Catheterization ; Endoscopy ; Esophageal and Gastric Varices ; complications ; drug therapy ; surgery ; therapy ; Gastrointestinal Hemorrhage ; drug therapy ; etiology ; surgery ; therapy ; Humans ; Octreotide ; therapeutic use ; Somatostatin ; therapeutic use ; Vasopressins ; therapeutic use

Animal models of pancreatic cancer are important for the experiments of pancreatic cancer research.An ideal an- imal model of pancreatic cancer provides effective tool for exploring the tumorigenesis of pancreatic cancer.This paper summari- zes the methods for establishing mouse model of pancreatic ductal adenocarcinoma and discusses interpretd the advantages and disadvantages of different models.

Objective To analyze the features of quality management of maternal serum prenatal screening for Down syndrome in the second trimester and investigate the methods to establish and improve quality control system.Methods Prenatal screening and clinical data were collected for statistical analysis from 17 prenatal screening centers in Zhejiang Province from 2011 to 2012.The impacts of maternal age , weight, gestational age , specimen collection , the median values of serum markers selection and different analysis software on prenatal screening results for Down syndrome were analyzed respectively .Results Totally 417 347 and 463 846 prenatal screening cases were collected in 2011 and 2012 respectively.The maternal age of the entire province presented as a Gaussian distribution.The age distributions of different screening institutions were inconsistent , while maternal weight distributions were similar.The approach to determine gestational age was significantly different among screening institutions.Median MoM of the samples from the blood collection points was different from those of the main screening center.Median MoM-freeβ-hCG was positive bias , particularly the specimens from the blood collection points.After strengthening the control of temperature and time during samples transportation , Median MoM-free β-hCG of specimens from blood collection points became nearly equal to those of main screening center .Use of local median made the median MoM value closer to 1.0 in the centers with positive or negtive bias of the markers , which had little effect in detection rate and decreased the false positive rate and screening positive rate.Six more positive cases were detected by the Lifecycle software instead of 2T software in 213 followed-up positive cases, which means the Lifecycle software can improve the detection rate.Conclusions The impact of maternal age, weight, gestational age, specimen collection and other factors on screening performance should be taken into consideration when it evaluates the screening quality of different laboratory .The use of local medians is necessary in prenatal screening.Optimization of screening analysis software can reduce false negative rate.

Objective To explore the relationship among professional commitment, learning burnout and academic self-efficacy of undergraduate nursing students. Methods 506 undergraduate nursing students were investigated with the three Questionnaires of college students: professional commitment questionnaire, learning burnout inventory and academic self-efficacy scale. Results The scores of affective commitment, ideal commitment, normative commitment and continued commitment of the undergraduate nursing students were (28.229 ± 5.327), (20.348 ±4. 507), (19. 405 ± 3. 730), (18. 148 ± 2. 954) and( 86. 130 ± 13. 421), respectively. And the scores of depression, misconduct, low sense of accomplishment, total bumrnut of the undergraduate nursing students were(21.733 ±5.338), (18.459 ±3. 918) , (17.083 ±3. 596)and(57. 275 ±9. 766) , respectively. As well as the scores of learning ability of self-efficacy, learning behavior of self-efficacy and total self-efficacy were(35.765 ±5.835), (35.247 ±4.840)and (71.012 ±9.659), respectively. The affective commitment,ideal commitment and normative commitment of professional commitment were negatively correlated with the dimensions of learning bumout. And the continued commitment was significant correlated with the low sense of accomplishment. Otherwise, the dimensions of professional commitment were positive correlated with the dimensions of academic self-efficacy. However, the dimensions of academic self-efficacy were significant negative correlated with the dimensions of learning burnout (P＜ 0. 01). Conclusions The professional commitment, learning bumout of undergraduate nursing students are closely related with the academic self-efficacy of undergraduate nursing students. The higher the levels of professional commitment and academic self-efficacy are, the lower the level of learning bumout is.

Objective To investigate the therapeutic effect of island flap pedicled with dorsal cutaneous branches of digital inter-nal artery for severe thermos injury of fingers .Methods From May 2008 to May 2012 ,15 fingers in 12 cases with severe thermos injury were treated with island flap pedicled with dorsal cutaneous branches of digital internal artery .The defect size ranged from 1 .5 cm × 2 .0 cm to 2 .2 cm × 3 .0 cm ,4 fingers with anterograde flap repair ,11 fingers with retrograde flap repair .Results Partial necrosis happened at the distal end of 2 island flaps ,All the other flaps survived completely .The patients were followed up for 6-12 months with satisfactory cosmetic and functional results ,cicatricial contracture around the skin graft in 3 fingers ,The two-points discrimination distance was 9-11 mm in flaps .Conclusion These flaps have the advantages of an extended skin paddle and a versa-tile pivot point on the phalanx ,and they allow coverage of wide and distal defects .

0.05).Conclusions There is imbalance of Th1/Th2 cells in CHB children.Th1 cytokines are positively correlated with hepatic inflammatory activity.In the course of disease,Th2 cytokines are predominant and they have a correlation to the chronic prognosis of the illness.So we can conclude the degree and prognosis of disease by observing the change of Th1/Th2 cytokines in CHB children.

Objective To investigate the effects of wortmannin (WT) on leukemia cells cycle and BCL-2 protein expression. Methods 0 25?mol/L PI-3 kinase inhibitor wortmanin was used to treat K562 cells for 24 hours, and Arac was simultaneously used to induce the cell apoptosis. The specific fluoresent staining and FCM analysis were adopted to measure the cell cycle distribution and BCL-2 expression. Results Compared with the control cells, the proliferation index(PI) of the K562 cells treated by wortmannin was significantly lower, the cell number of G1 phase and the percentage of cell apoptosis increased, and the BCL-2 protein expression significantly decreased. Conclusion Wortmannin could inhibitedtheproliferationofK5 6 2cells ,andwascellcyclespecificagent (CCSA) .

Objective To observe the correlation between heart rate turbulence (HRT) and heart rate variability in patients with essential hypertension.Methods 50 cases of essential hypertension were selected and 30 healthy subjects were taken as controls.Turbulence onset (TO) and turbulence slope (TS) were calculafed according to 24 h Holter results of the two groups.The correlation between TO,TS and SDNN of 24 h RR,every-5-min of 24 h RR and rMSDD of RR as well as the correlation between TO and TS Was studied.Results TO in essential hypertension group Was remarkably higher than in control group but TS Was lower.TO and TS were correlated with SDNN, SDANN and rMSDD (r=-0.587,r=0.679,r=0.423,r=0.513,r=0.336,r=0.417)(P<0.05 respectively). Conclusion Systolic HRT before ventricular period is weakened in patients with essential hypertension.TS can be an index in evaluating autonomic nerve function of primary hypertension.

Objective: Our aim was to observe the protective effect of propofol in clinical relevant concentration on the peroxidative injured erythrocyte. Methods: Intravenous blood samples taken from 20 healthy adults were prepared for red blood cell (RBC) suspensions and divided equally into 5 groups: groupⅠfor control, group Ⅱ with hydrogen peroxide (H2O2, 100 mmol/L) -induced injury, and group Ⅲ, Ⅳ, Ⅴ with the same injury as the group Ⅱ but being pretreated with 3 different concentrations of propofol (25, 50, 75 μmol/L), respectively. The concentrations of potassium and malondialdehyde (MDA) in RBC suspensions and hemolytic degree after incubation were measured. Results: After 60-minute incubation, the extracellular potassium concentrations (0.16, 0.14, 0.14 mmol/L), MDA concentrations (5.66, 5.57, 6.20 nmol/L), and hemolytic degree (76.89%, 59.84%, 64.22%) decreased significantly in the groups that were pretreated with propofol as compared with the group Ⅱ (0.26 mmol/L, 9.19 nmol/L, and 100%), but no difference has been seen within the groups pretreated with 3 different concentrations of propofol and between the propofol-treated groups and the group Ⅰ(0.10 mmol/L, 4.13 nmol/L, 52.73%). Conclusion: Propofol in clinical relevant concentrations may decrease MDA production, hemolytic degree, and potassium exflux from erythrocyte in response to in vitro oxidative challenge with hydrogen peroxide and enhance erythrocyte antioxidant capacity. The protective effect is not related with concentrations.

Objective To monitor the changes of resting energy expenditure in ventilated critically ill children,to compare the results of standard equations and indirect calorimetry (IC) in predicting energy expenditure,and to investigate the possible influence factors of the metabolic status of the critically ill children.Methods From September 2012 to September 2013,56 critically ill children on assisted ventilation and fitting the requirements of IC in pediatric intensive care unit of Shanghai Children's Medical Center were enrolled in this prospective study.IC measurements were performed using metabolic cart on day 1,4,7,10 after trachea intubation.General clinical data of these children were recorded.Results 130 IC measurements were performed in the 56 children.The measured resting energy expenditure (MREE) did not exhibit significant differences among day 1,4,7,and 10 (P =0.379).Although there were no significant differences between MREE and energy expenditure predicted with Schofield and WHO equations (P =0.917,P =0.995),the agreement was poor between the measured and predicted values (R2 =0.185,R2 =0.322).The metabolic status of the children on day 1 of ventilation was only correlated with age (P =0.000) and height (P =0.027),not with severity of underlying diseases or clinical outcomes.Conclusions MREE of IC method in ventilated critically ill children did not significantly change over time in this study.A poor agreement was observed between equationpredicted energy expenditure and MREE.IC measurement of resting energy expenditure is recommended for guiding individual nutritional support among critically ill children so as to improve clinical outcome.