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.

Objective To analyze the effect of individualized care on prevention of postoperative urinary retention of malignancy patients undergoing hysterectomy and pelvic lymph node dissection.Methods 74 cases of patients with malignancies undergoing total hysterectomy and pelvic lymph node dissection in our hospital from June 2009 to December 2011 were chosen as the research object.They were divided into the control group and the observation group with 37 cases in each group.The control group was given traditional routine care,while the observation group was given individualized nursing assessment and intervention.The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients were analyzed and compared between two groups.Results The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients in the observation group were better than those of the control group,there were significant differences.Conclusions The effect of individualized care to prevent postoperative urinary retention of malignancies patients after hysterectomy and pelvic lymph node dissection is better.It plays an active role in improving mastering of knowledge about prevention of urinary retention and cooperative degree with nursing.

ObjectiveTo explore the effect of problem-based health education on self-care ability and psychological situation of gynecological cancer patients after surgery.Methods68 cases after gynecological cancer from January 2009 to December 2011 in our department for treatment were chosen.By taking mechanical sampling method,45 cases were randomly set as the observation group,which took problem-based health education.Other 23 cases were set as the control group,which adopted general health education model.The effect of health education was compared between two groups.ResultsIn the observation group,the self-care skills score was (20.4±5.8),self-responsibility score(27.6±9.4),the self-concept score (15.7±8.3) and self-care ability score (111.6± 20.3),significant higher than those of the control group,which were (11.6± 4.4 ),( 17.3 ± 6.5 ),(7.4 ± 5.1 ) and (53.2 ± 12.8).The SAS score was (1 1.6 ± 4.4) and SDS score was (17.3± 6.5) in the observation group,significantly lower than (20.4 ± 5.8) and (27.6± 9.4) of the control group.ConclusionsApplication of problem-based health education in gynecological cancer patients can significanfly improve their self-care capacity and patients＇ anxiety and depression.

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 investigate the classification and distribution of external nasal fracture, and its influence to the nasal septum. METHOD: We randomly chose 60 patients who received nasal CT scan because of nasal trauma and diagnosed as external nasal fracture. We reviewed their CT data in PACS system with computer. RESULT: Of the 60 cases of nasal trauma, 90 sides got external nasal fracture, among which 58 sides (64.4%) had only nasal bone fracture, 16 sides (17.8%) had only maxillary frontal process fracture, and 16 sides (17.8%) had both. Half of these 60 patients got unilateral external nasal fracture, among whom 14 patients (46.7%) had traumatic nasal septum deviation meanwhile. The other 30 patients suffered from bilateral external nasal fracture, among whom 26 patients (86.7%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). Moreover, 24 patients got fracture of either nasal bone or maxillary frontal process, 11 of whom (45.8%) got traumatic nasal septum deviation at the same time. The other 36 patients suffered fracture of both these two bones, 29 of whom (80.6%) had traumatic nasal septum deviation. The difference between these two groups was statistically significant (P < 0.01). We classified the nasal bone fracture as below: 16 patients with only unilateral external nasal fracture belonged to Type I, of whom 15 patients (25.0%) were type Ia with nasal bone or maxillary frontal process fracture and 1 patient (1.7%) fell into type Ib with fracture occurred on both of these two bones at the same side. Four patients suffered bilateral external nasal fracture belonged to type II, among whom 2 patients (3.3%) belonged to type IIa with nasal bone or maxillary frontal process fracture and 2 patients fell into type IIb with fracture of both of these two bones at different sides. The other 40 patients (66.7%) belonged to Tpye III, who suffered external nasal fracture accompanied with traumatic nasal septum deviation. CONCLUSION Traumatic nasal septum deviation was extremely concomitant in patients with external nasal fracture. It will be better to perform external nasal reconstructive surgery and plasty of nasal septum deviation by using the endoscope within 1 month for the patients whose symptom were serious or who cared a lot about the appearance.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Fractures, Bone ; classification ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Nasal Bone ; injuries ; Nasal Septum ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Young Adult

Gestational hyperlipidemic pancreatitis is an uncommon complication of pregnancy that incurs a high risk of morbidity and mortality of both maternal and fetal patients.We described the response of continous renal replacement therapy in a woman with extreme gestational hyperlipidemia and severe pancreatitis.Five consecutive plasma exchanges didn't lead to a remarkable reduction(10.4% and 4.8%,for the first and fourth times,respectively) at triglyceride levels as the literatures have reported,which reveals that plasma exchange and continous veno-venous heamofiltration may be importment,instead of crucial methods in dealing with gestational hyperlipidemic pancreatitis.Abstract:SUMM ARY Gestational hyperlipidem ic pancreatitis is an uncommon complication of pregnancy that in-curs a high risk ofmorbid ity and mortality of both maternal and fetal patients.W e described the response of continous renal replacement therapy in a woman with extreme gestational hyperlipidem ia and severe pancreatitis.Five consecutive plasma exchanges d idn’t lead to a remarkable reduction(10.4% and 4.8%,for the first and fourth times,respectively) at triglyceride levels as the literatures have reported,which reveals that plasma exchange and continous veno-venous heamofiltration may be importment,in-stead of crucialmethods in dealing with gestational hyperlipidem ic pancreatitis.

Since the mechanism reform in 2001,the quality construction has been the center of our publication work.With the awareness of brand and service strengthened continuously,the publication quality is raised and the publication scope is widened so that the benefit in military,economy and society is enhanced comprehensively.This paper reviews the five-year publication practice of Chinese medical equipment journal and explores its prospects,which can be a reference for further development and the realization of new aim.

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.