Pancreatic cancer is a common malignancy of gastrointestinal system, with features of early metastasis, easy invasion to adjacent tissues and organs and neural metastasis. Therapies include surgery, chemotherapy, radiotherapy, physi-cal and biological therapy and so on. Surgical management, including radical resection and palliative operation, is a major approach. Radiotherapy and chemotherapy could improve the resectional rate and decrease the tumor dissemination. Physical and biological therapies are widely recommended, and there is a rapid progress in zoopery. However, the efficacy of all the thera-pies is far from satisfactory. Recently, the therapy consisting of surgical resection, radiotherapy, chemotherapy, physical and biological therapy in increasing the long-term survival rate and improving the life quality of patients, along with combined thera-py has attracted the attention of surgeons.

Primary liver cancer is the fourth most common malignancy and the second most common cause of cancer death in China, posing a serious threat to the health of Chinese people. Hepatocellular carcinoma (HCC) represents more than 90% of primary liver cancers, among them 66% of patients are with intermediate-advanced HCC. Therefore, prevention strategies and conversion therapies to patients with intermediate-advanced HCC are particularly important. Hepatic arterial infusion chemotherapy (HAIC) is one of the important treatment methods to treat intermediate-advanced HCC. The tumor objective response rates and surgery conversion rates of HAIC-based conversion therapies are promising. The authors review the history of HAIC and the HAIC-based conversion therapies in this article.

Object To observe the effects of Astragali Injection (Hi) and extracts from Atractylodes macrocephala Koidz. (B1, B4, B9, B13) on the migration of rat small intestinal crypt like cells line (IEC 6). Methods IEC 6 cells were inoculated in 6 well microplates and injured in 72 h, and added with Hi, B1, B4, B9, B13. Then D PBS to negative control in the same amount and EGF to positived control, the cell migration was observed in 24, 48 and 72 h after treatment. Results B4?B9?B13 and EGF significantly promoted the migration of wounded IEC 6 cells (P

Exertional heat stroke (EHS) is an emergency with a high mortality rate, characterized by acute onset and identification difficulties. EHS prevention focuses on evaluating the environment by professionals, making preventive measures in advance, identifying internal and external risk factors for the onset of disease, carrying out prior heat adaptation and endurance training, monitoring the status of high risk persons in real time. After occurrence of EHS, the key to success treatment is on-site accurate identification and diagnosis and rapid implementation of effective cooling measures, thus winning time of EHS patients transferred to the hospital for the treatment. This article reviews the current status of EHS prevention and treatment in domestic and foreign from the scene to the hospital. Summarizing the recognition, diagnosis, cooling measures, treatment concepts and principles of EHS, we hope to provide a reference for the rescue of EHS in hospital and outside.

Objective To evaluate the effect of early limited fluid resuscitation in treatment of severe pelvic fracture accompanied with traumatic hemorrhagic shock. Methods A retrospective study was done on 96 patients with severe pelvic fractures accompanied with traumatic hemorrhagic shock admitted into hospital from January 2002 to December 2006. Of all, 55 patients ( routine resuscitation group)were dealt with routine fluid resuscitation and 41 (limited resuscitation group) with limited fluid resuscitation. The injury severity, degree of shock, start time of resuscitation, transfusion volume were statistically analyzed and compared in two groups. Results Routine resuscitation group received transfusion volume of (3 432 ± 1 156) ml, with cure rate of 64% and mortality rate of 36% ; while limited resuscitation group received transfusion volume of (2 685 ± 524) ml, with cure rate of 83% and mortality rate of 17%. There was statistical difference between both groups ( P ＜ 0.05 ). Conclusion Limited fluid resuscitation can improve cure rate of severe pelvic fracture accompanied with traumatic hemorrhagic shock.

0.05). After operation, in the pedicle screw fixation group the indexes were restored, but the restoration was lost gradually at later follow- up stage. Their superior- inferior endplate angle before operation averaged 19.5? , but 8.6? after operation, and 20.0? at the latest follow- up. Their wedged angle before operation averaged 20.7? , but 9.1? after operation, and 15.9? at the latest follow- up. In the non- pedicle- screw fixation group, the indexes decreased gradually at the later follow- up. Their average superior- inferior endplate angle before operation was 16.6? , 14.6? after operation, and 23.0? at the latest follow- up. Their average wedged angle before operation was 15.6? , 16.6? after operation, and 22? at the latest follow- ups. Conclusions The height of the fractured vertebra may be lost and the wedged vertebra may occur again after surgery but conditions may become stable in 2 years. The spinal kyphosis deformity, however, may go on. Its possible causes are structural changes of the vertebra after surgery, the early degenerative changes of the adjacent intervertebral discs, and osteoporosis.

Objective To study the reference range of umbilical artery blood gas and the significance of umbilical artery blood pH on the diagnosis of neonatal asphyxia. Methods Five thousand six hundred and eleven live-births new born in our hospital were consecutively enrolled. The following five items related to birth asphyxia were recorded including antepartum high-risk factors, Apgar scores, umbilical artery blood pH, organ damage, and differential diagnosis on the causes of low Apgar score. Reference range of umbilical artery blood gas, the correlations between the umbilical artery blood pH and the other items were analysed. Results The reference range of umbilical artery blood gas ((x|-)?2s) were pH 7.00 - 7.40, PaO2 0.34 - 6.10 kPa, PaCO2 3.43 - 10.03 kPa, BE 1.5 - - 18. 5 mmol/L. The umbilical artery blood pH was negatively correlated with organ damage (r = - 0. 99,P

Objective To investigate and compare the change of extravascular lung water (EVLW) and levels of cytokines in septic patients without clinical acute lung injury (ALI) /acute respiratory distress syndrome (ARDS) with those in spetic patients with sepsis-induced ALI/ARDS in order to determine the role of EVLW involved in the pathogenesis of lung injury in the patients by quantifying the relationship between EVLW and biomarkers of lung injury in patients with sepsis.Methods A total of 40 septic patients complicated either with or without clinical ALI/ARDS after sepsis. In each patient,transpulmonary thermodilution (PiCCO) was used to measure cardiovascular hemodynamics and EVLWI for 7 days via an arterial cannula indwelled within 72 hours after diagnosis of severe sepsis was made, and serial bronchoalveolar lavages (BAL) were carried out.Other examinations including blood gas analysis,ventilator parameters,chest X-ray and the levels of pro-inflammatory cytokines such as tumor necrosis factor (TNF-oα),interleukin-1 in the BAL were recorded.In-hospital and ICU mortalities were also observed.Results Of total 40 patients,29 were complicated with clinically defined septic ALI/ARDS ( ARDS n =15,and ALI n =14).The septic patients complicated with ALL/ARDS had significantly higher amount of EVLWI and higher levels of TNF-α and interleukin-1 in the BAL than patients without ALI/ARDS ( P ＜ 0.05).The arterial oxygen tension/fractional inspired oxygen ratio,lung injury score,and the levels of TNF-α,IL-1 in the BAL correlated with EVLWI.Moreover,in-hospital mortality,ICU mortality and the length of ICU stay of the patients with high amount of EVLWI were markedly increased than those of patients with low amount of EVLWI. Conclusions In septic patients complicated with ALI/ARDS, the extravascular lung water index correlates with oxygenation,lung injury severity and inflammatory cytokines in lung.Determination of EVLWI may be useful for evaluation of severity of lung injury and prognosis of septic patients.

Objective To examine the levels of serum tissue inhibitor of metalloproteinase in severe sepsis patients with disseminated intra-vascular coagulation (DIC) and evaluate its diagnostic value in severe sepsis with DIC.Methods Sixty patients were divided into 3 groups,namely severe sepsis group (SS group,n =28),severe sepsis with DIC group (SSD group,n =12) and normal group (n =20).Clinical data including APACHE Ⅱ score and DIC score of these patients were collected.Serum levels of TIMP-1 and TIMP-2 of these patients were measured by using ELISA.Results The patients of SS group had higher levels of TIMP-1 (723.74 ± 96.27) and lower levels of TIMP-2 (68.08 ± 14.87) than healthy control subjects (TIMP-1:574.24 ± 79.99,TIMP-2:89.99 ± 18.45) (P ＜ 0.05).The patients of SSD group had higher levels of TIMP-1 (907.56 ± 200.20) and lower levels of TIMP-2 (44.84 ± 22.13) than patients of SS group (P ＜ 0.05).An association was found between TIMP-1 and fibrinogen (FIB) (r =-0.392,P ＜ 0.05),TIMP-1 and D-dimer (r =0.407,P ＜ 0.05),TIMP-2 and PLT (r =0.484,P ＜0.01),TIMP-2 and PCT (r=-0.523,P＜0.01),TIMP-2 and DIC score (r=-0.579,P＜0.01).The areas under the curves (AUC) for TIMP-1/TIMP-2 was 0.896 (95％ CI:0.843 ～ 0.950 (P ＜ 0.05).Conclusions Serum levels of TIMP-1 in patients with severe sepsis complicated with DIC increased and TIMP-2 decreased,suggesting they were valuable in diagnosis of severe sepsis complicated with DIC.