Objective To study the diagnosis,treatment and prognostic factors of pancreatic neuroendocrine neoplasms (pNENs).Methods The clinical,pathological and follow-up data of 44 patients with pNENs treated at the Peking University First Hospital from Jan.2007 to Dec.2016 were retrospectively studied.Survival analysis was performed with the Kaplan-Meier method.Results There were 21 male and 23 female patients.The mean age was (54.8 ± 14.0) years.25 patients had non-functional,while 19 had functional pNENs.Curative resection was performed in 40 patients.Neural invasion and intravascular cancer emboli were found in 7 and 5 patients,respectively.The pathologic data showed that the number of patients with G1,G2,G3 were 23 (52.3 ％),15 (34.1％),6 (13.6％),respectively.The number of patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ were 23 (52.3 ％),16 (36.4％),2 (4.5 ％) and 3 (6.8 ％),respectively.The predictive factors on prognosis included curative resection or not,WHO grade,TNM staging,lymph node metastasis and distant metastasis (P ＜ 0.05).Conclusions Curative surgical resection is the first choice of treatment for pNENs.WHO grade,TNM staging,lymph node metastasis and distant metastasis were significantly related to the prognosis of pNENs.

This paper briefly introduces the frame structure, design concept and main functional modules of outpatient emergency care information system developed by our hospital. This system can optimize the procedure when patients seek medical advice, create warm medical circumstances, increase work efficiency of medical care personnel, strengthen quality management of medical cases and promote hospital modern construction.

Objective To evaluate the changes of ventricular synchrony in patients with acute myocardial infarction(AMI)before and after percutaneous coronary intervention(PCI)by speckle tracking imaging(STI).Methods Thirty patients with AMI were examined by traditional echocardiography and STI before and 5 d,1 month after PCI.Myocardial imaging of left ventricular apical long views and parasternal left ventricular short axis views were recorded and stored.The time to peak longitudinal systolic and diastolic strain rate(TS-SRL,TE-SRL)and to peak radial systolic and diastolic strain rate(TS-SRR,TESRR)were measured respectively.The differences of the maximum and minimum systolic and early diastolic peak time(TSL-diff,TER-diff)and the standard deviation(TSL-SD,TER-SD)in 18 longitudinal segments were calculated.And the differences and standard deviation of TS-SRR and TE-SRR(TSR-diff,TSR-SD,TER-diff,TER-SD)were calculated also.These parameters were compared before and after PCI.Results Compared with before and 5 d after PCI,the values of TSL-diff,TSL-SD,TEL-diff and TEL-SD in 1 month after PCI were decreased significantly(P＜0.01).TSR-diff,TSR-SD,TER-diff and TER-SD were decreased also and the differences had statistical significance(P＜0.01).The cardiac synchronized index and LVEF values showed good negative correlation.Conclusions The systolic and diastolic synchrony of left ventricle in AMI patients was abnormal.STI can evaluate left ventricular synchronized function and the changes before and after PCI to assess the effect of PCI.

Objective To evaluate the effect of adenosine triphosphate postconditioning on myocardial ischemia reperfusion injury in rabbits by ultrasound speckle tracking imaging(STI).Methods Forty-two healthy rabbits were randomly divided into three groups averagely:ischemia-reperfusion (IR ) group, ischemia postconditioning(IPost)group,ATP-pharmacological postconditioning(PPost)group.The model of myocardial ischemia reperfusion was established.Echocardiography examinations were conducted before the coronary artery ligatured,after 45 min later and at the end of reperfusion.Pathological examinations were applied to detect the change of which two rabbits randomly selected from each group after the coronary artery ligatured 45 minutes later and the rests after reperfusion of 120 min.Results ①Ischemic and infarct changes could find in the six rabbits which were sacrificed after the coronary artery ligatured 45 minutes later.The same changes also could be found in the three groups after reperfusion,and the damage in IR group was the most significant.②After block of coronary artery,left ventricular ej ection fraction(LVEF) decreased in all groups (P <0.05)and STI index decreased in all groups (P <0.01).③After reperfusion of 1 20 min later,global longitudinal systolic strain rate (GLSrsys ),global longitudinal systolic strain (GLSsys)increased in IPost group and GLSrsys increased in ATP-PPost group,and longitudinal systolic strain rate(SrLsys),longitudinal diastolic strain rate(SrLd),longitudinal systolic strain(SLsys)increased both in IPost group and ATP-PPost group(P <0.05 or P <0.01).Compared in groups,GLSsys,SrLsys, SLsys in IPost group and ATP-PPost group all higher than those in IR group (P <0.05).Conclusions STI can evaluate exactly the global and regional myocardial function of rabbit myocardial infarct-reperfusion model and local index is better than overall index.STI can also detect correctly the protect effects on myocardial reperfusion inj ury of ATP.

Objective To evaluate left ventricular(LV)global and regional systolic function by three-dimensional speckle tracking imaging (3D-STI)in patients with systemic lupus erythematosus (SLE). Methods Twenty-two patients with SLE were selected randomly as SLE group and twenty-two healthy people were included as control group.3D-STI was performed in all participants to get global and regional strain parameters,including global longitudinal peak systolic strain(GLS),global circular peak systolic strain (GCS ),global radial peak systolic strain (GRS ),global area peak systolic strain (GAS ),segmental longitudinal peak systolic strain (SLS),segmental circumferential peak systolic strain (SCS),segmental radial peak systolic strain (SRS),and segmental area peak systolic strain (SAS).The sensitivity and specificity of GCS and GAS reflecting LV systolic function in patients with SLE were analyzed under the receiver operating characteristic (ROC)curve.Results ①The global strain:compared with the control group,GCS and GAS decreased significantly in SLE group (P <0.01),there was no significant change in GLS and GRS(P >0.05).②The regional strain:compared with the control group,the SCS in segments of basal anteroseptal,basal inferoseptal,mid anterior,mid inferosptal,mid anterolateral,apical inferior,apical lateral decreased significantly in SLE group.The SAS of basal anterior,basal inferoseptal,mid inferosptal, mid anterolateral,apical anterioe,apical lateral decreased significantly in SLE group (P <0.01).The SCS in segments of apex and the SAS of mid anterior,apical septal,apex decreased in SLE group (P <0.05).③The ROC curve:the sensitivity and specificity of GCS on detecting the LV systolic dysfunction were 59.1%and 87.5%,and those of GAS were 77.3% and 83.3%,respectively.Conclusions 3D-STI is a convenient and accurate way to early detect LV global and regional systolic dysfunction in SLE patients.

Functional gastrointestinal disease is a group of clinical syndrome of non-organic disease. Its various clinical symptoms have a certain specificity and overlap phenomenon, and the mechanism is not clear. TCM believes thatphychological factorsare an important cause. Emotion failurecan effect spleen and stomach functionthrough liver and heart directly or indirectly.At present, the phychological factors and the relationship between functional gastrointestinal disease are getting attentiongradually. It is recognized that the mechanism of phychological factorsmay be related to brain axis dysfunction, mast cell activation, intestinal flora and so on. This article expounded the above-mentioned mechanism and reviewed the detailed TCM intervention measures to functional gastrointestinal disease in recent years.

Irritable bowel syndrome( IBS)is a common functional gastrointestinal disease,relevant investigations on pathogenesis of IBS mainly focus on genetic susceptibility, social psychological stress, visceral hypersensitivity, dysregulation of brain-gut axis,dysbiosis of intestinal flora,and dysimmunity of intestinal mucosa. This article reviewed the correlation between dysbiosis of intestinal microbiota and dysregulation of brain-gut axis in IBS.

Objective To investigate the left ventricular(LV) systolic hemodynamics and the distribution of blood flow in patients with hypertrophic cardiomyopathy(HCM) by vector flow mapping(VFM).MethodsThirty-five random non-obstructive HCM patients(case group) and forty healthy volunteers (control group) were enrolled.Peak systolic velocity (Vs),peak systolic flow (Fs) and total systolic negative flow (SQ-) of two groups were compared.Velocity vector,streamline and vortex distribution of two groups were observed.Results Vs,Fs,SQ- of the control group and Vs,Fs of the case group all showed a decreasing trend from the basal segments to the apical segment(P<0.05).SQ- of the case group lost this decreasing tendency.Vs,Fs of all segments and SQ- of the middle and apical segment of the case group were higher than those of the control group.SQ- of the basal segment of the case group were significantly lower than that of the control group(P＜0.01).Distribution of blood flow:The velocity of blood flow was faster in the case group than that in the control group and the direction was disordered.The streamlines of the case group were discontinuous,and vortexes in the case group were more than that in the control group.Conclusions VFM technology could quantitatively evaluate LV systolic hemodynamics in patients with HCM,and can clearly show the distribution of blood flow.

Objective To discuss the short-term currative effect of horizontal osteotomy across injured vertebral forⅤdegree old frac-ture-dislocations of thoracolumbar spine.Methods The data of 4 patients who received horizontal osteotomy across injured vertebral internal fixation in our hospital from April 2010 to October 2012 were retrospectively analyzed,of which 1 case with T8-9 fracture dislocation,2 cases with T10-11 fracture dislocation,1 case with T11-12 fracture dislocation.The Franke1 classification of all patients were grade A.Results All 4 cases were achieved completely fracture reduction and followed-up for 2-14 months(an average of 7.4 months),who could get sitting posi-tion with the support of brace 1 week after operation.The postoperative follow-up indicated that all 4 cases got fusion,but there was no improve-ment for Franke1 classification.Conclusion The method of horizontal osteotomy across injured vertebral forⅤdegree old fracture-dislocations of thoracolumbar spine has good short-term clinical effect,with the advantages of shorter operation time,less bleeding and good reduction effect.

Objective To evaluate therapeutic results of radiofrequency endovenous obliteration (RFO) for the treatment of varicose veins of the lower limbs. Methods Fifty six cases (56 limbs) of primary greater saphenous vein tributary varicose veins were randomly assigned to RFO group (n=28) and conventional stripping operation group (n=28). In RFO group, the wall of the greater saphenous vein was treated at 85℃ with the catheter to occlude the whole length of the vein. The other 28 cases underwent stripping procedure. The scattered superficial varicose veins in calf in both groups were managed by phlebectomy. The number of surgical incision, postoperative pain, average hospital days and the short-term results were compared. Results Patients in RFO group have less surgical incisions and less postoperative pain, without subcutaneous hematoma. The average hospital stay was 2.5?1.00 days in RFO group compared to 4.14?0.85 days in stripping operation group. Conclusions RFO effectively obliterates the whole length of the great saphenous vein and is of less trauma,faster recovery, and less scars.