Objective To investigate the diagnostic value of serum miR-21 andCA199 for pancreatic cancer,and aim to provide a potential diagnostic method for the diagnosis of pancreatic cancer in clinical practice.Methods Detect the levels of CA199 and the relative expression of miR-21 in 134 pancreatic cancer patients,97 benign pancreatic disease patients and 106 healthy subjects from January 2014 to December 2015 in Clinical Laboratory of 263 Clinical Department of Army General Hospital,Evaluate the diagnostic value of single and combined detection of CA199 for pancreatic cancer.The diagnostic values were evaluated by receiver operating characteristic curve,sensitivity and specificity.The area under the receiver operating characteristic curve was compared by the z-score test.Results Compared with healthy control group,CA199 and miR-21 in benign pancreatic disease group and pancreatic cancer group showed significantly increased.Compared with benign pancreatic disease group,CA199 and miR-21 alsoshowed significantly increased in pancreatic cancer group.For discriminating the healthy control group and pancreatic cancer group,the sensitivity and specificity were 77.61％and 69.81％respectively when combination CA199 and miR-21.The AUC of combination CA199 and miR-21 was0.85,it showed significantly higher when compared with CA199 and miR-21 alone(P=0.021,P=0.036).For discriminating the benign pancreatic disease group and pancreatic cancer group,the sensitivity and specificity were 69.40％and 65.98％respectively when combination CA199 and miR-21.The AUC of combination CA199 and miR-21 was 0.78,it showed significantly higher when compared with CA199 and miR-21 alone(P=0.017,P=0.023).Conclusions miR-21 showed certain diagnostic value for pancreatic cancer.Combined with CA199,miR-21 may provide a potential assistant diagnostic method for the diagnosis of pancreatic cancer.

The process of exercise regulating bone metabolism is complicated, which involves a number of signaling pathways. A large number of studies in vitro have indicated that mechanical stress regulates bone metabolism by Wnt, bone morphogenetic protein (BMP), and osteoprotegerin (OPG)/receptor activator of NF-κB ligand (RANKL)/receptor activator of NF-κB (RANK) signaling pathways. Both the in-tensity and frequency of mechanical stress have varing impact on bone tissue and cells. Plenty of studies in vivo also have shown that exer-cise regulates bone metabolism by key factors in bone metabolism signaling pathways. This paper reviewed the effects of exercise on bone metabolism pathways and their mechanisms.

Objective To evaluate effects of acitretin on HaCaT cells cultured in hypoxic condition,and to preliminarily explore the possible therapeutic mechanisms of acitretin in psoriasis.Methods HaCaT cells were divided into several groups to be cultured in hypoxic condition with the presence of acitretin at concentrations of 10-5,10-6,10-7 and 10 8 mol/L respectively,with cells treated with dimethyl sulfoxide (DMSO) as DMSO control group and those receiving no treatment as blank control group.Cellular proliferative activity was evaluated by CCK-8 assay after 12-,24-and 36-hour hypoxic culture in vitro.The mRNA and protein expressions of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were determined by reverse transcription (RT)-PCR and Western-blot analysis,respectively,after 24-hour hypoxic culture.Results After 24-hour hypoxic culture,the cellular proliferation rate was inhibited by 13.31％ ± 1.15％,21.86％ ± 5.31％,32.05％ ± 2.99％ and 37.28％ ± 3.21％ in the 10 8-,10-7-,10-6-and 10-5-mol/L acitretin groups respectively.With the increase of culture duration and acitretin concentrations,the degree of inhibition on cellular proliferation increased gradually.Compared with the blank control group,the 10-5-mol/L acitretin group showed significantly decreased protein expression of HIF-1α (0.319 ± 0.180 vs.1.196 ± 0.088,P ＜0.05),as well as decreased mRNA and protein expressions of VEGF (mRNA:0.442 ± 0.090 vs.1.108 ± 0.073;protein:0.216 ± 0.066 vs.1.174 ± 0.186;both P ＜ 0.05).However,no significant difference was found in the mRNA expression of HIF-lα between the 10-5-mol/L acitretin group and blank control group.Conclusion Acitretin can suppress the in vitro proliferation of HaCaT cells cultured in hypoxic condition,and down-regulate the expressions of HIF-1α and VEGF proteins as well as VEGF mRNA.

Objective To screen an optimum method for in vitro culture of Helicobacter pylori-spe-cific CD4+T cells and apply it to immunodominant Th epitopes screening .Methods PBMCs were isolated from subjects positive for Helicobacter pylori infection and were stimulated with HpaA recombinant protein . Various induction conditions including serum containing mediums , concentrations of antigen and time were screened to obtain an optimum method for in vitro culture of Helicobacter pylori-specific CD4+T cells.The cells were harvested and stimulated using HpaA synthesized overlapping peptide pool .The percentage of an-tigen-specific CD4+T cells was evaluated by intercellular cytokine staining of interferon-γand the results were compared under different conditions .The possible immunodominant Th epitopes were screened by using synthetic overlapping peptides .Results Antigen-specific CD4+T cells were well cultured in RPMI 1640 culture medium containing human AB serum in comparison with those cultured in fetal bovine serum based medium.The highest percentage of antigen-specific CD4+T cells was achieved when stimulated with HpaA recombinant protein at the concentration of 0.2 μmol/L.CD4+T cells in response to the stimulation of 0.2μmol/L of HpaA recombinant protein was observed on the ninth day after culture and its peak was reached on the fifteenth day .A possible immunodominant Th epitope ( HpaA220-237 ) was screened in subjects with He-licobacter pylori-infection by using synthetic overlapping peptides .Conclusion Helicobacter pylori-specific CD4+T cells were successfully cultured in vitro by using RPMI 1640 culture medium containing human AB serum and stimulated with 0.2 μmol/L of HpaA recombinant protein for fifteen consecutive days .This cul-ture method could be applied to immunodominant Th epitopes screening and provide evidences for further in -vestigation on the development of Helicobacter pylori epitope-based vaccine .

Objective To investigate the value of echocardiography for assessing the right ventricular function before and af ter treatment in the patients with pulmonary embolism.Methods Ninety-six patients with pulmonary embolism in our hospital from June 2014 to December 2015 were selected as the research subjects and divided into low-risk group,intermediate-risk group and high-risk group according to the disease severity.The echocardiographic examination was performed before and after treatment in all cases.Results The pulmonary artery systolic pressure after treatment in the low-risk group was lower than that before treatment (P＜0.05).The transverse diameter of right ventricle,transverse diameter of right ventricle and pulmonary artery systolic pressure after treatment in the intermediate-risk group and high-risk group were lower than those before treatment (P＜0.05).The Tei index after treatment in the low-risk group,intermediate-risk group and high-risk group was lower than that before treatment (P＜ 0.05).The right ventricle ejection fraction (RVEF),right ventricular end-systolic volume (RVESV) and right ventricular end-dias tolic volume (RVEDV) in the low-risk group had no statistically significant difference between before and after treatment.RVEF after treatment in the intermediate-risk group and high-risk group was higher than that before treatment(P＜0.05),while RVESV and RVEDV after treatment were lower than those before treatment (P＜0.05).Conclusion Echocardiography can objectively re flect the change situation of right heart function before and after treatment in the patients with pulmonary embolism,and can be used as an evaluation method for the effect of pulmonary embolism treatment.

Objective:3D hydrogel cell model was established,and cyclic compressive loading on MC3T3-E1 cell with different intensities,frequencies and durations was applied,in order to research the suitable solution about promoting the osteoblast differentiation with cyclic compression.Methods:Cyclic compressive loading on MC3T3-E1 cell was applied with different intensity,frequency and time.After compressive loading finished,the total RNA extraction from cell-gel constructs were performed and quantified ATF4,ALP,Runx2,Osteocalcin,RANKL and RANK mRNA.Results:RANKL and RANK mRNA expression significantly with different frequencies cyclic compressive loading (P ＜ 0.05),and ALP mRNA (P ＜ 0.05) and Runx2 mRNA (P ＜ 0.01) expression significantly with different intensities and frequencies cyclic compressive loading (P ＜ 0.05).Meanwhile,Runx2 mRNA expression with 4h significant higher than 12h (P ＜ 0.05),and RANKL mRNA expression with 4h significant lower than 12h (P ＜ 0.05).Conclusion:Determine the stress intensity and frequency,1％ intensity,frequency of 0.5 Hz,4 h of cyclic compression intervention could promote the growth of osteoblasts-like cells in the 3D hydrogel model.

Objective To analyze the risk factors of post-ERCP pancreatitis (PEP) and to evaluate the relationship between cannulation time and PEP.Methods The data of cannulation time in 1 625 patients who underwent ERCP from 2010 to 2012 were retrospectively studied.The risk factors associated with PEP were analyzed by univariate and multivariate Logistic regression analysis.The effect of different cannulation time on PEP was evaluated.Results The incidence of overall PEP was 4.6％ (75/1 625) including 4.1％ (67/1 625)of mild and 0.5％ (8/1 625)of moderate-to-severe.Univariate analysis revealed that diabetes mellitus (P =0.02),choledocholithiasis (P =0.02),malignant biliary stenosis (P =0.007),duodenal stenosis (P =0.029),precut (P＜0.01),cannulation time ≥ 8 min (P＜0.01),blood platelet count ≥ 180× 109/L(P =0.089),alkaline phosphatase ≥ 120 U/L (P =0.083) and total bilirubin ≥ 17.1 μmol/L (P =0.094)were associated with PEP.Multivariate analysis revealed that precut (OR=1.93,95％CI:1.10-3.39,P=0.022),cannulation time ≥8 min (OR =3.50,95％CI:2.00-6.13,P＜0.01) and duodenum stenosis (OR=2.92,95％CI:1.08-7.86,P=0.034) were independent risk factors of PEP.Within 30 min of cannulation,longer cannulation time was accompanied with higher PEP rate.Conclusion The cannulation time is an independent risk factor of PEP.Overall PEP is increased when cannulation time is more than 8 min.

Objective To explore the preventive effect of the supplemental dietary boron on bone damage of rats with excess fluoride (EF) ingestion. Methods Twenty-four Sprague-Dawley rats aged 4-5 weeks old were divided into the control (C group, treated with distilled water and the elementary dietary), the excessive fluoride dose group (EF group, treated with distilled water with 100mg/L F-from 221.0g NaF per liter and the elementary dietary) and the boron prevention group (P group, treated with 100mg/L F-distilled water and the supplemental boron dietary). Three months after the experiment, fluorine, boron contents and AKP activities in serum, total RNA and fluorine contents in bone, vertical and transverse diameter and dry weight of tibias of rats were assayed, and bone biomechanics of femur and bone mineral density (BMD) were determined. Results Compared with those in the C group, fluorine contents in serum and bone, AKP activities in serum of rats in the EF group significantly increased; total RNA in bone and BMD of the bone of whole body and tibia decreased, vertical and transverse diameter of tibias was shortened, dry weight was decreased; peak load of femur increased but maximum deformation decreased. Compared with those in EF group, fluorine contents in serum and bone, AKP activities in serum of rats in the P group obviously decreased; total RNA in bone and BMD of whole body, lumbar vertebrae and tibias notably increased, vertical and transverse diameters and dry weight of tibia were enhanced, peak load of femur was obviously raised. Boron contents in serums of rats in three groups had no significant differences. Conclusion Bone damage obviously occurred in rats with EF intake, and the supplemental dietary boron had a preventive effect on these changes.

Objective To investigate and analyze the preventive effect of boron on the cartilage damage in rats with intake excessive fluoride. Methods Fifty-ix Sprague-Dawley rats were divided into the control group (C, intake distilled water), the excessive fluoride dose group (EF, intake distilled water with 100 ppm F-) and the boron prevention group (P, intake distilled water with 100 ppm F- as well as the supplemental boron dietary). 3 to 5 months later, fluorine contents in serum, RNA contents in costal cartilage were assayed. The morphological changes in tibia growth plate cartilage (GPC) in rats were observed. Results Although exposed to the same dose of fluoride, the fluorine contents in serum in rats of P group decreased notably compared with those of EF group, the damage of tibia GPC under optical and electron microscope lessened significantly, and RNA contents in costal cartilage increased obviously in the 3rd month. Conclusion Boron added could decrease the fluorine level in the body and relieve the toxic symptom of excess fluoride, and thus boron has a preventive effect on skeletal fluorosis.

Objective:To understand the status of outpatients′medical care and their impact on the doctor -pa-tient trust in Beijing .Methods:Three tertiary hospitals were selected due to most concentrated high -quality medi-cal resources , the largest number of patient visits , universalism and particularism trust could be compared , taking field observations , personal interviews and questionnaires methods .Results:The main factors affecting clinical doctor-patient trust are time, the doctor skills, medical ethics, medical and prescription drug division , etc.are appropriate and effective .Conclusion:Play the role of pyramidmedical system′s overall effectiveness , and es-tablish a patient-centered system for outpatient care as soon as possible a comprehensive grasp of the overall con -struction team doctor , continue to strengthen the standardized management of medication .