Objective To detect the expressions of decoy receptor 3 (DcR3) in pancreatic cancer tissues and to analyze the significance of DcR3 in the diagnosis, treatment and prognosis of patients with pancreatic cancer.Methods The expressions of DcR3 in pancreatic cancer tissues (n =100), paracancer tissues (n =15) and normal tissues (n =15) were detected with immunohistochemical method (Envision method).Results The positive rate of DcR3 in pancreatic cancer tissues was significantly higher than that in adjacent-tumor pancreatic cancer tissues (86.0％ vs.46.6％, P ＜ 0.05).The positive rate of DcR3 in adjacent-tumor pancreatic cancer tissues was significantly higher than that in normal tissues (46.6％ vs.13.3％, P ＜ 0.05).In clinical stage Ⅲ, the positive rate of DcR3 was significantly higher than that in stage Ⅱ and stage Ⅰ (100％ vs.87.0％, P＜0.05;100％ vs.62.5％, P＜0.05).There were significant differences among the three groups (P ＜ 0.05).With lymph node metastasis, the DcR3 positive rate was significantly higher than that in the group without lymph node metastasis (93.4％ vs.79.6％, P ＜ 0.05).In poorly differentiated pancreatic cancer, the positive rate of DcR3 was significantly higher than that in the highly differentiated group (100％ vs.64.0％, P ＜0.05), the positive rate of DcR3 was significantly higher in the moderately differentiated group than that in the highly differentiated group (88.6％ vs.64.0％, P ＜ 0.05) , There were significant differences among the three groups (P ＜ 0.05).There was no significant difference in the positive rate of DcR3 between the different age groups or the different gender groups (P ＞ 0.05).Conclusions The expression levels of DcR3 in patients with pancreatic cancer gradually increased from normal tissues to paracancer tissues, to pancreas tissues.The expression level of DcR3 protein was closely related to clinical stage, degree of tissue differentiation and presence of lymph node metastasis, but not associated with age, sex, and tumor diameter size.

Objective To analyze perioperative management and risk factors for the prognosis of hip fracture surgery in elderly patients.Methods The present study included 112 elderly patients (aged ≥65 years) who received hip fracture surgery from January 2009 to January 2013 in our department,and their clinical data were retrospectively analyzed.Results The percentage of cases with concomitant diseases before operation was 91.0 ％,and the postoperative complications rates were 35.7％.One-year mortality after operation was 21.4％.The percentage of survival cases with daily living activities fully restored to pre injury status was 47.6％.Logistic regression analysis revealed that independent risk factors for the one-year mortality included general health before injury (OR=13.36,P =0.047),pulmonary disease (OR =18.33,P =0.007),number of postoperative complications (OR=15.14,P=0.025),and renal failure (OR=11.26,P=0.034).Conclusions Elderly hip fracture patients have many different concomitant diseases.By applying the qualified levels of perioperative management,anesthetic and operative methods,and postoperative rehabilitation measures according to the conditions of the patient,the incidence of perioperative complications and one year mortality can be decreased,and qualified surgical outcomes can be obtained.The independent risk factors for the one-year mortality include general health before injury,pulmonary disease,number of postoperative complications and renal failure.

Rotator cuff tears are one of the three most prevalent musculoskeletal disorders, with the supraspinatus tendon as the most common lesion site. It may lead to chronic shoulder pain, weakness and limited joint motion, and eventually to secondary degeneration of the shoulder. As traditional biomechanical experiments are limited by measurement techniques and ethical issues, it is almost impossible to clarify the stress distributions at the rotator cuff under physiological and pathological conditions. Recently, advances in computer science, software development and image processing have rapidly improved finite element models of shoulder joint which promote the researches into pathogenesis of rotator cuff tears and their surgical techniques, making finite element analysis an indispensable means in the biomechanic research of rotator cuff. This paper reviews the recent literature available in China and abroad to expound on the element models of shoulder joint applied in the researches into pathogenesis and surgery of rotator cuff tear.

Paclitaxel is the first-line chemotherapy drug for a variety of cancers. However， the paclitaxel resistance greatly reduced the efficacy in the later treatment stage， which seriously increased the mortality and recurrence rate of cancer and limited the clinical application of paclitaxel. At present， Chinese medicine compound prescription， proprietary Chinese medicine， and Chinese medicine injection are widely used as the adjuvant chemotherapy drugs for the treatment of cancer in clinic. Chinese medicine has shown unique advantages in improving the efficacy of chemotherapy drugs and the prognosis of chemotherapy， and reducing the toxic and side effects. However， the specific mechanism and effective monomer composition of Chinese medicine for reversing the resistance of chemotherapy drugs are unclear， and the application of Chinese medicine in different types of cancer is also limited， which are worthy of further exploration. This review summarized the composition of Chinese medicine monomer with synergistic antitumor effect combined with paclitaxel in recent years. The specific mechanism and pharmacological activities of Chinese medicine monomer reversing paclitaxel resistance were classified. This review found that through acting on the membrane transport protein， Chinese medicine monomer promoted the accumulation of paclitaxel in tumor cells， inhibited the expressions of protein and metabolic enzyme related to multidrug resistance and the metabolism of paclitaxel， and regulated the levels of apoptosis genes and factors and apoptosis-related pathways to promote the inhibitory effect of paclitaxel on cell proliferation. Chinese medicine monomer also significantly improved paclitaxel chemotherapy sensitivity by regulating the expression levels of micro ribonucleic acid （microRNA） and long non-coding ribonucleic acid RNA （lncRNA）， inhibiting the characteristics of tumor stem cells and tumor metabolic reprogramming， improving tumor microenvironment， and triggering tumor cell death autophagy and oxidative stress response. This review provides a theoretical basis for clarifying the specific anti-tumor mechanism of Chinese medicine monomer combined with paclitaxel， which is of great significance for the development of new Chinese medicine and the clinical research of the drugs combined with paclitaxel， and has certain value for the application of Chinese medicine combined with other chemotherapy drugs.