Objective:To study the treatment result of the unresectable advanced pancreatic cancer by radiotherapy. Methods: A total of 16 patients with unresectable advanced pancreatic cancer were treated by radiotherapy from March 1996 to December 2001. According to TNM staging system, there are 5 patients in stage II, 6 in stage Ⅲ and 5 in stage Ⅳ. Karnofsky score were ranged from 30～70. Eight patients were treated by the conventional fractionation (1.8～2.0 cGy/f, 5f/w), and eight patients treated by non-conventional fractionation(1.2～1.8Gy/f,2～3f/d).The radiation dose was70Gy for 3 cases. Results:The remission rate was 85.7 percent. The median survival course was 9.2 months(3～30months). 1-year survival rate was 31.25 percent. The pretreatment performance status and TNM stage were important prognostic factors. Both groups of Karnofsky score 60～70 and stageⅡ,Ⅲ showed a highly significantsurvival improvement when compared with groups of Karnofsky score 30～50and stage IV ( P

Objective To investigate the early diagnostic value of high‐sensitivity C‐reactive protein(hs‐CRP) ,D‐dimer and cTnI in ACS .Methods All the 83 blood samples of patients with chest pain in the emergency department of our hospital were enrolled in the study ,and 30 healthy people were recruited as the control group .According to the final clinical diagnosis ,29 patients were grouped into non‐ischemic chest pain(NICP) group and 54 patients were grouped into ACS group .Venous blood samples were col‐lected and the concentrations of serum hs‐CRP ,cTnI ,plasma D‐dimer were measured .The diagnostic value of the 3 indicators and their combined test for ACS was evaluated by using the receiver operating characteristic(ROC) curve and Youden index .Results The levels of hs‐CRP ,cTnI and D‐dimer in ACS group were significantly higher than those of the control group and the NICP group (P<0 .05) .The levels of hs‐CRP and D‐dimer in ACS group were significantly higher than those of the NICP group(P<0 .05) . ROC showed that the area under urve of hs‐CRP ,D‐dimer and cTnI were 0 .564 ,0 .631 and 0 .639 respectively .The sensitivity ,spe‐cificity and accuracy of the combined detection of hs‐CRP ,cTnI and D‐dimer were 88 .1% ,58 .7% ,53 .2% respectively . Conclusion To some extent ,the levels of hs‐CRP ,cTnI and D‐dimer all could be used as indicators in the diagnosis of ACS .But combined detection of hs‐CRP ,cTnI and D‐dimer could improve the sensitivity and specificity ,and had value to guide clinical diagno‐sis of ACS in the early stage .

Objective To evaluate the diagnostic value of hysterosalpingography in infertility caused by salpingian obstraction.Methods 892 cases of femiles infertility were reported in the group,ranged in age from 20 to 36 years and the mean age was 26 years.The hysterosalpingography was taken under fluoroscopic guidance during third to 7th day after menstruction,the radiographes were taken and analysed.The different segments and shapes of salpingian obstruction were correspondently divided into 3 levels and 3 degrees respectively according to the different therapeatic methods for infertility.Results There were total 776 cases with salpingian obstructional infertility,of them,both side involved in 582 cases,and one side in 194 cases,the total of abnormal fallopian were 1358 tubes including 1 st level 423,2nd level 561;3rd level 374,1 st degree 263,2nd degree 553 and 3rd degree 542.Conclusion Hysterosalpingography plays an important role in the therapy and diagnosis of the inferility caused by salpingian obstraction.

Objective To determine whether the antiserum produced by immunizing mice with conotoxin GI coupled with bovine serum albumin (BSA) could neutralize GI conotoxin.Methods The GI-BSA was prepared by glutaraldehyde-coupled method,and the mice were immunized with the GI-BSA to produce antiserum.The antibody neutralization assay was used to test the detoxication of the antiserum.Results The SDS-PAGE protein electrophoresis showed that the coupling reaction of GI hapten with BSA was successful.The two distinct protein bands of GI-BSA were more than 120×103.Each mouse was immunized four times with 99 μg every two weeks.After the fourth immunization,the serum neutralization titer was more than 1:64 000.After the intraperitoneal injection of the mixture of 100 or 200 μl of the antiserum and different doses of GI,75% of the mice survived in the group with 100 μl of the antiserum and 1× LD50 GI(16.3 μg/kg).The same percentage of mice also survived in the group of with 200 μl of serum and 25.8 μg/kg of GI.Conclusion The antiserum produced by immunizing mice with GI-BSA exhibits significant detoxication activity to conotoxin GI.

Objective To explore clinical effect of small dose of glucocorticoid in the treatment of AECOPD patients with severe disease associated with low levels of cortisol.Methods72 patients with AECOPD in our hospital were randomly divided into control group and treatment group.The control group was treated with conventional AECOPD method,the treatment group was treated on the base of the treatment group with a small dose of corticosteroids,CRP, IL-6, TNF-α, FEV1, PCT and other indicators, as well as patients with ventilation, shock and mortality were compared after the end of treatment.ResultsThe time of non mechanical ventilation, the time of non-mechanical ventilation, and the time of non-shock were increased, the shock and the mortality was lower in the treatment group,(P<0.05);The CRP level of patients in the treatment group was lower(P<0.05);IL-6, TNF-α, PCT levels of patients in the treatment group was lower (P<0.05);FEV1, FVC and FEV1/FVC level in the treatment group were higher(P<0.05).ConclusionSmall dose glucocorticoid can improve the pulmonary function of patients with AECOPD complicated by severe disease, and alleviate the disease, significantly reduce the levels of inflammatory factors, promote the improvement of the lung function.

Objective The purpose of this study was to discuss the therapies for hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.Methods After three cases of pancreatoduodenectomy,the disruptions of pancreatojejunal stoma resulted in serious pancreatic leakage and the hemorrage in abdominal cavity.During all the second operations,the drainage-tube insertions into the main pancreatic ducts were used to lead the pancreatic juice into the neighboring loop of jejunum.Results Afer the operations,the supportive treatment,continuous irrigation of peritoneal cavity and pancreatic enzyme inhabition were given to the patients of these cases and all of the patients were successfully cured.Conclusions The bridge-crossing internal drainage which inserts drainage-tube into the main pancreatic duct was a convenient and effective therapy and method to rescue the hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.While the patients' lives were saved,their functions of pancreas were preserved and the qualities of life were improved after the operations.

The way to develop the seven-year program studnts'ability mainly includes:paying great attention to study the basic theory for developing students'comprehensive abilities;laying stress on clinical teachers'important role in training students'ability on scientific research and their participation in clinical scientific research activities in order to develop their ideology and ability of clinical oncology scientific research.

Objective To discuss the clinical value of immunofecal occult blood test in screening of colorectal cancer and its precancerous lesions in a large series of health checkup population. Methods Colorectal cancer and its precancerous lesions in 5919 subjects undergoing health checkup in our hospital were screened out by using immunofecal occult blood test from July 2006 to June 2007; positive cases with the test were subjected to colorectal endoscopy or X-ray barium enema examination. Relevant results were analyzed in combination with clinical and pathological data. Results Positive result was obtained in 314 out of the 5919 subjects undergoing health checkup with immunofecal occult blood test; the positive rate was 5.30%. 241 cases(76.75% )of them accepted colorectal endoscopic examination and 23 cases(7.32%) accepted X-ray barium enema examination. The total follow up rate was 84.08% with 50 cases out of contact. After excluding the cases out of cantact, 16 cases of colorectal cancer were found morbidity 2.37‰ including 8(50.00% )cases of Dukes A,7 cases (43.75%)of Dukes B and 1 case of Dukes C (6 .25%).The detection rate of colorectal cancer with postive imunofecal occult blood test was 6.06% (16/264). 94 cases (16.01‰) of adenomatous polyps were found including 55 cases (58.51%) of tubular adenoma, 23 cases (24.47% )of villiform- tubular adenoma and 16 cases(17.02%) of villfform adenoma. Among these cases 55 (58.51%)were solitary and 39(41.49%) multiple. In addition, 6 cases of ulcerative colitis in active phase were found. Altogether 116 (43.94%)of the 264 cases with positive immunofecal blood test and not out of contact were found to have colorectal cancer or its precancerous lesions. Conclusion Immunofecal occult blood test is suitable for screening of colorectal cancer and its precancerous lesions in large series of population. Colorectal cancer and its precancerous lesions may be found in relatively early phase and be eradicated in curable stage, thus to reduce the morbidity and mortality.

Objective To evaluate the use of spiral enteroscopy in diagnosis and treatment of smallbowel diseases.Methods The data of 8 patients who underwent spiral enteroscopy from July to September 2009 were retrospectively studied.The variables including maximal insertion depth,total procedure time,complications,and outcome were evaluated.Results The average maximal depth of intubation was 2.2 m beyond the Ligament of Triez (0-3.6 m beyond Ligament of Triez),with a mean procedure time at 41 min (25 to 77 min).Small bowel Crohn's disease was diagnosed in 2 cases with biopsy suggesting active inflammation and granular formation.Small intestinal tumor was detected in 1 patient with pathological finding of high grade dysplasia.Jejunal ulcer was detected in 1 patient.Multiple polyps were found in 1 patient after jejunal anastomosis,which were then treated with endoscopic argon plasma coagulation (APC).No abnormalities were found in 3 other patients.No complications occurred during and after the procedure.The maneuver of spiral enteroscopy and APC were same as that of balloon enteroscopy.Conclusion Spiral enteroscopy is simple and convenient to operate,which is of great potential in clinical use.

lem and direct necessary intervention to improve the completion rate of whole small intestine examination.