Objective To study the method of surgical treatment for patients with postpancreatic vascular invasion by pancreatic head carcinoma. Methods 25 patients with pancreatic head cancer and 1 with recurrent duodenal carcinoma with postpancreatic vessels involved by malignancy were treated by radical pancreatoduodenectomy with involved vascular resection(RPDIVR). Results There was no operation death in the 26 patients.Of the 26 cases, 4 had pancreatic fistula and 2 bile fistula postoperatively, but no vascular complication occurred. All of the 26 patients were followed up for 2.5-6.5 years( median time 4.5 years) and the average survival time was 56 months with 96.1%,88.4%, and 57.5% of 1,3,5 year survival rate. Coclusions (1)Colour Dopper imaging is a more useful and practical method in the preoperative examination of the vessels involved by malignancy. (2)When the postpancreatic vessels are involved by pancreatic head carcinoma, the rational treatment is RPDIVR. RPDIVR is a useful, safe, and an effective method and can improve the 5 year survival.

0.05), and both groups got ideal clinical effect. Conclusions MGHSV is an ideal operation for various types of duodenal ulcer, which with a preferable long-term effect. It is worth to be widely applied in clinical practice.

Objective To investigate the pathogenic constitution of thyroid nodular diasease and it' s di-agnosis and treatment.Methods A retrospective analysis was performed on data of 576 patients accepted hospi-tal therapy with thyroid nodular diasease from January 2004 to June 2008.Results Definite diagnosis of all easeswere made by surgery biopsy or fine needle aspiration-cytology.529 eases were benign lesions, another 47 eases were malignant lesions.Condusions Ultra-sound , FNAC and frozen sections have important value in differenti-al diagnosis for the thyroid nodules, nodular goiter is most common, and which have a close relationship with thy-roid carcinoma.Regular surgical resection would reduce the recurrence of thyroid nodular diasease and avoid missed diagnosis for thyroid carcinoma.

Objective To investigate the minimal persistent pigment dose (MPPD)of normal skin to UVA in Guangzhou city,and to observe its relationship to sex,age,skin type,seasons,ITA,and the years lived in Guangzhou.Methods 316 healthy subjects were exposed to Solar 601-300,and the MPPD was measured and observed by two professional technicians after 2-3 hours.Results The average MPPD value of all subjects was (9.61±2.57) J/cm2.In male and female,the average MPPD values were (11.09 ± 2.82) J/cm2 and (9.01 ± 2.20) J/cm2 respectively,and male was significantly higher than female (P＜0.01).There was significant difference of the MPPD value in different seasons (P＜0.01).The MPPD value in winter (10.66± 2.71) J/cm2) was significantly higher than spring (9.37±2.39) J/cm2,summer (9.53±2.66) J/cm2 and autumn (8.98±2.25) J/cm2.There was significant difference of the MPPD value between different ITA groups (P＜0.01).ITA grade-3 (10.72± 2.84) J/cm2 was significantly higher than grade-1 (8.50±1.45) J/cm2 and grade-2 (9.12±2.31) J/cm2 (P＜0.01),but there was no significant difference from grade-4 (11.87±2.73) J/cm2 (P =0.93).The MPPD value in subjects lived in Guangzhou over 10 years (8.97± 1.88) J/cm2 was significantly lower than those whose residence was less than 1 year and from 1 to 5 years,respectively (P＜0.01),but there was no significant difference from those lived from 5 to 10 years (P =0.47).Conclusions The MPPD value of the subjects in Guangzhou is related to gender,seasons,ITA grade and the years lived in Guangzhou city,while there is no correlation with age and skin types.

Objective To investigate the operation technique, feasibility and clinical outcome of endoscopic clearance of axillary lymph node with liposuction(E-ALNC) in 32 patients with breast cancer. Methods From January 2005 to December 2008, a total of 32 patients with breast cancer were treated with E-ALNC.The clinical data of the patients were analyzed retrospectively and compared with those of 46 patients who have undergone traditional axillary lymph node clearance(T-ALNC)during the same period. Results Both groups were Ⅰ～Ⅱ breast cancer. There were no interim open surgery, massive bleeding, subcutaneous emphysema,fat embolism and other complications in E-ALNC. There was no significant difference between E-ALNC and T-ALNC in lymph number removed(15.5 in E-ALNC) and operation time(80 min in E-ALNC). But there was less bleeding (380ml) and lower postoperation complication rate in E-ALNC. Conclusions The E-ALNC and T-ALNC can have the same effect in the breast conserving surgery.The method makes patients attain a physiological and psychological minimal invasiveness. Besides assuring the quality of axillary lymph node clearance, the method can reduce the occurrence of surgical complication and improve the patients'life quality. E-ALNC can replace the routine surgery and can be carried out in the qualified hospitals.

A 38-year-old woman presented with a 20-year history of yellow papules and band-like atrophy on the right neck. The lesions developed slowly and were asymptomatic. There was no history of long-term sun exposure or family history of similar diseases. Skin examination revealed multiple irregularly sized yellow papules and plaques on the right anterior neck following cleavage lines, multiple pin cap-sized perifollicular papules on the posterior right neck. Well-defined band-like atrophic patches with fine wrinkling were observed in the whole right neck, giving an aged appearance. The skin of the left neck was nearly normal. Pathological examination of biopsy specimens from the yellow papules showed a normal epidermis, scant lymphohistiocytic and melanophage infiltrates around the vessels in the superficial dermis without solar degradation. The collagen bundles in the mid dermis were slightly thickened and arranged tightly in parallel to the skin surface with the absence of inflammatory infiltrate. Verhoeff-van Giesen's staining confirmed a nearly complete absence of elastic fibers in the mid dermis as well as obvious swelling and breakage of resident scant elastic fibers. Von Kossa's staining was negative. Based on the above findings, the diagnosis was made as unilateral mid-dermal elastolysis.

Objective To investigate the minimal erythema does (MED) of normal skin to UV in Guangzhou city,and to observe its relationship to sex,age,skin type,seasons and the years lived in Guangzhou.Methods 621 healthy subjects were exposed to Solar Simulator (GS2004) and the MED was measured and observed by two professional technicians after (24±2) hours.Results The average MED value of all subjects was (1170.2±333.2) mJ/cm2.In male and female group,the average MED values were (1132.8-339.4) mJ/cm2 and (1182.1 ± 330.7) mJ/cm2,respectively,and there was no significant difference between male and female (P=0.20).The MED value in subjects aged from 30 to 50 (1014.7 ± 359.7) mJ/cm2 was significantly lower than those aged from 20 to 29 (1222.9±304.3) mJ/cm2 and over 50 years (1179.0±374.3) mJ/cm2 (P＜0.01).The MED value in skin type Ⅱ (673.53±228.3) mJ/cm2 was significantly lower than those in type Ⅲ (1224.3±254.2) mJ/cm2 and Ⅳ(1363.1±278.5) mJ/cm2(P＜0.01).There was significant difference of the MED value between different seasons (P＜0.01).The MED value in spring (969.2±355.8) mJ/cm2 was lowest,and followed by summer (969.2± 355.8) mJ/cm2.However,there was no significant difference between autumn and winter (P＞0.05).The MED value in subjects lived in Guangzhou from 5 to 10 years was significantly lower than those whose residence time was from 1 to 4 years and over 10 years,respectively.Conclusions The MED value of the subjects in Guangzhou is quite different from other cities of China,and related to age,skin types,seasons and the years lived in Guangzhou city,while there is no correlation between MED value and gender difference.

Tumor-associated macrophages (TAMs) are the most abundant innate immune cells in tumors, which generally exhibit anti-inflammatory M2 phenotypes, and are the key inducers of tumor development, metastasis and drug resistance, and thus becoming a popular target in the field of antitumor immunotherapy.The study and application of nanocarriers optimize TAMs-targeted antitumor therapy.According to the characteristics and functions of TAMs, modulation strategies based on TAMs are elaborated, including TAMs depletion, inhibition of TAMs recruitment and TAMs repolarization.At the same time, in order to apply the above strategies more efficiently and overcome the general off-target problems in treatment, specific TAMs-targeted therapies based on nanocarriers are reviewed and analyzed, including passive targeting to TAMs, active targeting to macrophages and specifically active targeting to M2-TAMs. Finally, based on the limitations of targeting TAMs alone, new therapeutic strategies of targeting both TAMs and tumor cells via nanocarrier based delivery systems are introduced to provide new ideas for the application of these strategies in the field of tumor immunotherapy and combination therapy with other antitumor strategies.

Objective: To analyze changes in sensitivity of clinical strains of Ureaplasma urealyticum (Uu) to 9 kinds of common antibiotics from 2017 to 2018. Methods: The results of drug sensitivity testing of clinical Uu strains, which were isolated from 19 431 patients in Laboratory of Sexually Transmitted Disease (STD) , Department of Dermatology and Venereology, The Third Affiliated Hospital, Sun Yat-Sen University from 2007 to 2018, were analyzed retrospectively. Of the 19 431 patients, 6 076 were males, and 13 355 were females. Their age ranged from 15 to 68 years. The tested antibiotics included minocycline, doxycycline, erythromycin, azithromycin, clarithromycin, roxithromycin, ciprofloxacin, sparfloxacin and levofloxacin. Results: Resistance rates of clinical Uu strains to minocycline and doxycycline gradually decreased from 10.08% and 10.42% in 2007 to 1.15% and 2.61% in 2018, respectively, while sensitivity rates to minocycline and doxycycline gradually increased from 85.88% and 87.56% in 2007 to 97.02% and 96.42% in 2018, respectively. The resistance rate and sensitivity rate of clinical Uu strains to erythromycin fluctuated greatly during 2014—2017, with the resistance rate fluctuating around 20%, and the sensitivity rate fluctuating around 50%. The resistance rate of clinical Uu strains to azithromycin dropped rapidly from 42.02% in 2007 to 8.39% in 2011, and then fluctuated slightly around 10%. However, the sensitivity rate to azithromycin increased from 8.40% in 2007 to 86.05% in2011, and remained above 80% from then on to 2018. During 2007—2018, Uu strains showed low resistance rates (10%-20%) and high sensitivity rates to clarithromycin (80%-90%) , and the resistance and sensitivity rates to roxithromycin were similar to those to erythromycin. Uu strains showed constantly high resistance to ciprofloxacin (more than 80% after 2013) and low sensitivity (persistently less than 10%) . The sensitivity rate of clinical Uu strains to sparfloxacin fluctuated around 40%, while the resistance rate was maintained below 10% after 2011. The resistance and sensitivity rates of Uu strains to levofloxacin were similar to sparfloxacin, but the sensitivity rate to levofloxacin was relatively lower, which had been maintained at about 30%. Conclusion From 2007 to 2018, clinical Uu strains maintained a relatively stable low resistance rate and a high sensitivity rate to minocycline, doxycycline and clarithromycin, a high resistance rate and low sensitivity rate to ciprofloxacin, and a low resistance rate and sensitivity rate to sparfloxacin and levofloxacin; a relatively stable low resistance rate and a high sensitivity rate to azithromycin were achieved only after 2011; the resistance rate and sensitivity rate to erythromycin and roxithromycin fluctuated greatly.

Objective:The aim of this study was to explore the perception and cognition of patients with laryngeal cancer post total laryngectomy accepted expressive writing intervention, analyze the intervention effect from the perspective of patients, and provide a basis for psychological intervention of these patients.Methods:From July to August 2021, the descriptive research method was applied to 13 patients with laryngeal cancer post total laryngectomy who had participated in the expressive writing intervention hosted in the General Hospital of Ningxia Medical University, in order to understand the patients′ perception and cognition of the intervention, and the data were analyzed by using content analysis method.Results:A total of 2 themes and 9 sub themes were extracted. Theme 1: the positive feedback of expressive writing intervention: relieve related physical symptoms and improve sleep; reduce anxiety and regulate emotions effectively; reduce psychological stress and promote positive coping; reduce stigma and improve social withdrawal; make up for lost pronunciation and clear mind. Theme 2: Difficulties and challenges in the application of expressive writing intervention: physical discomfort affects the compliance of patients, poor economic status affects the enthusiasm of patients to participate, poor social and family support affects the willingness of patients to participate, and literacy and writing habits affect the completion of participation.Conclusions:The application of expressive writing intervention promotes the psychological and social functional rehabilitation of patients with laryngeal cancer post total laryngectomy and has satisfactory effects and certain feasibility. The researchers should fully consider the influencing factors of intervention and optimize the plan in the future.