Background and purpose: Sorafenib, a multiple targeted agent, can inhibit proliferation and induce apoptosis of diverse tumor cell in vitro. It has extensive biological activities, but the pancreatic cancer effect of monotherapy is poor. This may be related to nuclear factor-kappa B (NF-κB) pathway activation in cancer. Therefore, it is necessary to combine with Pyrrolidinedithiocarbamate (PDTC, a NF-κB activation inhibitor) to enhance curative effect. To investigate the influences of cell proliferation, cell cycle and expression of NF-κB via their acting on human pancreatic cancer PANC-1, and explore their possible mechanism. Methods:The experiment groups were divided into sorafenib group with different concentrations (1.5, 3.0, 6.0, 12.0 μmol/L), PDTC group with different concentrations (10.0, 25.0, 50.0, 100.0 μmol/L) and combination group with low concentration (3.0 μmol/L sorafenib+25.0 μmol/L PDTC). The proliferative activity of PANC-1 of each group was measured by MTT assay at different time points of 24

Objective To analyze the clinical laboratory characteristic of Candida albicans caused antibiotic-associated diarrhea (AAD) .Methods 100 cases of AAD were selected .Based on the results ,they were divided into Candida albicans group and non-Candida albicans group .The levels of sodium ,potassium ,fasting blood-glucose and albumin ,investigation of antimicrobial usage were compared in two groups .Results Candida albicans were detected in 42 cases .The levels of sodium ,potassium and fasting blood-glucose in the Candida albicans group were significantly higher than those in non-Candida albicans group(P<0 .01) ,and al-bumin were significantly lower than that in non-Candida albicans group(P< 0 .01) .The rate of two or more antibiotic usage in Candida albicans group was significantly higher than that in non-Candida albicans group(P<0 .05) .The drug resistance rates of fluconazole ,itraconazole ,voriconazole ,amphotericin B and flucytosine in Candida albicans group were significantly lower than those in non-Candida albicans group(P<0 .05) ,and the antibiotic sensitive rates of fluconazole ,itraconazole ,voriconazole ,amphotericin B and flucytosine in Candida albicans group were significantly higher than those in non-Candida albicans group(P<0 .05) .The drug resistance rates of vancomycin and macrodantin in Candida albicans group were significantly higher than those in non-Candida al-bicans group(P<0 .01) ,and the antibiotic sensitive rates of vancomycin and macrodantin in Candida albicans group were signifi-cantly lower than those in non-Candida albicans group(P<0 .01) .Conclusion For AAD cases ,the fecal culture can provide exper-imental basis for clinical treatment and avoid the abuse of antibiotics .

Cancers of the digestive system account for a large portion of malignant tumors in humans,and the trend is on the rise.The formation of neovascularization is the dominant factor in the metastasis of tumors.The vascular endothelial growth factor(VEGF) is well documented as the most potent inducer of angiogenesis.It promotes the formation of new blood vessels in several aspects,such as proliferation of endothelial cells,endothelial cell migration and increased vascular permeability.So VEGF is regarded as an important factor in the development of digestive system tumors.The purpose of this review is to investigate the relationship between VEGF and digestive system tumors.

Objective To design a multi-functional portable bento for single field soldier by reducing the health load of the army and improving the fighting capacity.Methods It is designed by selecting the suitable material and integrating the minimal volume with function.Results The bento can be designed on light material,small in size and used in water or waterless condition.Conclusion The bento is fit for the field army request to carry picnic tool and can improve the combat effectiveness of the force.

Objective To Investigate the value of HPV genotyping in diagnosis of cervical intraepithelial neoplasia(CIN).Methods From July 2012 to February 2013,200 women from Tianjin Medical University General Hospital and 244 women from Affiliated Hospital of the Chinese People's Armed Forces Logistics College were selected to be HPV genotyping test and thin liqid-based cytology test.Consequently,132 samples were performed colposcopy test and cervical biopsy.Results HPV prevalence was 26.4％ (117/444) in this study.The infection of one type HPV was more common.The top 5 of HPV types were HPV16,58,33,18,and 52.The top 5 of the risk for CIN Ⅱ and above followed HPV16,33,39,52 and 18.There was no significant difference between age and HPV positive rate (x2 =0.948,P ＞ 0.05).Multiple infection and cervical lesions rank correlation analysis(r =0.132,P ＞0.05).For CIN Ⅱ and above disease,cytology positive rate was 90％ (44/49),and HPV positive rate was 96％ (47/49) cytology combine HPV positive rate was 98％ (48/49,x2 =0.063,P ＞ 0.05).Conclusions HPV infection should increasing trends with age.Cytology test and HPV genotyping test had good consistency.The combination of them can improve the sensitivity for high-grade lesions.

Objective: Our purpose was to study the effect of anisodamine on the injury of myocardium after myocardial ischemia reperfusion. Methods: Eighteen patients (ASA grade Ⅱto Ⅲ) scheduled for valve replacement, were randomly divided into 2 groups during extracorporeal circulation. Anisodamine (0.25 mg/kg) was given intravenously in the anisodamine group before reperfusion. Equivalent volumes of normal saline were administered in the control group. The central venous blood samples were collected at different time after ischemia and reperfusion. We then measured the concentrations of lactic dehydrogenase (LDH), creatine kinase (CK), and malondiadehyde (MDA) with biochemical methods. Results: The levels of serum LDH, CK, and plasma MDA increased significantly in the control group during ischemia and reperfusion. In the anisodamine group, the levels of serum LDH and CK increased. But the values were lower at corresponding time than those in the control group (P<0.05) during reperfusion. The plasma level of MDA unchanged in the anisodamine group during ischemia and reperfusion. The postoperative cardiac function recovered much more better in the anisodamine group. Conclusion: Anisodamine can reduce the degree of reperfusion injury. A certain protective effect on myocardial ischemia reperfusion injury exsists during valve replacement.

Objective To evaluate the efficacy and safety of endoscopic versus open component separation technique (CST) for abdominal hernia.Methods Systematic review was carried out to identify the controlled clinical studies comparing endoscopic CST with open CST for abdominal hernia.The Meta-analysis was performed with RevMan 5.2 software.Results The selection criteria was met in five studies.A total of 185 patients with abdominal hernia were included.Analysis of the data suggested that there was no significant differences in recurrence rate between endoscopic CST and open CST(P =0.84,risk difference =-0.01,95％ CI-0.12 to 0.10).However,endoscopic CST compared with open CST was associated with a significant reduction of postoperative wound complications (P ＜ 0.000 1,odds ratio =0.19,95％ CI 0.09 to 0.41).And there was no significant differences in operation time,intraoperative blood loss and postoperative hospital stay (all P ＞ 0.05).Conclusions As compared to open CST,endoscopic CST show equivalent clinical effects with similar recurrence rate.However,endoscopic CST was associated with a significant reduction of postoperative wound complications,and there was no significant differences in in operation time,intraoperative blood loss and postoperative hospital stay.

Objective: The compare the safety and efficacy between cryoablation (CRYO) and radiofrequency catheter ablation (RFCA) for treating the patients with atrio-ventricular nodal reentrant tachycardia (AVNRT) by meta-analysis.
Methods: We systemically searched the Medline, Cochrane library and Embase database to fulifll our pre-deifned criteria until the publication of May 2014.
Results: There were 5 randomized controlled trials (RCTs) and 14 retrospective trials enrolled in our study with 2900 patients. The patients were allocated into 2 groups:CRYO group, n=1384 and RFCA group, n=1516. The overall pool-analysis demonstrated that compared with RFCA group, CRYO group had the lower risk of permanent atrio-ventricular nodal block (OR:0.27, 95%CI 0.11 to 0.62, P<0.01) and shorter X-ray exposure time (WMD:-3.36, 95%CI-5.58 to-1.15, P<0.01);while CRYO group had the lower immediate procedural success rate (OR:0.63, 95%CI 0.42 to 0.96, P<0.05), longer procedural time (WMD:10.97, 95%CI 3.35 to 18.58, P<0.01), and higher long-term arrhythmia recurrence rate (OR:2.89, 95%CI 2.05 to 4.06, P<0.01).
Conclusion: Although CRYO could decrease the risk of permanent atrio-ventricular nodal block, while its effectiveness was lower than RFCA for AVNRT treatment in relevant patients.

Objective To study the clinical significance of the novel tumor marker Cytokerantin?19?fragment( CYFRA 21?1) of peripheral blood in patients with esophageal cancer. Methods The CYFRA 21?1 level in peripheral blood of 72 patients with benign tumor of esophagus or reflux esophagitis and 60 patients with esophageal cancer was examined before and 7 days after operation by enzyme?linked immuno sorbent assay ( ELISA) . At the same time, patients with esophageal cancer were followed up for 3 years, and the level of CYFRA21?1 was examined. Results (1)Before the operation,the level of CYFRA 21?1 was 0-3. 30 μg/L in 51. 67%( 31/60 ) of the patients with esophageal cancer, higher than that of the control group ( 16. 67%(12/72),χ2=3. 88,P<0. 05). (2)Before the operation,the level of CYFRA21?1 in patients with esophageal cancer,stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ were (3. 27±0. 33) μg/L and (4. 88±1. 21) μg/L,and of the control group was (2. 24±1. 17) μg/L. The levle of CYFRA21?1 in patients with esophageal cancer,stage Ⅰ,Ⅱ andⅢ,Ⅳ were significantly higher than that of the control group( t=2. 37,2. 00,P<0. 05) . ( 3) On the 7th day after operation,the level of CYFRA21?1 was (2. 26±1. 16) μg/L,and the difference was not significant compared with the control group(t=0. 95,P>0. 05). The level of CYFRA21?1 with the palliative resection of esophageal cancer was (3. 31±0. 66) μg/L,and the difference was significant compared with the control group(t=4. 33,P<0. 05) . ( 4 ) After 3 years of follow?up, the factors affecting the survival rate of esophageal cancer were as following:the pathologic stages of tumor(OR 4. 423,95%CI 1. 943-4. 972,P<0. 05),types of operation(OR 0. 023,95%CI 0. 012-0. 036,P<0. 05),the level of CYFRA21?1 before operation(OR 6. 798,95%CI 4. 328-8. 105,P<0. 05),and the decreased level of CYFRA21?1 after operation(OR 0. 117,95%CI 0. 074-0. 202,P<0. 05) . ( 5) During the follow?up period,the level of CYFRA21?1 in patients with local recurrence and distant metastasis of esophageal carcinoma was (7. 97±0. 44) μg/L,significantly more than that of the control group(t=5. 11,P <0. 05) . Conclusion CYFRA21?1 is a useful tumor marker in the positive rate of preoperative diagnosis of esophageal cancer, postoperative monitoring of recurrence, distant metastasis and prediction of prognosis.

Objective To identify the correlation between doctors' job burnout and medical errors.Methods In stage 1,a cross-sectional retrospective survey on doctors' job burnout and medical errors was conducted for 300 doctors serving in the First Affiliated Hospital of Fujian Medical University,who were randomly sampled in June 2013.The survey covered basic demographic information,self-assessed job burnout and medical errors.In stage 2,231 doctors without medical errors in stage 1 were selected for a prospective study focusing on a follow-up on their medical errors within half a year.Results Medical errors were found to influence job burnout of doctors significantly.Multiple logistic regression analysis was made based on the three independent variables of A-emotional exhaustion,B-depersonalization,and C personal sense of accomplishment,and the dependent variables Y1 and Y2 indicating the occurrence or non-occurrence of common medical errors or serious medical errors,respectively.The calculation aims to identify if there is line relationship among the three independent variables.Conclusions This study suggests that all kinds of medical errors influence job burnout;scores of the three dimensions of job burnout may be predictors of occurrence of different medical errors.