Carcinoma of pancreas is the most common primar y pancreatic malignancy. Symptoms usually are nonspecific and include abdominal pain, jaundice, loss of appetite, weight loss, nausea, and vomiting. CT usually demonstrates a mass with ill-defined margins but also solid components and dil atation of the main pancreatic duct. This tumor is usually smaller and virtuall y never contains calcification. Following contrast material administration,all masses were enhanced less than the surrounding pancreas. Tumors were oval, rou nd or lobular,and is almost always locally invasive. These features can be used to differentiate carcinoma of pancreas from other pancreatic tumors.

Anti-endothelial cell antibodies (AECA) are heterogeneous autoimmune antibodies, which target at a group of antigens expressed in endothelial cells. In 1971, AECA was reported by Lindquist and Osterland for the first time. Since then, an increasing number of researches have showed that AECA exists and plays potential pathogenic role in the immune or inlfammation-related diseases, especially in systemic vasculitis. AECA may be a useful sera marker for the diagnosis and prognosis judgment of related autoimmune diseases. In this review, we summarize the recent progress on the relationship between AECA and systemic vasculitis.

Trauma and infection may cause a stress reaction to the body,which leads to the metabolic imbalance of organs and tissues,but some treatment methods can effectively reduce the negative effects of undesirable stress on body metabolism.This article focuses on the effects of trauma and infection stress on the protein metabolism,furthermore,introduces some related treatment methods.

Objective To observe the clinical efficacy ofToutongning Formula in the treatment of migraine. Methods Totally 100 cases of migraine patients (wind disturbance, blood stasis syndrome) were randomly divided into two groups. Patients in the experimental group were treated withToutongning Formula orally, and patients in the control group were treated with flunarizine capsules 5 mg orally, for 30 d. The scores of number, degree, duration and accompanying symptoms of episodes before and after treatment were observed, the total scores were calculated, and adverse reactions were recorded, to evaluate the clinical efficacy and safety.Results Clinical total efficiency was 92.0% (46/50) in experimental group and 64.0% (32/50) in the control group; the incidence rate of adverse reactions was 20.0% (10/50) in experimental group and 80.0% (40/50) in the control group; there was statistical significant differences in efficacy and adverse reactions between the two groups (P<0.05). After the treatment, the differences in the scores of number, degree, duration and accompanying symptoms of episodes, and in the total scores between the two groups was statistically significant (P<0.05). There was statistical significance in the different value of above indexes before and after treatment between the two groups (P<0.05).ConclusionToutongning Formula can not only improve symptoms significantly in patients with migraine (wind disturbance, blood stasis syndrome), but also reduce adverse reactions, with more safety and efficacy than flunarizine capsules.

Objective To investigate the causes of hearing loss for people over 60 years old. Methods People more than 60 years old in 14 provinces, 22 districts were investigated with a self-designed questionnaire, and a hearing test was also done for every subject. Results Among all the subjects, the etiological factors of hearing loss were otitis media (10.5%), hereditary deafness (2.9%), noise-induced hearing loss (3%), ototoxic deafness (6.4%), traumatic deafness (2%), presbycusis (33.8%), sudden deafness (1%) and other reasons (36.2%), respec-tively, with 11.3%unknown. Conclusion Presbycusis is the main reason of hearing loss for old people, and otitis media is the second. The cause of hearing loss is different with ages, districts, and whether in rural areas.

Objective To discuss the practical application effect of the work process oriented teaching model that based on flipped classroom in the teaching of higher vocational Chinese medicines.Method We chose 97 students from Grade 2012 higher vocational Chinese traditional medicine,set them into experimental group (47 students) and comparison group (50 students).The experimental group was applied with the flipped classroom teaching,combined with the teaching mode of working process and the comparison group was applied with the traditional teaching mode from September 2014 to July 2015.At the end of the experiment,through the questionnaire survey,the differences of the experimental group students' autonomous learning ability and problem solving ability were compared between before the experiment teaching and after the teaching.The difference of post adaptation ability of the experimental group and the control group was also compared,and besides,the students' satisfaction degree to flipped classroom combined with working process teaching mode was investigated and analyzed.SPSS 16.0 software was used for statistical analysis,and t test was used to compare two groups' measurement information and count data with chi-square test.Result The score of independent learning ability after teaching in the experimental group was significantly higher than before [(77.50 ± 7.10) vs.(88.51 ± 9.30);t=6.451,P=0.000].However,there was no statistically significant difference in problem-solving capability before and after the teaching[(83.70 ± 2.32) vs.(84.30 ± 2.11);t=1.312,P=0.193].The score of five aspects of the adaptability to work in the experimental group and total score were higher than the comparison group and the difference was statistically significant [work attitude (18.72 ± 2.01) vs.(16.78 ± 3.33),t=3.447,P=0.001;service ability (17.99 ± 1.98) vs.(16.05 ± 2.15),t=4.614,P=0.000;professional ability (18.19 ± 2.46) vs.(15.37 ± 2.79),t=5.267,P=0.000;completion of work (19.01 ± 1.75) vs.(16.88 ± 1.83),t=5.851,P=0.000;strain capacity:(18.33 ± 2.09) vs.(17.01 ± 2.46),t=2.839,P=0.006;the total score of job adaptability (92.24 ± 3.89) vs.(82.09 ± 4.05),t=12.574,P=0.000].Experimental group's satisfaction showed that 91.48％ of students liked the teaching model,87.23％ thought that it improved their learning interest,82.98％ believed that it was beneficial to improving their communication skills.Conclusion Teaching mode of flipped classroom combined with working process helps to improve teaching quality.

Objective To determine whether or not capsazepine(CPZ),a transient receptor po-tential vanilloid-1(TRPV1)antagonist,attenuates lidocaine-induced cytotoxicity on rat dorsal root ganglion (DRG)neurons in vitro.Methods Adequate DRG neurons from 3-day neonatal Wistar rats were obtained,cultured and purified in vitro.To achieve higher cell viability,we reduced the concen-tration of trypsin to 0.125% compared with others.The purified DRG neurons were incubated with 0,2.5,5,10,20 and 40 mmol/L lidocaine for 10 min,respectively,their viabilities were examined using Cell Counting Kit(CCK-8)assay,and the lethal concentration 50(LC50 )of lidocaine on DRG neurons was calculated.Then,the variation of lidocaine-induced cell viability at LC50 ,when 0,1,10 and 100 μmol/L CPZ were respectively added to the incubations,was examined with CCK-8 assay. Results The purified percentage of DRG neurons was as high as 91% after digesting by 0.125%trypsin and purifying in vitro.Cell viability of DRG neurons in group L1,L2,L3,L4,L5 was signifi-cantly down regulated compared with the control group,to be specific,that of L3,L4,L5 being re-markably lower than that of L1,that of L4,L5 lower than that of L2 and that of L5 lower than that L3 and L4.After lidocaine induced DRG neurons for 10 min,LC50 was 30 mmol/L;10 μmol/L and 100 μmol/L CPZ significantly reduced LC50 DRG neuron toxicity induced by lidocaine (P <0.05). The effect of 10 μmol/L CPZ had reached the maximal effect,decreasing the cell viability decrease from 50% to 35%.Conclusion The novel method in this experiment is effective to obtain good DRG neurons,the LC50 of lidocaine on rat DRG neurons is 30 mmol/L,and CPZ attenuates the cytotoxicity induced by lidocaine on rat DRG neurons.

Objective:To explore dynamic change of heart rate variability (HRV) before and after circumferential pulmonary vein ablation (CPVA ) in patients with paroxysmal atrial fibrillation (PAF) and its relationship with postoperative recur‐rence .Methods:A total of 108 PAF patients undergoing left atrial circumferential pulmonary vein electrically isolated ra‐diofrequency ablation were selected .According to 12‐lead DCG on 3d and three months after operation ,patients were di‐vided into early recurrence group (n=10) ,late recurrence group (n=21) and no recurrence group (n=77) .HRV changes were followed up and compared among all groups .Results:Compared with before ablation ,on 3d after ablation ,there were significant reductions in standard deviation of normal to normal RR intervals calculated over the 24 h period (SDNN) , standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording (SDANN) ,root‐mean square of differences betweensuccessive normal to normal intervals (rMSSD) ,low frequency (LF) ,high frequency (HF) in no recurrence group ;significant rise in mean heart rate ,and significant reductions in SDNN ,LF and LF/HF in early recur‐rence group ( P< 0.05 or <0.01);compared with no recurrence group ,there were significant rise in mean heart rate [(69.3 ± 11.2) beats/min vs .(75.4 ± 14.0) beats/min] ,SDANN[(66.9 ± 25.7)ms vs .(137.5 ± 92.3)ms] ,rMSSD [(22.1 ± 10.6)ms vs .(46.2 ± 19.2)ms] ,LF [(233.1 ± 31.4)ms vs .(251.7 ± 17.3)]and HF[(228.0 ± 82.4) ms2 vs . (508.0 ± 13.5) ms2 ] ,and significant reduction in LF/HF[(1.13 ± 0.53) ms2 vs .(0.41 ± 0.13) ms2 ]in early recurrence group (P<0.05 or < 0.01);significant rise in rMSSD [(23.9 ± 11.10) ms2 vs .(52.0 ± 28.7) ms2 ]and HF[(344.4 ± 103.2) ms2 vs .(482.1 ± 100.6) ms2 ] ,and significant reduction in LF/HF[(1.16 ± 0.41) vs .(0.85 ± 0.43)]in late recur‐rence group , P<0. 05 or <0. 01. Conclusion:Vagal tone reduction may reduce recurrence after CPVA in PAF patients .

In recent years,researchers have carried out a lot of studies about endogenous and exogenous protective mechanisms of ischemic brain injury and have found that cerebral ischemia can stimulate cell proliferation and neurogenesis.This article reviews the cerebral ischemia induced neural stem cell proliferation,the protection mechanisms of directional migration and differentiation,as well as the promoting effects of the application of exogenous factors on neurogenesis after ischemia.