Several minimally invasive techniques were used to treat infection secondary to pancreatic and (or peri-pancreatic) necrosis recent years,including percutaneous catheter drainage (PCD),endoscopic transluminal treatment,min-incision surgery,video-assisted minimally invasive technique and laparoscopic surgery.We should grasp the indication of each technique.PCD/ endoscopic transluminal surgery usually acted as initial therapy.Open surgery is still effective,and acts as a rescue operation when minimally invasive techniques fail.

Acute Pancreatitis Classification Working Group published Classification of Acute Pancreatitis-2012:Revision of the Atlanta Classification and Definitions by International Consensus in 2012,which redefined the diagnosis,severity,local complication,local infection of acute pancreatitis (AP).Under the guidance of revised Atlanta classification (RAC),the constituent ratio of severe acute pancreatitis (SAP) decreases significantly,which is between 3.7％ ～ 25.4％,and less than 10.0％ is reported in most researches.The mortality of SAP is between 10.0％ ～ 52.9％,and more than 20％ is observed in most publications.The constituent ratio of mild severe acute pancreatitis (MSAP) is between 10.9％ ～ 40.1％,the mortality is between 0 ～ 4.8％,and the incidence rate of organ failure is between 4.6％ ～ 34.0％.The percentage of patients with SAP who need ICU care and surgery intervention is higher than that of MSAP,and the total hospital stay of SAP are longer than that of MSAP.RAC could better reflect the severity and predict the outcome of AP than Atlanta classification published in 1992,but RAC also has some potential limitations.For example,the “local infection” is not included in this classification.This paper veviewed the relavent issues.

Objective To explore the effect of radiofrequency catheter ablation( RFCA) on cardiac reverse remode-ling and improvement of life quality in cardiomyopathy patients with paroxysmal atrial fibrillation( PAF) . Methods 95 cardiomyopathy patients with PAF were enrolled in our study and divided into two groups. RFCA group:62 patients received circumferential pulmonary vein isolation, ( left ventricular end-diastolic ) LVEDD ≥55 mm (male), LVEDD ≥50 mm (female); Drug group:33 patients were treated with drug for controlling heart rate ( resting heart rate around 60~80 bpm, heart rate during daily activity <100 bpm) . 72 hours after admission or 6 months after surgery in RFCA group, when the heart rate returned to normal or 6 months after treatment in Drug group, Short-Form36(SF-36) was used to evaluate the quality of living in the patients respectively; transthoracic echocardiography was performed in sinus rhythm;LAD, LVEDD and LVEF of the patients were measured. Results in RFCA group, LAD and LVEDD of 62 patients reduced and LVEF increased in 6 months after surgery statisti-cally significant(P<0. 05). In Drug group, 6 months after treatment, LAD and LVEDD of 33 patients increased ( P<0. 05 ) , without significant change in LVEF. There was no statistical significance in psychological health, physical function and general health perceptions, but there was significant improvement in social function and phys-ical function,affective state, physical role and energy in both RFCA group and drug group (P<0. 05), and it was more obvious in RFCA group(P<0. 05). Conclusion RFCA can reverse cardiac structural remodeling via sinus rhythm maintenance and improve the quality of life in cardiomyopathy patients with PAF.

Objective To evaluate the situation of blood concentration detection in Zunyi city by the way of analyzing the practice of blood concentration detection for the past 4 years .Methods The bood samples of 194 928 persons who were voluntary blood donators since full implementation of centralized blood test from February 2011 to December 2014 were analysed .Results The unqualified rates of the 5 detection indicators from the seven blood center banks were closed to the centre blood station ,which was rang from 3 .15% to 4 .85% ,the total unqualified rate was 3 .72% and no significant difference was found(P> 0 .05) .Since the concentration of blood detection ,blood donators in the 7 blood center blood banks increased year by year .Conclusion Blood concen-tration detection improves the blood test quality in this single region ,and promotes the development of blood donation career .

Objective To study the regional anatomy of the cavernous sinus for skull base surgery.Methods Continuous thin sections on coronary plane were performed with freezing milling technique on an head specimen from March 2008 to November 2011.After segmenting,labeling and extracting in a seraial sections,we finished the three dimensional reconstruction of the cavernous sinus.Results Three hundred and ninety thin coronary sections were obtained.The related structures were described in six typical sections.The cavernous sinuses were located on each side of the sphenoid sella.The sinus connects to the superior orbital fissure below and lateral to the anterior clinoid process,opens into the basilar sinuses lateral to the dorsum sellae.The four main spaces within the sinus,identified by their relation to the carotid artery,were the medial,the anteroinferior,the posterosuperior compartments and the lateral space.The four spaces were located differnently and communicate with each others in three dimensional images.Conclusion Combination of coronary section anatomy and three dimensional reconstruction can display the anatomical characters of the s cavernous sinus.The 3D models are video films that continuously and dynamically display anatomic structures in 3D space at different velocities.

ObjectiveTo investigate the effects of sleep deprivation on expressions of Mir-132,mir-134 in the different regions of rat brain.MethodsAll the male SD rats were divided into control group ( normal sleep group),sleep deprivation (SD).The modified multiple platform method (MMPM) was used to establish sleep deprivation model.Mir-132,mir-134 level was detected by real time PCR.ResultsMir-132 were significantly increased in SD groups in hippocampus compared with the control groups ( 51.87 ± 8.13 vs 67.25 ± 7.59 ) (P ＜0.01 ).Mir-134 were significantly decreased in SD groups compared with the control groups( 1.82 ±0.15 vs 1.45± 0.12 )(P ＜ 0.01 ).There were no statistically significant differences in cortex and thalamus (P ＞ 0.05 ).Cortex mir-132 level in SD group and control group was 1.57 ±0.10,1.48 ±0.11 respectively,and it was 1.37 ±0.09,1.36 ±0.11 in thalamus;Cortex mir-134 level in SD group and control group was 98.26 ± 5.17,100.80 ±4.15respectively,and it was 97.56 ± 6.28,91.01 ± 4.07 in thalamus.ConclusionThe upregulation of mir-132 and downregulation of mir-134 implies that two miRNAs did opposite actions in the processes of sleep deprivation.This findings indicate that hippocampus mir-132,mir-134 levels in the SD rat may reflect associated depressive patho-physiological processes.

OBJECTIVETo investigate the clinicopathological characteristics, diagnosis and treatment of primary testicular yolk sac tumor (YST).

METHODSWe studied 8 cases of primary testicular YST by microscopy and immunohistochemistry.

RESULTSThe 8 cases of primary testicular YST, including 2 consultation cases, were confirmed from 1998 to 2013, accounting for 10.7% (8/75) of all the testicular germ cell tumors diagnosed in our hospital. The patients ranged in age from 7 to 43 years, 23.9 years on average. The main clinical manifestation of the patients was painless unilateral testis swelling. Microscopically, reticular tissues, schiller-duvaI (S-D) bodies, and eosin-stain transparent bodies were seen in the tumors. One of the cases was confirmed to be simple YST, while the other 7 mixed YST. AFP was a characteristic immunophenotype marker of the tumors.

CONCLUSIONPrimary testicular YST is a rare malignancyr with poor prognosis. Its diagnosis depends on preoperative AFP test and postoperative pathology. Comprehensive treatment, including orchiectomy, chemotherapy, and radiotherapy, can prolong the survival of the patients.

Adolescent ; Adult ; Child ; Endodermal Sinus Tumor ; metabolism ; pathology ; therapy ; Humans ; Immunohistochemistry ; Male ; Neoplasms, Germ Cell and Embryonal ; metabolism ; pathology ; therapy ; Orchiectomy ; Rare Diseases ; metabolism ; pathology ; therapy ; Testicular Neoplasms ; metabolism ; pathology ; therapy ; Young Adult

Objective To observe the therapeutic efficacy of Tian Yuan acupuncture method in treating liver cancer pain and its effect on quality of life (QOL) and adverse reactions. Method A total of 108 patients with liver cancer were randomized into an observation group and a control group, with 54 cases in each group. The observation group was intervened by Tian Yuan acupuncture method, while the control group was intervened by the three-step analgesic ladder recommended by the World Health Organization (WHO). The clinical efficacies, changes in Visual Analogue Scale (VAS) and QOL, and the occurrence of adverse reactions in the two groups were observed. Result The total effective rate in the observation group was significantly higher than that in the control group (P<0.05); the VAS and QOL scores showed improvement after treatment in both groups and the improvements in the observation group were more significant than those in the control group (P<0.05); adverse reactions occurred in both groups, and the occurrence rate was 25.9％ in the observation group, significantly lower than 53.7％ in the control group (P<0.05).Conclusion Tian Yuan acupuncture method can produce significant clinical efficacy in treating liver cancer pain. It can effectively improve the symptoms of cancer pain and enhance the QOL.

Objective To investigate the appropriate method in diagnosing precursor lesions of pancreatic cancer and its treatment. Methods From Jan. 2006 to Dec. 2007, 92 cases were operated for pancreatic neoplasms. Among them 7 cases had pancreatic precursors. The mucinous cystic neoplasm was found in 1 case, intraductal papillary mucinous neoplasm(IPMN) in 2 cases, endocrine tumor in 1 case and pancreatic intraepithelial neoplasia (PanIN) in 3 cases. CA19-9 level was tested by immunoflucence assay. All of the 7 patients were examined by CT. Endoscopic ultrasound(EUS) and endoscopic retrograde cholangio-pancreatography examinations were performed on 1 and 2 patients respectively. Results There was neither specific symptom related to these precursors nor any evidence of mass as revealed by CT or ultrasound. But dilatation and stricture of pancreatic duct were found in PanIN patients, and cystic dilatation of pancreatic duct in pancreatic head was present more in IPMN patients. For cystic neoplasms in pancreatic body and tail, they were commonly solid and isolated. CA19-9 level was slightly elevated in some patients but with no diagnostic value. Surgical resection was done with excellent result. Conclusion For the suspected pancreatic precursors, aggressive diagnostic approach and surgical resection will be the best option and can further prevent cancer development.

Objective To develop an efficient and rapid method to synthesize 68 Ga?DOTA?TATE, and to perform PET/CT imaging on neuroendocrine tumor (NET) bearing mice and one patient. Methods 68GaCl3 was eluted by 0.05 mol/L HCl in 68 Ge?68 Ga generator, then added to pre?adjusted DOTA?TATE buffer, and heated for 15 min at 85 ℃, then filtered with 0.22 μm microfiltration membrane. The radiochemical purity and in vitro stability of 68 Ga?DOTA?TATE were analyzed with radio?HPLC. The biodistribution and PET/CT imaging on HT?29 colon cancer xenografts mice model were performed. After approved by Peking University Cancer Hospital Ethics Committee, a case of NET patient received 148 MBq 68 Ga?DOTA?TATE intravenous?ly, followed by a whole?body scan at 60 min post?injection. Results 68 Ga?DOTA?TATE was prepared in high radiochemical purity (>98%) and with specific activity of 55 GBq/μmol in 25 min. The tracer showed excellent in vitro stability and no acute toxicity. PET/CT imaging on mice model showed positive uptake in tumor tissues. PET/CT imaging on one NET patient showed positive uptake of 68 Ga?DOTA?TATE in primary and metastases lesions. Conclusions A rapid, high radiolabeling yield and high specific activity method to prepare 68 Ga?DOTA?TATE is established. 68 Ga?DOTA?TATE could be specifically uptaken by somatostatin receptor ( SSTR) positive NET with high affinity. It could serve as a useful tool for early diagnosis of SSTR positive NET and has clinical prospective for somatostatin?mediated targeting therapy.