螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

胰管结石的分型和治疗

Objective To explore the classification and surgical management of pancreatic duct stones.Methods The clinical data of 54 patients with pancreatic duct stones who were admitted to the People's Hospital of Hunan Province from June 1994 to November 2009 were retrospectively analyzed. Stones were found in the head of the pancreas (type Ⅰ ) in 31 patients, in the body and tail of the pancreas (type Ⅱ ) in 7 patients, and in all the pancreas (type Ⅲ ) in 16 patients. According to the types of the pancreatic duct stones, ten patients (6 with type Ⅰ , two with type Ⅱ and two with type Ⅲ pancreatic duct stones) received opening of the main pancreatic duct + pancreaticojejunostomy or pancreaticogastrostomy ( group A). Twenty-four patients ( 16 with type Ⅰ and eight with type Ⅲ pancreatic duct stones) received pancreaticoduodenectomy (group B). Fifteen patients (nine with type Ⅰ and six with type Ⅱ pancreatic duct stones) received subtotal resection of pancreatic head preserving duodenum (group C). Five patients with type Ⅱ pancreatic duct stones received resection of the body and tail of the pancreas and the spleen (group D). All data were analyzed using the t test. Results The mean operation time, blood loss, length of postoperative stay and hospital charges of group A were (2.2 ± 1.2)hours,( 127 ±24)ml,( 11.4 ±4.3) days and (3.24 ± 1.15 ) × 104 yuan, respectively. Five out of nine patients who were followed up had stone recurrence. The mean operation time, blood loss, length of postoperative stay and hospital charges of group B were (7.6 ± 1.1 ) hours, (409 ± 37 ) ml, ( 18.9 ± 2.5 ) days and (7.93 ± 1.35 ) × 104 yuan, respectively.No stone recurrence was detected in the 21 patients who were followed up. The mean operation time, blood loss,length of postoperative stay and hospital charges of group C were (4. 1 ± 0.7 ) hours, ( 156 ± 63 ) ml, ( 10.3 ±2.1 )days and (4. 12 ± 1.22) × 104 yuan, respectively. No stone recurrence was detected in the 15 patients who were followed up. The mean operation time, blood loss, length of postoperative stay and hospital charges of group D were (3.3 ± 1.4) hours, ( 185 ± 36 ) ml, ( 9.3 ± 2.0) days and ( 3.22 ± 1.05 ) × 104 yuan, respectively. No complication was detected after the operation, and no stone recurrence was detected in the three patients who were followed up. There were significant differences in the mean operation time, blood loss, length of postoperative stay and hospital charges between patients with type Ⅰ and Ⅲ pancreatic duct stones who received pancreaticoduodenectomy and subtotal resection of pancreatic head preserving duodenum (t = 12. 143, 14. 099, 11. 550, 9. 103,P < 0.05 ). Conclusions Classification of the pancreatic duct stones is important for choosing the proper surgical procedure. Subtotal resection of pancreatic head preserving duodenum is ideal for the treatment of patients with type Ⅰ or Ⅱ pancreatic duct stones.     

胰腺癌组织中程序性细胞死亡因子4与细胞色素C的关系

Objective To study the relationship between the expression of cytochrome c ( Cyt c) and programmed cell death 4 (PDCD4) in pancreatic cancer, and investigate the pathway of PDCD4 inducing the apoptosis of pancreatic cancer cells. Methods Pancreatic cancer specimens from 69 patients who received pancreatic resection from 1990 to 2002 in First Affiliated Hospital of China Medical University were collected. The expression of Cyt c in the 69 paraffin specimens of pancreatic cancer was detected by immunohistochemistry, and the expression of Cyt c in 8 samples of cold-preserved fresh pancreatic cancer and normal pancreatic tissues were detected by Western blot. The expression of PDCD4 and Cyt c in pancreatic cancer was analyzed by paired t test and chi-square test. Results Compared with normal pancreatic tissues, the expression of Cyt c in pancreatic cancer was significantly decreased. The positive expression rate of Cyt c in 69 samples of pancreatic cancer was 41% (28/69). The expression of Cyt c was positive in most patients with positive expression of PDCD4, and the expression of PDCD4 was negative in most patients with negative expression of Cyt c. The expression of PDCD4 and Cyt c was closely correlated with each other (χ2= 10.52, P < 0.05). Conclusions There is a close relationship between the expression of PDCD4 and Cyt c in pancreatic cancer. PDCD4 may induce the apoptosis of pancreatic cancer cells through mitochondrial pathway.     

RCAS1在胰腺癌诊断中的作用

Objective To evaluate the effect of receptor-binding cancer antigen expressed on SiSO cells(RCASI) as serum tumor marker on the diagnosis of pancreatic cancer. Methods Receiver-operating characteristics(ROC) curve methods were used to assay the serum content of RCAS1 ,CA19-9 and CA242 in 46 patients with pancreatic cancer, 18 patients and 20 normal tissues of chronic pancreatitis detected by enzymelinkod immunosorbent assay (ELISA), and the results were analyzed by statistics methods. The expressions of RCAS1 protein were analyzed by immunohistochemical method in 32 patients with pancreatic cancer, 10 patients with chronic pancreatitis and 6 cases of normal pancreatic specimens. Results The serum levels of RCAS1 ,CA19-9 and CA242 in pancreatic cancer were higher than that in chronic pancreatitis respectively (P ＜ 0.01). The area under curve of RCAS1, CA19-9 and CA242 were 0.826, 0.804 and 0.737 ,respectively. Subgroup analysis indicated that the RCAS1 and CA19-9 levels of pancreatic cancer patients without obstructive jaundice were lower than those for patients with obstructive jaundice (P＜0.01). CA19-9 levels of patients with resectable pancreatic cancer were lower than those with unresectable pancreatic cancer(P ＜ 0.01). Immunohistochemistry showed that the expression rates of RCAS1 in pancreatic cancer and chronic pancreatitis were 87.5% and 40.0% ,respectively (P ＜0. 05). Conclusions In diagnosis of pancreatic cancer,the clinical value of RCAS1 is available. And the combination test of RCAS1 and CA19-9 have clinical value to evaluate if the pancreatic cancer can be resected before operation.     

Faculty of Anaesthetists of the Royal College of Surgeons of Ireland

The Faculty of Anaesthetists of the Royal College of Surgeons of England, 35–43 Lincoln's Inn Fields, London WC2A 3PN. Telephone: 01-405 3474.     

深圳市某两所小学流行性腮腺炎突发疫情的流行病学分析

目的：通过对深圳市某两所小学发生的流行性腮腺炎突发疫情的流行病学特点及差异性进行分析,为制定科学、高效的防控策略提供科学依据。方法2013年5～7月深圳市大鹏新区某两所小学爆发流行性腮腺炎,以学校为整体研究对象,分别标记为学校A（24个班,学生1210例）和学校B（27个班,学生1274例）,对比两所小学的疫情流行病学差异性。结果分析发现,学校A流行性腮腺炎发病率为4.30%,发病班级所占比54.17%,均较学校B1.73%和29.63%高,对比差异有统计学意义（P＜0.05）;分析显示学校A学生出现疫病平均年龄为（11.2±1.1）岁,较学校B（9.34±1.0）岁,对比差异明显（P＜0.05）;且两组疫病患儿在接种疫苗率对比上差异无统计学意义（P＞0.05）;但疫情发生时,学校B疫苗紧急接种率明显高于学校A,对比差异有统计学意义（P＜0.05）。结论小学作为流行性腮腺炎爆发的主要场所之一,疫病爆发高峰季节前,针对易感染人群给予相应的疫苗接种等预防控制措施,同时加强流行性腮腺炎的监测,对于降低感染人群数量,减轻、遏制疫情有着积极的意义,值得相关防控部门重视。