The high occurrence of neural invasion in pancreatic carcinoma, which can be as much as 90%-l00%,leads to the poor survival rate in patients. The classical pathology includes invasion of both the extrapancreatic and intrapancreatic neurons. Metastasis into the extrapancreatic plexus promotes invasion into the intrapancreatic neurons and therefore results in pain. An increased in the diagnosis of new-onset diabetes mellitus, on the other hand, correlates with an increase in pancreatic cancer. This implies that hyperglycemia may promote neural invasion of pancreatic carcinoma. Novel auxiliary therapy of pancreatic carcinoma with neural invasion includes controlling of blood sugar and optogenetics, a new genetic technology which can further be utilized for surveillance.

Objective To investigate the laparoscopie resection of the adrenal tumor effects and clinical experience. Methods Among the 24 cases of Laparoscopic adrenalectomy tumors, there were 8 cases of adrenal adenoma, 7 cases of pheochromoeytoma and 9 eases primary aldosteronism. Results One ease was transit to open operation, the other 23 were successful,each surgerical time was 40～130 min with an average of 98 rain. Hemorrhage was 50～300 mL, 140 ml average, no blood transfusion. It was 1～2 d after sur- gery to remove drainage tubes, and could take some activities and have fresh flow in the second day. The pa- tients didn't appear complications and discharged after 5～7 d. Follow-up of 6～24 months, there was no recurrence and long-term complications. Conclusion Laparoscopic adrenalectomy has the advantages of minor trauma surgery, less bleeding, good demonstrating, convenient operation, fewer complications and quick recovery.

Objective To observe clinical curative effect of modified total cystectomy and Mainz Ⅱ neobladder. Methods Seventeen patients with bladder neoplasms were treated with modified total cystectomy and Mainz Ⅱ neobladder for urinary diversion. The paries posterior allantois with intestinum rectum and colon sigmoideum were taken 10 cm respectively, split the mesenterium edges, conduplicated and bilayer sutured from the junction of intestinum rectum and colon sigmoideum, bilateral ureters antireflux anastomosed respectively with colon sigmoideum and rectal papilla, then bilayer sutured paries anterior became Mainz allantois. Results There was no surgical mortality. The operative time was 340 ～ 420 mins (mean, 350 mins).Blood transfusion was 400 ～ 800 ml ( mean 600 ml). The follow-up was 4 ～ 18 months, urine and dejecta were shunt, uresis continence was fine and the operation had fewer severe complications. Conclusion Modified total cystectomy and Mainz Ⅱ neobladder to be an effective method for urinary diversion because of its simple operation, fewer severe complications, good uresis continence and high quality of life.