Objective Four cases of screen epilepsy were reported Methods Clinical analysis of four cases of TV epilepsy Results Of the four cases, two had the seizures evoked by changing channel of TV set only, one evoked by watching TV, and the other had the seizure triggered by video game. The seizures of two cases showed GTCS, one case showed partial seizure with secondarily generalized seizure, and the other showed partial seizure and absence Conclusion Screen epilepsy may have several seizure types, not only have GTCS but also have partial seizure and absence.

Objective To detect the expression and potential correlation of ERK1 and P16 in gastrointestinal stromal tumor group and in control group.Methods Tissue chip and immunohistochemistry Elivison were used to detect the expression of ERK1 and P16 in 40 cases of gastrointestinal stromal tumor and 40 cases of control tissues.Quantitative analysis of mean absorbent density of the expression of ERK1 and P16 was conducted with image analytic software.Results The expressions of ERK was higher in GIST group than that in control group(P

Objective To investigate the incidence of postoperative hepatic metastasis,clinicolpathological characteristics and the prognosis for pancreatic cancer. Methods Totally 83 cases with pancreatic cancer admitted in our hospital during January 2007 to September 2012 was retro?spectively analyzed according to clinicolpathological data. Results Postoperative liver metastasis occurred in 31 cases with a metastatic rate of 37.3%. The size(χ2=9.606;P=0.002),vascular invasion(χ2=4.794,P=0.029)and UICC stage(χ2=5.318,P=0.021)were correlated with he?patic metastasis. Univariate analysis revealed the poor prognosis in pancreatic cancer patient with hepatic metastasis(χ2=9.967,P=0.002). Cox re?gression analysis revealed hepatic metastasis as an independent prognostic factor(P=0.001). Conclusion Pancreatic cancer has a high possibility of hepatic metastasis. Postoperative hepatic metastasis was one of the independent factors for the prognosis of pancreatic cancer. Tumor size,vascular invasion and UICC stages were risk factors for postoperative liver metastasis of pancreatic cancer.

Objective To compare the short-term clinical outcomes of hand-assisted laparoscopic surgery(HALS),laparoscopic-assisted surgery (LAS)and open surgery(OS)for colorectal cancer treatment. Methods The clinical data of 74 patients underwent HALS,LAS and OS for colorectal cancer treatment between October 2011 and December 2015 were assessed retrospectively. All the surgeries were performed by the same surgical team. The intraoperative details,postoperative recovery,postoperative complications,oncologic results and cost were compared among the three groups. Results A total of 24 patients in HALS group,25 patients in LAS group and 25 patients in OS group were finally included. The gen-eral data and oncologic baseline were comparable among the three groups. The comparative results showed that the operative time increase d and in-cision length shortened gradually in OS group,HALS group and LAS group(P<0.05). HALS group was favor of less number of trocars used com-pared with LAS group(P<0.05),but there was no statistical difference of the conversion rate between the two groups(P>0.05). In terms of post-operative recovery,postoperative complications and oncologic results,there was no statistical difference between the three groups(P>0.05). As for cost,the total cost and operative cost of OS group were lower than HALS group and LAS group(P<0.05),but there was no significant differ-ence between HALS group and LAS group(P>0.05). The material cost increase gradually in OS group ,HALS group and LAS group(P<0.05), and there was no significant difference on the part of other cost among the three groups(P>0.05). Conclusion HALS,LAS and OS are compen-satory with each other,and clinicians can choose the reasonable procedure according to personal proficiency and situation of patients.

BACKGROUND:Mimics software is a three-dimensional (3D) image processing and editing tool based on CT scan data. Mimics software can rebuild the data and images gotten in CT, MRI and ultrasound scans into 3D images and display on the computer screen so as to help clinicians understand the type of fracture and the relationship of the 3D structure of the surrounding tissue and to provide a great help in the development of orthopedics operation. OBJECTIVE:To explore the application effect of Mimics software 3D reconstruction on perioperative period of Pilon fracture. METHODS:This study selected 61 cases of Pilon fracture, who received the surgery in the Zhongshan City Xiaolan People’s Hospital from September 2008 to September 2013, as research objects. They were randomly divided into 3D group and control group in accordance with the time of admission. Al patients underwent anterioposterior and lateral X-ray film examination and multi-slice spiral CT scan. Patients in the control group received internal fixation according to above examination results. Patients of the 3D group, on the base of those of the control group, were subjected to internal fixation after three-dimensional entity reconstruction by using Mimics V 10.0 software. Operation time and functional curative effect in the postoperative folow-up were compared between the two groups. RESULTS AND CONCLUSION:The operation time was significantly less in the 3D group than in the control group (P < 0.05). The number of patients with excelent 6-month functional curative effect was more, and the number of patients with poor effect was less in the 3D group than in the control group. The 6-month functional curative effect was better in the 3D group than in the control group (P < 0.05). These results showed that the application of Mimics software 3D reconstruction to the perioperative period of Pilon fractures can give comprehensive assessment of the situation of fracture, optimize and improve the preoperative plan and reduce the risk of surgery, and promote the successful completion of internal fixation.

Background and purpose:Metastatic colorectal cancer (mCRC) patients with K-ras mutation won’t benefit in the anti-epidermal growth factor receptor (EGFR) treatments. Thus K-ras mutation analysis is mandatory before this treatment. There is controversy that K-ras mutation analysis should be performed on primaries or related metastases. The aim of our study was to evaluate the concordance of K-ras status between primary and related metastases tumors, thus investigate the validity and rigorousness of clinical K-ras testing. Methods:Seventy-six patients with confirmed mCRC treated in Fudan University Shanghai Cancer Center were enrolled. After DNA extraction and PCR amplification, tumor specimens with paired primary tumors and related metastatic sites were put into sequencing analysis. And the K-ras mutation status in exon 2 was assessed. Results: K-ras mutation was detected in 31 out of 76 primary tumours (40.8%) and also 40.8%of the metastatic sites. But discordance was found between primary tumor and metastasis in 15 cases (19.7%):8 primary tumors had a K-ras mutation with a wild-type metastasis, meanwhile 7 primary tumors were wild type with a K-ras-mutated metastasis. Conclusion:Our study indicated that quite a few mCRC cases have different K-ras status between primary tumors and related metastatic sites, and it’s not very rigorous to choose the anti-EGFR treatments merely according to the primary tumor-K-ras mutation.Further study and consultation are needed on this problem.

Background and purpose:Tumor budding is a poor prognostic factor in colorectal cancer. In this study, we studied the tumor budding by counting the actual number in 10 high power fields and evaluated itsclinical application in predicting lymph node metastasis of T1 colorectal cancer.Methods:Tissue specimens from 307 patients with histologically conifrmed T1 colorectal cancer were enrolled. The clinicopathological characteristics including tumor budding were evaluated for their predictive value in lymph node metastasis. A formula was created to calculate the risk score for prediction of lymph node metastasis which was validated by 14 new cases.Results:In the multivariate analysis, it showed that tumor grade, lymphovascular invasion and the number of tumor budding were signiifcantly associated with lymph node metastasis. The probability of lymph node metastasis was calculated using the following equations:Z=1.571×(lymphovascular state: invasion, 1; no invasion, 0)+2.661×(tumor grade: high grade, 1; low grade, 0)+0.024×(budding counts)-3.885; Probability=1/1+e-Z. The high scores were correlated with the lymph node metastasis in the validations.Conclusion:We can accurately assess the risk of lymph node metastasis by counting the number of tumor budding in 10 high power fields. Therefore tumor budding could potentially assist treatment decision making in T1 colorectal cancer patients with high-risk lymph node metastasis.

Objective To evaluate core needle biopsy (CNB) in detecting estrogen receptor (ER) and progesterone receptor (PR) of HER2,Ki67,and molecular classification of breast cancer.Methods Clinical data of 188 breast cancer patients admitted from Nov 2012 to Jun 2015,were retrospectively analyzed.All patients received both CNB and open excision biopsy (OEB).Immunohistochemistry (IHC) was used to evaluate the expression of ER,PR,HER2 and Ki67.All cases were categorized into four molecular subtypes:Luminal A,Luminal B,triple negative breast canccr and HER2 over-expression breast cancer.Kappa test was used to evaluate the consistency of CNB and OEB.Results Concordance rate of ER,PR,HER2 receptor status and Ki67 value were 94.68％,93.62％,94.68％ and 73.40％.There was no difference between CNB and OEB for non-Luminal tumors (P =0.774).Ki67 expression in OEB samples was higher than in CNB samples (25.90％ vs.21.65％,P ＜ 0.001).Concordance rate between CNB and OEB for molecular subtypes was 72.34％ (K =0.606 4).Conclusions CNB is accurate in evaluating ER,PR,HER2 and Ki67 in breast cancer.CNB is accurate in diagnosing non-Luminal molecular subtypes of breast cancer.

Objective The aim of this study is to demonstrate the pathological characteristics about two types of pancreati‐tis ,providing new thinking about the mechanism of severe acute pancreatitis .Methods Thirty male Sprague‐Dawley rats were ran‐domly divided into three equal groups :sham‐operated (SO ,n=10) group ,mild acute pancreatitis (MAP ,n=10)) group and severe acute pancreatitis (SAP ,n=10) group ,all the rats were killed after 12 h of building model .Under the microscope ,we detected the pathological changes of pancreas ,liver ,lung and small intestine .The ultrastructure of pancreas ,liver ,lung and small intestine tissue were observed by transmission electron microscope .Results In SAP group ,congestion ,edema ,inflammatory cell infiltration ,lea‐king of blood componedts ,vascular endothelial injury and thrombosis of microcirculation were obviously observed .There is no ap‐parent pathological changes in the MAP group except the edema of pancreas .Conclusion Hemorrhage and necrosis are the main pathological characteristics in SAP rats ,has essential difference with MAP .These pathological characteristics provides us a new thinking for further study about the mechanism of SAP .

Objective To assess retinal arteriole stenosis in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and to evaluate the relationship between retinal arteriole stenosis with cranial MRI changes and clinical features. Methods Sixteen CADASIL patients (mean age was (43.4±8.1)years, mean duration was(4.7±3.4)years)and sixteen age matched healthy individuals were enrolled. Mini-Mental State Examination (MMSE) and modified Rankin scale scoring were performed in 16 patients. Cranial MRl with Coulthard scores was assessed on CADASIL patients as well. Retinal examinations for arteriole stenosis were done for each subject. Bivariate correlations (Kendall's tau-b) were used to assess the relationship among the grade of retinal stenosis, MMSE, modified Rankin seale, cranial MRI with Coulthard scores and age. Results Retinal arteriole stenosis presented in 15 cases. in whom 4 cases showed mild arterio-venous nicking. while it only presented in 2 controls. Grade 0.Ⅰ, and Ⅲ of retinal arteriole stenosis are noted in 1/16,4/16,7/16 and 4/16cases respectively. Coulthard scores of cerebral MRl were 6.0.19.0.25.1 and 29.8 respectively from Grade 0 toⅢ of retinal arteriole stenosis. The correlation coefficient of retinal arteriole stenosis and cranial MRI scores was 0.743(P＜0.001＝,MMSE-0.429(P＜0.05＝,modified Rankin scale 0.437(P＞0.05).and age 0.299(P＞0.05).Conclusion Retinal arteriole stenosis is significantly correlated with lesion in cranial MRI and dementia.