Objective To analyze and compare the effect of early minimally invasive surgical treatment and conventional treatment for patients with severe acute pancreatitis.Methods According to the including criteria,eight randomized-controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed and analyzed by using Revman 4.2 software.Results Compared with conventional treatment,early minimally invasive surgical treatment was associated with a significantly lower incidence of mortality(RR=0.35,95%CI:0.20～0.63,P

Objective To evaluate the efficacy, safety, and patient acceptance of a vacuum-assisted, hand-held biopsy device(Mammotome) in minimally traumatic percutaneous removal of multiple breast masses in female patients under real-time ultrasound guidance. Methods Forty-three women with 99 low-risk multiple palpable masses were involved in the study. Forty-one breast lesions with the diameter between 9 and 20mm, and 58 with the diameter between 21 and 33mm, were removed by the aid of a vacuum-assisted, hand-held biopsy device with 11-gauge or 8-gauge probes. The pathological examination and follow-up evaluation were performed after the procedure. Results The imaged lesions were completely removed successfully from 27 patients and 16 patients using the 8-guage probe and 11-gauge probe, respectively. Most of the lesions were proved to be breast fibroadenoma by pathological examination. No evidence of recurrence was found by physical examination and the ultrasound evaluation during the follow-up period. Most patients were satisfied with the incision, postoperative breast appearance, and the procedure results. Conclusions Minimally traumatic percutaneous removal of palpable benign breast masses using the Mammotome system with ultrasound guidance is feasible, safe, and yields high patient satisfaction.

Objective To analyze and compare the effect of early surgical treatment and nonsurgical treatment for patients with severe acute pancreatitis.Methods Acccording to the including criteria,five randomized controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects,results of the studies were reviewed and analysed by using Revman 4.2 software.Results Compared with nonsurgical treatment,early surgical treatment was associated with a significantly higher(incidence) of mortality(RR 3.42,95% CI 1.81～6.47,P=0.0002) and complications(RR 3.16,95% CI 2.15～4.64,P

Objective To study the effect of fragile histidine triad (FHIT) gene on pancreatic adenocarcinoma cells growth and tumorigenicity and explore the mechanism of FHIT gene in suppressing the deve lopment of pancreatic adenocarcinoma. Methods By the method of liposome transfection, pRC/CMV FHIT plasmid was transfected into 1990 cell lines which lose all of FHIT gene. Integration and expression of exogenous FHIT gene were confirmed by RT PCR and Western blot technique. 1990 pFHIT cell growth was observed in regular culture medium and tumorigenicity in nude mice. Its DNA was analyzed by electrophoresis. Results The growth of the cells transfected with FHIT gene (named as 1990 pFHIT cells) was suppressed significantly, and the tumorigenicity of the 1990 pFHIT cells was dramatically inhibited in nude mice as compared with that of the parental 1990 cells. Significantly increased apoptosis in 1990 pFHIT was found. Conclusions The growth and tumorigenicity of pancreatic adenocarcinoma cell can be inhibited by transduced exogenous FHIT gene. It's spectulated that FHIT suppress the development of pancreatic adenocarcinoma by the path of apoptosis.

Objective To discuss the clinical value of u ltrasound-guided stereotactic biopsy and excision using the Mammotome system in the treatment of benign breast lesions. Methods A retrospecti ve analysis was made on the efficacy of ultrasound-guided Mammotome biopsy and e xcision in the management of 61 patients clinically diagnosed as having benign b reast lesions between October 2001 and October 2002. Results T he lesions were histologically confirmed as fibroadenoma in 51 patients and mast opathia in 10 patients. The operative time was 20.6?4.1 min. All procedures w ere performed smoothly. Of the 61 patients, no infection or breast deformity occ urred on short-term follow-up examinations (1 month) except for mild subcutaneou s hemorrhage in 3 patients, and no obvious scarring was seen on long-term follow -up (2 years). Recurrence was found in only 2 patients. Conclusions Treatment of benign breast diseases by the Mammotome system can offer comp lete excision of the lesion, minimal invasion, a low recurrence rate, and good c osmetic outcomes.

Objective To explore the application of case-based discussion combined with translational medicine teaching method in clinical teaching of gastrointestinal surgery.Methods Totally 100 undergraduates of clinical medicine in grade 2007 and 100 undergraduates in grade 2008 from the second military medical university were divided into experimental class (50 students,25 in discussion class and 25 in comprehensive class) and control class (50 students).Method of case-based discussion was applied in discussion class; method of case-based discussion combined with translational medicine was employed in comprehensive class and traditional method was used in control class.Results Scores in experimental class were superior to those in control class ; questionnaire survey showed that 90％ students thought the new model was better than the traditional model; the interests of students in exploring clinical problem in experimental class were increased (90％ vs.50％ ) ;the sense of mission and responsibility was Strengthened (86％ vs.64％ ) ;the scientific research thinking was more active (80％ vs.48％ ) ; the individual ability and quality were enhanced (76％ vs.50％ ),the depth and width of study were markedly increased (80％ vs.52％ ),the consciousness of independent study and thinking was strengthened (88％ vs.54％ ).Comprehensive class had more obvious improvements in scientific research thinking,individual ability and quality,depth and width of study,independent study and thinking.Conclusions The new teaching model which combined translational medicine with case discussion breaks through the traditional model and adapts to the requirements of modem medicine,it can enhance the teaching effect and worth promoting in educational reform.

Objective To compare the clinical efficacy of different doses of ultrafine extracted granule preparation (EGP) and traditional herbal decoction (THD) of Li Zhong Tang in treatment of epigastric pain. Methods Sixty cases of epigastric pain patients in accordance with the diagnostic criteria of deficiency and cold pattern of spleen and stomach in TCM were randomly divided into THD group, 1/3 dose group and 1/5 dose group, and were given THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP, respectively. The clinical efficacy of the three groups after one course of medication was comparatively analyzed. Results There were no significant differences in age, course of disease, symptom score before treatment, epigastric pain efficacy and syndrome curative effect among the three groups, the differences had no statistical significance (P>0.05). The severity, frequency and duration of epigastric pain were all reduced in the three groups, with significant differences between before and after treatment (P<0.05). Conclusion There are no significant differences in the clinical efficacy on epigastric pain among THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP. In addition, the effect of 1/3 dose group is very close to the THD group.

Objective To establish the method and assess the safety，feasibility and clinical efficacies of percutaneous transhepaticcontrast-enhancedcholangio-ultrasonography(PTCECUS).Methods Twenty-one patients aged(58.5±16.65)years(range 27-93)with biliary obstruction or stricture underwent percutaneous transhepatic cholangiodrainage or ch01ecystodrainage.A dose of more than 50 ml of 0.94% Sono Vue(Bracco，Itay)solution was injected into their bile ducts(n=17)and cholecysts(n=4)through the drainage catheter.Their biliary tracts，cholecysts and duodenums were scanned under contrast pulsed sequencing mode(CPS，Sequoia 512，Siemens)to achieve related contrast-enhanced ultrasonograms.Severity of biliary obstruction were assessed according to the PTCECUS findingswith a comparison toconventionalultrasonography(CVUS)，magnetic resonance cholangiopancreatography(MRCP)and percutaneous transhepatic cholangiography(PTC)in a part of the patients.Results①PTCECUS gave rise to good-quality contrast-enhanced uhrasonograms of biliary tracts.②PTCECUS was superior to CVUS and in consistence with MRCP and PTC in evaluating the severity of biliary tract obstruction.This method helped to make a proper design for biliary drainage.③PTCECUS was more efficient than PTC in that PTC had the patients receive transhepatic puncture and cholangiography in separated departments.④Neither any complications immediate from transhepatic puncture and administration of SonoVue inall the 21 patients，nor those 1 to 8 months late during ultrasound follow up in 14 patients were found.Conclusions PTCECUS，characterized in bettering the display of biliary tracts，especially the severity of obstruction of biliary tracts，is safe through the procedure and valuable in supervising biliary drainage against obstructive jaundice.

0.05).After treatment for 7 days,TNF-a and IL-6 levels decreased in the medication groups(P

Objective:To evaluate the inhibitory effect of intraperitoneal sustained-release chemotherapy with 5-FU on the growth of H22 ascitic tumor in mice.Methods: Mouse H22 ascitic tumor model was established by intraperitoneal injection of(0.2 ml) H22 ascitic cells(4?10~(6)cells) and the animals were subsequently divided into 4 groups randomly, namely,the saline control group(received saline),peritoneal chemotherapy group(received common 5-FU),sustained-release chemotherapy group(received sustained-release 5-FU),and negative control group(received control sustained-release agent).The survival times of the mice were recorded in all groups.The apoptosis rates of H22 ascitic cells were analyzed with flow cytometry 9 and 12 days after injection of H22 cells and the proliferation index was calculated.Electron microscope was used to observe H22 cells 12 days after peritoneal injection.Results: The average survival time of peritoneal chemotherapy group([13.7?1.7] d) was significantly shorter than that of sustained-release chemotherapy group([15.3?2.0]d)(P