0. 05 ). For detection of pancreatic duct dilation and lymph node metastasis, EUS was better than CT ( P=0.039,P=0.004). The accuracy of EUS in determing peripancreatic fat infiltration and organic invasion was correlated with tumor size (P=0.015,P=0.022) , pancreatic duct dilation was correlated with the location of tumors ( P

Deep vein thrombosis (DVT) has attracted great attention because of its high morbidity in orthopedics department, which could easily cause lethal pulmonary embolism (PE). Based on the domestic and foreign findings from the prophylaxis and nursing of DVT, this thesis summarized the key problems in orthopedic patients. It firstly defined the conception of DVT,and then emphasized the morbidity and severity of DVT in orthopedics department. After that it reviewed the possible risk factors that contributed to DVT. Moreover it also pointed out some matters needing attentions through discussing and analyzing the nursing and prophylactic measures against DVT, and it also gave some recommendations on it. It expounded the nursing progress on prophylaxis of the deep venous thrombosis in department of orthopedics, so as to provide reference for clinical work and study.

Background and purpose:Drug resistance is a major cause of failure in lung cancer chemotherapy. This study aimed to investigate the effect of YAP on doxorubicin resistance in lung cancer and its underlying mechanism. Methods:Doxorubicin resistant lung cancer cell clones were established from parental sensitive cancer PC9 cell line via in vitroinduction, and the expression of YAP was analyzed. YAP was down-regulated via shRNA to different levels. MTS assay was employed to determine cell proliferation and drug sensitivity. Flow cytometry was used to determine cell cycle distribution, apoptosis and uptake of Rh-123. Western blot and quantitative real-time polymerase chain reaction (QRT-PCR) assay were used to determine the expression of ABCB1, ABCC1, p53, Runx2, ITGB2 and ErbB4. The phosphory-lation of serine/threonine kinase (AKT) was determined as well.Results:Doxorubicin resistant PC9/Adr cell clone was obtained with over-expressed YAP. Expression of YAP in PC9/Adr cells was down-regulated to different levels via shR-NA. After YAP silencing, cell proliferation was reduced, while sensitivity to doxorubicin was increased. The cell cycle was significantly halted by G0/G1 phase. Doxorubicin induced-apoptotic rate and cellular uptake of Rh-123 were increased,with positive correlation to YAP silencing level. Western blot and QRT-PCR results showed that after YAP silencing, ABCB1, ABCC1, Runx2, ITGB2, and ErbB4 proteins were down-regulated, while the expression of p53 was up-regulated. Phosphorylation of AKT was inhibited as well.Conclusion:Over-expression of YAP is involved in doxorubicin resistance in PC9/Adr cell line. Silencing of YAP could restore doxorubicin sensitivity. The mechanism involves regulation of drug resistance-related genes and promotion of apoptosis.

Objective To evaluate the risk of the occurrence of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer in the oral HPV carriers through a population-based investigation in Shanghai.Methods A total of 1200 cases of outpatients who attended the annual cervical examination and 50 preoperational cases of inpatients with CIN Ⅲ or invasive cervical cancer were enrolled from three clinical centers in Shanghai.The oral HPV infection was determined by real-time PCR.In 1200-case cross-sectional study,the incidence rate of CIN was compared between the oral HPV positive and negative cohort.In 1250-case case-control study,the positive rate of oral HPV DNA test was compared among normal control group,CIN Ⅰ-Ⅲ,and invasive cancer case groups,and all odds ratio (OR) values were calculated,respectively.The HPV transmission-related demographic and behavioral characters of the oral HPV carriers were also analyzed.Results The oral HPV carriers accounted for 5.9％ (71/1200) of the investigated outpatients.The oral HPV DNA positive rates were gradually increased with the cervical disease grades,which were 5.8％ (68/1182,normal),2/13 (CIN Ⅰ),1/5 (CIN Ⅱ),31.4％ (11/35,CIN Ⅲ) and 5/15 (invasive cancer).In cross-sectional cohort studies,the relative risks (RR) of CIN Ⅰ,Ⅱ were 2.9 and 4.0 for oral HPV carriers,respectively.In case-control study,the OR values for CIN Ⅰ-Ⅲ and invasive cervical cancer were 3.1(95％CI:1.6-10.1),4.2(95％CI:1.7-28.4),7.1(95％CI:4.8-19.8) and 10.1 (95％ CI:3.2-32.1),respectively.The oral sex and multi-sexual partner were two major risk factors for the oral and cervical HPV co-infection,HPV-related cervical cancer and precancerous diseases according to behavioral analysis.Conclusions There are complicated transmission pathways between oral and cervicalHPV.Oral HPV carriers should be intensively followed up and their oral HPV infection and HPV-related cervical diseases should be treated together.

Phthaloyl dichloride (1)was reacted with LiAlSeH2 to give benzo[c]selenophene-1;3-dione (2);which was treated with the Grignard reagents to generate hydroxyl compounds 3a-3h.These compounds were finally converted to target products 4a-4h by treatment with hydriodic acid.The structures of 4a-4h were confirmed by MS and 1 H NMR.Their inhibitory activity against adenosine diphosphate (ADP)-induced platelet aggregation was evaluated by Born′s turbidimetric assay;free radical scavenging activity was assayed by xanthine oxidasemethod and 1;10-phenanthroline spectrophotometric method.It was found that compound 4 f displayed more potent inhibi-tory effect on platelet aggregation than 3-n-butylphthalide and comparable hydroxyl free radical scavenging activity in vitro to that of edaravone.Therefore;compound 4 f might be the candidate for further investigation.

In order to search for new antiplatelet agents with higher potency, a series of tetramethylpyrazine ( TMP) /chalcone hybrids ( 2-26) were synthesized and evaluated based on the principle of bioisostere and hybrid-ization. They exerted inhibitory activity against adenosine diphosphate ( ADP )-induced and arachidonic acid ( AA)-induced platelet aggregation to varied extent. Among them, compound 8 was the most potent with IC50 of 0. 14 mmol/L on ADP-induced platelet aggregation ( 9. 1 folds of TMP and 10. 5 folds of chalcone ) and 0. 09 mmol/L on AA-induced platelet aggregation ( 8. 8 folds of TMP and 10. 0 folds of chalcone) , which was superior to clinically used anti-platelet drug aspirin ( ASP, IC50 =0. 15 mmol/L) .

Objectives Brain atrophy plays a key role in post-stroke dementia. The current study aims to explore risk factors for brain atrophy in different regions in order to find the ultimate therapeutic strategy. Methods Consecutive stroke and/or transient ischemic attack (TIA) patients were recruited from July 2012 to June . The clinical features, neuro?imaging findings and risk factors were collected during hospitalization. Logistic regression analysis showed that, except for age, female gender (Odds ratio, OR=2.447, P=0.007) and the number of silent lacuna infarcts (OR=1.414, P=0.027) were independent risk factors for frontal lobe atrophy. Ischemic stroke history (OR=2.224, P=0.024) was the independent risk factor for parietal lobe atrophy. All of extra-/intracranial larger artery diseases (OR=2.584, P=0.015) and white mat?ter severity score (OR=1.112, P=0.007) as well as the number of silent lacuna infarcts (OR=1.158,P=0.042) were inde?pendent risk factors for medial temporal lobe atrophy. Moreover, diabetes (OR=2.109, P=0.001),atrial fibrillation (OR=1.934, P=0.015) and white matter severity score (OR=1.098, P=0.002) were independent risk factors for global brain atro? phy. Conclusion Risk factors for brain atrophy included diabetes,atrial fibrillation, silent lacuna infarcts and white mat?ter changes. We should pay more attention to those patients with above risk factors in order to slow down the progression of brain atrophy and also prevent them from dementia by early interventions.

Objetive The present study was aimed to explore the risk factors of mid-term cognitive decline in pa?tients with indexed TIA/minor stroke (NIHSS≤3) in a Chinese hospital-based cohort. Methods We recruited all consec?utive Chinese TIA/minor stroke patients from July to December in 2012 and followed them up in stroke clinics at 3 and 18 months after indexed TIA/minor stroke. The outcome was defined as significantly cognitive decline at 18 months com?pared with that at 3 months. Results A total of 209 consecutive Chinese TIA/minor stroke cases completed their fol?low-up investigation. Among them, 24 (11.5%) exhibited significantly cognitive decline. The independent risk factors of cognitive decline post TIA/minor stroke were education years (OR=0.869,P=0.021), atrial fibrillation(OR=5.950, P=0.001) and multiple silent lacunar infarcts (OR=5.179,P=0.020). Conclusion It is necessary to evaluate the cognition among TIA/minor stroke cases and a close follow-up is required for patients with atrial fibrillation and multiple silent la?cunar infarcts frequently in order to decrease the risk of cognitive decline post TIA/minor stroke.

This paper introduced the concept of positive psychology and its application background among breast cancer patients mainly summarized the application of 6 kinds of positive psychology intervention in breast cancer patients. In this paper, we found that positive psychology was the research hotspot in mental intervention for breast cancer patients for the moment which was still at the start stage in China. Researchers have to fully consider cultural differences before study and take positive psychology intervention for breast cancer applicable to our country based on doing indigenous research well. At the same time, researchers should expand the influence of positive psychology in nurses to actually implement the application of positive psychology in mental nursing among breast cancer patients in our country so as to improve patients＇ psychologic status and quality of life.

Objective To investigate whether simple visual assessment of FVERVOT(the right ventricular outflow tract Doppler flow velocity envelop) graphs aids in hemodynamic differentiation. Method The hemodynamics, echocardiography, and clinical data of 88 patients with pulmonary hypertension (PH) were reviewed. The FVERVOTgraphs were categorized into normal pattern (no notch; NN), late systolic notch pattern (LSN) or mid-systolic notch pattern (MSN). Results The pulmonary vascular resistance (PVR) was highest in the MSN pattern (9.2±3.5 WU; P＜0. 001), in comparison with LSN (5,7 ±3. 1 WU) and NN (3.3±2.4 WU) patterns. The ratio of stroke volume to pulse pressure (compliance) also varied with different patterns of FVERVOr graph (MSN = 1.2 ± 0. 5; LSN = 1.7 ± 0.8; NN = 2.6 ± 1. 7, P = 0.001 and 0.04 respectively compared with NN). The specificity and sensitivity of MSN were 96% and 71%, respectively in case of a PVR ＞ 5 WU (PPV 98%). In the patients with PH, any notching pattern of FVERVOT graph was highly associated with PVR ＞ 3 WU (OR = 22.3, 95 % CI: 5.2 ～ 96.4), whereas the NN pattern predicted a PVR ≤3 WU and pulmonary artery wedge pressure (PAWP) ＞ 15 mmHg (OR =30.2, 95%CI: 6.3 ～ 144.9). Conclusions Visual inspection of the shape of the FVERVOT graphs provides insight into the hemodynamic status of patients with PH.