Most of the pancreatic cancer was diagnosed at advanced stages and the resection rate was only 10％-20％.Vascular invasion was a common event in the pathogenesis of pancreatic cancer.However,in the traditional view,vascular invasion is a contraindication of pancreatic resection.With the development of surgical techniques and perioperative management,radical resection of pancreatic cancer with vascular resection and reconstruction was performed in some large centers.Preliminary results suggested that this procedure could increase the resection rate and 5-year survival to 26％-46％ and 20％ respectively,without increasing morbidity and mortality.Radical resection of pancreatic cancer with vascular resection and reconstruction was a safe and effective method for the surgical treatment of advanced pancreatic cancer,which should be performed by experienced pancreatic surgeons.

Objective To study the diagnostic significance of the gray degree of lip-around and facial edge skin on the spleen-stomach symptoms.Methods With the International ColorCheck,160 cases of facial digital images were got from physical examination groups.The gray degree of the upper and lower lip-around and facial edge skin were judged.Questionnaires of spleen-stomach symptoms were also collected from the people.Results Logistic results showed that the dark upper lip-around skin were closely related with dry mouth,stomach pain,etc; the dark lower lip-around skin were closely related with hiccups,etc; the dark facial edge skin were closely related with bloating- afternoon,bad-breath,vomiting,cool-stomach,the thick white fur and so on.Conclusion The gray degree of lip-around and facial edge skin implied the status of the spleen and stomach function,which could be used as diagnostic indicators for spleen and stomach symptoms.

More than 25％ pancreatic cancers are locally advanced and unresectable.For patients underwent pancreatectomy,about 80％ of patients had pancreatic cancer recurrence in 2 years.The aim of palliative treatment for locally advanced and metastatic pancreatic cancer is to relieve the disease-associated symptoms,including biliary obstruction,duodenal obstruction,and intractable abdominal pain.Surgical strategies,such as palliative resection (R1 resection ),biliary drainage and gastroenterostomy have been widely used.During recent years,neoadjuvant chemotherapy and radiation have been recommended as the palliative treatment of choice for patients with locally advanced and metastatic pancreatic cancer.However,The controversy still exists.This article summarized current data of surgical and non-surgical strategies for the treatment of locally advanced and metastatic pancreatic cancer.

Objective To determine the growth differential factor 15 (GDF-15) in CMS rat model, investigate the significance of GDF-15 in CMS and the relationship between GDF-15 and hepcidin. Methods 32 rats of CMS model were taken as experimental group (EXP), the other 16 rats fed in Xining (CON) were taken as control group. The mRNA and protein expression levels of GDF-15 were detected respectively. Results Compared with that in CON group, the level of mRNA and protein of GDF-15 were significantly higher in EXP group (P<0.01). GDF-15 and EPO had correlation in EXP (r=0.397, P=0.031), but had no correlation with serum hepcidin in EXP (r = -0.224, P = 0.218). Conclusion GDF-15 can promote CMS and represent erythrocytosis, while GDF-15 has no inhibition to the expression of hepcidin.

The 48th annual meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago from June 1-5 2012 and the risk-adapted therapy of multiple myeloma (MM) was discussed.MM is a heterogeneous disease and all patients should be accepted risk-adapted therapy. According to cytogenetic abnormalities, MM patients are divided into three groups,standard risk, intermediate risk and high risk.Patients with standard risk may received 4 cycles Rd regimes (lenalidomide plus low dose dexamethasone) or VCD regimes (bortezomib,cyclophosphamide,dexamethasone) for induction therap.Patients with intermediate risk may received 4 cycles VCD regimes for induction therapy.Patients with high risk may received 4 cycles VRD regimes (bortezomib,lenalidomide,dexamethasone) for induction therapy.After induction treatment,patients can received autologous hematopoietic cell transplantation or consolidation/maintenance therapy. The determination of which patients are eligible for autologous hematopoietic cell transplantation according age,comorbidities and performance status.

Multiple myeloma is a malignancy of plasma cells and renal function impairment is one of common complications of multiple myeloma.Light-chain deposition in renal tubules which induces renal tubular disease is the major pathogenesis of renal impairment.The renal function impairment should be estimated based on glomerular filtration rate in multiple myeloma patients. Bortezomib with high-dose dexamethasone is effective to myeloma patients with renal impairment and improves renal function.Treatment experience of thalidomide is limited,but it can be used at the standard dosage to patients with renal failure.Lenalidomide is effective and can reverse renal impairment of several myeloma patients when this agent is used at reduced doses according to renal function.

Based on the practive of traditional allogeneic hematopoietic stem-cell transplantation therapy allo-HSCT and the development of nonmyeloablative conditioning, a new immunotherapy for solid tumor nonmyeloablative allo-HSCT, has been initiated. The nonmyeloablative,preparative regimens are associated with the use of lower dose of drugs,and less treatment-related toxicities. Instead of achieving maximal tumor reduction, the regimens are disigned to induce adequate immunosuppression to permit the engraftment of donor hematopoietic stem cells and serve as the platform for the administration of donor T cell in adoptive cell therapy. Donor's T-cell mediates a graft-versus-tumor(GVT)effect. This response is effective for the eradication of acceptor's tumor cell. This article reviews the concept, rationale, early clinical results, and limitation of nonmyeloablative allo-HSCT as a novel immunotherapy in solid tumors.

Human telomerase reverse transcriptase(hTERT),a catalytic subunit of telomerase,is highly expressed in a vast majority of cancer cells,but not in most normal adult cells,which makes it a broadly applicable molecular target for cancer immunotherapy.T cell epitope-based vaccines make use of T-cell epitopes from tumor antigens,and have its own unique advantages in cancer immunotherapy.The T-cell epitope peptide vaccine derived from hTERT can efficiently evoke specific cytotoxic T lymphocytes(CTL) responses,and has exhibited its anti-tumor effect in vivo in mice.Now it has already been put into experiment on human beings and displayed a good application prospect.

Many complex symptoms are observed in multiple myeloma and the most common symptom is bone damage, decreased renal function, increased infection susceptibility, anemia and peripheral neuropathy. Moreover some patients have other accompanying disease, such plasmacytoma and amyloidosis.Symptoms in multiple myeloma are the important basis for initiating anti-myeloma therapy. This paper is to review the pathophysiology of the complication of multiple myeloma and its treatment.

To assure the quality and safety of nuclear medicine imaging,quality control for the imaging equipment is essential.Quality control consists of a series of special tests for assurance and adjustment of equipment accuracy according to specific standards.The development and status of quality control and the standards for nuclear medicine imaging equipment are investigated and reviewed in this study.The results show that the quality control and feasibility of the standards are both in need of improvement in China.