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Objective To investigate the diagnosis and treatment of solid-pseudopapillary tumor of pancreas (SPTP). Methods The clinical manifestations, imaging findings, treatment and prognosis of 36 patients with SPTP from September 2005 to December 2015 were retrospectively analyzed. Results All patients were female, with the average age of 30.5 years. There were 11 cases of abdominal mass and 15 cases of abdominal tenderness. Thirty-three patients underwent ultrasonography, which showed pancreatic solid heterogeneous hypoechoic, echogenic light clusters or cystic mixed echogenic masses;the tumors boundary were clear, and some tumors were separated in the center; most tumors were not accompanied by pancreatic duct and bile duct dilatation. CT plain scan showed that most tumors were single circular mixed density shadow with clear capsule;CT enhanced scan showed that the arterial phase of the cyst wall and solid area was mild or moderately enhanced, and the portal phase and the delayed phase continued to strengthen, and the cystic part was not strengthened in each period. All patients underwent surgical treatment. Postoperative pancreatic fistula occurred in 8 cases, edematous pancreatitis in 6 cases, incision infection in 2 cases, all of which were cured after symptomatic treatment. The patients were followed up for 5 to 120 months with an average of 56 months. All patients were not treated with postoperative radiotherapy or chemotherapy. Thirty-four patients had a good prognosis and no signs oftumor recurrence and metastasis;1 patient died of acute leukemia 2 months after discharge, and 1 patient was lost in follow-up after 1 year of postoperative liver metastasis. Conclusions The main patient group of SPTP is young women. The clinical symptoms are mostly abdominal mass and tenderness. Preoperative diagnosis is difficult. Imaging examination is great significance for the preoperative diagnosis of SPTP. Surgical resection is the only effective treatment. The choice of surgery should be based on the location of the tumor, the invasion tendency of the tumor seen during surgery, and the rapid pathology of the operation. Most patients with SPTP have a good prognosis, and the recurrence rate and metastasis rate are low.
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Objective To explore the association between urinary lactate/creatinine ratio and neonatal asphyxia,and to clarify the application value of urinary lactate/creatinine ratio in forecasting the hypoxie-ischemic encephalopathy (HIE)in neonates.Methods Using case-control study design method,40 cases of neonatal asphyxia infants were selected as asphyctic group and 40 healthy infants were used as control group.The urinary lactate/creatinine ratio in the first day after birth, urinary N-Acetyl-β-D-glucosaminidase (NAG)/creatinine and the score of Apgar of 80 infants were detected.The relationship between the urinary lactate/creatinine ratio,urinary NAG/creatinine ratio, as well as the score of Apgar and HIE were analyzed and compared in asphyctic group and control group.Results The Apgar scores at 1 and 5 min in asphyctic group were significantly lower than those in control group (P<0.01). The urinary lactate/creatinine ratio and urinary NAG/creatinine ratio in asphyctic group 1 d after birth were significantly higher than those in control group(P<0.01).There was significantly negative correlation between the urinary lactate/creatinine ratio and the 1-min and 5-min Apgar scores(r=-0.636,P<0.001;r=-0.883,P<0.01),but there was a significantly positive correlation between the urinary lactate/creatinine ratio and urinary NAG/creatinine ratio(r=0.433,P<0.01).Conclusion The urinary lactate/creatinine ratio may have decisive roles in prognosis evaluation of neonatal asphyxia,and so as the important foundation for the prediction of HIE.
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Objective To observe the clinical characteristics and efficacy of laser photocoagulation of aggressive posterior retinopathy of prematurity (AP-ROP).Methods Twenty-eight eyes of 14 infants with AP-ROP from May 2008 to December 2010 were enrolled in this study.The infants were examined using RetCam photography and indirect ophthalmoscopy.Among the 28 eyes,24 eyes were classified as zone one and 4 eyes zone two.All eyes were treated within 24 hours using binocular indirect ophthalmoscope and laser photocoagulation.The initial energy was 200 mW,using energy was 200 - 500 mW,exposure time was 200 ms.Every two photocoagulation spot was linked together,but no overlap.Follow-up ranged from 3 to 24 months,with a mean of 11.5 months. The retinal bloods,the iris surface vessels,the fiber hyperplasia on retina,retinal detachment or ruffle form were observed.Results Twenty-five of 28 eyes (89.3 ％) recovered or were classified as control; 1 of 28 eyes (3.6 ％) was suffered retinal detachment one month after treatment.The detachment was resolved through vitrectomy Surgery.Two of 28 eyes (7.1 ％)did poorly.The parents gave up treatment resulting in loss of vision.No treatment-related complications were observed during the follow-up period,such as damage to cornea,iris and lens. Conclusion Photocoagulation is a safe and effective way to treat most AP-ROP.