Surgical treatment has improved the prognosis of resectable pancreatic cancer considerably de-spite the generally aggressive behavior of its malignancy. Neoadjuvant therapy for pancreatic cancer has been shown effective in improving a survival benefit. Few prospective randomized controlled clinical trials (RCTs) on the use of neoadjuvant chemotherapy and chemoradiation has been done tp show the survival advantage of systemic chemotherapy (5-FU/FA or gemcitabine) following surgical resection. Up to now, there is no high-level evidence of any benefit deriving from neoadjuvant chemo therapy for pancreatic cancer. Well designed trials are needed to compare neoadjuvant chemotherapy with surgery to judge the value of neoadjuvant cherqo-therapy in multimodal treatment concepts of pancreatic cancer.

Objective To explore the constituent ratio and clinical characteristics of multifocal thyroid papillary carcinoma (MPTC).Methods The clinical data of 1616 cases of papillary thyroid carcinoma(PTC) were retrospectively analyzed from January 2002 to December 2011 of the First Affiliate Hospital of Dalian Medical University,which operated at the first time and confirmed by pathology.The change of constituent ratio of MPTC in PTC was analyzed and the differences of the clinical characteristics of the multifocal group and single focal group were analyzed.Results The constituent ratio of MPTC in PTC was increasing from 8.33％ (4/48) in 2002 to 30.38％ (96/316) in 2011 gradually.Compared to the single focal group,MPTC group had higher rate of neck lymph node metastasis(45.09％ vs 25.02％ ; P =0.000) and extrathyroidal invasion (20.95％ vs 9.04％ ;P =0.000).Compared with pure microcarcinoma,none pure microcarcinoma had higher rate of neck lymph node metastasis (P =0.000).More than two focuses has higher rate of neck lymph node metastasis than two focuses (P =0.000).The rate of recurrence with lymph node metastasis was higher than that without lymph node metastasis (24.05％ vs 8.98％ ;P =0.000) conformed by postoperative pathology.Conclusions The number and constituent ratio of MPTC in PTC is increasing gradually.MPTC group has high proportion of lymph node metastasis and extrathyroidal invasion than single focal group.None pure microcarcinoma has higher rate of neck lymph node metastasis than pure microcarcinoma;more than two focuses has higher rate of neck lymph node metastasis than two focuses.The recurrence rate is correlated with the rate of lymph node metastasis.

Objective To investigate the effects of muscle relaxant antagonism on patients with residual paralysis in postanesthesia care unit (PACU).Methods The similar patients who were daily accepted into PACU were chosen to make pairs,and were randomly divided into experimental (J; n =26) and control (F; n =26) groups.On arrival to the PACU,the train-of-four ratio (TO-Fr) was assessed using electromyography.When TOFr reached 4,Grour J was given with neostigmine 40 μg/kg and atropine 20 μg/kg; Group F was given with 5ml saline.Extubation was determined with standard clinical criteria.We recorded TOFr,PaO2,PaCO2at the time point of extubation,SpO2 at the time point of left the PACU,the stay time in PACU,the incidence of respiratory dysfunction,and the side effect.Results The TOFr at the time point of extubation in group J (0.96 ± 0.04) was significantly higher than group F (0.92 ±0.06) (P ＜0.05).The stay time in PACU in group J [(26 ±5)min] was significantly less than group F [(33 ±7) min] (P ＜ 0.01).PaO2,PaCO2,extubation time,and SpO2 were no significant difference between two groups (P ＞ 0.05).Two patients in group F had respiratory dysfunction.There was no incidence of postoperative nausea,vomiting,and other side effects in two groups.Conclusions Regular muscle relaxant antagonism lowered the risk of postoperative residual muscle relaxant effect,shortened the PACU residence time,and had no postoperative nausea and vomiting(PONV) and other side effects.

Objective To evaluate the effects of different rates of remifentanil infusion on cardiovascular response to tracheal intubation in older patients. Methods Thirty ASA Ⅰ-Ⅲ patients aged 65-75 yrs weighing 50-80 kg scheduled for elective abdominal operation were randomly divided into 3 groups (n = 10 each) according to the remifentanil infusion rate: group A 0.05 ?g?kg-1?min-1; group B 0.1 ?g?kg-1?min-1 and group C 0.15 ?g ?kg-1?min-1. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Radial artery and subclavian vein were cannulated for BP and CVP monitoring and blood sampling. ECG, BP, HR and SpO2 were monitored during anesthesia. After 10 min stabilization induction of anesthesia was commenced with remifentanil infusion for 10 min. Midazolam 0.1 mg?kg-1 was then given Ⅳ. Succinylcholine 1.5 mg?kg-1 was given to facilitate intubation after the patients lost consciousness. BP and HR were recorded immediately before induction of anesthesia (T0, baseline), immediately after intubation (T1 ) and at 2, 5 and 10 min after intubation (T2 ,T3 ,T4 ) . Cardiovascular intubation response was defined as increase in SP or HR by 15% of the baseline value within 2 min after intubation. Blood samples were taken at T0-4 for determination of plasma concentration of norepinephrine (NE) and epinephrine (E) by HPLC. Side effects such as chest wall rigidity and hypotension were also recorded. Results The cardiovascular intubation response rate was significantly higher in group A (80%) than in group B (10% ) and C (10% ) . The incidence of side effects was significantly higher in group C (70% ) than in group B (20%) and A. Plasma NE and E concentrations were significantly increased after intubation in group A (at T2-4) and B (at T2,3) as compared with baseline values at T0; while in group C only plasma NE concentration was significantly increased at T2 and T3 and there was no significant change in plasma E concentration after intubation. The plasma NE and E concentrations were significantly higher in group A (T2-4) and B (T2,3) than in group C. Conclusion The appropriate infusion rate of remifentanil for tracheal intubation is 0.10 ?g?kg-1 ?min-1 in older patients.

Objective:To study the immune response to murine pancreatic carcinoma by bone marrow-derived dendritic cells(BM-DCs) modified with interleukin-23 after acquiring antigen from apoptotic pancreatic carcinoma cell.Methods:The murine IL-23 cDNA was sub-cloned into dual-expression vector.DCs were pulsed with apoptotic tumor cell antigen after transduced with interleukin-23 gene.The immune preventative and immunotherapeutic effects of DC vaccines on mice with pancreatic cancer were assessed.Results:IL-23 protein could apparently increase the antigen presenting ability of DC.After the vaccination of DC vaccines.IFN-? production in treatment group were significantly more than that of control group(P

Objective To define that human cytomegalovirus (HCMV) can cross the placenta of the Balb/c mice and induce liver damage in developing fetus. Methods HCMV AD169 (6.0 logTCID 50 , 3.0 logTCID 50 , 1.5 logTCID 50 per mouse respectively) was injected into the peritoneum of mice (half of mice were female) when they were about 10 weeks old (weight 25 30g). Then, these mice were paired to mate. Fetus on day about to give birth was removed from the uterus and liver was obtained for virus isolation, pathological studies, examination of the viral DNA positive cells by in situ hybridization using digoxigenin labelled HCMV DNA oligonucleotide probe. Results HCMV could be isolated from the supernatant of tissues; HCMV DNA was found by PCR in supernatant of cell culture with CPE; the presence of viral DNA sequence in hepatocytes was confirmed by in situ hybridization; pathological changes in liver consist of swollen cytoplasm and destroyed nuclei of hepatocytes and distinct intranuclear inclusion in hepatocytes with a cellular infiltrates of predominantly phagocytic cells. All above were found more obviously in fetal mouse liver tissues from the group inoculated with 6.0 log TCID 50 HCMV AD169 as compared with 3.0 log TCID 50 group. In contrast, these positive results couldn't be well found in 1.5 log TCID 50 group. Nothing could be found in normal controls. Conclusions Our research suggests that primary maternal HCMV infection during pregnancy could induce congenital infection in fetus by transplacental transmission and induce fetal liver damage. The mouse model will provide the basis for the study on pathogenesis of congenital HCMV infection in liver and the development of prevention, diagnosis and antiviral agents for congenital HCMV infection in human being.

Objective Hepatic stimulator substance(HSS)is newly defined as a growth mitogen to hepatocytes.This sutdy is aiming to investigate the effect of recombinant human hepatic stimulator substance(rhHSS) on growth of liver oval cells(OVCs). Methods OVCs were prepared from intoxicated rats with 3'-methyl-dimethylaminoazobenzene.After confirmation of OVC morphologically and histochemically,the cell cultures of OVC were exposed to various dosages of rhHSS for 12 and 24?h,respectively.The cellular proliferation was analyzed by MTT and flow cytometry. Results Administration of rhHSS(160-400 mg/L)inhibited the proliferation of OVC,as indicated by MTT and cell cycle analysis,the effect appeared non-dose dependent pattern.The peak of inhibition occurred at 240?mg/L.After incubation with 240?mg/L of HSS for 12 and 24?h,the percentages of S-phase were reduced 47.8% and 35.8% to those of the untreated cells.respectively.Conclusion rhHSS exhibits the inhibitory effect on growth of OVC.

0.05). The incidence of anastomotic leakage in the control group (16.7%) was higher than that of the study group (4.3%). The area of collagen fibrils 3 d, 5 d and 7d after intestinal anastomosis in the study group were significantly more than that in the control group ( P

Objective To analyze clinicopathologic characteristics and prognostic factors of the patients with invasive lobular carcinoma of breast. Methods Clinical data of 125 patients with invasive lobular carcinoma of breast treated at Cancer Center of Sun Yat-sen University from Jan. 1990 to Dec. 2008, were analyzed. The clinical characteristics, recurrence and survival of the patients were summarized. Results Median age of 125 patients was 45 years old (range, 27 to 76 years old). The patients with large tumor mass (≥ 3cm), positive local lymph node, more than Ⅱ stage and positive hormone receptor at diagnosis were 77 cases(61.6 %), 64 cases(51.2 %), 101 cases(80.8 %) and 112 cases(89.6 %), respectively. The median time of follow-up was 58 months (range, 11-222 months). Of the 125 patients, 32 had local recurrence and metastasis, and 18 died. The 5-year disease-free and overall survival rates were 82.2 % and 87.3 %, respectively. Multivariate COX regression analysis showed that whether endocrine therapy or not was only a prognostic factor of patients with invasive lobular carcinoma of breast. Conclusion There is no difference in media age of patients with invasive lobular carcinoma of breast at diagnosis from other pathologic type of breast cancer. These patients are usually with larger tumor masses, more lymph node metastasis and a higher proportion of positive hormone receptor. The prognosis of patients is not affected by clinicopathologic parameters.

Objective To determine the expression of peroxisome proliferators-activated receptors (PPARs), nuclear factor-κB (NF-κB) and activity of superoxide dismutase (SOD) in rats with obstructive jaundice induced by bile duct ligation (BDL) and elucidate the molecular regulation mechanisms of hepatic injury due to obstructive jaundi(c)e. Methods All rats were sacrificed on the 7th day and 19th day after BDL and blood and liver tissue samples were obtained. SOD enzyme activity was detected by SOD kit. RT-PCR was performed to determine the mRNA expression of PPARs in all groups. The detection of PPARs protein and activation of NF-κB were performed using an immunohistochemical method. Results The activities of normal SOD and CuZn-SOD were decreased compared to the sham group (P＜0.01), and the decrease on 19th day after BDL were more significant. The level of PPARs expression in the BDL groups liver except the PPARβ in the BDL 7th group was reduced compared to the sham group (P＜0.01), and the level on the 19th day after BDL were more significantly reduced. PPARs protein expression was significantly inhibited (P＜0.01) in the sham group. SOD in BDL groups had significant positive correlation as compared with PPARs protein expression (P＜0.01), but NF-κBp65 protein expression had significant negative correlation as compared with PPARs protein expression (P＜0. 01). Conclusion PPARs are inhibited in expression level, and this inhibition becomes more significant as the pathological process progresses. PPARs might be key regulatory factors for SOD and NF-κB. The low expression of PPARs might be one of the important molecular mechanisms in liver injury due to obstructive jaundice.