients(42.1%), and those in the body or tail of pancreas in 11 patients(57.9%). The initial symptom is mainly characterized by abdominal pain (57.9%). Abdominal pain (73.7%), dyspepsia(63.2%) and weight loss(36.8%) were common symptoms when patients were diagnosed. Jaundices is not a common symptom in these patients. The abnormal rates of routine laboratory tests were dramatically lower than those in common PC. The assay of tumor markers between GCCP and common PC were approximately same. The sensitivity and accuracy of diagnosis by ultrasonography, spiral computed tomography and magnetic resonance imaging were high. The carcinomas grew so large that 9 patients ( 47.4%)were in stage Ⅳ, the rate of which was higher than that in common PC. Osteoid formation was found under microscopy in some patients, and the tumor cells differentiated poorly in most of patients. The overall 1-year survival rate was 17.6%, which was lower than that in common PC. Conclusions The clinicopathologic features of GCCP are different from those of common PC. Imaging tests may be combined with the assay of tumor markers simultaneously so as to diagnose GCCP as early as possible and thus the prognosis of GCCP patients could be improved.

This study was aimed to assess the proportion and causes of misdiagnosis of pancreatic cancer (PC), and the effects of misdiagnosis on and treatment of PC, so as to sum up experiences and improve the diagnosis and treatment. 1027 cases with confirmed diagnosis of PC were retrospectively analyzed in detail. The patients were divided into misdiagnosed group and a group with correct diagnosis. The relevant data of the two groups were analyzed by stastical methods, and the differences between them were assessed. It was found that 586 cases (57 1%) were misdiagnosed.Fifty five diseases were involved in misdiagnosis, among them gastritis and duodenitis, peptic ulcer, virus hepatitis, cholecystitis and cholelithiasis, chronic pancreatitis wese the commonest. The differences of duration of diagnosis, main symptoms, resection rate, and half year survival rate between misdiagnosed group and correct diagnosis group were significant. It is concluded that PC is often misdiagnosed as other diseases. Early diagnosis and treatment is critical to the prognosis. The physician should be aware that PC may present a veriety of clinical manifestations, and therefore he or she should analyze comprehensively the symptoms and signs in order to improve diagnosis and treatment.

This study was conducted to assess the diagnostic value of serum CA19 9 in patients with pancreatic cancer. Seven hundred and seventy eight patients with the diagnosis of pancreatic cancer were involved in the study, and every patient had serum CA19 9 determined. The descriptive statistics and correlation analysis were used to evaluate the serum CA19 9 as an index in patients with pancreatic cancer. Results showed that 80 33% patients had the serum CA19 9 value higher than 37U/ml. Further more, a positive correlation was found between the serum CA19 9 and the TNM status of pancreatic cancer( r =0 513, P

To study the clinical features of the pancreatic cancer (PC), clinical symptoms of 1027 diagnosed cases of PC were retrospectively analyzed in detail, including their dynamic changes with regards to the patients'sexes, ages, blood types, and tumor locations in the pancreas. The results showed that abdominal pain, jaundice and epigastric discomfort were the prevailing initial symptoms in these 1027 cases. Abdominal pain, jaundice, weight loss, and anorexia were the main symptoms. Unusual symptoms were seemed to be different in different patients. The clinical symptoms could be dramatically different with difference in patients′ age and tumor location. The blood type might also infhluence the clinical symptoms in certain degree. It is concluded that the clinical symptoms of the PC were atypical in general, but still there were some characteristics.The physician should grasp these characteristic symptoms in order to make an early diagnosis.

Objective To analyze the anti hypertensive drugs use of clinical characteristics of obstructive sleep apnea hypopnea syndrome(OSAHS) patients complicated with hypertension.Methods 233 obstructive sleep apnea hypopnea syndrome patients complicated with hypertension were enrolled,and they were theated with three different therapy methods.After the treatment,the situations of kind,effect and combined use of oral antihypertensive drugs were statistically analyzed.Results The most frequently used drugs were calcium channel blocker (CCB),especially nifedipine sustained-release tablets [75.5％ (176/233)];the combined prescription was 63.9％ (149/233) of all prescriptions,but the data reduced to 57.1％ (133/233) after OSAHS therapy.Conclusion There is a good condition regarding using oral antihypertensive drugs in Weihai.However,some antihypertensive drugs are used irrationally.

Objective To discuss the treatment and clinical efficacy of repair of soft tissue and nerve defect of thumb with island flap of first dorsal metacarpal artery based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.Methods The skin and nerve defect in 14 thumbs were repaired by dorsal island flap of index fingers based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve.The size of skin defect ranged from 52 mm × 32 mm to 10 mm × 8 mm.The length of the nerve defect ranged from 9 mm to 22 mm.Results The average followup was 6-35 months.All 14 flaps survived with satisfactory appearance and function.The injured side of thumb pulp sensation recovered S3 + and the injured two-point discrimination ranged from 4 mm to 7 mm.No scar contracture or sensory dysfunction complication were observed in the donor sites.Conclusions The repair of soft tissue and nerve defect of thumb with dorsal island flap of index finger based on the first dorsal metacarpal artery carrying dorsal branch graft of digital proper nerve is recommendable,since it can obtain satisfactory clinical efficacy and be easily and conveniently oerformed.

Objective To investigate the expression and distribution of basic fibroblast growth factor (bFGF)and platelet-derived growth factor (PDGF)in the different phases of femoral neck fracture.Methods Immunohistochemical assays were used to determine the expression and distribution of bFGF and PDGF protein in 36 human specimen of femoral neck fracture.A was measured and analyzed by CMIAS color imaging analysis system for signals of bFGF protein were found high in the mesenchymal cells,monocyte and vascular endothelial cells at 1st week after fracture in 9 subjects,with A of (0.4076 ±0.0902).The weakly positive signals of PDGF protein were found in the mesenchymal cells,while strongly positive in the vascular endothelial cells with A of (0.2261 ±0.0636).At 2rd week,in 9 cases the expression of bFGF and PDGF was strongly expressed in fibroblasts,endothelial cells,cartilage cell and cartilage matrix,osteoblast,with A of[(0.6404±0.0920)and (0.7457±0.0756)]and significandy higher than that at 1st week (P＜0.05,P＜0.01).There was no significant difference between the 3rd and 3nd week with A of[(0.7168±0.1346)and (0.8033±0.0491),P＞0.05 ].The expression of bFGF and PDGF protein was reduced obviously at 4th week but was positive in young and cartilage tissue,with A of [(0.5374correlation between bFGF and PDGF protein in different phases (r1week=0.792,r2week=0.834,r3week=0.880,entiation of cartilage cell and osteoblast,and induce proliferation of vascular endothelial cells and new blood vessel.③ Both bFGF and PDGF are bone growth factors, cooperating in regulating proliferation and differentiation of cartilage cell and osteoblast for fracture healing.

Objective To study the first metacarpal dorsal artery anatomy,and explore the flap based on the branch chain of the first metacarpal dorsal artery.To provide anatomical basis for clinical application of the flap.Methods The origin,courses and distribution of the branch chain of the first metacarpal dorsal artery from 8 fresh hand specimens perfused by red latex were explored from January,2015 to December,2016.Results There was a dorsal artery network in the dorsal side of the first metacarpal.The radial and ulnar dorsal artery of the first metacarpal originated from the radial artery and along the first metacarpal lateral margin to go down.The initial diameter of the radial dorsal artery was (0.82±0.06)mm.The initial diameter of the ulnar dorsal artery was (0.74±0.05) mm.And anastomosed with the dorsal branches of the thumb inherent arteries.The both inherent arteries of thumb give off dorsal branches count (2.62±0.34).The initial diameter of proximal dorsal branch was (0.32±0.03) mm.The initial diameter of distal dorsal branch was (0.24±0.08) mm.Conclusion The radial and ulnar dorsal vascular chain of the first metacarpal were constant.The anastomosed branches with the dorsal branches of the thumb inherent arteries were abundant.The free flap or retrograde flap based on the vsscular chain has reliable blood supply.And without destroyed the main artery of thumb.

Objective To investigate the influence of intermittent catheterization methods on the urinarytract infection in patients with spinal cord injury. Methods Thirty-one cases of spinal cord injury and urinarytract infection were recruited. By use of intermittent catheterization, the bladder function was trained. Bacteria cul-ture and identification of in urine from the patients were conducted before the training (indwelling catheterization)and after 15 or 30 days of intermittent catheterization. Results The rates of urinary tract infection (colony count≥1?10~5cfu/ml) after 15 or 30 days of intermittent catheterization were 38. 7% and 35. 5%, respectively, whichwere significantly lower than those of indwelling catheterization (100%), P

Therapeutic hypothermia has been shown to improve neurological outcomes after global ischaemia/hypoxia in patients who have had cardiac arrest. Therapeutic hypothermia is one of the most extensively studied and influential therapeutic strategies of acute ischemic stroke. Previous studies of therapeutic hypothermia mainly focused on whole-body cooling. However, delayed induction and systemic complications have limited the clinical application of whole-body cooling. As a selective cerebral hypothermia, the selective intra-arterial brain hypothermia treatment has the characteristics of rapid and even induction of hypothermia, and less affecting the core body temperature. Therefore, it has become a promising treatment modality. This article reviews the application of selective intra-arterial brain hypothermia in acute ischemic stroke and its advantages and limitations in order to provide reference for further experimental studies and future clinical trials.