Neoplasms of the small intestine have no specific features at early stage,and the prognosis is poor.The 5-year survival rate of all the patients is about 30％ and the middle survival time is 19 months.The retrospective analysis shows that adjuvant chemotherapy after surgical resection might improve the disease free survival while the overall survival is not improved obviously.The patients who are at advanced stage or have regional lymph node metastasis may obtain benefits from adjuvant chemotherapy.Palliative chemotherapy may improve progress free survival and overall survival of patients who are at advanced stage.The therapeutic effect of patients at advanced stage using FOLFOX regimen ( 5-fluorouracil,calcium folinate and oxaliplatin ) is better compared with other regimens.The molecular targeted therapy of small intestine cancer is still in the study process and advanced studies are also needed for chemotherapy.

BACKGROUND: Human skeletal muscle derived myoendothelial cells (MECs) are located in the vascular wall and co-express the markers of muscle stem cells and vascular endothelial cells (CD56+CD34+CD144+CD45-). Studies have shown that MECs are similar to mesenchymal stem cells, express the surface markers of mesenchymal stem cells and have the potential of multidirectional differentiation. OBJECTIVE: To establish an in vitro culture system for human umbilical cord blood CD34+ cells with MECs as trophoblastic layer, and to evaluate the in vitro supporting effect of human skeletal muscle MECs on hematopoietic stem/progenitor cells by measuring the changes in the number, immunophenotype and colony forming ability of CD34+ cells before and after culture. METHODS: There were three groups in the experiment. In experimental group, human umbilical cord blood CD34+ cells were co-cultured with MECs as the nourishing layer; in control group, human umbilical cord blood CD34+ cells were co-cultured with bone marrow mesenchymal stem cells as the nourishing layer; and in blank control group, human umbilical cord blood CD34+ cells were cultured alone without the nourishing layer. The main outcome measures, including the number of human umbilical cord blood CD34+ cells, immunophenotype of blood cells and colony formation ability of hematopoietic stem/progenitor cells were analyzed and compared at 1, 2, and 4 weeks after co-culture. No detection was conducted at 5 weeks due to the lack of survived cells. RESULTS AND CONCLUSION: (1) The number of human umbilical cord blood CD34+ cells increased by MECs as the nourishing layer compared with bone marrow mesenchymal stem cells as the nourishing layer at 1, 2, and 4 weeks; however, there was no significant difference between the two groups (P > 0.05). (2) The cell immunophenotype by flow cytometry analysis indicated that only in the 2nd week, the expression of CD34+CD33- in human umbilical cord blood CD34+ cells in the control group was significantly higher in the experimental group (P < 0.05). Other subtypes of immunophenotypes CD45+, CD14+, CD10+/ CD19+ showed no significant difference between the two groups (P > 0.05). (3) The colony formation capacity of hematopoietic stem/progenitor cells showed no significant difference between the experimental and control groups at 1, 2, and 4 weeks (P > 0.05). (4) Due to the non-nourishing layer culture system, the number of human umbilical cord blood CD34+ cells decreased significantly in the 1st week, and no cells survived in the 2nd week. Therefore, blood cell immunophenotype and colony analysis could not be performed. (5) To conclude, human skeletal muscle MECs as trophoblasts are the same as human bone marrow mesenchymal stem cells, which have a hematopoietic support in vitro.

Anthrax is a malignant infectious disease caused by Bacillus anthracis spores,after entering the host Bacillus an-thracis produces and releases anthrax toxin,which is the main cause leading to death of the host. The anthrax toxin is composed of two enzymatically active components:lethal factor(LF)and edema factor(EF),and one shared receptor binding and translocation com-ponent:protective antigen(PA). PA combined with LF is called lethal toxin(LeTx),while PA combined with EF called edema toxin (EdTx). Currently,the main drugs for treating anthrax are antibiotics,but antibiotics can only kill part of anthrax spores and bacte-ria,and cannot inhibit the activity of anthrax toxin. So it is necessary to develop novel drugs for inhibiting anthrax toxin. This review summarizes the evolution of small-molecule inhibitors of anthrax toxin respectively targeting PA,LF and EF.

AIM: To observe the efficacy and side effects of interferon ? 1b (interferon) combined with oxymatrine in the treatment of chronic hepatitis B. METHODS: 87 patients were randomly divided into two groups: 45 patients in treatment group were given interferon 30 ?g?d -1 (im) for 4 wk, then 30 ?g?d -1 (im, qod) combined with oxymatrine 600 mg?d -1 (im) for 3 mon; 42 patients in control group were given the same dose of interferon as above only. After completion of therapy, liver function and markers of HBVM were compared between the two groups. RESULTS: The rates of ALT decreased to normal range in treatment group and control group were 88.9 % and 60%, respectively (P

Objective To explore the structure of self-developed "The Compliance Scale Among Kidney Transplantation Recipients" in order to provide effective tool to evaluate kidney transplantation recipients' compliance. Methods 886 follow-up kidney transplantation recipients of six organ transplantation centers in Shanghai were surveyed by "The Compliance Scale Among Kidney Transplantation Recipients". Results The exploratory factor analysis yielded a 25-item four-factor model termed medication compliance, life habits compliance, self-monitoring compliance, follow-up compliance. Conclusions The self-developed "The Compliance Scale Among Kidney Transplantation Recipients" could be a useful tool for evaluating compliance among kidney transplantation recipients.

Objective To investigate the role of miR-200b on gemcitabine induced epithelialmesenchymal transition (EMT) in pancreatic cancer cell line MiaPaCa-2.Methods Different concentrations of gemcitabine were used to induce MiaPaCa-2,and the concentration of 50％ cell proliferation inhibited (IC50) was applied to obtain drug-resistant MiaPaCa-2 cells.MiR-200b or nonsense small molecular fragments (negative control,NC) was transfected into MiaPaCa-2 cells by liposomes,then gemcitabine of IC50 was used to induce cells to obtain drug-resistant MiaPaCa-2 cells transfected with miR-200b or NC.The morphological characteristics of MiaPaCa-2 cells were observed by inverted microscope.Invasion of cells were detected by transwell chamber.The expression of miR-200b was measured by using real-time PCR.The expressions of Ecadherin,Vimentin,Zebl,Zeb2 proteins were determined by Western blot.Results After gemcitabine treatment,the cells' size gradually diminished,intercellular junctions decreased,pseudopodium increased,which presented the characteristics of mesenchymal morphology.The invaded cell number increased from (26 ± 3) to (85 ± 6),and the expression of Vimentin Zebl,Zeb2 was increased to (1.87 ± 0.17),(2.57 ±0.21),(5.24 ± 0.83) folds of the parent cells.The expression of miR-200b was decreased to (0.36 ± 0.01)folds of the parent cells,and the expression of E-cadherin was decreased to 0.47 ± 0.05 folds of the parent cells,while the invaded cell number of drug-resistant MiaPaCa-2 transfected with miR-200b was decreased to (42 ± 4),and the expression of Zebl,Zeb2 was decreased to (0.36 ± 0.07),(0.08 ± 0.01) folds of drugresistant MiaPaCa-2 transfected with NC.Conclusions The occurrence of EMT is observed in pancreatic cancer cell line MiaPaCa-2 during gemcitabine induction,and miR-200b down-regulation may be a possible mechanism.

0.05), after treatment all the indexes in the 2 groups were decreased(P

β-arrestins, a kind of important adaptor protein and signal transduction protein found in the purification process ofβ-adrenergic receptor kinase (β-ARK) ,were first identified as pro-teins that have the ability to desensitize G protein-coupled recep-tors ( GPCR) . Fibrosis is defined by the overgrowth, hardening, and scarring of various tissues and is attributed to excess deposi-tion of extracellular matrix ( ECM ) components including colla-gen . A large number of studies have shown thatβ-arrestins play an important role in the process of fibrotic diseases, involved in inflammatory response and excess deposition of ECM. This re-view discusses the research status and development prospects ofβ-arrestins-mediated fibrotic diseases.

Objective To observe the effect of low tidal volume lung protective ventilation management strategy on postoperative outcome of elderly patients with poor pulmonary function after abdominal surgery.Methods Eighty patients of poor pulmonary function undergoing open gastrointestinal surgery,male 64 cases,female 16 cases,aged over 65 years old,ASA physical status Ⅱ or Ⅲ,NYHA cardiac function Ⅱ or Ⅲ grade,expected operation time 2-4 h were screened.The patients were randomly divided into 2 groups: protective ventilation management group (group P) and conventional mechanical ventilation group (group C),40 cases in each group.Multi-mode anesthetic management was performed in both groups.The respiratory parameters were adjusted according to the group after tracheal intubation,and the respiratory rate was adjusted to maintain PETCO2 35-45 mm Hg.The blood gas evaluated postoperative oxygen and postoperative spontaneous breathing recovery time,recovery time,extubation time,PACU time,gastrointestinal function recovery time,ambulation time,hospital stay and cost of hospitalization were recorded.The occurrence of major complications were observed at 30 days after surgery.Results PaO2 of group C was significantly decreased at 1 and 3 days after surgery than that before operation (P<0.05),PaCO2 of group C was significantly higher at 1 and 3 days after surgery than that of group P (P<0.05);PACU residence time of group P was (76.63±29.72) min,significantly shorter than that of group C [(93.80±42.90) min] (P<0.05);The difference spontaneous breathing recovery time,awake time,extubation time,exhaust time,ambulation time,postoperative hospitalization time and hospitalization expenses of two group was not statistically significant.Within 30 d after operation,2 cases (5%) of respiratory failure patients,3 cases (7.5%) of pneumonia in group P;5 cases (12.5%)of respiratory failure patients,3 cases (7.5%) of pneumonia,postoperative hemorrhage in 1 cases (2.5%) and 1 cases (2.5%) delirium in group C,there was no significant difference of the main complications in 30 d after operation between two groups.Conclusion Under the condition of this research,low tidal volume lung protective ventilation management strategy can improve elderly patients with poor pulmonary function after abdominal surgery postoperative oxygen and help to reduce the occurrence of postoperative adverse reactions.

Objective To investigate the prevalence of and risk factors for glucocorticoid-induced diabetes mellitus (GDM) in patients with pemphigus or pemphigoid receiving glucocorticoid therapy.Methods This study included 68 hospitalized patients with pemphigus or pemphigoid receiving glucocorticoid therapy in the Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College from December 2011 to January 2013.Comparisons were carried out between patients with GDM and those without regarding multiple parameters,including age,sex,body mass index (BMI),pathological type,initial dose and maximum daily dose of glucocorticoids,family history of diabetes mellitus,immunosuppressive treatment,etc.Independent samples t test was used for intergroup comparisons,Chi-square test and Fisher exact probability test for the analysis of count data,and a logistic regression model for the determination of risk factors.Results Among the 68 patients,26 (38.2％) developed GDM during glucocorticoid therapy.Univariate logistic regression analysis showed that the initial dose of glucocorticoids (P ＜ 0.05,OR 1.023,95％ CI 1.002-1.044),maximum daily dose of glucocorticoids(P ＜ 0.01,OR 1.037,95％ CI 1.013-1.062),duration of glucocorticoid treatment (P ＜ 0.05,OR 1.143,95％ CI 1.028-1.271),BMI (P ＜ 0.01,OR 1.265,95％ CI 1.080-1.481) and dexamethasone use (P ＜ 0.01,OR 6.0,95％ CI 1.887-19.076) were risk factors for GDM in these patients.Multivariate logistic regression analysis showed that BMI (P ＜ 0.05,OR 1.223,95％ CI 1.017-1.471) and maximum daily dose of glucocorticoids (P ＜ 0.05,OR 1.037,95％ CI 1.009-1.065) were independent risk factors for GDM.Conclusions In this study,38.2％ of the patients with pemphigus or pemphigoid developed GDM during glucocorticoid therapy.BMI and maximum daily dose of glucocorticoids seem to be independent risk factors for GDM.