Pancreatic enzyme replacement therapy is given to manage pancreatic exocrine insufficiency (PEI) in cystic fibrosis (CF) and following pancreatectomy, total gastrectomy or chronic pancreatitis. The article reviews on aspects of pancreatic enzyme replacement therapy containing the assement of pancreatic exocrine function, the pathogenesis of exocrine pancreatic insufficiency, pancreatic enzyme preparations and their efficiency, dosing of pancreatic enzymes, enteral nutrition and pancreatic enzyme replacement, the modulation of pancreatic exocrine and adverse reactions to pancreatic enzyme.

Objective To study the effect of ? interferon in the treatment of renal cell carcinoma after radical nephrectomy. Methods From Jan 1988 to Jan 1998 ,46 cases of renal cell carcinoma were randomized into two groups: the interferon group treated by radical nephrectomy and ? interferon and the control group with radical nephrectomy alone. Results The T lymphocyte subsets CD 3,CD 4,CD 8,the ratio of CD 4/CD 8 were significantly different berfore and after treatment in the interferon group( P

Objective To study the volume of residual urine as related to the surgical indication for BPH. Methods Urodynamic study was carried out in 103 BPH patients who were assigned to group A (no residual urine),group B (residual urine0.05) but significantly different between group C and A or between B and A (P60 ml should be strictly followed.Early surgical intervention should be undertaken if the bladder ontlet obstruction or bladder function deteriorated by BPH causing residual uine.Other causes such as neurogenic should be ruled out before surgery.

Traditional Chinese Medicine (TCM), especially acupuncture and herbal medicine, is mainly applicated in musculoskeletal diseases, gynaecopathia, functional gastrointestinal diseases and cancer related pain in recent decade over the world. The influence of TCM on quality of life of pain patients received more attention, but still lacked evidence-based basis. Recent years, the basic studies were focusing on the function researches and tried to find out the relationship between functional units with systems biology methods to explain the holistic concept of TCM. After searching the database during 2002 to 2012, this article reviewed the character, development and innovation of TCM applicated in pain management.

BacKground:The mechanism of diabetic gastrointestinaI dysmotiIity is stiII uncIear. More and more studies showed that gastrointestinaI smooth muscIe derived factors pIay an important roIe in gastrointestinaI dysmotiIity. RecentIy,the roIe of RhoA/ROCK signaIing pathway in diabetic compIications become a research hotspot. Aims:To investigate the possibIe roIe of RhoA/ROCK signaIing pathway in diabetic coIon dysmotiIity by examining the expressions of major signaIing moIecuIes in diabetic coIon muscIe. Methods:NormaI coIon tissue sampIes taken from patients undergoing radicaI surgery for coIonic cancer from Sept. 2012 to Dec. 2013 at the First AffiIiated HospitaI of Nanjing MedicaI University were coIIected. According to gIycated hemogIobin IeveI,the patients were divided into diabetes meIIitus( DM)group and controI group. The expressions of major signaIing moIecuIes in RhoA/ROCK1 signaIing pathway incIuding RhoA,ROCK1,MYPT1 and p-MYPT1 were determined by immunohistochemistry or Western bIotting. Results:Immunohistochemistry showed that expression of RhoA protein in DM group was significantIy Iower than that in controI group(P<0. 05). Western bIotting showed that expression IeveIs of RhoA,ROCK1 and p-MYPT1 proteins were significantIy Iower in DM group than in controI group(0. 62 ± 0. 42 vs. 1. 15 ± 0. 69,0. 54 ± 0. 09 vs. 0. 75 ± 0. 05,0. 70 ± 0. 28 vs. 1. 04 ± 0. 47;P<0. 05),whereas no significant difference in expression IeveI of MYPT1 protein was found between DM group and controI group(0. 94 ± 0. 50 vs. 1. 21 ± 0. 80,P>0. 05). Conclusions:The inhibition of RhoA/ROCK signaIing pathway in diabetic coIon muscIe may have some correIation with diabetic coIon dysmotiIity.

Objective To study the correlation between serum bilirubin and restenosis after stent implantation of coronary heart disease (CHD).Methods Two hundred and fourtynine patients with CHD were divided into Instent-restenosis (ISR) of CHD group and non-ISR of CHD group according to their angiography findings.Theirserum bilirubin levels were compared and correlation between serum bilirubin level and ISR of CHD was studied.Results The serum bilirubin level was significantlylower in ISRof CHD group than in non-ISR group (P ＜ 0.05),in TBIL (9.9322 ± 3.8748μmol/L) to (12.08 ±4.6679μmol/L)、DBIL (3.1744 ± 1.60μmol/L) to (3.8949 ± 1.825μmol/L)、IBIL (6.757 ±2.822μmol/L) to (8.174 ± 3.388μmol/L).Conclusions The serum bilirubinlevel is lower in CHD patients with ISR than in CHD patients with non-ISR,which is an indepent risk factor for ISR of CHD.

Objective To investigate the meridians and acupoints selection in the treatment of post-stroke spastic paralysis with Tuina (Chinese massage). Methods The literatures about Tuina therapy for post-stroke spastic paralysis were retrieved. The frequency of meridians and acupoints used was counted and analyzed. Results 99 papers were collected, which involved in 226 acupoints and 1602 times of application. The selected acupoints were distributed in all the fourteen meridians and 64.5% (1033/1602, 606 on upper limb, 427 on lower limb) of them were on the limbs. The acupoints of the Yang meridians was 75.0% (1200/1602) and the specific acupoints was 71.7% (1148/ 1602). Conclusion The acupoint selected was basically focused on the local areas in Tuina for post-stroke spastic paralysis, assisted with the involved meridians and distal acupoints. The acupoints of the Yang meridians were the first option, mainly on the extremities. The specific acupoints were the major components of the prescription, especially the Five-shu acupoints and the He acupoints.

Objective To investigate the factors related to outcome (recovery of motor, activities of daily living, and balance) of stroke patients. Methods 67 stroke patients with hemiplegia were evaluated with the Ueda Classfication of upper and lower limbs function, Functional Independence Measure (FIM), Berg balance scale (BBS) before and after treatment. The scores of all the assessment were as the dependent variable respectively, and regression analyzed with the factors possiblely related to the outcome. Results The positive factors for lower limbs function included rehabilitation intervention, time of rehabilitation, and hypercholesterolemia; while the negative factors were body mass index (BMI), and damage of superficial sensibility. The positive factors for upper limbs function were rehabilitation intervention and time of rehabilitation; while the negative factors were BMI, dysphagia, damage of superficial sensibility, and frequency of attack. The positive factors for hand function were rehabilitation interventions and interval from diagnosis to rehabilitation, while the negative factors were the muscle tension, incontinence, and frequency of attack. The positive factors for FIM were the rehabilitation intervention, while the negative factors were BMI, incontinence, hypercholesterolemia, gender and residence status. The positive factors for BBS were the rehabilitation intervention, while the negative factors were BMI, frequency of attack, and hyperglycemia. Conclusion Rehabilitation promotes the recovery of stroke patients, but the BMI may block it.

Objective:To investigate the effect of the extract of Schisandra chinensis on the matrix metalloproteinases(MMPs) system in kidney tissue of the diabetic rats,and to explore its protective effect on the kidney tissue from the matrix degradation perspective.Methods:STZ was used to establish rat models of diabetes mellitus.A total of 45 diabetic rats were randomly divided into model group,extract of Schisandra chinensis group and Benazepril group,and there were 15 rats in each group.Another 15 rats were selected and used as normal control group.12 weeks after administration,the routine blood and urine biochemical indexes,the histological changes,blood glucose (BG),blood urea nitrogen(BUN),serum creatinine(Scr),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterin(LDL-C),total cholesterol(T-CHO),and triglyceride(TG) levels,excretion rates of albuminuria and proteinuria of the rats in various groups were detected;the expression amounts of fibronectin (FN),type Ⅳ collagen (Col Ⅳ),and matrix metalloproteinase inhibitor metalloproteinase-2 (TIMP-2) in kidney tissue of the rats were detected by immunohistochemical method;the activity of matrix metalloproteinase-2 (MMP-2) was detected by zymography.Results:Compared with model group,the glomeruli matrix accumulation of the rats in extract of Schisandra chinensis group was significantly improved,the excretion rate of albuminuria,LDL-C level and serum MDA level were decreased(P<0.05),the activities of CAT(P<0.01)and SOD(P<0.05)in kidney tissue were increased,and the level of MDA in kidney tissue was decreased(P<0.05).The immunohistochemistry results showed that compared with model group,the expression amounts of FN,Col Ⅳ,and TIMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group were significantly decreased.The zymography results showed that compared with model group,the activity of MMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group was significantly increased(P<0.05).Conclusion:Extract of Schisandra chinensis has protective effect on the kidney tissue of the diabetic rats induced by STZ,and the mechanism may be related to the inhibition of oxidative stress and the improvement of MMP-2 activity as well as the inhibition of TIMP-2 expression which could improve the matrix degradation.

Purpose To investigate relationship between PD-L1 molecule expression and Treg infiltration in non-small cell lung cancer ( NSCLC) tissue and to explore their clinical significance. Methods Immunohistochemistry was used to detect the PD-L1 molecules expression and Treg infiltration of 78 NSCLC tissues. The relationship among PD-L1 expression, Treg infiltration and clinic-pathological parameters was analyzed in the patients. Results PD-L1 molecule was highly expressed in lung cancer tissues than adjacent tissues (52. 5% vs 6. 4%), and same to Foxp3 +Treg (18. 63 ± 16. 67)/HPF vs (2. 96 ± 2. 97)/HPF. There was close relationship between PD-L1 expression and Treg infiltration with lymph node metastasis and clinical stage of patients, but was no statistical correlation with patient’ s age, gender, histological type and degree of differentiation of the tumor cells. PD-L1 expression was significantly higher in advanced stage than that in early stage (70. 0% vs 41. 7%) and same to Treg infiltration (73. 3% vs 35. 4%). There were also signif-icantly higher infiltration with lymph node metastasis than that without metastasis. In addition, PD-L1 molecule expression and Foxp3 +Treg infiltration were positively correlated (rs =0. 611, F=78. 82, P=0. 023). Conclusion There was strong relationship among PD-L1 expression, Treg infiltration and disease progress in lung cancer patients, and they possibly participate in the progression and immune escape of lung cancer.