Objective To investigate the clinical significance of K-ras mutations in pancreatic diseases, specifically in the diagnosis of pancreatic carcinoma. Methods One hundred and seventeen surgical-resected pancreatic specimens, including 24 pancreatic ductal adenocarcinoma, 19 peritumoral ductal atypical hyperplasia, 58 peritumoral ductal hyperplasia, 19 normal duct at the tumor-free margin and 24 ductal lesion from chronic pancreatitis were obtained, and DNA was extracted from the specimens. Codon 12 K-ras mutations were examined using two-step polymerase chain reaction (PCR) combined with restriction enzyme digestion, non radioisotopic single-strand conformation polymorphism (SSCP) analysis and automated DNA sequencing. Results K-ras mutation rate in the lesion of pancreatic carcinoma was 79.2%(19/24), which was significantly higher than 33.3%(8/24) in the lesion of chronic pancreatitis( P

Objective To explore the clinical characteristics,management and pregnancy outcome in patients with ovarian tumor and ovarian tumor like condition complicated with pregnancy.Methods The clinical data of 248 patients with ovarian tumor and ovarian tumor like condition eomplicated with pregnancy who treated,operated and pathology conducted from January 2003 to December 2009 was analyzed retrospectively.Results Among of 248 patients,8 patients were found by pelrioscopy,184 patients were found by sonography.The rate of ovarian tumor and ovarian tumor like condition during pregnancy was 0.49％ (248/50 652),about 52.82％(131/248)were diagnosed as benign tumor,most of them were ovarian mature teratoma(22.18％,55/248).About 45.56％(113/248)were diagnosed as ovarian tumor like condition,most of them were ovarian chocolatecyst(23.79％,59/248).Four patients(1.61％,4/248)were ovarian malignant tumor.Two hundred and sixteen received operation,term birth was in 164 patients,premature birth was in 19 patients,miscarriage was in 33 patients.Conclusions Pelvioscopy and sonogaraphy are principally important in the diagnosis and detection of ovarian tumor during pregnancy.Pregnancy complicated with ovarian tumor or ovarian tumor like condition should be treated by tumor resection.Suitable surgery intervention during second trimester is safe.

Objective:To investigate the application value of pulse-indicated continuous cardiac output (PICCO) monitoring combined with critical care ultrasound-oriented convulsive therapy in the management of fluid intake in shock patients.Methods:Eighty-two patients with shock who received treatment in Shaoxing People's Hospital, China between May 2017 and May 2020 were included in this study. They were randomly assigned to undergo either PICCO monitoring (control group, n = 41) or PICCO monitoring combined with critical care ultrasound-oriented convulsive therapy (study group, n = 41). Fluid intake management-related indexes [24-hour total fluid intake, central venous pressure, mean arterial pressure, oxygenation index and lactic acid] and treatment outcome-related indexes (mechanical ventilation time, intensive care unit length of stay, 24-hour remission rate, 28-day mortality rate, sequential organ failure assessment score) were compared between control and study groups. Results:24-hour total fluid intake and lactic acid level in the study group were (2 516.98 ± 254.78) mL and (0.60 ± 0.05) mmol/L, respectively, which were significantly lower than those in the control group [(2 920.02 ± 295.33) mL, (1.34 ± 0.15) mmol/L, t = 16.573, 3.837, P < 0.01, P = 0.041). Central venous pressure, mean arterial pressure and oxygenation index in the study group were (13.381 ± 1.41) mmHg, (82.34 ± 8.22) mmHg and (224.06 ± 23.21) mmHg, respectively, which were significantly higher than those in the control group [(8.53 ± 0.85) mmHg, (70.92 ± 7.18) mmHg, (192.30 ± 19.70) mmHg, t = 5.152, 6.754, -2.498, all P < 0.05]. Mechanical ventilation time and intensive care unit length of stay in the study group were (7.54 ± 0.72) days and (11.46 ± 1.11) days, respectively, which were significantly shorter than those in the control group [(11.72 ± 1.13) days, (18.29 ± 1.73) days, t = 4.727, 5.224, both P < 0.05). 24-hour remission rate in the study group was significantly higher than that in the control group [85.37% (35/41) vs. 63.41% (26/41), χ2 = 5.185, P < 0.05]. 28-day mortality rate in the study group was significantly lower than that in the control group [7.32% (3/41) vs. 29.27% (12/41), χ2 = 6.608, P < 0.05]. Sequential organ failure assessment score in the study group was significantly lower than that in the control group [(6.86 ± 0.63) points vs. (11.05 ± 0.91) points, t = 4.814, P < 0.05]. Conclusion:PICCO monitoring combined with critical care ultrasound-oriented convulsive therapy exhibits an obvious effect in the management of fluid intake in shock patients, which can greatly reduce total fluid intake and remarkably improve treatment outcome-related indexes.