Surgical treatment has improved the prognosis of resectable pancreatic cancer considerably de-spite the generally aggressive behavior of its malignancy. Neoadjuvant therapy for pancreatic cancer has been shown effective in improving a survival benefit. Few prospective randomized controlled clinical trials (RCTs) on the use of neoadjuvant chemotherapy and chemoradiation has been done tp show the survival advantage of systemic chemotherapy (5-FU/FA or gemcitabine) following surgical resection. Up to now, there is no high-level evidence of any benefit deriving from neoadjuvant chemo therapy for pancreatic cancer. Well designed trials are needed to compare neoadjuvant chemotherapy with surgery to judge the value of neoadjuvant cherqo-therapy in multimodal treatment concepts of pancreatic cancer.

Thyroid carcinoma is the most frequent endocrine cancer,and most are found in women.Different pathologic types of thyroid carcinoma has different biologic behaviors,and onset is hidden,which results in difficults to diagnose the early thyroid carcinoma.With the development of the molecular biology,more researches are focus on thyroid carcinoma in recent years.This article reviews the tumor markers,oncogene and gene therapy of thyroid carcinoma.

Objective To summarize the sonographic features and the diagnostic value of transvaginal three dimensional OmniView sonography for congenital uterine malformation. Methods Thirty-six patients who were suspected as uterus septus on transvaginal two-dimensionalultrasound (2D US) were examined by transvaginal three dimensional ultrasound (3D US) of OmniView. The coronal plane images were acquired. The fundus,cavity and cervix of the uterus were analyzed. The depths of fundal cleft were measured.In comparison with the test results of hysterosalpingography (HSG), hysteroscopy, hysteroscopy combined with laparoscope or magnetic resonance imaging (MRI), the sonographic features and the diagnostic value of transvaginal three dimensional OmniView sonography were summarized. Results Among the 36 cases underwent transvaginal three-dimensional ultrasound (3D US), 16 cases were diagnosed as incomplete septate uterus, 5 cases as complete septate uterus, 5 cases as arcuate uterus, 4 cases as bicornuate uterus, 4 cases as gemini and 2 cases as unicornuate uterus. The results of all 36 cases were confirmed by surgery or magnetic resonance imaging (MRI). The sonographic features of transvaginal three dimensional OmniView sonography:(1) Twenty-one septate uterus had convexes (in 12 cases) or minimally depressed fundus (in 9 cases, depth of cleft ≤ 1.0 cm) and had Y-shaped (16 incomplete septate uterus without septum extending into cervix) or V-shaped cavity (5 complete septate uterus with septum extending into cervix). (2) Five arcuate uterus had an obtuse angle at the central point of septum. (3) Four bicornuate uterus had fundal depression more than 1.0 cm and were divided into two cornuas. (4) Four gemini had two complete uterus and cervix. (5) Two uterus unicornis had single endometrial and smaller than normal. Conclusions Transvaginal 3D OmniView sonopgraphy of uterine may display a good coronal plane, on which the relationship of the cavity and the fundus, the depth of fundal cleft and the angle at the central point of the septum can be well depicted and measured. It is a practical, reliable and noninvasive method, and superior to 2D US in the diagnostic classification of complex uterus malformation.

Objective To explore the expression of Ki 67 in 72 cases of breast cancer and to analyze the correlation of Ki67 expression with clinicopathological factors and efficacy of neo-adjuvant chemotherapy .To as-sess the prediction value of Ki 67 in selecting neo-adjuvant chemotherapy .Methods Ki67 expression in tumor tissues of 72 cases of breast cancer was detected before and after neo-adjuvant chemotherapy .Tumor tissues are a-chieved by core needle biopsy .Results Ki67 overexpression was found in those with axillary lymph node ( ALN) metastasis, in pathological stage III and tumor diameter >2 cm(P＜0.05).Ki67 expression was not significantly associated with age(P>0.05).Objective response(OR)rate of neo-adjuvant chemotherapy was 84.2%(61/72). Patients with Ki67 over-expression were more sensitive than those with lower-expression(P>0.05).Positive ex-pression rate of Ki67 was reduced significantly by neo-adjuvant chemotherapy(P＜0.05).Positive expression rate of Ki67 was reduced significantly in pathological complete response ( PCR ) group, clinical complete remission (CCR)group and partial response(PR)group.Conclusion The expression of Ki67 may be a potential predictive biomarker for neo-adjuvant therapy response in patients of breast cancer and can provide the basis for individual therapy for breast cancer .

Asthma is the most common chronic inflammatory airway disease in childhood. Adhering to a daily anti-inflammatory treatment is the most important cornerstone of bronchial asthma control. However,with the large number of clinical studies conducted in recent years,learning inhaled corticosteroids as an anti-inflam-matory drug of choice,there is a mixed compliance rate of inhaled corticosteroids in children. Standard treatment and control of asthma has yet to be further improved. This review discusses the medication adherence to long-term inhaled corticosteroid as well as the relevant aspects of research progress.

In this paper 100 cases of renal space-occupying lesions which had been examined before operation by sonography and verified by surgery and pathology were analysed retrospectively. Results showed 99 cases of renal space-occupying lesions and 1 case of retroperitoneal tumor. There were 2 eas-es of false negative and 1 case of false positive for the localization by ultrasound.Nephromas were found to be 92.92%(92/99)totally.in which rnalignant and benign tumors were 86.96%(80/92)and 13.04%(12/92)respectively.5 cases of misdiagnosis and 2 cases of pitfall in qualitative analysis were iden-dried by pathology.The rate of accuracy was 92%(92/100).

0.05).The comparison of operating time and hospital stay was not performed due to insufficient data.Conclusion:Relative small J-pouch and straight anastomos is provided similar early results after low anterior resection.Both of these methods were proved to be safe and effective.

Objective:To explore the safety profile of telmisartan based on the data from the literatures on its adverse drug reactions(ADRs).Methods:The literatures about clinical data of ADRs of telmisartan from 2004 to 2008 in China, collected by the databases of China Hospital Knowledge Database,Wanfang Data and VIP Information,were reviewed. Results:Of 1197 patients receiving telmisartan,95(7.94%) had ADRs involving six systems such as nervous system, cardiovascular system,gastrointestinal system,musculoskeletal system,and so on.The ADR incidences of oral 40 mg?d~(-1) administration and 80 mg?d~(-1) administration were respectively 5.29%(31/586) and 8.96%(42/469) and only 1 case (0.08%) was forced to stop his or her medication due to serious ADRs.Conclusion:Telmisartan was generally safe,and was generally well tolerated for its low incidence of adverse reactions,and therefore,there was no need to interrupt the treatment.The recommendation dose was locked in 40 mg?d~(-1).In clinical application of telmisartan,special attention should be paid to the ADRs of the nervous system and cardiovascular system.It is necessary to closely observe the serumal potassium level and orthostatic hypotension.

OBJECTIVE To investigate the prevalence of metallo-?-lactamase in carbapenem-resistant clinical Pseudomonas aeruginosa isolates.METHODS Sixteen strains of P.aeruginosa isolated from Tianjin General Hospital during 2005-2006 which were resistant to all tested antibiotics besides carbapenem were studied.The general PCR was adopted to amplify the resistance genes of matallo-?-lactamae.Restriction endonucleases performed restriction analysis were used to certify the type of genes of matallo-?-lactamase by different endonuclease recognition site.RESULTS Two of the 16 clinical strains of P.aeruginosa(named P02 and P16) were confirmed bearing IMP-1 metallo-?-lactamase gene detected by PCR amplification and restriction analysis.CONCLUSIONS P.aeruginosa producing IMP-1 metallo-?-lactamase is the major type in our hospital.The hydrolyzing effect of the metallo-?-lactamase is not the main machanism in these carbapenem-resistant P.aeruginosa isolates.