Objective To analyze the characteristics ot lymph node metastasis and prognostic factors for carcinoma of papilla of Vater (CPV) after pancreaticoduodenectomy (PD).Methods From January 2005 to December 2010,94 patients with CPV underwent PD and dissection of regional lymph nodes at the Eastern Hepatobiliary Surgery Hospital.We carefully evaluated nodal involvement in the patients to determine the lymphatic spread of CPV and analyzed the clinicopathological variables in relation to prognosis.Results The overall rate of nodal involvement was 46.8％.Using the UICC staging (7th edition),lymphatic invasion in pT1,pT2,pT3 and pT4 were 15.4％ (2/13),62.7％ (32/51),80.0％ (8/10) and 100％ (2/2),respectively.The metastatic rates in the posterior pancreaticoduodenal lymph nodes,the mesopancreatic lymph nodes,the hepatoduodenal ligamental lymph nodes and the proper hepatic periarterial lymph nodes were 30.9％ (29/94),21.3％ (20/94),11.7％(11/94) and 6.4％ (6/94),respectively.Significant prognostic factors were tumor pT stage (P＜0.01),duodenal wall infiltration (P =0.001),liver metastasis (P =0.001),pancreatic paren chymal invasion (P=0.004),nodal involvement (P＜0.01) and different regional lymph nodes invasion (the posterior pancreaticoduodenal,P＜0.01; the mesopancreatic,P＜0.01; the hepatoduodenal ligamental,P＜0.01; the proper hepatic periarterial,P=0.010).Cox regression analysis for overall survival revealed that the posterior pancreaticoduodenal nodal involvement (P＜0.01),the mesopancreatic nodal involvement (P＜0.01) and duodenal wall infiltration (P=0.019) were significant independent prognostic risk factors.Conclusions The mesopancreatic lymph nodes and the posterior pancreaticoduodenal lymph nodes should equally be regarded as the first stop in lymphatic spread of CPV.Therefore,we should pay much attention to these regional lymph node dissections,especially to ensure complete resection of the uncinate process and the mesopancreas.

Objective To examine the content of the 69 iPhone applications(Apps) for smoking cessation that were distributed through the online iTunes store and explore Apps′level of adherence to the U .S .Public Health Service′s 2008 Clinical Practice Guideline for Treating Tobacco Use and Dependence (called guidelines) for the purpose of developing high quality Apps ,as of De-cember 29 ,2012 .Methods All Apps was categorized into 5 types based on National Tobacco Cessation Collaborative .In order to get the Apps′level of adherence to guidelines ,the content of every application was compared with guidelines respectively .Results Apps identified for smoking cessation were found to have low levels of adherence to key guidelines .Conclusion It is necessary that current and future Apps should be developed around evidence-based practices and guidelines to get reliable Apps for smoking cessa-tion .

Acupuncture therapy for regaining consciousness activates soreness, numbness, distention, heaviness, radiating and moving, electric shock and ant climbing sensations at the specific acupoints in the stroke patients. Radiating and moving sensations are the summary of needling sensations such as soreness, numbness and twitching presenting during lifting and thrusting manipulation. These sensations are the essential factors of the therapeutic effect of regaining consciousness. Radiating sensation refers to the conduction along meridians and radiation of soreness and numbness. Moving sensation refers to the local muscular twitching at acupoints and the involuntary movement of limbs, joints and the distal. Acupuncture at the specific acupoints achieves radiating and moving sensations for promoting the circulation in meridians, regulating qi and mind and balancing yin and yang in stroke patients. This therapy was introduced in the paper in view of acupoint location, needle insertion and manipulation.
Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Consciousness ; Humans ; Meridians ; Needles ; Stroke ; psychology ; therapy

Objective To investigate the clinical efficacy of acupuncture at point Shanzhong(CV17) plus cupping on Back-Shu points in treating migraine. Methods Seventy migraine patients were randomly allocated to treatment and control groups, 35 cases each. The control group received conventional acupuncture and the treatment group, acupuncture at point Shanzhong(CV17) plus cupping on Back-Shu points in addition. The VAS score was counted in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results The cure and marked efficacy rate and the total efficacy rate were 88.6%and 100.0%, respectively, in the treatment group and 62.9%and 94.3%, respectively, in the control group. There was a statistically significant difference in the cure and marked efficacy rate between the two groups (P＜0.05). There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups (P＜0.05). There was a statistically significant post-treatment difference in the VAS score between the treatment and control groups (P>0.01). The clinical symptom improvement rate was (78.3±10.6)%in the treatment group and (49.8±11.2)%in the control group;there was a statistically significant difference between the two groups (P＜0.01). Conclusion Acupuncture at point Shanzhong plus cupping on Back-Shu(CV17) points is an effective way to treat migraine.

Objective To investigate the effect of elemene on mRNA expressions of tumor necrosis factor (TNF) receptor associated factor 6 (TRAF6) and caspase-8 in tumor tissues of mice bearing hepatoma H22.Methods Forty BALB/c mice models bearing hepatoma H22 were established by subcutaneous inoculating tumor cells.Forty BALB/c mice were randomly divided into 4 groups:model group,low-and high-elemene dosage groups,and cisplatin group.The tumors after executing mice were weighted.The mRNA expressions of TRAF6 and caspase-8 in tumor tissues were detected by quantitative real-time reversetranscription polymerase chain reaction (RT-PCR).Results The dosage of elemene could inhibit tumor growth.The inhibition ratio of cancer in the low-and high-elemene dosage and cisplatin group was 24.2％,27.4％,and 28.2％,respectively.It reduced significantly tumor weights(P ＜0.01).Compared to the model group,the expression level of TRAF6 mRNA on tumors was decreased significantly,while the expression level of caspase-8 mRNA was increased significantly in the other groups(P ＜ 0.05).Conclusions The present results indicated that molecular mechanism of inhibition of liver cancer growth treated by elemene might be through down-regulating mRNA expressions of TRAF6 and caspase-8,promoting tumor cells apoptosis,and achieving the anti-tumor effect.

BACKGROUND: As a result of immature brain of children and their imperfect blood brain barrier, improper clinical treatment would affect growth and development of children. It is fully important to perform further investigation on immature brain injury induced neurodegeneration.OBJECTIVE: To observe the ultramicrostructure of neurons in homolateral parietal cortex and hippocampus in newborn 7-day SD rat with contusion of parietal cortex.DESIGN: Completely randomized controlled trial.SETTING: Laboratories of Nerve Morphology and Cytobiology, Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology, Chinese Academy of Science.MATERIALS: The experiment was performed in Teaching and Research Section of Anatomy, Laboratories of Nerve Morphology and Cytobiology ofShanghai Second Medical University (Medical College of Shanghai Jiaotong University; Electron Microscope Room of Institute for Physiology of Chinese Academy of Science from October 2002 to June 2003. A total of 19newborn 7-day SD rats were randomly divided into experimental group, operation control group and normal control group with 15, 2 and 2 in each group respectively.METHODS: In experimental group, free-fall device for brain injury was used for establishing model of contusion of parietal cortex in newborn 7-day SD rat. Anesthesia and scalp incision were conducted, without using free-fall device in operation control group. But above procedures were not carried out in normal control group. The changes of ultramicrostructure were observed under transmission electron microscope after routine treatment of electron microscopic samples.MAIN OUTCOME MEASURES: Ultramicrostructure of neurons in homolateral parietal cortex and hippocampus.RESULTS: All the 19 rats entered results analysis. ① There were two sorts of morphological changes in neurons in experimental group. One was evident swelling of dendrites and bodies of neurons, accompanied with the changes of organelles. In the early stage, expansion of endoplasmic reticulum cisterna could be observed and mitochondria became compact and concentrated. Then, vacuolization of endoplasmic reticulum, progressive swelling and vacuolization of mitochondria, dissociation of polysomes from rough endoplasmic reticulum and scattering of them in cytoplasm could be seen. Changes of nucleolus presented after significant changes of cytoplasm. Nuclear chromatin clustered together under karyotheca and arranged as clockface, which were some masses with irregular contours gathering to the center. Axons were almost normal. The other was concentration of cytoplasm and nucleolus with vacuolizations of unequal size in cytoplasm. ②There was no abnormal change in neurons in homolateral parietal cortex and hippocampus both in operation control group and normal control group.CONCLUSION: Swelling of brain cell and concentration of cytoplasm and nucleolus after brain injury play important roles in brain injury-induced neurodegeneration of immature rats.

Atherosclerosis is a complex disease characterized by lipid accumulation in the vascular wall and influenced by multiple genetic and environmental factors. To understand the mechanisms of molecular regulation related to atherosclerosis better, a protein interaction network was constructed in the present study. Genes were collected in nucleotide database and interactions were downloaded from Biomolecular Object Network Database (BOND). The interactional data were imported into the software Cytoscape to construct the interaction network, and then the degree characteristics of the network were analyzed for Hub proteins. Statistical significance pathways and diseases were figured out by inputting Hub proteins to KOBAS2. 0. The complete pathway network related to atherosclerosis was constructed. The results identified a series of key genes related to atherosclerosis, which would be the potential promising drug targets for effective prevention.
Atherosclerosis ; genetics ; Databases, Factual ; Humans ; Protein Interaction Mapping ; methods ; Protein Interaction Maps ; Software