The phenomenon of perineural invasion in pancreatic cancer occurs more easily.It can cause pain and tumor recurrence,and result in poor prognosis.The perineural invasion of pancreas cancer is closely related to the anatomical basis of pancreas and nerve tissue as well as the changes in the tumor microenvironment.Multiple factors in the microenvironment take part in the development of perineural invasion,meanwhile,the tumor tissue itself can also change the microenvironment.This article is to overview the research on the anatomy and molecular biology of perineural invasion of pancreas cancer.

ObjectiveTo detect the mRNA expression levels of RORγt and Foxp3 genes in peripheral blood mononuclear cells(PBMCs) of children with atopic dermatitis(AD),and to explore their possible roles in the development of AD.MethodsSixty-three children with AD and 54 age-matched normal children were eligible for this study.Real-time fluorescence-based quantitative PCR was carried out to measure the mRNA expressions of RORγt and Foxp3 genes in PBMCs of these subjects.ResultsThe relative expression levels of Foxp3 and RORγt mRNA were significantly higher in children with AD compared with the normal controls (2.4060 ± 0.3355 vs.1.1852 ± 0.4189,t =17.50,P＜ 0.01; 6.9130 ± 0.2046 vs.2.7501 ± 0.2518,t =98.63,P ＜ 0.01 ).A statistical increase was observed in the level of RORγt mRNA in children with severe AD compared with children with mild and moderate AD(7.1203 ± 0.1056 vs.6.8046 ± 0.1731 and 6.8655 ± 0.3671,t =6.61,5.23,both P ＜ 0.01).No significant difference was noted in the expression of RORγt mRNA between children with mild and moderate AD,or in the Foxp3 mRNA expression among children with mild,moderate and severe AD.The severity of AD was positively correlated with the level of RORγt mRNA (r =0.62,P ＜ 0.01 ),but uncorrelated with the level of Foxp3 mRNA(r =0.04,P ＞ 0.05).ConclusionsThe high expressions of RORγt and Foxp3 genes may be involved in the pathogenesis of AD,and the severity of AD is positively correlated with the expression intensity of RORγt gene.

Objective To compare the effects of transcranial and trans-spinal low frequency magnetic stimulation (MS) on the expression of growth-associated protein-43 (GAP-43) in the spinal neurons of rats after spinal cord injury (SCI). Methods Forty-five Sprague-Dawley female rats were divided randomly into a transcranial magnetic stimulation (TMS) group,a trans-spinal cord magnetic stimulation group and a model control group with 15 in each group.Another 6 rats served as a normal control group.Spinal cord injury at the T9-10 level was modeled according to the modified Allen's method.The rats in the two MS groups received magnetic stimulation at 0.5 Hz and 75％ of the maximum output intensity ( 1.9 T) of the magnetic stimulator beginning 24 h post injury.They received 30 pulses daily for 28 days while the rats in the model control group were not exposed to MS.Basso-Beattie-Bresnahan (BBB) scale scores and motion evoked potentials (MEPs) were measured at the 1st,7th,14th,21 st and 28th day post injury.The expression of GAP-43 protein was studied using immunohistochemical methods and semi-quantified by Western blotting. Results At the 4th week post injury the average BBB scores in the model control group,the TMS group and the trans-spinal cord magnetic stimulation group were all significantly different. MEP amplitudes decreased significantly in all groups after the injury,and the latency was prolonged,but there were no significant differences among groups at any time point.GAP-43 expression also increased after SCI,and it was significantly higher in the MS groups than in the model control group at 4 weeks. Moreover,the expression of GAP-43 in the trans-spinal cord MS group was significantly greater than in the TMS group.Conclusion Magnetic stimulation can promote nerve regeneration and improve locomotor recovery after spinal cord injury,at least in rats.The effect of trans-spinal cord magnetic stimulation is superior to that of TMS.The mechanism may be related to the activation of central pattern generators.

Calomel is a common traditional Chinese medicine (TCM) containing mercury in clinical external application. Although the toxicity of calomel has attracted concern, there is no unified standard yet in clinical external application. Risk assessment is used for evaluating the potential health effects of hazardous substances. The purpose of this article was to evaluate the health risk of calomel in clinical external application on the basis of toxicity data, to ensure safe and rational application of TCM containing calomel. The toxicity data of transdermal administration of calomel or mercurous chloride were collected by searching the literature. The daily maximum exposure dosage of calomel in clinical external application was estimated by following the four procedures of risk assessment, and Margin of Safety (MOS) as an evaluation indicator was then calculated to evaluate the safety of calomel on clinical application. It has been reported that the adult in single transdermal administration of calomel at 1. 5 g was lethal. Based on the LOAEL of calomel for long-term transdermal exposure (1 month) in rats was 0.096 g · kg(-1) · d(-1), the NOAEL of calomel for patients (about 60 kg) by external application within 2 weeks was estimated to be 1.46 mg · kg(-1) · d(-1). When MOS value equals to 1, the daily maximum exposure of calomel in clinical external application within 2 weeks was calculated to be 1.1 g. The results suggest that daily single dose of calomel in clinical external application should be lower than 1.5 g for adults, and more attention should be paid to changes in hepatic and renal function of patients when repeated dose more than 1.1 g within 2 weeks. The approach of risk assessment could be helpful in rational application of TCM containing mercury.
Animals ; Humans ; Medicine, Chinese Traditional ; Mercury Compounds ; toxicity ; No-Observed-Adverse-Effect Level ; Rats ; Risk Assessment

Objective To investigate the anatomical characteristics and clinical application of the distal musculocutaneous perforators derived from the descending branch of lateral circumflex femoral artery in the anterolateral thigh flap transplantation. Methods From July 2007 to December 2009, the anatomic variations of musculocutaneous perforator were investigated in 96 cases who received anterolateral thigh flap and 10 preserved cadavers. Thirty-five cases who received the anterolateral thigh flap using the distal musculocutaneous perforators were included in the study. There were 19 males and 16 females. The age ranged from 28-55 years old, with an average of 38.5 years old. Single flap was used in 20 cases while lobulated flap in 15 cases. Single flap area ranged from 7 cm×15 cm to 9 cm×25 cm, lobulated flap ranged from 5 cm×7 cm to 8 cm×20 cm. Results The cadaver study found that the most musculocutaneous perforators were concentrated in the far fourth of the anterolateral thigh region. The musculocutaneous perforators commonly arose from the the lateral femoral circumflex artery. The perforator arose directly from the femoral artery or the deep femoral artery in one case separately. In the clinical study, 2-5 musculocutaneous perforators were found in 94 cases but not in the other 2 cases. The descending branch of lateral circumflex femoral artery became the direct m musculocutaneous perforator. The proximal intermuscularseptum perforator was found in 2 cases. Postoperative follow-up time ranged from 6-11 months. All flaps survived in the follow-up.Marginal necrosis was found in 3 cases. Only 1 case had complained of knee joint instability. Conclusion The results of this study suggest that the vascular anatomy of the distal musculocutaneous perforator was reliable. The perforator may serve as an option for proximal one in anterolateral thigh flap transplantation.

Objective To investigate the value and limitations of ultrasound determination-evaluated brachial artery endothelial function in elderly diabetic patients. Methods High-resolution two-dimensional ultrasound was used to determine brachial artery(BA) flow-mediated vasodilation(FMD) during reactive hyperemia. Endothelial function was evaluated by FMD in 67 elderly patients with type 2 diabetes. Results In diabetes versus normal control group,the BA diameter and flow velocity showed no significant difference (P＞0.05) at basal state,but showed significant decreases (P＜0.05) after reactive hyperemia. Single-factor correlation analysis showed that FMD was in negative correlation with disease course, TG, ISI and age (r=-0.2357,-0.2215 and -0.3256, -0.2415,(all P＜0.05～0.01),and showed no correlation of FMD with BMI, TC, FBG, HbA1c, FIns. Conclusions FMD has a value in evaluating the flow-mediated endothelial dysfunction in older T2DM patients, while our analysis of the results should consider the patient's age, gender, race, disease course, blood lipids and other factors.

To treat 30 cases of diarrhea of insufficiency of the spleen-yang type by moxibustion with salt at Shenque (CV 8 ). The total effective rate was 93.3%.

This paper reviewed the history of Sodium Morrhaute,summarized the action mechanism and clinical use of Sodium Morrhuate as sclerosant and hemostyptic, and described the research and application of Sodium Morrhuate as the drug for birth control. The further applications for antitumorigenesis and antifertility in the medical field were also discussed.

Neurotrophin 3(NT-3) is required for proprioceptive neuron survival and physiological function.During embryonic development,NT-3 deficient in developing muscle dues to loss of proprioceptive neurons in dorsal root ganglia or their axons by apoptosis,and then to the absence of muscle spindles.The chemoattractant effect of NT-3 on dorsal root ganglion axons has been improved that NT-3 is a key requirement for the development of proprioceptive projection to motor neurons.Depletion of NT-3 in the period of adult educes to the decline of the function of proprioception.NT-3 has extensive protective effect on proprioceptive neuron and enhances them to restore the normal physiological function under the pathological state.

The metastases status of internal mammary lymph node(IMLN) is an independent prognostic factor for breast cancer and it also is an important reference for neoplasm staging.The patients with IMLN metastases consistently have worse outcomes.The overall risk of IMLN metastases is 18 ％-33 ％.Metastases exclusively situated in the IMLN,without concurrent axillary metastases,occur in 2 ％-11％ of patients.Factors related to IMLN metastases include the status of axillary node,the age of patients,the localization and characteristics of primary tumor.Recently,with the development of sentinel lymph node biopsy(SLNB), internal mammary-SLNB may access the status of IMLN with a minimal risk. Internal mammary-SLNB procedure can improve the system for nodal staging of breast cancer,and it will contribute to the individualized treatment for breast cancer patients.