Objective To study the influencing factors and clinical characteristic of High Intensity Focused Ultrasound(HIFU) abhtion analgesic in middle-late stage pancreatic carcinoma.Methods Seventyone cases pancreatic cancer patients underwent HIFU treatment were grouped according to the pain efficacy of related influencing factors and the data was analyzed by single factor correlation analysis.The relationship between influencing factors and analgesic effect were analyzed through the pain outcome score.Results Pain score decreased ≥50％ in advanced pancreatic cancer patients occurred in ＜60 years old,Body mass index (BMI) ＜ 22 kg/m2,tumor location in the pancreatic head and neck,tumor size of 2-5 cm,and the average power of HIFU treatment ＞ 400 W,Ductal adenocarcinoma of the tumor histological type were related to the degree of pain rehef,and the difference was statistically significant (P ＜ 0.05).And fewer complications occurred after HIFU ablation.Conclusion Analysis of the relationship between the different factors and the analgesic effect in advanced pancreatic carcinoma can be used to predict the efficacy of HIFU treatment.

Objective To investigate the therapeutic effect and safety of high intensity focused ultrasound(HIFU) combined with Gemcitabine in treating unresectable pancreatic carcinoma Methods Forty one patients suffering from unresectable pancreatic carcinoma were randomly divided into two groups.The patients in experimental group(n =21) were provided with HIFU in combination with gemcitabine therapy and those in control group(n =20)received HIFU treatment alone.The effect,clinical benefit rates,changes of tumor marker carbohydrate antigen 19-9(CA19-9)and adverse reactions were compared between these two groups.The median survival time,6-month and 12-month survival rates were calculated by Kaplan-Meier method and Logrank test.Results The median survival time,6-month and 12-month survival rates were 10.22 months,76.2％(16/21) and 42.9％(9/21) in experimental group,and they were 7.43 months,50.0％(10/20) and 15.0％(3/20) respectively in control group.Among them,12-month survival rates was significantly higher in experimental group than that in control group(x2 =4.00,P ＜ 0.05).The clinical benefit rates in experimental group were significantly higher than that in control group[76.2％(16/21) vs 45.0％(9/20),x2 =4.20,P ＜0.05].But there was no significant difference on pain remission rate between the two groups(66.6％ vs45.0％,P ＞ 0.05).There was significant difference on CA19-9 after treated for 2,3,4,5 and 6 months in experimental group than that in control group(t =2.225,2.133,1.743,2.599,2.278,respectively,P ＜ 0.05)Conclusion HIFU in combination with Gemcitabine therapy is better than application of HIFU treatment alone.The former may become of the most effective treatmenffor unresectable pancreatic carcinoma.

Objective To determine the role of serum procalcitonin(PCT)and C-reactive protein (CRP)in predicting spontaneous bacterial peritonitis(SBP)in patients with liver cirrhosis combined with ascites. Methods Ninety-eight patients with liver cirrhosis combined with ascites were enrolled, including 48 cases with SBP(SBP group)and 50 cases without SBP(non-SBP group).The levels of serum PCT and CRP were compared between 2 groups.The receiver operating characteristic(ROC)curves were used to evaluate the diagnostic SBP value of PCT and CRP levels in patients with liver cirrhosis combined with ascites.Results The serum PCT and CRP levels in SBP group were significantly higher than those in non-SBP group:3.90(6.95)μg/L vs.0.50(0.43)μg/L and 20.80(11.27)mg/L vs.10.87(6.22)mg/L, and there were statistical differences(P<0.01).The ROC cures results showed that the areas under the curve of serum PCT and CRP levels were 0.924(95% CI 0.860-0.987)and 0.852(95% CI 0.777-0.926), and the optimal cut-off of predicting SBP in patients with liver cirrhosis combined with ascites were 0.81 μg/L and 13.89 mg/L. The sensitivity was 91.7% and 85.4%, and the specificity was 80.0%and 70.0% respectively.The mortality in SBP group was significant higher than that in non-SBP group:20.83%(10/48)vs.6.00%(3/50),and there was statistical difference(P<0.05).In SBP group,the serum PCT and CRP levels in death patients were significant higher than those in survival patients: 13.00 (10.90) μg/L vs. 2.50 (5.30) μg/L and 35.40 (31.22) mg/L vs. 18.05(10.15) mg/L, and there were statistical differences(P<0.01 or<0.05).Conclusions The increase of serum PCT and CRP levels can be used as an important diagnostic index for SBP in patients with liver cirrhosis combined with ascites, and has predictive value for prognosis.