5 000 respectively. Results Among 2 175 cases with clonorchis eggs, 1 244 cases showed clinical complications (57.2%). The average EPG in 61 cases counted was 3 055, 34 (55.7%) showed medium or heavy intensity of infection. The cases distributed in 80% of the townships, more concentrated in 2 towns and 1 farm. The patients aged between 3 to 76 years old with a ratio of male to female 3.6 ∶ 1. 45.5% of the cases were farmers. 1 308 cases (60.1%) were Zhuang Minority. The number of cases seeking medical treatment increases year by year since mid-1980s. 66.0% of the cases had a habit of raw fish-eating. Conclusion Clonorchiasis sinensis widely distributes in Guigang City, number of cases admitted in hospitals increases yearly.

Objective To observe the effect of triptolide combined with gemcitabine on proliferation and apoptosis of pancreatic cancer cells ,and to analyze the relevant mechanisms .Methods After treated with TPL ,GEM or TPL combined with GEM in vitro , PANC-1 cells proliferation was accessed by MTT assay and the interaction between the two drugs was calculated .Apoptotic mor-phological changes and apoptosis rate of the cells were investigated by Hoechst 33258 staining and flow cytometry ,respectively .The expression of signal transduction and transcription factor 3(STAT3) ,cysteine aspartate specific proteases-3(caspase-3) protein were detected by Western blot analysis .Results TPL ,GEM or TPL combined with GEM could significantly inhibit the prolifera-tion of PANC-1 cells ,and the combination of the two drugs had a synergistic effect .The cells of the TPL group ,GEM group ,as well as the combined group showed typical apoptotic morphological changes .Compared with the TPL group and GEM group ,the number of apoptotic cells of the combined group increased significantly .Compared with the control group ,the cells apoptosis rate of the TPL group ,GEM group and combined group was significantly increased (P< 0 .05) ,and the apoptosis rate of the the combined group was significantly higher than that of the monotherapy group(P<0 .05) .TPL combined with GEM synergistically inhibited p-STAT3 protein expression and activated caspase-3 protein expression .Conclusion TPL combined with GEM can synergistically in-hibit proliferation and induce apoptosis of pancreatic cancer PANC-1 cells ,its mechanism is related to the inhibition of STAT 3 sig-naling pathway ,promotion the expression of caspase-3 protein .

Objective To investigate the expression of DNMT3b mRNA and microRNA-29b (miR-29b) in pancreatic cancer cells and analyze their relationship.Methods Real-time RT-PCR method was used to detect the expression of DNMT3b mRNA and miR-29b in five pancreatic cancer cell lines ( PANC1,BxPC3,CFPAC,AsPC 1,Capan 2 ) and the relationship between DNMT3b mRNA and miR-29b expression was analvzed by pearson linear correlation method.Results The expression of DNMT3b mRNA in PANC1,BxPC3,CFPAC,AsPC 1,Capan 2 were 0.497 ±0.184,0.420 ±0.168,0.439 ±0.217,0.122 ±0.111 and 0.731 ±0.387,while the expression of miR-29b were 0.745 ± 0.596,0.797 ± 1.000,0.464 ± 0.430,1.836 ± 1.623 and 0.216 ± 0.335.The expression of DNMT3b mRNA was negatively correlated with the expression of miR-29b (r =-0.922,P =0.026 ).Conclusions Both DNMT3b and miRNA29b are involved in the carcinogenesis of pancreatic cancer,and they are negatively correlated.

Objective To investigate the effect of mild hyperthermia on chemoresistance of gemcitabine in the pancreatic cancer cell line PANC1.Methods The PANC1 cell was treated with gemcitabine ( 1 μmol/L) for 1 h,then was heated at 37℃,42℃ and 45℃ for 1 hour,and was cultured for 0 h,24 h,48 h.Cell growth was analyzed by CCK-8 assay.Cell apoptosis was analyzed by Annexin Vfluorescein isothiocyanate ( FITC)/propidium iodide (PI) staining.Results The proliferation of cells at 42℃ and 45℃ for 24 h and 48 h were significantly lower than that at 37℃ (0.96 ± 0.05,0.88 ± 0.03vs 1.05 ±0.02;1.28 ±0.04,0.94 ±0.04vs 1.49 ±0.09;t =4.367,25.120,P ＜0.05).The proliferation of cells at 45℃ was significantly lower than that at 42℃ (t =3.348,11.732,P ＜0.05).The cell apoptosis rates at 37℃,42℃,45℃ after 48 h were (7.125 ±0.064)％,(9.985 ±0.615)％,(14.845 ± 1.987)％,the difference among the 3 groups was statistically significant (t =10.320,9.832,4.575,P ＜0.05).Conclusions Mild hyperthermia can reduce chemoresistance of gencitabine in pancreatic cancer cell PANC1.

Objective:This paper designs to analyze the status of catastrophic disease medical assistance in A and B regions, and put forward feasible suggestions to improve the medical assistance level and financial effects. Methods:We selected A city at Hubei province and B county at Guizhou province as sample areas, and obtained 872 copies of questionnaires in the field survey. Then, out-of-pocket health expenditure per year, the incidence, and rel-ative gap of catastrophic health expenditure before and after the financial aid were calculated. Results: Catastrophic disease medical assistance plays a limited role in relieving patients' economic burden. Low financial aid rate, narrow range, high deductibles and low ceiling level are responsible for much lower effective financial aid rate. Conclusion:Raise financial aid rate and widen the scope of medical assistance gradually;Establish effective link-up between cata-strophic disease medical assistance and catastrophic disease insurance / basic medical insurance;Put outpatient OOP into the scope of catastrophic disease medical assistance.

Objective To investigate the correlation of K-ras gene mutations and activation of Hedgehog signaling pathway in pancreatic cancer cell lines.Methods Real-time PCR was used to detect K-ras gene mutations at codon 12 and 13 in pancreatic cancer cell lines of SW1990,PaTu8988,CFPAC-1,PANC1,AsPC-1,Capanc-2,BxPC-3 and the mRNA expression of Glil,Smo in these cell lines.Results The K-ras mutation of PANC1,CFPAC-1,AsPC-1,PaTu8988 was at codon 12,while SW1990 was at codon 13,BxPC-3,Capanc-2 were wild type.The expressions of Glil mRNA of AsPC-1,CFPAC-1,PANC1,PaTu8988,SW1990,BxPC-3,Capanc-2 were 7.84 ± 8.92,1.82 ± 3.45,1.00± 0.00,0.07 ± 0.10,0.88 ± 1.48,0.52 ± 0.98,0.15 ± 0.19,and the expressions of Smo mRNA were 144.00 ± 58.33,3.48 ±3.77,1.00 ±0.00,81.68 ±28.26,0.72 ±0.87,0.34 ±0.60,0.02 ±0.03.Glil,Smo mRNA expressions of cells with wild tpye K-ras were significantly lower than those with mutant type,and wild type BxPC-3's Glil,Smo mRNA expressions were significantly lower than that of mutant AxPC-1 (P ＜ 0.05).Conclusions Activation of Hedgehog signaling pathway may be related to K-ras gene mutations.

Objective To investigate the expression of protease-activated receptors (PARs) in colon mucosal tissue of patients with diarrhea-predominant irritable bowel syndrome (D-IBS). Methods Colon mucosa tissues were obtained from 28 D-IBS patients and 18 normal controls by colonoscopy.The expression of PARs was detected using Western blotting and real-time PCR. Data were analysed by SPSS 18. 0 softwave, and comparisons between groups were done using Mann-Whitney U test.Results There was no difference in expression of PAR1 between D-IBS patients and normal controls (P=0. 300). The expressions of PAR2 and PAR4 were higher in D-IBS patients than those in normal controls (0.99±0.67 vs 0.63±0.38, P=0.038 and 0.37±0. 14 vs 0.25±0. 11, P=0.013,respectively). The results of real-time PCR were in accordance with those of Western blotting.Conclusion The increased expressions of PAR2 and PAR4 in colon mucosa of D-IBS patients indicate that these two PAR receptors may be involved in the process of D-IBS.

Stakeholder theory and game theory were applied to analyze the stakeholders,role definition,participation,interest,power,position and the shift of positions under different conditions in the negotiation.Use SPSS 17.0 to analyze the database of NCMS in 2009～2010 in three counties of Hubei province,and then employ Linear programming method to do a case study of price negotiation.It is difficult to meet all stakeholders' expectations under the current condition of catastrophic disease insurance pooled at municipal-level.Medical cost differences in tertiary hospitals at provincial level are small for different regions,which constitute a basis for price negotiation at provincial level.Besides,the negotiation at province level can effectively address the conflicts of interest,and promote the negotiations.Negotiation at provincial level for such diseases,and formulating unified pricing standards for multi-wins.

Objective To evaluate the safety and efficacy of therapeutic ERCP for patients above 90 years of age.Methods The data of 37 patients of above 90 years who underwent 42 ERCP procedures from January 2001 to December 2009 were studied retrospectively and compared with those of 152 matched patients ( 168 procedures) below 65 years old at a 1∶4 ratio for success rate and complications.Results The rate of complete success,partial success,and failure in observation group was 73.81％ (31/42),19.05％(8/42) and 2.38％ (1/42),respectively,which were similar (P ＞0.05) with those in control group,with complete success rate at 85.12％ ( 143/168),partial success rate at 12.50％ (21/168) and failure rate at 2.38％ (4/168).The rate of terminated operation in observation group (4.76％,2/42) was significantly higher than that of the control group (0.00％,0,P =0.039).The overall rate of complication in observation group was 7.14％ ( 3/42 ),slightly higher than that of the control group ( 6.55％,11/168,P ＞0.05 ).There was no significant difference between the two groups regarding the rates and severity of such complications as pancreatitis,hemorrhage and infection ( P ＞ 0.05 ).No perforation or death was observed.Conclusion Therapeutic ERCP for patients of 90 years or older is safe and effective.Adverse events related to chronic concomitant diseases need early detection and proper management.