Pancreatic carcinoma is a high malignancy,as radical resection is the only cure for long-term survival.In an attempt to improve outcomes and prognosis,surgeons over the decades have employed various active surgical strategies to combat this disease.Through document analyses of radical pancreaticoduodenectomy for pancreatic head carcinoma,regional lymphadenectomy,retroperitoneal nerve dissection,and combined vessel resection,the extent and disputes about radical resection for pancreatic head carcinoma are investigated.Total mesopancreas excision appears to be a novel and promising surgical procedure for the improvement of prognosis of patients with pancreatic head carcinoma.However,further studies based on the data of larger number of patients are mandatory to raise the evidence for this surgical procedure.

Objective To detect the expressions of VEGF and nm23 in non-small cell lung cancer (NSCLC) tissues and their relationships,and explore their clinical value in the diagnosis and treatment.Methods lmmunohistochemistry(SP method) was used to detect the expressions of VEGF and nm 23 in NSCLC and peritumor tissues.Results The positive expression rate of VEGF in NSCLC(63.3 ％,38/60)was significantly higher than in the peritumor tissues(16.7 ％,10/60)(x2=27.22,P＜0.01).nm 23 is on the contrary (53.3 ％,32/60)(x2=17.79,P＜0.01).The positive expression of VEGF in NSCLC was positively correlated significantly with the lymph node metastasis and histological classification(P＜0.05).The positive expression of nm 23 in NSCLC was negative correlated significantly with lymph node metastasis,P＜0.01.2-year survival rate of the VEGF-positive patients was significantly lower than that of VEGF-negative patients,and nm 23 is on the contrary(x2=5.55,P＜0.05).No correlation was found between the expressions of VEGF and nm 23 in NSCLC (x2=1.83,P＞0.05) Conclusion The VEGF and nm 23 may be closely associated to carcinogenesis and progression of NSCLC.Detection of VEGF and nm 23 are beneficial to indicate the biologic behavior of NSCLC.It has positive effect on diagnosis and treatment of NSCLC.

Objective To investigate the changes of learning and memory function ,vascular endothelial growth factor (VEGF) and heme oxygenase‐1(HO‐1) expression in cerebral cortex and hippocampus of chronic ischemic vascular dementia rats . Methods Thirty‐six healthy SD rats were divided into the control group ,sham operation group and model group ,12 cases in each group .The chronic ischemic vascular dementia rat model was established by the permanent bilateral carotid artery occlusion The sham operation group received the same treatment to the model group except without bilateral carotid artery occlusion .The learning and memory abilities were tested by the Morris water maze experiment and climbing rope strength experiment at 1 ,4 ,8 ,12 weeks respectively .The expressions of VEGF and HO‐1 in rat cerebral cortex and hippocampus was determined by immunohistochemical SP technique .Results The escape latency time at 8 ,12 weeks in the model group was longer than that in the sham operation group and control group ,and the number of crossing the platform was less than that in the sham operation group and control group ,the differences were statistically significant (P<0 .05);the time of climbing at 1 -12 weeks had no statistical difference between the model group and the sham operation group and between the model group and the control group (P>0 .05) .The positive expression of HO‐1 and VEGF protein contents in the control group and sham operation group was less than that in the model group with sta‐tistical difference(P<0 .05) .Conclusion Chronic cerebral hypoperfusion has a permanent damage to the learning and memory abil‐ities in rats ,while has no influence on the motor function .VEGF and HO‐1 may play a protective role in chronic cerebral ischemia .

Objective To explore serum Cystain C (Cys C) level in chronic heart failure (CHF) patients and its relation?ship with cardiac function and ventricular remodeling. Methods Patients with heart failure (n=75) and healthy adult (n=35) were enrolled in this study. According to the NYHA classification,CHF patients is divided into NYHA Ⅱ, NYHAⅢand NYHAⅣ;CHF patients can also be divided into 2 groups base on their level of serum Cys C:Cys C>0.95 mg/L is defined as elevated serum Cys C group, serum Cys C≤0.95 mg/L is defined as normal serum Cys C group;According to left ventricu?lar ejection fraction (LVEF), CHF patients can also be divided into 2 groups:LVEF≥0.50 is defined as ejection fraction re?served group, LVEF<0.50 is defined as the ejection fraction reduced group. Cys C, N terminal B-type natriuretic peptide (NT-proBNP), serum creatinine(Scr),UREA and Echocardiography were analyzed in all groups and their correlation was studied. Results Serum Cys C level in CHF patients was obviously higher than that in healthy controls, and it increased with NYHA heart function classification;compared with normal Cys C group,Cys C elevated group presented higher NT-proBNP level but lower eGFR and LVEF (P<0.05);compared with ejection fraction reduced group, ejection fraction reserved group demonstrated lower NT-proBNP, LVEDD, LVMI and Cys C levels (all P<0.05);Correlation analysis revealed that Cys C is correlated with age, NT-proBNP, LVEF, LVEDD, Scr and UREA (r=0.411, 0.658, 0.465, 0.310, 0.552, 0.486, P<0.01). Conclusion Serum Cys C can be used to evaluate cardiac function of heart failure, and is associated with ventricular remodeling.

AIM: To inverstigate the protective effects of procyanidin on myocardial ischemia reperfusion injury in rats. METHODS: Myocardial ischemia reperfusion injury models were established by the ligation of left desending coronary artery for 40 min and referfusion for 120 min in rats, and the influence of procyanidin on enzymes of myocardial, myocardial infarction size and lipid peroxide were observed. RESULTS: Procyanidin decreased myocardial creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) release significantly diminished myocardial infarction size, raised the activity of superoxide dismutase (SOD), reduced malondialdehyde (MDA) content in myocardial and serum in comparison with the control. CONCLUSION: Procyanidin has a protective effect on myocardial ischemia reperfusion injury. The action is related to the inhibition of the free radical and subsequent lipid peroxidation.

AIM To study the effects of rh bFGF on healing quality of chronic gastric ulcer in rats. METHODS Ulcer model induced by acetic acid was established. Rats were treated with rh bFGF ig until ulcer healing and then continually treated for 10 days(30 total treatment days). The effects of rh bFGF on healing quality of chronic gastric ulcer was evaluated not only from gastric mucoal barrier tissue structure but also from gastric mucus barrier. RESULTS rh bFGF( 5 000 ～ 10 000 AU?kg -1 ) increased the thickness of regenerated gastric mucosa, lowed its abnormity degree and made its align state near to normal. rh bFGF( 2 500 ～ 10 000 AU?kg -1 ) increased collagen and capillary density in scar tissue, added mucus quantity, mucopolysaccharide layer's thickness and PGE 2 content on the surface of regenerated gastric mucosa. CONCLUSION rh bFGF has effects of promoting gastric mucosal barrier to mature, increasing the function of gastric mucus barrier and increasing the quality of ulcer healing.

Objective To explore the effects of up-and down-regulation of Cox-2 expression on the growth and radiation sensitivity of human esophageal cancer EC9706 xenograft in nude mice.Methods Cox-2 specific siRNA and Cox-2 gene eukaryotic expression vector were constructed and transfected to esophageal cancer cells EC9706, and the stable transfected cell lines were obtained by the method of G418 screening.The expressions of Cox-2 mRNA and its protein were detected by RT-PCR and Western blot, respectively.The inhibitory effects of Cox-2 regulation combined with X-ray irradiation on cancer cell growth were detected by the nude mouse xenograft assay.Results Cox-2 gene expression was significantly decreased in the Cox-2 down-regulated group and increased in the Cox-2 up-regulated group.Compared with the control group without gene transfer, the average volumes of EC9706 xenograft tumor in the Cox-2 up-and down-regulated group significantly decreased (F =34.26, P ＜ 0.05) and increased (F =26.38, P ＜ 0.05) , respectively.After 20 Gy X-ray irradiation, the average volume of xenograft was significantly reduced in the Cox-2 down-regulated group (F =16.35, P ＜ 0.05) , but it had no significantly changes in the Cox-2 up-regulated group.Conclusions Down-regulation of Cox-2 expression inhibits the growth of human esophageal cancer EC9706 xenograft in a nude mice and increases cell radiation sensitivity, but upregulation of Cox-2 expression makes tumor cells to become radioresistant.

To explain how to ensure and improve the quality of the clinical practice teaching for the clinical institutes,we expatiate on the practical experience in the hospital from enhancing the practice teaching management,improving the teaching consciousness,meliorating the teaching environment and reforming the method.

Objective To evaluate the outcomes of small (5 ～ 10mm),arterially enhancing nodules (SAENs)shown exclusively at the hepatic arterial phase of CT in a hepatocellular carcinoma(HCC) surveillance population and to determine risk factors for developing HCC.Methods The study population included 112 patients (maleifemale =100 ∶ 12 ; aged 36 ～ 92 years) with 1 7 5 SAENs who were at risk of HCC.We evaluated serial changes during follow-up(1.4 ～41.8 months,mean 35.7 months) and analysed the initial CT findings of SAENs and the accompanying lesions to elucidate the risk factors for HCC development.Results Of 175 SAENs,101 (57.7％) disappeared and 34(19.4％) persisted.Forty SAENs(22.9％) became HCC in 33 patients(29.5％).Presence of HCC treatment history(P =0.005,risk ratio =7.429),a larger size of SAEN(P =0.003,risk ratio =1.630),presence of coexistent HCC(P =0.021,risk ratio =3.777) and absence of coexistent typical arterioportal shunts (P =0.003,risk ratio =4.459) turned out to be independently significant risk factors for future development of HCC.Conclusion SAENs are frequently seen in an HCC surveillance population and have a 22.9％ probability of becoming HCC on a per-lesion basis.Risk increased particularly when the lesion is associated with a previous or concurrent HCC,a large size or found without a coexistent typical arterioportal shunt.

A nutrition survey, covering a total of 4801 preschool children in 6 provinces, autonomous regions and municipalities, has been carried out. The objective was to determine the effects of various dietary patterns on the blood hemoglobin, free erythrocyte proporphyrin, and serum ferritin values. The results indicated a high prevalence of iron deficiency (average 51.9%). Iron deficiency anemia was detected in 16.4% of the children examined and the incidence rate was particularly high among infants at the age group of 6 months and one year, which was 28.7% and 22.9% respectively. The dietary patterns were different in the above geographic areas. The results of dietary survey revealed that a low incidence of iron deficiency was found in those children who consumed more animal food and protein.