Objective To discuss the influence of the holistic nursing careng on clinical value in patients with advanced pancreatic cancer.Methods 70 patients with pancreatic cancer were randomly divided into the observation group and the control group,with 35 cases in each group.The control group was given routine nursing measures.The observation group received the holistic nursing careng on the basis of routine nursing measures.The hospitalization time,satisfaction degree,treatment compliance and mentality were observed.Results The SAS,SDS scores of the observation group after nursing were (56.87 ±6.01)points and (61.79 ±6.17)points,which were significantly lower than (39.11 ±5.68)points and (40.82 ±5.31)points of before nursing(t =9.136,8.561,all P <0.05).The hospi-talization time,exhaust time of the observation group were (32.9 ±6.6)days and (8.21 ±1.29)days,which were significantly lower than (45.1 ±10.2)days and (13.56 ±1.77)days of the control group(t =8.561,3.769,all P <0.05).The treatment satisfaction and treatment compliance in the observation group were also significantly better than the control group(χ2 =8.292,8.156,all P <0.05).Conclusion Hsystematic nursing intervention can significantly improve thepostoperative anxiety and depression,and improve the quality of life of patients with severe pneumonia.

Objective To study the correlation between blood glucose variability and TOAST type of patients with acute ischemic stroke and provide new evidence which can improve the prognosis of ischemic stroke.Methods One hundred and forty-three hospitalized patients with acute ischemic stroke from August 2013 to August 2014 were included.All patients were estimated about the general state of health and performed laboratory examinations and other auxiliary examinations.Then the TOAST type of all cases was classified.The 24-hour blood glucose monitoring was done to the patients to calculate the blood glucose variability.One hundred and forty-three cases were divided into blood glucose variability group ( standard deviation of glucose ( GluSD )≥1.4 mmol/L, 85 cases ) and control group ( GluSD <1.4 mmol/L, 58 cases) according to glucose variability.We estimated the neurologic impairment of the patients with the US National Institutes of Health Stroke Scale ( NIHSS) and the activities of daily living with Barthel index.The relation between blood glucose variability and the prognosis of ischemic stroke was analysed with multivariate analysis.Results Differences were significant in age, history of diabetes and NIHSS score between blood glucose variability group and control group.The degree of neurologic impairment of large artery atherosclerosis (LAA) group (moderate and severe neurologic impairment:43/53(81.0%)) and cardio-aortic embolism ( CE) group ( moderate and severe neurologic impairment:15/17 ) was more serious than that in small artery occlusion ( SAO) group ( moderate and severe neurologic impairment:6/71 ( 8.5%) ) , especially in CE group.The differences were significant (χ2 =7.043,P<0.05).Blood glucose variability in patients with LAA was more obviously than that in other patients.NIHSS score and activities of daily living of the patients estimated on admission and after 2 weeks were not different in the blood glucose variability group, but the difference was significant in control group.The poor prognosis in blood glucose variability group was 2.821 times that in control group ( 95% CI 1.880 -4.233 ).Conclusions The people sufferd ischemic stroke with old age, diabetes or severe case are more vulnerable to abnormal blood glucose variability.Abnormal blood glucose variability is an independent risk factor for acute ischemic stroke and induces difficulty to recovery and poor prognosis.

BACKGROUND:Mongolian Pharmaceutical Betel Shisanwei Ingredients Pil has achieved good clinical efficacy, but the underlying mechanism remains unclear. OBJECTIVE: To study the effects of Mongolian Pharmaceutical Betel Shisanwei Ingredients Pil on the hypothalamic-pituitary-adrenal axis negative feedback function in the chronic depressed rats, and to explore anti-depression mechanisms of Mongolian Pharmaceutical Betel Shisanwei ingredients pil. METHODS: Eighty male Wistar rats were randomly divided into ten groups according to the sugar consumption test (with eight rats in each group): normal control group, model group, fluoxetine group, high-, medium- and low-dose Betel Shisanwei Ingredients Pil groups, RU486 group, high-, medium- and low-dose Betel Shisanwei Ingredients Pil plus RU486 groups. Except normal control group, the other groups were treated with the chronic unpredictable mild stress stimulation combined with lonely rising, to establish depression models. In the meantime, rats of the high-, medium- and low-dose Betel Shisanwei Ingredients Pil groups were given oral gavage of Betel Shisanwei Ingredients Pil (0.2, 0.4, 0.8 g/kg) for 28 days; rats of the normal control group and model group were intragstricaly administered with sodium carboxymethyl celulose; rats of RU486 group were given abdominal subcutaneous injection of RU486 from day 21 after modeling; rats of the high-, medium- and low-dose Betel Shisanwei Ingredients Pil plus RU486 groups were intragstricaly administered with Betel Shisanwei Ingredients Pil (0.2, 0.4, 0.8 g/kg) and subcutaneous injection of RU486 from day 21. RESULTS AND CONCLUSION:Compared with normal control group, cortisone content increased significantly (P < 0.05), the expression of glucocorticoid receptor mRNA in hippocampus, hypothalamus and pituitary gland decreased significantly, and hypothalamic corticotrophin releasing hormone mRNA expression increased significantly in the model group and RU486 group. Compared with model group, cortisone content decreased, the expression of glucocorticoid receptor mRNA in hippocampus, hypothalamus and pituitary gland increased significantly, and hypothalamic corticotrophin releasing hormone mRNA expression decreased significantly in rats treated with Betel Shisanwei Ingredients Pil. Compared with RU486 group, Betel Shisanwei Ingredients Pil administration led to changed in cortisone content, glucocorticoid receptor mRNA expression in hippocampus, hypothalamus and pituitary gland, as wel as hypothalamic corticotrophin releasing hormone mRNA expression. Experimental findings indicate that, Betel Shisanwei Ingredients Pil can directly regulate excessive secretion of glucocorticoid, and improve the dysfunction of hypothalamic-pituitary-adrenal axis central negative feedback through increasing glucocorticoid receptor mRNA expression and decreasing corticotropin releasing hormone mRNA expression. After the hypothalamic-pituitary-adrenal axis negative feedback pathway is blocked, the effect of Betel Shisanwei Ingredients Pil is weakened.

BACKGROUND:The enamel matrix derivative has been used in the clinical treatment of severe periodontitis; however, the mechanism(s) by which enamel matrix derivative promotes periodontal regeneration is stil obscure. OBJECTIVE:To explore the effects of enamel matrix derivatives on the differentiation and proliferation of periodontal ligament stem cels. METHODS:Periodontal ligament stem cels were isolated and identified from human teeth. Cloning forming efficiency, surface antigen expression and pluripotency were detected and identified. Enamel matrix derivatives with different concentrations (20, 50, 100 mg/L) were used to culture periodontal ligament stem cels for 2 and 4 weeks. Colagen synthesis and mineralized nodule formation were detected using Trichrom staining and Von Kosa’s staining, respectively; real-time RT-PCR was employed to detect expressions of colagen type I, osteocalcin, and RUX2; MTT and cel growth rate assay were used to detect the proliferation of periodontal ligament stem cels. RESULTS AND CONCLUSION:Periodontal ligament stem cels were spindle-shaped and showed a higher colony forming efficiency than periodontal ligament cels. The expressions of surface antigens of periodontal ligament stem cels-CD105, CD29, CD45, CD44 were respectively 99.8%, 99.7%, 1.26%, 98.8%, indicating periodontal ligament stem cels have the multilineage differentiation potential. Enamel matrix derivatives improve the colagen synthesis and mineralization nodule formation of periodontal ligament stem cels in a time-dose dependent manner. They also can improve the expression of osteogensis-related genes colagen type I, osteocalcin, RUX2 and proliferation of periodontal ligament stem cels.

Objective To evaluate the clinical efficacy of “Shamrock” ultrasound images?guided lumbar sympathetic ganglion blockade ( LSGB) . Methods Sixty patients of both sexes, aged 18-60 yr, weighing 50-70 kg, of American Society of Anesthesiologists physical statusⅠorⅡ, undergoing unilater?al LSGB, were divided into groupⅠ ( n=30) and group Ⅱ ( n=30) using a random number table. In group Ⅰ, unilateral LSGB was performed at the L2 level under ultrasound guidance with paramedian trans?verse scanning. In groupⅡ, unilateral LSGB was performed at the L2 level under ultrasound guidance with“Shamrock” ultrasound images. After final needle position was confirmed, 2% lidocaine 6?0 ml was ad?ministered in each patient. At 20 min before and after LSGB, the visual analogue scale scores and skin temperature of the big toe of the affected foot were recorded, and the successful blockade and visibility of important paravertebral structures on ultrasound images were recorded during puncture. Results The visu?al analogue scale scores were significantly lower, and the skin temperature on the affected side was signifi?cantly higher after LSGB than before LSGB in both groups ( P<0?05) . The important paravertebral struc?tures such as erector spinae, quadratus lumborum, psoas major, transverse process of L2 vertebrae, and the curved edge of L2 vertebrae were visible in both groups. The visibility rate of the inferior vena cava or ab?dominal aorta on ultrasound images and the success rate of blockade were significantly lower in group Ⅰthan in group Ⅱ (P<0?01). Conclusion Compared with paramedian transverse scanning, LSGB has some advantages such as real?time monitoring, higher success rate of blockade, better efficacy and avoiding damage to great vessels when performed under “Shamrock” ultrasound image guidance.

Objective To evaluate Zeus robot-assisted laparoscopic cholecystectomy. Methods Forty patients were divided into two groups receiving respectively Zeus robot-assisted laparoscopic cholecystectomy (group A, 20 cases), and laparoscopic cholecystectomy (group B, 20 cases). A variety of clinical parameters were evaluated. Compared between these two groups. Results Camera clearing (1.1?1.0) times and time used for operation field adjustment in group A (2.2?0.7) min were significantly less than those in group B (4.5?1.5,7.5?1.2) min. Dissection actions(337?86)times and operative errors(10%) in group A were less than those in group B(389?94) times,25%. The operation time(104.9?20.5) min and setup time (29.5?9.8) min in group A were longer than those in group B (78.6?17.1) min,(12.6?2.5) min. The blood loss,and postoperative hospital stay were similar. There were no postoperative complications in either groups, and conversion to open surgery was done in one each patients. Conclusions Compared with laparoscopic technique, Zeus robotic surgical system offers greater ability of controlling operation field, precise and stable operative manipulations though it requires longer operation time.

In this study, we explored the feasibility of biotin-mediated modified polymeric micelles for pancreatic cancer targeted photodynamic therapy. Poly (ethylene glycol)-distearoyl phosphatidyl ethanolamine (mPEG2000-DSPE) served as the drug-loaded material, biotin-poly(ethylene glycol)-distearoyl phosphatidyl ethanolamine (Biotin-PEG3400-DSPE) as the functional material and the polymeric micelles were prepared by a thin-film hydration method. The targeting capability of micelles was investigated by cell uptake assay in vitro and fluorescence imaging in vivo and the amounts of Biotin-PEG-DSPE were optimized accordingly. Hypocrellin B (HB), a novel photosensitizer was then encapsulated in biotinylated polymeric micelles and the anti-tumor efficacy was evaluated systemically in vitro and in vivo. The results showed that micelles with 5 mol % Biotin-PEG-DSPE demonstrated the best targeting capability than those with 20 mol % or 0.5 mol % of corresponding materials. This formulation has a small particle size [mean diameter of (36.74 ± 2.16) nm] with a homogeneous distribution and high encapsulation efficiency (80.06 ± 0.19) %. The following pharmacodynamics assays showed that the biotinylated micelles significantly enhanced the cytotoxicity of HB against tumor cells in vitro and inhibited tumor growth in vivo, suggesting a promising potential of this formulation for treatment of pancreatic cancer, especially those poorly permeable, or insensitive to radiotherapy and chemotherapy.
Animals ; Antineoplastic Agents ; chemistry ; Biotin ; Drug Carriers ; chemistry ; Drug Screening Assays, Antitumor ; Humans ; Micelles ; Pancreatic Neoplasms ; drug therapy ; Photochemotherapy

Vaccination is the primary strategy for the prevention and control of pandemic influenza. Because influenza virus is highly variable across strains, universal influenza vaccines need to be developed to address this problem. This review describes the research progress in conserved epitopes of influenza virus, the advances in the research and development of universal influenza vaccines based on the relatively conserved sequences of NP, M2e, HA2, and headless HA, the mechanisms of cross-protection, and the methods to improve cross-protection.
Animals ; Cross Reactions ; Humans ; Orthomyxoviridae ; immunology ; Species Specificity ; Viral Proteins ; immunology ; Viral Vaccines ; genetics ; immunology

Objective To study the effect of paeonol on the proliferation and apoptosis of A375 human melanoma cells and its mechanism.Methods Cell counting kit-8 (CCK8) was used to evaluate the proliferative activity of A375 cells treated with paeonol of 0.5,1,2,4,8 mmol/L for 24,48 and 72 hours respectively.Subsequently,A375 cells were treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours followed by double staining with annexin V and propidium iodide for the detection of cell apoptosis,fluorometric assay for the estimation of caspase 3,caspase 8 and caspase 9 activity,and Western blot for the determination of the levels of p53,nuclear factor-κB proteins and some of their target proteins.The A375 cells receiving no treatment served as the blank control group.Statistical analysis was carried out by t test.Results Within the investigated concentration and time ranges,paeonol significantly inhibited the proliferative activity of A375 cells in a concentration-and timedependent manner.Compared with the blank control group,a significant increase was observed in the early apoptosis rate in A375 cells treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours (13.74％-± 1.73％,25.95％ ± 0.57％ and 46.44％ ± 0.81％ vs.3.11％ ± 0.53％,P ＜ 0.05 or 0.01),as well as in the activity of caspase 3,8 and 9 in A375 cells treated with paeonol of 2.5 and 5 mmol/L for 24 hours (P ＜ 0.05 or 0.01).After 24-hour treatment,the protein levels of p53 and Bax were elevated,but those of nuclear factor-κB,Bcl-2 and Bcl-XL were decreased in A375 cells with the increase of paeonol concentration.Conclusions Paeonol can inhibit the proliferation but induce the apoptosis of A375 cells,and the apoptosis-inducing effect may be realized through intrinsic and extrinsic pathways by modulating nuclear factor-κB and p53 genes.

Objective To assess the efficacy of intedeukin (IL)-1Ra,a recombinant human IL-1receptor antagonist,plus methotrexate ( MTX ) in patients with active rheumatoid arthritis ( RA ) refractory to MTX therapy.Methods A total of 54 patients with active RA,who had been taking MTX at a stable dosage,were randomized to receive daily subcutaneous injections of IL-1Ra (80 mg) or placebo.The proportion of patients who had a response as assessed by ACR20,ACR50 and ACR70 was analyzed using Chi-square test measures.Baseline variables and DAS28 were analyzed using Student's t-test (parametric) or Wilcoxon's rank sum test (nonparametric) as appropriate.Results After 24 weeks,more patients achieved clinical benefits treated with IL-1Ra plus MTX compared with MTX alone (64％ vs 17％,P=-0.004) as determined by the ACR20 improvement.In the IL-1Ra group,an ACR50 response was observed in 38％ and an ACR70 response in 17％.None of the patients treated with MTX alone achieved ACR50 or ACR 70 improvement.However,9 of 42 (21％) patients in the IL-1Ra group,who showed therapeutic response initially,had secondary drug failure to IL-1Ra therapy thereafter.A significant increase in mean DAS28 from baseline was found in the nonresponders to IL-1Ra,compared with placebo.Conclusion IL-IRa is effective for the treatment of patients with active RA by blocking IL-1.However,the efficacy of IL-1Ra is lost soon in about one-fifth of patients in soite of initial good resoonse.