Based on the domestic and international research in the past few decades,we present an intelligent non-destructive diagnostic instrument for coronary artery disease(CAD).This instrument analyses the multi-channel heart sounds of patients who have coronary artery disease and combines other information about CAD,then wavelet analysis,artificial neural network and pattern recognition technology are also used.The result of clinic application indicates that this instrument has certain reference value to the diagnosis of CAD and provides potential possibility of general examination.

Denervation is the abscission or destruction of the nerve,and when the endogenous and exogenous nerves distribited in the colon would be damaged,the colon would become a denervated one.That may be a result of surgical process or the symptom of disease such as Hirschsprung's disease.The denervated colon would have some changes in motility,absorption and secretion,thus the function of the colon would be affected.

Objective To investigate the changes of autonomic nerve function of coronary heart disease (CHD) patients with panic disorder(PD). Methods All the subjects who met with the diagnostic code of CHD and PD were divided into CHD group(n=40) ,PD group(n=36) ,comorbid CHD and PD group(n=27) ,and 40physical examinee were recruited as normal control group. They had a 24 hours Holter ECG monitoring by time and frequency domain analysis of heart rate variability. ANOVA analysis was utilized to statistic the collected data. Results Compared with normal controls,the patients of others groups had every indexs of HRV were reduced. The indexs of HRV of comorbid CHD and PD were lower than the patients of CHD or PD group. The score of time domain SDNN(70.40 ± 14.74)ms,SDANN(91.72 ± 24.46)ms,PNN50(2.83 ±2.07)%, RMSSD( 15.66 ±7.45)ms,frequency domain LF(647.54 ± 129.24)ms2, HF(596. 16± 127.66) ms2 in comorbid CHD and PD. There were significant differences with others groups(P ＜ 0.05 ). Conclusion The autonomic nervous functional of the patients with CHD and PD were in disorder. The autonomic nervous functional disorder of the patients with comorbid CHD and PD was more severe.

Objective To assess the therapeutic strategies and prognostic factors that influence clinical outcome of malignant fibrous histiocytoma (MFH) of the abdomen. Methods Between Jul 1980 and Nov 2003, 51 intraabdominal MFH patients undergoing resection were retrospectively analyzed. Results Postoperative recurrence developed in 35 patients, with local recurrence in 15 (29. 4% ) , distant metastasis in 20, including lung metastasis in 8 ( 15. 7% ) , liver metastasis in 4(7. 8% ) , and bone metastasis in 6 ( 11. 7% ). The 1-, 3- and 5-year disease-free survival rate was 70. 6% , 43. 1% and 29. 4% , respectively, and the 1-, 3- and 5-year cumulative survival rate was 74. 5% , 52. 9% and 31. 4% , respectively. Conclusions Intraabdominal MFH is a rare entity with high biological aggressiveness and high metastasis potential. Surgical resection has generally been accepted as the treatment of choice for MFH, at the same time, there appears to be a role for radiation therapy, in combination with surgery for better local control, particularly in high-grade lesions.

As the improved understanding of the biological behavior of colorectal cancer and the development of diagnosis and surgical techniques,the prognosis of patients with locally advanced colorectal cancer has been improved significantly.Locally advanced colorectal cancers are best treated with multivisceral resections,but the procedure is high technique-demanding and the indications for the procedure should be strictly followed.In this article,the procedure of right colectomy combined with pancreatoduodenectomy for colon cancer was described in detail in order to share the experiences and skills with surgeons.

Objective To summarize the clinical features of mercury poisoning diagnosed by blood and urine tests for improving the diagnosis and treatment of the disease.Methods Poisoning causes,clinical manifestations,diagnosis,treatment and prognosis were retrospectively reviewed in 92 in-patients with mercury poisoning in our hospital from January 2000 to April 2010.Results Of the 92 patients,37 were male and 55 were female with an average age of 33.1(2-65)years old.The mercury poisoning was caused by occupational exposure and non-occupational exposure,such as iatrogenic exposure,life exposure and wrong intake or suicidal intake of mercury-containing substances,mainly through respiratory tract,digestive tract and skin absorption.The most common clinical symptoms were as the followings:nervous system symptom,such as memory loss in 50 eases(54.3%),fatigue in 34(37.0%),numb limb in 25 (27.2%),dizziness and headache in 22(23.9%),cacesthesia in 20(21.7%),fine tremor(finger tip,tongue tip,eyelids)in 15(16.3%),insomnia and more dreams in 12(13.0%);gastrointestinal symptoms:nausea in 16 (17.4%),abdominal pain in 14(15.2%),stomatitis in 5(5.4%);joint and muscle symptoms:muscle pain in 16(17.4%),joint pain in 5(5.4%);cardiovaseular system:chest tightness,hean palpitations in 6(6.5%);urinary system:edema in 9(9.8%);other system:hidrosis in 20(21.7%).After the treatment with sodium dimercaptopropane sulfonate (DMPS),the symptoms were gradually alleviated.Their gastrointestinal,cardiovascular symptoms were alleviated within 2 weeks;neurological symptoms were alleviated within 3 months;kidney damage showed a slower recovery and could be completely'alleviated within 6 months.Conclusions Because of its diverse clinical symptoms,the mercury poisoning was easy to misdiagnosis and missed diagnosis:therefore the awareness of the disease should be further enhanced.Leaving from the poisoning environment timely and giving appropriate treatment with DMPS will lead to a satisfactory prognosis.

Objective To investigate nerve growth factor (β-NGF) and its receptors expression in human pancreatic ductal adenocarcinoma. Methods Expression and distribution of β-NGF, tyrosine kinase A (TrKA) and P75NGFR were detected in operation tissue specimens of pancreatic ductal adenocarcinoma with immunohistochemistry and real-time PCR. Relations of β-NGF and its receptors with clinicalpathological characters, especially nerve invasion were analyzed. Results β-NGF and TrKA expression are higher in pancreatic adenocarcinoma than normal pancreas, and the differences are significant (P < 0. 01). Β-NGF and TrKA expression are associated with the differentiation grades(DG), lymphatic node metastasis, nerve invasion and surgical pathological stages. Poorer of DG and later stages, more expression of β-NGF and TrKA. Β-NGF and TrKA expression have positive correlations. Β-NGF, TrKA and P75NGFR mRNA expression have significantly increased 3.84,4. 23 and 2. 41 times than normal tissues by real-time PCR, respectively. Conclusions β-NGF and TrKA might play potential rules in carcinogenesis for pancreatic cancer,have affinity with clinicopathological characters of pancreatic cancer. Β-NGF and TrKA may have mutual effect in signal transduction leading to perineural invasion of pancreatic carcinoma.

pancreatic carcinoma by some signal transduction.

Objective To evaluate the significance of the expression of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) as prognostic indicators for patients with stage Ⅱ colorectal cancer. Methods A total of 285 patients with stage Ⅱcolorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. Patients were followed up every 3 months to review CEA and CA19-9 levels. Two years later, the chest and abdominal CT examination were performed every 3 months, and then every 6 months until 5 years. Results Out of these 285 patients, 99 (42.60%) patients had high CEA levels, 25 (8.77 %) patients had high CA19-9 levels, and 12 (4.21 %) patients had both high CEA and CA19-9 levels. The overall survival rates of patients with both high CEA and CA19-9 levels were significantly worse than those of others (P< 0.05). During the study, 51 recurrences were diagnosed. There were 22 hepatic recurrences, 10 pulmonary recurrences, 9 local recurrences, 8 lymph node recurrences, and 2 peritoneal recurrences. CT, CEA and CA19-9 were the first abnormal examinations in 30, 5 and 8 recurrent patients, respectively. In 27 % of recurrent patients, the recurrence was detected earlier by CEA and CA19-9 than that by CT. Conclusions The detection of preoperative CEA and CA19-9 levels is useful for predicting the prognosis after potentially curative surgery in patents with stage Ⅱ colorectal cancer. For early detection of occult recurrence of colorectal cancer, tumor markers are relevant.

Objective To assess the feasibility and short-term effect of transanal everted extraction of laparoscopic rectal excision without abdominal incision.Methods Eleven patients were operated by transanal everted extraction of laparoscopic rectal excision without abdominal incision.Results All the operations were accomplished successfully,the average operative duration was (189.5±25.2) min,the intra-operative blood loss volume was (25.4±9.4) ml,the average time to flatus was (38.9±8.6) h,the average postoperative hospital stay was (12.7±2.5) d,and the number of lymph nodes harvested was 13.5±4.1.There were no post-operative complications.Conclusion The technique of transanal everted extraction of laparoscopic rectal excision without abdominal incision is safe and feasible,but the long-term effects need more observation.