Objective To evaluate the safety and efficacy of laparoscopic distal pancreatectomy in treatment of insulinoma.Methods Clinical data of 8 cases of insulinoma treated by laparoscopic distal pancreatectomy from Apr.2015 to Apr.2017 were retrospectively reviewed.Results Locations of the insulinoma in distal pancreas were all identified preoperatively by enhanced CT,MRI or somatostatin receptor scintigraphy (SRS).Laparoscopic distal pancreatectomy was applied to 8 cases,including combined splenectomy to 1 case.The operation time,bleeding volume,and postoperative hospital stay was (159±44) min,(125±119) ml and (5.5±1.4) days,respectively.Grade B fistula happened to one patient after surgery.The level of postoperative blood glucoses was normal in all cases.Conclusion Laparoscopic distal panreatectomy is safe,effective,and less invasive in treating insulinoma,with quick recovery and high efficacy in spleen preservation.

Breast cancer is one of the most common malignant tumors in females.Recent years,surgery,chemotherapy as well as other systemic therapy had greatly improved the prognosis of the patients.However,damage of ovarian function by chemotherapy lowered life quality,especially for young females.At present,there are several methods to protect the ovarian function of female patients undergoing chemotherapy,such as administration of a gonadotropin-releasing hormone (GnRH) analogs,ovarian cryopreservation,unfertilized ova cryopreservation,embryo cryopreservation,inhibitors of apoptosis,etc.Each method has its advantage,disadvantage and indications.Issues related to ovarian protection are reviewed here.

Primary aldosteronism(PA) is one of the most common causes of secondary hypertension,plasma aldosterone concentration(PAC)/plasma renin activity (PRA) ratio is widely used in clinical practice.However,PRA reflects the level of plasma renin indirectly.In recent years,plasma renin concentration (PRC) has been measured by automatic chemiluminescence immunoassay,which is more stable,convenient and with less confounding factors than conventional renin activity.This review briefly introduces methods of examining PRA,PRC and PAC,and compares the value of PAC/PRC ratio with PAC/PRA ratio in PA detection.

Pancreatic neuroendocrine tumors (P-NETs) are a group of heterogeneous tumors,including functional and nonfunctional ones.With the enhancement of clinicians' awareness about this disease and the improvement of imaging diagnostic techniques,the incidence of P-NETs has obviously increased in the past years.Based on the mitotic counting and Ki-67 positive index,the grading classification is of great value for the diagnosis,treatment and even prognosis of P-NETs.P-NETs are a group of malignant tumors with inert biological behaviors,whose surgical resection rate and long-term survival is much better than those of pancreatic ductal adenocarcinoma.P-NETs have different malignant potentials.Clinicians need to develop a comprehensive treatment plan in combination with the patient's symptoms,tumor grading classification and TNM staging information.Surgery is the only curable way to cure P-NETs.Even if radical resection is not suitable,palliative surgery may alleviate the patients,symptoms,and even prolong their survival time.According to the tumor location,size,quantity,degree of grading,local invasion and distant metastasis,different surgical procedures should be selected.

Induced pluripotent stem cell (iPSC) is a type of pluripotent stem cell that can be generated directly from adult cells through gene reprogramme and cell dedifferentiations.The researching history and advantages of iPSC were reviewed in this paper.In addition,the application of iPSC on diabetis mellitus was also summarized and prospected.

Objective To evaluate the effect of obesity on the incidence of surgical site infection (SSI) in patients with inguinal hernia after tensionless repair and its treatment.Methods Clinical data of 628 cases with inguinal hernia undergoing tensionless repair from Sep.2008 to May.2016 were retrospectively analyzed.The 628 patients were divided into obesity group (n=150) and non-obesity group (n=478),or SSI group (n=9) and non-SSI group(n=619).The effect of obesity on SSI after inguinal hernia and its treatment was analyzed.Re sults Among the 628 patients,SSC happened to 9 patients and the incidence was 1.43％.The rate of SSI in obesity group and non-obesity group was 4.00％ (6/150) and 0.63％ (3/478),respectively (x=6.960,P=0.002).BMI was 30.92±3.03 and 26.24±3.79 respectively in SSI group and non-SSI group (t=3.686,P=0.000).The difference has statistical significance.Factors such as diabetes,age,sex,albumin levels,American society of anesthesiology (ASA),type of hernia,method and duration of operation had no significant difference between SSI group and non-SSI group (P＞0.05).Conclusion By analyzing the risk factors of SSI after tensionless hernia repair,we find that patients with obesity are more likely to have SSI.Strengthening prevention and early treatment is a key measure to prevent postoperative infection in these patients.