Objective To compare the clinical effects of palliative drainage to pancreatic and periampullary carcinoma which could not be excised with the operation.Methotis A retrospective study was accomplished on the palliative drainage treatment of 68 patients with pancreatic and petiampullary carcinoma hospitalized from 1996 to 2003.Results The disease course was two days to eight months.A definite preoperative diagnosis was made for 64 cases.Among them.single test diagnosed 24 cases and multiple tests diagnosed 40 cases.56 patients suffered from jaundice before operation.34 patients were treated by Roux-Y choledochojejunostomy.Choledochoduodenostomy was performed in 16 patients,cholecystduodenostomy for biliary by pass Was performed in 8 patients and stented internal drainage of the biliary duct in the liver and duodenostomy was performed in 10 patients.After reducing jaundice,12 patients was performed surgical resection.The second operation was performed in 4 patients because of postoperative jaundice and in 3 patients because of pylofic obstruction.The pefioperative compllcations include 4 cases of jaundice pyloric,3 cases of obstruction,2 cases of postoperative bleeding and 5 cases of infection of incisional wound.The aver-age stay in hospital waa 13.3 days(8～22 days).Conclusion Multiple tests were helpful to make a definite preoper-ative diagnosis.The selection of palliative drainage method based on the condition of patients had good curative effect in clinic.Surgocal exploration and reducing jaundice could set win conditions for second operation.

Objective To observe the clinical features of 575 patients with cardiac diseases from the First Affiliated Hospital of Shantou University Medical College,and to get a preliminary understanding of the incidence of cardia cancer in high incidence area of Chaoshan cardia lesions.Methods Recorded the clinical data of the patients with pathological changes of gastric cardia diagnosed in the First Affiliated Hospital of Shantou University Medical College from 2007 to 2011.Analyzed the distributions of these patients by sex,age and pathological changes.Results There were 575 cases with all kinds of pathological changes of gastric cardia enrolled in this hospital,including 16.34% of chronic inflammation,3.3% of low grade intraepithelial neoplasia,2.26% of high grade intraepithelial neoplasia and 78.09% of gastric cardia cancer.Most patients were gastric cardia cancer.Trend χ2 test results showed that the numbers of gastric cardia cancer patients increased with age(P =0.000).The prevalence of pathological changes of gastric cardia in males was obviously higher than that in females.In gastric cardia cancer the ratio of male to female was 4.76∶1.Conclusion Most of the patients with gastric cardia pathological changes admitted in the First Affiliated Hospital of Shantou University Medical College are middle -aged and elderly men,and gastric cardia cancer is common with a higher frequency in males than that in females.

Objective To investigate the clinicopathological features of gastric cardia cancer with neuroendo-crine cell differentiation(NED).Methods From September 2007 to October 2014,the clinicopathological features of 70 gastric cardia cancer patients with NED and 76 cases without NED confirmed by surgical pathology specimens and immunohistochemistry (Syn and CgA)in the First Affiliated Hospital of Shantou University Medical College were ret-rospectively analyzed and compared.Results The positive expression rates of synaptophysin(Syn)and chromogranin A(CgA)were 43.2% and 22.6%,respectively.Tumor differentiation was significantly related with NED (χ2 =4.989,P =0.026).Tumors with NED were larger and had deeper invasion,but they were not statistically significant. Conclusion Immunohistochemistry is important to the diagnosis of NED.Gastric cardia cancer with NED has poorer differentiation.

Objective: The incidence and mortality of gallbladder cancer from Chinese cancer registries in 2014 were analyzed to describe the prevalence of gallbladder cancer in China. Methods: Incidence and mortality data of gallbladder cancer in 2014 derived from registration data in 2017, collected by the National Central Cancer Registry (NCCR). Qualified data from 339 cancer registries were calculated after evaluating. According to the national population data of 2014, the gallbladder cancer incidence and mortality of China in 2014 were stratified by the area, gender and age.The age composition of standard population of Chinese census in 2000 and Segi′s population were used for age-standardizes incidence and mortality in China and worldwide. Results: 339 cancer registries cover a total of 288 243 347 population including 146 203 891 males and 142 039 456 females (144 061 915 in urban and 144 181 432 in rural areas). The mortality to incidence ratio of gallbladder cancer was 0.74. The morphologically verified cases (MV%) and death certificate-only cases (DCO%) were 48.38% and 2.66%, respectively. Unclear diagnosis cases (UB%) was 0.48%. The crude incidence of gallbladder cancer in China in 2014 was 3.82/100 000, which accounted for 1.37% of new cancer cases (4.48/100 000 in urban areas and 3.01/100 000 in rural areas, 3.59/100 000 for male and 4.05/100 000 for female). Age-standardized incidence rates by Chinese standard population (ASR China) and world standard population (ASR world) were 2.38/100 000 and 2.37/100 000, respectively, and the cumulative incidence rate (0-74 age years old) was 0.27%.Besides, the crude mortality of gallbladder cancer was 2.86/100 000 (3.47/100 000 in urban areas and 2.12/100 000 in rural areas, 2.59/100 000 for male and 3.14/100 000 for female). Age-standardized mortality rates by ASR China and ASR world were 1.72/100 000 and 1.71/100 000, with a cumulative mortality rate (0-74 age years old) of 0.19%. Conclusion The incidence and mortality of gallbladder cancer were significantly different between the city and country, while not obviously different between the female and male.