With a high invasive ability and poor prognosis, the morbidity of pancreatic cancer is about 98%.Combination of chemotherapy and radiotherapy is the primary management for locoregionally advanced pancreatic cancer, but its efficacy is limited. Results from a number of meta-analysis have confirmed that gemcitabine is associated with significantly better clinical response and one-year overall survival rates;therefore, currently gemcitabine is the standard chemotherapy for advanced pancreatic cancer. Gemcitabine-based multi-drug regimens may have potentially favorable effects on patients' survival. However, evidence from phase Ⅲ clinical trials is lacking. Newer chemotherapy and targeted therapy agents are clearly needed for patients with advanced pancreatic cancer.

Objective:To study the force system of teeth produced by utility arch and rocking-chair arch for the treatment of deep o-verbite.Methods:Finite element model of mandible,mandible teeth,edgewise brackets and arch was established,utility arch and rocking chair arch were applied respectively,the force direction and magnitude of molars and incisors was analyzed by ANSYS.Re-sults:When utility arch was used,incisors bear intrusive force and molars bear extrusive force.With the utility arch wire was giving intrusive force to canine,the intrusive force to incisors reduced,the extrusive force to the first molars increased.When adding the bracketed teeth,the intrusive force to incisors increased,but the extrusive force to the canines and the force direction of the molars changed.Conclusion:While the utility arch exerts intrusive pressing force to the canines,the intrusive force to the lateral incisors de-crease,therefore,pressing of canines shall be independently completed after completing pressing of incisors.Different application methods of rocking-chair arches will produce different force to teeth.With addition of teeth applied with rocking-chair arch,the force to lateral incisors and molars changes the most.

Objective To study the effect of Nourishing-Yin Removing-Fire and Dissipating-Stagnation Decoction on intrathyroid vascularity( ITV) and serum vascular endothelial growth factor(VEGF) levels in patients with new diagnoses of Graves disease(GD).Methods 100 patients with new diagnoses of GD were divided into two groups:Group A were treated with Nourishing-Yin Removing-Fire and Dissipating-Stagnation Decoction combined with methimazole(MT) and Group B were treated with MT alone.Thyroid volumes, superior thyroid artery peak systolic velocity(STA-PSV), thyroid vascularity index(TVI) and serum VEGF levels in patients were also observed in Group A and B before and after treatment.The correlation between thyroid volumes and serum VEGF levels in patients was analyzed.Results The parameters of GD were significantly higher than those in control group (P<0.01) .There were positive correlation between thyroid volumes and thyroid vascularity index(TVI) or serum VEGF levels in patients(r=0.57, P<0.05;r=0.59,P<0.05).The parameters in Group A and Group B decreased after treatment(P<0.01).STA-PSV, TVI and serum VEGF levels decreased significantly in Group A than those in in Group B after treatment(all P<0.05).Conclusion Nourishing-Yin Removing-Fire and Dissipating-Stagnation Decoction can improve goiters more effectively than traditional western medicine alone by decreasing serum VEGF levels of patients with GD.

MicroRNAs( miRNAs)are a family of endogenous noncoding small RNA molecules that are approximately 20 nucleotides in length. Aberrant expression or dysfunction of miRNAs and subsequent dysregulation of their target genes might be involved in the occurrence and development of various cancers. Gastric cancer is a leading malignant disease worldwide. Recent studies have shown that some miRNAs are closely associated with the proliferation,migration,invasion, apoptosis and chemosensitivity of gastric cancer cells by regulating their target genes. Advances in study on gastric cancer-related miRNAs,their target genes,and the use of miRNAs-targeted therapy in gastric cancer were reviewed in this article.

Objective Isosorbide-5-mononitrate(ISMN), a long-acting venous dilator,has been shown to decrease portal pressure and used in cirrhotic patients to prevent esophageal variceal bleeding(EVB). We performed a meta-analysis to evaluate ISMN in prevention of EVB. Methods Data from Medline(1968-2003), EMBASE(1986-2003), Cochrane Library(issue 3,2003),CJFD(1994-2003) were searched to retrieve randomized controlled trials comparing ISMN combined with or without other treatments to placebo or other treatments in prevention of EVB.Outcome measure was odds ratio( OR ) of bleeding rate. Mantel-Haeszel method was used in fixed model, while Der Simonian and Laird methods were used in random model. Results Seven trials were identified including prevention of first bleeding and rebleeding. The results of meta-analysis indicated that ISMN had no effect on prevention of EVB[study group vs control group: 88/463 vs 117/465, random model: OR (95% CI ): 0.63(0.37, 1.08 )]. Based on sensitivity analysis compared with control group, ISMN had no effect [43/314 vs 40/314, fixed model: OR :0.63(0.37, 1.08)]on prevention of first bleeding, but had therapeutic efficacy [45/149 vs 77/151, fixed model: OR :0.39 (0.24,0.65)]on prevention of rebleeding. Combination therapy of ISMN and ?-blocker revealed more effective than single therapy with ?-blocker[53/327 vs 74/329, fixed model: OR :0.64(0.42, 0.98)]in prevention of rebleeding [25/80 vs 41/81, fixed model: OR :0.44(0.23, 0.85 )], but had no significant difference in prevention of first bleeding[28/247 vs 33/248, fixed model: 0.84(0.48, 1.44)]. Conclusions ISMN is effective in prevention of esophageal variceal rebleeding. Furthermore , combination with ?-blockers has more therapeutic efficacy in prevention of esophageal variceal rebleeding.

Objective To explore the expression of survivin gene in gastric cancerous tissue and its relationship with gastric cancer prognosis. Methods All the samples were obtained from patients with gastric cancer who underwent surgery in Zhongshan Hospital from July 1995 to June 1996.“ Envision two steps”of immunochemistry was used to detect survivin expression in the resected gastric cancerous tissue.TNM stages were determined by pathological diagnosis and clinical status.All the cases were followed up at least 5 year or until death.The discrepancy of survivin expression was compared in different pathological types and TNM stages.Survivial curves were compared in the two groups with or without survivin expression. Results Totally 96 cases(male/female:59/37;age:29-84 years old,mean age 56) were recruited and survivin expression rate was 70.8%(68/96).Among pathological types,78 cases were adenocarcinoma,18 were non-adenocarcinoma.Survivin expression was similar in different pathological types (69.7% in adenocarcinoma vs.60.0% in non-adenocarcinoma,P=0.369).Among adenocarcinoma,survivin expression rate was higher in poorly differentiated group than that in well differentiated one(82.1% vs. 62.5%,P=0.053).As the infiltration denoted in adenocarcinoma,the expression rates of survivin were 33.3% in cases limited to mucosa and submucosa,81.3% in cases limited to muscularis layer and 75.9% in cases infiltrated to whole layers (P= 0.020).Expression rate of survivin was not related with lymph node metastasis(68.1% vs.70.8%,P= 0.771).Five-year survival rate in 68 survivin positive cases was 42.93%,lower than 52.93% of 28 survivin negative cases,but no statistical difference was observed. Conclusions Survivin is highly expressed in gastric cancer.Survivin expression is closely related with differentiation status of adenocarcinoma and degree of infiltration.Further studies are needed to evaluate its role in the prognosis of gastric cancer.

Objective To study relationship of Helicobacter pylori (H.pylori) eradication and pathological development of gastric mucosa among H.pylori related diseases. Methods One hundred and ninty one H.pylori infected patients were randomly given anti H.pylori or non anti H.pylori medications, and endoscopic examination was repeated one year after the treatment. Pathological classification was followed the Sydney system. Results Among 191 patients, degree of chronic inflammation of gastric mucosa had ameliorated ( P

OBJECTIVE:To compare the efficacy and safety of Leonurus artemisia cream and Dan’e fukang cream in the treat-ment of primary dysmenorrhea. METHODS:80 patients with primary dysmenorrheal were randomly divided into L. artemisia cream group (40 cases) and Dan’e fukang cream group (40 cases). L. artemisia cream group received L. artemisia cream 10 g, orally,twice a day. Dan’e fukang cream group received Dan’e fukang cream 10 g,orally,twice a day. The treatment was stated before 10 days of menstruation. 10 days was regarded as 1 treatment course,and it lasted for 6 courses. Cold drink and food were forbid during medication,washing face and feet with warm water,soaking feet with hot water if they can,paying attention to keep the lower abdomen and legs warm. If patients felt unbearable pain in menstruation,0.3 g Ibuprofen sustained release capsule was given,orally twice a day. Clinical efficacy,symptom score(dysmenorrhea degree,abdominal pain,lumbosacral pain)before and af-ter treatment,dysmenorrhea duration,frequency of taking painkillers and the incidence of adverse reactions in 2 groups were ob-served. RESULTS:There were no significant differences in the total effective rate and the incidence of adverse reactions in 2 groups (P>0.05). Before treatment,there were no significant differences in dysmenorrhea degree,abdominal pain,lumbosacral pain score,dysmenorrheal duration and frequency of taking painkillers in 2 groups (P>0.05). After treatment,the dysmenorrhea degree,abdominal pain,lumbosacral pain score in 2 groups were significantly lower than before,and Dan’e fukang cream group was lower than L. artemisia cream group with statistical sighificance(P<0.05),and dysmenorrheal duration and frequency of taking painkillers were significantly lower than before,with statistical significance(P<0.05),while there was no significant difference in 2 groups(P>0.05). CONCLUSIONS:Both L. artemisia cream and Dan’e fukang cream have good efficacy and safety in the treat-ment of primary dysmenorrhea,while Dan’e fukang cream is superior to L. artemisia cream in terms of improving clinical symp-toms.

Sepsis is a common acute systemic infection,severe sepsis has a high rate of mortality,and its incidence rate is rising year by year.Due to the overproduction of free radicals in sepsis,microcirculation blood is drived disorder,multiple organ function can be impaired.This review describes the role of ascorbic acid in sepsis patients,which can reverse the oxidative stress injury rapidly through an eNOS-dependent mechanism,resisting platelet adhersion,preventing capillary embolism,resevering microcirculation blood flow,so as to improve patients' survival.

Objective To evaluate the surgical therapy on dislocated fracture of talus. Methods Retrospective analysis was mode in 21 patients with dislocated fracture of talus collected from Jan. 2004 to Jan.2010, which were treated with open reduction, cannulated screw fixation, and kept neutral position plaster fixation with no weight loading, to do functional exercise depending on the Ⅹ film demonstrations. Results All the patients were followed up from 6 months to 3.8 years post-operation, and according to the evaluation standard by American Foot-Ankle Surgery Society, good rate was 61.91%. Conclusion Treating dislocated fracture of talus with emergency operation, anatomical reduction, valid internal fixation and no weight loading plaster fixation post-operation, shows good effect with low rate of complication.