Carcinoma of pancreas is the most common primar y pancreatic malignancy. Symptoms usually are nonspecific and include abdominal pain, jaundice, loss of appetite, weight loss, nausea, and vomiting. CT usually demonstrates a mass with ill-defined margins but also solid components and dil atation of the main pancreatic duct. This tumor is usually smaller and virtuall y never contains calcification. Following contrast material administration,all masses were enhanced less than the surrounding pancreas. Tumors were oval, rou nd or lobular,and is almost always locally invasive. These features can be used to differentiate carcinoma of pancreas from other pancreatic tumors.

Objective To investigate the effect of internal fixative operation with special-shaped plate on Pi- lon fracture.Methods 84 cases of Pilon fracture were treated respectively by continuous skeletal traction of calca- neus,internal fixative operation with general steel plate or Kirschner wire,or internal fixative operation with special- shaped plate.Results All the cases were followed up for 6 months to 2 years postoperatively.The rate of being ex- cellent and fine of 3 groups treated by 3 different methods was 42%,61% and 72 % separately.Conclusion Inter- nal fixative operation with special-shaped plate is a good way to treat Pilon fracture for its less complication and more recuperation and retention of function for anklebone.

Objective To explore the clinicopathological and immunohistochemical features of primary malignant pericardial mesothe- lioma.Methods Seven cases of primary malignant pericardial mesothelioma,in 4 females and 3 males,with the age ranged from 22 to 51 and a mean of 40 years old,were studied with clinicopathological,immunohistochemical and histochemical techniques,The pertinent litera- ture was also comprehensively reviewed.Results 3 biopsy specimens and 4 surgical specimens,including 2 autopsy specimens,were stud- led.The main clinical symptoms were palpitation and short breath,which were aggravated after movement.The longest course was 4 years,and the mean disease course was 12 months.The chest films demonstrated an obviously increase in heart shadow,and the pericardi- um was thickened in some cases.CT clearly showed tumorous shadow in 2 cases.The histopathologic picture showed tubular type in 2 ca- ses,papillary in 2,signet ring cell type in 1 and myofibroblast types in 2.In 2 autopsy specimens it was found that pericardium was dif- fusely thickened.In one case the tumor was metastasized to the right lung,mediastinum,and pulmonary hilar lymph node.In another case there was metastasis to right kidney.Immunohistochemical staining showed that the neoplastic cells of all cases were positive for CK5/6, calretinin,CK.vimentin and EMA,but negative for CEA.In the histochemical staining seven cases,the malignancy was positive for CI to different extent,but negative for HCL Conclusion Immunohistochemistry and histochemistry play an important role in diagnosis and dif- ferential diagnosis for primary malignant mesothelioma and other tumors in pericardium.

Objective To investigate the relationship among early parenchymal enhancement,post- gadolinium(Gd)hyperintense middle cerebral artery(HMCA),and subsequent hemorrhagic transformation (HT)in patients with hyperacute ischemic stroke.Methods Twenty-four consecutive patients with ischemic stroke who underwent MRI within 6 h[(4.3?1.4)h]of symptom onset were retrospectively reviewed.All of these patients underwent at least one follow-up MRI or non-enhanced CT study at 2 to 7 days.Post-Gd T_1WI were analyzed for parenchymal enhancement and hyperintense MCA.Gradient echo MRI and CT were used for assessment of HT.Results Ten patients developed HT on follow-up imaging (hemorrhagic group).Early parenchymal enhancement was found in 6 patients with HT(P

Lots of evidence show a correlation between air pollution and chronic respiratory diseases, of which the effect of particulate matter is the most concerned.It is the current research hotspot that respiratory diseases in both children and adults are closely related with atmospheric pollution levels.The influence mechanisms of atmos-pheric pollution on respiratory diseases include oxidative stress, inflammation, genetic damage, etc.This paper made a review of the latest advances s on the pathogenesis of chronic respiratory diseases caused by atmospheric particulates PM2.5 .

Objective To observe and assess the effect about bundles of cure Rule of three three in the treatment for residual stones after Flexible Ureteroscope.Methods 120 patients with a single stone after urinary lithotripsy were divided into two groups according to the different indwelling time.Two cases of the control group were rejected because of severe hematuria.The control group (n=58) was subjected to the regular education (drinking water 3 000 ml per day with moderate exercise);The experiment group (n=60) was subjected to the Rule of three three (drinking 3 cups of water in thc morning、midday and night,with contralateral position 30 minutes,hot towel applying and gently tapping the kidney region 30 minutes).Results The calculi discharge rate and the net rate of experiment group [86.67％ (52/60),55.00％ (33/60)] were higher than the control group [53.45％(32/58),18.97％(11/58)] 14 days after surgery.The difference was statistically significant (P ＜ 0.01).Further analysis showed that the discharge rate of residual stones in lower renal calyx in experiment group [86.67％(26/30)] was higher than the control group [32.14％(9/28)].The difference was statistically significant (P ＜ 0.01).Conclusions The bundles of cure called rule of three three can improve the discharge rate of residual calculi after flexible ureteroscope and increase the discharge rate of residual stones in lower renal calyx significantly.

Recent researches show that follicle stimulating hormone (FSH) plays an important regulatory role in the angiogenesis of ovarian cancer by influencing the level of some factors such as hypoxia inducefactor-1 ( HIF-1 ) ,vascular endothelial growth factor (VEGF). Meanwhile, recent studies report that FSH and FSH receptor(FSHR) may also participate in the angiogenesis of other solid tumors like lung cancer. FSH is closely related to the tumor angiogenesis, which provides a novel therapeutic target for anti-angiogenesis thera-py.

Objective To detect plasma concentrations of Calcitonin gene-related peptide (CGRP),endothelin (ET)-1 at different periods after subarachnoid hemorrhage(SAH),and probe the correlation of CGRP,ET-1 and the pathogenesis of cerebral vasospasm after SAH.Mehods Plasma concentrations of CGRP,ET-1 were measured in patients who were diagnosed with SAH (38 cases) at different periods (1-3 d,4-7 d,14-21 d after SAH) by radio-immunity technique.According to the occurrence of cerebral vasospasm,these patients were separated into two groups:vasospasm group(31 cases) and non-vasospasm group(7 cases).Twenty healthy persons after physical examinations were allocated to be control group.Results Compared with control group and nin-vasospasm group,the plasma concentration of CGRP in vasospasm group was obviously lower,especially in the 4-7 d time slot,and ET-1 was obviously higher,especially in the 4-7 d time slot.There were statistical differences among the three groups(P<0.05 or <0.01).Cerebral vasospasm occurred in 2 cases during 1-3 d,in 28 cases during 4-7 d and in l case during 14-2l d after SAH.Conclusions CGRP,ET-1 participate in the pathological process of SAH.The abnormality of vascular endnfhelial construction/diastolic function is correlated with delayed cerebral vasospasm.

The integration of laboratory equipment resources,integration of digital informa-tion resources and integration of management resources to the requirements of teaching guarantee were expatiated.The purpose was to introduce the latest methods of the educational technology into the education and training to make reform and innovation in training contents,methods and means by using new technologies,new equipment and new methods.

Objective To introduce the clinical significance and pathophysiologic aspects of the circulatory and cardiac complications in terminal stage cirrhosis.Methods Recently relevant literatures were reviewed and summarized.Results Haemodynamic changes in cirrhosis arose on the basis of combined humoral and nervous dysregulation,with abnormalities in cardiovascular regulation,volume distribution and cardiac performance.Conclusion Comprehending the mechanisms of cardiovascular complications will contribute a lot for the treatment of terminal stage cirrhosis.