Objective To explore the clinical features,diagnosis and treatment of solid-pseudopapillary tumor(SPT)of pancreas.Methods The clinical data of 19 patients with SPT treated in 8 years were studied retrospectively,included 3 males and 16 females.Results The type of operation was decided by the size and location of tumor.Pancreatic leakage was a familiar complication,there were 9 cases.Patients were followed up from 3 to 70 months,and no recurrence or metastsis was found.Conclusion Pancreas SPT is a rare type neoplasm of pancreas.Pancreas SPT is affecting primarily young women,complete resection results in excellent prognosis.

Objective To investigate the teaching effects of Sandwich teaching mode applied in clinical oncology teaching.Methods Totally 72 clinical medicine undergraduates were divided into two groups randomly:Sandwich teaching group and traditional teaching group.Sandwich teaching mode was introduced to Sandwich teaching group while traditional teaching mode was carried out in traditional teaching group.Questionnaires and test paper were analyzed between the two groups and two teaching modes were evaluated.Examination results were statistically analyzed by t test.Results According to the questionnaires,more than 80 percent of the students thought that the initiative and enthusiasm were fully mobilized by the Sandwich teaching mode.Studying efficiency was improved significantly and skills of independent thinking,comprehensive analysis and problem-solving were trained,meanwhile,Sandwich teaching mode can improve the ability of expression and communication.Test score of students in Sandwich teaching group was higher than those in traditional teaching group (P＜0.05).Conclusions Sandwich teaching mode has obvious advantages in improving teaching quality of clinical oncology and it may help to cultivate high quality oncology specialists.

Objective To design and formulate price evaluation indexes for medical services and develop a framework of indexes for the comprehensive evaluation of price formulation and implementation for medical services so as to provide government departments with management and decision-making tools with regard to prices for medical services.Methods The theories and methods of the sciences of medicine,economics,statistics,prices,and evidence-based medicine were used to develop by means of the Delphi method an evaluation model and a framework of price evaluation indexes for medical services.Results The framework developed could well evaluate the following items in price formulation and implementation for medical services: the management goals of the government,the quality of medical services in the hospital,work efficiency,cost control,economic benefits,and the involvement and satisfaction of the citizens.Conclusion It is absolutely necessary to develop a framework of price evaluation indexes for medical services.The framework developed in the present study is able to meet the current needs of price evaluation for medical services.

Objective:To explore and evaluate the application of flipped classroom in the integrated curriculum of pathology and pathophysiology overview.Methods:This study included in 172 students from the 8-year program of clinical medicine of Batch 2016 (observation group), and 142 students of Batch 2014 (control group). The observation group adopted traditional classroom teaching combined with flipped classroom teaching, and the control group used only traditional classroom teaching. In the observation group, the teaching contents were redesigned in the form of flipped classroom. The relevant knowledge points were provided before class. Group discussions and in-class presentations were used in the teaching. And the cultivation of students' learning autonomy, interaction and innovation were emphasized. The teaching evaluation was obtained from the questionnaire survey and final exam performance of the two groups of students. SPSS 21.0 was used for t test. Results:Students in the observation group had high satisfaction with flipped classroom which was helpful to improve students' independent learning ability, oral expression ability and innovative thinking ability. However, there was no significant difference in the final exam scores between the two groups ( P=0.306). Conclusion:Flipped classroom teaching can improve students' interest in learning and stimulate their independent learning and innovation. However, the teaching effect evaluated only by the final performance can't reflect the superiority of flipped classroom, which should be assessed by more evaluation indexes.

OBJECTIVE This study is to investigate the effects on nasopharyngeal carcinoma cell lines(CNE-2Z)induced by As2O3 and its possible mechanisms.METHODS CNE-2Z cells were treated with various concentrations of As2O3 for different times.The IC50 values were detected by trypan blue stain assay to choose the optimal concentration of As2O3.Cell cycle redistribution was analyzed by flow cytometry.The expression levels of p16、 RASSF1A、DNMT 3B mRNA were assessed by RT-PCR.RESULTS The suppression of cell proliferation by As2O3 was time and dose-dependent.After being treated with different concentration of As2O3,the IC50 values of As2O3 were(1.50?0.05),(1.09?0.13),(0.65?0.04)?mol/L at 24,48,and 72h,respectively.As2O3 also arrested CNE-2Z cells in G2/M phase of cell cycle.After CNE-2Z cells being treated with As2O3,the expression of RASSF1A mRNA were up-regulated(P

Objective To investigate oxycodone hydrochloride injectio in treatment of postoperative laparoscopic cholecystectomy and its effects on analgesia and levels of 5-hydroxytryptamine(5-HT),nitric oxide(NO),substance P(SP).Methods 90 patients of underwent laparoscopic cholecystectomy who received therapy from August 2013 to August 2016 in Hangzhou Tvaditional chinese Medical hospital were selected and randomly divided into observation group and control group,45 cases in each group.Before incision,the observation group were gived intravenous oxycodone hydrochloride injection 0.1mg/kg,the control group were gived intravenous sufentanil 0.2μg/kg.The changes of anesthesia,postoperative pain,adverse reactions and 5-HT,NO and SP after operation were compared between the two groups.ResultsThere was no significant difference in the anesthesia time,operation time,spontaneous breathing recovery time,wake up of time between two groups,after postoperative two,four,24 h,the scores of incision pain,visceral pain in the observation group were lower than the control group,the difference was statistically significant(P<0.05).After the operation,the levels of 5-HT,NO,SP of two groups were changed,the difference was statistically significant(P<0.05),but the results in observation group were lower than the control group,the difference was statistically significant(P<0.05),the total incidence of postoperative adverse reactions in observation group were lower than the control group,the difference was statistically significant(P<0.05).Conclusion Oxycodone hydrochloride injection is well for laparoscopic cholecystectomy,which can effectively reduce the release of 5-HT,NO,SP,relief of postoperative pain,high security.

Purpose:To investigate effect on bcl-2 and bax expression in apoptic PGCl_(3) cells and to study the mechanism of apoptosis of PGCl_(3) cells induced by death associated protein kinase(DAPK).Methods:Eukaryotic express vector pcDNA3.1-DAPK was tranfected into High-metastasis Non-small Lung Cancer Cell PGCl_(3).Changes of bcl2 and bax expression were detected with RT-PCR.Phospharation of Bcl-2 was examined with Westernblotting.Results:It was demonstrated that bcl-2 expression was down regulated,but bax expression did not change in apoptosis of PGCl_(3) cells induced by DAPK.Level of Phospharation of Bcl-2 increased.Conclusions:Apoptosis of PGCl_(3) cells induced by over-expression of DAPK may be associated with down regulating of bcl-2 expressio and increase of phospharation of Bcl-2.

Background and purpose:Thyroglobulin antibody (TgAb) is often positive in papillary thyroid carcinoma (PTC) patients. This study aimed to investigate the effect of TgAb on radioiodine ablation efficacy in PTC patients.Methods:A total number of 329 PTC patients with no distant metastasis were included and classified into 2 groups[G1 group (>115 U/mL,n=84) and G2 group (<115 U/mL,n=245)], G2 group was further divided into 2 subgroups[S1 (>40 U/mL,n=31) and S2 (<40 U/mL,n=214)], before131I ablation. The median follow-up time was 24 months after a total or subtotal thyroidectomy and subsequent131I ablation. The efficacy in terms of131I ablation success rates (IBR) between two groups were compared and the influencing factors were analyzed according to criteria posed by 2015 American Thyroid Association Guidelines, then the effect of131I dose on IBR was also explored.Results:Female and younger age were more prevalent in patients with high TgAb (P<0.05). The G1 group presented lower IBR over the G2 group (35.7%vs 72.7%,P=0.000). Moreover, S1 group also presented lower IBR over S2 group (54.8%vs 75.2%,P=0.017), indicating the adverse effect from high titer TgAb on IBR. No matter high or low dose, the G1 group presented lower IBR (34.1%vs 71.9%, 37.2%vs 73.2%;P=0.000). However, IBR did not differ in G1 or G2 group either with high or low dose131I (P>0.05). TgAb was the only adverse indicator correlating with IBR in multi-logistic regression analysis (P=0.018).Conclusion:TgAb could negatively affect131I ablation efficacy, while increasing the dose of131I failed to improve the success rate in such cases.

0.05). ② The Fo in groups 2 and 3 were (5.0?1.5) and (5.2?1.5) respectively, which were significantly lower than that in group 1 (6.1?1.2)(q=4.690, 3.383, P

ve In order to improve the reliability of somatosensory evoked potentials (SSEP) monitoring during anesthesia, we compared the effects of three commonly used volatile anesthetics on SSEP to choose suitable volatile anesthetic and determine the appropriate end-expiratory concentrations which have least effects on SSEP monitoring. Methods Sixty ASA I - II patients undergoing elective intracranial surgery were randomly divided into three groups: group A received enflurane; group B isoflurane and group C desflurane. The demographic data including age, body weight, height and sex were not significantly different between the three groups. In addition to SSEP, ECG, BP, SpO2, PET CO2 and end-tidal concentration of inhalation anesthetic were monitored. The SSEP electrodes were placed on N13 on the neck and N20 on the scalp. Before experiment the patient was asked to lie quietly for 10 min, then the patient started breathing 100% O2 and fresh-gas-flow (FGF) was set at 5 L/min. Median nerve on one side was stimulated and SSEP waves from cortex and cervical spinal cord were recorded as baseline tracing before anesthesia. The concentration of inhalation anesthetic was gradually increased from 0 to 0.3, 0.5, 0.75, 1.0 and 1.5 MAC. Each concentration was maintained for 15 min and SSEP waves were recorded. During experiment if the patient developed respiratory depression, oral airway was inserted and assisted ventilation was performed to maintain PETCO2 at 35-45minHg. If the patient developed hypotension, fluid was infused at an increased rate and vasopressor was given if necessary to maintain normal BP (baseline ? 20 % ) . Results The three volatile anesthetics did not change N13 latency and amplitude. Increasing concentrations of enflurane, isoflurane and desflurane were associated with graded reduction in N20 amplitude and increase in N20 latency and N13-N20 interpeak latency. Conclusions The results suggest (1) cortical SSEPs are moresensitive to the volatile anesthetics than subcortical SSEPs, (2) end-tidal concentration of enflurane less than 0.75 MAC is compatible with effective SSEP monitoring, whereas the end-tidal concentration of isoflurane or desflurane compatible with effective SSEP monitoring was less than 1.0 MAC. Enflurane has greater effect on SSEP than isoflurane and desflurane.