As one of the gastrointestinal malignancies,pancreatic cancer is well known because of high degree of malignancy,low survival rate and very poor prognosis.Lymphatic metastasis,the most important metastasis of pancreatic cancer,has the characteristics of metastasis in an early stage and high occurrence rate.Recently,some studies have suggested that widespread micrometastasis of lymph nodes occurring in the early stage of pancreatic cancer could play an important role in influencing postoperative neoplasm recurrence.Further studies on lymph node micrometastasis of pancreatic cancer are needed to help to understand pancreatic cancer more deeply and to comprehend metastasis rule more clearly.So we can choose more reasonable surgical treatment for every patient,achieving individual treatment,so as to improve the prognosis of the pancreatic cancer patients.

Kawasaki disease is an acute self-limiting systemic vasculitis syndrome and usually occurs in children.The small and medium arteries of the whole body are mainly invaded, and marked with coronary arteries.Coronary artery dilation and aneurysm formation mainly occur in the early period.Thrombi, intimal hyperplasia, and calcification could be formed during the later period.Consequently, sometimes, it develops intochronicischemic cardiopathy or myocardial infarction.In that, Kawasaki disease has become the leading cause of acquired heart disease for children in developed countries.Presently, the treatment of coronary artery lesions caused by Kawasaki disease includes drug therapy, and interventional and surgical treatment.However, medications usually fail to solve severe coronary conditions, and only interventional and surgical treatment can we choose.Therefore, the development and indications of interventional and surgical treatment of coronary artery lesions caused by Kawasaki disease were reviewed in this article.

[Objective] To study the bacteriological feature of the wound infection of open fracture and supply the reasonable advise to the use of antibacterials. [Methods]One hundred and thirty-six samples were collected from the wound patients with open fracture between January in 2004 and December in 2008. The identification of bacteria and drug sensitive test were carded out by ATP-expression.[Results]One hundred and fifty one isolates were collected from 136 samples. The prevalence of staphylococcus aureus, pseudomonas aeruginosa, staphylococcus haemolyticus,staphylococcus epidermidis, eolon bacillus were most ,accounting for 17.22%, 13.24%, 11.92%, 9.93%and 9.27% respectively. The prevalence of MRSA was higher than 57.7%.Gram positive coccus , gram negative bacilli and candida accounted for 48.34%, 43.05% and 8.61% respectively. The prevalence of ESBLs was 28.6%. None of gram negative bacilli was found resistant to sulbactam and cefopcrazone. The resistance rate of gram negative bacilli to ampicillin , ampicillin -sulbactam and cephazolme were 71.4%. The rate of resistance of staphylococcus to methicillin was higher than 57.7%.Except vancomycin was not drug-fast, some sensitive antibacterials include cotrimoxazole, nitrofurantion, rifampicm tetracycline.[Conclusion]Endogenic normal flora and conditioned pathogen from the surroundings have become the main pathogens of the wound infection of open fracture. So the early debride and reasonable use of antibacterials would play a positive role in preventing postoperative fracture infection.

Child ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Pneumonia, Mycoplasma ; diagnosis ; drug therapy

Objective To investigate the diagnosis and treatment of injury in choledocho-pancreatico-duodenal junction. Methods The clinical data of 6 patients with injury in choledocho-pancreatico-duodenal junction who had been admitted to Beijing Hospital from January 2000 to January 2008 were retrospectively analyzed. Results Of the 6 patients, 4 were diagnosed according to the intraoperative findings, cholangiography and fiber cholangioscopy. The 4 patients were cured after suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage. Two patients developed severe abdominal and retroperitoneal infection and other complications after operation, and were diagnosed by cholangiography and fiber cholangioscopy. Of the 2 patients, 1 was cured and 1 died after multiple drainage procedures and debridement. Conclusions Diagnosis and treatment in the early stage are crucial for the curative purpose. Cholangingraphy and fiber cholangioscopy are effective in the diagnosis of injury in choledocho-pancreatico-duodenal junction. The suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage should be chosen for patients who are diagnosed during primary operation. For patients with abdominal and retroperitoneal abscess and cellulitis, drainage and debridement should be performed, and biliopancreatic diversion and duodenal diverticularizatian are applied to patients when necessary.

The study of 295 patients with T2DM and 336 healthy subjects was carried out and three diabetic sub-groups of DM with high total cholesterol(H-TC),DM with high triglyceride(H-TG) and H-TC plus H-TG were set.The results showed that the level of non-HDL-C was increased in all three groups of H-TC,H-TG,and H-TC plus H-TG(all P

Objective To explore the clinical efficacy of small-incision Dewar's operation for acute acromioclavicular dislocation.Methods Without exposing the a-c joint,the coracoid tip with tendon were transferred to the clavicle to reconstruct the coracoclavicular ligaments.And then the a-c joint was statically fixed and dynamically replaced.Results A 1-to 9-year follow-up(mean,4.9 years)was available in 52 patients.According to the Lazzcano Criteria,44 cases had excellent and 7 cases had good results,only one was failed because of bolt prematurity at 2 month after the operation.Roentgenogram,CT,and MRI showed that the surface of the acromioclavicular joint was smooth,no arthritic sign of cirrhosis,hyperplasia,or theca.The signal of the a-c joint was uniform.The Roentgenograms showed that,at the neutrality position,the distal end of the clavicle of the injured side was higher than that of the healthy side.The D/W of the healthy side was 0.432?0.101,which was significantly higher than that in the injured side(0.523?0.083,t=2.188,P=0.042).The difference between the neutrality and hold of the healthy side was 0.116?0.025,while that of the injured side was 0.087?0.016(t=1.114,P=0.280).The Roentgenograms of the raise position showed no impact in the a-c joint.Conclusions Small incision Dewar's operation is an effective,safe,and minimally invasive method for the treatment of acute acromioclavicular dislocation.

Objective To explore a three-dimensional examination method for retinal vessels. Design Experimental study. Participants Retinal vascular digest preparations of rat. Methods After deep anaesthesia, rats were sacrificed and perfused till eyeballs pale. Then 4% paraformaldehyde was perfused for vascular internal fixation. Eyeballs were fixed in 4% paraformaldehyde for 24hr, and the retinal vessels were isolated with collagenase digest technique. After immunofluorescence staining, the retinal vessels were observed with laser scanning confocal microscope. Main Outcome Measures The digest state of retinal vascular digest preparations and three-dimensional observation of the preparations. Results Ideal complete retinal vascular digest preparations were obtained after collagenase digestion. Three-dimensional characteristics of retinal vessels can be observed with laser scanning confocal microscope. Conclusions Modified retinal vascular digest preparations combined with laser scanning confocal microscope provided us a method for retinal vascular three-dimensional structure observation.(phthalmol CHN,2006,15:138-141)

Objective To investigate the efficacy of video-assisted thoracic small incision in diagnosis and treatment of small pulmonary nodules.Methods From February 2007 to February 2008,53 patients(aged over 40 years) with small solitary pulmonary nodule(≤3 cm in diameter) were treated by video-assisted thoracoscopy via a small incision.The nodules were removed during the operation,and then based on the results of quick pathological examination,malignant cases received further surgeries.Results Totally 39 patients were diagnosed with malignant disease,34 of them received small-incision radical lobectomy for primary lung cancer,small-incision resection of the lesions were performed on 5 patients who had bilateral(2 cases) or metastatic lung cancer(3 cases).Benign lesions were confirmed in 14 patients during the operation,and were removed by local resection.All of the patients with primary lung cancer,except one,achieved an mean of 7 months follow-up(ranged 2 to 12 months),31 of the patients survived without tumor during the period;2 patients showed recurrent cancer in 6 months after the operation,and thus received lobectomy.The 2 patients who had bilateral lung cancer and the 3 cases of metastatic lung cancer died in 2 to 6 months(mean,4 months) after the surgery.The 14 benign cases were followed up for 3 to 12 months(mean,7.5 months),none of them had recurrence.Conclusion Video-assisted thoracic small incision is effective in the diagnose and treatment of small pulmonary nodules.

Objective To explore the relationship between family environment and parental rearing patterns and adolescent schizophrenia , for the prevention of adolescent mental and provide scientific basis of schizophrenia . Methods In adolescent patients with schizophrenia in 101 cases( case group ) ,101 cases of the other without a histo-ry of psychosis patients as control group ,using the family environment scale ,EMBU for two groups of patients quality of life evaluation,non conditional Logistic regression analysis of related factors were analyzed .Results Intimacy, emotion expression,entertainment and father emotional warmth and understanding (F1) was a protective factor(OR=0.643,95%CI=0.235~0.863,P=0.01;OR=0.582,95%CI=0.168~0.906,P=0.01;OR=0.478,95%CI=0.174~0.834,P=0.01),but the contradiction,the father punished severely(F2),father′s refusal and denial(F5) and mother′s over interference(M2) as a risk factor(OR=1.535,95%CI=1.096~2.187,P=0.01;OR=1.516, 95%CI=1.097~2.096,P<0.01;OR=1.375,95%CI=1.034~1.989,P=0.01;OR=1.347,95%CI=1.272~1.915,P<0.01).Conclusion Good family environment and parental rearing pattern can reduce the incidence of schizophrenia .