Objectives To determine the serum levels of high mobility group box-1 protein ( HMGB1 )in patients with acute pancreatitis (AP) and to investigate the contributions of HMGB1 in the pathogenesis of AP. Methods The serum HMGB1 concentrations were determined by enzyme-linked immunosorbent assay in 33 patients with severe acute pancreatitis (SAP), 38 patients with mild acute pancreatitis (MAP) and 28 healthy controls at the time of admission within 72 h after the onset. THe relationships between the serum HMGB1 levels and sex, age, etiology, disease onset, Ranson score, Balthazar CT score, C-reactive protein,lactate dehydrogenase and serum creatinine, total bilirubin levels, local and systematic complications were analized. Results The serum HMGB1 levels in healthy control group, MAP group and SAP group were ( 1.82 ±0.64)μg/L, (6. 13 ±5.80) μg/L and (11.48 ±6.94)μg/L, respectively. The mean value of serum HMGB1 level in MAP group was significantly higher than that in healthy group ( P < 0. 05 ), while it was significantly lower than that in SAP group ( P <0.05 ). Within 24 h after disease onset, the serum levels of HMGB1 began to increase, and reached the peak at 48 h, then decreased and remained higher than normal value at 72 h.There were no remarkable relationships between the serum HMGB1 levels and sex, age, etiology, but it was positively correlated with Ranson score, Balthazar CT score, C-reactive protein, lactate dehydrogenase and serum crkatinine. The serum levels of HMGB 1 in patients with local and / or systematic complications were higher than those in patients without complications, but the difference was not statistically significant.Conclusions HMGB1 is a late inflammation mediator and serum HMGB1 levels were correlated with the severity of AP. HMGB1 may participate in the development of acute renal insufficiency during SAP.

Objective To explore the value of serum level of interleukin 6 (IL-6),tumor necrosis factor alpha (TNF-α) and high mobility group box-1 protein( HMGB1) in early assessment the severity and prognosis of acute pancreatitis (AP). Methods Thirty-three severe acute pancreatitis (SAP) patients and 38 mild acute pancreatitis (MAP) patients were selected as study objects;and 51healthy individuals were set as control group. Serum IL-6,TNF-α and HMGB1 concentrations were determined by enzyme-linked immunosorbent assay (ELISA),the association of them and the scores of Ranson,APACHE Ⅱ . Balthazar CT,serum biochemical parameters and prognosis was analyzed.Results The serum IL-6 levels of SAP group,MAP group and healthy control group were (553. 72±175.76) pg/ml,(265. 73±179. 95) pg/ml and (16. 43±3. 32) pg/ml;and there were statistical significance of these three groups (all P＜0. 01). There was no significant difference of TNF-α in the three groups (all P＞0. 05). The serum HMGB1 levels of SAP group,MAP group and healthy control group were (11. 48±6. 94)μg/L,(6. 13±5. 80)μg/L and (1. 82±0. 64)μg/L respectively,and there were statistical significant of these three groups (all P＜0. 05). The correlation coefficient of serum HMGB1 with IL-6 and TNF-α were 0. 896 and 0. 724 (P＜0. 01) respectively. The IL-6 level was positively correlated with the scores of Ranson,APACHE Ⅱ and Balthazar CT. The TNF-αconcentration was positively correlated with APACHE Ⅱ score,and the HMGB1 concentration positively correlated with scores of Ranson and Balthazar CT. The levels of IL-6,TNF-α and HMGB1were all positively correlated with the serum creatinine concentration. The IL-6 levels of patients with local and/or systemic complications were significantly higher than those without complications.Conclusion The serum levels of IL-6,TNF-α and HMGB1 are significantly correlated with the severity of pancreatitis,all of them take part in the development of acute renal insufficiency. The high level of serum IL-6 significantly correlated with complications.

A monoclonal antibody 1C34-5 raised against human peripheral mononuclear cells was produced. This antibody, a monoclonal IgG1. showed positive reaction with about 90% of T and B lymphocytes, monocytes. granulocytes and bone marrow cells, but negative reaction with red blood cells and platelets by indirect immunoflurorescent technique. 1C34-5 also reacted with leucocytic cell lines except a non-T non-B lymphoid line Reh but not with erythroid line K562, HeLa cells and fibroblast cells so far tested.This antibody was also assayed histologically by an indirect immunoperoxidase technique against a variety of human normal tissue frozen sections. It was found that 1C34-5 bound to all lymphoid tissues including lymph nodes, tonsil, thymus. Peyer's patches and leucocytes scattered in other tissues, but not to all non-hematopoietic tissues as well as erythropoietic foci in fetal liver. Thus. 1C34-5 appears to recognize a human leucocyte antigen specifically.

Objective To analyze the efficacy and safety of DCF and XELOX regimens in the treatment of advanced gastric cancer and to explore the appropriate chemotherapy regimen for advanced gastric cancer.Methods 63 patients with advanced gastric cancer were divided into two groups.Group A (31 patients) was administered with DCF regimen,with docetaxel 60-75 mg/m2 on day 1,5-fluorouracil 500 mg/m2 on day 1 to day 5,cisplatin 75 mg/m2 on day 1,a total cycle of 21 days.Group B (32 patients) was performed with XELOX regimen,with oxaliplatin 130 mg/m2 on day 1,capecitabine 100 mg/m2 twice a day on day 1 to day 14.Results 63 cases were eligible to analyze the efficacy and adverse reactions.The efficient rate (PR+CR) of group A and B were 58.1％ and 62.5 ％,respectively.The median survival time were 10.9 months and 11.5 months,but there were no significant difference between the two groups (P ＞ 0.05).The patients in both groups showed the similar tolerance of adverse reaction.Bone marrow suppression above level 3 in group A (16.1％) was higher than that in group B (9.3 ％).Hair loss above level 2-3 in group A was higher (77.4 ％).Hand-foot syndrome in group B (68.8 ％) was higher than that in group A (9.6 ％).Mild liver function damage in group B (37.5 ％) was higher than that in group A (16.1％).Conclusion The DCF and XELOX schemes have the similar effect in the treatment of advanced gastric cancer with the tolerate side effect.

OBJECTIVETo investigate the efficacy and adverse effect of DCF regimen with subsequent S-1 maintenance chemotherapy in patients with advanced gastric cancer (AGC).

METHODSSixty AGC patients without disease progression after 4 to 6 cycles of DCF regimen as the first-line chemotherapy were randomized into maintenance group and control group (30 patients each). The patients in the maintenance group received maintenance chemotherapy with S-1 (40 mg/m(2), twice daily for 14 days; 21 days for a treatment cycle) until disease progression or with intolerant toxicity, and those in the control group received optimal supportive care.

RESULTSThe response rate (CR+PR) was 33.3% in the maintenance group, significantly higher than that in the control group (3.33%, P<0.05), and the disease control rate (CR+PR+SD) also differed significantly between the two groups (73.3% vs 46.7%, P<0.05). The median time to progression was 7.9 months in the maintenance group and 6.8 months in the control group, with median overall survival time of 13.8 and 11.7 months, respectively (P>0.05). The most common adverse effect in the maintenance group included nausea, vomiting, leucocytopenia, and hand-foot syndrome; no death occurred in relation to the therapy.

CONCLUSIONS-1 maintenance chemotherapy, with a tolerable toxicity profile, can improve the RR, DCR and median time to progression in AGC patients who respond to DCF regimen, but its efficacy still awaits further evaluation.

OBJECTIVE To compare the efficacy of Danning tablet， taurosodeoxycholic acid and ursodeoxycholic acid in preventing the recurrence of choledocholithiasis after endoscopic retrograde cholangiopancreatography （ERCP）. METHODS The clinical data of 153 patients who underwent ERCP choledocholithotomy from January 2017 to January 2020 in Nantong First People’s Hospital were retrospectively analyzed. According to the different drug treatment received after surgery， patients were divided into three groups， namely， Danning tablet group （group A， 49 cases）， tauroursodeoxycholic acid group （group B， 44 cases） and ursodeoxycholic acid group （group C， 60 cases）. The above groups of drugs are all single-use， starting from 2 weeks after surgery for a course of 180 days. The effects of bile component indicators [total bilirubin （Tbil）， direct bilirubin （Dbil）， alkaline phosphatase （ALP）， glutamyltransferase （GGT）]， lipid metabolism indicators [total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL）， high-density lipoprotein （HDL）]， the occurrence of clinical symptoms （abdominal pain， bloating， nausea， and poor appetite） at 6 months after ERCP， and the recurrence of choledocholithiasis at 6， 12， 18 and 24 months after surgery were compared among 3 groups. RESULTS Compared with before surgery， the serum levels of Tbil， Dbil， ALP， GGT， TC， TG and LDL were significantly reduced （P＜0.05）， while serum HDL levels were significantly increased （P＜0.05） in the three groups at 6 months after surgery. The proportion of patients who experienced abdominal pain， bloating， nausea， and poor appetite at 6 months after surgery was significantly reduced （P＜0.05）. The Tbil levels of groups A and B were significantly lower than those of group C （P＜0.05）， while the Dbil and ALP levels of group A were significantly lower than those of groups B and C （P＜0.05）； however， there was no statistically significant difference in GGT levels among the 3 groups （P＞0.05）. Compared with groups A and C， the levels of four lipid metabolism indicators in group B were significantly improved （P＜0.05）； the proportion of patients with abdominal pain， bloating， and poor appetite in group A was significantly lower than groups B and C （P＜0.05）， but there was no statistically significant difference in the proportion of patients with nausea among the 3 groups （P＞0.05）. At 6，12 and 18 months after surgery， there was no statistically significant difference in the rate of choledocholithiasis recurrence among the 3 groups （P＞0.05）； at 24 months after surgery， the rate of choledocholithiasis recurrence in group A （2.04%） was significantly lower than group B （15.91%） and group C （15.00%） （P＜0.05）. CONCLUSIONS Compared with tauroursodeoxycholic acid and ursodeoxycholic acid， the application of Danning tablet after ERCP is more beneficial to reduce the secretion of bile acid， prevent the recurrence of gallstones， and improve clinical symptoms， but tauroursodeoxycholic acid can significantly accelerate the lipid metabolism of patients compared with the other two drugs.