Pancreatic cancer has a very poor prognosis, with a five-year survival less than 5%. Nowadays, to improve the treat-ment efficacy of pancreatic cancer has been a highlight for medical researchers worldwide. Increasing knowledge about the molecular pathogenesis of the disease has shown that genic mutations, such as oncogene Kras2, and anti-oncogenes Cdkn2a, and TP53, are hall-marks of pancreatic cancer. Therefore, it is vital to deeply understand the pathogenetic mechanism of pancreatic cancer and find new therapeutic strategies to cover it. In this review, we summarized the recent advances in the signaling pathways of pancreatic cancer.

BACKGROUND:There is no unified method for treatment of intertrochanteric fracture. Previous dynamic hip screw fixation has some shortcomings, and is gradual y replaced by intramedul ary nail fixation. interTan is a compression interlocking intramedul ary nail designed by Smith Nephew in USA according the characteristics of intertrochanteric fracture. Unique design of pressurized screw thread has control able linear pressure. Moreover, it has the stability of Z-effect anti-rotation.
OBJECTIVE:To analyze the clinical therapeutic effects and superiority of interTan compression interlocking intramedul ary nail for intertrochanteric fracture.
METHODS:A total of 60 patients with intertrochanteric fracture undergoing interTan compression interlocking intramedul ary nail in the Department of Orthopedics, Beijing Chaoyang Emergency Rescue Center from January 2011 to December 2012 were enrol ed in the experimental group. A total of 60 patients with intertrochanteric fractures receiving dynamic hip screw fixation in the Department of Orthopedics, Beijing Chaoyang Emergency Rescue Center from January 2009 to December 2010 were enrol ed in the control group.
RESULTS AND CONCLUSION:Peri-operative bleeding volume, postoperative ambulation time, numerical rating scale score, radiographic healing time and weight-bearing time in the experimental group were lower than those of control group. At 3, 6 months and 1 year after fixation, Harris score and hospital for special surgery knee score were higher in the experimental group than in the control group. These data indicated that compared with dynamic hip screw, interTan compression interlocking intramedul ary nail has unique stability due to its design. Internal fixation can reduce operation trauma, promote fracture healing and improve joint function, and exhibit good clinical therapeutic effects for intertrochanteric fractures.

Objective To review the results and complications of open reduction and internal fixation (ORIF) through the posteromedial approach for posterior pilon fractures.Methods From March 2009 through November 2013,18 consecutive posterior pilon fractures were surgically treated through the posteromedial approach,involving 12 males and 6 females.Their ages ranged from 15 to 65 years (average,42 years).All of them were complicated with fracture of external malleolus,and 6 of them with fracture of anterior colliculus of medial malleolus.The time from injury to surgery ranged from 2 to 15 days (average,7 days).Results The patients were followed up for an average of 15 months (range,from 10 to 19 months).All the fractures healed after 11 to 16 weeks (average,13 weeks).No complications like neurovascular injury,implants failure,nonunion,or malunion occurred,except one case of superficial wound infection which responded to nonoperative management.According to the AOFAS (American Orthopaedic Foot and Ankle Society) evaluation system,15 cases were excellent,2 cases good and one case fair.Conclusion It is safe,reliable and effective to treat posterior pilon fractures using anti-rotation plate ORIF through the posteromedial approach.

Objecfive To investigate possibihty of monitoring myocardial isehemia by eontinuous EASI 12-lead ST-segment trend analysis during orthopaedic surgery and find its rules.Methods Three hundred and eleven consecutive patients who underwent orthopaedic surgery were monitored bv continuous EASI 12-lead ST-segment analysis during surgery.Results Among 311 patients 81 patients(26.0%) had myocardial ischemic events.The ischemie incidence of general anesthetics WaS signifieantly higher than local anesthetics(the spinal or epidural anesthetics and nerve-block anesthetics)(38.1%vs 23.0%.P＝ 0.01 5).During ischemie events the patients whose heart rate exceeded 90 beat per minute was 71.6% (58/81).Among the 177 isehemie events,the duration ofless than 5 minutes was 79.7%(141/177).ST-seg- ment deviation ofless than 0.15 mV was 71.2%(126/177).Conclusions During orthopaedic surgery EASt 12-lead electrocardiogram is the optimal approach for monitoring myocardial isehemia.The ischemic incidence of general anesthetics is significantly higher than local anesthetics.The myocardial ischemia events correlates with fast heart rate.The intraoperative myocardial ischemia events are more often transient.In most of these ischemic events ST-segment deviation is not very serious.

Objective To investigate the influence of different crown cutting mode on operation time and post-operation trauma in extracting the mandible third molar by dental drilling system.Methods According to different impaction types,the patients were divided into vertical impaction,horizontal impaction,and mesioangular impaction groups.The operation time,mouth opening,swelling,and pain degrees were recorded during traditional extraction,crown "T"-shaped cutting,crown three section cutting,and crown-root cutting in the extraction of mandibular wisdom teeth.Results In the vertical impaction group,the operation time,the degree of swelling,limitation of mouth opening and the pain degree were(8.2± 2.5) min,(14.7±2.0) mm,(3.9±2.4) mm and 3.4±1.8,respectively using crown cutting,and(14.0±2.7) min,(18.2± 1.9) mm,(9.7±3.6) mm and 6.9±2.3 using traditional extraction method(P＜0.05).In the horizontal impaction group,the operation time,degree of swelling,limitation of mouth opening and pain degree (14.0± 2.0) min,(19.2±3.9) mm,(9.5±2.5) mm,5.6± 1.7 respectively using crown "T"-shaped cutting,and (18.0±3.1) min,(23.6±3.5) mm,(9.8± 2.7) mm and 8.5±2.3 using crown three section cutting.There was significant difference in operation time,degree of swelling and pain(P＜0.05),but no significant difference in the limitation of mouth opening(P＞0.05).In mesioangular impaction group,operation time,degree of swelling,limitation of mouth opening and pain degree were (10.2±2.6) min,(18.4±2.9) mm,(6.4±2.5) mm and 4.8± 1.8,respectively using "T"-shaped cutting,and (15.0±3.5) min,(18.9±3.0) mm,(7.0±3.7) mm and 7.6±2.3 using crown-root cutting.The operation time and pain degree were significantly different (P＜0.05),but not different in limitation of mouth opening and swelling degree(P＞0.05).Conclusions Different impaction types of wisdom teeth should choose different cutting mode.Vertical impacted tooth uses distal crown cutting."T"-shaped cutting is preferred with horizontal impaction.According to the angle and depth of the mesioangular impaction,"T"-shaped cutting or the crown-root cutting can be selectively used.

OBJECTIVETo seek the optimum treatment for patients with primary gastric non-Hodgkin's lymphoma and factors associated with prognosis.

METHODSA retrospective study was conducted on 157 primary gastric non-Hodgkin's lymphoma patients who had received operation for 45 years.

RESULTSThe X-ray diagnosis rate was 39.4% before operation. The diagnosis rate by gastroscopy was 52.7%. Among the 157 patients, 32 belonged to stage I(E), 40 stage II(E), 29 stage III(E), and 56 stage IV(E). All of the patients were received chemotherapy or radiation. The 3-, 5-, 10-, 15-year survival rates were 51.1% (69/135), 42.3% (55/130), 20.7% (23/111), and 13.5% (14/104).

CONCLUSIONSThe 3-, 5-year survival rates in stage I(E) and stage II(E) were 2 to 5 times higher than those in stage III(E) and IV(E) (P < 0.01). The 3-, 5-year survival rates of primary gastric non-Hodgkin's lymphoma were 60.2% (65/108) and 50.0% (52/104) respectively. The prognosis was better than the 5-year survival rate of gastric cancer patients with D(2) lymphodenectomy (33.3%). Early diagnosis and treatment are effective to prevent complications, enhance quality of patient's life, and prolong the survival.

Objective: To investigate the variants of middle colic artery (MCA) and ileocolic vein (ICV) and their influence on the deci-sion regarding approach of laparoscopic right hemicolectomy. Methods: We analyzed the diagnosis and treatment of one right colon cancer patient with variant MCA and ICV who was admitted to the Tianjin Medical University Cancer Hospital in March 2018. The pa-tient underwent laparoscopic right hemicolectomy via a limited medial approach after a multidisciplinary treatment (MDT) discussion. Following were the observation indicators: 1) surgical and postoperative recovery situations; 2) postoperative pathological examina-tion; and 3) follow-up situation. Results: 1) Surgical and postoperative recovery situations: the patient successfully underwent laparo-scopic right hemicolectomy via a limited medial approach. No intraoperative or postoperative complications occurred. Duration of postoperative hospital stay was 11 days. 2) Postoperative pathological examination: the number of dissected lymph nodes was 39. Postoperative pathological tumor stage was pT3N0. Postoperative pathological tumor type was moderately differentiated adenocarci-noma. 3) Follow-up situation: the patient was followed-up for 10 months with disease-free survival. Conclusions: Individual and stan-dard surgery will be the best choice for treating colon cancer patients. MDT can facilitate clinical decision-making and benefit patients.

Nuclear emergency medical rescue is one of the important courses of military medical professional education, and improving the training level of nuclear emergency medical rescue plays a very important role in improving post competency of trainees. Based on the problem of disconnection between "teaching" and "need" in the occupational education of nuclear emergency medical rescue in the past, this study proposes the curriculum goal of "the combination of three abilities" and performs the optimization and practice of the occupational education curriculum system of nuclear emergency medical rescue from the aspects of curriculum setting, curriculum content, teaching methods, and assessment and evaluation. The results show that the new curriculum system can significantly improve the comprehensive ability of nuclear emergency medical rescue among trainees and better meet the requirements for their posts, thereby playing an important role in cultivating high-quality military medical talents in nuclear emergency medical rescue.

Mice ; Animals ; Humans ; Disease Models, Animal