Objective To study the impact of diabetes mellitus (DM) and postoperative blood glucose control on the clinicopathological characteristics and prognosis of patients with pancreatic cancer who underwent radical surgery.Methods From January 2010 to January 2015, the clinical and follow-up data of 83 patients with pancreatic cancer who underwent radical surgery at Tianjin Medical University General Hospital were retrospectively studied.Patients were classified into the diabetic group (28 cases) and the non-diabetic group (55 cases) according to the preoperative status of DM.The clinicopathological characteristics, postoperative conditions and prognosis were compared.Results The incidences in the two groups of patients whose postoperative blood glucose levels were poorly controlled were 71.4％ (20/28) and 20.0％ (11/55) in the diabetes group and the non-diabetic groups, respectively.The difference was significant (P ＜0.05).The 3-year survival rate of the diabetic and the non-diabetic groups were 11.3％ and 31.8％ , respectively.The difference was significant (P ＜ 0.05).The 3-year survival rate of patients with poorly-controlled blood glucose levels were 8.8％, and 34.6％, respectively.The difference was significant (P ＜ 0.05).Conclusions The postoperative blood glucose level in pancreatic cancer patients with DM was poorly controlled after radical surgery.The prognosis of pancreatic cancer patients with DM or poorly postoperative blood glucose control was poor after radical surgery.

Objective To investigate the effect of adrenomedullin on epithelial barrier function of Caco-2 cells under hypoxia/reoxygen-ation injury and the molecular mechanism.Methods Build hypoxia/reoxygenation injury model,Caco-2 cells were randomly divided into three groups:normal control group( N) ,hypoxia/reoxygenation group( H/R) and hypoxia/reoxygenation plus 1 μmol/L adrenomedullin group(H/R+AM).Transepithelial electrical resistance(TEER) was determined,and the laser confocal microscope was used to detect the construction of tight junction.The protein expressions of tight junction proteins (Occludin and ZO-1) and nuclear factor kappa B(NF-κBp65) were examined by using western blotting.Results Pretreatment of AM significantly attenuated the disruption of morphological structure of tight junction caused by H/R.The TEER of N group,H/R group and H/R+AM group were(157.68 ±5.54),(96.06 ±3.42),(134.56 ± 4.72) Ohm/cm2 respectively.After AM pretreatment, the TEER were significantly raised compared with that in H/R group by 40.00%(P<0.05).The relative protein expressions of Occludin and ZO-1 in N group,H/R group and H/R+AM group were [(0.43 ±0.03), (0.27 ±0.04)],[(0.20 ±0.03),(0.15 ±0.07)],[(0.32 ±0.15),(0.21 ±0.03)]respectively.After AM pretreatment,the protein ex-pression of Occludin and ZO-1 were significantly raised compared with that in H/R group(by 60.00% and 40.00%).Simultaneously,the relative protein expressions of NF-κBp65 in N group,H/R group and H/R+AM group were (0.53 ±0.30),(2.89 ±0.16),(1.75 ±0.25) respectively.And H/R induced NF-κBp65 activation was significantly inhibited by AM treatment (decreased as compared with H/R group by 40.00%).Conclusion AM can attenuate intestinal epithelial barrier dysfunction by regulating the expression of intestinal tight junction pro-teins.The inhibition of NF-κB activation may be involved in this mechanism.

Objective To observe the method of mechanical ventilation in the chest compressions during cardiopulmonary resuscitation (CPR),and to explore the influence of the flow pattern selection of square-wave and decelerating-wave on airway pressure of patients. Methods A prospective self-pairing study was conducted. Forty patients undergoing CPR admitted to Department of Emergency of Lishui City Central Hospital from January 2011 to February 2013 were enrolled. Using Respironics Eisprit ventilator,the working mode and parameters of ventilator were set reasonably according to previous research,while the chest compressions was performed in a stable state by the same doctor,. Each patient received different flow,waves,including square-wave and decelerating-wave,and the highest peak airway pressure was recorded as a pair of data when the time-pressure and time-flow waveform were frozen. Two pairs of data by different doctors were collected in each patient. Eighty pairs of data from 40 patients were collected for statistical analysis by paired t test. Results The highest peak airway pressure of decelerating-wave was (38.15± 5.99)cmH2O (1 cmH2O=0.098 kPa),which was (5.71±1.98)cmH2O lower than that of square wave 〔(43.86± 6.68)cmH2O〕with significantly statistical difference(t=22.010,P=0.000). 73.75%patients undergoing square wave with peak airway pressure over 40 cmH2O were found,but only 45.00% patients were found in decelerating-wave. Conclusion Because decelerating-wave used in mechanical ventilation during CPR can obviously reduce the peak airway pressure,the occurrence of barotrauma,and the probability of triggering high pressure ventilator alarm,and improve the compliance of ventilator,so decelerating-wave is more reasonable than square-wave.

Malignant obstruction of the stomach or duodenum is a preterminal event in patients with ad-vanced malignancies of the upper gastrointestinal.It severely limits the quality of life in affected patients.Most patients are in bad conditions and have an short expecting live time,so they not only can not bear but also do not need such an invasive operation.Because of this,a minimally invasive but effective palliative treatment is quite necessary.This paper makes a summary and contrastive analysis of several ways of pallia-five treatment which are widely used for malignant gastroduodenal obstruction in recent years.

Objective To investigate the fermentation conditions for the heat-labile enterotoxin B subunit (LTB) of genetic recombinant E.coli. Methods The effects of different kinds of media, the range of pH, the induction time, the glucose concentration, and the fed-batch on LTB level in 10-liter fermenter under the condition of cascade controlling dissolved oxygen content were analyzed. Results Under the established conditions, the cell output per liter was 40.5g, and the expression level was 30.6%. Conclusion The results indicate that the stable fermentation technology with high efficiency has been established.

Objective To summery the value of treatment for pancreatic benign tumor following the organ preserve principle.Methods The clinical data of 77 patients with pancreatic benign tumor at the General Hospital of Tianjin Medical University from Jan 2002 to Jan 2012 was analyzed.All patients were divided into traditional pancreatic surgical treatment group (n=24) which include pancreaticduodenectomy(PD) and pancreatic body and tail resection plus spleenectomy(DP) and treatment following organ preserve principle (n =53).Results There are tumor evacuation,segmentectomy,pancreatic head resection with duodenum preserving and pancreatic body and tail resection with spleen preserving in the group of treatment following organ preserve principle.Pathology diagnosis showed insulinoma 30 cases,mucinous cystadenoma 16,serous cystadenoma 10,intraductal papillary mucinous tumor 17,solid pseudopseudopapillary tumor 3 and 1 case of pancreatic intraductal hyperplasia.The rate of pancreatic leakage were 26.3％ (5/19) in traditional surgical treatment group and 24.3％ (9/37) in group of treatment following organ preserving respectively.There was no significant difference between these two groups(P＞0.05).The rate of new development diabetis and aggrasive of the preexist diabetis post the pancreatic surgery were 20.8 ％ (5/24),20 ％ (1/5),13.2(7/53),30 ％ (3/10)respectively.There was no significant difference between these two groups(P=0.485,P=1.000).Conclusions The surgical treatment following the organ preserving is a safe and effective procedure for the patients with pancreatic benign tumor.This new method can preserve the pancreatic parenchymal maximally,avoid the extra-and endo-secrete function loss and preserving the function of spleen.

egrated interventional and minimally invasive therapy could improve the life and survival and it is an effective adjunctive therapy for primary hepatocellular carcinoma with metastasis outside the liver.

Clinical characteristics were retrospectively analyzed in a patient with parathyroid crisis as the main symptoms of parathyroid adenoma and asymptomatic pheochromocytoma.This analysis was aimed to implement specific diagnosis and treatment and to accumulate experience in managing these diseases.

Objective To observe the therapeutic effect of single lower limb traction plus massage for the lumbosacral tunnel syndrome.Methods The selected 80 candidate patients were divided into the observation group with 38 patients and treatment group with 39 patients. The observation group received single lower limb traction plus massage and the treatment group received pelvic traction plus massage. Both groups therapy last 5 days, The Japanese orthopaedic association scores (JOA) was evaluated for subjective symptoms, signs, functional activity and bladder function score. The therapeutic effect was evaluated.Results The total effective rate (94.7% vs. 82.1%;χ2=12.160,P=0.007) in the observation group was significantly higher than that in the control group. O, The scores of JOA at one week after treatment (20.2 ± 2.0 vs. 18.3 ± 2.8;t=3.419, P<0.01) and two weeks after treatment (24.4 ± 1. 4vs. 22.6 ± 3.0;t=3.359,P<0.01) in the observation group were significantly higher than those in the control group.Conclusions The single lower limb traction plus massage can improve the clinical symptoms of patients with lumbosacral tunnel syndrome, and be superior to the pelvic traction plus massage.

ObjectiveTo observe the effect of intravesical instillation of Brucea Javanica oil emulsion on recurrence of bladder cancer after transurethral resection of bladder tumor (TUR-Bt) operation.Methods187 patients with superficial bladder carcinoma after TUR-Bt operation were randomly divided into the group A (85 cases) and group B (102 cases). Patients of the group A were treated with instillation of Brucea Javanica oil emulsion; those of the group B were treated with mitomycin. A three-years following up was performed to observe the recurrence and side effects.ResultsAfter a 3-years following up, the recurrence rate of group A was 12.94%, lower than that of group B (34.31%). The side effects were seldom seen in the group A.ConclusionThe effect of intravesical instillation of Brucea Javanica oil emulsion to prevent the recurrence of bladder cancer after TUR-Bt operation is favorable.