Pancreatic cancer is a highly malignant tumor of digestive tract which early diagnose is very difficult and has low rate of surgical resection of advanced pancreatic cancer. However, the rate of postoperative recurrence and metastas is high. Its prognosis is poor. To improve the prognosis of pancreatic cancer , it is necessary to improve its early diagnosis and effective prediction of postoperative recurrence and metastasis. In recent years, with the development of proteomics, the early diagnosis of pancreatic cancer and its early diagnosis of recurrence and metastasis was possible. Wsing proteomics technology for protein differences screening, isolation and identification is conductive to early detection of pancreatic proteome changes and establishment of the markers for early diagnosis, and recurrence and metastasis of pancreatic cancer.

Objective To evaluate the effectiveness and safety of Xuebijing (XBJ) injection in therapy of sepsis.Methods It is a prospective,randomized controlled trial conducted in multicenter.Totally 731 patients with sepsis were enrolled from January to December 2011 at 37 centers and randomly (random number) separated into the XBJ group (n =392) and the control group (n =339).Basic therapy was adoptd in the both groups,but XBJ injection was additionally used in the XBJ group.The effectiveness of XBJ injection was evaluated by comparing the differences of MEDS score,APACHE Ⅱ score,DIC score,SOFA score,coagulation parameters,duration of mechanical ventilation and antibiotic therapy between the two groups.The influence on the outcome of XBJ injection was assessed by mortalities of 28-day and 90-day.The side-effects of XBJ injection were recorded.Results The score of each system and the abnormal rates of coagulation parameters were significantly higher in the XBJ group than in the control group at admission (P ＜ 0.05).After combined treatment of XBJ injection and basic therapy,the score values of the XBJ group decreased distinctly,and the differences of pre-therapy and post-therapy in the two groups had statistical significance (P＜0.01).The abnormal rates of coagulation parameters in the XBJ group decreased after therapy.The 90-day mortality of the XBJ group was lower than the control group (P ＜ 0.05).No severe side-effects were found during study.Conclusions This study proved that the severity of sepsis can be alleviated by XBJ injection.Meanwhile,the organ function and the coagulation status can be protected,and then the prognosis can be improved.The safety of XBJ injection was good.

Objective To study the treatment and prevention of allergic response in IVP by ominipaque. Methods 39 cases with allergic reaction were divided into four grades of slight, moderate, moderately severe and severe. Results Of the 39 cases, 38 ones were with slight slight allergic reaction, and 1 case was with moderate reaction. Conclusion Rapid and proper treatment can eliminate the allergic reaction by ominipaque.

Objective To evaluate the curative effects and side effects of burcea javanica oil emulsion(BJOE) in the treatment of pleural effusion of lung cancer by thoracic injection.Methods 40 cases with pleural effusion of lung cancer were treated by using BJOE.A dose of 50～100ml BJOE was injected intrapleurally,once every 5～7 days,4 time for a course of treatment,then the effects and side effects were observed after one month.Results The effective rate was 90%(36/40).The side effects were fever(n=4) and digestive sickness(n=2) as well thoracalgia(n=1).Conclusion Brucea javanica oil emulsion has good curative effect and low side effect in the treatment of pleural effusion of lung cancer.

ObjectiveTo explore the effects of different anesthesia approaches on hemorheology in patients with pregnancy-induced hypertension (PIH) during cesarean section.MethodsOne hundred and sixty-five patients with PIH were divided into epidural anesthesia (81 cases,control group) and combined spinal epidural anesthesia (84 cases,experiment group).The hemorheology and Apgar score were compared.Results The anesthesia and post-parturition,the levels of whole blood low shear viscosity,whole blood middle shear viscosity,whole blood high shear viscosity,erythrocyte aggregation index,plasma viscosity,fibrinogen were improved compared with those before anesthesia [experiment group:(6.3 ± 0.7 ),(6.6 ± 0.6)mPa·s vs.(8.1 ± 1.8) mPa·s,(3.8±0.6),(3.9±0.4) mPa·s vs.(5.2±0.9) mPa·s,(3.1 ±0.8),(3.2±0.7) mPa·s vs. (4.5 ± 1.2) mPa·s,3.0 ±0.4,3.1 ±0.7 vs.2.8 ±0.7,(1.2 ±0.2),(1.1 ±0.5) mPa·s vs.(1.8 ±0.6) mPa·s,(5.3 ± 0.8),(5.3 ±0.7) g/L vs.(4.7 ±0.8) g/L;control group:(7.9 ±0.8),(7.5 ±0.7)mPa·s vs.(8.2± 1.3) mPa·s,(4.5±0.4)、(4.5 ±0.4) mPa·s vs.(5.4±0.7) mPa·s,(3.7±0.8),(3.5±0.8 ) mPa· s vs. (4.6 ± 0.5 ) mPa· s,2.8 ± 0.6,2.9 ± 0.3 vs.2.7 ± 0.6,( 1.6 ± 0.4),( 1.7 ± 0.1 ) mPa· s vs.(1.9 ±0.8) mPa ·s,(5.0 ±0.9),(4.8 ±0.8) g/L vs. (4.7 ±0.5) g/L,P ＜0.05],and all the level of hemorheology in experiment group were improved compared with control group (P ＜ 0.05).There was no significant difference in 1,5 min Apgar scores between two groups (P ＞ 0.05).ConclusionThe epidural anesthesia and combined spinal epidural anesthesia can improve hemorheology of patients with PIH during cesarean section,but the combined spinal epidural anesthesia is more effective and favorable for pregnancy outcome.

Objective To investigate the expression of apolipoprotein E (ApoE) and complement C4b1 in pancreatic carcinoma and study its significance. Methods Immunohistochemistry was used to detect the expression of ApoE and C4b1 protein in 38 cases of pancreatic carcinoma tissues and adjacent normal pancreatic tissues, and RT-PCR was used to detect the expression of ApoE and C4b1 mRNA in 20 cases of pancreatic carcinoma tissues and adjancent normal pancreatic tissues. The relevance of ApoE and C4b1 expressions to the biological features of pancreatic carcinoma were analyzed. Results The positive rates of ApoE and C4b1 expressions are 86.8% (33/38) and 76.3% (29/38) in pancreatic carcinoma, respectively,which were significantly higher than those in normal pancreatic tissues [42.1% (16/38) and 26.3% ( 10/38 ),P ＜ 0.01]. The positive rates of ApoE and C4b1 expressions [78.3% ( 18/23 ) and 73.9% ( 17/23 )] in patients with metastasis were significantly higher than in those without metastasis [(33.3% (5/15) and 40.0%(6/15), P ＜ 0.05). Significantly higher expressions of ApoE and C4b1 mRNA were noted in pancreatic carcinoma(4.83 ± 0.65 and 7.94 ± 0. 95 ) than those in the normal pancreatic tissue ( 1.78 ± 0.74and 1.22 ±0.57, P ＜ 0.01 ), and patients with metastasis showed significantly higher expression of ApoE and C4b1 mRNA (5.05 ±0.71 and 8.24 ± 1.07) than those without metastasis (4.42 ±0.25 and 7.39 ±0.15,P ＜ 0.05). Conclusions ApoE and C4b1 were highly expressed in pancreatic cancer, and may be closely related with lymph node metastasis.

Objective To investigate the expressions of complements 3 (C3), 4B1 (C4B1) and apolipoprotein E (ApoE) in pancreatic cancer and relations with TNM staging and lymph node metastasis of pancreatic cancer. Methods Thirty-eight pancreatic cancer biopsy specimens, 20 fresh pancreatic cancer specimens and 20 adjacent normal tissues of pancreatic cancer were collected. The expressions of C3, C4B1, ApoE in pancreatic cancers and normal pancreatic tissues were detected by immunohistochemistry and Western-Blot, the positive expression rates of C3, C4B1, ApoE and the differences in gray scale were also observed. Their association with pancreatic cancer TNM staging and lymph node metastasis were analyzed by SPSS 13.0. Results The expression rates of C3, C4B1, ApoE in pancreatic cancer were 73.68% (28/38), 86.84%(29/38) and 76.31% (33/38) respectively, higher than those in normal pancreatic tissues which were 42.11% (16/38), 26.32% (10/38) and 42.11% (16/38) accordingly, the differences were statistically significant (χ2 was 7.77, 19.01, 16.6, and P value were 0.01, 0.00, 0.00 respectively). The gray scale of C3, C4B1 and ApoE in pancreatic cancer were 1.63±0.28,1.25±0.18 and 2.57±0.22 respectively, higher than those in normal pancreatic tissue (0.88±0.19,0.65±0.13,1.28±0.24 respectively), the differences were statistically significant (t value were 9.93,11.81,17.71 and all P value were 0.00, respectively). There was no association between C3 and TNM staging or lymphatic metastasis of pancreatic cancer. C4B1 and ApoE were closely related with TNM stage and lymph node metastases. The expressions of C4B1 and ApoE in stage Ⅱ to Ⅳ pancreatic cancer or with lymphatic metastasis were significantly higher than those in stage Ⅰpancreatic cancer and those without lymph node metastasis. Conclusion C3, C4B1 and ApoE were all highly expressed in pancreatic cancer. C3 was only involved in early event in pancreatic cancer, not related with development of pancreatic cancer. C4B1 and ApoE were involved in tumor growth and metastasis.

To study the effect of unilateral vocal cord paralysis on vocal vibration, EGG parameters of 46 patients were analysed. EGG of most patients were abnormal, CQ decreasing while CI, CQP and CIP increasing. The incidence of normal EGG in patients whose vocal cord located in the middle was higher than that in the para - middle. Inversely, the incidence of abnormal EGG - CQ of the former was lower than that of the latter. EGG of the group in the intermediate was abnormal. The position of paralyzed vocal cord had no effect on CI,CQP and CIP. EGG reflects the characteristics of per vibratory cycle, and is a potential technique to study the irregular vocal vibration.

Objective To study the therapeutic effect of pulse-activating injection on acute poisoning by pa-raquat(PQ). Methods 50 Sprague-Dawley (SD) rats were randomly divided into five experimental groups: blank group, negative control group, positive control group, low-dose pulse-activating injection group (LDG), and high-dose pulse-activating injection group(HDG) (n = 10 for each group). Blank group were injected with normal suline,30 ml/kg,and other groups were established as acute paraquat poisoning models. Macroscopic and histopathological ex-aminations were performed and biological indexes were measured for the lung specimens. The indexes included lung wet weight/dry weight,the rats of neutrophils and protein content in the pulmonary alveolar lavage fluid. In the mean time, the level of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) both in plasma and bronchoalveolar lavage flui(BALF) were detected. Results Compared with that in negative control group,lung congestion and lung edema of LDG group were mitigated; and the MDA level decreased from (5.04± 0.50) nmol/ml,(1. 19±0.18) nmol/ml to (4.04±0.21) nmol/ml,(0.79±0.04) nmol/ml both in plasma and BALF;the SOD activities were increased from (123.30±20. 39) U/ml, (26.43±2.22) U/ml to (277.09± 11.66) U/ml,(37.10± 2.49) U/ml as well; the GSH-Px activities were increased from (1796.63 ±81. 12) U/ml, (598.24 ± 62.50) U/ml to (2151.54 ± 148.32) U/ml, ( 1788.44 ± 175.11 ) U/ml as well ( P < 0. 01 ). Conclusions Administration of pulse-activating injection could improve the lipid peroxidation damage caused by a-cute poisoning of PQ.

Objective To summarize the outcomes and clinical experience of orthotopic heart transplantations in Shanghai Zhongshan Hospital.Methods From May 2000 through October 2005,141 patients,101 males and 40 females,diagnosed as having dilated cardiomyopathy in 118,hypertrophic cardiomyopathy in 2,restrictive cardiomyopathy in 2,end-stage ischemic heart disease in 9, primary malignant cardiac tumor in 4,valvular heart disease in 3 and others in 3,underwent orthotopic heart(transplantations) at our center.The operative procedures included 120 bicaval anastomotic cardiac transplantations,19 conventional Stanford orthotopic cardiac transplantations and 2 total heart transplantations.The immunosuppressive therapy strategies included Cyclosporine A or tacrolimus,corticosteroids and mycophenolate mofetil.For the latest 28 patients,induction therapy with Daclizumab was applied.Results There were 3 operative deaths with an operative survival of 97.9 %.During the follow-up from 1 month to 65 months,the actuarial survival rate was 90.8 % after 1 year,84.6 % after 3 year and 81.4 % after 5 year.Acute rejection,infections,graft failure and metastasis of primary cardiac tumor were the main causes of death in the 1st postoperative year,while acute rejection and graft coronary vasculopathy were the leading causes of death thereafter.Postoperative complications included acute rejection,infections,renal dysfunction and graft failure.Conclusions Orthotopic heart transplantation was proved to be a reliable choice for endstage heart disease with excellent outcomes.More attention should be paid to surveillance and management of acute rejection, infections and graft coronary vasculopathy in the long-term follow-up.