ObjectiveTo summarize the experience of the operations of pancreaticoduodenal combined trauma.MethodsClinical data of pancreaticoduodenal combined trauma in 12 cases were analyzed retrospectively.Head of pancreas with duodenal combined trauma occurred in 9 cases,body-tail of pancreas with duodenal conbined trauma in 3 cases.Diferrent operative fashion were used.ResultsPostoperative pancreatic fistula in 2 cases( 16.7％ ),were cured by continuing lower pressure suction of all cases,11 cases were cured (91.7％ ) and 1 cases died (8.3％).ConclusionOperation in time and correct operative fashion were the key of successful treatment.Three-cavity twoBlakemore Tube had a certain value.

Objective In order to study the effect of cold stress on the secretory function of rat ovary, the changes of hCG-induced progesterone and cAMP were observed and the livability of the oocytes was determined. Methods The rat luteal and granulose cells and the oocytes were cultured, progesterone and cAMP content was determined by radioimmunoassay kit (RIA kit) under 37 ℃, 0 ℃, -5 ℃, -10 ℃,-15 ℃, -20 ℃ and -25 ℃ respectively. The livability of the oocytes was determined by MTT assay. Results At -5 ℃ to -25 ℃, the content of progesterone in the luteal cells and granulose cells medium decreased compared with the control group. At 0 ℃～-25 ℃, the content of cAMP in the luteal cells and granulose cells medium was higher compared with the control. The livability of the oocytes was decreasing from -15 ℃. Conclusion Cold stress can inhibit hCG-induced progesterone secretion in the luteal and granulose cells of rats in the one hand, and can increase cAMP, decrease the livability of the oocytes in the other hand.

Objective To investigate the value of improving the prediction accuracy of near-term risk for developing breast cancer by transforming the original mammography image and fusing the different types of image features using the algorithm of machine learning.Methods The craniocaudal (CC) full-field digital mammography (FFDM) of 185 women were downloaded from the clinical database at the university of Pittsburgh medical center.Firstly,the original gray images were segmented and transformed into virtual optical density images.Then the asymmetry features were separately extracted from original gray images and virtual optical density images.Two decision tree classifiers of the first stage were trained based on the features extracted from two types of image.And the scores output from the two classifiers were used as input to train the second stage of one decision tree classifier.Leave-one-case-out method was used to validate the prediction performance of near-term risk of breast cancer.Results Using two-stage decision tree fusion method to predict breast cancer,the area under the ROC curve (AUC) was 0.9612±0.0132.And the sensitivity,specificity and prediction accuracy were 96.63％(86/89),91.67％(88/96) and 94.05％(174/185).Conclusion The features extracted from virtual optical density image have higher discriminatory power of predicting breast cancer.Fusing the two kinds of image features twice by two-stage decision tree method can help to improve the prediction accuracy of near-term risk of breast cancer.

Objective To evaluate the therapeutic effect,as well as the safety,of on-demand sildenafil on men with idiopathic ED.Methods One hundred and four men who met the diagnosis criteria of idiopathic ED were recruited into 2 groups.Among them,46 men who refused or were reluctant to take pharmacotherapy were recruited into the clinical control group with instruction of sexual knowledge and skills.Fifty-eight men who were involved in the on-demand group,were administrated sildenafil 50 mg just 1h before the coitus at thebeginning,then,if needed adjusted the dosage according to the effect and tolerance of the first four administration.The questionnaire of IIEF-5 was completed at the baseline and the end point,and the clinic total effective rate,the fully recovery rate of ED and the adverse events were also evaluated at the end of administration.Both groups were treated for 3 months.The therapeutic effect was reevaluated 1 month and 3 months later,respectively.Results After 3 months treatment,scores of IIEF-5 at the baseline and the end point for control group and on-demand group were as follow:5.2 and 12.6,4.2 and 19.8 ;and the fully recovery rate of ED for each group were as follow:12 (26.1％),56 (96.6％) ; the total effective rate for each group were 27.7％,97.2％ ; 1 month and 3 months after the end point,the fully recovery rate of ED and the total effective rate were evaluated separately,for 1 month:8 (17.4％),56(96.6％) and 19.4％,97.1％; for 3 months:7 (15.2％),55 (94.8％) and 16.4％,96.4％.The side effects in on-demand group (16,27.6％) was little higher than the control group (5,10.9％) (P ＞0.05).Most of the side effects were not only subtle and transient but also would vanish with the time.Accordingly,no one discontinued because of side effects.Conclusions Treatment of idiopathic ED with sildenafil was effective and safe.In terms of the fully recovery rate,total effective rate and effect maintenance,the on-demand group at the end point,even 1 month and 3 months after the end point,showed a great advantage over the control group.

Objective To compare the therapeutic effects with different dosages of sertraline on patients suffering from idiopathic premature ejaculation. Methods IIEF-5 and CIPE questionnaires were completed before the treatment, and 86 patients who met the diagnostic standard of idiopathic premature ejaculation were finally recruited. Subjects were administered sertraline 50 mg/d combined with behavior therapy at stage Ⅰ for 4 weeks. Then, according to the therapeutic effects and the adverse events, all of the patients were divided into 3 groups for stage Ⅱ (another 4 weeks) as ①subjects with good effectiveness but with no or slight adverse events,would continue the treatments ②subjects with no therapeutic effects and with no obvious adverse events were allowed to increase the dosage of sertraline to 100 mg/d;③patients with effectiveness and obvious adverse events were al follows:lowed to reduce the dosage of sertraline to 25 mg/d. Those who had obvious adverse events and no effectiveness quit the study. Results During stage Ⅰ , 63 of 86 patients were effective (73.3%), and 23 patients had no improvement (26. 7%). Thirty-three patients had adverse events (38. 4%), and the remaining 53 patients had no obvious adverse events (61.6%). During stage Ⅱ , of the patients that responded to treatment, 35 patients who had no adverse events and 12 who had slight adverse events continued the treatment. Furthermore, 16 with intolerable adverse events were allowed to reduce the dosage to 25 mg/d. Meanwhile, of those without improvement, 18 subjects without obviousadverse events were allowed to increase the dosage to 100 mg/d, and 5 patients discontinued the treatment. Eight weeks later, among the patients taking 50 mg/d, 47 subjects were effectively with no obvious adverse events. Among the patients taking 25 mg/d, 10 showed improvement, 6 showed no improvement, and 2 had tolerable slight adverse events. Among the patients taking sertraline 100 mg/d,8 witnessed effectiveness, 13 had tolerable adverse events and 2 discontinued the treatment, with 1 having neither effectiveness nor obvious adverse events. The adverse events rate was 21.0% and the total effective rate of 8 weeks of treatment was 80.2 %. Conclusions Sertraline administration is an effective and safe way to treat idiopathic premature ejaculation. Although the effectiveness of the individualized treatment had no obvious improvement comparing routine therapy, there was a notable reduction in the adverse events rate, which increased the patient compliance.

The Medical Healthcare Service Center,located at the Youxian District,Mianyang City of Sichuan Province,successfully rescued the people affected by the Wenchuan earthquake and the Tangjiashan barrier lake with great help from the senior hospitals.We suggest that the community healthcare service center could play an important role in emergency response system.

Objective To investigate the clinical value of chest low-dose CT (LDCT) combined with computer-aided detection (CAD) system for lung cancer screening in high risk population. Methods Two hundred and nineteen healthy candidates underwent 64-slice LDCT scan. All images were reviewed in consensus by two radiologists with 15 years of thoracic CT diagnosis experience. Then the image data were analyzed with CAD alone. Finally images were reviewed by two radiologists with 5 years of CT diagnosis experience with and without CT Viewer software. The sensitivity, false positive rate of CAD for pulmonary nodule detection were calculated. SPSS 11.5 software and Chi-square test were used for the statistics. Results Of 219 candidates ,104(47.5% )were detected with lung nodules. There were 366 true nodules confirmed by the senior radiologists. The CAD system detected 271 (74.0%)true nodules and 424 false-positive nodules. The false-positive rate was 1.94/per case. The two junior radiologists indenfifid 292(79.8%), 286(78.1%) nodules without CAD and 336 (91.8%), 333 (91.0%) nodules with CAD respectively. There were significant differences for radiologists in indentifying nodules with or without CAD system (P<0.01). Conclusions CAD is more sensitive than radiologists for indentifying the nodules in the central area or in the hilar region of the lung. While radiologists are more sensitive for the peripheral and sub-pleural nodules,or ground glass opacity nodules, or nodules smaller than 4 mm. CAD can not be used alone. The detection rate can be improved with the combination of radiologist and CAD in LDCT screen.

Objective: To study the effects of vitamin E and selenium on apoptosis and c-Myc expression in human leukemia cells. Methods: DNA gel electrophoresis and Northern blotting hybridization were used to detect the apoptosis and the expression of c-Myc gene, respectively. Human leukemia cell line HL-60 and K562 were cultured in vitro. Results: The apoptosis of HL-60 and K562 cells were induced after being exposed to vitamin E (100 ?mol/L) and selenium (8 ?mol/L) for 24 hours, respectively. In HL-60 cell line, c-Myc mRNA was down-regulated significantly by vitamin E(100 ?mol/L),but not selenium(8 ?mol/L).In contrast, the expression of c-Myc gene was repressed by selenium(8 ?mol/L) and not by vitamin E(100 ?mol/L) in K562 cell. Conclusion: Our observations suggest that c-Myc down-regulation and induction of apoptosis by selenium and vitamin E are important pathways in repressing leukemia cell proliferation.The results suggest there are different mechanisms of repressing leukemia cell proliferation for selenium and vitamin E.

Objective To investigate the difference of retinal nerve fiber layer thickness(RNFL)in opti-cal coherence tomography(OCT)under low and moderate signal strength. Methods Four hundred eyes of people aged 46~75 with clear fundus image,no obvious fundus diseases,and satisfactory optical coherence tomography were classified according to their ages and signal strength. The peripapillary and 4 quadrants of RNFL were detect-ed with OCT. Results In satisfactory OCT images ,the signal strength that reached 4/10 and 7/10 was 1.5% and 27% respectively. Under low and moderate signal strength ,the maximum thickness of RNFL was at the superior and inferior,and the minimum thickness of RNFL was at the nasal and temporal. There were no significant differ-ences in RNFL thickness under low or moderate signal strength. Conclusion RNFL results are reliable under low and moderate signal strength.

Heat stroke (HS) is a life-threatening illness characterized by core body temperatures above 40 ℃ coupled with central nervous system (CNS) dysfunction, including delirium, convulsions, and/or coma. Its morbidity has increased dramatically in the past few decades. Multiple organ dysfunction syndrome (MODS) is not only the most serious complication of HS, but also the leading cause of deaths. Understanding the pathogenesis, characteristic and advancement pattern of MODS caused by HS will have a profound effect on the clinical treatment, research and mortality decrease. The pathogenesis, injury characteristic of each system and organ, and treatment methods were summarized in this review so as to deepen the clinical recognition of this disease.