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Objective To study the diagnostic value of CT combined with serum carbohydrate antigen 19-9(CA19-9), carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125)in diagnosis of pancreatic cancer.Methods 68 patients with pancreatic occupying lesions were selected and they were divided into pancre -atic cancer group(n=43)and non-pancreatic cancer group(n=25)according to pathological diagnosis.34 cases from physical examination were set as the control group .All patients received CT examination and the consistency between CT diagnosis and pathological results was analyzed .Serum CA19-9, CEA, and CA125 were detected by chemiluminescence method.The sensitivity, specificity and accuracy of CT combined serum CA 19-9, CEA, CA125 were analyzed.Results Among the 68 cases, 35 cases were pancreatic cancer diagnosed by CT , and the CT diagnosis was not ideal compared with pathological results .Nonparametric test found that serum CA 19-9, CEA and CA125 in pancreatic cancer group were higher than those of the non-pancreatic cancer group and the control group, and the difference had statistical significance ( P0.05 ) .Conclusion CT diagnosis had high susceptibility and low specificity ,CT combined with serum CA19-9,CEA, and CA125 can improve accuracy of pancreatic cancer diagnosis .
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Objective To investigate the feasibility and technique in laparoscopic cholecystectomy and exploration of common bile duct (CBD) in patients who have previous subtotal gastrectomy.Methods From January 2001 to October 2010,22 patients who had a history of subtotal gastrectomy received laparoscopic cholecystectomy and CBD exploration in our hospital.In addition,these patients received cholangioscopic lithotomy,electrohydraulic lithotripsy,T-tube drainage,or primary suturing of the CBD wound.Results The procedures were completed successfully in 18 patients.In 4 patients,conversion to laparotomy was necessary because of multiple stones in a stenosed CBD (n=1),severely congested CBD wall with edema (n=1),CBD carcinoma associated with impacted stones (n=1) or Mirzzi syndrome (n =1).T tube drainage was employed in 16 patients,and primary suturing in 2 patients at the end of the operation.There was no hemorrhage,biliary leakage or abdominal infection.At a mean follow-up of 13 (range 3 to 60) months there was no residual stone,biliary stenosis or cholangitis.In 3 patients Stone recurred,and another 3 patients were lost to follow-up.Conclusions A history of subtotal gastrectomy is not a contradiction to laparoscopic cholecystectomy and CBD exploration.With choledocoscopy,surgery can be safe and feasible even for patients with previous gastectomy.
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Objective To study the effects and advantages of the treatment for simple bone cysts of the long bones in children with AO titanium elastic nail and autologous bone marrow injection. Methods Eighteen patients with a simple bone cyst at humerus or femur were managed with AO titanium elastic in-tramedullary nail combined with autologous bone marrow injection. There were eleven boys and seven girls in total, with the mean age of 8.1 years, ranged from 6 to 12 years. Twelve cysts was located in the proximal end of humerus, five in the proximal end of femur and one in the middle part of the shaft of femur. Twelve cysts were active and six inactive according to Neer standard. Radiographic evaluation was performed three, six, twelve and eighteen months after operation during the 11 to 23 months follow-up by taking anteroposteri-or and lateral X-ray pictures. Then we measured residual radiolucent areas on X-ray pictures and did statistic research with group comparison. Results Six cysts (33.3%) healed completely, and twelve (66.7%) healed with residual radiolucent areas which were visible on X-ray pictures 3 to 6 months after operation. Residual radiolucent areas on X-ray pictures gradually reduced during the different phases and it has statistical signif-icance by group comparison. There was no recurrence or major complication except for one patient with mild irritation of skin caused by the end of the nail up to now. Conclusion The treatment for simple bone cysts of the long bones in children combined with AO titanium elastic nail and autologous bone marrow injection not only has satisfactory healing rate but also can provide early stability to the long bones, and accelerate the healing of cysts which allows early mobilization and thus obviates the long-term need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture.
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0.05). The improvement in total score of symptoms of the herb group was better than that of the western medicine group (P0.05). The blood glucose,HbA1c,and insulin of both groups was lowered after treatment (P