Pancreatic cancer is one of the most common and malignant tumor in the field of digestive system.Surgery still is potential method to cure pancreatic cancer.Laparoscopic surgery with the advantage of minimal invasion has been applied in the treatment of benign and low malignant tumors,but it is in great controversy whether laparoscopic surgery could be used in treatment of pancreatic cancer.This study reviews the literatures of laparoscopic surgery for pancreatic cancer and the clinical outcomes,and explores its current development and prospects.

Objective To invstigate the diagnostic value of the detection of telomerase activity in the specimen obtained from CT guided percutaneous transthoracic needle biopsy of lung nodules.Methods The techniques of TRAP silver staining were performed to detect telomerase activity in 43 cases. Results 43 mass cases were studied includirg 32 proved to be primary lung cancer, and 11 benign lesions cytologically and clinically. Telomerase activity was detected as 28(87.5%) of 32 lung carcinomas, whereas in benign lung lesions was 1(9.1%) in 11 cases.Conclusions Detection of telomerase activity in the specimen of lung nodules by CT guided percutaneous transthoracic needle biopsy may be an effective method in the diagnosis of lung cancer and also as tumor marker.

Objective To evaluate relations between lung cancer and the expressions of P53 protein together with proliferating cell nuclear antigen(PCNA) in specimens of lung lesions by needle biopsy.Methods CT-guidance percutaneous biopsy of lung lesions were performed in 66 patients with the determination of expressions of p53 protein and PCNA by flow cytometer (FCM). Results 1. The sensitivity of CT-guidance percutaneous biopsy was 94.3% in 53 cases of lung cancer with the diagnostic accuracy of 90.9% totally. The complication rate of pneumothorax was 4.6%. 2. The expression of P53 protein was (29.9?2.7)% in lung cancer (53 cases), while ( 17.9 ?2.8)% in benign lesions (13 cases) (t=2.0, P0.05).Conclusions FCM plays and valuable role in determining the expression of P53 protein and PCNA in the specimen of lung cancer by CT-guided percutaneous biopsy. The expression of p53 and PCNA may be useful in the diagnosis of lung cancer by providing the relation between imaging of lung cancer and the molecular mechanism, and furthermore revealing the characteristics of molecular biology of lung cancer at protein level.

Glomerulonephritis and rheumatic heart disease are usually inferred as immune complex disease caused by infections, but the pathogenesis of rheumatic heart disease is still not clear. In this experiment, we infected 38 rabbits with cercariae of S. japonicum and de-monstrated the histopathological changes of endocarditis, myocarditis and perivasculitis in the heart tissues of 33(86.8%) infected rabbits. Thrombosis was also found in heare vessels, but adult schistosomes or eggs were not found in the heart tissues. Direct and ndirect immune enzyme staining studies showed the presence of schistosome-specific antigenst and host antibodies in the heart tissues, suggesting that the histopathological changes in ithe infected rabbit hearts were resulted from the deposition of immune complexes and th secondary events pf host autoimmune reactions. In this paper, correlative clinical cases were reviewed and the possibility of heart disease in human schistosomiasis caused by immune mechanism was discussed. We hope that the above findings might broaden our understanding of the pathogenesis of rheumatic heart disease, myocardiopathy and cardio-vascular diseases (Plates 1-3).

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Objective To examine the proto_oncoge ne c_f os expression and its distribution in rat medulla oblongata induced by electro_a cupuncture of Neiguan point. Methods Anti_c_fos immunohistochemical method w as applied. Results Fos_like immunoreactive positive neurons mainly located in nucleus tractus solitarius, dorsal motor nucleus of vagus nerve, inferior ol ive nucleus, cuneate nucleus, external cuneate nucleus, and ventrolateral m edulla(VLM). VLM included lateral reticular nucleus, ambiguous nucleus and the s urrou nding reticular structure. Conclusion Electro_acupuncture of Neiguan point c an activate the proprioceptive pathways and the nucleus in the medulla oblongata that is related to visceral informatio n.

Objective To cvaluate the efficacy and safety of HabibTM VesOpen intravascular radiofrequency catheter percutaneous radiofrequency ablation combined with TACE in the treatment of portal vein tumor thrombus of primary hepatocellular carcinoma.Methods Thirty-nine patients with primary hepatocellular carcinoma complicated with portal vein thrombosis were treated with HabibTM VesOpen intracavitary catheter ablation combined with TACE.The postoperative success rate,complication,blood index,α-fetoprotein (AFP),portal vein patency and tumor thrombus imaging changes were assessed.Results All of 39 patients underwent surgery successfully without occurrence of perforation,infection,hepatapostema,intra-abdominal hemorrhage nor other complications associated with surgery.Blood routine examinations (WBC,RBC,PLT) after 2 weeks and 4 weeks of surgery had no statistical difference compared with those of preoperation.Liver function indexes including ALT,AST,ALB had statistical difference before and after the surgery except for TBIL.AFP had statistical difference before and after surgery.Doppler ultrasonography after 4 weeks showed blood flow in original blocked portal vein.Enhanced CT or MR examinations after 8 weeks on the abdomen,suggested that tumors were shrinked or disappeared.Conclusion Radiofrequency catheter ablation with intracavitary radiofrequency catheter of HabibTM VesOpen is an effective method in the treatment of portal vein tumor thrombus in primary hepatocellular carcinoma.

Japan has accumulated much experience in medical education through a long time exploration.Through some reform measures,such as training talent physicians,reforming education systems,choosing core teaching courses,and establishing comprehensive education system,Japanese medical education has been well promoted,which will be helpful to our country's medical education reforms.

Objective To investigate the clinical feature, treatment and prognosis of severe hand-footmouth disease without typical skin lesions. Methods Clinical data from 24 patients with severe hand-footmouth disease without typical skin lesions collected from January 2010 to May 2010 were retrospectively analyzed.Results There were 17 males and 7 females among the 24 patients. Of them, 3 patients with positive EV71 showed no skin lesions at the first visit, 2 presented with only herpes of mouth, 3 with only skin rashes in gluteal regions, 5 with only skin rashes on the palms, 2 with only skin rashes of the knees, 9 with skin rashes in hands, feet and gluteal regions simultaneously. The skin rashes were sparse with an atypical distribution.Fever occurred in all the 24 patients and lasted 6 - 7 days. Nervous system was involved in all the patients,and pulmonary hemorrhage occurred in 4 patients. RT-PCR and real-time PCR showed that the pharyngeal swab was positive for EV71 in 13 patients, for CoxA16 in 2, for other enterovirus in 3, and feces samples were positive for EV71 in 9 patients, for CoxA16 in 1, for other enterovirus in 2. Five patients were positive for EV71 in both pharyngeal swab and feces samples. Four patients died of multiple organ failure, the other 20 patients were cured and discharged from hospital. Conclusions The major pathogen causing severe hand-footmouth disease is EV71 in the 24 patients; children under 2 years are liable to this disease; high fever is common with various rashes. Early recognition of atypical skin lesions and timely management are most important for the control of severe hand-foot-mouth disease and improvement in overall survival of patients with this entity.

OBJECTIVE:To systematically evaluate therapeutic efficacies of perioperative application of single-dose and multipie-dose of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation,and to provide evidence-based reference.METHODS:Retrieved from PubMed,EMBase,CBM,Cochrane Library,CBM,CJFD,VIP and Wanfang database,RCTs about perioperative application of single-dose (trial group) and multiple-dose (control group) of antibiotics for preventing surgical site infection after closed fractures patients receive incision and internal fixation were collected.Meta-analysis was performed using Rev Man 5.3 statistical software after literature screening,data extraction and quality evaluation by improved Jadad.RESULTS:Finally 8 clinical studies were included,involving 3 457 patients.The results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection [OR=1.02,95％ CI(0.63,1.66),P=0.94)].Cefazolin stadies were included in subgroup analysis according to drug use,and results of Meta-analysis showed that there was no statistical significance in the rate of surgical site infection[OR=1.33,95％CI(0.55,3.20),P=0.52].CONCLUSIONS:Prophylactic application of single-dose of antibiotics is recommended for preventing surgical site infection after closed fractures patients receive incision and internal fixation.