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Objective To summarize the diagnosis and surgical therapeutic experience of functional insulinoma.Methods The clinical materials of 21 cases of functional insulinoma confirmed by pathologic examination from Jul.2006 to Aug.2016 were analyzed retrospectively.Results All patients showed signs of Whipple's triad.19.0％ of them were misdiagnosed at the first visit.Before surgery,insulin to glucose ratio(IRI/G)was calculated in all patients,which in 21 cases (100％) was higher than 0.3.The accuracy of preoperative tumor localization,detected by ultrasonography,CT and MRI,was 38.1％,91.67％ and 77.78％,respectively.Intraoperative ultrasound (IOUS) plus palpation was able to localize tumor in 100％ of the cases.All of the 21 cases were solitary,among which 1 case was malignant insulinoma which was diagnosed with the left lateral lobe metastasis (4.8％).All the 21 cases underwent surgery,among whom 8 cases (38.1％)underwent laparoscopic resection.There were 4 cases (19.0％) of pancreatic fistula.Conclusions IRI/G higher than 0.3 can be used as the main evidence for diagnosis of insulinoma in clinically suspected patients.Multislice spiral CT is the first choice for preoperative localization of insulinoma.The significance of intraoperative ultrasound localization should be paid more attention.Surgical management of insulinomas is considered to be the only curative method.Precise localization,minimally invasive surgery and damage control treatment will be the development trend in the future.
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Cartoons were used in teaching of medical decision-making analysis course to analyze and reveal the connotations in different decision-making models according the difficulties of students in understanding the teaching decision-making models.The cartoons could effectively improve the understanding of abstract analysis model and the meaning of teaching analysis model in students because they could directly show the iterative and optimizing computation process in decision-making analysis, thus laying a solid foundation for the accurate analysis and ra-tional explanation of the results.Teachers should make full use of the visual cognition potential of students, and fo-cus their attention on the knowledge transmission and information exchange between teachers and students when they design the cartoons in order to improve the classroom teaching effect of teaching decision-making model.
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<p><b>OBJECTIVE</b>The purposes of this study were to investigate effects of chloroqquine (CQ) on inhibiting the decomposition of hydrogen peroxides (HP), and to optimize composition of the tooth-bleaching agent.</p><p><b>METHODS</b>According to the principle of the color-changing reaction between horse radish peroxidase and substrate, the tooth-bleaching agent made of HP was divided into four groups with different amounts of CQ. The stability of HP was observed using ELISA for 3 months.</p><p><b>RESULTS</b>With the prolongation of store time, the absorbance of HP solutions containing different concentrations of CQ declined at different degrees, which showed a dependent relation between absorbance values and concentrations of CQ. Within the range of experiment concentrations of CQ, the higher the concentration of CQ was, the stronger the stability of HP was. And the duration of tooth-bleaching effects in 150.0 mg/ml of CQ was prolonged 4 to 6 times compared to that without CQ.</p><p><b>CONCLUSION</b>The data indicate that CQ can inhibit the decomposition of HP. The bleaching effect of the tooth-bleaching agent which is made of HP and proper amount of CQ is satisfactory.</p>
