For the high rate of relapse and metastasis,the 5-year survival rate in Pancreatic cancer patients is low.Surgery still is a effective treatment in pancreatic cancer.With the deep understanding of the disease,the operation of pancreatic cancer has been improved.In recent years,with the rapid development of laparoscopic techniques,minimally invasive surgery is also applied to the treatment of pancreatic cancer.This review summarizes some pancreatic cancer surgical operations developed in recent years.

Objective To study the results of laparotomy and Cool-tip radiofrequency ablation to treat large liver tumors.Methods Laparotomy and Cool-tip radiofrequency ablation were carried out on 64 patients with large hepatic cancer.To destroy the tumor completely,for tumors of 3.0～4.0 cm in diameter,7 ablations were required; for 4.0～5.0 cm in diameter 15 ablations; for 5.0～6.0 cm in diameter 19 ablations; for 6.0～7.0 cm in diameter 40 ablations.Result The complete necrosis rate of laparotomy and radiofrequency ablation was 93.75％ (60/64).The short-term results were good.Conclusions Laparotomy and Cool-tip multipoint overlapping radiofrequency ablation for large liver tumors (tumor diameter＞3 cm) could result in a high complete necrosis rate and a low complication rate.It is a good radical treatment for unresectable and large liver cancer.

Objective To investigate the effects of improved end-to-end invagination pancreaticojejunostomy on the occurrence of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 396 patients who received pancreaticoduodenectomy at the Cancer Hospital of Shandong Province from January 2001 to January 2011 were retrospectively analyzed.All patients were divided into the improved group(235 patients)and traditional group(161 patients)according to different anastomotic methods.All the operations were done by the same surgical group,and the digestive tract was reconstructed by the Child method.Patients in the improved group received improved end-to-end invagination pancreaticojejunostomy,and patients in the traditional group received traditional end-to-end anastomosis.The volume of operative bleeding,operation time,incidence of pancreatic fistula and duration of hospital stay of the 2 groups were compared.All data were analyzed using the t test,chisquare test or Fisher exact probability.Results The operative blood loss,operation time and duration of hospital stay were(383 ±56)ml,(7.2 ± 1.0)hours,(21 ±3)days in the improved group,and(381 ±39)ml,(7.0 ± 0.5)hours,(22 ± 5)days in the traditional group,with no significant difference between the 2 groups(t =0.388,1.680,-1.835,P ＞ 0.05).No operative death was detected in the 2 groups,and the overall incidence of pancreatic fistula was 7.6％(30/396).The incidence of pancreatic fistula of the improved group was 0(0/235),which was significantly lower than 18.6％(30/161)of the traditional group(P ＜ 0.05).Patients complicated with pancreatic fistula in the traditional group were cured by drainage,somatostatin administration and parenteral nutrition.Conclusion Improved end-to-end invagination pancreaticojejunostomy can significantly reduce the incidence of pancreatic fistula after pancreaticoduodenectomy.

Objective To explore the molecular and cytogenetic abnormalities in multiple myeloma (MM).Methods The la-boratory data of bone marrow smears were retrospectively analyzed in 61 patients of MM.24 hours short-term culture of bone marrow and R banding technology were performed in 31 patients.Among these patients,10 cases were selected for de-tecting the IgH gene expression by the interval FISH method.Results The proportions of myeloma cells were 0.19~0.94 in bone marrow smears of 61 patients.In 31 patients,25 patients had enough metaphases for analysis,in which 19 cases (71.3%)had abnormal clones,8q24,11q13,13q14 and 17p13 were important structural abnormalities,where 14q32 rear-rangement was the most characteristic abnormal structure,6 patients were detected IgH gene rearrangement.Conclusion Bone marrow smear combined with other laboratory examinations could make the diagnosis of MM,chromosomal abnormali-ties may help to explore the pathogenesis of MM,and provide a theoretical basis for the early diagnosis,treatment and prog-nosis of this disease.

Objective To compare the performance of novel Ag/AgCl pulverized electrodes with conventional Ag/AgCl coating electrodes in cerebral application of Electrical Impedance Tomography(EIT).Methods Based on the EIT system developed by our group,raw data were measured on a phantom and an adult volunteer,with Ag/AgCl coating electrodes and pulverized electrodes,respectively.The performances of electrode systems were evaluated in contact impedance and two other figures(the high-frequency SNR,HFSNR;the low-frequency SNR,LFSNR).Results Ag/AgCl pulverized electrode plays a better performance in resisting noise and keeping stabilization.Conclusion Ag/AgCl pulverized electrode develops the needs of imaging and monitoring human brains in EIT more availably.

Objective To provide the hardware system of EIT with an excellent direct current(DC) power source. Methods The spectrums of the outputs of DC power source and the driving source were analyzed by means of Spectrum Analyzer- E4408B when EIT system was respectively powered by battery, linear power source and switching power source. Based on the numbers and power levels of the spurs of the three power sources and the numbers and power levels of the interferences within the driving source, the influence of the three power sources on the error of measuring was estimated. Meanwhile the EIT system did data acquisition, the overall signal-to-noise-ratio(SNR) of the three power sources at the 18 frequencies were calculated and the influence of the three power sources on the error of measuring was judged. Results With respect to the numbers and power levels of the interferences within the driving source when EIT was powered respectively by the three power sources, the battery output 6 interferences, the highest power of which achieved -78.25 dBm; the linear power source output 6 interferences, the highest power of which achieved -67.11 dBm; the switching power source output 15 interferences, the highest power of which achieved -35.83 dBm. The overall SNRs of the battery at the 18 driving frequencies were higher than that of the linear power source, and the overall SNRs of the linear power source were higher than that of the switching power source. Conclusion The power mode of battery is the best for the hardware of EIT among the three power sources.

Objective To study the image processing methods of electrical impedance tomography(EIT) in order to improve the display quality.Methods Evaluate the conductivity of the nodes using the conductivity of the adjacent triangle elements.The conductivity of any point in one triangle element was calculated according to the conductivity of 3 vertexes of the element by 2D linear interpolation method.Results The original blocky images of electrical impedance tomography by the triangle elements can be transformed into smoothing images.Conclusion The visual quality of the images is improved greatly.The image processing method is adaptive to all kinds of images of electrical impedance tomography based on triangle element.

Objective To investigate the clinical features of internal carotid steal syndrome. Methods The clinical manifestations, CT or MRI, digital subtraction angiography, and blood flow compensation in 6 patients with internal carotid steal syndrome were analyzed. Results Of the 6 patients, 2 had unilateral internal carotid artery stenosis, 4 had severe stenosis (in which 2 were on the left side, 1 was on the right side, and 1 was on both sides). The clinical manifestations of the patients with internal carotid steal syndrome were watershed infarction and transient ischemic attack. Four patients had posterior circulation ischemia and 2 had anterior circulation ischemia. Digital subtraction angiography demonstrated that collateral circulation was established in all the 6 patients. The anterior communicating artery, posterior communicating artery, and pial artery were the common compensatory vessels. Conclusions Internal carotid artery steal syndrome can be presented as anterior or posterior circulation ischemia, and the collateral circulation plays an important role in the compensation.

Objective To compare the medical selection standards of flying cadets in the nervous and mental system between Air Force of PLA(PLAAF) and the US Air Force(USAF), and to offer suggestions on revising PLAAF medical standards for flying cadets .Methods All our candidates who had participated in the final medical selection of flying cadets were subjected to neurological examinations , and determined as qualified or not according to USAF Medical Standards Directory.Results 123 people were disqualified during the neurological examination , accounting for 1.1% of the total. According to USAF Medical Standards Directory , 13 of them were disqualified , 24 of them were qualified , and 86 of them needed a second examination .There was marked difference between disqualification rates of PLAAF and USAF .Conclusion There are some differences in medical selection standards for flying cadets in the nervous and mental system between PLAAF and USAF, and we could revise PLAAF standards using USAF standards for reference .

Objective To investegate the influencing factors of intra-abdominal infectious complications after pancreatoduodenectomy(PD). Methods The postoperative intra-abdominal infectious complications occurrence rate and the influencing factors after PD in 196 patients in recent 7 years were retrospectively analyzed.Results After PD,the rate of postoperative intra-abdominal infections was significantly higher than the rate of other complications. The rate of intra-abdominal infections in patients with near normal pancreatic remnent and with pulmonary infections were significantly higher than those in with harder pancreatic remnant and without pulmonary infections(P