Background:Gemcitabine is the first-line drug for chemotherapy of pancreatic cancer. However,owing to the inherent and acquired resistance,gemcitabine does not change obviously the prognosis of patients with pancreatic cancer. Exploration of the mechanism of acquired resistance to gemcitabine is of great clinical importance. Aims:To establish a gemcitabine-resistant human pancreatic cancer cell subclone and to explore preliminarily the resistance mechanism. Methods:Human pancreatic cancer cell line SW1990 was stimulated continuously with 0. 5 μmol/ L gemcitabine in vitro to establish the gemcitabine-resistant subclone SW1990-0. 5. The resistance index of SW1990-0. 5 cells was counted by CCK-8 assay. Proliferation and invasion of SW1990 and SW1990-0. 5 cells were detected by cell doubling time assay and scratch wound healing assay in vitro;cell cycle and cell apoptosis were detected by flow cytometry;expressions of multidrug-resistance related genes(MDR-1,MRP-1,and BRCP)and gemcitabine metabolic enzyme related genes(dCK,RRM1, and RRM2)were determined by real-time PCR. Results:The resistance index of SW1990-0. 5 cells was 9. 32. Compared with the parental SW1990 cells,the proliferation capacity but not the invasion capacity of SW1990-0. 5 cells in vitro was reduced. When treated with gemcitabine,the cell cycle of SW1990-0. 5 cells was similar to that of parental cells,whereas the cell apoptosis was significantly inhibited;expressions of MRP-1,BRCP and dCK mRNA were down-regulated,while expressions of MDR-1,RRM1 and RRM2 mRNA did not change. Conclusions:A stable gemcitabine-resistant human pancreatic cancer cell subclone SW1990-0. 5 was successfully established. Inhibition of cell apoptosis and down-regulation of dCK expression might contribute to the acquired resistance to gemcitabine of pancreatic cancer.

Objective To explore the improvement effect of rehabilitation nursing on joint swelling and pain after total knee arthroplasty.Methods According to the digital table,100 patients with total knee arthroplasty were randomly divided into observation group and control group,50 cases in each group.The control group after operation used routine nursing care,the observation group was given targeted rehabilitation nursing.They were compared with visual analogue scale (VAS),American Knee Society Score (AKSS),range of motion (ROM),length of hospital stay,joint swelling degree.Results Mter treatment,the VAS score of the observation group was lower than the control group[(2.43 ±0.51) points vs.(4.58 ± 0.81) points,t =15.882,P ＜ 0.05],AKSS scores and ROM were higher than those in the control group[(69.94 ± 14.23)points vs.(53.23± 12.91)points,(103.47 ± 14.84)° vs.(91.23 ±12.53) °,t =6.149,4.456,all P ＜ 0.05].The hospitalization time of the observation group was shorter than that of the control group[(14.23± 3.81)d vs.(17.82 ± 4.03) d,t =4.577,P ＜0.05].At 3d and 7d after operation,the swelling degree of the observation group was lower than those of the control group[(1.23 ±0.26)mm vs.(1.97 ±0.38)mm,(0.62 ± 0.21) mm vs.(1.38 ± 0.35) mm,t =11.364,13.166,all P ＜ 0.05].Conclusion The application of rehabilitation nursing after total knee joint surgery can effectively relieve joint swelling and pain,and it is worth to be popularized.

Objective To investigate the effects of 25‐hydroxy vitamin D [25(OH)D] status on the pregnancy outcome in the second and third trimester pregnant women living .Methods A total of 143 pregnant women (12 -42 weeks gestational age) were participated in the study .Their serum 25(OH)D concentrations were detected by liquid chromatography‐mass spectrometry method .Finally ,vitamin D status was assessed according to sufficiency group(n= 32) ,inadequacy group(n= 49) ,insufficiency group(n=51) and deficiency group(n=11) .Retrospective analysis were adopted to follow up the pregnancy outcome of pregnant women .Results (1)The average serum 25(OH)D level was(22 .49 ± 9 .51)ng/mL in the second and third trimester of pregnancy . (2)Abortion rate were 3 .1% (1/32) in sufficient group ,2 .0% (1/49)in inadequacy group ,11 .8% (6/51) in insufficiency group , 36 .4% (4/11) in deficiency group ,fetal distress incidence were 3 .1% (1/32) ,8 .2% (4/49) ,11 .8% (6/51) ,36 .4% (4/11) in each group .Abortion ,fetal distress rate were higher in deficiency group compared with the other three groups(P<0 .05) .(3)Bacterial vaginosis incidence were 0(0/32) ,4 .1% (2/49) ,13 .7% (7/51) ,27 .3% (3/11)in each group ,deficiency group and insufficiency group were higher(P<0 .05) .(4)Otherwise ,the gestation period were (39 .48 ± 1 .44) weeks in sufficient group ,(39 .00 ± 1 .70) weeks in inadequacy group ,(38 .09 ± 2 .01) weeks in insufficiency group ,(37 .29 ± 0 .49) weeks in deficiency group ,pregnancy cycle was significantly shorter when 25(OH)D<20 .00 ng/mL (P<0 .05) .Conclusion Vitamin D deficiency in pregnant women could increase the risk of abortion ,fetal distress ,bacterial vaginosis ,and significantly shorten the gestation period .

Background:Gemcitabine is the main drug for chemotherapy of advanced pancreatic cancer,however,the prognosis of pancreatic cancer patients has not been changed obviously because of the high innate and acquired resistance of cancer cells to gemcitabine. Aims:To investigate the correlation of DNA repair and expression of human APE1 / Ref-1(apurinic/apyrimidinic endonuclease 1 / redox factor-1),the key enzyme in base excision repair pathway,with the resistance of pancreatic cancer to gemcitabine. Methods:A gemcitabine-resistant human pancreatic cancer cell line SW1990-0. 5 with a resistance index of 9. 32 and its parental cell line SW1990 were treated with gemcitabine. DNA injury was assessed by comet assay. Expressions of APE1 / Ref-1 mRNA and protein were determined by real-time PCR and Western blotting, respectively. Results:In comet assay,after treated with gemcitabine for 24 hours,OTM value of SW1990-0. 5 and SW1990 cells were 0. 32 ± 0. 13 and 26. 96 ± 6. 83,respectively. Expression level of APE1 / Ref-1 mRNA in SW1990-0. 5 cells was 2. 48 ± 0. 49;and expression levels of APE1 / Ref-1 protein in SW1990-0. 5 and SW1990 cells were 1. 57 ± 0. 08 and 0. 84 ± 0. 06,respectively. Statistically significant differences were existed in all these parameters between SW1990-0. 5 and SW1990 cells(P all < 0. 05). Conclusions:DNA repair might be correlated with the resistance of pancreatic cancer to gemcitabine,and up-regulation of APE1 / Ref-1 might contribute to this resistance by its function on DNA repair.

Objective] To summarize teacher Qin’s clinical experience in treating premature ovarian failure by mainly reinforcing kidney. [Method] Collect the clinical cases, and analyze the etiology and pathogenesis, syndrome differentiation and treatment of premature ovarian failure for teacher Qin ’s. [Result] Teacher Qin thought that this disease was mainly due to kidney deficiency, especially kidney-yin deficiency, and accompanied by liver depression. This disease can be divided into kidney-yin deficiency, kidney-yang deficiency, deficiency of kidney-yin and yang, deficiency of kidney and liver depression. Reinforcing kidney-yin for kidney-yin deficiency; reinforcing kidney-yang for kidney-yang deficiency; reinforcing kidney-yin and yang for deficiency of kidney-yin and yang; tonifying the kidney essence and soothing liver-qi stagnation for deficiency of kidney and liver depression. [Conclusion] Treatment of premature ovarian failure is based on tonifying kidney, supplement on soothing liver, while some change therapies, should combine disease with syndrome.

Objective To investigate the association between glucose metabolism status and brachial-ankle pulse wave velocity(baPWV)in Chinese patients with coronary artery disease(CAD).Methods baPWV values were measured in 198 CAD patients.Plasma glncose,serum lipids,hsCRP and other baseline data were obtained in all the patients.According to the glucose level,the participants were divided into 3 groups:normal glucose tolerance(NGT)group,impaired glucose regulation(IGR)group and diabetes mellitus(DM)group.ResultsbaPWV values in the DM group(1807±381)cm/s were significantly higher than those in the NGT group[(1615±248)cm/s,P=0.000]and IGR group[(1674±277)cm/s.P=0.035].Multiple stepwise linear regression analyses indicated that higher baPWv values were associated with aging and hsCRP levels in 198 patients.In DM group,higher baPWV values were independently associated with aging and HbA1 C levels.Conclusions In patients with coronary artery disease.baPWV values increase with different glucose metabolism status from NGT to IGR then DM.baPWV values in the patients with DM were significantly higher than those in the other two groups.Glycemic control may ameliorate arterial stiffness.

Objective To investigate the predictive value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) calculated from 18F-FDG PET-CT results for postoperative recurrence and prognosis in patients with resectable pancreatic cancer. Methods From may 2009 to December 2015, 30 patients with pancreatic cancer who underwent curative resection after PET-CT examination were enrolled, and the clinic pathological data and 18F-FDG PET-CT data were retrospectively analyzed. The prognostic value of SUVmax, SUVmean, MTV, TLG and other prognosis factors were analyzed. Results In 30 patients with pancreatic cancer, preoperative 18F-FDG PET-CT detected all primary lesion (10 0%). 29 patients were recurrence or metastasis, and 26 patients were died with median of 17.8 months (2.6-39.6 months) follow-up. The median progression-free survival (PFS) time was 6.5 months and the median overall survival (OS) time was 11.6 months. The multivariate analysis revealed the histological differentiation and MTV were the independent influencing factors for PFS (both P<0.05). The lymph node metastasis, MTV and TLG were the independent influencing factors for OS (all P<0.05). Conclusion The MTV and TLG of PET-CT may be predicting the recurrence and survival of patients with pancreatic cancer after curative resection, suggesting that it can be used to guide the individual treatment.

Objective To investigate the prognosis and recurrent factors of primary retroperitoneal liposarcoma (PRPLS).Methods The retrospective case-control study was conducted.The clinicopathological data of 51 patients with PRPLS who were admitted to the Southwest Hospital of the Third Military Medical University from January 2005 and March 2015 were collected.Observation indicators:(1) follow-up institution.(2) Analysis of prognostic factors:gender,age,tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence.(3) Analysis of recurrent risk factors:gender,age,tumor diameter,combined organs resection,pathological type and cancer risk.(4) Stratified analysis:the independent risk factors of recurrence were done by the stratified analysis.(5) Correlation between cancer risk and tumor diameter or number of organs invaded.(6) Correlation between adjacent organ invasion and tumor diameter.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence up to October 2015.The survival rate and curve were respectively calculated and drawn by KaplanMeier method.The univariate analysis and survival analysis were done using the Log-rank test.The multivariate analysis was done by the COX regression model.The correlation analysis was done using the Pearson test.Results (1) Follow-up institution:51 patients were followed up for 3-114 months,with a median time of 43 months.The 3-year survival rate of 51 patients was 70.6％.Twenty-two patients had the first local recurrence,with a recurrent time of 3-60 months and a median time of 29 months.(2)Analysis of prognostic factors:the results of univariate analysis showed that tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence were the related factors affecting prognosis of patients with PRPLS (x2 =5.926,4.936,17.856,17.279,14.568,P ＜ 0.05).The results of multivariate analysis showed that combined organs resection,pathological type and cancer risk were the independent factors affecting prognosis of patients with PRPLS [OR =0.538,0.645,9.620,95％ confidence interval (CI):0.238-0.997,0.458-1.058,1.692-18.714,P ＜ 0.05].(3) Analysis of recurrent risk factors:the results of univariate analysis showed that pathological type and cancer risk were the related factors affecting recurrence of patients with PRPLS (x2 =12.375,12.364,P ＜ 0.05).The results of multivariate analysis showed that cancer risk was an independent factor affecting recurrence of patients with PRPLS (OR =6.234,95％ CI:1.419-27.377,P ＜ 0.05).(4) Stratified analysis:the 3-year survival rates of 11 patients with low risk of recurrence of PRPLS and with high risk of recurrence of PRPLS were 63.6％ and 9.1％,respectively,with a statistically significant difference (x2 =12.364,P ＜ 0.05).(5)Correlation between cancer risk and tumor diameter or number of organs invaded.Tumor diameter and number of organs invaded were respectively (17 ±8)cm,1 ± 1 in 33 patients with low risk of PRPLS and (19 ±5)cm,2 ± 1 in 18 patients with high risk of PRPLS,with no statistically significant difference in tumor diameter (r =0.222,P ＞ 0.05) and with a statistically significant difference in number of organs invaded (r =0.666,P ＜ 0.05).(6)Correlation between adjacent organ invasion and tumor diameter.Tumor diameter was (16 ± 8) cm in 19 patients without adjacent organ invasion and (19 ± 7)cm in 32 patients with adjacent organ invasion,respectively,showing no statistically significant difference (r =0.225,P ＞ 0.05).Conclusions The combined organs resection,pathological type and cancer risk are independent factors affecting prognosis of patients with PRPLS,and cancer risk is an independent factor affecting recurrence of patients with PRPLS.The prognosis of patients with low risk of PRPLS is better than that with high risk of PRPLS.The organ invaded is much likely to occur in patients with high risk of PRPLS.

Objective To investigate the correlation of plasma heme oxygenase-1 (HO-1) level and type 2 diabetes mellitus (T2DM). Methods The outpatient with type 2 diabetes mellitus (T2DM) undergoing oral glucose tolerance test and healthy individuals with physical examination were divided into T2DM group and healthy control group, the differences between the two groups in HO-1 and methane dicarboxylic aldehyde (MDA), mean fluorescence intensity (MFI), homeostasis model assessment of insulin resistance (HOMA-IR) and fasting blood glucose (FBG) were comparatively analysed , and analyzed the correlations between HO-1 and reactive oxygen species (ROS) MFI, MDA, HOMA-IR and FBG. Results The type 2 diabetes group in MDA and MFI, the expression rate of HO-1 were higher than those of control group (P<0.05), correlation analysis of expression of HO-1 was positively correlated with MFI, MDA (r=0.489, 0.763, P<0.05) in the T2DM group, HO-1, HOMA-IR and FBG were significantly higher than the healthy control group, the difference was statistically significant(P<0.05). The expression of HO-1 and HOMA-IR and FPG levels were positively correlated in the T2DM group (r=0.271, 0.426, P <0.05). Conclusion T2DM patients with hyperglycemia and oxidative stress, plasma HO-1 expression is significantly increased, HO-1 is related to oxidative stress, insulin resistance and hyperglycaemia, which has certain value on clinical assessment of T2DM and therapeutic efficacy.

This study was aimed to optimize the extraction process conditions of lycopene in tomato. Ketchup was used as raw material. Method verification, single factor experiment and orthogonal method were used in the study on extraction process of lycopene. The results showed that the best optimization process conditions of lycopene extraction with ethyl acetate: extraction temperature at 50℃, extraction time for 40 min, ethyl acetate concentration of 80%, solid-to-liquid ratio of 1?2 (g·mL-1). Under these conditions, the extraction rate of lycopene reached 15.564 mg·100g-1. It was concluded that the extraction process of lycopene can provide experimental basis for further development and utilization of lycopene.