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Pancreatic carcinoma remains one of the most challenging malignant tumor with an increasing morbidity in China.The significance of multidisciplinary and comprehensive treatment of pancreatic cancer has been recognized in recent years.Moreover,several novel clinical staging standards of pancreatic cancer have emerged to help optimize the treatment strategies and improve patients' prognosis in precise treatment era.Currently,in addition to the traditional TNM stage,usage of histologic grade (G),resection marginstatus (M),lymphatic invasion status (L),vascular invasion status (V),perineurial invasion status (P) and combination of these stages recommended by NCCN guideline as GTNMLVP stage have emerged.Other novel staging standards include respectability status,standardized pancreatic surgery classification,genetics classification,etc.This review summarized the characteristics and clinical significance of these novel established methods for pancreatic cancer precise staging.
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Objective To compare four therapies for elderly patients with cerebellar hemorrhage breaking into the ventricles.Methods Clinical data of 158 elderly patients with severe spontaneous cerebellar hemorrhage breaking into the ventricles were retrospectively analyzed.There were 28 cases in the conservative management (CM) group and 130 cases in the surgical therapy (ST) group with an external ventricular drainage (EVD) subgroup (n=40),an external ventricular drainage combined with intraventricular fibrinolysis (EVD + IVF) subgroup (n =43),and a clot evacuation (CE) subgroup (n=47).The mortality at 1 month and modified Rankin Scale (mRS) at 6 months were employed to evaluate clinical effectiveness.In addition,statistical analysis of correlative factors for prognosis was conducted.Results The 1-month mortality (x2 =7.529,P =0.006) and 6-month mRS in the CM group (x2 =4.819,P =0.028) were significantly higher than those in the ST group.There was no significant difference in mortality after one month among the three ST subgroups (x2 =0.143,P=0.931),whereas significant differences were observed in 6-month mRS among them (x2 =7.209,P=0.027),and the scale in the EVD+IVF subgroup was significantly lower than in the CE and EVD subgroups.The incidence of complications such as pulmonary infections and stress ulcers in the CM group was significantly higher than in the ST group.Statistical differences were found in the incidence of pulmonary infections among the three ST subgroups (x2 =6.694,P=0.035),and the incidences in the EVD subgroup and the EVD+IVF subgroup were lower than the incidence in the CE subgroup.Nevertheless,there was no significant difference in the incidence of stress ulcers among the three ST subgroups (x2 =0.547,P=0.776).Conclusions EVD+ IVF is an effective treatment for cerebellar hemorrhage breaking into the ventricles in elderly patients,especially for those who cannot withstand a craniotomy or those who have primary diseases.It may speed up the absorption of hematoma,and decrease the operative risk and the incidence of postoperative complications.
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Objective To study the relationship between hair selenium content and arsenism among population from endemic arsenism area caused by coal combustion in the southern of Shaanxi Province.Methods Four high-arsenic-exposed villages in southern Shaanxi Province were selected as the study area,and the nonarsenic-exposed villages nearby were selected as the control area,90 hair samples of residents exposed to high arsenic in the study area and 14 hair samples of residents in the control area were collected.Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was used to determine the contents of arsenic and selenium in hair samples.Selenium/hair arsenic (Se/As) value was calculated,and the relationship between selenium content in hair samples and arsenicosis was analyzed.Results The geometric mean of selenium concentration in hair from the study area was 8.72 mg/kg,which was significandy higher than that from the control area (0.54 mg/kg,t =9.811,P ＜ 0.05).However,selenosis case was not found in the study area.Selenium content in hair was not obviously correlated with arsenism (r =0.075,P ＞ 0.05),while the Se/As value was negatively associated with the grade of arsenism (P ＞ 0.05).The geometric mean of selenium content in hair of female from the study area was 12.79 mg/kg,which was higher than that in hair of male (6.5 mg/kg,t =1.738,P ＜ 0.01).Meanwhile,the Se/As value in hair of female from the study area (1.15) was significantly higher than that in hair of male (0.65,t =3.218,P ＜ 0.05).Conclusions The environment of the study area is polluted by arsenic and selenium derived from stone-coal burning.Antagonism between arsenic and selenium might reduce the toxicity of selenium.Therefore,selenosis is not found in the study area.In addition,antagonism between arsenic and selenium might also induce lower prevalence of arsenism for female in the studly area.
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Objective To explore the life quality of postoperative patients after a hypertensive cerebral hem-orrhage in the basal ganglia and the factors influencing it, so as to provide evidence for improving the life quality of such patients. Methods A total of 128 patients were studied retrospectively. Their gender, age, occupation, mari-tal status, education level, place of residence and family size were tabulated, as well as whether or not they were liv-ing with their children, smoking or drinking alcohol. Their household income was recorded along with their clinical condition during surgery ( midline shift, blood loss, operative time, whether a hernia occurred, consciousness, and whether bleeding broke into the ventricles. The SF-36 health measurement scale was used to evaluate the patients′life quality, and the factors influencing it were analyzed. Results Univariate analysis showed that: ( 1) Their physio-logical functioning ( PF) and global health ( GH) were mainly affected by age, marital status, family size, midline shift, quantity of cerebral hemorrhage, occurrence of herniation, consciousness and whether the hemorrhage broke in-to the ventricles. (2) Their physiological role (RP) was influenced by marital status, education background, household monthly income, midline shift, consciousness and whether the hemorrhage broke into the ventricles. (3) Pain (BP) was mainly affected by marital status and family size. (4) Social functioning (SF) was closely related to marital status, family size, consciousness and whether hemorrhage broke into the ventricles. (5) Their mental health (MH) was main-ly affected by the amount of bleeding, whether they were living with their children, the operation′s duration and whether the hemorrhage broke into the ventricles. (6) Their emotions (RE) were influenced by their consciousness and whether bleeding broke into the ventricles. (7) Their vitality (VT) was affected by their marital status, smoking, consciousness and whether the bleeding broke into the ventricles. Multivariate analysis showed that whether the hemorrhage broke into the ventricles was the most influential factor. Family size was also influential. Conclusions Age, number of family members, whether they are living with their children, and whether hemorrhage broke into the ventricles are all influen-tial in predicting the life quality of survivors of hypertensive cerebral hemorrhage in the basal ganglia.
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Objective To compare the safety and efficacy of carotid artery stenting (CAS) and carotid endarterectomy(CEA) for the treatment of carotid stenosis. Methods The electronic databases (PubMed, EMbase, Cochrane Central Register of Controlled Trials, CNKI, VIP and Wanfang) were searched in order to retrieve randomized controlled trials (RCTs) about comparing CAS and CEA for the treatment of carotid stenosis. Cochrane collaboration's RevMan 5.0.24 were used for analyzing data. Results Twelve RCTs totalling 6903 patients (3460 patients were randomized to CAS and 3443 randomized to CEA) with symptomatic or asymptomatic stenosis were included in the meta-analysis. There were significantly higher 30-day relative risks after CAS than after CEA for death or any stroke [RR=1.64, 95%CI (1.33-2.03), P＜0.00001] and for stroke [RR=1.70, 95%CI (1.34-2.14), P＜0.00001]. The relative risks of myocardial infarction [RR=0.62, 95%CI (0.39-0.97), P=0.04] and cranial neuropathy [RR=0.07, 95%CI (0.03-0.16), P＜0.00001] was significantly less after CAS than after CEA. The relative risks of death [RR=1.27, 95%CI (0.82-1.96), P=0.29] or disabling stroke within 30 days [RR=1.33, 95%CI (0.78-2.28), P=0.29] and any stroke or death at 1 year after the procedures [RR=0.96, 95%CI (0.63-1.46), P=0.84] did not differ significantly between CAS and CEA operation. Conclusions CEA remains the first choice for treatment of carotid stenosis for patients with low surgery risk. For patients with high surgery risk and unsuitable for surgery, CAS has more advantages. It is reasonable to view CAS and CEA as complementary rather than competing modes of therapy.
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Functional multineuron calcium imaging(fMCI)is an optical recording technique to monitor neuron population action potentials in the spatiotemporal pattern by recording calcium signal changes in neurons.The review describes the technology of fMCI and its application prospect in neuropharmacology research.fMCI provides a kind of powerful tool to analyze various functions of brain and to research some central nervous system drug mechanism based on neural network.
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[Objective]To discuss the technique and outcome in the treatment of old nonunion of long bone fracture by using autologous fibula plate alone or combination with internal fixator plates.[Method]Fifty-seven patients(41 males and 16 females;average age of 41.6 years)with nonunion of long bone fracture were recruited.Of them 18 had short deformity(average 2.6 cm)and 12 had angled deformity(average 15?).Average time was 12 months(6-36 months).The sclerosed cortex was removed at both ends of the nonunion long bone.A suitable length of fibula plate were transplanted by screw with or without internal fixator plates.[Result]The follow-up average time was 3 years(ranged,1 to 6 years).At 1,3,6,12,24 months after operation,the outcome was analyzed by radiography.Bone healing was found in all 57 patients,with an average of 15 weeks(8-24 weeks).All the patients exhibited a good function in walking and burdening.No nonunion occurred.[Conclusion]Autologous fibula plate with or without internal fixator plates for nonunion of long bone fracture can facilitate healing and early functional recovery.This therapeutic method is an ideal technique in treating patients with nonunion of long bone fracture.