Objective To investigate the effect of Gum mastic combined with gemcitabine on human pancreatic carcinoma BxPc-3 cells and its mechanism.Methods Cell proliferation and apoptosis were examined using the methyl thiazolyl tetrazolium assay and propidium iodine staining,respectively.After BxPc-3 cells were treated with different concentrations of Gum mastic and gemcitabine,the expression of NF-κB p65 subunit,IkB,Bcl-2 and Bax proteins was detected by Western blot.BxPc-3 cells were injected subcytaneously into nude mice to establish pancreatic xenograft tumors,and the changes of tumor volume were monitored.Results Compared to either single agent,treatment with Gum mastic (40 mg/L) combined with gemcitabine (10 mg/L) for 72 h signi cantly inhibited the proliferation of BxPc 3 cells (P＜0.01).Its rate of apoptosis(45.13±4.01)was more than Gum mastic,gemcitabine(P＜0.01) and control group (5.07 ± 1.37,P＜ 0.01).When cells were treated with gemcitabine in combination with gum mastic in human pancreatic carcinoma BxPc-3 cells for 48 h,the IκB level was increased,whereas NF-κB activation was blocked; the expression of Bax protein was substantially increased,but Bcl-2 protein was down-regulated; gum mastic or combined with gemcitabine could significantly inhibit the growth of pancreatic xenograft tumors (P ＜ 0.05).Conclusions Gum mastic could effectively strengthen the sensitivity of human pancreatic carcinoma BxPc-3 cells to gemcitabine.It may inhibit the expression of NF-κB p65 subunit and Bcl-2 proteins and increase the expression of IκB and Bax proteins.

Objective To discuss nicardipin′s influence on post operation cognitive dysfunction (POCD) in senior patient after hip joint replacement operation.Methods 180 senior patient, who received selective unilateral hip joint replacement operation between October 2015 and October 2016 under the condition of combined spinal-epidural anesthesia (CSEA) were randomly divided into Group A (with nicardipine) and Group B (without nicardipine).Nicardipine was only appropriately pumped into vein in time in Group A.MAP was observed and recorded 30 minutes after starting the operation and at the end of the operation.Mini-mental state examination (MMSE) was applied to score the patient one day before, one day, three days and five days after operation, and the number of POCD was recorded.Results Compared with Group B, Group A was obviously lower in MAP level (P<0.05) after 30 minutes.MMSE score of Group A was obviously higher (P<0.01) one day after operation.The number of POCD in Group A was 8 (8.89%) significantly lower than than that of Group B (19, 21.11%).Conclusion Nicardipine could maintain hemodynamic stability of senior patients receiving selective unilateral hip joint replacement operation under the CSEA and prevent POCD to a certain extent.

Objective:To promote the hearing, improve the appearance, shorten the therapeutic course in congenital malformation of external and middle ear,the program of primary restoration has been designed. Method:Under general or local anaesthesia a Z-shaped incision is made in skin. After turn up the flap A(defective ear)and flap B(retroauricular skin), a periosteal flap C with pedicle in front is made and elevated from mastoid.Then made frameworklize on mastoid and perform tympanoplasty. Once the myringograft is put properly the flap C is turn into the mastoidal cavity to serve as the lining of anterior wall. Flap A is sutured with the edge of retroauricular incision to serve as the lower part of new auricle. Then use the flap B to wrap a siliceous frame to make the upper part of new auricle.Finally,the naked walls of mastoidal cavity are lined with free skin graft and the cavity is packed with vaseline gauze for two weeks. Result:Two cases of congenital malformation of external and middle ear were treated with the procedure mentioned above and were followed up for one and 3 years respectively. Both effects of shape and hearing were good.Conclusion:The primary restoration for congenital malformation of external and middle ear designed by the authors is an excellent method worthy to be recommended.

OBJECTIVE:To establish an HPLC method for determining the contents of Quercetin and Isorhamnetin in Bupleurum.smithii var.parvifolium Shan et Y.Li.METHODS:The HPLC was performed on Kromasil column C18(250mm? 4.6mm,5? m),using methanol-0.4% phosphoric acid(55∶ 45)as mobile phase,with flow rate at 1.0mL? min-1 and detection wavelength at 256nm.RESULTS:The linear range of Quercetin was 0.08～ 0.40? g(r=0.999 6),with an average recovery rate of 101.02%(RSD=1.53%);that of Isorhamnetin was 0.06～ 0.30? g(r=0.999 2),with an average recovery rate of 101.26%(RSD=2.95%).CONCLUSION:This method is simple and accurate with good reproducibility.It is suitable for the quality control of Bupleurum.smithii var.parvifolium Shan et Y.Li.

Objective: To study the hemodynamic changes of fetal umbilical artery (UA) and middle cerebral artery (MCA) and its influence on fetal outcome using color Doppler ultrasound. Methods: Fifty pregnant women who underwent color Doppler ultrasound examination in Zhejiang Xin'an International Hospital from June to December 2018 with normal prenatal examination were selected as control group, and 80 pregnant women with oligohydramnios during the same period of pregnancy were selected as observation group. Color Doppler ultrasound examination was performed on both groups of pregnant women. The results of color Doppler ultrasound examination were compared between the two groups of pregnant women, and the fetal prognosis was followed up. Results: Compared with the control group, the peak systolic velocity/end diastolic velocity (S/D), resistance index (RI) and pulsatility index (PI) values of UA in the observation group were significantly increased, while the S/D, RI and PI values of MCA were significantly decreased, and there were significant differences (P < 0.05). In addition, UA of 34 cases (42.5%) in observation group had S/D ≥ 3, which was much higher than that of 8 cases (16.0%) in control group, and there was significant difference (P < 0.05). The difference between the two groups was statistically significant (P < 0.05). The incidence of fetal distress, intrauterine growth retardation (IUGR) and Apgar < 4 points in observation group were significantly higher than those in control group [26.2%(21/80) vs. 12.0%(6/50), 15.0%(12/80) vs. 2.0%(1/50), 7.5% (6/80) vs. 0], and the difference were statistically significant (P < 0.05). Conclusions Prenatal color Doppler ultrasound can accurately detect the hemodynamic indexes of UA and MCA, predict the fetal intrauterine development, evaluate the fetal outcome, and provide scientific basis for clinical diagnosis.

Objective To investigate the clinicopathological characteristics and postoperative prognosis analysis of intra-thoracic localized Castleman disease (LCD).Methods The clinical data of 9 patients with intra-thoracic LCD who accepted surgical treatment were retrospectively analyzed.There were 5 males and 4 females,with age of (32.8 ± 10.9) years.Two patients complained of chest pain,1 patient suffered from paraneoplastic pemphigus,and the rest were diagnosed by physical examination.Four cases were diagnosed with LCD by preoperative CT examination.Results All patients underwent surgical resection.Four patients were performed open surgery and 5 patients had video assisted thoracic surgery.All patients accepted radical surgery.But 2 of these patients had postoperative complications.One patient was the injury of phrenic nerve and another was pericardial effusion.Patho-histological showed hyaline vascular type of Catleman disease in all patients.All patients survived without recurrence during the follow-up for 2-53 months.Conclusions Intra-thoracic is rare and liable to misdiagnosed.For increasing the preoperative diagnosis rate of LCD,the combined application of imaging tests is important,and clinicians and radiologists should also enhance the awareness of this disease.Complete surgical resection of the tumor is the best therapeutic alternative for intra-thoracic LCD.

Objective To explore the protective effect and mechanism of vitamin D combined with puerarin on liver fibrosis.Methods The rats were divided into normal control group (C),tetrachloromethone group (CCl4),vitamin D group (V),puerarin group(P) and vitamin D combined with puerarin group(V+P).After 8 weeks,the rats were sacrificed and blood and liver samples were collected.The level of blood hyaluronic acid(HA) was tested.The hydroxyproline(Hyp) level in the liver was measured.The liver paraffin sections were made and examined by the sirius red staining.The mRNA levels of collagen Ⅰ and collagen Ⅲ in the liver tissue were detected by RT-PCR,and the levels of NF-κB and TNF-α in the liver were detected by Western blot.Results The CCl4 group appeared obvious liver fibrosis.The liver fibrosis degree was significantly improved in the group V,P and V+P,the blood HA level and liver Hyp level were reduced.The mRNA levels of collagen Ⅰ and collagen Ⅲ as well as the protein levels of NF-κB and TNF-α in the liver were significantly decreased.Among them.The liver fibrosis improvement degree in the V+P group was most significant.Conclusion Vitamin D combined with puerarin can protect rat liver fibrosis induced by CCl4 and its mechanism may be related with reducing the activation of hepatic stellate cells(HSC) and decreasing the collagenous fibers secretion.

Objective To investigate MSCT features of the intraductal papillary mucinous tumor of the pancreas.Methods The CT findings of 40 cases of intraductal papillary mucinous tumors confirmed by pathology were retrospectively analyzed,and the location,size,shape,edge and enhancement of the tumor were observed.Results Malignant (n=8):all of them were mainly pancreatic duct type,including 6 cases in the head of pancreas and 2 cases in the tail.All of them were multi-room,with 7 cases of cystic wall nodules and 7 cases of uneven septum thickening.The diameter of tumor cystic lesion was(41.0±0.5)mm on average,and the widest diameter of the dilated pancreatic duct was (6.9±1.0) mm.The cystic wall,wall nodule and interval were mild and moderate enhancement in the arterial phase,and continuous strengthening in the portal and delayed phases.Borderline(n=15):8 cases of main pancreatic duct type,1 case of branch pancreatic duct type,and 6 cases of mixed type.There were 10 cases in the head of the pancreas and 5 in the tail of the pancreas.There were 10 cases of multi room in the lesion,and the CT findings were composed of multiple clusters of small cystic lesions,with 3 cases of tuberous nodules on the cyst wall and 4 cases of irregular thickening of the cysts.5 cases were single room type,with capsule wall smooth and whole.The diameter of tumor cystic lesion was (28.0±0.5) mm on average,and the maximum diameter of the dilated pancreatic duct was (5.2±0.3) mm.The cystic wall and interval were mild and moderate enhancement in the arterial phase,and mild and continuous strengthening in the portal and delayed phases.Benign (n=17):1 case of main pancreatic duct type,10 cases of pancreatic duct type and 6 cases of mixed type;There were 12 cases in the head of the pancreas and 5 in the tail.All of them were single cystic type,and the cyst wall was smooth.The diameter of the tumor cystic lesion was (26±0.3) mm on average and the maximum diameter of the dilated pancreatic duct was (3.5±0.4) mm.There was no enhancement of the cystic wall in the arterial phase,mild enhancement in the portal phase,and mild continuous delayed phase in 2 cases,no enhancement in 15 cases.Conclusion MSCT expression of the intraductal papillary mucinous tumor of the pancreas has its characteristic features,which is helpful for the diagnosis and treatment of the disease.

This study aims to explore the diagnostic value of specific immunoglobulin E (sIgE) and specific immunoglobulin G (sIgG) of Aspergillus fumigatus in the diagnosis of allergic broncho-pulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS). A total of 17 ABPA patients and 14 SAFS patients were enrolled. The levels of sIgG [2 294.00 (1 527.00, 14 170.00) U/ml vs. 972.60 (650.90, 1 792.00) U/ml] and sIgE [8.77 (1.64, 16.85) kU/L vs. 1.04 (0.70, 2.05) kU/L] in ABPA patients were significantly higher than those in SAFS patients (P<0.05). Aspergillus fumigatus sIgG was strongly correlated with Aspergillus fumigatus sIgE (r_s=0.797, P<0.001) in ABPA patients. When combined with Aspergillus fumigatus sIgG (>1 000.00 U/mL) and Aspergillus fumigatus sIgE (>1.00 kU/L), the sensitivity was 82.3% and specificity 78.6% for the differential diagnosis of ABPA and SAFS. It demonstrates the diagnostic value of Aspergillus fumigatus sIgG and sIgE.

Objective To investigate the expression of melanoma antigen- encoding gene (MAGE) A1 protein in esophageal squamous cell carcinoma, and explore its correlation with the clinicopathological factors and prognosis. Methods A retrospective analysis was performed on 197 patients with esophageal squamous cell carcinoma who accepted radical surgical treatment from January 2006 to December 2012. The expressions of MAGEA1 protein in these specimens of cancer tissue and cancer adjacent tissue were detected by immunohistochemistry with tissue microarray technology. Results MAGEA1 protein was expressed in cytoplasm and nucleus of tumor cells. The positive expression rate of MAGEA1 protein in cancer tissue was significantly higher than that in cancer adjacent tissue: 73.6％ (145/197) vs. 5.6％ (11/197), and there was statistical difference (P<0.01). The positive expression of MAGEA1 protein had no correlations with sex, age, history of smoking/drinking, family history of upper gastrointestinal cancer, depth of tumor invasion, lymph node metastasis, tumor differentiation, location and TNM stage (P>0.05). Kaplan-Meier survival analysis result showed that the 5-year survival rate in patients with MAGEA1 protein positive expression was significantly lower than that in patients with MAGEA1 protein negative expression (37.2％ vs. 53.8％), and there was statistical difference (P=0.018). Multivariate analysis result showed that MAGEA1 protein positive expression was an independent predictor of prognosis in esophageal squamous cell carcinoma patients (HR=1.91, 95％CI 1.22 to 2.98, P = 0.004). Conclusions The expression of MAGEA1 protein is abundant in esophageal squamous cell carcinoma, and is related to worse clinical outcome. MAGEA1 protein could be a candidate target for tumor immunotherapy.