Objective To study the clinicopathologic characteristics,the optimal therapy and prognosis of patients with pancreatic carcinoma with elevated serum alpha-fetoprotein (AFP).Methods CNKI,Wanfang database,VIP Database for Chinese Technical Periodicals,PUBMED and EMBASE were searched.Studies which met the inclusion criteria were evaluated.Results 24 reports were found which included 28 patients with pancreatic carcinoma with elevated serum AFP.The carcinoma was characterized clinically by a predilection for older male.The majority of patients had metastases at the time of diagnosis,especially liver metastases.Histopathologically,not all tumors were hepatoid carcinoma,and acinar cell carcinoma was most common.Surgical resection was the optimal treatment for patients at an early stage.Combined therapies were used on patients at an advanced stage.Patients with hepatoid carcinoma of the pancreas might be sensitive to treatment similarly to hepatocellular carcinoma.In AFP-producing pancreatic carcinoma,serum AFP level was a useful marker for diagnosis and evaluation of therapeutic response and recurrence.However,there were no sufficient evidence to support whether pancreatic carcinoma with elevated serum AFP was associated with a higher frequency of liver metastasis and poor survival.Conclusions Further studies are needed to identify the prognosis and the effective therapies for the AFP expression variance of pancreatic carcinoma with elevated serum AFP.Detecting AFP and variants of AFP are important for the early diagnosis of pancreatic carcinoma with elevated serum AFP,and increase in therapeutic response and prog nosis.

Objective To observe the clinical effects of invigorating the spleen promoting blood flow and removing stasis therapy on hypertension .Methods 104 subjects were randomly divided into 2 groups :control group ,including 52 cases ,which was treated by Benalapril and treatment group ,including 52 cases ,which was treated by Benalapril and herbs ,with a course of 4 weeks .The clinical symptom score ,blood rheology were observed .Results The total effective rate was 92 .31% in treatment group ,which was higher than that in control group ,whose effective rate was 76 .92% (P<0 .05);Improvement of the clinical symptoms and blood rheology were better in treatment group than in control group(P<0 .01) .Conclusion This therapy is quite effective for hyperten-sion and can reduce blood lipid and improve blood rheology .

Epilepsy was arousing the attention of medical circles because of the complexity of its mechanism and the difficulty of its control.The project which used the pioneering research as the basement and was directed by the chinese medicine used the modern multidisciplinary research technologies and explored the mechanism of the brain damage in epilesy.The project′s treatment idea is different from the others,which provided a new way for seeking new medicines for treating epilepsy.The research techniques took use of the application of the behavioral methods and the electrophysiological methods creatively and the subject firstly used this way to observe it dynamically,which greatly improved the accuracy of evaluating the models and pharmacodynamics studies of the epilepsy.The research method of the project firstly observed the changing mechanism of the brain damage and the regulation of the apoptosis related genes,and even the efficiency of tsaoko-anemarrhenae decoction,which enriched the scientific intension of the decoction.The conclusions palyed a very important role in exploiting the new medicine for treating epilepsy and enriching the knowledge of the five visceras in chinese medicine.

Objective To evaluate the pathogenesis and disease progression by detecting the expression of Serum High mobility group protein 1 (HMGB1) and TLR2 in monocytes of patients with systemic lupus erythematosus (SLE).Methods Forty patients with SLE were selected randomly,20 patients were in active disease group and others were in stable disease group.The expression of HMGB1 in the serum of these cases were detected by enzyme linked immunosorbent assay (ELISA) and TLR2 on CD14+ monocytes in the peripheral blood were detected by FCM.The correlation between these indexes and clinical,laboratory indexes about SLE were analyzed using one-way ANOVA,and Kruskal-Wallis test.Results The expression levels of HMGB-1 in serum was [(48.9±11.3) μg/L] in the active group,while that was [(14.8±1.9) μg/L] in the stable group was,and [(13.5±3.6) μg/L] in the control group.HMGB1 in the active SLE group was significantly higher (P＜0.05) when compared with that of the stable and control group.The expression of TLR2 in the peripheral blood mononuclear cells was [(96.7±1.3)％] in the active group,[(83.5±9.1)％] in the stable group,and [(83.3±9.9)％] in the control group TLR2 in the active SLE group was up-regulated when compared with the stable and control groups (P＞0.05).There were positive correlation between the serum levels of HMGB1and TLR2 in the peripheral blood mononuclear cells (r=0.551,P＜0.05).Conclusion The expression levels of HMGB-1 in serum and the expression of TLR2 in peripheral blood mononuclear cells may participate in the pathological processes of SLE.

Objective To investigate the pathogenesis and clinical features of ankylosing spondylitis (AS) concurrent with multiple myeloma (MM).Methods The clinical characteristics,pathogenesis,diagnosis and treatment of 3 cases who were diagnosed as AS concurrent with MM were analyzed and relevant literatures were reviewed.Results MM was confirmed in patients who had long-term stable AS.A wide variety of manifestations,including persistent pain in spine and thorax,pathologic fracture,anemia,kidney damage and nervous system abnormalities were frequently presented.These patients were insensitive to nonsteroidal anti-inflammatory drug treatment,and they had a unfavorable prognosis.Conclusion Patients who are diagnosed as AS concurrent with MM can present with a variety of clinical features.Manifestations which are difficult to explain clinically by AS and poor response to treatment especially when the patients have longterm stable AS are potential clues for MM.

Objective To analyze the pressure source and effect of comprehensive intervention in type 2 diabetes mellitus patients. Methods 200 diabetes patients were randomized into the observation group and the control group with 100 cases in each group. Comprehensive intervention was introduced into the observation group and the control group underwent routine treatment. The pressure source was investigated after intervention by questionnaires and the results were compared. Results Fearing of serious complications bocame the most common cause of pressure. The scores of Self-rating Depression Scale(SDS)and Self-rating Anxiety Scale(SAS)were lower and the biochemical index was also better in the observation group than those in the control group as well as those before intervention in the observation group(P＜0.05).Conclusion The depression, anxiety status and biochemical index in patients with type 2 diabetes mellitus were effectively controled by corresponding and comprehensive intervention measures according to the sequence order of pressure source.

Objective To summarize the clinical,radiographic and genetic features of a family with metatropic dysplasia,in order to improve the level of understanding and diagnosis of this disease.Methods The proband,a one-year old boy,was diagnosed as metatropic dysplasia.His mother was 26 years old with mildly phenotype.Their clinical features and bone X-ray findings were analyzed.The DNA samples of the proband and his parents were collected.The coding exons and flanking introns regions of transient receptor potential vanilloid 4 (TRPV4) gene were amplified by polymerase chain reaction (PCR) and analyzed by DNA automatic detector.The pathology,diagnosis,treatment and prognosis were expounded.Results The symptoms of the boy were characterized by short extremities,a short trunk with progressive kyphoscoliosis,and craniofacial abnormalities that include a prominent forehead,midface hypoplasia,and a squared-off jaw.His motor development was slightly delayed.Mental development was normal.Bone X ray of the boy showed platyspondyly and severe metaphyseal enlargement with shortening of long bones and irregularities and delayed ossification of epiphysis.The patient and his mother were heterozygous for the nucleotide substitutions c.2396 ＞ T (p.P799L) in TRPV4 gene.Conclusions The patient and his mother with metatropic dysplasia were diagnosed with TRPV4 gene analysis.The patient showed typical clinical features.His mother was mild.Metatropic dysplasia had significantly clinical heterogeneity.Gene analysis is helpful for the diagnosis.

0.05). Conclusions Following retroperitoneal laparoscopy, the cerebral blood flow is increased and no cerebral anoxia is found.

Objective To investigate the effects of neuromuscular blockade(NMB) by atracurium on facial nerve monitoring.Methods Twenty patients with chronic otitis media scheduled for radical mastoidectomy under general anesthesia were selected.Anesthetic inducement was made with sufentanil at 0.4 ?g/kg,lidocaine at 0.5~1 mg/kg,propofol at 2 mg/kg,and scoline at 1.5 mg/kg in their given order intravenously.After endotracheal intubation,mechanical ventilation was employed with an anesthetic machine.Intraoperative facial nerve minitorization was performed using the neuromuscular transmission monitor(TOF Guard) and the NMB level of right musculus adductor pollicis was assessed with the Nerve Integrity Monitoring System(Medtronic Inc.) simultaneously.No muscle relaxants were given until the electromyogram(EMG) of the facial nerve was induced.Propofol and sufentanil was administered intravenously to maintain the anesthesia.Minimal facial nerve stimulations(regarded as thresholds) causing EMG responses were measured during both nil NMB and 100% NMB by atracurium at 0.5 mg/kg.Results With propofol and sufentanil intravenously administered,the anesthesia was maintained successfully both before and after the administration of atracurium.The EMG of the facial nerve was induced even during the 100% NMB level by atracurium,but the thresholds were elevated significantly from 0.22?0.09 mA to 0.39?0.17 mA(t=-8.643,P=0.000).Conclusions Facial nerve monitoring can be performed even during the 100% NMB level by atracurium,with significant elevated stimulating thresholds.Propofol and sufentanil can be used to maintain adequate level of anesthesia without the need of muscle relaxants in radical mastoidectomy.

Objective To evaluate the prophylactic effect of continuous epidural block combined with desflurane anesthesia on increase of sympathetic neural activity induced by desflurane Methods Thirty patients were randomly allocated to two groups: desflurane anesthesia (DA) group (n=15) and epidural block combined with desflurane anesthesia (ECDA) group (n=15) After rapid induction with fentanyl propofol scoline, in DA group 2% desflurane in oxygen was inhaled firstly, then imposed with successive 1% increase of desflurane until balance and in ECDA group epidural blockade at T 9 10 or T 10 11 was firstly performed with 2% lidocain and other procedures were same as DA group The central venous blood samples were taken before induction, 30 min following desflurane inhalation(T 1), 60 min after operation beginning(T 2) and at the end of operation(T 3), to measure the plasma conentrations of catecholamine with high performance liquid chromatography Results Compared with baseline, following desflurane inhalation, MAP increased in DA group, but decreased in ECDA group, with significant difference between both groups As compared with the baselines, plasma epinephrine (EPI) and norepinephrine (NE) concentrations increased significantly in DA group at T 1, T 2 and T 3, but in ECDA group remained unsignificant changes at T 1, rose markedly at T 2 and T 3 EPI and NE levels were evidently higher in DA group at T 1 and T 2 than those in ECDA group Conclusions Continuous epidural blockade can effectively prevent the increasing in sympathetic neural activity induced by desflurane