Objective To study 18F-FDG PET/CT and enhanced CT in the evaluation of resectability of pancreatic cancer.Methods The 18F-FDG PET/CT and enhanced CT images of patients with pancreatic cancer were analyzed and the results in assessing resectability were compared.The diagnosis of pancreatic cancer and resectability were confirmed by intraoperative findings and histopathology.Results 31 patients with pancreatic cancer underwent surgery.Complete resection of the tumor was successfully carried out in 18 patients.Palliative operations were performed in the remaining 13 patients because the tumors were unresectable.The sensitivity,specificity and accuracy for unresectabilitywere 94.4％,15.3％,61.2％ using enhanced CT,94.4％,38.4％,70.9％ using 18F-FDG PET/CT,and 88.8％,53.8％,71.3％ using a combination of these two examinations,respectively.There was no significant difference between enhanced CT and 18 F-FDG PET/CT.A combination of these two examinations was significantly better than either one of these examinations.Conclusions Either enhanced CT or 18F-FDG PET/CT was useful,and they complemented each other in assessing resectability of pancreatic tumor.A combination of these two examinations was more evaluable than either one of these examinations.

Epidermal Growth Factor ; therapeutic use ; Humans ; Recombinant Proteins ; therapeutic use ; Tympanic Membrane ; injuries ; Tympanic Membrane Perforation ; drug therapy

Objective To analyze the surgical treatment of pancreatic duct stones.Methods The clinical data of 46 patients with pancreatic duct stones treated in our hospital from January 2008 to January 2013 were retrospectively analyzed.Results The most common symptoms were abdominal pain in 42 patients,diarrhea in 4 patients,diabetes in 6 patients,increased level of amylase in 4 patients,high level of CA19-9 in 9 patients and concomitant pancreatic cancer in 5 patients.4 patients had history of acute pancreatitis.All patients were diagnosed with pancreatic duct stones by preoperative imaging.The stones were located in the head of the pancreas in 21 cases,in pancreatic body and tail in 17 cases,and in the whole length of the pancreas in 8 cases.7 cases had single stone,28 cases had 2 to 3 stones,and 11 cases had more than three stones.21 cases had stones with a maximum diameter more than 1.0 cm,and 25 cases with a maximum diameter less than 1.0 cm.Pancreatic lithotomy plus pancreaticojejunostomy was performed in 33 cases,pancreatoduodenectomy in 8 and resection of the body and tail of pancreas plus splenectomy in 5 cases.6(13.0％) patients had postoperative complications,and there was no mortality.3(6.5％) patients had postoperative residual stones.39 cases were followed up with follow-up time ranging from 3 months to 57 months.Pain relief rate was 85.7％,Stone occurred in 2 (4.3％) patients.Conclusions Surgery is an important treatment for pancreatic duct stones,and treatments should be adopted based on the situations of individual patients.

Objective To investigate the feasibility and safety of surgical device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary.Methods A total of 45 patients diagnosed as doubly committed sub-arterial ventricular septal defect (dcVSD) with transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE) were enrolled from June 2014 to August 2016 in Henan Children Heart Center,Henan Provincial People's Hospital.There were 39 males and 6 females,with the mean age of (2.2 ±2.1) years old(0.5-8.0 years),the body weight (13.8 ± 7.1) kg(7.0-34.1 kg),the defect size (4.5 ± 1.0) mm (3.0-8.0 mm).After general anesthesia,the patients were in supine and evaluated by TEE which indicated whether they were fit to closure.Then,they were turned to the right lateral position while this technique was determined.A vertical incision of 2-3 cm was made between the third and the fifth intercostal space and invasion in thoracic space via fourth intercostal space.Puncture was done at the anterior surface of right ventricular outlet tract to build a delivery tract.The occluder was released and the VSD was occluded under transesophageal echocardiography guidance.Results Forty-one patients had a successful surgical dcVSD closure with asymmetric occluders sized (6.0 ± 1.5) mm(4-10 mm).Among 4 failure cases,2 cases (4.4％) were switched to open-heart surgical repair,1 case (2.2％) due to device related aortic regurgitation,the rest 1 case (2.2％) experienced a dislocation of occluder into pulmonary artery and was converted to surgical repair after retrieve of occluder.Trivial residual shunt was detected in 2 cases (4.4％) postoperatively,a spontaneous closure was observed by 1 month follow-up and 3 months follow-ups,respectively.All the patients were discharged 5 to 8 days after the operation.With a follow-up of (10.4 ±5.0) months [3-24 months],there were no complications such as pericardial effusion,displacement of device,atrioventricular block or new valvular dysfunction.Conclusions Minimally invasive device closure of doubly committed sub-arterial ventricular septal defect via left sub-axillary is a feasible and safe treatment for closure of dcVSD.This technique has advantages of minor wound,less exudation,covert incision,however,long term follow-up is necessary.

By silica gel column chromatography, solvent extraction and preparative high performance liquid chromatography (HPLC), four new related substance were isolated and purified from the mass production and preparation process of alogliptin benzoate. Then it was analyzed and confirmed by various spectrum identification methods such as nuclear magnetic resonance (NMR) spectroscopy, high-resolution mass spectrometry (HR-MS) and Fourier-transform infrared spectroscopy (FTIR) according to its physical and chemical properties. The chemical structures of the four related substances produced in each step of the synthesis process of alogliptin benzoate were determined, and they were named as impurities L, M, T, and V. These four related substances were new impurities which were found for the first time. The isolation and identification of these impurities are of great importance to the quality control of alogliptin benzoate, and the optimization of manufacturing process.

Objective: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. Results: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18–0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03–0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. Conclusion Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.

Objective:To investigate the effect of polyethylene glycol combined with simethicone on boston bowel preparation scale(BBPS) score and tolerance in patients with colonoscopy.Methods:From January 2018 to January 2019, 220 patients who underwent colonoscopy in Beijing Shijitan Hospital Affiliated to Capital Medical University were selected as the research objects.According to different bowel preparation schemes, they were divided into control group and observation group, 110 cases in each group.In the control group, 4 bags of compound polyethylene glycol electrolyte powder were added with cold boiled water to prepare 4 L solution for intestinal preparation.Starting 6 hours before endoscopy, 1 L solution was taken every hour, and the interval from the last time to the beginning of colonoscopy was≤4 h. On the basis of the control group, the observation group was given 30 mL simethicone emulsion 4 hours before endoscopy on the basis of the control group.The BBPS score, intracavitary liquid volume score, total score, tolerance and adverse reactions were compared between the two groups.Results:The whole colon score (7.16±0.61), left colon score (2.89±0.62), transverse colon score (2.78±0.64) and right colon score (1.58±0.49), intestinal cavity fluid score (1.47±0.48) and total score (8.84±0.87) of the observation group were higher than those of the control group ((5.13±0.76), (2.23±0.86), (2.15±0.76), (1.14±0.16), (0.91±0.55), (7.11±1.04)), and the differences were statistically significant ( t=21.854, 6.532, 6.652, 8.957, 8.054, 13.380, all P<0.05). The tolerance of the observation group (90.00%(99/110)) was higher than that of the control group (81.81%(90/110)), but the difference was not statistically significant( χ 2=3.043, P=0.081). The incidence of abdominal distension in the observation group (1.82%(2/110)) was lower than that in the control group (8.18%(9/110)), the difference was statistically significant(χ 2=4.690, P<0.05), and there was no significant difference in the incidence of electrolyte disorder, nausea and vomiting, hypoglycemia or hunger, palpitation and chest tightness between the two groups (all P>0.05). Conclusion:The application of polyethylene glycol combined with Spanish silicone oil in intestinal preparation can improve the intestinal cleanliness of patients, but does not increase the tolerance of patients compared with polyethylene glycol alone, but significantly reduces the incidence of abdominal distension.

Objective To summarize the outcomes and the median follow －up finding of stage 1 surgical approaches of coarctation of aorta(CoA)combined with cardiac anomalies.Methods A retrospective study was per-formed for summarizing the operative and follow－up finding of 82 patients(40 males and 42 females)of CoA combined with cardiac anomalies,who underwent stage 1 repair from February 2013 to December 2016 at the Department of Cardio-vascular Surgery,Henan Provincial People's Hospital.The operative age was ranged from 1 month to 8 years old[mean (11.92 ± 22. 51)months]and the weight was (7.31 ± 6.79)kg. Forty －five cases had ventricular septal defect (VSD)or atrial septal defect (ASD).Septal defect and patent ductus arteriosus were found in 31 patients.CoA was associated with aortic arch hypoplasia in 5 patients.Complex cardiovascular deformity was found in 7 cases.The surgical methods included end－to－end anastomosis,end－to－side anastomosis and patch augmentation of the coarctation seg-ment.Results Seven patients died after operation,3 cases of them died of low cardiac output syndrome amd circulatory failure,1 case died of circulatory failure and respiratory failure,1 patient died of malignant arrhythmia,and 2 cases died of respiratory failure.Postoperative echocardiogram suggested that anastomosis maintained patency in all the patients. The follow－up time was 8 months to 4 years,63 patients were followed up,and follow－up rate was 77%.No death or aneurysm occurred during follow－up period.Recoarctation was found in 5 cases.Conclusions Stage 1 repair for CoA combined with cardiac anomalies is effective,and has low complications during postoperative and median follow－up period.Long－term results need further study.

Objective To analyze the etiological characteristics of human Brucella strains isolated, and to improve the precision in control and prevention of brucellosis. Methods In 2016, blood samples were collected from patients in Jingyuan County Gansu Province, and tested via the Rose-Bengal Plate Agglutination Test (RBPT) and the tube agglutination test methods,and serological positive blood samples were inoculated to bidirectional blood culture bottle for culturing, and further identified by traditional biological classification method and the Brucella abortus, Brucella melitensis, Brucella ovis, and Brucella suis species-specific PCR (AMOS-PCR). Multiple-locus variable number tandem repeat sequence analysis (MLVA) -16 was used to detect molecular typing and do cluster analysis. Results The isolated strain was identified by the traditional biological classification method, bacteria could grow in thionine and reddened dye, A and M factors agglutination tests were positive, Bk2phage treatment of bacterial strain cracking, but Tb, Wb phages were not cracked. AMOS-PCR amplification result showed a 731 bp band, which was a strain of Brucella melitensis. The results of MLVA-16 showed that there was a difference in the number of repeats on some Variaable Number of Tandem Repeat(VNTR)sites of the isolated strain. Clustering analysis showed that, the isolated strain was clusted into the same clade with the clustering of Brucella melitensis type 3 from GS-201605 in Gansu. And the clustering was similar compared with that of Zhejiang, Guangdong, Fujian and Yunnan. Conclusion Human brucellosis is a inputting transmission in Gansu Province, there is a genetic variation of genotype 3 sheep Brucella between Gansu Province and other domestic provinces.