Objective To evaluate the efficacy of preoperative biliary drainage (PBD) in the pancreaticoduodenectomy for malignant obstructive jaundice.Methods Database including PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Academic Degree Dissertation Database and Conference Database were searched with malignant obstructive jaundice,pancreaticoduodenectomy,preoperative biliary drainage,comparative study.Literatures about the randomized controlled trials of PBD (PBD group) and efficacy of early surgery (ES group) in the pancreaticoduodenectomy were retrieved from January 2001 to December 2013,and then a Meta analysis was carried out based on the data.The count data were analyzed using the odds ratio (OR),relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using mean difference (MD) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Data were integrated by fixed or random effect model.Results Twelve literatures including 1 982 patients were selected.There were 1 029 patients in the PBD group and 953 in the ES group.The results of Meta analysis showed that the operation time,volume of blood loss and rate of postoperative wound infection in the PBD group were significantly different from those in the ES group (MD =10.50,107.92,95％ CI:6.34-14.66,16.43-199.42;RR =1.62,95％CI:1.19-2.21,P ＜0.05).There were no significant differences in the postoperative mortality,incidence of pancreatic fistula,incidence of bile leakage,incidence of delayed gastric emptying and duration of hospital stay between the 2 groups (RR=0.69,95％CI:0.52-0.92;OR =0.68,1.35,95％CI:0.38-1.21,0.93-1.95;MD =0.69,95％CI:-0.67-2.05;RR =0.00,95％ CI:-0.02-0.01,P ＞0.05).Conclusion PBD in the pancreaticoduodenectomy for malignant obstructive jaundice cannot reduce postoperative mortality and incidence of complications in patients,and should not be used as the conventional management in the perioperative period.

Objective To evaluate the efficacy of interventional MRI in radiofrequency ablation (RFA)of breast cancer.Methods 12 patients with breast carcinoma proven by core-needle biopsy-were enrolled in this study.Among them, 7 patients were in phase Ⅳ(6 with lung metastasis, 1 with bone metastasis),and 5 patients were in phase Ⅲ(all of them rejected the surgical operation because of various contraindications,including severe hypertension,diabetes mellitus,liver or kidney dysfunction,and advanced age).Moreover, all of the tumor size could not be further shrunk after medical treatment (such as 4-6 cycles chemotherapy, endocrine therapy or targeted therapy).Additionally,breast lesions were still remained to be confirmed by imaging examination and biopsy pathology.Then the tumor and surrounding breast tissue were ablated with radiofrequency,followed by clinical follow-up and imaging examination after 1, 3, 6 and 12 months.Results All the patients completed 18 times RFA treatment.MRI showed that all the tumor lesions were necrotic, blood supply was disappeared and therewas no enhancement.Radiographic examination showed the original breast lesions were fuzzy or disappeared.All the tumors were achieved complete remission (CR) examined by imaging,and the effective rate was 100%.All the postoperative patients survived 1 year according to the follow-up data.Conclusion Interventional MRI is safe and effective method in the radiofrequency ablation of breast cancer.